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In light of the clinical importance of understanding co-morbidity within offender populations, the purpose of this paper is to examine the prevalence and comorbidities of clinical disorder (Axis I) and personality disorder (Axis II) within a sample of high risk, male offenders located in a high secure, prison-based personality disorder treatment service.

The study utilised clinical assessment data for both Axis I diagnoses (Structured Clinical Interview for DSM-IV) and Axis II diagnoses (International Personality Disorder Examination) of 115 personality disordered offenders who met the criteria for the treatment service between 2004 and 2015.

Co-morbidity between Axis I and Axis II diagnoses was high, with 81 per cent of the sample having co-morbid personality disorder and clinical disorder diagnosis. The most prevalent Axis I disorder was substance misuse, and Axis II was antisocial, borderline, and paranoid personality disorder. Following χ² analysis, Cluster A personality disorder demonstrated co-morbidity with both mood disorder and schizophrenia/other psychotic disorder. Paranoid, schizoid, narcissistic, and avoidant personality disorder demonstrated a level of co-morbidity with Axis I disorders. There was no association found between the clinical disorders of substance use and anxiety with any personality disorder within this sample.

In part these results suggest that certain Axis II disorders may increase the risk of lifetime Axis I disorders.

The findings of no co-morbidity between the clinical disorders of substance use and anxiety with any personality disorder within sample are inconsistent to previous findings.

The paper published below was prepared by Taylor Ostrander for Frank Knight’s course, Economic Theory, Economics 301, during the Fall 1933 quarter.

Adults over the age of 65 who are diagnosable with personality disorder face numerous problems within current mental health service provision. These include a lack of diagnostic clarity and a lack of specialist personality disorder‐specific interventions. The authors present a pilot mini therapeutic community service for older adults diagnosable with personality disorder consistent with recommendations from NSF, NIMHE and NICE. Clinical experience suggests that positive outcomes demonstrated in similar services for adults of working age may be possible in this group and preliminary outcome results described in the article suggest a trend of clinical and functional improvement, and some economic benefits. This will need to be replicated and tested with a larger sample to confirm these findings.

To examine how clinicians navigate providing treatment to Borderline Personality Disorder (BPD) in the context of the DSM 5, deinstitutionalization, and the biomedical model.

We conducted 39 interviews with mental health providers in the United States in a two-year period preceding and following the release of the DSM 5. Using Constructivist Grounded Theory, we analyzed the data for themes that emerged.

Clinicians faced pressures from insurance companies, the DSM categories, and their professional training to focus on biomedical treatments. These treatments, which emphasized pharmaceuticals and short courses of care, were ill-suited to BPD, which has a strong evidence base recommending long-term therapeutic interventions. We term this contradiction a “biomedical mismatch” and use Gidden’s concept of structuration to better understand how clinicians navigate the system of care. Providers ranged in their responses to the mismatch: some championed biomedicine, others were complicit, and a final group behaved as activists, challenging the paradigm. The sum of the strategies had downstream effects which included crisis reinstitutionalization and a discourse of untreatability. Ultimately, we discuss how social factors such as gender bias, stigma, and trauma are insufficiently represented in the biomedical model of care for BPD.

BPD fits poorly within the biomedical underpinnings of the current system. Accordingly, it illuminates the structuration of health care and where the rules of care break down. More precisely, deinstitutionalization was designed to remove patients from long courses of inpatient care. Many patients with BPD have failed to experience this outcome, with some patients now cycling through long courses of short-term crisis reinstitutionalization instead of having effective outpatient care over long periods. This unintended consequence of deinstitutionalization calls for a more biopsychosocial response to BPD.

GREAT things had been expected of the American National Air Races this year, with many new racing machines to the fore. The Hughes high‐wing monoplane, equipped with a 1,000 h.p. twin‐row Wasp engine and built at a cost of $120,000 in Los Angeles, California, was expected, from wind tunnel tests, to achieve a speed of 367 miles per hour, but, unfortunately, was completed too late for participation in the races. Actually, the competing aeroplanes and the pilots were in the end the same that had gained prominence in former years. The records established by J. Doolittle in 1932—a landplane speed record of 294·38 miles per hour and an average of 252·686 miles per hour in the closed circuit Thompson Trophy race, secured in a Gee Bee Sportster—were not even approached, as can be seen from Table I. The difficulty in aeroplane racing in the United States lies in the fact that the well‐established manufacturers do not regard it as worth their while to participate. Racing machines are built by small adventurous groups of pilots and individualistic constructors, and these groups in the lean depression years have generally found it difficult to secure financial backers.

Recent guidelines suggest that cognitive behavioural therapy (CBT) has a pivotal role to play in the treatment of common mental health problems (CMHPs). There is a danger that we simply ask for ‘more of the same’ instead of looking at all the current limitations preventing individuals from accessing appropriate help. Doing this leads us to aim for a more radical and innovative approach to the CMHPs. This paper suggests that progress in primary care mental health has been much more limited than mental health workers and, in particular, researchers often acknowledge. It looks at the major obstacles barring the way to the development of services that could meet the needs of the very large number of people in our communities with CMHPs.

The purpose of this paper is to examine the predictors of self-harm in male inmates.

Male inmates with and without a background of self-harm (i.e. suicidal and non-suicidal) were compared across two distal (static and trait) and two proximal (environmental and current/state psychological) domains. The factors from the four domains which may accurately classify self-harm history were also examined.

The two groups were significantly different across the four domains, particularly on psychological characteristics. The self-harm group was associated with childhood trauma, violent offences, institutional misconducts and lower levels of social support significantly more than the non-self-harm group. Being single, childhood abuse, impulsivity, antisocial personality disorder and global psychopathology were the five key predictors that contributed to 87.4 per cent of all cases being correctly classified.

The high levels of psychiatric morbidity and childhood trauma in the self-harm group indicated a need for interventions that address emotional and interpersonal difficulties and optimization of adaptive coping skills. Also, interventions may require a focus on the behavioural functions.

A novel approach was taken to the grouping of the variables. A comprehensive range of variables, was assessed simultaneously, including some not previously considered indicators, and in an understudied population, Australian male inmates. The lower levels of agreeableness, conscientiousness and generalized anxiety disorder which distinguished the self-harm and non-self-harm group, were newly identified for self-harm.

The idea of conceptual mapping goes back to the semantic differential and conceptual clustering. Using multivariate statistical techniques, one can map a dispersion of texts onto another dispersion of their content indicators, such as keywords. The resulting configurations of texts/indicators differ from one another according to their meaning, expressed in terms of co‐ordinates of a semantic field. We suggest that by using principal component analysis, one can design a user‐friendly semantic space which can be navigated. Further, to learn the names of embedded magnitudes in semantic space, the idea of conceptual clustering is used in a broader context. This is a two‐mode statistical approach, grouping both documents and their index terms at the same time. By observing the agglomerations of narrower, related terms over a corpus, one arrives at broader, more general thesaurus entries which denote and conceptualise the major dimensions of semantic space.

Research in industrial and organizational psychology demonstrates that the regulation of negative emotions in response to both organizational stressors and interpersonal workplace interactions can result in functional and dysfunctional outcomes (Côté, 2005; Diefendorff, Richard, & Yang, 2008). Research on the regulation of negative emotions has additionally been conducted in social psychology, developmental psychology, neuropsychology, health psychology, and clinical psychology. A close reading of this broader literature, however, reveals that the conceptualization and use of the term “emotion regulation” varies within each research field as well as across these fields. The main focus of our chapter is to make sense of the term “emotion regulation” in the workplace by considering its use across a broad range of psychology disciplines. We then develop an overarching theoretical framework using disambiguating terminology to highlight what we argue are the important constructs involved in the process of intrapersonal emotion generation, emotional experience regulation, and emotional expression regulation in the workplace (e.g., emotional intelligence, emotion regulation strategies, emotion expression displays). We anticipate this chapter will enable researchers and industrial and organizational psychologists to identify the conditions under which functional regulation outcomes are more likely to occur and then build interventions around these findings.

Exposure therapy is a widely used treatment for patients with post-traumatic stress dis -order. It involves reduction of fear through progressive exposure to frightening stimuli in a therapeutic environment. Here we propose a new method designed to improve the effectiveness of exposure therapy. We hypothesized that device-guided breathing during exposure therapy can increase the capability of the patient to undergo effective exposure. The successful application of the method is described for a single patient. Using a device to slow and regularize breathing, the patient was calmed and experienced a greater sense of control and a profound effect of the exposure. The use of the breathing-guiding device is believed to reduce arousal level and excitability of sympathetic “fight-flight” behaviors. The present study suggests that device-guided breathing integrated with exposure therapy may provide a practically feasible and potentially promising non-pharmacological treatment after trauma.