Jean-Pierre Guay

A taxometric analysis of the latent structure of psychopathy: evidence for dimensionality.

The taxonomic status of psychopathy is controversial. Whereas some studies have found evidence that psychopathy, at least its antisocial component, is distributed as a taxon, others have found that both major components of psychopathy-callousness/unemotionality and impulsivity/antisocial behavior-appear to distribute as dimensions and show little evidence of taxonicity. In the present study, recent advances in taxometric analysis were added to P. Meehls (1995) multiple consistency tests strategy for assessing taxonicity, and they were applied to Psychopathy Checklist-Revised (R. D. Hare, 2003) ratings of 4,865 offenders sampled from multiple forensic settings. The results indicated that both the individual components of psychopathy and their interface are distributed dimensionally. Both the implications of these results for research in psychopathy and the integration of these findings with previous taxometric studies of psychopathy are discussed.

Victim-choice polymorphia among serious sex offenders.

The victim-choice polymorphia of 178 sexual aggressors divided into six subtypes, incest offenders, pseudoincest offenders, sexual aggressors of familiar children, sexual aggressors of unfamiliar children, sexual aggressors of familiar women, and sexual aggressors of unfamiliar women, was compared. Results showed that sex offenders remained stable in their choice of victim from one offence to another in terms of victim age, victim gender, and aggressor–victim relationship. Subjects characterised by high levels of polymorphia were pseudoincest offenders and sexual aggressors of familiar women, whereas sexual aggressors of both unfamiliar women and unfamiliar children were characterised by low levels of polymorphia. Recommendations regarding how to further refine sex offender typologies are discussed.

An Assessment of Long-Term Risk of Recidivism by Adult Sex Offenders: One Size Doesn't Fit All

Numerous instruments are available to clinicians for evaluating sex offenders’ reoffense risk. Although they have demonstrated effectiveness in predicting recidivism significantly better than unstructured clinical evaluation, little is known about their predictive accuracy in subgroups of sexual offenders or in the long term. This study was undertaken to evaluate the predictive accuracy of nine instruments (VRAG, SORAG, RRASOR, Static-99, Static-2002, RM2000, MnSOST-R, SVR-20, PCL-R) among three groups of sexual offenders across a 15-year follow-up period. The results indicate that these instruments yielded marginal to modest predictive accuracy for sexual recidivism. A more detailed study of aggressor subgroups indicated that in both the short and the long term, these instruments were more effective at predicting the sexual recidivism of child molesters and the violent and nonviolent recidivism of rapists. Finally, although mixed offenders sexually reoffend more often and more rapidly than do rapists or child molesters, firm conclusions cannot be drawn because of the small number of mixed offenders in the sample.

Influence of abdominal adiposity, waist circumference, and body mass index on clinical and pathologic findings in patients treated with radiotherapy for localized prostate cancer

Increased body mass index (BMI) has been associated with more aggressive prostate cancer (PC). The relation among abdominal visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), waist circumference (WC), and BMI was compared with clinical and pathologic findings in patients treated with radiotherapy for localized PC.

Distribution of prostate specific antigen (PSA) and percentage free PSA in a contemporary screening cohort with no evidence of prostate cancer

To explore the distribution of total prostate specific antigen (PSA) and percentage free/total PSA (%f/tPSA) in healthy volunteers with no clinical evidence of prostate cancer, who participated in prostate cancer screening.

Fracture of the neck structures in suicidal hangings: A Retrospective study on contributing variables

INTRODUCTION Several factors may play a role in the development of fractures of the neck structures in hanging. It has been repetitively demonstrated that the incidence of fractures increases with age. The role of other variables is less clear, different studies presenting contradictory results on the role of gender, the type of suspension, or the type of ligature. However, most of these studies evaluated these factors independently of the age of the victims. Considering that age is probably the most important factor in the development of neck structure fractures, all other contributing factors should be studied in relation to age. The aim of the present study is to evaluate the role of contributing factors to the development of neck structure fractures, taking age categories into account. MATERIALS AND METHODS A total of 206 cases were analysed for the presence and localization of thyroid fracture. For each case, the following information was also compiled: the presence and localization of other neck structure fractures, gender and age, height and weight, body mass index (BMI) type of suspension (complete or incomplete), type of ligature used (rope, wire, clothes, sheet or lace) and localization of the knot (anterior, right, left or posterior). RESULTS The incidence of neck structure fractures increased with age (χ(2)=21.85; p<.001) and is significantly higher in male victims (31.4%) compared to female victims (11.8%) (χ(2)=5.41; p=.02). The incidence of fractures varied significantly with the height (t=2.19; p=.031; D=.33), weight (t=4.38; p<.001; D=.89) and BMI (t=3.84; p<.001; D=.60). The incidence of fractures did not vary significantly with the type of suspension (i.e. complete hanging with feet off the ground or incomplete hanging with body parts partially supporting the weight of the body) (χ(2)=3.12; p=.077; Phi=.077) and the type of ligature (i.e. narrow vs wide) (χ(2)=.05; p=.828; Phi=.015). However, when taking the age of the victims into account, a different picture was revealed: in individuals aged 40 years or more, victims with complete suspension of the body presented with a significantly higher incidence of fractures (63.2%) compared to victims with incomplete suspension (31.0%) (χ(2)=6.79; p=.009; Phi=.318). CONCLUSION Several variables contribute to the development of neck structure fractures in hanging. Age is probably the most important one. Other contributing factors are gender, height, weight, BMI and the type of suspension.

Effect of Statins and Anticoagulants on Prostate Cancer Aggressiveness

PURPOSE Statins and anticoagulants (ACs) have both been associated with a less-aggressive prostate cancer (PCa) and a better outcome after treatment of localized PCa. The results of these studies might have been confounded because patients might often take both medications. We examined their respective influence on PCa aggressiveness at initial diagnosis. MATERIALS AND METHODS We analyzed 381 patients treated with either external beam radiotherapy or brachytherapy for low-risk (n = 152), intermediate-risk (n = 142), or high-risk (n = 87) localized PCa. Univariate and multivariate logistic regression analyses were used to investigate an association between these drug classes and prostate cancer aggressiveness. We tested whether the concomitant use of statins and ACs had a different effect than that of either AC or statin use alone. RESULTS Of the 381 patients, 172 (45.1%) were taking statins and 141 (37.0%) ACs; 105 patients (27.6%) used both. On univariate analysis, the statin and AC users were associated with the prostate-specific antigen (PSA) level (p = .017) and National Comprehensive Cancer Network risk group (p = .0022). On multivariate analysis, statin use was associated with a PSA level <10 ng/mL (odds ratio, 2.9; 95% confidence interval, 1.3-6.8; p = .012) and a PSA level >20 ng/mL (odds ratio, 0.29; 95% confidence interval, 0.08-0.83; p = .03). The use of ACs was associated with a PSA level >20 ng/mL (odds ratio, 0.13; 95% confidence interval, 0.02-0.59, p = .02). CONCLUSION Both AC and statins have an effect on PCa aggressiveness, with statins having a more stringent relationship with the PSA level, highlighting the importance of considering statin use in studies of PCa aggressiveness.

Predictive Modeling in Hostage and Barricade Incidents

The study examined 534 hostage and barricade incidents. Its objective was to present an integrated and formalized vision of current conceptualizations of critical incidents to optimize decision making. To this end, logistic regression and recursive partitioning models are presented and compared. In all, 18 distinct static and dynamic individual and situational factors were used to predict various outputs during this type of situation. Results highlight the importance of considering the origin of the emergency call and being barricaded in ones home in the assessment of perpetrators propensity for violence, the fact that time is not always on the polices side during critical incidents, and the relatively minor importance of hostage taking in the general comprehension of these high-risk events.

Agonal sequences in 14 filmed hangings with comments on the role of the type of suspension, ischemic habituation, and ethanol intoxication on the timing of agonal responses.

The Working Group on Human Asphyxia has analyzed 14 filmed hangings: 9 autoerotic accidents, 4 suicides, and 1 homicide. The following sequence of agonal responses was observed: rapid loss of consciousness in 10 ± 3 seconds, mild generalized convulsions in 14 ± 3 seconds, decerebrate rigidity in 19 ± 5 seconds, beginning of deep rhythmic abdominal respiratory movements in 19 ± 5 seconds, decorticate rigidity in 38 ± 15 seconds, loss of muscle tone in 1 minute 17 seconds ± 25 seconds, end of deep abdominal respiratory movements in 1 minute 51 seconds ± 30 seconds, and last muscle movement in 4 minutes 12 seconds ± 2 minutes 29 seconds. The type of suspension and ethanol intoxication does not seem to influence the timing of the agonal responses, whereas ischemic habituation in autoerotic practitioner might decelerate the late responses to hanging.

Can We Do Better? The Assessment of Risk of Recidivism by Adult Sex Offenders

Clinicians have at their disposal a variety of instruments with which to evaluate the risk presented by sex offenders. These measures yield similar predictive potency, and combining them does not appear to enhance prediction. The present study examined whether classification and regression tree analysis could identify new combinations of predictors that would improve predictive validity. Items from seven actuarial instruments were used to construct classification trees. Overall, classification trees achieved slightly higher predictive accuracy than did actuarial instruments. In addition, these analyses highlight the heterogeneity among sex offenders. Despite this improvement, one should consider the incorporation of other predictors into the instruments—including dynamic factors, protective factors, and measures with strong theoretical justification.