Patient education in Parkinson's disease: Formative evaluation of a standardized programme in seven European countries.

OBJECTIVE: To evaluate a newly developed education programme for Parkinson's disease (PD) patients. METHODS: The programme consisted of eight sessions and aimed at improving knowledge and skills related to self-monitoring, health promotion, stress management, depression, anxiety, social competence, and social support, all with special reference to PD. The programme was formatively evaluated in seven European countries (Spain, Finland, Italy, The Netherlands, United Kingdom, Estonia, Germany) with 151 patients diagnosed with idiopathic PD. The evaluation included patients' ratings of the comprehensibility and feasibility of the programme as well as mood ratings before and after each session. Patients also completed questionnaires at the beginning and end of the programme to explore possible changes in disease-related psychosocial problems, quality of life, and depression. RESULTS: The programme was feasible to run, and patients were able to understand its elements. Patients reported mood elevations following individual sessions and reduced disease-related psychosocial problems after completing the programme. There were no substantial differences in results between cultures. CONCLUSION: Patient education appears to have potential as a useful and feasible intervention, complementing medical treatment in PD. PRACTICE IMPLICATIONS: The present programme will soon be available in seven European languages and can be tested in different health care systems.

A comparison of selected Rorschach variables of violent female offenders and female non-offenders.

A national sample of incarcerated violent female offenders (N = 45) and a sample of female non-offenders (N = 30) were compared on nine selected Rorschach CS (Exner, 2003) variables and three of the aggression variables of Gacono and Meloy (1994). The results indicate that an avoidant and inconsistent coping style was more characteristic of the offenders than the non-offenders. The offenders were characterized by social immaturity and limited capacities to cope with stress as compared with the non-offenders. No significant differences were found between the two groups in handling intense emotions. Although the aggressive scores revealed no discrimination between the groups, significant correlations were found between the aggressive content score and childhood victimization. An inverse relation was found between the aggressive past score and the emotional intensity of the violent offense. The study indicates that the selected RCS variables related to adaptive resources for coping discriminate between violent offenders and non-offenders, but that the variables related to affective features need further examination.

Psychopathy in violent female offenders in Finland.

BACKGROUND: The base rate and construct of psychopathy in violent female offenders were examined. SAMPLING AND METHODS: More than half of all violent female offenders in Finland who where either hospitalised (n=12) or incarcerated (n=46) during the year of the study were assessed by the Hare Psychopathy Checklist-Revised (PCL-R), Structured Clinical Interview II for DSM-IV, Beck Anxiety Inventory, Beck Depression Inventory-II and Wechsler Adult Intelligence Scale-Revised. RESULTS: PCL-R mean scores and a base rate of psychopathy were found to be in line with earlier studies, showing both lower values and prevalence in females. The PCL-R correlated with symptoms of cluster B personality disorders as well as with depressive personality disorder. Factor 2 was observed to positively correlate with anxiety and depression and negatively with verbal cognitive ability. Logistic regression analysis on the PCL-R items revealed that the items shallow affect, lack of remorse or guilt, conning/manipulation and lack of realistic goals seem to be important indicators of female psychopathy together with callous/lack of empathy, impulsivity and failure to accept responsibility for own actions. CONCLUSION: The finding indicates that the prevalence of psychopathy is lower among female offenders than among male offenders, but further research is needed to examine the base rate of psychopathy in women, and whether the symptoms of psychopathy are expressed differently in women than in men.

The violent female perpetrator and her victim.

The aim of the present study was to examine the relationship between violent female offenders and their victims as well as the putative differences in the motives and specific psychological factors among three groups of female offenders: women who have victimised someone closely related to them, those who have victimised an acquaintance and lastly women who have victimised a stranger. More than half (N=61) of all violent female offenders hospitalised or incarcerated in Finland during the year of study were interviewed and assessed by Structured Clinical Interview II for DSM-IV (SCID-II) and Hare's Psychopathy Checklist-Revised (PCL-R). In 34% of the cases the victims were persons close to the offender, in 41% the victims were acquaintances and in 25% strangers. The victims in homicide offences were more often both male and closer to the perpetrator than in assault offences. Although motives were related to interpersonal problems, self-defence and long-term physical or psychological abuse were reported by only a few women, even for the small proportion of women whose victims were intimate partners. The most frequent reason for offences stemmed from confrontational situations in connection with alcohol use. Women who victimised acquaintances and strangers were also more likely to have a history of criminality and substance abuse than women who victimised those in close personal relationships. The latter were also more likely to have an antisocial personality disorder (PD) and psychopathic characteristics. There were, however, no significant differences found between those who had experienced physical or psychological abuse in childhood or adulthood and those who had no adverse experiences. These findings suggest that the violent behaviour by females leads more often to the death of the victim, when the victim is closely related to the perpetrator. The commonly-held view that violent female offending occurs primarily as a consequence of precipitation by the victim was not supported.