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We study violence risk prediction at St. Joseph's Healthcare Hamilton. Data from January 2016 to December 2017 have been anonymized and collected, for a total of 870 episodes of inpatient aggressions perpetrated by 337 patients. We examine the predictive performance of a clinical indicator embedded in a mandatory assessment tool for psychiatric facilities in Ontario, the Resident Assessment Instrument for Mental Health (RAI-MH): the Risk of Harm to Others Clinical Assessment Protocol (RHO CAP). The RHO CAP's performance is studied among two groups of patients. Moreover, an analysis of the most important risk factors associated with harmful incidents is presented. The RHO CAP has demonstrated a better performance in discriminating which patients were more at risk to commit some type of aggression than at identifying the risk of harm among those who will commit aggression. [ABSTRACT FROM AUTHOR]

Serious mental illness is a major risk factor for aggression and violence. The present study aimed to develop and test an algorithm to predict inpatient aggressions that involve a risk of harm to self or others. This work is based on a retrospective study aimed to investigate the prediction of risk of harm and aggressions at St. Joseph's Healthcare Hamilton, between 2016 and 2017. An analysis of the risk factors most strongly associated with harmful incidents is, followed by the description of the process involved in the development of a predictive model which estimates the risk of harm. The efficiency of the model developed is finally evaluated, showing an overall accuracy of 75%: the specificity to identify episodes considered not at risk of harm is equal to 91.85%, whereas the sensitivity to identify episodes considered harmful is equal to 28.57%. The model proposed can be seen as a seminal project towards the development of a more comprehensive, precise and effective tool capable to predict the risk of harm in the inpatient setting. [ABSTRACT FROM AUTHOR]

Early maladaptive schemas (EMSs) are thought to act as templates for information processing which influence individuals’ emotional reactions to life situations and their styles of interpersonal relating. The association between EMSs and psychopathology is also believed to be mediated by the use of maladaptive compensatory coping and deficits in adaptive coping (e.g., avoidance, surrender). As styles of coping, humor may be such a mediator. This study examined correlations between domains of the Young Schema Questionnaire-Short form and subscales of the Humor Styles Questionnaire. A number of EMS domains were associated with reduced use of adaptive affiliative and self-enhancing humor styles and increased use of maladaptive self-defeating humor. In addition, the maladaptive aggressive style of humor was associated with the EMS involving insufficient self-control. The relationship between most EMS domains and depressed mood was mediated by both self-enhancing and self-defeating humor styles. [ABSTRACT FROM AUTHOR]

Understanding comorbidity is an important challenge for psychopathology researchers and diagnostic systems given the repeated finding of very high comorbidity rates among Axis I disorders in psychiatric samples. This paper proposes that perfectionism may be a critical factor for understanding levels of comorbidity, and a conceptual argument for the importance of perfectionism as an explanatory construct for comorbidity is advanced. The link between perfectionism and comorbidity in a large sample of patients (N = 345) who attended an anxiety disorders clinic is examined using a variety of methods. Diagnoses were established using the Structured Clinical Interview for DSM-IV (SCID-IV), and perfectionism was assessed using both the Hewitt and Flett and Frost Multidimensional Perfectionism Scales. Overall, scores on both the Hewitt and Flett and Frost perfectionism scales were correlated with the number of diagnoses, and a logistic regression analysis, controlling for current symptoms, showed that maladaptive evaluative concerns perfectionism in particular predicted higher levels of comorbidity. [ABSTRACT FROM AUTHOR]

The interpersonal model of depression developed by Coyne proposes that depression leads to a number of negative interpersonal consequences. We hypothesized that underlying personality traits, particularly autonomy, moderate this relationship. Patients with depression (n = 41) and normal controls (n = 41) were assessed on sociotropy and autonomy and participated in a brief interactional task. Sociotropy was associated with a higher level of interpersonal relatedness during the task, whereas autonomy and depression were associated with orientation toward oneself. Depression and autonomy, particularly in combination, were related to fewer positive social behaviors and to partner rejection. Moreover, social behavior mediated the relationship among depression, autonomy, and rejection. The results suggest that the interpersonal model of depression could be made more specific with the inclusion of these personality factors. Clinical and theoretical implications of these results are discussed. [ABSTRACT FROM AUTHOR]

The Sociotropy Autonomy Scale (SAS), especially the Autonomy Scale, has demonstrated inconsistent results concerning its relationship to depression and psychopathology. We hypothesized that these inconsistent findings may be related to the factor structure of the SAS. Exploratory and confirmatory factor analyses of the SAS were conducted in two separate samples of psychiatric outpatients (n = 1033, n = 1034). The results revealed a two-factor solution for sociotropy: Preference for Affiliation and Fear of Criticism and Rejection. The second factor, Fear of Criticism and Rejection, had a stronger association with psychopathology than the first factor. The results also indicated a two-factor solution for autonomy: Sensitivity to Others' Control and Independent Goal Attainment. Although the Sensitivity to Others' Control factor had a positive correlation with psychopathology, the Independent Goal Attainment factor had a negative correlation with psychopathology. We speculate that Independent Goal Attainment may be associated with resilience or hardiness and functions as a buffer against stress. Implications for revising the SAS as well as employing these factors in future studies are discussed. [ABSTRACT FROM AUTHOR]

Dysphoric and nondysphoric women who had predominantly sociotropic or predominantly autonomous personality features were compared on their responses to a standardized interpersonal task in which a confederate acted as a "helper" to plan life changes. As predicted, sociotropic subjects, whether dysphoric or not, were more concerned about interpersonal relatedness in the task, whereas autonomous subjects were more concerned about self-definition. Sociotropic subjects also perceived their partners more positively and liked them more than did autonomous subjects. Dysphoric autonomous subjects were liked less well than were dysphoric sociotropic subjects or either nondysphoric group. These results reinforce theoretical speculations that two distinct cognitive-interpersonal patterns underlie the behavior of dysphoric individuals and indicate that both personality features and dysphoria influence interpersonal rejection. [ABSTRACT FROM AUTHOR]

Examines perfectionism and standard-setting within a self-regulation framework and their role in dysphoria and social anxiety. Relation of socially prescribed perfectionism to frequent appraisal; Relation of self-oriented perfectionism to establishing goals that exceed perceived social ability and to value of meeting personal goals; Social efficacy and perfectionism.