Developing Clinical Practice Guidelines for violence risk assessment in mental health triage : a systematic review

Background : On a global level, there is a growing trend to utilise mental health triage service systems as a way of providing consumers with access to 24 hour mental health care. At present, violence risk assessment in mental health triage lacks a suitable evidence base and clear guidelines. This presentation provides an overview of a Clinical Practice Guideline for violence risk assessment at point of entry to health services.
Aims : The objective of this study was to develop Clinical Practice Guidelines for violence risk assessment in mental health triage, and to pilot test the Clinical Guidelines in two major hospitals in Melbourne.
Method : The method employed in the study was a systematic review, as per the Australian National Health and Medical Research Council’s methodology for developing Clinical Guidelines. Research was conducted at the Royal Melbourne Hospital and the Alfred Hospital to establish the utility of the Guideline in practice.
Results : The systematic review established the highest level of evidence for violence risk assessment. Clinical Practice Guidelines for mental health triage were developed from these findings.
Conclusions : Evidence based Clinical Guidelines maximise the potential for creating safer outcomes for consumers, families/carers, and health care workers.

Emotional habituation to filmed violence employing the startle probe response

This thesis reports on research examining the habituation of emotional variables to filmed violence. The following subjective emotional variables were assessed: positive feelings, anxiety, disgust, entertainment and anger. In addition, an objective measure of emotional response was recorded physiologically, using the startle eyeblink response. The mediating influence of personality, individual differences and contextual features on an individuals’ perception of and reaction to filmed violence were also explored. Study one was exploratory in nature served to identify and select the film stimuli to be employed in the subsequent studies. The primary aim of the study was to allow for the identification of violent stimuli considered to be most socially and culturally relevant. The present research builds on existing scientific literature which has began to appreciate that differences in the context of a portrayal holds important implications for its impact on viewers. Thus, a secondary and more specific desire of study one was to obtain an evaluation of the contextual features of the violent film segments. A sample of 30 participants viewed and rated the film stimuli on the variables of realism, fantasy and violence. From this exploratory study four violent film stimuli were subsequently employed. Study 2 used the eyeblink startle response proposed by Vrana, Spence and Lang (1988) to explore the habituation of emotional variables to a realistic depiction of filmed violence. Emotional response was assessed both objectively, using the eyeblink startle response and subjectively through individuals self-reports. In addition the study investigated the significance of individual differences as mediators of emotional response. Questionnaire and physiological data were obtained from 30 participants. Overall, repeated exposure to filmed violence resulted in a decline in both objective and subjective emotional response. Differences were identified in the manner in which men and women responded to the film. Women reacted initially and over time with more intense physiological and psychological reactions to the violent film than males. Specifically, men displayed more curiosity and reported greater entertainment and positive feelings in response to the film, whilst women found the violence more disgusting and reported higher levels of anger and anxiety. It was found that the eyeblink startle magnitude paralleled the subjective emotional processing of the violent film, thus providing further confirmatory evidence of its validity in the investigation of emotional reactions to a stimulus. Personality factors were found to mediate emotional response to filmed violence, with neuroticism most powerfully implicated. High levels of neuroticism were found to be associated with greater anger and anxiety and less positive feelings whilst viewing violent film. A high score on extraversion was correlated with higher levels of anger and lower levels of curiosity and entertainment. Whilst the aims of study 3 were identical to that of study 2, a variation in the contextual feature of the violent film stimuli under investigation was the distinguishing and pertinent feature. Study 2 provided data on the habituation of emotional response to a realistic depiction of filmed violence. Study 3 was concerned with emotional response over repeated exposure to a fantasized violent depiction. Therefore, allowing for a comparison regarding the effects of context on emotional response. The results of study 3, with respect to habituation of emotional response, personality and individual differences, were similar to that obtained in study 2. A comparison of the two studies, however, revealed that individuals responded significantly different to the contextual features of the violent portrayal. Compared to the fantasised portrayal the realistic film stimulus was reported to be more digusting, anxiety provoking and less entertaining. In addition, and not surprisingly respondents reported that the realistic portrayal resulted in the production of more anger and less positive feelings.

The Carey 'king hit' : journalists and the coverage of domestic violence

In recent years Australia’s football codes have been rocked by allegations that star players, both past and present, have acted inappropriately off-field. In some instances these allegations have involved violence towards partners. This paper explores one such case, involving former AFL great Wayne Carey. In so doing, it explores the so-called ‘cult of celebrity’ and the impact this has both on the players and the media who cover such stories. People caught up in traumatic situations labelled as domestic violence have been vulnerable to media misunderstanding and misinterpretation. Coverage of these events and issues surrounding such violence has undergone change in line with social change. Work by community groups has produced calls for further shifts in thinking and suggestions for a name change to family violence. The so‑called ‘Wayne Carey Affair’ has demonstrated that journalists have their own vulnerabilities to the cult of celebrity, with extended interviews and coverage often centred on possible explanations/ “excuses” for the behaviour patterns of this one individual avoiding the wider social policy implications. By examining coverage surrounding Wayne Carey, this paper will explore the issues surrounding this major social problem and will question the role of journalists vis a vis the particularly vulnerable individuals caught up in family violence.

Viewer characteristics, film context and habituation/desensitisation to filmed violence

This thesis comprises three studies aimed at examining viewers' responses to filmed violence. The first focused on habituation, the second desensitisation and the third compared the paradigms. Results indicated that several factors influence how an individual responds to filmed violence and provide some insight into the impact of repetitive exposure to media violence. The portfolio presents four case studies emphasising the difficulties for assessing risk and associated interventions in the client population of individuals found not guilty because of mental impairment. This as an area of fundamental discord between psychology and law.

Perceptions and personality : a viewer-centred approach to film violence research

This thesis took a viewer-centred approach to the study of media violence. The findings indicated that viewer perceptions and personality mediate the affective, cognitive and arousal responses of viewers. The importance of the viewer perception and personality examined in this thesis also differed as a function of gender and age. The portfolio focused on the current Victorian correctional system's response to, and attempts to rehabilitate, convicted sexual offenders. It presents four case studies to demonstrate how the Victorian Sexual Offender Treatment Program attempts to apply empirically validated "best practice" principles of offender rehabilitation.

Professionals' attributions and referral decisions in cases of domestic violence

This thesis is the first national study of workers who have contact with victims and perpetrators of domestic violence. It highlights that the victim and perpetrator's gender, as well as the relevant professional's agency type and experience, all influenced their attitudes to, and service delivery decisions with, domestic violence-related clients. The portfolio utilises four case studies to examine the way that two Victorian sex offender programs attempt to balance risk-need and good lives principles in the assessment and treatment of sex offenders.

Men's accounts of domestic violence

Domestic violence against men by their female partners is a much neglected area of attention. Sufficient data has emerged recently to suggest men suffer domestic violence more than previously acknowledged. The findings were that, overall, the men were hurt more by the emotional aspects than any physical violence. They found no dedicated support systems for male domestic violence victims.

Islam and political violence : Muslim diaspora and radicalism in the West

How do we engage with the pressing challenges of xenophobia, radicalism and security in the age of the "war on terror"? The widely felt sense of insecurity in the West is shared by Muslims both within and outside Western societies. Growing Islamic militancy and resulting increased security measures by Western powers have contributed to a pervasive sense among Muslims of being under attack (both physically and culturally). Islam and Political Violence brings together the current debate on the uneasy and potentially mutually destructive relationship between the Muslim world and the West and argues we are on a dangerous trajectory, strengthening dichotomous notions of the divide between the West and the Muslim world.