Criminal Recidivism After Forensic Psychiatric Treatment. A Multicenter Study on the Role of Pretreatment,Treatment-Related,and Follow-Up Variables

This study examined associations between criminal recidivism after discharge from forensic treatment and variables related to either the time before the current forensic treatment, or the current forensic treatment, or the follow-up after discharge. Participants were treated in 12 forensic clinics according to section 63 of the German penal code. A patient was classified as a criminal recidivist when the patient or the aftercare reported that the patient was delinquent at follow-up. Patients without criminal recidivism were patients for which both perspectives (patient and aftercare) reported no delinquency at follow-up. Mann–Whitney U-tests and Fisher's exact tests were performed. Data to classify patients were available for N = 249 patients. Fifteen patients (6%) were classified as criminal recidivists. The follow-up was M = 12.58 (SD = 1.84) months, and the criminal acts occurred M = 6.00 (SD = 5.55) months after discharge. Differences between patients with and without criminal recidivism were found in pretreatment (young age at first crime, early onset of mental disorder, previous forensic treatments), treatment-related (disorder due to psychoactive substance use, gradual release abuses, outbreaks, assaults against staff, criminal act during treatment, type of discharge, outcome ratings), as well as follow-up variables (no specified housing situation, not being abstinent from psychoactive substances, inpatient readmission, course of outpatient treatment, course of mental disorder) (all p < 0.05). To conclude, it is important to consider variables related to the time before the current treatment, treatment-related variables, and variables related to the follow-up to identify the patients at risk of criminal recidivism after discharge from forensic treatment.     

Responsive Aggression Regulation Therapy (Re-ART) Improves Executive Functioning in Adolescents and Young Adults with Severe Aggression Problems: A Pilot Study

This pilot study (N = 25) compared the effects of a short, four-month version of Responsive Aggression Regulation Therapy Outpatient (Re-ART Compact) and the entire, ten-month intervention (Re-ART Complete) on specific executive functioning (EF) and the risk of violent recidivism in adolescents and young adults (13–23 years). Re-ART is a cognitive behavioral-based intervention for adolescents and young adults with severe aggression problems. The Re-ART Compact and Re-ART Complete groups were comparable on the EF measures inhibition, flexibility, emotion regulation, self-evaluation, and self-control, but the Re-ART Complete group showed more improved risk of violent recidivism. We conclude that Re-ART Compact can be used as a compact, short intervention for EF, which is a valuable addition to the field of forensic mental health care where many problem behaviors relate to poor EF.     

Validation of an ELISA-based screening assay for the detection of amphetamine, MDMA and MDA in blood and oral fluid

The use of amphetamine and 'ecstasy' (MDMA) has increased exponentially in many European countries since the late nineties, leading to a rapid growth in the number of clinical and forensic analyses. Therefore, a rapid screening procedure for these substances in biological specimens has become an important part of routine toxicological analysis in forensic laboratories. The objective of this study was to evaluate the Cozart amphetamine enzyme-linked immunosorbent assay (ELISA) for the screening of plasma samples and oral fluid samples (collected with the Intercept device). Authentic plasma samples from drivers (n=360) were screened, using an 1:5-fold dilution. True positive, true negative, false positive and false negative results were determined relative to the in-house routine GC-MS analysis. Samples consisted of 144 amphetamine-only positives, 141MDMA/MDA-only positives, and 74 negatives when using the limit of quantitation as the cut-off level for confirmation (10 ng/mL). Using these results, receiver operating characteristic (ROC) curves were generated and optimal cut-off values for the screening assay were calculated. Analysis showed that the ELISA is able to predict the presence of either amphetamine or *MDMA/MDA (*MDMA as its metabolite MDA) in plasma samples with 98.3% sensitivity and 100% specificity at a cut-off value of 66.5 ng/mL d-amphetamine equivalents. A similar analysis was conducted on 216 oral fluid specimens collected from a controlled double blind study. Subjects received placebo or a high (100 mg) or low (75 mg) dose of MDMA. Oral fluid samples were collected at 1.5 and 5.5h after administration. Combined results of the analysis of the high and low dose oral fluid samples indicated a screening cut-off of 51 ng/mL d-amphetamine equivalents with both a sensitivity and specificity of 98.6% (using a LC-MS/MS confirmation cut-off of 10 ng/mL). In conclusion, these data indicate that the Cozart AMP EIA plates constitute a fast and accurate screening technique for the identification of amphetamine and MDMA/MDA positive plasma samples and oral fluid specimens (collected with Intercept. It should be emphasized that method validation should be performed for each type of biological matrix.     

Quantitative indices for anti-human trafficking policies: based on reports of the U.S. State Department and the Council of Europe

Quantitative ratings of policies of national governments are an important tool for the monitoring of compliance with international standards in many domains. In this article we present a global index of anti-human trafficking policies developed by a research consortium using the TIP country reports of the U.S. State Department (the 3P index) and an index based on the reports of the monitoring body of the Council of Europe Convention against Human Trafficking (GRETA). Although the global 3P index gives more favorable ratings to most European countries than the GRETA-based index, a moderately strong correlation was found between the two indices. This is an encouraging result lending support to the validity of the assessments of both monitoring mechanisms as well as to their transformation into quantitative scores. We also demonstrate that the detailed GRETA-based index can be used to identify best practices in anti-trafficking policies and specific areas where these policies are most in need of improvement, e.g. legal aid and compensation for victims. Our analyses of the relationships between the various items of the index revealed positive correlations between the existence of units of specialized prosecutors and the numbers of convictions of traffickers. Our paper, then, demonstrates the potential of quantitative indices of counter human trafficking policies as tools for both effective monitoring of the implementation of international standards and for analytical purposes.