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      Migrants With Schizophrenia in Forensic Psychiatric Hospitals Benefit From High-Intensity Second Language Programs

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          Abstract

          Background: As a result of migration, an increasing number of patients in forensic psychiatric hospitals show poor skills in the national language, which can affect their treatment. Improving the second language (L2) of inpatients with schizophrenia may help to enable effective psychotherapy and thus reduce the risk of criminal recidivism and facilitate reintegration into society, for example because of a language-related higher degree of social functioning. For this purpose, a Hessian forensic psychiatric hospital established a ward specialized in L2 acquisition. The ward accommodates up to 21 patients with schizophrenia, who attend an L2 program consisting of 800–900 lessons within 1 year.

          Aims: The study aimed to evaluate whether patients on the specialized ward (experimental group) achieve at least Common European Framework of Reference (CEFR) level A2 in the L2 program. Additionally, it examined whether language acquisition is better among participants in the experimental group than among those on regular wards (control group).

          Methods: Achievements in the L2 were assessed by an L2 test 3 times: at the beginning of the program, after 6 months, and after 1 year. The impact of intelligence on achievements in L2 was evaluated using Raven's Standard Progressive Matrices.

          Results: The experimental group showed significantly better improvement than the control group. Literacy was a significant predictor of improvement in the L2. The majority of the experimental group reached at least CEFR level A2 after 1 year.

          Conclusions: High-intensity L2 programs are an effective way to improve the L2 of inpatients with schizophrenia in forensic psychiatric hospitals.

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          Most cited references36

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          The Brief Symptom Inventory: an introductory report.

          This is an introductory report for the Brief Symptom Inventory (BSI), a brief psychological self-report symptom scale. The BSI was developed from its longer parent instrument, the SCL-90-R, and psychometric evaluation reveals it to be an acceptable short alternative to the complete scale. Both test--retest and internal consistency reliabilities are shown to be very good for the primary symptom dimensions of the BSI, and its correlations with the comparable dimensions of the SCL-90-R are quite high. In terms of validation, high convergence between BSI scales and like dimensions of the MMPI provide good evidence of convergent validity, and factor analytic studies of the internal structure of the scale contribute evidence of construct validity. Several criterion-oriented validity studies have also been completed with this instrument.
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            How Big Is “Big”? Interpreting Effect Sizes in L2 Research

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              The impact of culture and education on non-verbal neuropsychological measurements: a critical review.

              Clinical neuropsychology has frequently considered visuospatial and non-verbal tests to be culturally and educationally fair or at least fairer than verbal tests. This paper reviews the cross-cultural differences in performance on visuoperceptual and visuoconstructional ability tasks and analyzes the impact of education and culture on non-verbal neuropsychological measurements. This paper compares: (1) non-verbal test performance among groups with different educational levels, and the same cultural background (inter-education intra-culture comparison); (2) the test performance among groups with the same educational level and different cultural backgrounds (intra-education inter-culture comparisons). Several studies have demonstrated a strong association between educational level and performance on common non-verbal neuropsychological tests. When neuropsychological test performance in different cultural groups is compared, significant differences are evident. Performance on non-verbal tests such as copying figures, drawing maps or listening to tones can be significantly influenced by the individual's culture. Arguments against the use of some current neuropsychological non-verbal instruments, procedures, and norms in the assessment of diverse educational and cultural groups are discussed and possible solutions to this problem are presented.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                11 August 2021
                2021
                : 12
                : 711836
                Affiliations
                [1] 1Department of Forensic Psychiatry and Psychotherapy, Ulm University , Ulm, Germany
                [2] 2Vitos Clinic for Forensic Psychiatry Hadamar , Hadamar, Germany
                [3] 3Department of Forensic Psychiatry and Psychotherapy II, Hospital of the Landschaftsverband Rheinland, Academic Teaching Hospital of the University of Cologne , Cologne, Germany
                [4] 4Medical Faculty, Institute for the History of Medicine and Medical Ethics, University Hospital, University of Cologne , Cologne, Germany
                [5] 5Chair of Social Philosophy and Ethics in Health Sciences, Department of Medicine, Faculty of Health Sciences, University Witten/Herdecke , Witten, Germany
                Author notes

                Edited by: Birgit Angela Völlm, University of Rostock, Germany

                Reviewed by: Alexander Ian Frederic Simpson, Centre for Addiction and Mental Health (CAMH), Canada; Allan Olavi Seppänen, Helsinki University Central Hospital, Finland

                *Correspondence: Maximilian Lutz maximilian.lutz@ 123456uni-ulm.de

                This article was submitted to Forensic Psychiatry, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2021.711836
                8385231
                a9975a71-f862-4edf-bca6-feacfad3e0e9
                Copyright © 2021 Lutz, Streb, Titze, Büsselmann, Riemat, Prüter-Schwarte and Dudeck.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 19 May 2021
                : 16 July 2021
                Page count
                Figures: 0, Tables: 6, Equations: 0, References: 37, Pages: 9, Words: 7220
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                second language acquisition,schizophrenia,language,forensic psychiatry,language learning,longitudinal

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