Focus (American Psychiatric Publishing)最新文献_第5页

Violence and Mental Illness: Principles, Pathways, and Perspectives of Peril. 暴力和精神疾病：危险的原则、途径和观点。

Focus (American Psychiatric Publishing) Pub Date : 2026-01-01 Epub Date: 2026-01-15 DOI: 10.1176/appi.focus.26024101

引用次数: 0

Empirically-Based Dynamic Risk and Protective Factors for Sexual Offending. 基于经验的性犯罪动态风险与保护因素研究。

Focus (American Psychiatric Publishing) Pub Date : 2026-01-01 Epub Date: 2026-01-15 DOI: 10.1176/appi.focus.26024107

Michael C Seto, Carissa Augustyn, Kailey M Roche, Gabriella Hilkes

{"title":"Empirically-Based Dynamic Risk and Protective Factors for Sexual Offending.","authors":"Michael C Seto, Carissa Augustyn, Kailey M Roche, Gabriella Hilkes","doi":"10.1176/appi.focus.26024107","DOIUrl":"10.1176/appi.focus.26024107","url":null,"abstract":"This review provides an overview and update of empirical evidence for psychologically meaningful dynamic risk factors and protective factors for sexual offending. Using the review by Mann et al. (2010) as a starting point, we reviewed relevant literature that has appeared since this publication, focusing on meta-analyses, systematic and scoping reviews of dynamic risk factors, recent evaluations of commonly used dynamic assessment tools, and studies of dynamic risk and protective factors in community samples in addition to clinical or forensic samples. Two risk factors previously deemed promising by Mann et al. (2010), hostility towards women and dysfunctional coping (conceptualized as hostile masculinity and emotional regulation deficits, respectively, in this review), could now be considered supported using this review's criteria of three or more studies demonstrating an effect size of 0.15 or greater. No new risk factors were identified. We conducted a broader search of protective factors in recognition of the relative newness of this literature: Positive social support was the only protective factor identified as empirically supported. We also discuss situational risk and protective factors. Reprinted from Clin Psychol Rev 2023; 106:102355, with permission from Elsevier. Copyright © 2023.","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"24 1","pages":"83-98"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Structured Violence Risk Assessments: Generations Ahead of Clinical Judgment. 结构化暴力风险评估：领先临床判断的几代人。

Focus (American Psychiatric Publishing) Pub Date : 2026-01-01 Epub Date: 2026-01-15 DOI: 10.1176/appi.focus.20250035

Charles Scott, Barbara McDermott

引用次数: 0

Preventing Violence in Psychiatric Settings. 预防精神病院的暴力行为。

Focus (American Psychiatric Publishing) Pub Date : 2026-01-01 Epub Date: 2026-01-15 DOI: 10.1176/appi.focus.20250031

Katherine Warburton

引用次数: 0

The Clinical Risk Management of Stalking: "Someone Is Watching Over Me..." 跟踪的临床风险管理：“有人在监视我……”

Focus (American Psychiatric Publishing) Pub Date : 2026-01-01 Epub Date: 2026-01-15 DOI: 10.1176/appi.focus.26024104

J Reid Meloy

引用次数: 0

Impact of Digital Literacy Training on Outcomes for People With Serious Mental Illness in Community and Inpatient Settings. 数字素养培训对社区和住院环境中严重精神疾病患者预后的影响。

Focus (American Psychiatric Publishing) Pub Date : 2025-10-01 Epub Date: 2025-10-15 DOI: 10.1176/appi.focus.25023025

Erica Camacho, John Torous

{"title":"Impact of Digital Literacy Training on Outcomes for People With Serious Mental Illness in Community and Inpatient Settings.","authors":"Erica Camacho, John Torous","doi":"10.1176/appi.focus.25023025","DOIUrl":"10.1176/appi.focus.25023025","url":null,"abstract":"Objective: The authors explored whether a digital literacy program, Digital Outreach for Obtaining Resources and Skills (DOORS), could improve self-reported functional skills and clinical outcomes among people with serious mental illness.Methods: The 8-week program was offered to participants receiving treatment in community mental health centers (N=113) and an inpatient psychiatric unit (N=74). Pre- and postintervention self-report surveys were collected. Descriptive statistics and two-tailed t tests were used for analysis.Results: For patients treated in a community center, improvements were observed in 27 of the 29 self-reported functional skills that measured digital literacy. Changes in seven of these skills were statistically significant. Although these participants reported larger improvements in clinical outcomes than did inpatient participants, no statistically significant changes in symptoms were seen in either setting.Conclusions: Digital skills training is necessary to increase access to care through technology. DOORS can improve self-reported digital literacy, but further research is necessary to determine its immediate impact on symptoms.","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 4","pages":"489-493"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From Theory to Therapy: The Evolution and Future of Cognitive-Behavioral Therapy for Psychosis in U.S. Mental Health Care. 从理论到治疗：美国精神卫生保健中精神病认知行为治疗的演变和未来。

Focus (American Psychiatric Publishing) Pub Date : 2025-10-01 Epub Date: 2025-10-15 DOI: 10.1176/appi.focus.20250019

Sarah L Kopelovich, Poppy Brown, Kate Hardy

{"title":"From Theory to Therapy: The Evolution and Future of Cognitive-Behavioral Therapy for Psychosis in U.S. Mental Health Care.","authors":"Sarah L Kopelovich, Poppy Brown, Kate Hardy","doi":"10.1176/appi.focus.20250019","DOIUrl":"10.1176/appi.focus.20250019","url":null,"abstract":"Cognitive-behavioral therapy for psychosis (CBTp) is an evidence-based intervention targeting distress and impairment associated with psychotic symptoms. Despite strong empirical support and international endorsement, it remains underutilized in U.S. psychiatric and forensic settings. This article traces CBTp's theoretical foundations and chronicles its U.S. development, highlighting key milestones, policy shifts, and clinical applications. A narrative review of cognitive-behavioral models, landmark trials, and federal and state implementation initiatives reveals CBTp's evolution from educational and behavioral intervention models into a flexible approach incorporating cognitive, behavioral, motivational, and environmental strategies for the full psychosis spectrum. Recent years have seen diversification into group-based, low-intensity, and digital formats, with growing access via state-sponsored training. Persistent barriers include clinician training, reimbursement, and integration into routine care. Understanding CBTp's theoretical roots, evidence base, and U.S. history can help mental health practitioners advance its integration. Psychiatrists are well positioned to advocate for and participate in enhancing access.","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 4","pages":"429-438"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ethical and Legal Aspects of Treating Schizophrenia. 治疗精神分裂症的伦理和法律问题。

Focus (American Psychiatric Publishing) Pub Date : 2025-10-01 Epub Date: 2025-10-15 DOI: 10.1176/appi.focus.20250017

Jacob M Appel

引用次数: 0

Practice Assessment Tool for the Care of Patients With Borderline Personality Disorder. 边缘型人格障碍患者护理实践评估工具。

Focus (American Psychiatric Publishing) Pub Date : 2025-10-01 Epub Date: 2025-10-15 DOI: 10.1176/appi.focus.20250032

Laura J Fochtmann, Jennifer Medicus, Seung-Hee Hong, Emily A Kuhl

{"title":"Practice Assessment Tool for the Care of Patients With Borderline Personality Disorder.","authors":"Laura J Fochtmann, Jennifer Medicus, Seung-Hee Hong, Emily A Kuhl","doi":"10.1176/appi.focus.20250032","DOIUrl":"10.1176/appi.focus.20250032","url":null,"abstract":"Borderline personality disorder (BPD) is characterized by a long-term pattern of instability of interpersonal relationships, unstable self-image, marked impulsivity, and/or affective instability. In addition, these features can be evidenced by efforts to avoid real or feared abandonment, chronic feelings of emptiness, mood reactivity, recurrent self-injurious or suicidal behavior, other impulsive behaviors with potential for self-damaging effects, intense anger or difficulty with anger control, and transient paranoid ideation or stress-related dissociative symptoms. BPD is associated with substantial lifetime burdens and psychosocial impairments, including high rates of co-occurring psychiatric disorders; disruptions in interpersonal relationships, school, work, and housing; and suicide attempts and nonsuicidal self-injury. Consequently, early identification and treatment of BPD are crucial. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Borderline Personality Disorder aims to enhance knowledge and increase the appropriate use of interventions for BPD, thereby improving the quality of care and treatment outcomes. To this end, this evidence-based Performance in Practice tool can facilitate the implementation of a systematic approach to practice improvement for the care of individuals with BPD. This practice assessment activity can also be used in partial fulfillment of Continuing Medical Education and ABPN Continuing Certification, Improvement in Medical Practice.","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 4","pages":"446-460"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Call to Action for Starting Clozapine: Increasing Clozapine Use and Safety in a Post-REMS Era. 启动氯氮平的行动呼吁：后rems时代增加氯氮平的使用和安全性。

Focus (American Psychiatric Publishing) Pub Date : 2025-10-01 Epub Date: 2025-10-15 DOI: 10.1176/appi.focus.20250023

Jonathan G Leung, Robert O Cotes

{"title":"A Call to Action for Starting Clozapine: Increasing Clozapine Use and Safety in a Post-REMS Era.","authors":"Jonathan G Leung, Robert O Cotes","doi":"10.1176/appi.focus.20250023","DOIUrl":"10.1176/appi.focus.20250023","url":null,"abstract":"Clozapine remains the only medication approved by the U.S. Food and Drug Administration (FDA) for managing treatment-resistant schizophrenia and for reducing the risk of recurrent suicidal behavior in patients with schizophrenia or schizoaffective disorder. Despite its known benefits, its use remains suboptimal with non-evidence-based treatments often trialed before clozapine. These delays have been shown to reduce the likelihood of clozapine response or increase the risk of early discontinuation. With the elimination of the Clozapine Risk Evaluation and Mitigation Strategy program, one barrier that had impeded clozapine use has been negated. However, barriers persist that are related to clinicians' perceptions of clozapine and knowledge related to appropriate titration, monitoring, and management of adverse drug reactions. With a growing body of evidence suggesting that current FDA-recommended hematologic monitoring is overly cautious, there is future potential that these requirements become less stringent. This marks an important time to bring forth a call to action for increased use of clozapine and focus on important clozapine-related initiation and monitoring strategies. Such strategies include slower initial titration, understanding differences in clozapine metabolism across different genetic ancestry groups, awareness of inflammatory reactions, recognition of pneumonia-related mortality, and appropriate bowel care. This review highlights best and evidence-based practices to help clinicians increase clozapine prescribing and ensure that patients have the greatest opportunity for a successful, potentially life-saving clozapine trial.","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 4","pages":"375-388"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0