SV Scores Research Articles

A Novel Quantitative Computer-Assisted Score Can Improve Repeatability in the Estimate of Vascular Calcifications at the Abdominal Aorta.

In CKD and in the elderly, Vascular Calcifications (VC) are associated to cardiovascular events and bone fractures. VC scores at the abdominal aorta (AA) from lateral spine radiographs are widely applied (the 0–24 semiquantitative discrete visual score (SV) being the most used). We hypothesised that a novel continuum score based on quantitative computer-assisted tracking of calcifications (QC score) can improve the precision of the SV score. This study tested the repeatability and reproducibility of QC score and SV score. In forty-four patients with VC from an earlier study, five experts from four specialties evaluated the data twice using a dedicated software. Test–retest was performed on eight subjects. QC results were reported in a 0–24 scale to readily compare with SV. The QC score showed higher intra-operator repeatability: the 95% CI of Bland–Altman differences was almost halved in QC; intra-operator R2 improved from 0.67 for SV to 0.79 for QC. Inter-observer repeatability was higher for QC score in the first (Intraclass Correlation Coefficient 0.78 vs. 0.64), but not in the second evaluation (0.84 vs. 0.82), indicating a possible heavier learning artefact for SV. The Minimum Detectable Difference (MDD) was smaller for QC (2.98 vs. 4 for SV, in the 0–24 range). Both scores were insensitive to test–retest procedure. Notably, QC and SV scores were discordant: SV showed generally higher values, and an increasing trend of differences with VC severity. In summary, the new QC score improved the precision of lateral spine radiograph scores in estimating VC. We reported for the first time an estimate of MDD in VC assessment that was 25% lower for the new QC score with respect to the usual SV score. An ongoing study will determine whether this lower MDD may reduce follow-up times to check for VC progression.

Factors Associated with Smartphone Addiction during COVID-19 Pandemic Lockdown in Students of Faculty of Medicine in North Sumatera

Introduction: The popularity of cell phones among the younger generation has increased rapidly in a short period leading to the high prevalence of smartphone addiction among adolescents worldwide, especially during the Covid-19 pandemic lockdown period. This study aimed to investigate the factors associated with smartphone addiction measured by the Indonesian version of the Smartphone Addiction Scale-Short version (SAS-SV) score in both preclinical and clerkship students. Methods: A cross-sectional study was conducted from November 2020 to December 2020 in preclinical and clerkship students of the Faculty of Medicine from the Universitas Sumatera Utara, North Sumatra Islamic University, Hospital of North Sumatra University, and Hospital of Haji Medan academic year of 2019-2020. The Indonesian version of the SAS-SV questionnaire was distributed to the study subjects through Google Form. Results: Bivariate analysis showed all variables to be significantly associated with SAS-SV score (all p values were <0.05). Meanwhile, multivariate analysis showed all variables but the type of smartphone and the closest family members to be significantly associated with the SAS- SV score. Conclusion: Age, gender, education level, monthly income, duration of smartphone use, sleep duration, parental educational background, monthly internet costs, and other uses of smartphones were found to be associated with smartphone addiction as measured by the Indonesian version of the SAS-SV score. Meanwhile, the type of smartphone and the closest family members were not associated with smartphone addiction as measured by the Indonesian version of the SAS-SV score.

Validation of Sinhala version of Psoriasis Epidemiology Screening Tool.

Psoriatic arthritis (PsA) occurs in one-third of patients with psoriasis and mostly remains undetected leading to debilitating deforming arthritis, eventually. The Psoriasis Epidemiology Screening Tool (PEST) is a quick and valid tool, widely used to detect PsA in clinical practice, and it has been validated to many languages. In this study, we intended to validate a Sinhala version of the PEST and assess its psychometric properties. The Sinhala version of the questionnaire was tested on 199 patients with psoriasis attending the dermatology clinic at a tertiary care National Hospital in Sri Lanka. Patients who were detected to have PsA previously (n = 5) and those with other rheumatologic conditions (n = 12) were excluded. All patients were examined by a dermatologist, and demographic and disease characteristics were obtained. All patients were assessed by two rheumatologists who were blinded to the answers provided in the questionnaire. The diagnosis of PsA was made based on the CASPAR criteria. We observed the total PEST score of 3 or more to be the best cutoff value to screen for PsA. This cutoff value showed the highest Youden index (sensitivity = 0.89, specificity = 0.95). In the ROC analysis, the area under the curve of the PEST_sv was 0.95 (SE 0.02, p < 0.001). PEST_sv total score showed a significant correlation with body surface area involved but not with Dermatology Life Quality Index or Psoriasis area and severity index score. The Sinhala version of PEST demonstrated satisfactory performance as a screening tool for PsA. Key Points • Psoriatic arthritis (PsA) is the most debilitating complication of psoriasis and lack of quick, valid screening tool is a limiting factor for early identification in Sri Lankan context. • Sinhala version of the Psoriasis Epidemiology Screening Tool (PEST_sv) was tested on 199 patients with psoriasis and examined for the diagnosis of PsA according to Classification of Psoriatic Arthritis (CASPAR) criteria. • PEST_sv score of 3 or more was observed to be the best cutoff value to screen for PsA with sensitivity and specificity of 0.89 and 0.95 respectively. • PEST_sv demonstrated satisfactory performance as a screening tool for PsA.

Utility of the MMPI-2-RF in Sexual Violence Risk Assessment

The prediction of sexual violence recidivism is an important societal concern and has been the frequent subject of psychological research. Although research has supported the use of the MMPI-2-RF in violence risk assessment, there is a paucity of research related to sexual violence risk assessment. The present study evaluated the convergent validity of the MMPI-2-RF with measures used in sexual violence risk assessment evaluations (i.e., the Static 99, SVR-20, and PCL:SV) in a sample of German inmates in a psychological treatment setting. Analyses generally showed an expected pattern of results, with MMPI-2-RF externalizing scales having the strongest associations with measures of violence and sexual violence risk assessment. Indeed, although smaller associations were found with Static-99 scales, there were moderate to large associations between SVR-20 and PCL:SV scores and MMPI-2-RF externalizing scales. Taken together, these findings suggest that, although the MMPI-2-RF does not appear to be associated with specific static risk factors (e.g., previous victim qualities, type of sexual offenses), the externalizing scales on the MMPI-2-RF are useful in examining more dynamic factors (e.g., those assessed on the SVR-20) in conjunction with other dynamic and static risk tools (e.g., SVR-20, Static-99) in sexual violence risk evaluations.

Patient Interviews Improve Empathy Levels of Preclinical Medical Students

Objective: In order to cultivate and maintain empathy during medical school, an experiential learning program, “A Patient as a Human Being”, was designed to promote empathy in second-year medical students through interviews with patients focusing on their suffering and the difficulties arising from their illnesses and hospital stays. Methods: The second-year medical students were divided into groups of three and four. Each group was assigned a patient to interview under close supervision. The selected patients were informed beforehand about the interview and voluntarily agreed to participate. The Thai version of the Jefferson Scale of Physician Empathy–Student Version (JSPE-SV) was used to assess the students’ empathy levels. Results: The baseline JSPE-SV score (n = 310) was 114.10±10.20. After the interview, the scores significantly increased (1.19 [0.21-2.18], P = 0.009). Students in the lower-half group of baseline scores showed a higher improvement (2.64 [1.14–4.15], P < 0.001) than those in the upper-half group. The difference coefficient by multivariate analysis of the improved JSPE–SV scores between the two groups was 3.03 [1.08-4.98] ( p = 0.002), accompanied by a correlation between the pre-activity empathy score and the improved score ( = - 0.21, P-value < 0.01). Conclusion: The patient interviews improved the empathy levels of the preclinical medical students, especially those with lower baseline empathy levels.

Moderate Intensity Intermittent Exercise Modality May Prevent Cardiovascular Drift.

Cardiovascular drift (CV-Drift) may occur after the ~10th min of submaximal continuous exercising. The purpose of this study was to examine whether CV-Drift is prevented by an intermittent exercise modality, instead of a continuous exercise. Seven well-trained male cyclists volunteered to take part in the study (O2max: 61.7 ± 6.13 mL·min−1·kg−1). Following familiarization sessions, athletes’ individual maximal O2 consumption (O2max), maximum stroke volume responses (SVmax), and cardiac outputs (Qc) were evaluated by a nitrous-oxide re-breathing system and its gas analyzer. Then, continuous exercises were performed 30 min at cyclists’ 60% O2max, while intermittent exercises consisted of three 10 min with 1:0.5 workout/recovery ratios at the same intensity. Qc measurements were taken at the 5th, 9th, 12nd, 15th, 20th, 25th, and 30th min of continuous exercises versus 5th and 10th min of workout phases of intermittent exercise modality. Greater than a 5% SV decrement, with accompanying HR, increase, while Qc remained stable and was accepted as CV-Drift criterion. It was demonstrated that there were greater SV responses throughout intermittent exercises when compared to continuous exercises (138.9 ± 17.9 vs. 144.5 ± 14.6 mL, respectively; p ≤ 0.05) and less HR responses (140.1 ± 14.8 vs. 135.2 ± 11.6 bpm, respectively; p ≤ 0.05), while mean Qc responses were similar (19.4 ± 2.1 vs. 19.4 ± 1.5 L, respectively; p > 0.05). Moreover, the mean times spent at peak SV scores of exercise sessions were greater during intermittent exercise (1.5 vs. 10 min) (p < 0.001). In conclusion, intermittent exercises reduce CV-Drift risk and increases cardiac adaptation potentials of exercises with less physiological stress.

The impact of pre-treatment responsivity and treatment participation on violent recidivism in a violent offender sample

ABSTRACTThis study assessed whether pre-treatment responsivity (psychopathy, motivation to attend treatment, denial and minimisation of offending behaviour, and feelings of guilt or shame) predicted violent recidivism and/or moderated the effectiveness of a violence intervention programme. Participants were 114 male violent offenders who were referred to a structured violent offender group treatment programme; 84 offenders commenced the programme. Results showed that treatment completion did not have a significant main effect on recidivism but that psychopathy scores moderated the effects of treatment. Offenders with high scores on the Psychopathy Checklist: Screening Version (PCL:SV) who were rated as having good engagement with treatment, or who completed treatment, had similar violent recidivism rates compared to offenders with low PCL:SV scores. In contrast, offenders with high PCL:SV scores who dropped out of treatment or were poorly engaged had significantly higher rates of violent recidivism. These findings indicate that treatment effectiveness could be enhanced, and greater reductions in recidivism achieved, if programmes find ways to engage and maintain psychopathic offenders in treatment.

Assessing Risk for Recidivism in Individuals Convicted of Stalking Offenses

This study examined the internal validity and predictive accuracy of the Guidelines for Stalking Assessment and Management (SAM), a structured professional judgment risk assessment tool for stalking. Interviewers rated 89 stalking offenders on the Psychopathy Checklist: Screening Version (PCL:SV) and SAM Nature (N) and Perpetrator (P) subscales. Researchers obtained stalking and violence outcomes prospectively from several sources, for an average follow-up period of 2.5 years. Cox Proportional Hazard analyses including SAM and PCL:SV scores demonstrated a significant positive relationship between SAM total and subscale scores in predicting stalking recidivism, whereas PCL:SV scores were negatively associated with recidivism. However, the SAM clinical risk ratings did not significantly predict stalking reoffending. There were also no significant associations between SAM scores and violent outcomes. These findings provide mixed support for the use of the SAM as a risk assessment tool for stalking offenders.

Rater differences in psychopathy measure scoring and predictive validity.

Although field studies reveal that some forensic evaluators tend to assign higher psychopathy measure scores to sexual offenders than others, the extent to which these findings apply to psychopathy measure scoring in other contexts is unclear. And no study has examined the impact of evaluator differences in scoring on predictive validity. We used data from the MacArthur Violence Risk Assessment Study to examine whether there were rater differences in psychopathy measure scoring and predictive effects among trained raters in a rigorous research context. The proportion of variance in Psychopathy Checklist: Screening Version (Hart, Cox, & Hare, 1995) scores attributable to raters was larger for Part 1 (14%) than Part 2 (4%) scores. The association between Facet 4 scores and future violence was stronger among evaluators who assigned higher and more variable Facet 4 scores, but there were no similar effects for other PCL:SV scores. Although there was only limited evidence for an association between PCL:SV scoring tendencies and predictive validity, findings show that mean differences in scoring have implications for score interpretation, with the cut score that indicates a high level of risk being lower when it comes from a rater who assigns relatively low scores compared to a rater who assigns relatively high scores. These findings suggest that evaluators should carefully consider their own psychopathy measure scoring tendencies across cases and the extent to which these tendencies are consistent with the normative sample scores that form the basis of their psychopathy measure score interpretations.

Dodecafluoropentane Emulsion (DDFPe) Decreases Stroke Size and Improves Neurological Scores in a Permanent Occlusion Rat Stroke Model.

Background: Dodecafluoropentane emulsion (DDFPe), given IV one hour after stroke, has been shown to greatly reduce the percent stroke volume (%SV) in rabbits. With repeated doses its effect continued for 24 hours.Purpose: Test DDFPe as neuroprotective agent in permanent occlusion rat stroke models in Sprague Dawley (SD) and Spontaneously Hypertensive Rats (SHR) measuring both %SV and neurological assessment scores (NAS). Methods: The male rats received either saline (control), or one or four doses (1x or 4x) of DDFPe (0.6ml/kg IV) one hour post stroke. Treatment groups were SD (n=26) (control, 1x and 4x; n=12, 7 and 7) and SHR (n=14) (control, 1x and 4x; n=7, 3 and 4). The 4x doses were given at 1.5 hour intervals. At six hours post stroke, the rats received a NAS using standard tests for balance, reflexes, and motor performance. Then rats were euthanized and brains removed for TTC evaluation of %SV.Results: For %SV analysis strain differences were not significant therefore strains were combined. DDFPe significantly decreased %SV in 1x and 4xDDFPe groups compared to control groups (2.59±1.81 and 0.98±0.88 vs. 9.24±6.06, p≤0.001 each; p≤0.0001 for the overall test for treatment effect). The 1x versus 4xDDFPe groups were not significantly different (p=0.40). In NAS analysis both strains showed significant improvement with 4xDDFPe therapy vs. controls, (SD: 5.00+2.45 vs. 9.36+3.56, p=0.01; SHR: 7.75+4.43 vs. 12.14+3.08, p=0.05). Differences between the 1x DDFPe group and controls were not significant (SD: 8.43+3.69; SHR: 9. 33+3.51). Conclusion: DDFPe treatment provides significant neuroprotection when assessed six hours post stroke.

Semantic variability predicts neural variability of object concepts

The prevailing approach to the neuroscientific study of concepts is to characterize the neural pattern evoked by a given concept, averaging over any variation that might occur upon multiple retrieval attempts (e.g., across time, tasks, or people). This approach—which diverges substantially from approaches to studying conceptual processing with other methods—treats all variation as noise. Here, our goal is to determine whether variation in neural patterns evoked by semantic retrieval of a given concept is more than just measurement error, and instead reflects variation arising from contextual variability. We measured each concept's diversity of semantic contexts (“SV”) by analyzing its word frequency and co-occurrence statistics in large text corpora. To measure neural variability, we conducted an fMRI study and sampled neural activity associated with each concept when it appeared in three separate, randomized contexts. We predicted that concepts with low SV would exhibit uniform activation patterns across stimulus presentations, whereas concepts with high SV would exhibit more dynamic representations over time. We observed that a concept's SV score predicted its corresponding neural variability. This finding supports a flexible, distributed organization of semantic memory, where a concept's meaning and its neural activity patterns both continuously vary across contexts.

Improvement of the diagnostic accuracy of MRA with subtraction technique in cerebral vasospasm.

Vasospasm has been considered the most severe acute complication after subarachnoid hemorrhage (SAH). MRA is not considered ideal for detecting cerebral vasospasm because of background including the hemorrhage. The aim of this study is to evaluate the efficacy of Subtraction MRA (SMRA) by comparing it to that of conventional MRA (CMRA) for diagnosis of cerebral vasospasm. Arteries were assigned to one of three categories based on the degree of MRA diagnostic quality of vasospasm (quality score): 0, bad … 2, good. Furthermore each artery was assigned to one of four categories based on the degree of vasospasm severity (SV score): 0, no vasospasm … 3, severe. The value of the difference between DSA-SV score and MRA-SV score was defined as the DIF score. CMRA and SMRA were compared for each arterial region with regard to quality score and DIF score. The average CMRA and SMRA quality score were 1.46 and 1.79; the difference was statistically significant. The average CMRA and SMRA DIF score were 1.08 and .60; the difference was statistically significant. Diagnosis of cerebral vasospasm is more accurate by SMRA than by CMRA. The advantages are its noninvasive nature and its ability to detect cerebral vasospasm.

ADHD Symptoms in Adults with Asperger’s Disorder: Findings from a Sample in Japan

Introduction: DSM-IV and ICD-10 criteria do not allow co-diagnosis of Pervasive Developmental Disorders (PDD) and Attention-Deficit/Hyperactivity Disorder (ADHD), but some researchers have noted that persons with PDD including Asperger’s disorder (AS) sometimes have symptoms similar to those of ADHD. The present study evaluated ADHD symptoms in adults with AS using Conner’s Adult ADHD Rating Scales screening version (CAARS-S:SV) in a Japanese sample. Methods: The present study evaluated ADHD symptoms in 40 adults with AS and 38 normal adults using CAARS-S:SV, Autism-Spectrum Quotient (AQ), Schizotypal Personality Questionnaire (SPQ), and Eysenck Personality Questionnaire (EPQ). The AS and the normal control group did not differ significantly in age, sex ratio, or estimated IQ. Results: Total, Inattention/Memory, and Hyperactivity/Restlessness scores of CAARS-S:SV were significantly higher in persons with AS than those in controls. In persons with AS, there was no significant correlation among three CAARS-S: SV scores and AQ. Discussion: These findings indicated that adults with AS have considerable ADHD symptoms, as well as in childhood and adolescence reported in previous reports. The results that in persons with AS total score of AQ was not correlated with CAARS scores indicated that ASD and ADHD have different pathophysiology.

Predictors and impact of non-adherence in adults with attention-deficit/hyperactivity disorder receiving OROS methylphenidate: results from a randomized, placebo-controlled trial

BackgroundMedication non-adherence has an important impact on treatment efficacy and healthcare burden across a range of conditions and therapeutic areas. The aim of this analysis was to determine predictors of non-adherence and impact of non-adherence on treatment response in adults with attention-deficit/hyperactivity disorder (ADHD).MethodsPost-hoc analysis of a 13-week randomized, double-blind placebo-controlled study of OROS methylphenidate (MPH) 54 and 72 mg/day. Primary efficacy variable was the Conners’ Adult ADHD Rating Scale – Screening Version (CAARS:O-SV). Daily adherence was calculated as average daily adherence (100 × capsules taken/2), with overall adherence calculated as the average daily adherence. Predictors of adherence were assessed using mixed-effects logistic regression. Descriptive statistics were generated for change in CAARS:O-SV score for adherent (> 95% adherence) and non-adherent subjects. Predictors of change were analyzed using a mixed model.ResultsSubjects were allocated to OROS MPH (54 mg, n = 87; 72 mg, n = 92) or placebo (n = 97). Mean adherence was 92.6% and 93.3% (OROS MPH 54 and 72 mg/day, respectively), versus 97.5% (placebo). Adherence was higher and less variable in completers. Factors significantly associated with non-adherence included female sex, shorter time since ADHD diagnosis, higher education level (completion of university) and score on the Drug Use Screening Inventory psychiatric disorders subscale. Improvements from baseline in CAARS:O-SV score were numerically greater in subjects defined as adherent than in those who were non-adherent. Significant predictors of CAARS:O-SV change in patients who completed the study included percentage adherence up to the point of assessment (p < 0.0001), baseline score (p < 0.0001) and family history of ADHD (p = 0.0003).ConclusionThe results of this analysis suggest that newly diagnosed patients, those with a high score on the DUSI-R psychiatric disorder scale, women, and subjects with high educational degrees may be at increased risk of non-adherence. Clinicians and policymakers should therefore pay special attention to these individuals, as non-adherence is a significant predictor of reduced response to treatment.Trial registrationEudraCT #: 2007-002111-82

Long-term efficacy and safety outcomes with OROS-MPH in adults with ADHD

Methylphenidate (MPH) is widely prescribed for adults with attention deficit hyperactivity disorder (ADHD), but data on long-term treatment and maintenance of effect are lacking. Osmotic release oral system-methylphenidate (OROS–MPH) was evaluated in a 52-wk open-label study in subjects who had previously completed a short-term placebo-controlled trial and short-term open-label extension. Efficacy was assessed using the investigator- and subject-rated Conners’ Adult ADHD Rating Scales (CAARS:O-SV and CAARS:S-S), and the Clinical Global Impression – Severity (CGI-S), Sheehan Disability Scale (SDS) and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Subjects completing ≥52 wk of treatment were eligible for a 4-wk randomized, placebo-controlled withdrawal phase in which loss of treatment effect was assessed using CAARS:O-SV and CGI-S. In the open-label phase (n=156), mean CAARS:O-SV score decreased from baseline by 1.9±7.8 (p<0.01), and small, statistically significant improvements from baseline were observed for CAARS:S-S, CGI-S and SDS. In the double-blind phase (OROS-MPH, n=23; placebo, n=22), CAARS:O-SV increased from double-blind baseline in the OROS-MPH and placebo arms (4.0±7.6 vs. 6.5±7.8, not statistically significant). Long-term OROS-MPH treatment was well tolerated, and there was no evidence of withdrawal or rebound after discontinuation. In conclusion, the short-term benefits of OROS-MPH continue during long-term open-label treatment. Maintenance of efficacy in a placebo-controlled withdrawal design remains to be confirmed in larger patient populations.

Subtypes of psychopathy in the British household population: findings from the national household survey of psychiatric morbidity

Cleckley asserted in 1941 that psychopathic personalities are found in the community as well as prisons. Subtypes of abnormal personality may be identifiable in the general population using contemporary measures of psychopathy. Cluster analysis of PCL:SV scores using the four-facet model with a representative sample of 624 adults aged 16-74years living in households interviewed in the second of a two-phase survey in Great Britain. Analysis confirmed an optimum 5-cluster solution and existence in the general population of prototypical or criminal psychopaths, non-psychopathic habitual criminals, and "successful psychopaths". Two additional clusters were identified, one uniquely characterised by impulsive/irresponsible (Facet 3) items and the other by social failure associated with low scores on each facet. The study confirmed previously hypothesised and two new subtypes of psychopathy within the general population. This prototypical classification may compliment existing typologies during clinical assessment following further refinement.

Correlation of symptomatic improvements with functional improvements and patient-reported outcomes in adults with attention-deficit/hyperactivity disorder treated with OROS methylphenidate

Objectives. To evaluate correlations between symptom severity and daily functioning in adults with ADHD. Methods. In the 5-week, double-blind LAMDA study, 401 adults with ADHD were randomly assigned to Osmotic-Release Oral System (OROS) methylphenidate (MPH) 18, 36 or 72 mg/day, or placebo. The primary variable – investigator-rated Conners’ Adult ADHD Rating Scale (CAARS:O-SV) – has been presented previously. Secondary endpoints included the self-reported version of CAARS (CAARS-S:S) and Clinical Global Impression – Severity (CGI-S). Daily functioning and quality of life were assessed using the Sheehan Disability Scale (SDS) and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Relationships between symptom and functional outcomes were evaluated in post-hoc Pearson partial correlation, multivariate regression and mediator analyses. Results. Improvements in CAARS-S:S, CGI-S and SDS scores were significantly greater in each OROS MPH arm versus placebo (P < 0.01 for all comparisons). Correlations between symptom and functioning scores were significant for all comparisons (P < 0.0001). In regression analyses, CAARS Hyperactivity/Impulsivity subscale and CGI-S were correlated with SDS (P < 0.05). CAARS Inattention was correlated with the SDS Family Life domain (P < 0.05). In a mediator analysis, the impact of treatment on SDS scores was fully mediated by improvement in CAARS:O-SV score. Conclusions. OROS MPH 18–72 mg/day was associated with significant improvements in ADHD symptoms, which correlated with improved daily functioning and health-related quality of life.

Predictors of suicidal ideation, suicide attempts, and self-harm without lethal intent in a community corrections sample

Purpose Little published research data exist about suicidal ideation and self-harm behavior in community corrections and we seek to fill this void. Aims To examine the effects of drug dependence, depression, anxiety, psychopathy, fracture, and child trauma on suicidal ideation, suicide attempts, and self-harm without lethal intent in community corrections. Methods The Semi-Structured Assessment for the Genetics of Alcoholism Revised (SSAGA II) and the screening version of the Hare Psychopathy Checklist (PCL:SV) were administered. Separate binary logistic regression analyses were used to predict lifetime suicidal ideation, suicide attempt, and self-harm behavior. Results Prevalences of suicidal ideation, suicide attempt, and self-harm without lethal intent were 41%, 19%, and 14%. Suicidal ideation was predicted by drug dependence, elevated PCL:SV Factor 2 score, and Caucasian race. Suicidal ideation and attempt were both predicted by fractures, depression, and child trauma. Self-harm was predicted by fractures, panic, PCL:SV score, and child trauma. Conclusions Child trauma and multiple fractures are potent predictors for suicidal ideation, suicide attempts, and self-harm without lethal intent in this community corrections sample. Depression predicted suicidal ideation and attempts, while panic predicted self-harm without lethal intent. Psychopathy was also an important predictor of suicidal ideation and self-harm behaviors without lethal intent.

Predictors of treatment outcome in adults with ADHD treated with OROS® methylphenidate

We conducted a post-hoc analysis of the Long-Acting MethylpheniDate in Adult attention-deficit hyperactivity disorder (LAMDA) study to investigate predictors of response in adults with ADHD randomly assigned to Osmotic Release Oral System (OROS)(®)-methylphenidate hydrochloride (MPH) 18, 36 or 72 mg or placebo. LAMDA comprised a 5-week, double-blind (DB) period, followed by a 7-week, open-label (OL) period. A post-hoc analysis of covariance and a logistic regression analysis were undertaken to detect whether specific baseline parameters or overall treatment compliance during the double-blind phase contributed to response. The initial model included all covariates as independent variables; a backward stepwise selection method was used, with stay criteria of p<0.10. Six outcomes were considered: change from baseline CAARS:O-SV (physician-rated) and CAARS:S-S (self-report) scores at DB and OL end points, and response rate (≥30% decrease in CAARS:O-SV score from baseline) and normalization of CAARS:O-SV score at DB end point. Taking into account a significant effect of OROS(®)-MPH treatment versus placebo in the original analysis (p≤0.015), across the outcomes considered in this post-hoc analysis, higher baseline CAARS scores were most strongly predictive of superior outcomes. Male gender and lower academic achievement were also predictive for improved results with certain outcomes. Several baseline factors may help to predict better treatment outcomes in adults receiving OROS(®)-MPH; however, further research is required to confirm these findings and examine their neurobiological underpinnings.

Needs and risks of patients in a state‐wide inpatient forensic mental health population

Routine needs assessments have become mandated requirements for public mental health services. However, the appropriateness of these generic health needs assessments to specialist populations remains questionable. This study sought to assess individual needs assessed using a widely used clinician rated assessment (Health of the Nation Outcome Scales-Secure; HoNOS-Secure), a subjective needs assessment that considers both staff and patient perspectives (Camberwell Assessment of Need-Forensic version; CANFOR), and a measure of risk for general criminal recidivism (Level of Service Inventory: Screening Version; LSI:SV) in a secure forensic mental health service. Results revealed significant positive correlations between staff ratings on HoNOS-Secure, CANFOR total needs, and CANFOR met needs scores, but no significant association between CANFOR ratings or HoNOS-Secure ratings and LSI:SV scores. Although patients and staff reported the same number of needs overall according to CANFOR (7.2 vs. 7.5, P > 0.05), patients reported that more of these needs were unmet (3.1 vs. 2.3, P < 0.05). Differences between staff and patient ratings of need suggest that needs assessments should include patient perspectives to facilitate more collaborative and comprehensive care planning. Divergent perspectives between patients and staff may impair patient engagement in treatment and therefore negatively impact on outcome. Service planning issues and opportunities for future research are discussed.