The current archival study assesses risk factors associated with recommitment of 142 individuals adjudicated Not Guilty by Reason of Insanity (NGRI) from civil settings to a forensic hospital in New York State. Within 10 years of transfer from a forensic hospital, 40 (28.2%) were recommitted. Using survival analyses to account for the wide range in opportunity for recommitment, period of transfer (i.e., pre versus post the 1995 case of George L, which clarified factors related to assessments of dangerousness) and the Historical scale and specific items of the HCR-20 emerged as important risk factors for recommitment. Specifically, hazard of recommitment was 2.9 times higher for those with high Historical scores as compared to those with low scores. However, few individual risk factors were associated with recommitment. Prior supervision failure, negative attitude, problems with substance use, and absent or less serious major mental illness and relationship problems were informative in predicting recommitment over 10 and 3 year follow-up periods.

BACKGROUND: Recent models of self-awareness draw a distinction between intellectual awareness (metacognitive knowledge of disabilities) and online awareness of errors (emergent and anticipatory awareness). OBJECTIVE: The present study compared these two types of self-awareness (metacognitive knowledge of disabilities and online awareness) in individuals with multiple sclerosis (MS) and healthy participants. The relationship between self-awareness and functional performance was also examined. METHODS: Participants included 18 individuals with MS and 16 healthy controls (HC) between the ages of 27 and 60. Intellectual awareness was assessed via discrepancy scores on the Functional Behavior Profile (FBP) between participants and their informants. Online Awareness was examined using self-prediction and self-assessment of performance on a functional task. RESULTS: Participants with MS had significantly lower levels of intellectual awareness relative to HCs. The MS group demonstrated worse prediction online awareness than HCs. However, assessment online awareness did not differ between groups, indicating that experience with a task can improve online awareness in persons with MS. CONCLUSION: This study highlights the necessity of adopting a multidimensional approach to assessing the multifaceted phenomenon of self-awareness in MS. In addition, it provides initial evidence to support a self-awareness treatment model for persons with MS.

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Although a growing literature on community-based victimization of people with mental illness exists, victimization within institutional settings is comparatively understudied. The current study seeks to fill this gap by exploring factors related to risk of victimization in a male forensic psychiatric sample using a relatively new risk assessment measure. The Short-Term Assessment of Risk and Treatability (START) is a short-term risk assessment measure that compiles information about several clinically relevant risk factors to evaluate risk of victimization, among other adverse outcomes. Nearly one-third (31.3%) of the sample experienced some type of victimization during their hospitalization. The summary risk judgment and subsets of select START items effectively predicted risk of victimization in this sample with a fair degree of accuracy over a 2-month period.