A decision-making model for pre-sentence evaluations for juveniles.

Forensic mental health assessments (FMHAs) are requested by the courts to assist in the sentencing process and can have a major impact upon the life of the person evaluated. Completing these assessments is a core competency for forensic psychologists. However, some FMHAs are undertaken by psychologists who have no forensic training. Despite this, there are no formalised Australian minimum standards to ensure reports are helpful to the courts and reflect sound evaluation methodologies. Drawing upon a critical review of the literature and recent research findings, we propose a 10-step decision-making model for pre-sentence evaluations of juveniles. Our model provides a framework for decision-making and highlights the key elements of an evaluation. The model provides a basis for developing practice guidelines and professional standards. The next step is to test the model in the field to determine its impact on the quality of psychological pre-sentence reports.

Factors underlying clinicians' judgements of patient insight and confidence in using clinical judgement in psycho-legal settings.

This study investigates the factors that clinicians use to make clinical judgements of insight and their confidence in using clinical judgement across three clinical and forensic assessment domains. The 12 participating clinicians rated 30 DVD vignettes of psychiatric patients with a psychotic disorder. Qualitative analyses revealed eight themes that align closely with the dimensions of insight reported in the literature. However, it is unclear how clinicians weigh each dimension. The clinicians were more confident in making a judgement on insight for treatment planning than for involuntary treatment or fitness to stand trial evaluations. They wanted more information when making a judgement in the forensic domains, recognising the greater consequences for the patients and the greater level of scrutiny of their judgements in legal settings compared to clinical settings. The data obtained suggest that both clinical and forensic assessment of insight would benefit from empirically derived structured professional judgement (SPJ) tools.

Psychological reports for sentencing juveniles in Australian courts.

Psychological reports for use in court must be relevant to the legal issues in dispute, meet professional standards, and reflect evidence-based practice. Using the Delphi method, a high degree of consensus was found among Australian experts in the methodology and knowledge required for conducting forensic mental health assessment (FMHAs) and the content needed in pre-sentence reports. Consensus was absent in two areas, if a pre-sentence report should always include a risk-assessment; and the need for a model to guide the FMHA. Without a model it is difficult for practitioners to justify their decision-making process, and judicial officers have no mechanism to determine if the work provided to the court is of an acceptable standard. Future research should focus on developing a model for presentence reports that includes a decision-making process and minimum standards. Researchers also need to determine judicial officers' views on the helpfulness of presentence reports.

Reliability of clinical judgements of insight in patients with psychoses.

We evaluated the reliability of scaled and binary clinical judgements of insight. Twelve clinicians rated 30 DVD interview recordings of patients diagnosed with a psychotic disorder. Scaled ratings produced an ICC of 0.62. Reliability of categorical (binary) ratings was 0.37 (k). While ordinal ratings are more reliable than binary ratings, reliability across both methods is too low for important decision-making. Clinical judgements of insight are impaired by a lack of standardised diagnostic criteria.

Faking good on the MCMI-III: implications for child custody evaluations.

Individuals administered the MCMI-III (Millon, Davis, & Millon, 1997) as part of a custody evaluation have shown elevations on the Desirability (Y), Histrionic (4), Narcissistic (5), and Compulsive (7) scales and low scores on the Debasement (Z) scale (McCann et al., 2001) and all other personality and clinical scales. In this experiment, we instructed participants (N = 138) to look like good parents (fake good) or to answer honestly. The fake-good group scored higher than the honest group on Y, 4, 5, and 7 and lower on scale Z and most other scales. We plotted the mean scale scores of our fake-good group against those of McCann et al.'s custody litigants and found the 2 profiles to be very closely matched and very different from our answer-honestly group's profile. These findings raise the possibility that scale elevations on 4, 5, and 7 by custody litigants are artifacts of faking good rather than pathology in those areas. Assessors should interpret this profile cautiously in custody evaluations.

Preventing suicide in prisons, part I. Recommendations from the International Association for Suicide Prevention Task Force on Suicide in Prisons.

In 2000 the Department of Mental Health of the World Health Organization (WHO) published a guide named Preventing Suicide. A Resource for Prison Officers as part of the WHO worldwide initiative for the prevention of suicide. In 2007 there are new epidemiological data on prison suicide, a more detailed discussion of risk factors accounting for the generally higher rate of suicide in correctional settings in comparison to the general population, and several strategies for developing screening instruments. As a first step, this paper presents an update of the WHO guide by the Task Force on Suicide in Prisons, created by the International Association for Suicide Prevention. A second paper, by the same Task Force, will present some international comparisons of suicide prevention services in correctional facilities.

Preventing suicide in prisons, part II. International comparisons of suicide prevention services in correctional facilities.

The International Association for Suicide Prevention created a Task Force on Suicide in Prisons to better disseminate the information in this domain. One of its objectives was to summarize suicide-prevention activities in the prison systems. This study of the Task Force uncovered many differences between countries, although mental health professionals remain central in all suicide prevention activities. Inmate peer-support and correctional officers also play critical roles in suicide prevention but there is great variation in the involvement of outside community workers. These differences could be explained by the availability of resources, by the structure of the correctional and community services, but mainly by the different paradigms about suicide prevention. While there is a common and traditional paradigm that suicide prevention services are mainly offered to individuals by mental health services, correctional systems differ in the way they include (or not) other partners of suicide prevention: correctional officers, other employees, peer inmates, chaplains/priests, and community workers. Circumstances, history, and national cultures may explain such diversity but they might also depend on the basic way we think about suicide prevention at both individual and environmental levels.

Validation of the holyoake codependency index.

Some clinicians working with families with alcohol or other drug problems continue to use the codependency model to guide their practice despite the limited empirical support for this approach. Research into codependency has been hampered by the lack of psychometrically sound instruments. The Holyoake Codependency Index (HCI; G. E. Dear & C. M. Roberts, 2000) is a 13-item self-report measure of codependent traits that has previously shown adequate to high reliability, initial evidence of construct validity, and an internal structure that is consistent across samples. In the 4 studies reported here, the internal structure of the HCI was confirmed using confirmatory factor analysis, and further evidence of construct validity was found in that the HCI subscales showed meaningful associations with other psychological and demographic variables.

Test-retest reliability of the Holyoake Codependency Index with Australian students.

The Holyoake Codependency Index is a 13-item self-report measure of three aspects of codependency: External Focus, Self-sacrifice, and a sense of being overwhelmed by another person's problematic behavior (termed Reactivity). Previous studies have supported internal validity and the internal consistency and construct validity of the subscales. The present scores for 59 students indicate full scale test-retest reliability of .88 and for subscales (.76 to .82) over a 3-wk. interval.

Factor structure of the Spielberger Anger Expression scales when used with Australian prisoners.

The State-Trait Anger Expression Inventory administered to prison inmates has supported the factor structure of the three anger expression scales although this structure has not been verified with Australian participants. Data collected from 397 Western Australian male prisoners produced a factor structure consistent with the scale structure outlined in the 1991 manual. Scale means and standard deviations were similar to those reported for U.S. and Canadian prisoners. It is therefore appropriate to use the standard scoring procedures with Australian male prisoners.

The Holyoake Codependency Index: further evidence of factorial validity.

The Holyoake Codependency Index (HCI) is a 13-item self-report scale that measures codependent traits. The HCI contains three subscales that correspond to key themes within the codependency literature and that were derived from factor analysis using a clinical sample of mainly females. The factor structure was subsequently replicated with an all-female general community sample. In this study the factor structure was replicated using a mixed-sex sample of 107 undergraduate university students and 378 other people who were snowball sampled from the student sample, and was found to hold for both male and female participants.

Perceptions of another person's heavy drinking as a function of one's relationship to the drinker a pilot study.

Of 301 participants in a telephone survey, 201 could identify a problem drinker within their social networks. In 67 cases the drinker was a partner, in 45 another family member, in 61 a friend, and in 28 a work colleague. Another person's heavy drinking was reported as most disrupting to one's life when that person was a partner or other family member or if one was living in the same residence as the drinker. The exception to this was that reported disruption to respondents' work life was greatest when the drinker was a work colleague. While there appear to be problems for friends and work colleagues, partners and other family members appear to report the most disruption so providing services to family members seems appropriate.