scholarly journals Treatment Responsivity of Aggressive Forensic Psychiatric Outpatients

2017 ◽  
Vol 62 (12) ◽  
pp. 3834-3852 ◽  
Author(s):  
Danique Smeijers ◽  
Erik Bulten ◽  
Jan Buitelaar ◽  
Robbert-Jan Verkes
Keyword(s):  
Cognitive Distortions ◽  
Dropping Out ◽  
Treatment Motivation ◽  
Psychiatric Outpatients ◽  
Aggression Replacement Training ◽  
Trait Aggression ◽  
The Social ◽  
Forensic Psychiatric ◽  
Treatment Responsivity ◽  
Control Modules

Aggression replacement training (ART) is widely used to reduce aggression. Results regarding its effectiveness, however, are inconclusive regarding adults and specific populations displaying severe aggression. The current open uncontrolled treatment study aimed at assessing the social skills and anger control modules of the ART to reduce aggression in forensic psychiatric outpatients (FPOs). Furthermore, characteristics associated with treatment outcome and dropout were examined. The results suggested that aggression changed during the ART. In addition, higher baseline levels of trait aggression were associated with greater reductions of aggression, whereas more cognitive distortions were associated with less reduction. Treatment dropouts were characterized by higher levels of psychopathic traits, proactive aggression, and more weekly substance use. As there was a considerable amount of dropout; it is important to assess risk of dropping out of treatment and, subsequently, improve treatment motivation. This might enhance treatment adherence which may lead to a more successful reduction of aggression.

scholarly journals Associations Between Neurocognitive Characteristics, Treatment Outcome, and Dropout Among Aggressive Forensic Psychiatric Outpatients

2018 ◽  
Vol 62 (12) ◽  
pp. 3853-3872 ◽  
Author(s):  
Danique Smeijers ◽  
Erik Bulten ◽  
Jan Buitelaar ◽  
Robbert-Jan Verkes
Keyword(s):  
Treatment Outcome ◽  
Cognitive Distortions ◽  
Psychiatric Outpatients ◽  
Anger Control ◽  
Aggression Replacement Training ◽  
Trait Aggression ◽  
The Social ◽  
Forensic Psychiatric ◽  
Underlying Mechanisms ◽  
Control Modules

Aggression Replacement Training (ART) is widely used to reduce aggression and is considered to be effective although there are also inconsistent results. Studies investigating the effectiveness of ART do not focus on neurocognitive characteristics. Focusing on these aspects would result in enhanced understanding of underlying mechanisms of ART. The current open uncontrolled treatment study assessed whether neurocognitive characteristics were associated with change in aggression during the social skills and anger control modules of ART among forensic psychiatric outpatients. Furthermore, differences between treatment dropouts and completers and change in these characteristics during ART were examined. A reduction of trait aggression, cognitive distortions, and social anxiety was observed. Neurocognitive characteristics were not associated with change in aggression, could not distinguish treatment completers from dropouts, and did not change after ART. It is suggested that new paradigms should be developed which take into account the social context in which these impairments appear.

scholarly journals Testing the Effects of a Virtual Reality Game for Aggressive Impulse Management: A Preliminary Randomized Controlled Trial among Forensic Psychiatric Outpatients

2021 ◽  
Vol 11 (11) ◽  
pp. 1484
Author(s):  
Danique Smeijers ◽  
Erik H. Bulten ◽  
Robbert-Jan Verkes ◽  
Sander L. Koole
Keyword(s):  
Randomized Controlled Trial ◽  
Virtual Reality ◽  
Controlled Trial ◽  
Self Report ◽  
Clinical Settings ◽  
Psychiatric Outpatients ◽  
Self Reflection ◽  
Aggression Replacement Training ◽  
Randomized Controlled ◽  
Forensic Psychiatric

Prior laboratory experiments among healthy samples found that training avoidance movements to angry faces may lower anger and aggression, especially people high in trait anger. To enrich this training and make it more suitable for clinical applications, the present researchers developed it into a Virtual Reality Game for Aggressive Impulse Management (VR-GAIME). The current study examined the effects of this training in a randomized controlled trial among forensic psychiatric outpatients with aggression regulation problems (N = 30). In addition to the aggression replacement training, patients played either the VR-GAIME or a control game. Aggressive behavior was measured pre-, half-way, and post-treatment via self-report and clinicians ratings. No difference was found between the VR-GAIME and the control game. However, the participants reported gaining more insight into their own behavior and that of others. Future VR intervention tools in clinical settings may capitalize more on their benefits for self-reflection within interpersonal settings.

Aggression Replacement Training for Violent Young Men in a Forensic Psychiatric Outpatient Clinic

2014 ◽  
Vol 30 (18) ◽  
pp. 3174-3191 ◽  
Author(s):  
Ruud H. J. Hornsveld ◽  
Floris W. Kraaimaat ◽  
Peter Muris ◽  
Almar J. Zwets ◽  
Thijs Kanters
Keyword(s):  
Outpatient Clinic ◽  
Young Men ◽  
Aggression Replacement Training ◽  
Psychiatric Outpatient ◽  
Psychiatric Outpatient Clinic ◽  
Forensic Psychiatric

Clinical Appraisals of Individual Differences in Treatment Responsivity Among Patients With Psychopathy: A Consensual Qualitative Research Study

2020 ◽  
pp. 009385482097059
Author(s):  
Evelyn Klein Haneveld ◽  
Wineke Smid ◽  
Kelsey Timmer ◽  
Jan H. Kamphuis
Keyword(s):  
Qualitative Research ◽  
Psychiatric Treatment ◽  
Negative Impact ◽  
Treatment Success ◽  
Patient Characteristics ◽  
Consensual Qualitative Research ◽  
Treatment Team ◽  
Psychopathy Checklist Revised ◽  
Forensic Psychiatric ◽  
Treatment Responsivity

This study addressed which factors expert clinicians consider crucial in successful completion versus dropout in the mandatory forensic psychiatric treatment of psychopathic patients in the Netherlands. Eleven clinicians were interviewed about patient characteristics, treatment (provider) characteristics, and other factors they deemed associated with failure (transfer to another facility) or completion. The interviews were coded using the guidelines of Consensual Qualitative Research (CQR). Overall, extremely high scores on Psychopathy Checklist–Revised (PCL-R) Facets 1 (Deceitful Interpersonal Style) and 2 (Defective Affective Experience) were thought to impede treatment retention, particularly by its negative impact on motivation and therapeutic relationship. Older patients, those with a prosocial network, and/or patients with comorbid borderline traits appeared to fare better. Treatment success was deemed more likely when treatment goals and expectations are stipulated in a concrete fashion, when an extended and gradual resocialization trajectory is offered, and the treatment team is expert, cohesive, and stable.

Lack of correspondence between the reactive proactive questionnaire and the impulsive premeditated aggression scale among forensic psychiatric outpatients

2018 ◽  
Vol 44 (5) ◽  
pp. 471-480 ◽  
Author(s):  
Danique Smeijers ◽  
Suzanne Brugman ◽  
Katinka von Borries ◽  
Robbert-Jan Verkes ◽  
Erik Bulten
Keyword(s):  
Psychiatric Outpatients ◽  
Forensic Psychiatric
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