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Biomedical subjects

J D Mendonca

Publications and source records attributed to J D Mendonca.

14 recordsLinked to original sources
PubMed2002

Experiments in change: pretrial diversion of offenders with mental illness.

OBJECTIVE: Our objective was to study the outcomes experienced by 2 communities after implementing pretrial diversion of offenders with mental illness. METHOD: The same method of diversion was implemented in a predominately urban and a predominantly rural county. We collected retrospective clinical and offence data from pretrial diversion assessments conducted in court. As well, we measured outcome for the diversion procedure in terms of actual vs expected rates of recidivism. RESULTS: Prior psychiatric treatment was associated with the diverted group, and a criminal history was associated with the nondiverted group. In the larger, urban county the diversion option was offered more often to persons with psychoses, mood disorders, and minor offenses. Conversely, in the smaller rural county diversion was offered most often to persons accused of serious offenses. The recidivism found in urban and rural diverted groups after a year of supervised care was only 2% to 3%, but the rate of use of diversion in both counties was low, owing to selection biases. CONCLUSION: Pretrial diversion of offenders with mental illness accused of minor crimes is eminently feasible for both urban and rural settings, provided that police, crown, and treatment policies are coordinated to favour the treatment option rather than prosecution.

Adolescent↗
PubMed1998

Are some motives more linked to suicide proneness than others?

This research examines the importance of assessing motivations that crisis patients attribute for considering a suicide attempt. For 251 consecutive patients attending a crisis unit, suicide attempters and ideators indicated agreement with each of 14 reasons for attempting suicide. Principal components analysis of these agreement ratings yielded two factor scales of motives: Extrapunitive/Manipulative Reasons and Internal Perturbations. Scores for internal perturbations correlated significantly with patients' wishes to die, clinicians' ratings of patients' suicidal desire and preparation for suicide, and clinicians' overall evaluation of patients' suicidal risk. Associations between internal perturbations and these suicide measures were nonredundant with hopelessness. It is concluded that evaluating a suicidal person's internal reasons for attempting suicide has unique assessment value.

Adolescent↗
PubMed1998

Interaction of affective and cognitive impairments in the suicidal state: a brief elaboration.

This report examines the comorbidity among three key symptoms associated with suicidal intent, namely hopelessness, depression and unusual thinking. A total of 97 out-patients with suicidal thoughts were assessed using the Beck Hopelessness Scale, the anxious depression and unusual thinking factor scales of the Derogatis Symptom Checklist-90, and the Beck Scale for Suicide Ideation. It was found that, in considering the interaction between key presenting symptoms, the combination of hopelessness and unusual thinking (which consisted of symptoms such as 'trouble concentrating' and 'mind going blank') was the strongest predictor of the seriousness of current suicidal inclinations.

Adult↗
PubMed1996

Are all suicidal ideas closely linked to hopelessness?

In this study, the link between hopelessness and suicidal intent was investigated for two categories of suicidal thoughts, and the associations of these two categories of thoughts with a range of symptoms were also examined. A total of 97 patients with suicidal thoughts were assessed at the crisis unit of a psychiatric hospital. In interviews, suicidal intent was assessed using the Beck Scale for Suicide Ideation, while psychological distress was assessed using both the Beck Hopelessness Scale and the Derogatis Symptom Checklist. Ideation items describing the frequency, duration and acceptance of a wish to die were significantly correlated with feelings of hopelessness. However, items reflecting preoccupation with a method of self-harm showed only a weak correlation with hopelessness, although the relationship varied according to diagnosis. That is, this preoccupation was significantly associated with hopelessness for depressed patients, but this was not the case for the personality disorder, anxiety disorder and substance-abuse subgroups. Finally, analyses indicated that the primary predictor of suicidal intent was the patient's cognitive distortion, not hopelessness.

Adult↗
PubMed1996

Key features of maltreatment of the infirm elderly in home settings.

OBJECTIVE: To identify contributory factors of elder abuse by caregivers in home settings. METHOD: Using a reliable instrument, visiting nurses rated observations symptomatic of abuse and neglect found in their current caseload of elderly patients. Their observations were also classified as related or unrelated to wilfull maltreatment. RESULTS: Regression analysis produced the following significant findings: 1. signs of poor physical care were found to be predictors of physical abuse; 2. signs of psychosocial distress and exploitation were identified as predictors of emotional abuse; 3. defensiveness and irritability shown by caregivers and strained family relationships, in general, were also associated with abuse. CONCLUSION: It appears that emotional abuse is more prevalent than, and not a necessary precursor of, physical abuse; however, reliable signs of impending or actual abuse of the elderly can be found in a home during visitation.

Activities of Daily Living↗
PubMed1992

Clinical construct validity of the Holden Psychological Screening Inventory (HPSI).

With a sample of 64 adult psychiatric patients, we examined the construct validity of the Holden Psychological Screening Inventory (HPSI) for a clinical population. Factor analysis supported the three-dimensional nature of the HPSI and the appropriateness of the instrument's scoring key. Reliability information confirmed the internal consistency of the inventory's scales. Clinical staff ratings were used as criteria, and analyses indicated that HPSI scales demonstrated convergent validity. Overall, findings extend previous nonclinical research on the HPSI and suggest that the instrument possesses construct validity for clinical applications.

Adult↗
PubMed1991

A prospective study of patient assaults on nurses in a provincial psychiatric hospital in Canada.

A 27-month prospective study was conducted of patient assaults on nurses in a Canadian psychiatric hospital. Rates were low (4% of the patients committing an assault) and the injuries mostly trivial. Schizophrenics accounted for 43% of attacks, but when allowance was made for the disproportionate number of patients in the hospital with this diagnosis, individuals with mental retardation or dementia were approximately twice as likely to be assaultive as schizophrenics. Repeat assaulters (greater than 4 attacks) were more likely to be suffering from paranoid schizophrenia.

Adolescent↗
PubMed1989

Suicide, hopelessness, and social desirability: a test of an interactive model.

We examined the relationships among suicidal indices, hopelessness, and social desirability. Both hopelessness and a measure of social desirability that reflected a sense of general capability were significant indicators of suicidal manifestations. In particular, hierarchical multiple regression procedures demonstrated that hopelessness and social desirability interacted in the prediction of suicide variables. Results generalized across various clinical diagnostic subgroups of psychiatric patients and a sample of prisoners and across different clinically evaluated and self-reported indices of suicidal behavior. Findings are interpreted to mean that a sense of general capability buffers the link of hopelessness to suicidal behavior. Implications for understanding the cognitions associated with suicide and for improving prediction of persons at risk are discussed.

Adult↗
PubMed1989

A prospective study of patient assaults on nursing staff in a psychogeriatric unit.

A 27 month prospective study concerned with aspects of patient-nurse assaults on the geriatric unit (three wards) of a Canadian provincial mental hospital was conducted. The findings were compared with those for the other words. The incidence of assaults was approximately the same in both areas (0.24-0.25 assaults/occupied bed/year respectively). In the former, the commonest diagnoses associated with assaultiveness were dementia followed by schizophrenia and in the rest of the hospital, schizophrenia. However, when base rates of assaultiveness were calculated allowing for the disproportionate number of patients with these conditions, mental retardation, and dementia were approximately twice as likely to be related to assaultiveness as schizophrenia; regardless of where the patients were located. In the geriatric unit attacks were more likely when patients were being physically guided or led and during the administration of drugs; elsewhere whilst physical restraints were being applied. In both hospital areas a comparatively small number of patients accounted for a disproportionate number of assaults and a few nurses were attacked repeatedly. The majority of episodes were trivial but in isolated cases personnel were off work for several months. The discussion focuses on the possibility of generalizing results.

Aged↗
PubMed1986

Motives and intent: a comparison of views of overdose patients and their key relatives/friends.

The purpose of the study was to compare the perceptions of patients with those of key relatives or friends as regards motives for self-poisoning and intent to die, in ninety-eight overdose cases. Patients admitted to the accident and emergency department of a district general hospital in the county of Warwickshire, England, were interviewed following their recovery. Their key relatives/friends were also interviewed concerning their views of the emergency. Analysis of the responses of patients and key persons indicated that there was a significant association between the perceptions of the two classes of subjects as regards selection of escape/relief motives, warning prior to the attempt and intention to die. There was also a significant association between patient and relative perceptions of suicidal intent and relief at being alive. The implication of these findings as regards follow-up therapy is discussed.

Adult↗
PubMed1984

Hopelessness, social desirability, and suicidal behavior: a need for conceptual and empirical disentanglement.

Although hopelessness has been postulated as the primary mediator that links depression and suicide, empirical evidence has produced varied results. A review of previous research suggests that the measurement of hopelessness has not been independent of social desirability. Consequently, the relationship of hopelessness to suicidal behavior remains unclear. It is suggested that the theoretical and clinical usefulness of assessing hopelessness depends on the use of theoretically explicit instruments to assess independently content and response styles with clinically relevant populations.

Humans↗
PubMed1982

Brief marital therapy outcome: personality correlates.

The purpose of the study was to investigate with regression analyses the relationship between personality and background variables and outcome of brief marital therapy. Twenty personality dimensions from the Personality Research Form and data on age, education, number of previous unions, number of children and number of sessions were used as independent variables. The dependent variable was provided by ratings of over-all improvement in affective communication: sexual, verbal, and social, provided by clinical records of 30 couples. The main result was that only the husband's traits were found to be important correlates of improvement in affective communication of both husbands and wives. The important traits involved husband's cognitive efficiency in the area of reflection and accurate judgement of situations, submissiveness, and sensitivity to social approval of his behaviour. The number of individual therapy sessions given to wives was also a notable predictor of improvement. Other personality and background variables were not significantly related to outcome.

Adult↗