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Detaining children: Are we sure we are doing the right things? 拘留儿童:我们确定我们在做正确的事情吗?
IF 1.2 4区 医学 Q3 CRIMINOLOGY & PENOLOGY Pub Date : 2022-08-13 DOI: 10.1002/cbm.2232
Annie Bartlett, Heidi Hales
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引用次数: 0
Forensic Child and Adolescent Mental Health: Looking back, looking around, looking to the future 法医儿童和青少年心理健康:回顾过去,环顾四周,展望未来
IF 1.2 4区 医学 Q3 CRIMINOLOGY & PENOLOGY Pub Date : 2022-08-13 DOI: 10.1002/cbm.2243
Susan Bailey
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引用次数: 1
Social, health and ethnicity correlates of complaints of excessive police force 社会、健康和种族因素与警察力量过度的投诉有关
IF 1.2 4区 医学 Q3 CRIMINOLOGY & PENOLOGY Pub Date : 2022-08-08 DOI: 10.1002/cbm.2255
Sven Smith, Christopher J. Ferguson, Claudia E. San Miguel, Marcus Antonius Ynalvez, Howard Henderson

Background

Following several high-profile police shootings of Black Americans, renewed debate has focused on race as a predictor of police violence. Past research has been inconsistent on this score. Some scholars argue that socioeconomic issues are better predictors of police-related violence than are race and ethnicity.

Aims

To test relationships between complaints of excessive use of police violence and racial/ethnic population demographics, allowing for social and mental health variables.

Methods

We examined records from all 195 municipal police departments in California to identify complaints of excessive force by police and tested for associations between such complaints and health, socio-economic and demographic data from county records, using multivariate analyses.

Results

There was no difference in reporting between communities according to Black or White American residency proportions; communities with more Latino Americans were less likely to complain formally of excessive use of police force. The strongest associate of complaints to police departments that their employees had used excessive force was experiencing mental distress in the community.

Conclusions

Our findings are limited by reliance on complaints to police authorities rather than actual incidence of police use of excessive force and by having to map municipal data on to county data, but the finding that factors other than or in addition to any inherent police problems may contribute to excessive use of force by the police offers new lines for remedying the problem. In particular, our findings suggest that more training for police in recognising and managing mental distress and more provision of mental health experts to work alongside police would be worth evaluating as a next step.

在几起备受瞩目的警察枪杀美国黑人事件之后,关于种族是否预示着警察暴力的争论重新开始。过去的研究在这一点上并不一致。一些学者认为,社会经济问题比种族和民族问题更能预测与警察有关的暴力。目的在考虑到社会和心理健康变量的情况下,检验对警察过度使用暴力的投诉与种族/族裔人口统计之间的关系。方法:我们检查了加州所有195个城市警察部门的记录,以确定警察过度使用武力的投诉,并使用多变量分析测试了这些投诉与县记录中的健康、社会经济和人口统计数据之间的关联。结果美国黑人和白人居住比例在不同社区间的报告没有差异;拉丁裔美国人较多的社区不太可能正式抱怨警察过度使用武力。向警察部门投诉其雇员过度使用武力的最强烈的同伙是在社区中遭受精神痛苦。结论:我们的研究结果受限于对警察当局的投诉,而不是警察过度使用武力的实际发生率,并且必须将市政数据映射到县数据,但是除了任何固有的警察问题之外的其他因素可能导致警察过度使用武力,这一发现为纠正这一问题提供了新的途径。特别是,我们的研究结果表明,下一步值得对警察进行更多的培训,以识别和管理精神痛苦,并提供更多的精神健康专家与警察一起工作。
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引用次数: 1
Responding to neurodiversity in the courtroom: A brief evaluation of environmental accommodations to increase procedural fairness 对法庭神经多样性的回应:对提高程序公平性的环境调整的简要评价
IF 1.2 4区 医学 Q3 CRIMINOLOGY & PENOLOGY Pub Date : 2022-08-05 DOI: 10.1002/cbm.2239
Betony Clasby, Brigit Mirfin-Veitch, Rose Blackett, Sally Kedge, Esther Whitehead

Recent research has highlighted that a high prevalence of young adults who have various forms of neurodivergence come into contact with the criminal justice system. Currently, many courts are not designed to respond to neurological differences often seen in young people who engage with them. The aim of this study was to identify ways to make locality courts more accessible, engaging, and ultimately more responsive to neurodivergence. A panel of neurodivergence specialists reviewed the general district courtroom environment of a new specialised young adult list court in Aotearoa New Zealand to identify potential barriers to accessibility and to highlight areas for improvement. The methodology involved naturalistic observation of a typical morning in the courtroom. We identified a series of recommendations with the potential to improve the court experience and increase access to justice for neurodivergent young adults. This study identified specific need for neurodiversity education and screening within the court environment.

最近的研究强调,有各种形式的神经分化的年轻人与刑事司法系统接触的比例很高。目前,许多法庭的设计并不是为了应对经常在与他们接触的年轻人身上看到的神经系统差异。本研究的目的是确定如何使地方法院更容易获得,参与,并最终对神经分化更敏感。一个由神经分化专家组成的小组审查了新西兰奥特罗阿一个新的专门青年名单法院的一般地区法庭环境,以确定妨碍无障碍的潜在障碍,并强调需要改进的领域。该方法涉及对法庭上一个典型早晨的自然观察。我们确定了一系列建议,这些建议有可能改善法庭经验,增加神经分化年轻人诉诸司法的机会。本研究确定了法庭环境中神经多样性教育和筛选的具体需求。
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引用次数: 2
Adverse childhood experiences are important but not the only risk to child development: Revisiting a full risk/resilience matrix 不良的童年经历是重要的,但不是儿童发展的唯一风险:重新审视一个完整的风险/弹性矩阵
IF 1.2 4区 医学 Q3 CRIMINOLOGY & PENOLOGY Pub Date : 2022-07-01 DOI: 10.1002/cbm.2238
Carole Sutton

Much research has sought to distinguish key interacting factors affecting children as they develop which influence later outcomes. Some factors, notably adverse childhood experiences (ACEs), pose serious risks for later health or mental health problems for the children or predispose them for involvement in offending behaviours. However, other experiences, alongside ACEs, also pose risks and yet others offer protection. A matrix showing interacting influences from the mother's pregnancy onwards was published earlier; a revised matrix has been developed, showing a fresh picture of cumulative risk and protective factors.

许多研究试图区分影响儿童成长的关键相互作用因素,这些因素会影响儿童后来的成就。有些因素,特别是不良的童年经历,对儿童日后的健康或精神健康问题构成严重风险,或使他们容易参与犯罪行为。然而,除了ace之外,其他经历也会带来风险,但也会提供保护。早些时候发表了一个矩阵,显示了母亲怀孕以来的相互影响;已经编制了一个订正的矩阵,显示了累积风险和保护因素的新情况。
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引用次数: 1
Psychometric characteristics of the Dutch Personality Assessment Scale in Papiamento-speaking prisoners 说帕皮亚门托语囚犯荷兰人格评估量表的心理测量特征
IF 1.2 4区 医学 Q3 CRIMINOLOGY & PENOLOGY Pub Date : 2022-06-25 DOI: 10.1002/cbm.2253
Micha van de Vorst, Frans G. M. Heijtel, Glenn M. Matroos, David J. Vinkers

Background

Although personality disorders are common among offenders, there is no validated translated questionnaire for the assessment of personality disorders in Papiamento, a Portuguese-Spanish influenced creole language, which is widely spoken on the former Dutch Antilles.

Aim

To evaluate the Dutch Personality Scale as translated into Papiamento in the prison of Bonaire.

Methods

The Dutch Personality Assessment Scale was translated into Papiamento by two independent experts and retranslated back into Dutch by two other fully bilingual and independent experts. Twenty-four Papiamento-speaking prisoners agreed to participate in the study.

Results

There was good agreement on translation of the assessment items. The prisoner participants reported no difficulties in answering the questions. The internal consistency was acceptable for the seven subscales except for ‘egoism’ (α 0.21) and very good for ‘inadequacy’ and ‘social inadequacy’ (0.88 and 0.82 respectively). The scores of neuroticism, rigidity, egoism and dominance were higher than in the general Dutch population.

Conclusion

Translation of the Dutch Personality Scale into the creole language Papiamento proved feasible. The cross-cultural translation and validation of personality assessment scales may be helpful in assessment of personality disorders in offenders speaking creole languages.

虽然人格障碍在罪犯中很常见,但在前荷属安的列斯群岛广泛使用的葡萄牙-西班牙影响的克里奥尔语帕皮亚门托语中,没有有效的翻译问卷来评估人格障碍。目的评价博内尔监狱中译为帕皮亚门托语的荷兰人格量表。方法由两名独立专家将荷兰语人格评估量表翻译成帕皮亚门托语,并由另外两名完全双语独立专家重新翻译回荷兰语。24名说帕皮亚门托语的囚犯同意参加这项研究。结果各评价项目的翻译结果一致。囚犯参与者报告说回答问题没有困难。除“自我主义”外,七个分量表的内部一致性均为可接受的(α 0.21),“不足”和“社会不足”的内部一致性均为良好(α 0.88和0.82)。神经质、僵化、利己主义和支配性的得分高于一般荷兰人。结论将荷兰语人格量表翻译成克里奥尔语是可行的。人格评估量表的跨文化翻译和验证可能有助于评估克里奥尔语罪犯的人格障碍。
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引用次数: 0
Misuse of prescribed psychotropic medication and drug crime offending: A follow-up case-control study of former adolescent psychiatric inpatients 精神药物处方滥用与毒品犯罪:前青少年精神科住院患者的病例-对照随访研究
IF 1.2 4区 医学 Q3 CRIMINOLOGY & PENOLOGY Pub Date : 2022-06-23 DOI: 10.1002/cbm.2254
Mikaela Kontu, Liisa Kantojärvi, Helinä Hakko, Kaisa Riala, Pirkko Riipinen

Background

Various psychotropic prescription drugs are known to have potential for misuse. Among teenagers, non-medical use of prescription drugs may predate illicit drug use or occur concomitantly.

Aims

Our aim was to examine prescriptions of psychotropic medications among drug crime offenders and non-criminal controls in a psychiatric inpatient cohort of 13–17-year-olds. Our research question was: were prescribed psychotropic and potentially addictive drugs associated with later drug crime offending.

Methods

Our sample was of all 60 adolescents who had been convicted of a drug crime by young adulthood with a twice-sized control group, matched for gender, age and family-type, from a cohort of 508 adolescents consecutively admitted to a psychiatric inpatient care in Finland between April 2001 and March 2006. Adolescence-related information on substance use and psychiatric disorders was obtained by semi-structured interviews. Follow-up information on crimes and medication purchases was obtained from Finnish nationwide registers. The association of studied factors to drug crime offending was examined using stepwise binary logistic regression analysis.

Results

75% of drug crime offenders and 47% of non-criminal controls had used addictive psychotropic medications during the follow-up period (p < 0.001). 74% of all drug crime offenders' purchases of prescribed addictive drugs occurred within the year preceding drug crimes. Of addictive drugs, the use of clonazepam and gabapentinoids was most likely to associate with drug crime offending (AOR 7.77, p < 0.001). Conduct and substance use disorders diagnosed in adolescence (AOR 3.49, p = 0.010; AOR 2.34, p = 0.050) were predictors for drug crime offending.

Conclusions

Our findings suggest that, when treating young adults with conduct disorder and a history of substance use, physicians should prescribe addictive medications with caution, favouring instead non-addictive medications complemented by psychosocial interventions.

背景:各种精神处方药都有被滥用的可能。在青少年中,处方药物的非医疗使用可能先于非法药物使用或同时发生。目的我们的目的是检查在13 - 17岁的精神病住院患者队列中,毒品犯罪罪犯和非犯罪对照的精神药物处方。我们的研究问题是:处方的精神药物和潜在成瘾性药物是否与后来的毒品犯罪有关。方法我们的样本是在2001年4月至2006年3月期间在芬兰精神科住院治疗的508名青少年中,所有60名在成年前被判犯有毒品犯罪的青少年和一个两倍大小的对照组,其性别、年龄和家庭类型相匹配。青少年有关物质使用和精神障碍的信息是通过半结构化访谈获得的。从芬兰全国登记册获得了关于犯罪和药品购买的后续信息。采用逐步二元logistic回归分析,对研究因素与吸毒犯罪的关系进行检验。结果在随访期间,75%的毒品犯罪者和47%的非犯罪对照者使用过精神药物成瘾性药物(p <0.001)。74%的毒品罪犯在毒品犯罪前一年购买处方成瘾性药物。在成瘾性药物中,氯硝西泮和加巴喷丁类药物的使用最有可能与毒品犯罪有关(AOR 7.77, p <0.001)。青少年行为和物质使用障碍诊断(AOR 3.49, p = 0.010;AOR为2.34,p = 0.050)是毒品犯罪的预测因子。结论:我们的研究结果表明,在治疗有行为障碍和药物使用史的年轻人时,医生应该谨慎开成瘾性药物,而不是倾向于非成瘾性药物,辅以社会心理干预。
{"title":"Misuse of prescribed psychotropic medication and drug crime offending: A follow-up case-control study of former adolescent psychiatric inpatients","authors":"Mikaela Kontu,&nbsp;Liisa Kantojärvi,&nbsp;Helinä Hakko,&nbsp;Kaisa Riala,&nbsp;Pirkko Riipinen","doi":"10.1002/cbm.2254","DOIUrl":"10.1002/cbm.2254","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Various psychotropic prescription drugs are known to have potential for misuse. Among teenagers, non-medical use of prescription drugs may predate illicit drug use or occur concomitantly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Our aim was to examine prescriptions of psychotropic medications among drug crime offenders and non-criminal controls in a psychiatric inpatient cohort of 13–17-year-olds. Our research question was: were prescribed psychotropic and potentially addictive drugs associated with later drug crime offending.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our sample was of all 60 adolescents who had been convicted of a drug crime by young adulthood with a twice-sized control group, matched for gender, age and family-type, from a cohort of 508 adolescents consecutively admitted to a psychiatric inpatient care in Finland between April 2001 and March 2006. Adolescence-related information on substance use and psychiatric disorders was obtained by semi-structured interviews. Follow-up information on crimes and medication purchases was obtained from Finnish nationwide registers. The association of studied factors to drug crime offending was examined using stepwise binary logistic regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>75% of drug crime offenders and 47% of non-criminal controls had used addictive psychotropic medications during the follow-up period (<i>p</i> &lt; 0.001). 74% of all drug crime offenders' purchases of prescribed addictive drugs occurred within the year preceding drug crimes. Of addictive drugs, the use of clonazepam and gabapentinoids was most likely to associate with drug crime offending (AOR 7.77, <i>p</i> &lt; 0.001). Conduct and substance use disorders diagnosed in adolescence (AOR 3.49, <i>p</i> = 0.010; AOR 2.34, <i>p</i> = 0.050) were predictors for drug crime offending.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that, when treating young adults with conduct disorder and a history of substance use, physicians should prescribe addictive medications with caution, favouring instead non-addictive medications complemented by psychosocial interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47362,"journal":{"name":"Criminal Behaviour and Mental Health","volume":"32 2","pages":"124-137"},"PeriodicalIF":1.2,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/3e/CBM-32-124.PMC9327718.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40239914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Triarchic psychopathic traits versus self-control: Comparing associations with youth antisocial outcomes 三型精神病特征与自我控制:与青少年反社会结果的比较
IF 1.2 4区 医学 Q3 CRIMINOLOGY & PENOLOGY Pub Date : 2022-06-20 DOI: 10.1002/cbm.2252
Pedro Pechorro, Rui Abrunhosa Gonçalves, Ricardo Barroso, Jorge Quintas, Matt DeLisi

Background

Psychopathy and low self-control are useful constructs for understanding antisociality/criminality. The triarchic model of psychopathy in particular is a recent and promising conceptualisation, composed of boldness, disinhibition, and meanness - three personality traits that have never been studied in tandem with low self-control.

Aims

To test relationships between the triarchic personality traits of boldness, disinhibition and meanness and low self-control with delinquent or antisocial acts.

Methods

In a cross-sectional, self-report study a schools' cohort of 14- to 18-year-olds (Mean 15.91 years, SD = 0.99 years) was recruited from regions in South Portugal and Lisbon, representative of the general population of this age in sex distribution and education. After parental consent, teenage volunteers in small groups completed psychopathy and self-control self-rating scales and then a questionnaire about their criminal or delinquent activities, all on one single occasion and in confidence from school staff or parents. Path analysis was used to test relationships.

Results

567 young people, 256 (45%) of them girls, completed all ratings, 89% of those invited to do so. Low self-control had the strongest relationship with antisocial/criminal acts, followed by the disinhibition or meanness traits of the triarchic psychopathy construct. The boldness trait of the triarchic psychopathy construct had the weakest relationship.

Conclusions

Our findings suggest that the most effective targets for intervention to prevent or limit antisocial behaviours by young people are likely to be self-control and disinhibition. Behavioural interventions that improve social skills and verbal problem-solving that encourage listening and waiting in response to environmental stimuli are likely to effect reduction of impulsive and aggressive reactions to others and so reduce conduct problems. Since disinhibition and self-control are such overlapping constructs, improvements in one area will generally facilitate improvements in the other area.

背景精神病和低自制力是理解反社会/犯罪的有用概念。精神病的三重模型是最近出现的一个很有前途的概念,它由大胆、去抑制和卑鄙组成——这三种人格特征从未与低自制力一起被研究过。目的探讨大胆、去抑制、卑劣、低自控等人格特征与青少年犯罪、反社会行为的关系。方法在一项横断面自我报告研究中,从葡萄牙南部和里斯本地区招募了14- 18岁(平均15.91岁,SD = 0.99岁)的学校队列,在性别分布和教育程度上代表了该年龄段的一般人群。在父母同意后,青少年志愿者小组完成了精神病和自我控制自我评定量表,然后在学校工作人员或家长的保密下完成了一份关于他们犯罪或不良行为的调查问卷。通径分析用于检验关系。结果567名年轻人完成了所有评分,其中256名(45%)是女孩,89%的人被邀请完成了评分。低自我控制与反社会/犯罪行为的关系最强,其次是三型精神病建构的去抑制或卑鄙特征。三型精神病构念的大胆特质关系最弱。结论:预防或限制青少年反社会行为最有效的干预目标可能是自我控制和解除抑制。提高社交技能和语言解决问题的行为干预措施,鼓励倾听和等待,以应对环境刺激,可能会减少对他人的冲动和攻击性反应,从而减少行为问题。由于去抑制和自我控制是如此重叠的结构,一个领域的改善通常会促进另一个领域的改善。
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引用次数: 2
Exploring substance use as rule-violating behaviour during inpatient treatment of offender patients with schizophrenia 探讨精神分裂症患者住院治疗过程中药物使用的违规行为
IF 1.2 4区 医学 Q3 CRIMINOLOGY & PENOLOGY Pub Date : 2022-06-17 DOI: 10.1002/cbm.2245
Martina Sonnweber, Johannes Kirchebner, Moritz Philipp Günther, Johannes Rene Kappes, Steffen Lau

Background

Rule-violating behaviour in the form of substance misuse has been studied primarily within the context of prison settings, but not in forensic psychiatric settings.

Aims

Our aim was to explore factors that are associated with substance misuse during hospitalisation in patients among those patients in a Swiss forensic psychiatric inpatient unit who were suffering from a disorder along the schizophrenia spectrum.

Methods

From a database of demographic, clinical and offending data on all residents at any time between 1982 and 2016 in the forensic psychiatric hospital in Zurich, 364 cases fulfilled diagnostic criteria for schizophrenia or a schizophrenia-like illness and formed our sample. Any confirmed use of alcohol or illicit substances during admission (yes/no) was the dependent variable. Its relationship to all 507 other variables was explored by machine learning. To counteract overfitting, data were divided into training and validation set. The best model from the training set was tested on the validation set.

Results

Substance use as a secure hospital inpatient was unusual (15, 14%). Prior substance use disorder accounted for so much of the variance (AUC 0.92) that it was noted but excluded from further models. In the resulting model of best fit, variables related to rule breaking, younger age overall and at onset of schizophrenia and nature of offending behaviour, substance misuse as a minor and having records of complications in prior psychiatric treatment were associated with substance misuse during hospitalisation, as was length of inpatient treatment. In the initial model the AUC was 0.92. Even after removal of substance use disorder from the final model, performance indicators were meaningful with a balanced accuracy of 67.95, an AUC of 0.735, a sensitivity of 81.48% and a specificity of 57.58%.

Conclusions

Substance misuse in secure forensic psychiatric hospitals is unusual but worthy of clinical and research consideration because of its association with other rule violations and longer hospitalisation. More knowledge is needed about effective interventions and rehabilitation for this group.

以药物滥用为形式的违反规则行为主要是在监狱环境中进行研究,而不是在法医精神病学环境中进行研究。我们的目的是探索在瑞士法医精神科住院病房中患有精神分裂症谱系障碍的患者住院期间与药物滥用相关的因素。方法从1982年至2016年苏黎世法医精神病院所有住院患者的人口学、临床和犯罪数据数据库中,选出364例符合精神分裂症或精神分裂症样疾病诊断标准的患者作为样本。入院期间任何确认使用酒精或非法物质(是/否)是因变量。它与所有507个其他变量的关系是通过机器学习来探索的。为了防止过拟合,将数据分为训练集和验证集。在验证集上对训练集中的最佳模型进行测试。结果作为安全住院患者的药物使用不常见(15.14%)。先前的物质使用障碍占了很大的方差(AUC 0.92),因此它被注意到了,但被排除在进一步的模型之外。在得到的最佳拟合模型中,与违反规则、总体年龄更小、精神分裂症发病年龄和犯罪行为的性质、未成年人滥用药物以及在先前的精神治疗中有并发症记录等相关的变量与住院期间的药物滥用有关,住院治疗时间也与药物滥用有关。初始模型的AUC为0.92。即使在最终模型中去除物质使用障碍后,性能指标仍具有意义,平衡精度为67.95,AUC为0.735,灵敏度为81.48%,特异性为57.58%。结论:在安全的法医精神病院中,药物滥用是不寻常的,但值得临床和研究考虑,因为它与其他违反规则和住院时间较长有关。对这一群体的有效干预和康复需要更多的知识。
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引用次数: 4
The all-Wales forensic adolescent consultation and treatment service (FACTS): A 5-year referral cohort study 全威尔士法医青少年咨询和治疗服务(FACTS):一项为期5年的转诊队列研究
IF 1.2 4区 医学 Q3 CRIMINOLOGY & PENOLOGY Pub Date : 2022-06-16 DOI: 10.1002/cbm.2244
Natasha Kalebic, Sarah Argent, Harry Austin, Lachlan Bramley, Gwen O’Connor, Caroline Hoskins, Abigail Willis, Julie Withecomb, Andrew Forrester, Peter Morgan, Pamela J. Taylor

Background

FACTS is a Wales-wide mental health service for 10–17-year-olds with needs beyond the remit of mainstream child and adolescent mental health services (CAMHS). As a purely consultation-liaison service, it differs from other UK services in the field.

Aims

To describe a complete cohort of referrals to FACTS 2013–2017 with service exit by June 2018.

Methods

Clinical, social and offending data were extracted from FACTS records.

Results

80 young people completed a FACTS episode, averaging nearly a year (309 days; range 13–859 days). Mostly boys (65, 81%) of mean age 15.4 years (range 9–18), two-thirds (n = 53) had three or more referral reasons, one invariably being threatened/actual harm to others; only half were criminal-justice involved. Half (41, 51%) were committing sexually harmful acts. Half were self-harming (41, 51%). All but seven had had at least one adverse childhood experience (ACE), nearly half (35, 44%) four or more. Nevertheless, post-traumatic stress disorder (PTSD) was rarely diagnosed (7, 9%); just over one-quarter (23, 29%) had no diagnosis at all. Correspondence analyses endorsed two distinct Attention deficit hyperactivity disorder groups, distinguished by presence/absence of evidenced brain damage or dysfunction. Suicide-related behaviours clustered with the other diagnoses, flashbacks and psychotic symptoms with no diagnosis. Change in home circumstances during a FACTS episode was slight.

Conclusions

The complexity of presenting problems and service involvement evidences need for FACTS. The extent of persistently harmful sexual behaviours is a novel finding, suggesting need for more expert input for this at other service levels. Rarity of PTSD diagnoses was surprising given the extent of ACEs. This raises concerns that services focus on disorder signs rather than the child's inner life. Given the extent of problems, minimal change may be a positive outcome – especially when remaining in the community. Further development of this service should include explicit case-by-case goals and indicative outcome markers.

FACTS是威尔士范围内的一项心理健康服务,服务对象是10 - 17岁的青少年,他们的需求超出了主流儿童和青少年心理健康服务(CAMHS)的范围。作为一种纯粹的咨询联络服务,它不同于英国在该领域的其他服务。目的描述一个完整的队列转介到FACTS 2013-2017服务退出2018年6月。方法从FACTS病历中提取临床、社会和犯罪资料。结果80名年轻人完成了一次FACTS,平均近一年(309天;范围13-859天)。大多数是男孩(65,81%),平均年龄15.4岁(范围9-18岁),三分之二(n = 53)有三个或更多的转诊原因,其中一个总是受到威胁/对他人造成实际伤害;只有一半涉及刑事司法。其中一半(41.51%)有性伤害行为。其中一半是自残(41.51%)。除7人外,所有人都至少有过一次不良童年经历(ACE),近一半(35,44%)有过四次或更多。然而,创伤后应激障碍(PTSD)很少被诊断出来(7.9%);超过四分之一(23.29%)的人根本没有诊断。对应分析支持两种不同的注意缺陷多动障碍组,通过存在/不存在证据证明的脑损伤或功能障碍来区分。自杀相关行为与其他诊断、闪回和没有诊断的精神病症状聚集在一起。在《事实》节目中,家庭环境的变化很小。结论提出问题的复杂性和服务介入证据需要FACTS。持续有害的性行为的程度是一个新的发现,这表明在其他服务水平上需要更多的专家投入。考虑到ace的严重程度,PTSD诊断的罕见程度令人惊讶。这引起了人们的担忧,即服务的重点是紊乱的迹象,而不是孩子的内心生活。考虑到问题的严重程度,微小的改变可能是一个积极的结果——尤其是在社区中。这项服务的进一步发展应包括明确的个案目标和指示性结果标记。
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Criminal Behaviour and Mental Health
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