A robust relationship has been established between psychopathy and violence, and psychopathy is considered essential in the process of violence risk assessment. This study presents data on a patient sample from a forensic psychiatric unit in Denmark. All patients were assessed for psychopathy using the Psychopathy Checklist Screening Version (PCL:SV) and the Comprehensive Assessment of Psychopathic Personality (CAPP). After a follow-up period of 5.7 years, recidivism outcomes were obtained from the Danish National Crime Register. Both psychopathy measures were related to a more severe and versatile criminal career as well as to violent recidivism. Overall, the predictive accuracy of violent recidivism of the two measures was good, and no significant difference was found in terms of predictability. The newly developed CAPP could be a promising clinical risk management tool in terms of its comprehensiveness. Its validity needs to be further explored, but at least its ability to predict violence similar to the PCL:SV is supported by the present study.

This multiple case study explored de-escalation processes in threatening and violent situations based on patients and staff members perspectives. Our post hoc analysis indicated that de-escalation included responsive interactions influenced by the perspectives of both patients and staff members. We assembled their perspectives in a mental model consisting of three interdependent stages: (1) memories and hope, (2) safety and creativity and (3) reflective moments. The data indicated that both patients and staff strived for peaceful solutions and that a dynamic and sociological understanding of de-escalation can foster shared problem solving in violent and threatening situations.

BackgroundEvidence-based outpatient psychotherapeutic programs are first-line treatment of borderline personality disorder (BPD). Early and effective treatment of BPD is crucial to the prevention of its individual, psychosocial, and economic consequences. However, in spite of recent advantages in diagnosing adolescent BPD, there is a lack of cost-effective evidence-based treatment programs for adolescents. Mentalization-based treatment is an evidence-based program for BPD, originally developed for adults.Methods/DesignAims/hypotheses: We will investigate whether a specifically designed mentalization-based treatment in groups is an efficacious treatment for adolescents with BPD or subthreshold BPD compared to treatment as usual. The trial is a four-center, two-armed, parallel-group, assessor-blinded randomized clinical superiority trial. One hundred twelve patients aged 14 to 17 referred to Child and Adolescent Psychiatric Clinics in Region Zealand are randomized to 1 year of either mentalization-based treatment in groups or treatment as usual. Patients will be included if they meet at least four DSM-5 criteria for BPD. The primary outcome is self-reported borderline features at discharge. Secondary outcomes will include self-harm, depression, BPD criteria, externalizing and internalizing symptoms, and social functioning, together with parental reports on borderline features, externalizing and internalizing symptoms. Measures of attachment and mentalization will be included as mediational variables. Follow-up assessment will take place at 3 and 12 months after end of treatment.DiscussionThis is the first randomized controlled trial to test the efficacy of a group-based mentalization-based treatment for adolescents with BPD or subthreshold BPD. If the results confirm our hypothesis, this trial will add to the treatment options of cost-effective treatment of adolescent BPD.Trial registrationClinicaltrials.gov NCT02068326, February 19, 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1431-0) contains supplementary material, which is available to authorized users.