Systematic Aggression Registration in Forensic Psychiatric Care: A Qualitative Study on Preconditions for Successful Implementation.

Available research emphasizes the importance of getting a systematic overview of inpatient aggression in forensic psychiatric care. However, the same research does not focus on how systematic aggression registration should be introduced in clinical practice. To facilitate the use of systematic aggression registration instruments, it is very relevant to gain insight into the perspective of staff members on the introduction of these instruments in daily clinical practice. Additionally, preconditions for achieving a successful implementation can be considered. Therefore, this study aims to gain insight into the perspective of the staff members on the implementation of a systematic aggression registration instrument-that is, the MOAS-in a forensic psychiatric unit. Interviews (n = 8) and a focus group with staff members were carried out. Three main themes: (1) creating the most appropriate context for introduction, (2) choice for the MOAS as relevant instrument, and (3) perpetuating the use of the MOAS in clinical practice are scrutinized. The mentioned preconditions can be used as guidelines when implementing systematic aggression registration in clinical practice. We hope that this paper can inspire other forensic psychiatric facilities to introduce systematic registration of aggressive incidents.

Novel Small Molecule-Derived, Highly Selective Substrates for Fibroblast Activation Protein (FAP).

Fibroblast activation protein (FAP) is a proline-selective serine protease. It is hardly expressed in healthy adult tissue but upregulated in tissue remodeling sites associated with several diseases including epithelial cancer types, atherosclerosis, arthritis and fibrosis. Ongoing research aims at clinical implementation of FAP as a biomarker for these diseases. Several immunochemical methods that quantify FAP expression have been reported. An alternative/complementary approach focuses on quantification of FAP's enzymatic activity. Developing an activity-based assay for FAP has nonetheless proven challenging because of selectivity issues with respect to prolyl oligopeptidase (PREP). Here, we present substrate-type FAP probes that are structurally derived from a FAP-inhibitor (UAMC1110) that we published earlier. Both cleavage efficiency and FAP-selectivity of the best compounds in the series equal or surpass the most advanced peptide-based FAP substrates reported to date. Finally, proof-of-concept is provided that 4-aminonaphthol containing probes can spatially localize FAP activity in biological samples.

The Relation Between Aggression and the Living Group Climate in a Forensic Treatment Unit for Adolescents: A Pilot Study.

In the current study, the associations between inpatient aggression and the living group climate as perceived by the adolescents admitted to a forensic psychiatric treatment unit, are investigated based on carefully registered longitudinal data. Multilevel regression analyses revealed a significant inverse relation between the number and severity of aggressive incidents and the amount of support, as well as with the possibilities of growth perceived by the adolescents. No significant associations of aggression and the perception of repression or atmosphere are found. Our study reveals preliminary evidence for the relation between the prevalence of aggressive incidents and how the adolescents perceive social contextual factors in daily forensic treatment practices. Moreover, preliminary evidence that evidence-based treatment programs and psychiatric care have an important influence on experienced possibilities for growth and support and as such prevent institutional aggression, is found.

Autobiographical memory specificity and affect regulation: coping with a negative life event.

Two decades of research have shown that depressed patients experience significant difficulties retrieving specific autobiographical memories. Importantly, reduced autobiographical memory (AM) specificity is a known vulnerability factor for depression and is predictive of a more chronic course. One of the models that has been put forward to explain the origin of this reduced specificity is the affect-regulation model, which assumes that being less specific might help to prevent negative or painful emotions by recalling events in a less specific way. This avoidant memory style might have beneficial effects in the short run (less emotional impact of stressful events) but is detrimental in the long run. The affect-regulation model, and more in particular the beneficial short-term effect of reduced memory specificity, was investigated in a prospective study. Students were followed over a period of 9 weeks after they failed at their first exams at university. In line with the affect-regulation model, memory specificity predicted the course of symptoms that were experienced as a result of failing these exams. The less specific the student, the less durable the emotional distress over this 9-week period. The correlational nature of this study limits to some extent the conclusions that can be drawn. The results offer support for the affect-regulation account of reduced autobiographical memory specificity.

Autobiographical memory specificity and affect regulation: an experimental approach.

This study investigated J. M. G. Williams's (1996) affect-regulation hypothesis that level of specificity of autobiographical memory (AM) is used to minimize negative affect. It was found that a negative event leads to more reports of subjective stress in high- as compared with low-specific participants. Also, afterward, high-specific participants rated their unprompted memories for the event as more unpleasant. The results indicate that, relative to high specificity, being less specific in the retrieval of AMs is associated with less affective impact of a negative event. Results are discussed within the affect-regulation model. It is suggested that future research take a more functional perspective on AM specificity.

Autobiographical memory specificity and trauma in inpatient adolescents.

Investigated the relation between memory specificity and self-reported trauma, depressive symptoms, and other emotional characteristics in a group of adolescent inpatients. Research with adults has shown that clinical depression is associated with a difficulty in retrieving specific autobiographical memories in response to cue words, and this pattern of overgeneral memory is related to the prognosis of depression. Research has also shown a clear positive association between self-reported trauma and overgeneral memory. This study's results showed that higher levels of trauma--both in terms of total number and in terms of severity or related distress--were associated with reduced autobiographical memory specificity (AM). None of the other emotional variables, such as depression, anxiety, worry, hopelessness, or subjective stress, were significantly related to the retrieval of specific memories. The results are reconcilable with Williams' (1996) developmental idea that a pattern of overgeneral AM retrieval originates in childhood trauma as a way of regulating affect.