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The aim of this current awareness bulletin is to highlight new articles in forensics, covering: diagnosis
of mental disorders (using the ICD-10 categorisation); offences (including violent crime and
aggression, homicide, and juvenile offenders); treatment and assessment (including offence-focused
treatment, therapeutic modalities, and risk assessment); specific services (prisons, secure units, and
women’s services); health policy and management; and ethics and law.

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                                        Forensic Mental Health Bulletin
                                                2019 Vol 6 No 8
                                                      -1-
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Index

Mental Disorders – Diagnosis
Organic, including symptomatic, mental disorders
Mental behavioural disorders due to substance use
Schizophrenia, Schizotypal, and delusional disorders
Mood [affective] disorders
Neurotic, stress related and somatoform disorders
Behavioural syndromes associated with physiological disturbances and physical factors
Disorders of adult personality and behaviour
Intellectual disability
Disorders of psychological development
Behavioural and emotional disorders with onset usually occurring in childhood and adolescence
Unspecified mental disorder

Offences
Homicide
Sex Offence
Violent Crime and Aggression

Treatment (including assessment)
Offence focused treatment
Physical Health
Risk management
Self harm and suicide
Therapeutic modalities (psychodynamic, cognitive behavioural etc.)

Services
Prisons
Secure Units
Women’s Services

Health Policy / Management
Health Economics
Mental Health Practice
Recovery – Rehabilitation

                                     Forensic Mental Health Bulletin
                                             2019 Vol 6 No 8
                                                   -2-
Mental Disorders – Diagnosis

                         Organic, including symptomatic, mental disorders

Brooke, J. and Jackson, D.
An exploration of the support provided by prison staff, education, health and social care
professionals, and prisoners for prisoners with dementia
Journal of Forensic Psychiatry & Psychology, 2019
The aim of this study was to gain an understanding of the lived experience of prison staff, education, health
and social care professionals and prisoners with a social care role who supported men with dementia in
prison. This qualitative exploration highlighted diversity within: education and training received by
participants; the development of participant’s roles to support prisoners with dementia; and diversity within
the prison regime which impacted on prisoners with dementia and those supporting them.
Click here to view abstract: http://dx.doi.org/10.1080/14789949.2019.1638959
                                                                                                        Index

                 Mental behavioural disorders due to psychoactive substance use

Reid, S. and Bhattacharyya, S.
Antipsychotic treatment failure in patients with psychosis and co-morbid cannabis use: A
systematic review
Psychiatry Research, 2019 280
Whilst the effects of cannabis preceding psychosis onset are well established, an effect post-onset is less
clear. This review sought to summarise current evidence regarding the effect of cannabis use on
antipsychotic treatment failure among users and non-users with psychosis. Cannabis use was associated
with the following deleterious outcomes increased: odds of non-remission, prescription of unique
antipsychotic medications, cumulative prescription of Clozapine and poor treatment trajectories.
Click here to view abstract: http://dx.doi.org/10.1016/j.psychres.2019.112523
                                                                                                       Index

                        Schizophrenia, Schizotypal, and delusional disorders

Aceituno, D., et al.
Cost-effectiveness of early intervention in psychosis: Systematic review
The British Journal of Psychiatry, 2019 215, 1, pp. 388-394
We aimed to review the cost-effectiveness evidence of early intervention in psychosis (EIP) services
worldwide. There is consistent evidence that the implementation of EIP services might be a cost-effective
alternative across different health systems. Such evidence, nevertheless, derives from heterogeneous and
sometimes methodologically flawed studies, reducing the certainty of such statement. More efforts must be
done to rigorously assess the value of this intervention, before expanding it among systems where mental
health budgets are more constrained.
Click here to view abstract: http://dx.doi.org/10.1192/bjp.2018.298

Albert, N. and Weibell, M. A.
The outcome of early intervention in first episode psychosis
International Review of Psychiatry, 2019 pp. 1-12
The aim of this article is to provide an overview over the most important trials and evidence regarding the
outcome of early intervention in first episode psychosis. In conclusion, both elements appear necessary in
order to develop an integrated service that can provide the optimal treatment for patients with FEP.
Click here to view abstract: http://dx.doi.org/10.1080/09540261.2019.1643703

                                        Forensic Mental Health Bulletin
                                                2019 Vol 6 No 8
                                                      -3-
Behan, C., et al.
Early intervention in psychosis: health economic evaluation using the net benefit approach in a
real-world setting
British Journal of Psychiatry, 2019 pp. 1-7
To evaluate the cost-effectiveness of early intervention by estimating the incremental net benefit (INB) of
an early-intervention programme, delivered in a real-world setting. INB measures the difference in
monetary terms between alternative interventions. Early intervention has a modest INB from the health
sector perspective and a large INB from the societal perspective. The perspective chosen is critical when
presenting results of an economic evaluation of a complex intervention.
Click here to view abstract: http://dx.doi.org/10.1192/bjp.2019.126

Bianco, C. L., et al.
Deficits in sexual interest among adults with schizophrenia: Another look at an old problem
Psychiatric Services, 2019
This study examined predictors of sexual interest among adults with schizophrenia. The strength of the
relationship between sexual self-efficacy and sexual interest warrants development of interventions to
address sexuality among people with serious mental illness, at least for those who are interested in
developing or maintaining intimate relationships.
Click here to view abstract: http://dx.doi.org/10.1176/appi.ps.201800403

Blomqvist, M., et al.
Health effects of an individualized lifestyle intervention for people with psychotic disorders in
psychiatric outpatient services: A two year follow-up
Issues in Mental Health Nursing, 2019 pp. 1-12
People with psychotic disorders experience to a great extent avoidable physical illnesses and early
mortality. The aim of the study was to investigate the potential effects for this group of participating in a
lifestyle intervention. Changes in biomedical and clinical measurements, self-reported health, symptoms of
illness and health behavior were investigated. Multilevel modeling was used to statistically test differences
in changes over time. Statistically significant changes were found in physical activity, HbA1c and waist
circumference.
Click here to view abstract: http://dx.doi.org/10.1080/01612840.2019.1642425

Browne, J., et al.
The therapeutic alliance in individual resiliency training for first episode psychosis:
Relationship with treatment outcomes and therapy participation
Journal of Consulting and Clinical Psychology, 2019 87, 8, pp. 734-744
The therapeutic alliance has long been considered an essential part of treatment. The present study
examined the alliance at Session 3, 4, or 5 and its relationship to 2-year treatment outcomes and therapy
participation in a sample of clients who received specialized first episode psychosis (FEP) treatment in U.S.
clinics. A stronger alliance was related to improved treatment outcomes in FEP.
Click here to view abstract: http://dx.doi.org/10.1037/ccp0000418

Chan, S. K. W., et al.
A systematic review of long-term outcomes of patients with psychosis who received early
intervention services
International Review of Psychiatry, 2019 pp. 1-16
This review aims to evaluate the effectiveness of early intervention (EI) services in improving long-term
outcomes of patients with psychosis. This review highlights the gap in current EI service provision and
suggests possible future directions for service improvement and further research.
Click here to view abstract: http://dx.doi.org/10.1080/09540261.2019.1643704

                                         Forensic Mental Health Bulletin
                                                 2019 Vol 6 No 8
                                                       -4-
Chau, A. K. C., et al.
Loneliness and the psychosis continuum: A meta-analysis on positive psychotic experiences
and a meta-analysis on negative psychotic experiences
International Review of Psychiatry, 2019
This meta-analytic review aimed to examine the respective associations of loneliness with positive and
negative psychotic experiences along the psychosis continuum. The associations between loneliness and
both positive and negative psychotic experiences were found to be smaller among clinical than non-clinical
samples. The above findings provided evidence for the associations between loneliness and the two core
dimensions of psychotic experiences along the phenomenological continuum.
Click here to view abstract: http://dx.doi.org/10.1080/09540261.2019.1636005

Díaz-Fernández, S., et al.
Suicide attempts in people with schizophrenia before and after participating in an intensive
case managed community program: A 20-year follow-up
Psychiatry Research, 2019
The purpose of this investigation was to assess treatment adherence, reasons for treatment discharge,
suicidal behaviour and impact of route of antipsychotics administration in a group of patients with
schizophrenia treated in a comprehensive, community-based, intensive case managed program for people
with severe mental illness. A combination of intensive case-managed and LAIAP treatment helped to
improve compliance and to reduce suicidal behavior compared to standard treatment in patients with
severe schizophrenia.
Click here to view abstract: http://dx.doi.org/10.1016/j.psychres.2019.112479

Holt, R. I. G., et al.
Structured lifestyle education for people with schizophrenia, schizoaffective disorder and first-
episode psychosis (STEPWISE): Randomised controlled trial
British Journal of Psychiatry, 2019 214, 2, pp. 63-73
We assessed whether STEPWISE, a theory-based, group structured lifestyle education programme could
support weight reduction in people with schizophrenia. Participants were successfully recruited and
retained, indicating a strong interest in weight interventions; however, the STEPWISE intervention was
neither clinically nor cost-effective. Further research is needed to determine how to manage overweight
and obesity in people with schizophrenia.
Click here to view abstract: http://dx.doi.org/10.1192/bjp.2018.167

Igoumenou, A., et al.
Prison vs. Hospital for offenders with psychosis; effects on reoffending
Journal of Forensic Psychiatry & Psychology, 2019
In a matched sample of released prisoners and discharged patients with psychosis we investigated
whether group participation (prison vs. hospital) affected the likelihood of reoffending as well as time to
reoffending. In conclusion, release from prison carries higher risk of a future offending and reduced time to
reoffending among offenders with psychosis.
Click here to view abstract: http://dx.doi.org/10.1080/14789949.2019.1651381

Kirkpatrick, B., et al.
An early developmental marker of deficit versus nondeficit schizophrenia
Schizophrenia Bulletin, 2019
The authors tested the hypothesis that those with deficit and nondeficit schizophrenia would differ on palate
width. This difference in palate width may reflect a divergence in development between deficit and
nondeficit patients that occurs by the early second trimmest and is consistent with the hypothesis that
deficit schizophrenia is a separate disease within the syndrome of schizophrenia.
Click here to view abstract: http://dx.doi.org/10.1093/schbul/sbz024

                                         Forensic Mental Health Bulletin
                                                 2019 Vol 6 No 8
                                                       -5-
Kuo, S. S., et al.
Establishing a standard emotion processing battery for treatment evaluation in adults with
autism spectrum disorder: Evidence supporting the Mayer-Salovey-Caruso Emotion
Intelligence Test (MSCEIT)
Psychiatry Research, 2019 278, pp. 116-124
This study aimed to establish Mayer-Salovey-Caruso Emotion Intelligence Test's (MSCEIT) factorial,
measurement, and structural invariance in community-residing adults with schizophrenia (N = 103) and
autism spectrum disorder (ASD) (N = 113) using multigroup confirmatory factor analysis. Both groups
operationalize MSCEIT measures similarly, with all measures except for Facilitation and Management
showing comparability across groups. To our knowledge, this study is not only the first to establish the
measurement and structural invariance of a standard emotion perception battery in adults with ASD, it is
also the first to establish its comparability across ASD and schizophrenia. Ultimately, these findings
underscore MSCEIT's utility for standardizing treatment evaluation of social cognitive outcomes across the
autism-schizophrenia spectrum.
Click here to view abstract: http://dx.doi.org/10.1016/j.psychres.2019.05.011

Lavin, R., et al.
The relationship between insecure attachment and paranoia in psychosis: A systematic
literature review
The British Journal of Clinical Psychology, 2019
The aim of the current review was to report the strength and consistency of associations between paranoia
and insecure attachment across published studies, and provide systematic appraisal of study quality. The
findings support the proposed role of attachment insecurity in the development and maintenance of
paranoia in psychosis and highlight the need to address insecure attachment representations in the
treatment of paranoia.
Click here to view abstract: http://dx.doi.org/10.1111/bjc.12231

López-Díaz, Á., et al.
The prognostic role of catatonia, hallucinations, and symptoms of schizophrenia in acute and
transient psychosis
Acta Psychiatrica Scandinavica, 2019
To examine the prospective temporal stability of acute and transient psychotic disorders (ATPDs) and
analyze whether there are clinical, psychopathological, or sociodemographic characteristics that predict
ATPD diagnostic stability. A symptom checklist assessing these psychopathological features would enable
early identification of those subjects whose initial ATPD diagnosis will remain stable over time.
Click here to view abstract: http://dx.doi.org/10.1111/acps.13092

Mullins, N., et al.
GWAS of suicide attempt in psychiatric disorders and association with major depression
polygenic risk scores
The American Journal of Psychiatry, 2019 176, 8, pp. 651-660
More than 90% of people who attempt suicide have a psychiatric diagnosis; however, twin and family
studies suggest that the genetic etiology of suicide attempt is partially distinct from that of the psychiatric
disorders themselves. The authors present the largest genome-wide association study (GWAS) on suicide
attempt, using cohorts of individuals with major depressive disorder, bipolar disorder, and schizophrenia
from the Psychiatric Genomics Consortium. This study provides new information on genetic associations
and demonstrates that genetic liability for major depression increases risk for suicide attempt across
psychiatric disorders.
Click here to view abstract: http://dx.doi.org/10.1176/appi.ajp.2019.18080957

                                          Forensic Mental Health Bulletin
                                                  2019 Vol 6 No 8
                                                        -6-
Puolakka, K. and Pitkänen, A.
Effectiveness of psychosocial interventions on quality of life of patients with schizophrenia
and related disorders: A systematic review
Archives of Psychiatric Nursing, 2019
To identify and synthesize the best available evidence on the effectiveness of family interventions, patient
education, social skills training and vocational rehabilitation on the quality of life of patients with
schizophrenia and related disorders. More research is needed to determine the effectiveness of
psychosocial interventions on the quality of life of patients with schizophrenia.
Click here to view abstract: http://dx.doi.org/10.1016/j.apnu.2019.07.001

Smucny, J., et al.
Baseline frontoparietal task-related BOLD activity as a predictor of improvement in clinical
symptoms at 1-year follow-up in recent-onset psychosis
The American Journal of Psychiatry, 2019
The goal of this study was to evaluate the ability of functional MRI (fMRI) measures of cognitive control-
related brain circuitry collected at baseline to predict symptomatic response in patients after 1 year. These
results suggest that frontoparietal activation during cognitive control performance at baseline significantly
predicts subsequent symptomatic improvement during early psychosis speciality care.
Click here to view abstract: http://dx.doi.org/10.1176/appi.ajp.2019.18101126

Studerus, E., et al.
Development and validation of a dynamic risk prediction model to forecast psychosis onset in
patients at clinical high risk
Schizophrenia Bulletin, 2019
The aim of this study was to develop and internally validate a dynamic risk prediction model (joint model)
and to implement this model in a user-friendly online risk calculator. Our results confirm that extended joint
modeling could improve the prediction of psychosis in Clinical High Risk for Psychosis (CHR-P) patients.
We implemented the first online risk calculator that can dynamically update psychosis risk prediction.
Click here to view abstract: http://dx.doi.org/10.1093/schbul/sbz059
                                                                                                        Index

                                        Mood [affective] disorders

Anderson, K. K., et al.
Access and health system impact of an early intervention treatment program for emerging
adults with mood and anxiety disorders
Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 2019 64, 7, pp. 492-500
Early intervention programs are effective for improving outcomes in first-episode psychosis; however, less
is known about their effectiveness for mood and anxiety disorders. We sought to evaluate the impact of an
early intervention program for emerging adults with mood and anxiety disorders in the larger health system
context, relative to standard care. Our findings suggest that early intervention services for mood and
anxiety disorders may be beneficial from a health systems perspective, and further research on the
effectiveness of this model of care is warranted.
Click here to view abstract: http://dx.doi.org/10.1177/0706743718809347

Charoenngam, N., et al.
Patients with rheumatoid arthritis have a higher risk of bipolar disorder: A systematic review
and meta-analysis
Psychiatry Research, 2019
The current study was conducted with the aim to investigate the relationship between rheumatoid arthritis
(RA) and bipolar disorder (BD). The risk of developing BD was significantly higher among patients with RA
than individuals without RA with the pooled relative risk of 2.06 (95% CI, 1.34–3.17; I2 86%). Chronic
inflammation is a potential mechanism and could be a modifiable risk factor of BD.
Click here to view abstract: http://dx.doi.org/10.1016/j.psychres.2019.112484

                                         Forensic Mental Health Bulletin
                                                 2019 Vol 6 No 8
                                                       -7-
Cheng, P. and Jaffe, P.
Examining depression among perpetrators of intimate partner homicide
Journal of Interpersonal Violence, 2019
This retrospective study provides a preliminary analysis that distinguished depressed from nondepressed
perpetrators of intimate partner homicide (IPH) from a sample of 135 cases analysed by a coroner's
homicide death review committee. Consistent with existing literature, the results indicated that depressed
perpetrators were significantly older, more like to commit homicide-suicide than homicide only, more like to
have prior threats or attempts of suicide, more likely to have been abused or witnessed domestic violence
as a child than nondepressed perpetrators and more likely to exhibit sexual jealousy.
Click here to view abstract: http://dx.doi.org/10.1177/0886260519867151

de Vries, Y. A., et al.
Predicting antidepressant response by monitoring early improvement of individual symptoms
of depression: individual patient data meta-analysis
British Journal of Psychiatry, 2019 214, 1, pp. 4-10
We aimed to investigate whether early improvement of individual depressive symptoms better predicts
response or remission. Examining individual symptoms adds little to the predictive ability of early
improvement. Additionally, early non-improvement does not rule out response or remission, particularly
after 12 rather than 6 weeks. Therefore, our findings suggest that routinely adapting pharmacological
treatment because of limited early improvement would often be premature.
Click here to view abstract: https://dx.doi.org/10.1192/bjp.2018.122

Ernst, M., et al.
Suicide attempts in chronically depressed individuals: What are the risk factors?
Psychiatry Research, 2019
Chronically depressed individuals have a high suicide risk. However, it is an open question whether
previously observed risk factors for suicide attempts also apply to chronic depression or whether there are
specific risk factors related to chronic-recurrent illness. Our findings corroborate previously observed risk
factors (e.g. sexual abuse, personality disorders) and suggest other risk factors which could be especially
relevant in chronic depression (e.g. depression severity, interpersonal problems, self-injurious behavior,
and overall years of depression).
Click here to view abstract: http://dx.doi.org/10.1016/j.psychres.2019.112481

Fabbri, C., et al.
Genome-wide association study of treatment-resistance in depression and meta-analysis of
three independent samples
British Journal of Psychiatry, 2019 214, 1, pp. 36-41
To investigate the genetic predictors of treatment-resistant depression (TRD) using a genome-wide
approach to contribute to the development of precision medicine. The identified gene sets are involved in
cyclic adenosine monophosphate mediated signal and chromatin silencing, two processes previously
implicated in antidepressant action. They represent possible biomarkers to implement personalised
antidepressant treatments and targets for new antidepressants.
Click here to view abstract: https://dx.doi.org/10.1192/bjp.2018.256

Gibbons, M. B. C., et al.
Predictors of treatment attendance in cognitive and dynamic therapies for major depressive
disorder delivered in a community mental health setting
Journal of Consulting and Clinical Psychology, 2019 87, 8, pp. 745-755
Our goal was to evaluate treatment attendance patterns, including both treatment completion and
premature termination from treatment, for 2 evidence-based psychotherapies for major depressive disorder
(MDD) delivered in a community mental health setting. Very early termination from services was higher in
CT compared with DT. Including techniques to improve engagement in both therapies and matching
patients to treatment based on predictors/moderators may be effective ways to optimize treatment
engagement.
Click here to view abstract: http://dx.doi.org/10.1037/ccp0000414

                                         Forensic Mental Health Bulletin
                                                 2019 Vol 6 No 8
                                                       -8-
Köhler-Forsberg, O., et al.
Effect of antidepressant switching between nortriptyline and escitalopram after a failed first
antidepressant treatment among patients with major depressive disorder
British Journal of Psychiatry, 2019 215, 2, pp. 494-501
Summary: To compare the switch between the tricyclic antidepressant (TCA) nortriptyline and the selective
serotonin reuptake inhibitor (SSRI) escitalopram. These results suggest that switching from a TCA to an
SSRI or vice versa after non-response or side-effects to the first antidepressant may be a viable approach
to achieve response among patients with major depressive disorder (MDD).
Click here to view abstract: http://dx.doi.org/10.1192/bjp.2018.302

Laroy, M., et al.
Association between hippocampal volume change and change in memory following
electroconvulsive therapy in late-life depression
Acta Psychiatrica Scandinavica, 2019
This study investigates whether hippocampal volume change (HVC) following electroconvulsive therapy
(ECT) predicts the change in memory performance six months after the end of the ECT treatment. A larger
absolute change in right hippocampal volume (HV) during ECT is associated with less improvement in
memory performance yp to 6 months post-ECT.
Click here to view abstract: http://dx.doi.org/10.1111/acps.13086

Madsen, T., et al.
Trajectories of suicidal ideation during 12 weeks of escitalopram or nortriptyline
antidepressant treatment among 811 patients with major depressive disorder
The Journal of Clinical Psychiatry, 2019 80, 4
Suicidal ideation is a frequent and difficult-to-treat clinical challenge among patients with major depressive
disorder (MDD). However, little is known regarding the differential development during antidepressant
treatment and whether some patients may suffer from persistent suicidal ideation. Approximately 1 of 5
patients with MDD showed high or fluctuating suicidal ideation despite antidepressant treatment. Studies
should investigate whether suicidal ideation may persist for longer periods and more targeted treatment
possibilities.
Click here to view abstract: http://dx.doi.org/10.4088/JCP.18m12575

McGrogan, C. L., et al.
Emotion regulation strategies in mania risk: A systematic review
Journal of Clinical Psychology, 2019
Difficulties in emotion regulation may contribute to the development of mania. This review aimed to assess
how emotion regulation strategies reported by individuals at risk of mania compare with clinical and
nonclinical controls. Findings were limited by overall lack of evidence for individual strategies, lack of
consideration of key mediating factors and reliance upon self-report designs.
Click here to view abstract: http://dx.doi.org/10.1002/jclp.22841

Moustafa, A. A., et al.
Depression following major life transitions in women: A review and theory
Psychological Reports, 2019
The authors conducted a systematic literature review of the factors underlying the occurrence of
depression following major life transition in some individuals (such as giving birth, menopause, retirement,
empty-nest transition, and midlife crisis). This review sows that major common life transitions can cause
depression if they are sudden, major, and lead to loss (or change) of life roles (e.g., no longer doing
motherly or fatherly chores after children leave family home).
Click here to view abstract: http://dx.doi.org/10.1177/0033294119872209

                                         Forensic Mental Health Bulletin
                                                 2019 Vol 6 No 8
                                                       -9-
Mullins, N., et al.
GWAS of suicide attempt in psychiatric disorders and association with major depression
polygenic risk scores
The American Journal of Psychiatry, 2019 176, 8, pp. 651-660
More than 90% of people who attempt suicide have a psychiatric diagnosis; however, twin and family
studies suggest that the genetic etiology of suicide attempt is partially distinct from that of the psychiatric
disorders themselves. The authors present the largest genome-wide association study (GWAS) on suicide
attempt, using cohorts of individuals with major depressive disorder, bipolar disorder, and schizophrenia
from the Psychiatric Genomics Consortium. This study provides new information on genetic associations
and demonstrates that genetic liability for major depression increases risk for suicide attempt across
psychiatric disorders.
Click here to view abstract: http://dx.doi.org/10.1176/appi.ajp.2019.18080957

Paulus, D. J., et al.
Trajectory of change in anxiety sensitivity in relation to anxiety, depression, and quality of life
among persons living with HIV/AIDS following transdiagnostic cognitive-behavioral therapy
Cognitive Behaviour Therapy, 2019 pp. 1-15
The current study sought to examine treatment-related changes in anxiety sensitivity and how the trajectory
of change relates to anxiety and depressive symptoms as well as overall quality of life of persons living with
HIV/AIDS (PLHIV). Results indicated that reductions in anxiety sensitivity were significantly related to
changes in anxiety, depression, and quality of life among PLHIV seeking treatment.
Click here to view abstract: http://dx.doi.org/10.1080/16506073.2019.1621929

Strawbridge, R., et al.
Augmentation therapies for treatment-resistant depression: systematic review and meta-
analysis
British Journal of Psychiatry, 2019 214, 1, pp. 42-51
We conducted a systematic review and meta-analysis to search and quantify the evidence of psychological
and pharmacological augmentation interventions for treatment-resistant depression (TRD). Despite being
used widely in clinical practice, the evidence for augmentation treatments in TRD is sparse. Although pre-
post meta-analyses are limited by the absence of direct comparison, this work finds promising evidence
across treatment modalities.
Click here to view abstract: https://dx.doi.org/10.1192/bjp.2018.233

Sun, Q. and Tan, L.
Comparing primary insomnia to the insomnia occurring in major depression and general
anxiety disorder
Psychiatry Research, 2019
Apart from possibly distinguishing the different clinical causes of insomnia, this article explores the
subjective and objective sleep differences amongst primary insomnia, major depression with insomnia and
general anxiety disorder with insomnia. Our findings showed that major depression with insomnia
increased active REM sleep and severe daytime function, which could alert clinicians to the risk of
depression. Major depression with insomnia and primary insomnia may be categorically different. However,
general anxiety disorder with insomnia and primary insomnia might be a continuum of a disease rather than
be categorically distinct.
Click here to view abstract: http://dx.doi.org/10.1016/j.psychres.2019.112514

Szuhany, K. L. and Otto, M. W.
Efficacy evaluation of exercise as an augmentation strategy to brief behavioral activation
treatment for depression: a randomized pilot trial
Cognitive Behaviour Therapy, 2019 pp. 1-14
The purpose of this study was to examine the credibility and exploratory effect size estimates of
augmenting behavioral activation (BA) with exercise. Results demonstrated strong credibility and
completion rates of BA+exercise comparable to other BA interventions. BA may be a useful strategy for
improving depression and increasing exercise.
Click here to view abstract: http://dx.doi.org/10.1080/16506073.2019.1641145
                                          Forensic Mental Health Bulletin
                                                  2019 Vol 6 No 8
                                                       -10-
Vernmark, K., et al.
Working alliance as a predictor of change in depression during blended cognitive behaviour
therapy
Cognitive Behaviour Therapy, 2019 48, 4, pp. 285-299
Blended Cognitive Behaviour Therapy (bCBT) is a new form of treatment, mixing internet-based modules
and face-to-face therapist sessions. How participants rate the therapeutic alliance in bCBT has not yet
been thoroughly explored, and neither is it clear whether therapist- and patient-rated alliances are
predictors of change in depression during treatment. The role of the therapist-rated alliance seems to be of
particular importance and should be carefully considered when collecting data in future studies on bCBT.
Click here to view abstract: http://dx.doi.org/10.1080/16506073.2018.1533577

Walderhaug, E. P., et al.
Relationships between depressive symptoms and panic disorder symptoms during guided
internet-delivered cognitive behavior therapy for panic disorder
Nordic Journal of Psychiatry, 2019
The current study explore the relationship between the trajectories of primary panic disorder symptoms and
secondary depressive symptoms during guided internet-delivered cognitive behaviour therapy for panic
disorder. Guided ICBT for panic disorder is effective for both primary panic disorder symptoms and
secondary depressive symptoms. Patients with high pre-treatment secondary depressive symptoms may
constitute a vulnerable subgroup. A high level of panic disorder symptoms early in treatment seems
beneficiary for depressive symptoms outcome. A time-dependent model may be necessary to describe the
relationship between PAD symptoms and depressive symptoms during the course of treatment.
Click here to view abstract: http://dx.doi.org/10.1080/08039488.2019.1646803

Zimmerman, M., et al.
Screening for bipolar disorder and finding borderline personality disorder: A replication and
extension
Journal of Personality Disorders, 2019 33, 4, pp. 533-543
The authors' group previously reported that patients who screened positive on the Mood Disorders
Questionnaire (MDQ), the most frequently studied screening scale for bipolar disorder, were as likely to be
diagnosed with borderline personality disorder (BPD) as with bipolar disorder. The results of the present
study were consistent with the original report, thereby indicating that the MDQ is not effective in helping
distinguish bipolar disorder from BPD.
Click here to view abstract: https://dx.doi.org/10.1521/pedi_2018_32_357
                                                                                                          Index

                          Neurotic, stress related and somatoform disorders

Anderson, K. K., et al.
Access and health system impact of an early intervention treatment program for emerging
adults with mood and anxiety disorders
Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 2019 64, 7, pp. 492-500
Early intervention programs are effective for improving outcomes in first-episode psychosis; however, less
is known about their effectiveness for mood and anxiety disorders. We sought to evaluate the impact of an
early intervention program for emerging adults with mood and anxiety disorders in the larger health system
context, relative to standard care. Our findings suggest that early intervention services for mood and
anxiety disorders may be beneficial from a health systems perspective, and further research on the
effectiveness of this model of care is warranted.
Click here to view abstract: http://dx.doi.org/10.1177/0706743718809347

                                         Forensic Mental Health Bulletin
                                                 2019 Vol 6 No 8
                                                      -11-
Butler, R. M., et al.
Social anxiety among transgender and gender nonconforming individuals: The role of gender-
affirming medical interventions
Journal of Abnormal Psychology, 2019 128, 1, pp. 25-31
The current study aimed to examine whether gender-affirming medical interventions (GAMIs) are
associated with lower social anxiety (SA) among TGNC individuals. Among those expressing interest,
utilization of GAMIs is associated with less SA. GAMIs may result in greater conformity to societal
expectations regarding binary gender norms, thus decreasing discrimination, rejection, victimization, and
nonaffirmation. Increased alignment of physical characteristics and gender identity may increase self-
esteem.
Click here to view abstract: http://dx.doi.org/10.1037/abn0000399

Cameron, D. H., et al.
A comparison of cluster and factor analytic techniques for identifying symptom-based
dimensions of obsessive-compulsive disorder
Psychiatry Research, 2019 278, pp. 86-96
The purpose of this study was to compare the two most commonly applied statistical techniques used in
addressing this question in the same large cohort of individuals with obsessive-compulsive disorder (OCD).
Although there was overlap in the models resulting from two statistical approaches, cluster analysis better
captured the dimensional nature of OCD by demonstrating the prevalence of symptom categories in each
subgroup.
Click here to view abstract: http://dx.doi.org/10.1016/j.psychres.2019.05.040

Cogan, C. M., et al.
The impact of exposure, relaxation, and rescripting therapy for post-trauma nightmares on
suicidal ideation
Journal of Clinical Psychology, 2019
This study investigated whether a brief psychotherapy for post-trauma nightmares (exposure, relaxation,
and rescripting therapy [ERRT]), reduced suicidal ideation (SI). We hypothesized that: (a) nightmare
frequency and severity, post-traumatic stress disorder (PTSD), depression, and sleep quality would be
related to SI at pretreatment; (b) SI would decrease from pre- to post-treatment; and (c) the decrease in SI
would remain after controlling for change in PTSD and depression. Results suggest brief psychotherapy
targeting post-trauma nightmares may decrease SI. More research is necessary to determine what factors
contribute to decreases in SI.
Click here to view abstract: http://dx.doi.org/10.1002/jclp.22852

Cox, R. C., et al.
Insomnia and posttraumatic stress symptoms: Evidence of shared etiology
Psychiatry Research, 2019
Posttraumatic stress disorder (PTSD) and insomnia are comorbid clinical conditions that are thought to
result from genetic and environmental effects. Though studies have established the heritability of these
disorders independently, no study to date has examined the genetic contributions to the relation between
insomnia and PTSD symptoms (PTSS). The present study assessed this gap in the literature using a
behavioral genetics approach to symptom dimensions. Results indicated a significant association between
insomnia symptoms and intrusions and insomnia symptoms and avoidance, and 36-44% of phenotypic
variance was accounted for by genetic contributions. These findings highlight a significant role for genetic
factors in the mechanisms underlying the comorbidity between insomnia and PTSS.
Click here to view abstract: http://dx.doi.org/10.1016/j.psychres.2019.112548

                                         Forensic Mental Health Bulletin
                                                 2019 Vol 6 No 8
                                                      -12-
Du Mont, J., et al.
Factors associated with posttraumatic stress disorder symptomology among women who have
experienced sexual assault in Canada
Journal of Interpersonal Violence, 2019
The present study used the General Social Survey on Victimization (GSS-V) to examine the association of
sociodemographic, health, and assailant characteristics and prior traumatic experiences in the form of
physical or sexual dating violence, physical assault, stalking, childhood abuse, and witnessing of violence
between parents with PTSD symptomology among sexually assaulted women. The results suggest that
PTSD symptoms in the near aftermath of sexual victimization are common, and there are a range of factors
that contribute to the likelihood of developing these symptoms.
Click here to view abstract: http://dx.doi.org/10.1177/0886260519860084

Jowett, S., et al.
Differentiating symptom profiles of ICD-11 PTSD, complex PTSD, and borderline personality
disorder: A latent class analysis in a multiply traumatized sample
Personality Disorders, 2019
This article aimed to identify groups with distinct profiles of self-reported complex posttraumatic stress
disorder (CPTSD) and borderline personality disorder (BPD) symptoms and associated trauma history
characteristics. Findings support the construct of a CPTSD diagnosis as a separate entity although BPD
features seem to overlap greatly with CPTSD symptoms in this highly traumatized clinical sample.
Click here to view abstract: http://dx.doi.org/10.1037/per0000346

Lewis, C., et al.
Internet-based cognitive behavioural therapy (i-CBT) for post-traumatic stress disorder (PTSD):
systematic review and meta-analysis
Acta Psychiatrica Scandinavica, 2019
To determine whether internet-based cognitive behavioural therapy (i-CBT) is an effective treatment for
those who meet diagnostic criteria for post-traumatic stress disorder (PTSD). While the review found some
beneficial effects of i-CBT for PTSD post-treatment, the quality of the evidence was very low due to the
small number of included trials and there was insufficient evidence to support the maintainance of
improvement at follow-up of three to six months.
Click here to view abstract: http://dx.doi.org/10.1111/acps.13079

Menzies, R. E., et al.
The relationship between death anxiety and severity of mental illnesses
The British Journal of Clinical Psychology, 2019
In the present study, the relationships between death anxiety and broad markers of psychopathology were
explored in 200 treatment-seeking participants with various diagnosed mental disorders. The findings
reveal a strong relationship between death anxiety and psychopathology across numerous disorders,
further supporting the transdiagnostic role of fears of death. As such, clinical implications revolve around
the potential need for innovative treatments which address death fears directly, in order to produce long-
term improvements in mental health.
Click here to view abstract: http://dx.doi.org/10.1111/bjc.12229

Michopoulos, V., et al.
Association of prospective risk for chronic PTSD symptoms with low TNFα and IFNγ
concentrations in the immediate aftermath of trauma exposure
The American Journal of Psychiatry, 2019
The present study aimed to characterize whether peripheral immune factors measured in blood samples
collected in an emergency department immediately after trauma exposure would predict later chronic
development of PTSD. Overall, the study findings suggest that assessing the proinflammatory immune
response to trauma exposure immediately after trauma exposure, in the emergency department, may help
identify individuals most at risk for developing chronic PTSD in the aftermath of trauma.
Click here to view abstract: http://dx.doi.org/10.1176/appi.ajp.2019.19010039

                                         Forensic Mental Health Bulletin
                                                 2019 Vol 6 No 8
                                                      -13-
Mulhall, K., et al.
Managing the monster in the mind: a psychoanalytically informed qualitative study exploring
the experiences of people diagnosed with obsessive-compulsive disorder
Psychoanalytic Psychotherapy, 2019 33, 2, pp. 117-132
This study sought to examine the experiences of individuals living with Obsessive-Compulsive Disorder
(OCD), including an exploration of early life experiences and interpersonal patterns. This study located
interpersonal experiences within participants' accounts that appeared to connect with the origins and
development of their obsessions and compulsions. The role that relationally oriented approaches may have
for people presenting with these difficulties are also discussed.
Click here to view abstract: https://dx.doi.org/10.1080/02668734.2019.1614087

Paulus, D. J., et al.
Trajectory of change in anxiety sensitivity in relation to anxiety, depression, and quality of life
among persons living with HIV/AIDS following transdiagnostic cognitive-behavioral therapy
Cognitive Behaviour Therapy, 2019 pp. 1-15
The current study sought to examine treatment-related changes in anxiety sensitivity and how the trajectory
of change relates to anxiety and depressive symptoms as well as overall quality of life of persons living with
HIV/AIDS (PLHIV). Results indicated that reductions in anxiety sensitivity were significantly related to
changes in anxiety, depression, and quality of life among PLHIV seeking treatment.
Click here to view abstract: http://dx.doi.org/10.1080/16506073.2019.1621929

Piper, A. and Berle, D.
The association between trauma experienced during incarceration and ptsd outcomes: A
systematic review and meta-analysis
Journal of Forensic Psychiatry & Psychology, 2019
The current systematic review and meta-analysis sought to explore the association between Potentially
Traumatic Events (PTEs) during incarceration and PTSD, summarise key characteristics of the existing
literature and understand the extent to which specific PTEs and participant characteristics are associated
with PTSD. The results of this review highlight the detrimental psychological effects of PTEs experienced
during incarceration. The associations highlighted underline the need for trauma-informed care and
eradications of PTEs within the prison environment.
Click here to view abstract: http://dx.doi.org/10.1080/14789949.2019.1639788

Shi, R., et al.
A meta-analysis of the relationship between anxiety and attentional control
Clinical Psychology Review, 2019 72
Attentional Control Theory (ACT) proposes that attention control (AC) deficits are central to the
development of anxiety. This meta-analysis investigated the size and nature of AC deficits in anxious
compared to non-anxious participants. The meta-analysis revealed a significant AC deficit for high
compared to low anxiety participants. Overall, results supported assumptions of ACT: anxiety produced
significant deficits in AC efficiency but not effectiveness; these deficits occurred in inhibition and switching
but not updating and studies with high cognitive load conditions found larger anxiety related AC deficits.
Click here to view abstract: http://dx.doi.org/10.1016/j.cpr.2019.101754

Stech, E. P., et al.
Internet-delivered cognitive behavioral therapy for panic disorder with or without agoraphobia:
a systematic review and meta-analysis
Cognitive Behaviour Therapy, 2019 pp. 1-24
The current systematic review and meta-analysis examined the efficacy and effectiveness of internet-
delivered cognitive behavioral therapy (iCBT) on panic disorder and agoraphobia symptom severity. Within-
group effects of iCBT suggest the reduction in panic and agoraphobia symptom severity is maintained at 3-
6 month follow-up.
Click here to view abstract: http://dx.doi.org/10.1080/16506073.2019.1628808

                                          Forensic Mental Health Bulletin
                                                  2019 Vol 6 No 8
                                                       -14-
Sun, Q. and Tan, L.
Comparing primary insomnia to the insomnia occurring in major depression and general
anxiety disorder
Psychiatry Research, 2019
Apart from possibly distinguishing the different clinical causes of insomnia, this article explores the
subjective and objective sleep differences amongst primary insomnia, major depression with insomnia and
general anxiety disorder with insomnia. Our findings showed that major depression with insomnia
increased active REM sleep and severe daytime function, which could alert clinicians to the risk of
depression. Major depression with insomnia and primary insomnia may be categorically different. However,
general anxiety disorder with insomnia and primary insomnia might be a continuum of a disease rather than
be categorically distinct.
Click here to view abstract: http://dx.doi.org/10.1016/j.psychres.2019.112514

Ternes, M., et al.
The perpetration of violence and the experience of trauma: Exploring predictors of ptsd
symptoms in male violent offenders
The International Journal of Forensic Mental Health, 2019
This study examined symptoms and predictors of Posttraumatic Stress Disorder (PTSD) in 150 male
violent offenders. Hierarchical linear modeling showed that more recent events were associated with a
greater number of trauma symptoms and peritraumatic dissociation was positively associated with trauma
symptoms. These results support the need for trauma-informed assessment and treatment for offenders.
Click here to view abstract: http://dx.doi.org/10.1080/14999013.2019.1643428

Vincent, L. and Norton, P. J.
Predictors and consequences of sudden gains in transdiagnostic cognitive-behavioural
therapy for anxiety disorders
Cognitive Behaviour Therapy, 2019 48, 4, pp. 265-284
This study investigated the association between sudden gains and cognitive change, therapeutic alliance,
and/or client engagement in transdiagnostic group cognitive-behavioural therapy for anxiety disorders. Of
58 treatment initiators, 21% (n = 12) exhibited a sudden gain. Consistent with previous research, sudden
gainers demonstrated significantly greater pre- to post-treatment symptom improvement than non-sudden
gainers.
Click here to view abstract: http://dx.doi.org/10.1080/16506073.2018.1513557

Walderhaug, E. P., et al.
Relationships between depressive symptoms and panic disorder symptoms during guided
internet-delivered cognitive behavior therapy for panic disorder
Nordic Journal of Psychiatry, 2019
The current study explore the relationship between the trajectories of primary panic disorder symptoms and
secondary depressive symptoms during guided internet-delivered cognitive behaviour therapy for panic
disorder. Guided ICBT for panic disorder is effective for both primary panic disorder symptoms and
secondary depressive symptoms. Patients with high pre-treatment secondary depressive symptoms may
constitute a vulnerable subgroup. A high level of panic disorder symptoms early in treatment seems
beneficiary for depressive symptoms outcome. A time-dependent model may be necessary to describe the
relationship between PAD symptoms and depressive symptoms during the course of treatment.
Click here to view abstract: http://dx.doi.org/10.1080/08039488.2019.1646803
                                                                                                     Index

                                        Forensic Mental Health Bulletin
                                                2019 Vol 6 No 8
                                                     -15-
Behavioural syndromes associated with physiological disturbances and physical factors

Cox, R. C., et al.
Insomnia and posttraumatic stress symptoms: Evidence of shared etiology
Psychiatry Research, 2019
Posttraumatic stress disorder (PTSD) and insomnia are comorbid clinical conditions that are thought to
result from genetic and environmental effects. Though studies have established the heritability of these
disorders independently, no study to date has examined the genetic contributions to the relation between
insomnia and PTSD symptoms (PTSS). The present study assessed this gap in the literature using a
behavioral genetics approach to symptom dimensions. Results indicated a significant association between
insomnia symptoms and intrusions and insomnia symptoms and avoidance, and 36-44% of phenotypic
variance was accounted for by genetic contributions. These findings highlight a significant role for genetic
factors in the mechanisms underlying the comorbidity between insomnia and PTSS.
Click here to view abstract: http://dx.doi.org/10.1016/j.psychres.2019.112548

Demmler, J. C., et al.
Shining the light on eating disorders, incidence, prognosis and profiling of patients in primary
and secondary care: national data linkage study
British Journal of Psychiatry, 2019 pp. 1-8
The aim of the paper was to examine the burden of eating disorders in the population in terms of incidence,
comorbidities and survival. Incidence of diagnosed eating disorders is relatively low in the population but
there is a major longer term burden in morbidity and mortality to the individual.
Click here to view abstract: http://dx.doi.org/10.1192/bjp.2019.153

Douglas, V. J., et al.
The interaction of sociocultural attitudes and gender on disordered eating
Journal of Clinical Psychology, 2019
The Tripartite Influence Model posits that social agents emphasize a thin ideal for women and a
muscularity ideal for men. There is a gap in the literature of how sociocultural body ideal internalization
affects overall disordered eating symptoms in men and specifically drive for muscularity in women. It is
important to emphasize, however, that men still exhibited higher rates of disordered eating symptoms when
they had increased internalization and women exhibited an increased drive for muscularity when they had
higher internalization.
Click here to view abstract: http://dx.doi.org/10.1002/jclp.22835

Hedman, A., et al.
Bidirectional relationship between eating disorders and autoimmune diseases
Journal of Child Psychology and Psychiatry, 2019 60, 7, pp. 803-812
The authors evaluated the strength of associations for the bidirectional relationships between eating
disorders (EDs) and autoimmune diseases. The interactions between EDs and autoimmune diseases
support the previously reported associations. The bidirectional risk pattern observed in women suggests
either a shared mechanism or a third mediating variable contributing to the association of these illnesses.
Click here to view abstract: http://dx.doi.org/10.1111/jcpp.12958

Linardon, J., et al.
Testing the measurement invariance of the Body Image Acceptance and Action Questionnaire
between women with and without binge-eating disorder symptomatology: Further evidence for
an abbreviated five-item version
Psychological Assessment, 2019
Tests of measurement invariance are needed to understand whether the Body Image Acceptance and
Action Questionnaire (BI-AAQ) operates in the same way for binge-eating disorder (BED) and non-BED
populations, thereby ensuring meaningful comparison across these groups. The authors tested the
measurement invariance of the BI-AAQ in participants with and without clinically significant BED
symptomatology. Present findings provide further psychometric support for an abbreviated five-item BI-
AAQ.
Click here to view abstract: http://dx.doi.org/10.1037/pas0000761
                                         Forensic Mental Health Bulletin
                                                 2019 Vol 6 No 8
                                                      -16-
Sun, Q. and Tan, L.
Comparing primary insomnia to the insomnia occurring in major depression and general
anxiety disorder
Psychiatry Research, 2019
Apart from possibly distinguishing the different clinical causes of insomnia, this article explores the
subjective and objective sleep differences amongst primary insomnia, major depression with insomnia and
general anxiety disorder with insomnia. Our findings showed that major depression with insomnia
increased active REM sleep and severe daytime function, which could alert clinicians to the risk of
depression. Major depression with insomnia and primary insomnia may be categorically different. However,
general anxiety disorder with insomnia and primary insomnia might be a continuum of a disease rather than
be categorically distinct.
Click here to view abstract: http://dx.doi.org/10.1016/j.psychres.2019.112514

Surman, C. B. H., et al.
Post-hoc analyses of the effects of baseline sleep quality on SHP465 mixed amphetamine salts
extended-release treatment response in adults with attention-deficit/hyperactivity disorder
CNS Drugs, 2019 33, 7, pp. 695-706
The presence of sleep problems at the time of presentation for ADHD treatment could impact the level of
improvement in ADHD symptoms or executive function occurring with ADHD pharmacotherapy. Therefore,
we examined the influence of baseline sleep quality on the effects of SHP465 mixed amphetamine salts
(MAS) extended-release. Improvements in ADHD symptoms and executive function occurred with dose-
optimized SHP465 MAS, regardless of baseline impairment in some aspects of sleep in adults with ADHD,
with no significant differences observed as a function of sleep impairment.
Click here to view abstract: http://dx.doi.org/10.1007/s40263-019-00645-z

Túry, F., et al.
Compulsory treatment in eating disorders: Control, provocation, and the coercion paradox
Journal of Clinical Psychology, 2019 75, 8, pp. 1444-1454
This paper discusses the major practical and ethical considerations surrounding the controversy of
professional acceptance of involuntary treatment of anorexia.
Click here to view abstract: http://dx.doi.org/10.1002/jclp.22783
                                                                                                   Index

                               Disorders of adult personality and behaviour
Banks, J., et al.
Prevalence of gambling disorder among prisoners: A systematic review
International Journal of Offender Therapy and Comparative Criminology, 2019
This article presents the first systematic review of studies on the prevalence of gambling disorder among
prisoners across international jurisdictions. The review indicates that the institution of problem gambling
treatment programmes in carceral settings is necessary, to aid community re-entry and reduce the
likelihood of re-offending.
Click here to view abstract: http://dx.doi.org/10.1177/0306624X19862430

Borkum, D. B., et al.
Predictors of slower time-to-cessation of individual therapy for borderline patients over 16
years of prospective follow-up
Journal of Personality Disorders, 2019 33, 1, pp. 135-144
The current study assesses time-to-cessation of individual therapy for patients with borderline personality
disorder (BPD) and comparison subjects with other personality disorders (OPD) after 16 years of
prospective follow-up. The results of this study suggest that prediction of slower time-to-cessation of
individual therapy is multifactorial in nature, involving factors related to demographics, childhood adversity,
comorbidity, individual competence, and temperament.
Click here to view abstract: http://dx.doi.org/10.1521/pedi_2018_32_335

                                          Forensic Mental Health Bulletin
                                                  2019 Vol 6 No 8
                                                       -17-
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