Beyond Advocacy: Mapping the Contours of Victim Work.

In contrast to works on victim advocacy in specific organizational contexts, this article introduces the term "victim work" to capture the vast array of victim-related roles and tasks that have proliferated in recent decades. Data are derived from in-depth interviews with 30 "victim workers" in public and private agencies in two Midwestern states. The interviews revealed diverse work experiences that spanned hotlines, crisis response, legal proceedings, and postconviction support. Three themes emerged that characterize "victim work": flexibility, emotions, and the challenge of "fit"-the multifaceted difficulties of interacting with victims and agents of the justice system. Based on the findings, we offer a revised model of criminal justice vis-à-vis victims and implications for practice and future research.

Living in squalor: neuropsychological function, emotional processing and squalor perception in patients found living in squalor.

BACKGROUND: Patients living in squalor have a wide range of psychiatric diagnoses, but these may have a common neural basis involving frontal systems. This study investigated frontal executive function, theory of mind, emotional processing including disgust, and appreciation of squalor in elderly patients found living in squalor. METHODS: Six patients referred to an old age psychiatry service underwent a battery of neuropsychological tests, assessment of living conditions and awareness of self and others' squalor. RESULTS: All six patients showed impairment in frontal executive function, typically accompanied by amnesic deficits. Theory of mind and emotional processing were surprisingly preserved. While five of the patients could recognize severely unclean or cluttered living conditions in newspaper photographs, more than half did not appreciate that their own living conditions were squalid. CONCLUSION: Deficits in frontal executive function appear important in the genesis of squalor although functions linked to orbito-frontal ability appear preserved.

Osteomalacia and vitamin D deficiency in a psychiatric rehabilitation unit: case report and survey.

BACKGROUND: Vitamin D deficiency is common and predisposes to many serious diseases, yet often goes unrecognized. FINDINGS: We describe a case of severe vitamin D deficiency with osteomalacia in a patient resident in a psychiatric hospital for more than 35 years, and discuss causes and complications. We assayed the serum 25-hydroxyvitamin D levels of all patients under our care on one old-age psychiatry rehabilitation unit. Ten of twelve (83%) of patients had vitamin D deficiency, and 92% had suboptimal vitamin D levels. Vitamin D status was strongly predicted by dietary supplementation. Of those not on vitamin D supplements, 100% had vitamin D deficiency, with vitamin D levels significantly below those of historical controls. Age, sex, and duration of admission did not predict vitamin D status in this group. CONCLUSION: We advocate vitamin D screening in all patients admitted to psychogeriatric units, and discuss treatment options given the current problems affecting high-dose vitamin D supply to the United Kingdom.

Predictive validity of the MMPI-2 Restructured Clinical (RC) Scales in a batterers' intervention program.

We examined the convergent and discriminant validity of the MMPI-2 Restructured Clinical (RC) scales in predicting relevant historical variables, treatment success, and recidivism in offenders enrolled in a batterers' intervention program. We used a sample studied previously by Petroskey, Ben-Porath, and Erez (2002), which included an ethnically diverse group of 483 men enrolled in a psychoeducational batterer's intervention program. We coded various historical variables (e.g., criminal history, substance abuse problems, mental health treatment, anger problems, and amount of partner violence), treatment dismissal, and recidivism up to 1 year posttreatment. Correlational analyses with the historical variables provided evidence of convergent and discriminant validity of the RC scales in this forensic sample. Regression analyses showed that these scales added to the historical variables in predicting treatment failure and recidivism. Relative risk analyses indicated the extent to which individuals entering treatment with elevated scores on RC4 and RC9 were at increased risk for these negative outcomes.

Theory of mind in patients with frontal variant frontotemporal dementia and Alzheimer's disease: theoretical and practical implications.

A key aspect of social cognition is the ability to infer other people's mental states, thoughts and feelings; referred to as 'theory of mind' (ToM). We tested the hypothesis that the changes in personality and behaviour seen in frontal variant frontotemporal dementia (fvFTD) may reflect impairment in this cognitive domain. Tests of ToM, executive and general neuropsychological ability were given to 19 fvFTD patients, a comparison group of Alzheimer's disease patients (n = 12) and matched healthy controls (n = 16). Neuropsychiatric assessment was undertaken using the Neuropsychiatric Inventory (NPI). Patients with fvFTD were impaired on all tests of ToM (first-order false belief; second-order false belief; faux pas detection; and Reading the Mind in the Eyes), but had no difficulty with control questions designed to test general comprehension and memory. By contrast, the Alzheimer's disease group failed only one ToM task (second-order false belief), which places heavy demands on working memory. Performance on the faux pas test revealed a double dissociation, with the fvFTD group showing deficits on ToM-based questions and the Alzheimer's disease group failing memory-based questions only. Rank order of the fvFTD patients according to the magnitude of impairment on tests of ToM and their degree of frontal atrophy showed a striking concordance between ToM performances and ventromedial frontal damage. There was a significant correlation between the NPI score and more sophisticated tests of ToM in the fvFTD group. This study supports the hypothesis that patients with fvFTD, but not those with Alzheimer's disease, are impaired on tests of ToM, and may explain some of the abnormalities in interpersonal behaviour that characterize fvFTD.