Pub Date : 2021-10-21DOI: 10.1080/14999013.2021.1995085
Louis De Page, S. Godinas, P. Titeca
Abstract In Belgium, when forensic patients infringe their conditional release, they are remitted to prison. Given the poor conditions of detention and the current lack of alternatives, revoking conditional releases has a high impact. However, little is known about which patients are remitted to prison and why. In this article, we compared a sample of remitted patients (n = 50) to a matched control group (n = 48). We found that patients with high actuarial risk factors (as assessed by the Violent Risk Appraisal Guide, VRAG), antisocial personality disorder traits (measured by the Comprehensive Assessment of Psychopathic Personality, CAPP), and substance abuse disorder were more likely to be remitted. New acts of violence and substance abuse are the most prevalent reasons for revoking a conditional release, at 71% and 65%, respectively. The current results are independent of living conditions, and highlight the need for future research regarding this subgroup of forensic patients, who are more likely to be set back in their rehabilitative processes.
{"title":"Circumstances Leading to and Characteristics of Belgian Forensic Patients Remitted to Prison","authors":"Louis De Page, S. Godinas, P. Titeca","doi":"10.1080/14999013.2021.1995085","DOIUrl":"https://doi.org/10.1080/14999013.2021.1995085","url":null,"abstract":"Abstract In Belgium, when forensic patients infringe their conditional release, they are remitted to prison. Given the poor conditions of detention and the current lack of alternatives, revoking conditional releases has a high impact. However, little is known about which patients are remitted to prison and why. In this article, we compared a sample of remitted patients (n = 50) to a matched control group (n = 48). We found that patients with high actuarial risk factors (as assessed by the Violent Risk Appraisal Guide, VRAG), antisocial personality disorder traits (measured by the Comprehensive Assessment of Psychopathic Personality, CAPP), and substance abuse disorder were more likely to be remitted. New acts of violence and substance abuse are the most prevalent reasons for revoking a conditional release, at 71% and 65%, respectively. The current results are independent of living conditions, and highlight the need for future research regarding this subgroup of forensic patients, who are more likely to be set back in their rehabilitative processes.","PeriodicalId":14052,"journal":{"name":"International Journal of Forensic Mental Health","volume":"21 1","pages":"298 - 306"},"PeriodicalIF":1.4,"publicationDate":"2021-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43541052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-18DOI: 10.1080/14999013.2021.1983087
Aaron Warner, J. Keenan
Abstract Mentalization Based Treatment (MBT) is offered as a potential treatment for clients with Antisocial Personality Disorder (ASPD), however, research suggests that delivering MBT can often present challenges for clinicians. Furthermore, there is agreement that working with clients with ASPD can significantly impact upon staff wellbeing. This project highlights the challenges experienced by clinicians when delivering an MBT service with adult offending males with ASPD within the community. Interpretative Phenomenological Analysis was conducted following semi-structured interviews with six MBT clinicians. Findings highlight how the challenges of working with clients with ASPD presented a significant threat to clinicians’ professional identity. These challenges were compounded by confusion surrounding the MBT model, lack of support from multidisciplinary staff and insufficient service infrastructure. MBT clinicians’ attempts to overcome these barriers led to them striving and breaching time boundaries, leaving them at risk of burnout. These findings contribute to existing literature surrounding clients with ASPD and provide new insight into implementation barriers when delivering a community based MBT service with this client group.
{"title":"Exploring Clinician Wellbeing within a Mentalization-Based Treatment Service for Adult Offending Males with Antisocial Personality Disorder in the Community","authors":"Aaron Warner, J. Keenan","doi":"10.1080/14999013.2021.1983087","DOIUrl":"https://doi.org/10.1080/14999013.2021.1983087","url":null,"abstract":"Abstract Mentalization Based Treatment (MBT) is offered as a potential treatment for clients with Antisocial Personality Disorder (ASPD), however, research suggests that delivering MBT can often present challenges for clinicians. Furthermore, there is agreement that working with clients with ASPD can significantly impact upon staff wellbeing. This project highlights the challenges experienced by clinicians when delivering an MBT service with adult offending males with ASPD within the community. Interpretative Phenomenological Analysis was conducted following semi-structured interviews with six MBT clinicians. Findings highlight how the challenges of working with clients with ASPD presented a significant threat to clinicians’ professional identity. These challenges were compounded by confusion surrounding the MBT model, lack of support from multidisciplinary staff and insufficient service infrastructure. MBT clinicians’ attempts to overcome these barriers led to them striving and breaching time boundaries, leaving them at risk of burnout. These findings contribute to existing literature surrounding clients with ASPD and provide new insight into implementation barriers when delivering a community based MBT service with this client group.","PeriodicalId":14052,"journal":{"name":"International Journal of Forensic Mental Health","volume":"21 1","pages":"287 - 297"},"PeriodicalIF":1.4,"publicationDate":"2021-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48765555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-13DOI: 10.1080/14999013.2021.1952355
Amanda M. Fanniff, Taylor M. York, Alexandra L. Montena, Kenzie Bohnsack
Abstract Forensic evaluators conduct assessments of individuals with a wide range of sociocultural identities. Although recommendations regarding how to incorporate cultural considerations in forensic evaluations have been published over the past decade, there is no clear consensus on best practices nor is it clear how evaluators interpret and apply the available recommendations. The current survey represents a replication and extension of a previous survey regarding self-reported culturally-informed practices among forensic evaluators. Subjects were forensic mental health professionals (n = 258; 64.7% women, 69.4% PhD or PsyD) recruited through listservs and training events to complete a survey online or by hard copy. Evaluators reported significant challenges in conducting culturally-informed evaluations, including lack of appropriate tests for their examinees, lack of guidelines for their evaluations, lack of colleagues from diverse backgrounds, and lack of relevant research. Evaluators reported engaging in a wide range of culturally-informed practices across all domains, some being nearly universal (e.g., considered cultural context when forming diagnosis). In contrast, other practices were relatively uncommon (e.g., referred the evaluation to another professional with more knowledge/experience regarding examinees with particular identities). Results indicate a need for more research, more practice guidelines, and diversification of the forensic mental health workforce.
{"title":"Current Practices in Incorporating Culture into Forensic Mental Health Assessment: A Survey of Practitioners","authors":"Amanda M. Fanniff, Taylor M. York, Alexandra L. Montena, Kenzie Bohnsack","doi":"10.1080/14999013.2021.1952355","DOIUrl":"https://doi.org/10.1080/14999013.2021.1952355","url":null,"abstract":"Abstract Forensic evaluators conduct assessments of individuals with a wide range of sociocultural identities. Although recommendations regarding how to incorporate cultural considerations in forensic evaluations have been published over the past decade, there is no clear consensus on best practices nor is it clear how evaluators interpret and apply the available recommendations. The current survey represents a replication and extension of a previous survey regarding self-reported culturally-informed practices among forensic evaluators. Subjects were forensic mental health professionals (n = 258; 64.7% women, 69.4% PhD or PsyD) recruited through listservs and training events to complete a survey online or by hard copy. Evaluators reported significant challenges in conducting culturally-informed evaluations, including lack of appropriate tests for their examinees, lack of guidelines for their evaluations, lack of colleagues from diverse backgrounds, and lack of relevant research. Evaluators reported engaging in a wide range of culturally-informed practices across all domains, some being nearly universal (e.g., considered cultural context when forming diagnosis). In contrast, other practices were relatively uncommon (e.g., referred the evaluation to another professional with more knowledge/experience regarding examinees with particular identities). Results indicate a need for more research, more practice guidelines, and diversification of the forensic mental health workforce.","PeriodicalId":14052,"journal":{"name":"International Journal of Forensic Mental Health","volume":"21 1","pages":"146 - 163"},"PeriodicalIF":1.4,"publicationDate":"2021-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44591556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-27DOI: 10.1080/14999013.2021.1973153
Jonathan Bridekirk, E. Ham, Laura C. Ball, Barna Konkolÿ Thege
Abstract Waypoint Centre for Mental Health Care expanded its facility in 2014 to include a new state-of-the-art forensic hospital building, called the Atrium. Prior to moving Waypoint’s forensic programs into the Atrium, the Therapeutic Climate Study (TCS) was launched in order to monitor changes in perceived and objective safety indicators among forensic staff and patients. The present study consisted of a 5-year cross-sectional sequential design, consisting of both survey and hospital administrative data. Across all years of data collection, inpatients ( = 256) reported higher perceived safety when compared to staff ( = 932). However, changes in perceived safety were not linear and only slightly improved for staff over time. Sociodemographic characteristics and perceived recovery measures predicted perceived safety for staff and inpatients, regardless of the move. Male staff reported higher perceived quality of patient-service provider relationships and lower perceived safety, whereas female staff reported higher perceived patient cohesion and higher perceived safety. Both staff and inpatients who perceived the hospital’s principles and practices as more recovery-oriented reported higher perceived safety. Inpatients who have been at the hospital longer reported lower perceived safety, regardless of the move. Hospital administrative data showed the number of incidents in a centralized emergency response system spiked right after the move but eventually tapered off, whereas the rates of violent incidents had increased and remained higher since moving to the new building. Results from this study suggest that staffs’ and inpatients’ sense of safety is determined by multiple factors, of which physical environment seems to play a less central role.
{"title":"Beyond Window Dressing: Does Moving to a New Building Really Shape the Perception of, and Actual Safety on Forensic Inpatient Programs?","authors":"Jonathan Bridekirk, E. Ham, Laura C. Ball, Barna Konkolÿ Thege","doi":"10.1080/14999013.2021.1973153","DOIUrl":"https://doi.org/10.1080/14999013.2021.1973153","url":null,"abstract":"Abstract Waypoint Centre for Mental Health Care expanded its facility in 2014 to include a new state-of-the-art forensic hospital building, called the Atrium. Prior to moving Waypoint’s forensic programs into the Atrium, the Therapeutic Climate Study (TCS) was launched in order to monitor changes in perceived and objective safety indicators among forensic staff and patients. The present study consisted of a 5-year cross-sectional sequential design, consisting of both survey and hospital administrative data. Across all years of data collection, inpatients ( = 256) reported higher perceived safety when compared to staff ( = 932). However, changes in perceived safety were not linear and only slightly improved for staff over time. Sociodemographic characteristics and perceived recovery measures predicted perceived safety for staff and inpatients, regardless of the move. Male staff reported higher perceived quality of patient-service provider relationships and lower perceived safety, whereas female staff reported higher perceived patient cohesion and higher perceived safety. Both staff and inpatients who perceived the hospital’s principles and practices as more recovery-oriented reported higher perceived safety. Inpatients who have been at the hospital longer reported lower perceived safety, regardless of the move. Hospital administrative data showed the number of incidents in a centralized emergency response system spiked right after the move but eventually tapered off, whereas the rates of violent incidents had increased and remained higher since moving to the new building. Results from this study suggest that staffs’ and inpatients’ sense of safety is determined by multiple factors, of which physical environment seems to play a less central role.","PeriodicalId":14052,"journal":{"name":"International Journal of Forensic Mental Health","volume":"21 1","pages":"273 - 286"},"PeriodicalIF":1.4,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42891125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-23DOI: 10.1080/14999013.2021.1972061
Y. Kotelnikova, C. D. Lefebvre, M. Campbell, D. Canales, Catherine Stewart
Abstract To purpose of the current study was to inform system level decision-making about the value of integrating clinically relevant personality information with criminogenic need risk appraisal in justice-involved youth. Using a Canadian sample of youth referred for court-ordered psychological assessments (N = 201, M age=15.62 years; 70% male), we examined the patterns of association and differentiation between youths’ Youth Level of Service/Case Management Inventory (YLS/CMI) criminogenic need/risk profiles with personality profiles derived from the personality scales of the Millon Adolescent Clinical Inventory (MACI, Millon, Millon adolescent clinical inventory. National Computer Systems, 1993). Specifically, latent profile analysis identified four MACI based personality profiles: externalizing, internalizing, dependent/followers, and complex dysregulated personality profiles. These groups varied significantly on YLS/CMI risk-need profiles. Although both externalizing and complex dysregulated sub-types represented higher criminal risk, their intervention needs diverged meaningfully. These results provide insight into the heterogeneity of justice-involved youth and point to the need for system resources that allow for appropriate intervention matching to maximize the goal of recidivism risk reduction in youth.
{"title":"Intersection between Justice-Involved Youth Personality Profiles and Criminal Risk-Need Patterns","authors":"Y. Kotelnikova, C. D. Lefebvre, M. Campbell, D. Canales, Catherine Stewart","doi":"10.1080/14999013.2021.1972061","DOIUrl":"https://doi.org/10.1080/14999013.2021.1972061","url":null,"abstract":"Abstract To purpose of the current study was to inform system level decision-making about the value of integrating clinically relevant personality information with criminogenic need risk appraisal in justice-involved youth. Using a Canadian sample of youth referred for court-ordered psychological assessments (N = 201, M age=15.62 years; 70% male), we examined the patterns of association and differentiation between youths’ Youth Level of Service/Case Management Inventory (YLS/CMI) criminogenic need/risk profiles with personality profiles derived from the personality scales of the Millon Adolescent Clinical Inventory (MACI, Millon, Millon adolescent clinical inventory. National Computer Systems, 1993). Specifically, latent profile analysis identified four MACI based personality profiles: externalizing, internalizing, dependent/followers, and complex dysregulated personality profiles. These groups varied significantly on YLS/CMI risk-need profiles. Although both externalizing and complex dysregulated sub-types represented higher criminal risk, their intervention needs diverged meaningfully. These results provide insight into the heterogeneity of justice-involved youth and point to the need for system resources that allow for appropriate intervention matching to maximize the goal of recidivism risk reduction in youth.","PeriodicalId":14052,"journal":{"name":"International Journal of Forensic Mental Health","volume":"21 1","pages":"256 - 272"},"PeriodicalIF":1.4,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43238476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-09DOI: 10.1080/14999013.2021.1966140
Grant Alan Blake, J. Ogloff, R. Fullam
Abstract Fitness to stand trial (equivalent to competency to stand trial) requires that defendants have a basic understanding of the purpose of the trial and the trial procedures. Little is known, however, about what constitutes a basic factual understanding of the matters. This study developed a legal knowledge survey in which participants were asked to define legal concepts and respond to legal scenarios. They then rated the importance of each component of the fitness to stand trial test to achieving a fair trial. Participants (N = 393; females 69.7%) aged between 18 and 66-years (M = 31.26-years, SD = 11.48-years) from each Australian state and territory completed the online survey. Legal knowledge was high (86.5% correct) and there was no difference between participants on any clinical (e.g., current or past mental illness, neurological conditions), criminological (e.g., criminal history), or demographic variable (e.g., gender, employment, education), except age (curvilinear R2 = .12). Participants under 30-years old used significantly more Americanisms on difficult items compared with participants over 30-years old. On average, participants rated almost every component of the legal test as “extremely important” to a fair trial. The legal knowledge survey had good psychometric properties (Cronbach’s α = .86, interrater reliability ĸ > .80 on most variables, single solution factor analysis). Overall, the results support the presumption underpinning the Australian test for fitness, which is that people possess a basic factual understanding of a trial and trial procedures. Further research should focus on testing knowledge in special populations (e.g., mental illness, dementia, intellectual disability).
{"title":"Knowledge and Opinions of Fitness to Stand Trial Elements in Australia","authors":"Grant Alan Blake, J. Ogloff, R. Fullam","doi":"10.1080/14999013.2021.1966140","DOIUrl":"https://doi.org/10.1080/14999013.2021.1966140","url":null,"abstract":"Abstract Fitness to stand trial (equivalent to competency to stand trial) requires that defendants have a basic understanding of the purpose of the trial and the trial procedures. Little is known, however, about what constitutes a basic factual understanding of the matters. This study developed a legal knowledge survey in which participants were asked to define legal concepts and respond to legal scenarios. They then rated the importance of each component of the fitness to stand trial test to achieving a fair trial. Participants (N = 393; females 69.7%) aged between 18 and 66-years (M = 31.26-years, SD = 11.48-years) from each Australian state and territory completed the online survey. Legal knowledge was high (86.5% correct) and there was no difference between participants on any clinical (e.g., current or past mental illness, neurological conditions), criminological (e.g., criminal history), or demographic variable (e.g., gender, employment, education), except age (curvilinear R2 = .12). Participants under 30-years old used significantly more Americanisms on difficult items compared with participants over 30-years old. On average, participants rated almost every component of the legal test as “extremely important” to a fair trial. The legal knowledge survey had good psychometric properties (Cronbach’s α = .86, interrater reliability ĸ > .80 on most variables, single solution factor analysis). Overall, the results support the presumption underpinning the Australian test for fitness, which is that people possess a basic factual understanding of a trial and trial procedures. Further research should focus on testing knowledge in special populations (e.g., mental illness, dementia, intellectual disability).","PeriodicalId":14052,"journal":{"name":"International Journal of Forensic Mental Health","volume":"21 1","pages":"241 - 255"},"PeriodicalIF":1.4,"publicationDate":"2021-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47859270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-07DOI: 10.1080/14999013.2021.1965267
K. Hipp, M. Kangasniemi
Abstract Pro re nata (PRN, as-needed) medication is commonly used in forensic psychiatric inpatient care, but little is known about the participation of patients in its prescription and administration. This study describes patient participation in PRN medication treatment in forensic psychiatric inpatient care. Data were collected during interviews with 34 inpatients and 19 registered nurses in a Finnish forensic psychiatric hospital. The data underwent inductive content analysis. We found that patient participation in PRN was related to patients’ individual needs and health conditions, and the use of PRN involved private decisions made in the social context of the ward. PRN was an integrated part of daily care, and it involved three stakeholders, namely patients, nurses, and physicians; however, the role of patients in this collaboration was undefined. The administration events for PRN were multiform, and depended on the level of agreement between patients and nurses on the need for PRN. In the future, more attention should be paid to how to motivate patients and provide them with equal opportunities to be involved in the planning of PRN, and to optimize shared decision making so that the expertise of both patients and nurses is utilized in the administration and evaluation of PRN.
{"title":"Patient Participation in Pro Re Nata Medication in Forensic Psychiatric Care: Interview Study with Patients and Nurses","authors":"K. Hipp, M. Kangasniemi","doi":"10.1080/14999013.2021.1965267","DOIUrl":"https://doi.org/10.1080/14999013.2021.1965267","url":null,"abstract":"Abstract Pro re nata (PRN, as-needed) medication is commonly used in forensic psychiatric inpatient care, but little is known about the participation of patients in its prescription and administration. This study describes patient participation in PRN medication treatment in forensic psychiatric inpatient care. Data were collected during interviews with 34 inpatients and 19 registered nurses in a Finnish forensic psychiatric hospital. The data underwent inductive content analysis. We found that patient participation in PRN was related to patients’ individual needs and health conditions, and the use of PRN involved private decisions made in the social context of the ward. PRN was an integrated part of daily care, and it involved three stakeholders, namely patients, nurses, and physicians; however, the role of patients in this collaboration was undefined. The administration events for PRN were multiform, and depended on the level of agreement between patients and nurses on the need for PRN. In the future, more attention should be paid to how to motivate patients and provide them with equal opportunities to be involved in the planning of PRN, and to optimize shared decision making so that the expertise of both patients and nurses is utilized in the administration and evaluation of PRN.","PeriodicalId":14052,"journal":{"name":"International Journal of Forensic Mental Health","volume":"21 1","pages":"228 - 240"},"PeriodicalIF":1.4,"publicationDate":"2021-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46651171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-02DOI: 10.1080/14999013.2021.1953193
R. Whittington, C. Pollak, Alice Keski-Valkama, Andrew Brown, Alina Haines-Delmont, J. Bak, J. Hvidhjelm, R. Almvik, T. Palmstierna
Abstract The Short-Term Assessment of Risk and Treatability (START) is a 20-item structured professional judgment instrument for assessing dynamic risk in mental health services. Much of the START research literature examines the relationship between Strengths and Vulnerabilities sub-scale total scores and various adverse outcomes including violence. This assumes that the two sub-scales have the psychometric property of unidimensionality i.e. all the items cluster together as a measure of a single construct. Such assumed unidimensionality is a necessary condition for any analyses based on scale “total score” and the widespread use of scores summated in this way in research studies may obscure more specific clusters of items within each sub-scale. This multinational study examined START assessments (n = 685) conducted in four forensic services in Scandinavia and the UK using principal component analysis. It was found that all but three Strengths items (Substance Use, Social Support and Material Resources) and all but four Vulnerabilities items (Substance Use, Social Support, Material Resources and Self care) loaded >0.5 on the expected component. This indicates a unidimensional structure underlying the START and provides empirical support from a large multinational sample for the widespread use of summated Strengths and Vulnerabilities scores in forensic psychiatric risk research.
{"title":"Unidimensionality of the Strengths and Vulnerabilities Scales in the Short-Term Assessment of Risk and Treatability (START)","authors":"R. Whittington, C. Pollak, Alice Keski-Valkama, Andrew Brown, Alina Haines-Delmont, J. Bak, J. Hvidhjelm, R. Almvik, T. Palmstierna","doi":"10.1080/14999013.2021.1953193","DOIUrl":"https://doi.org/10.1080/14999013.2021.1953193","url":null,"abstract":"Abstract The Short-Term Assessment of Risk and Treatability (START) is a 20-item structured professional judgment instrument for assessing dynamic risk in mental health services. Much of the START research literature examines the relationship between Strengths and Vulnerabilities sub-scale total scores and various adverse outcomes including violence. This assumes that the two sub-scales have the psychometric property of unidimensionality i.e. all the items cluster together as a measure of a single construct. Such assumed unidimensionality is a necessary condition for any analyses based on scale “total score” and the widespread use of scores summated in this way in research studies may obscure more specific clusters of items within each sub-scale. This multinational study examined START assessments (n = 685) conducted in four forensic services in Scandinavia and the UK using principal component analysis. It was found that all but three Strengths items (Substance Use, Social Support and Material Resources) and all but four Vulnerabilities items (Substance Use, Social Support, Material Resources and Self care) loaded >0.5 on the expected component. This indicates a unidimensional structure underlying the START and provides empirical support from a large multinational sample for the widespread use of summated Strengths and Vulnerabilities scores in forensic psychiatric risk research.","PeriodicalId":14052,"journal":{"name":"International Journal of Forensic Mental Health","volume":"21 1","pages":"175 - 184"},"PeriodicalIF":1.4,"publicationDate":"2021-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14999013.2021.1953193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49345843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-31DOI: 10.1080/14999013.2021.1963016
Lobke H. Keune, V. de Vogel, M. Eisenberg, H. V. van Marle
Abstract Narcissism is a personality construct with grandiose, and vulnerable aspects, that are interconnected through antagonistic characteristics. While antagonism is strongly related to antisocial behavior, the role of narcissism remains underexplored in offender rehabilitation practice. Research in non-forensic samples has already shown promising results in the differential associations for grandiose and vulnerable narcissism in relation to violent and antisocial behavior and treatment responsiveness that could be relevant for offender rehabilitation. To research the meaningfulness of both narcissism aspects for forensic offender rehabilitation practice, we systematically reviewed the electronic literature databases CINAHL EBSCOhost, Cochrane CENTRAL, EMBASE, Medline All Ovid, PsycINFO Ovid, and Web of Science Core Collection. Subsequently, we synthesized the outcome into meaningful data classifications related to the risk of violence in offender populations and treatment responsivity. In total, 14 publications on forensic samples were included. Overall, the findings suggest that grandiose narcissism was strongly related to proactive violence and a low treatment responsiveness. Vulnerable narcissism was associated with reactive aggression, mediated by impulsivity and negative emotions, and with a moderate responsivity level. As such, both narcissism aspects seem relevant for the development of structured and focused treatment plans in offender rehabilitation practice. The implications for offender rehabilitation practice are provided.
摘要自恋是一种具有宏大和脆弱方面的人格建构，这些方面通过对立的特征相互联系。虽然对抗性与反社会行为密切相关，但自恋在罪犯康复实践中的作用仍未得到充分探索。对非法医样本的研究已经表明，在与暴力和反社会行为以及可能与罪犯康复相关的治疗反应相关的浮夸和脆弱自恋之间的差异关联方面，取得了有希望的结果。为了研究自恋两个方面对法医罪犯康复实践的意义，我们系统地回顾了电子文献数据库CINAHL EBSCOhost、Cochrane CENTRAL、EMBASE、Medline All Ovid、PsycINFO Ovid和Web of Science Core Collection。随后，我们将结果合成了与罪犯群体暴力风险和治疗反应性相关的有意义的数据分类。总共收录了14份关于法医样本的出版物。总体而言，研究结果表明，浮夸的自恋与积极的暴力和低治疗反应性密切相关。易受伤害的自恋与反应性攻击有关，由冲动和负面情绪介导，并具有中等的反应水平。因此，自恋的两个方面似乎都与罪犯康复实践中结构化和重点治疗计划的制定有关。提供了对罪犯康复实践的影响。
{"title":"The Meaningfulness of Grandiose and Vulnerable Narcissism in Forensic Mental Health Rehabilitation Practice: A Systematic Review","authors":"Lobke H. Keune, V. de Vogel, M. Eisenberg, H. V. van Marle","doi":"10.1080/14999013.2021.1963016","DOIUrl":"https://doi.org/10.1080/14999013.2021.1963016","url":null,"abstract":"Abstract Narcissism is a personality construct with grandiose, and vulnerable aspects, that are interconnected through antagonistic characteristics. While antagonism is strongly related to antisocial behavior, the role of narcissism remains underexplored in offender rehabilitation practice. Research in non-forensic samples has already shown promising results in the differential associations for grandiose and vulnerable narcissism in relation to violent and antisocial behavior and treatment responsiveness that could be relevant for offender rehabilitation. To research the meaningfulness of both narcissism aspects for forensic offender rehabilitation practice, we systematically reviewed the electronic literature databases CINAHL EBSCOhost, Cochrane CENTRAL, EMBASE, Medline All Ovid, PsycINFO Ovid, and Web of Science Core Collection. Subsequently, we synthesized the outcome into meaningful data classifications related to the risk of violence in offender populations and treatment responsivity. In total, 14 publications on forensic samples were included. Overall, the findings suggest that grandiose narcissism was strongly related to proactive violence and a low treatment responsiveness. Vulnerable narcissism was associated with reactive aggression, mediated by impulsivity and negative emotions, and with a moderate responsivity level. As such, both narcissism aspects seem relevant for the development of structured and focused treatment plans in offender rehabilitation practice. The implications for offender rehabilitation practice are provided.","PeriodicalId":14052,"journal":{"name":"International Journal of Forensic Mental Health","volume":"21 1","pages":"211 - 227"},"PeriodicalIF":1.4,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46220943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-19DOI: 10.1080/14999013.2021.1952356
N. Hilton, E. Ham, S. Hill, Talia Emmanuel, Barna Konkolÿ Thege
Abstract People with mental health disorders face elevated risk of metabolic syndrome (MetS), which increases the risk of serious health problems and premature mortality. Obesity is prevalent among those hospitalized in forensic psychiatric units, and substantial weight gains during hospitalization have been reported. We examined International Diabetes Federation (IDF) criteria and proxy MetS indexes (body mass index [BMI], blood pressure, and waist circumference) in the medical records of 527 men admitted to a forensic hospital, and tested predictors of weight gain during their first year or less in hospital. IDF indexes were documented for 22% of men whereas proxy indexes were documented for 46%. Both suggested similar MetS prevalence: 16% IDF, 17% proxy. Weight gain averaged 1.72 kg per month; BMI, being a smoker, and length of stay were independent predictors. Interventions focusing on these risk factors are advisable in order to support both mental and physical health among individuals admitted to forensic psychiatric services. The proxy MetS indexes offer a rapid screening measure and a promising tool for research studies and clinical practice in the absence of blood test results.
{"title":"Predictors of Weight Gain and Metabolic Indexes among Men Admitted to Forensic Psychiatric Hospital","authors":"N. Hilton, E. Ham, S. Hill, Talia Emmanuel, Barna Konkolÿ Thege","doi":"10.1080/14999013.2021.1952356","DOIUrl":"https://doi.org/10.1080/14999013.2021.1952356","url":null,"abstract":"Abstract People with mental health disorders face elevated risk of metabolic syndrome (MetS), which increases the risk of serious health problems and premature mortality. Obesity is prevalent among those hospitalized in forensic psychiatric units, and substantial weight gains during hospitalization have been reported. We examined International Diabetes Federation (IDF) criteria and proxy MetS indexes (body mass index [BMI], blood pressure, and waist circumference) in the medical records of 527 men admitted to a forensic hospital, and tested predictors of weight gain during their first year or less in hospital. IDF indexes were documented for 22% of men whereas proxy indexes were documented for 46%. Both suggested similar MetS prevalence: 16% IDF, 17% proxy. Weight gain averaged 1.72 kg per month; BMI, being a smoker, and length of stay were independent predictors. Interventions focusing on these risk factors are advisable in order to support both mental and physical health among individuals admitted to forensic psychiatric services. The proxy MetS indexes offer a rapid screening measure and a promising tool for research studies and clinical practice in the absence of blood test results.","PeriodicalId":14052,"journal":{"name":"International Journal of Forensic Mental Health","volume":"21 1","pages":"164 - 174"},"PeriodicalIF":1.4,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14999013.2021.1952356","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47027427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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