A systematic review of effective therapeutic interventions and management strategies for challenging behaviour in women in forensic mental health settings

Women in secure forensic mental health care require therapy and care that is responsive to their specific needs. Despite the policy recognition that women require a distinct service, evidence based practice is not available for this population. This review was undertaken in response to a clinical need within a medium secure unit in Glasgow that was experiencing high levels of challenging behaviour, in a female ward. The review aimed to identify effective strategies or interventions for the management of challenging behaviour in women in secure services and, therefore, improve practice and patient care. A synthesis of the findings from the 11 identified studies revealed variability in the approaches used to support women in forensic services, including: behavioural programmes; organisational change with a focus on staff training and support; medication; ECT and mechanical restraint. The challenging behaviours assessed included self-harm; physical and verbal aggression; suicide attempts and arson/fire setting. The majority of articles suggested some improvement in aspects of challenging behaviour, however this was limited by the lack of control groups and small sample sizes. Further investigation is required to find out whether interventions identified in this review can sustain a reduction in challenging behaviours in the long-term.     

Serial killing and homosexual necrophilia,an exploration

The vast majority of literature regarding sexual homicide is premised on a male perpetrator and female victim, as is the sparse literature regarding acts of necrophilia. Little, therefore, is known of homicide committed by a homosexual male to facilitate necrophilic acts. A case is presented here of such an instance, an instance that escalated into serial homicide and, at least, a dozen victims. The prefacing role of sexual fantasy is explored, as well as the significance of the manner of death when necrophilic intent is the rationale for homicide. Potential indicators of necrophilic interests leading to sexual homicide are noted, and the literature regarding such interests is expanded.     

Somnophilia and Sexual Abuse through the Administration of GHB and GBL

Somnophilia, the desire to have sex with an unconscious, sleeping, or comatose person who is unable to respond, is a sexual paraphilia that is seldom reported. The underlying desire is often overshadowed by the act of sexual violation and when using GHB or GBL to induce unconsciousness, as in the case presented here, the victim might not even be able to recall, for certain, that they have been sexually violated. A case study is offered of a somnophile who adulterated drinks to render young men unconscious, so he could rape them in that state, before progressing to administering drugs anally on the pretext of applying lubrication to the anus to facilitate sexual intercourse. The offender's fetishistic compulsion to have sex with unconscious men propelled him to experiment with the means by which he surreptitiously administered drugs to his victims in order to deepen their comatose state.     

Coping with Imprisonment: Testing the Special Sensitivity Hypothesis for White-Collar Offenders

This study uses nationally representative prison data to test two competing theories of how white-collar offenders experience prison. The first perspective, referred to as the special sensitivity hypothesis, assumes that because of their social and demographic background characteristics white-collar offenders are more susceptible to the pains of imprisonment than other inmates. The second perspective, referred to as the special resiliency hypothesis, is based on the idea that these same background characteristics may reduce the pains of imprisonment for white-collar offenders. Ordinal and binary logistic regression models are used to estimate the effect of white-collar inmate status on several indicators of psychological adjustment. The current study finds partial support for the special resiliency hypothesis, but not the special sensitivity hypothesis. The results for each outcome are discussed regarding both theoretical and practical applications. The study’s limitations are also addressed and suggestions for future research on incarcerated white-collar offenders are given.     

Forensic Radiology Pitfalls: CT Imaging in Gunshot Wounds of the Head

Computed tomography (CT) imaging is increasingly used in emergency departments and trauma services and is being offered as a supplemental tool with autopsy in coroner's and medical examiner's offices throughout the United States. The availability of CT images in lieu of traditional X‐rays for medicolegal autopsies may lead to misinterpretation of images for forensic pathologists who are not familiar with these types of images. Forensic pathologists must become familiar with CT imaging, the basis of CT image formation and how to interpret CT images appropriately. We highlight potential pitfalls of CT image interpretation through two cases of fatal gunshot wounds of the head. Antemortem CT imaging available at the time of autopsy led to discrepancy between the initial image findings and the autopsy due to inexperienced manipulation of the images. With appropriate understanding of CT image interpretation and manipulation, forensic personnel should be able to avoid most sources of misinterpretation.     

Gender inequality and homicide: a cross-national examination

Studies examining gender inequality and crime have often explored the connection between female victimisation and crime. However, feminist theories do provide a rationale for gender inequality affecting all crime, not just female victimisation. Using the ameliorative and the backlash hypothesis the current analysis examined gender inequality and homicide in 94 countries. Using a gender inequality index, we found that as gender inequality increased the homicide rate increased. This finding supports the ameliorative hypothesis, which states that as societies become more equal crime will decrease.     

Examining Procedural Justice and Legitimacy in Corporate Offending and Beyond‐Compliance Behavior: The Efficacy of Direct and Indirect Regulatory Interactions

Tom Tyler's Procedural Justice Theory has received support in a variety of studies using criminal justice authorities as the research focus. To date, the theory has not been empirically tested using corporate malfeasance as an outcome, despite evidence that procedural justice is important in achieving regulatory compliance. This study uses factorial survey methods to examine whether corporate behavior is predicted by professionals' perceptions of procedural justice and legal legitimacy. We find that procedural justice and legitimacy considerations are salient only when managers have direct contact with regulatory authorities. This supports John Braithwaite's argument that effective regulation is enhanced by microlevel interactions in which procedural justice can be effectively leveraged to promote compliance.     

Does Treatment Quality Matter?

Research Summary

The Florida Department of Juvenile Justice has implemented a process to evaluate the treatment quality of interventions provided statewide in all long‐term residential programs. In the current study, we examine the predictive validity of this treatment quality component in the prediction of recidivism of youth (N = 2,397) who completed juvenile justice residential programs from July 1, 2013 to June 30, 2014. We use hierarchical linear modeling to assess the effects of treatment quality (as youth are nested within programs), controlling for demographic and criminal history factors. The results indicate that higher average treatment quality scores of interventions received within a residential program decreased the likelihood of subsequent arrest, conviction, and reincarceration, whereas the highest treatment quality score of any specific intervention provided within the program decreased the odds of reincarceration only.

Policy Implications

In this study, we confirm the importance of fidelity and implementation quality in the provision of crime prevention treatment interventions to serious, deep‐end juvenile offenders. Additionally, our results shed light on the ability of a juvenile justice agency to measure treatment quality in a substantively meaningful way with the use of limited additional resources. The services provided to keep communities safe, prevent future offending, and rehabilitate juvenile offenders must be held accountable for producing such outcomes, and one method of measuring such compliance is to evaluate the quality of the interventions with respect to staff training, fidelity adherence, evaluation, and corrective action processes.     

Parental Postconflict Explanations: Implications for Children's Adjustment Outcomes

The Post Conflict Explanations (PCE) scale is a compilation of behaviors commonly seen in parent‐child postconflict communications. Following exploratory factor analysis, the PCE emerged as a four‐dimension scale with adequate subscale internal consistency and intercorrelations: Dismissive (α = 0.86), Emotion Dysregulation (α = 0.85), Constructive (α = 0.97), and Blaming (α = 0.77). The PCE and its subscales were further validated through moderate‐to‐strong associations with established scales of family conflict, emotional security, and adjustment outcomes. The identification of these postconflict explanations represents a step forward in distinguishing constructive and destructive conflict behaviors.