Evaluation of the improving access to psychological therapies for offenders programme at HMP Lincoln: a three year prospective cohort study

The mental health needs of prisoners are significant with a high incidence of common mental health problems including anxiety and depression. Extending national initiatives such as the National Health Service Improving Access of Psychological Therapies programme to people in prison offers a valuable opportunity to address these mental health problems and improve continuity of care from prison to the community. This study adopts an observational, prospective cohort design and evaluates an IAPT for offenders service over the first three years of operation within a male Category B prison holding remand/convicted prisoners. The evaluation found large effect sizes for changes in anxiety and depression with clinical recovery being achieved in 55% of depression and 52% of anxiety cases. On average, prisoners were treated in less than five sessions employing a low-intensity cognitive-behavioural approach. The lack of established formal diagnoses and a control group limits the findings.     

Investigation of a typology of alcohol‐related violence defined by ultimate goals

Purpose. Alcohol‐related violence is a serious problem and treatments for high‐risk individuals need to be developed. Classification helps to route people into appropriate treatments. Drawing on animal research, we define alcohol‐related violence in relation to ultimate goals. We propose three types of violence: (1) violence in the pursuit of material goals, (2) violence in pursuit of social dominance goals, and (3) violence as defence in response to threat. The aim is to explore factors that we expect to relate to this tripartite typology, with the aim of providing a preliminary validation. Method. Participants were 149 young male prisoners who had committed an offence of violence that was alcohol related. Semi‐structured interviews elicited information about the offence that enabled classification into one of the three types. Differences between groups were examined at the event level – level of violence during the offence and alcohol consumption before the offence – and at group level – trait aggression, trait anxiety, anger control, and alcohol–aggression outcome expectancies. Results. No differences were found in levels of violence or alcohol consumption. Those whose violence was in the pursuit of material goals were high on trait aggression, trait anger, trait anxiety, and anger suppression. Those who used violence in the pursuit of social dominance showed high trait aggression and trait anger. Those whose violence was a defence in response to threat showed lower trait aggression and trait anger. Conclusion. The findings are discussed in relation to differential group profiles and treatment needs.     

Social problem solving,anxiety, and depression in adult male prisoners

Objectives. Social problem‐solving ability has been identified as a significant mediator between stressful life‐events and psychological distress in community samples. This study examined the relationships between social problem solving, anxiety, and depression in adult male prisoners. The hypothesis was that a negative problem orientation (NPO) would be the strongest predictor of anxiety and depression. Methods. Participants (N=68) completed the Social Problem‐Solving Inventory–Revised: Short Version (SPSI‐R:S) and the Hospital Anxiety and Depression Scale (HADS). Results. NPO was found to be the sole predictor of anxiety and depression. Conclusion. NPO includes feelings of nervousness, threat, and fear in response to problems. In a prison setting, this may serve to protect the individual against conflict with and abuse by dominant others. However, high levels of fear and anxiety may be disabling both for coping with imprisonment and for effective participation in rehabilitation programmes. While this raises issues regarding prison cultures and the damage imprisonment may cause to individuals, it also indicates that interventions to assist some prisoners to cope are required.     

Prevalence of mental disorders and deliberate self-harm in Greek male prisoners

The aim of this survey was to determine the prevalence of current and lifetime mental disorder and deliberate self-harm among male prisoners in Greece. The subjects were 80 randomly selected remanded and sentenced prisoners in a Greek prison. They were assessed for mental disorder including suicidality and substance misuse using the Mini International Neuropsychiatric Interview (MINI). We also collected information regarding contact with psychiatric services, previous deliberate self-harm as well as physical health and conducted a brief assessment of their intellectual functioning. Mental disorder was diagnosed in 63 (78.7%) prisoners. The main diagnoses were: anxiety disorder, 30 (37.5%); major depression, 22 (27.5%); antisocial personality disorder, 30 (37.5%); alcohol dependence, 21 (26.3%) and opiate dependence 22 (27.5%) and schizophrenic or bipolar disorder 9 (11.2%). Deliberate self-harm prior to and during imprisonment was reported by 15% and 2.5% of prisoners, respectively, and 12 prisoners (15%) had IQ below 75. This survey identified a significant level of need for specialist mental health services in prison. Further studies are required to assess the specific needs of those patients who are too unwell to remain in prison, the need for specific treatments for substance misuse and improved assessment/treatment of common psychiatric disorders.     

The relationship between aggressive behaviour in prison and violent offending following release

Aggression during incarceration impacts on parole release decisions. However, research examining the link between aggressive behaviour in custody and violence post-release is limited, particularly in relation to adult violent offenders. Several factors complicate the use of institutional aggression as a marker of risk for future violence, including environmental causes of aggressive behaviour and adaptation to prison. This study explored the association between aggressive behaviour in prison and violent recidivism post-release in a sample of 148 adult male violent offenders. Prisoners with three or more aggressive incidents recorded in prison incurred a violent charge more often and sooner after release than those with no aggressive incidents, when controlling for age, ethnicity, length of incarceration and risk for future violence. Subjects with one or two aggressive incidents were not at increased risk of violent recidivism. These findings suggest that institutional aggression can be used to identify individuals at risk of violence following release but only when repeated aggressive behaviour is evident. Importantly, some prisoners who were not aggressive in prison were charged with violent offences post-release and some prisoners with three or more aggressive incidents were not violent following release, highlighting the complexity of using in-prison aggression as a marker for violent recidivism.     

监所在押人员的心理障碍研究

监所在押人员的心理障碍是指在被羁押事件的刺激作用下,个体在其认知因素的影响下表现出明显的心理困扰,如抑郁、焦虑、恐惧和愤怒等。而要克服在押人员的心理障碍就要改变其不合理的观念,对羁押事件进行建设性归因,改变其认知失调状态等,从而提高监所在押人员的心理适应性。     

Female prisoners' understanding of ‘bullying’ and their methods of coping: a multinational perspective

Abstract

Whilst prison bullying is a well-researched form of aggressive behaviour, recent studies have suggested that there may be discrepancy between how prisoners and researchers understand the term ‘bullying’. Interviews with 26 female prisoners were subject to constant comparison framework analysis. More than 150 themes were identified. These suggested that whilst there is overall agreement between prisoners and researchers as to what behaviours constitute bullying, a consensus does not exist within the prisoner population. Behaviours identified as bullying behaviours by prisoners are also reported as methods of coping. Cultural differences in behaviour and how these relate to perceptions of aggression were identified by the women prisoners. The findings of this study have implications for researching bullying in institutions such as prisons, and for managing and intervening with bullies in prisons.     

Early detection and early intervention in prison: improving outcomes and reducing prison returns

Our aim was to investigate whether early detection was feasible in prison and whether it could improve mental health outcomes in young prisoners. A secondary aim was to explore whether it can reduce returns to prison. Between 2011 and 2014, a total of 2115 young prisoners were screened, 94 (4.4%) met criteria for ultra-high risk for psychosis and were offered an intervention, 52 actually received it. Return to prison data were sought on the 52 participants, receiving a formal intervention. Of the 52 prisoners who received an intervention, 30.8% returned to custody compared to national average reconviction rates of between 45.4 and 66.5%. Our results suggest that early detection is a feasible option in a prison setting, improving mental health outcomes and reducing returns to prison. Mental health outcomes were recorded for a sub-sample of those receiving the intervention. The results indicated statistically significant improvements on measures of depression, anxiety and psychological distress.     

Social anxiety as a predictor of dating aggression

By far, most research on the behavior of socially anxious individuals has focused on the "flight" rather than the "fight" response described in the traditional conceptualization of anxiety. More recently, however, there has been some speculation and emerging evidence suggesting that social anxiety and aggression may be related. The present study examined social anxiety as a predictor of dating aggression within a late adolescent sample. Two forms of dating aggression were assessed: physical aggression, such as slapping, use of a weapon, or forced sexual activity, and psychological aggression, such as slamming doors, insulting, or refusing to talk to one's partner. One aspect of social anxiety, Fear of Negative Evaluation (FNE), emerged as a significant predictor of male dating aggression, even after controlling for relationship quality. Notably, FNE was most predictive of increased aggression of both types when men also perceived their romantic relationship to be more antagonistic. Despite its demonstrated importance as a contextual variable, however, relationship quality did not mediate the association between FNE and psychological or physical aggression. Implications for prevailing conceptualizations of social anxiety and dating aggression are discussed.     

Individual differences in young offender emotional behaviour

Purpose. Recent research into adolescent emotional behaviour has confirmed a three‐factor structure for emotional style in samples of children and adolescents, ranging in age from nine to nineteen years ( Clarbour & Roger, 2004 ). This study was aimed at replicating the factor structure for the Emotional Behaviour Scale (EBS) amongst young offenders, and investigating the role of the factors in offender behaviour. Method. Both exploratory and confirmatory factor analyses were used to compare the responses of 307 male young offenders to those of 294 schoolchildren. A subsample of 264 offenders additionally completed indices of offending behaviour that were used for further validation of the EBS amongst young offenders. Results and conclusions. The three emotional style factors obtained for schoolchildren – social anxiety, malevolent aggression and social self‐esteem – were confirmed in the young offender sample. Lower scores on malevolent aggression, and higher scores on social anxiety and social self‐esteem, were significantly associated with later first police contact. High malevolent aggression and lower social anxiety were also significantly associated with placement on Governor's report, and high malevolent aggression was associated with violent offence types. The three scales were also found to relate systematically and predictably to a range of other personality and emotional style scales.     

Officer attitudes towards intra-group aggression in young people and young adults: does the reported motivation of an aggressor impact on intervention and support?

The present study aims to assess whether global and context specific attitudes influence the ability to correctly identify the motivation for aggression and selection of appropriate intervention strategies. A sample of 105 prison officers completed a measure assessing global attitudes towards prisoners, one assessing context specific attitudes towards aggression, and also a case vignette. Officers were asked to consider the motivation for aggression and to select an appropriate intervention. It was predicted that sex, age and level of experience would impact on global and context specific attitudes. Officers expressing positive global attitudes and non-aggressive context specific attitudes were expected to be more able to identify the motivation for aggression and more likely to adopt a rehabilitative approach. There was evidence to indicate sex differences in global and context specific attitudes but no impact of age. Level of experience of aggression impacted both on global and context specific attitudes. Global or context specific attitudes did not influence the ability to interpret aggression, but aggression type did. Limitations and directions for future research are discussed.     

Impulsivity,attribution and prison bullying: Bully-category and perpetrator–victim mutuality

The current study explores bullying behaviours among adult male prisoners, examining its relationship with aggression attribution and impulsivity. Employed are two separate methods of analysis to determine how this may influence results. Participants were 102 prisoners. All completed a revised version of the Direct and Indirect Prisoner behaviour Checklist (DIPC-R), the Barratt Impulsivity Scale: Version II (BIS-12) and the Expressive Aggression Scale (EXPAGG). Analysis included categorical analysis with prisoners placed into one of four groups (pure bully, pure victim, bully/victim and not-involved), and factorial analysis where perpetration and victimisation were assessed as continuous variables and evidence of interactions explored. It was predicted that perpetration would be associated with higher instrumental attributions and higher impulsivity than non-perpetration. It was predicted that a factorial analysis would demonstrate no interactions between perpetration and victimisation across aggression variables, questioning the utility of a distinct ‘bully–victim’ group. Bullies were found to have higher instrumental attribution scores than non-bullies, with no differences for expressive attribution. Victims were more impulsive than non-victims with evidence that perpetration moderated this relationship. A categorical analysis demonstrated that bully/victims were more impulsive, at least in relation to pure bullies. Results suggested that it was the combined effect of indirect and direct aggression which promoted differences between victims and bullies in relation to attribution and impulsivity. Results are discussed with reference to previous research concerning prison bullying, with directions for future research focused on exploration of perpetrator–victim mutuality using a range of variables and distinct methods of analysis.     

Interparental Aggression and Adolescent Adjustment: The Role of Emotional Insecurity and Adrenocortical Activity

Adolescents exposed to interparental aggression are at increased risk for developing adjustment problems. The present study explored intervening variables in these pathways in a community sample that included 266 adolescents between 12- and 16-years-old (M?=?13.82; 52.5 % boys, 47.5 % girls). A moderated mediation model examined the moderating role of adrenocortical reactivity on the meditational capacity of their emotional insecurity in this context. Information from multiple reporters and adolescents’ adrenocortical response to conflict were obtained during laboratory sessions attended by mothers, fathers and their adolescent child. A direct relationship was found between marital aggression and adolescents’ internalizing behavior problems. Adolescents’ emotional insecurity mediated the relationship between marital aggression and adolescents’ depression and anxiety. Adrenocortical reactivity moderated the pathway between emotional insecurity and adolescent adjustment. The implications for further understanding the psychological and physiological effects of adolescents’ exposure to interparental aggression and violence are discussed.     

Disturbed sleep as a risk factor for aggression in prisoners with a psychotic illness: a brief report

The objective of the present study is to examine whether a relationship exists between disturbed sleep and aggression in 19 male prisoners with a psychotic illness, incarcerated in the Penitentiary Psychiatric Centre in Amsterdam, the Netherlands. The sleep–wake rhythm was indirectly assessed by means of actigraphy. The results show that nocturnal restlessness was a significant predictor of aggression/agitation with a large effect size (R^2?=?.639, adjusted R²?=?.536). It was concluded that future research should focus on nocturnal restlessness as a possible cause of aggression in this population.     

Propensity to support prison gangs: its relationship to gang membership,victimisation, aggression and other disruptive behaviours

Propensity to support prison gangs and its association with aggression, victimisation and disruptive behaviour is explored. The sample comprised 423 adult male prisoners from three Canadian prisons. Participants completed the PGB (Propensity to support Gang-related Behaviour scale) and DIPC-R (Direct and Indirect Prisoner behaviour Checklist-Revised). The former indicated gang membership propensity and included a direct question on whether or not participants considered themselves a gang member. It was hypothesised that prison-based aggression would be predicted by a propensity to support prison gangs and by gang membership. It was also hypothesised that aggression and disruptive behaviours would be reported more frequently by gang members than non-gang members. Propensity to support prison gangs was associated with aggression and other disruptive behaviours, as was actual gang membership. Aggression and other disruptive behaviours were reported more frequently by gang members. Prisoners reporting both aggression perpetration and victimisation simultaneously (i.e. ‘perpetrator/victims’) were over-represented as gang members. Gang membership did not appear to protect against being victimised. Propensity to support prison gangs was composed of beliefs that gangs were supportive, well-ordered and protective, and comprised of friends. The importance of accounting for propensity to support prison gangs and not just self-reported gang membership is discussed.     

Aggressive behavior and measurement of psychopathy in female inmates of German prisons--a preliminary study

Studies concerning inmate psychopathy (as measured by Psychopathy-Checklist-Revised, PCL-R; Hare, 1991) have predominantly been concerned with male inmates. This study was the first to look into psychopathy using the PCL-R with the whole required procedure in German prisons with female inmates. The aims of the present study were to gain data about the prevalence of psychopathy in this sample and to examine potential relations between the types and motive of aggression, prosocial behavior and scores on the PCL-R. Sixty female inmates were examined. We obtained a prevalence rate of psychopathy of 17% (N=10, with a cut-off score of 25). Considering a wide range of subtypes of aggressive behaviors, we found that physical proactive, and relational reactive aggression as well as age predicted high scores of psychopathy. However, prosocial or helping behavior was not associated with psychopathy. Implications for diagnostic issues in forensics concerning female prisoners are discussed.     

Trajectories of Physical Aggression Among Hispanic Urban Adolescents and Young Adults: An Application of Latent Trajectory Modeling from Ages 12 to 18

This study sought to identify trajectories of physical aggression among urban Hispanic youth, and to examine the effects of risk and protective factors at age 11 on trajectories of physical aggression over time (ages 12–18). Relying on data from 731 urban Hispanic adolescents from Project Northland Chicago (PNC), latent trajectory modeling was used to determine the number of trajectories, and multinomial logistic regression was used to identify the predictors associated with trajectory membership. The results suggested five trajectories of physical aggression (non-aggressive, low stable, escalators, early-rapid desistors, and high aggression/moderate desistors). After adjusting for several risk and protective factors, language preference (e.g. speaking Spanish at home) was identified as a protective factor, while indirect exposure to alcohol, sadness/depression, fewer negative alcohol-related attitudes, and threatening to fight were associated with increased risk for physical aggression. Study implications indicate that early, multilevel prevention efforts are necessary to deter the initiation and promote the desistance of physical aggression over time among urban Hispanic adolescents.     

Prisoners with psychosis in England and Wales: diversion to psychiatric inpatient services?

The prevalence of psychosis among prisoners in England and Wales is ten times that in the household population and UK government policy is that prisoners should receive equivalent care to those in the community. This study investigated the implications of policy to divert more from the criminal justice system for psychiatric treatment. Psychotic prisoners were compared with psychotic persons in households and with other prisoners in two surveys of psychiatric morbidity in representative samples of the UK population. Psychotic prisoners were younger, more from ethnic minorities, with comorbid anxiety, substance misuse, ASPD, and childhood behavioural problems compared to psychotic persons in households. Less than a third had received previous inpatient treatment. Psychotic prisoners had similar criminal histories and higher psychopathy scores than non-psychopathic prisoners. Diversion is unfeasible without improved screening for psychosis and increasing bed numbers at higher levels of security to accommodate more patients who would pose high risk to the public. Future research should investigate why UK psychiatric services fail to identify psychotic prisoners and provide aftercare.