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People with personality disorder who offend tend to be neglected by health services in most countries. In the UK, there has been renewed interest in the field since government initiatives in the end of the 1990s. Government proposals themselves are controversial, but there is growing recognition that it is unsafe, both for the general public and for the primary sufferer alike, if the neglect continues. Years of experience have combined to provide a highly practical reference work covering: ·Models of understanding of personality development and disorder ·Methods of assessment and treatme

Background: Rates of suicide and suicide-related behavior (SRB) are high in prison. Those witnessing such behavior may develop psychological morbidity. Most previous studies have been quantitative. Little has been written about the witnesses' qualitative experience. Aims: The aim of the study was to explore, through interview and then thematic analysis, the core concerns of those witnessing another's SRB in prison. Method: We interviewed 70 detained young men about their experience of another's SRB in prison. Results: Three main themes were identified: their experience of another's SRB; their thoughts of why the victim died by/attempted suicide; and the physical, emotional, and cognitive effects of another's SRB on them. Responses to questions about the witnesses' experience of support from others, unmet needs, and peers' responses are also described. Two categories within the theme "thoughts of why the victim died by/attempted suicide" were associated with being in prison, all others could be experienced in the community. Over half of the sample reported negative reactions to witnessing another's SRB. Conclusion: Most themes were unrelated to prison. Though many reported negative reactions to their experience, suggesting a need for support, many denied that need. The implication of this study is that prison discipline and health-care staff need to consider how to provide needed support and care in an acceptable form to young men in prison.

Abstract

Aims
To quantify the relationship between alcohol and violence with increasing age.


Methods
Data were from The National Longitudinal Study of Adolescent to Adult Health (ADD Health) of 20,386 people representative of the US population. Mean age at the first wave of interviews was 16.2 years, with subsequent interviews mean of 1, 6.3 and 12.9 years later. We used random-effects models and predictive marginal effects of the association between varying quantities of alcohol consumption and violence while controlling for possible confounders.


Results
Violence was reported by 19.1% of participants at wave I but just 2.1% at wave IV. The random-effects model showed that consuming 1–4 drinks on each occasion was associated with a modest increase in risk of violence in both males (odds ratio (OR) 1.36, 95% CI 1.13–1.63) and females (OR 1.33, 95% CI 1.03–1.72). For consumption of five or more drinks on each occasion, the risk remained similar for females (OR 1.40 (0.99–1.97)) but increased considerably for males (OR 2.41 (1.96–2.95)). Predictive marginal effects models confirmed that violence rates decreased with age.


Conclusions
Alcohol is most strongly linked to violence among adolescents, so programmes for primary prevention of alcohol-related violence are best targeted towards this age group, particularly males who engage in heavy episodic drinking.

Background: Prison suicide rates are high, and suicide-related behaviors (SRBs) higher, but effects of contact with such behaviors in prison have not previously been examined. Aims: To compare the mental state of young men witnessing a peer's suicide-related behavior in prison with that of men without such experience, and to test for factors associated with morbidity. Method: Forty-six male prisoners (age 16–21 years) reporting contact with another's suicide-related behavior in prison were interviewed 6 months after the incident, with validated questionnaires, as were 44 without such contact at least 6 months into their imprisonment. Results: Significantly higher levels of psychiatric morbidity and own suicide-related behaviors were found in the witness group, even after controlling for their higher levels of family mental illness and pre-exposure experience of in-prison bullying. Some personal factors were associated with higher morbidity; incident and institutional factors were not. Conclusions: Findings of heightened vulnerabilities among young men exposed to suicide-related behaviors in prison suggest a need for longitudinal study to clarify temporal relationships and inform strategies to prevent or limit development of morbidity and further harm.