Screening for mental disorder using the UK national offender assessment system

Probation officers have large caseloads with high levels of psychiatric morbidity but receive minimal training in recognising/managing mental health problems. In the UK, there is no national screening procedure for mental illness among offenders that is considered effective. This study’s aim was to develop a screening system for mental/personality disorders using the Offender Assessment System. Seven screens for mental disorder were developed using items from assessments on 574 prisoners: alcohol misuse, drug dependence, antisocial personality disorder, psychopathy, learning difficulties, psychosis and severe mood disturbance. Internal validation showed that the screens performed well across accuracy estimates. Prevalence of mental disorders identified with the screens in test and validation samples was similar. However, the psychopathy and severe mood disturbance screens may be more effective in screening for true negatives. The screens are an economical method for prioritising mental health needs of the UK prison and probation population using routinely collected data.     

Mental disorders and cognitive impairment in ageing offenders

The aim of our study was to identify psychiatric and cognitive disorders among older prison inmates and to investigate whether there is an association between mental disorders and cognitive impairment. 138 men aged 50 and over were recruited in seven French prisons (Group 1) and 138 men aged 50 and over were recruited from the general public (Group 2). Participants were assessed using the Mini International Neuropsychiatric Interview, the Mini Mental State Examination, and the Frontal Assessment Battery. The results reveal very significant differences in the incidence of mental disorders and in cognitive performance between the two groups. However, there does not appear to be a significant link between mental disorders and cognitive performance. We discuss the risk factors for mental disorders and cognitive impairment. We raise particularly the issue of depression, which is the most common pathology in this population and which is generally associated with the risk of suicide.     

The Issue of Ethics and Authority for Licensed Mental Health Professionals Involved in Parenting Coordination

We examine the ethics of licensed mental health professionals accepting the authority inherent in binding arbitration when acting as parenting coordinators (PCs). PCs execute their duties under the umbrella of their professional identity and standards of practice. Fundamental differences exist in how the law and the behavioral sciences conceive human behavior and authority, in particular, authority by role and authority by status. Ethical concerns arise when licensed mental health professionals accept the authority to render binding judgments and ask clients to surrender their autonomy through informed consent. We offer recommendations for PCs to avoid these ethical complications.     

Analysis of some commonly found inhalants using gas chromatography-mass spectrometry (GC MS) – Effect of substrates on the identification of inhalants

Inhalant abuse is a serious and ever-evolving problem for our society. Inhalants are abused more commonly by teenagers and adolescents. Inhalants such as glue, paint thinners, correction fluid, and nail paint remover are easily available in the market which makes them readily abused. Out of various methods of abuse, huffing (placing a piece of cloth soaked with inhalant is placed in the mouth), bagging (placing head in a polythene bag containing inhalant), and ballooning (balloons filled with inhalant are used for inhaling vapors through the mouth) are most common. Inhalant abuse results in multiple target organ dysfunction with neuritis and brain damage due to the dissolution of the myelin sheath. In acute poisoning cases, it might cause death due to asphyxia and sudden sniffing syndrome. In such cases, various articles containing traces of inhalants could be retrieved from the scene of incidence and to detect these traces become an important facet of the investigation. However, it might be difficult due to the rapid evaporation of inhalants and the formation of reaction product species. In the present study, an attempt has been made to study the effect of three substrates (balloon, cloth, polythene) on component profiles of four paint thinners and four nail paint removers. The study suggests that although some components are retained, there is the formation of a large number of reaction product species and these must be taken into consideration before furnishing the opinion. These reaction product species might also be inhalant specific which must be further explored.     

青少年“网瘾”者矫治措施的合法性研究

本文从界定“网瘾”的概念入手,对目前我国矫治青少年“网瘾”所采取的种种措施之合法性展开研究．笔者认为,我国目前的“网瘾”概念有被扩大使用的情况。这种情况反而可能会侵害接受矫治的青少年之合法权益。     

Characteristics of female patients admitted to an adolescent secure forensic psychiatric hospital

Bluebird House is the only mixed gender NHS secure forensic psychiatric hospital for adolescents in the South of England. It has admitted more than 30 female patients since the service opened in 2008. The admission criteria are that patients must be detained under the Mental Health Act and present evidence of being a risk of harm to others. This article describes the clinical characteristics of 30 consecutive female patients admitted to a highly specialised adolescent forensic inpatient service. Key results include a very high rate of incidents of risk behaviours exhibited by female patients within the unit but good clinical outcomes. The majority of patients had severe symptoms of mental disorder, especially emotional instability, self-harm behaviours and aggressive behaviours. Few had diagnoses of mental illness. Assessment findings from the Millon Adolescent Clinical Inventory and the Structured Assessment of Violence Risk are discussed, as are parallel with studies from other female secure services.     

Characterising the psychiatric comorbidities among adults with ADHD who have a history of offending

The prevalence of attention deficit hyperactivity disorder (ADHD) among adult offenders is significantly higher than in the general population. Adults with ADHD often present with multiple psychiatric comorbidities. This study aims to characterise the comorbidities presented by adults with ADHD who have offended and also to investigate predictors of offending among this population. Seventy-three participants with a diagnosis of adult ADHD were divided into a group with a history of offending behaviour (n = 30) and a group of non-offenders (n = 43). Groups were compared on measures of ADHD symptoms, substance use and DSM-IV Axis I and Axis II disorders using the Millon Clinical Multiaxial Inventory – 3rd Edition. Major depression, cannabis use and childhood hyperactivity-impulsivity symptoms predicted offending. These findings indicate that adults with ADHD who have a history of offending behaviour are more likely to present with complex psychiatric needs.     

Antisocial personality disorder comorbid with borderline pathology and psychopathy is associated with severe violence in a forensic sample

Background: Evidence suggests the relationship between personality disorder (PD) and violence in offenders might be clarified by considering sub-groups of PD offenders defined by patterns of PD comorbidity. Aim: to identify patterns of PD comorbidity associated with severe violence, defined by its severity, quantity and age of onset (Violence Index: VI) in a forensic sample of 100 PD offenders. Methods: Correlations were first computed between VI and a range of personality and criminological variables; next, patients with antisocial/borderline comorbidity were compared with other PD patients; finally, regression analysis was conducted to identify unique predictors of VI. Results: The antisocial deviance factor of psychopathy and antisocial/borderline comorbidity were each significantly and independently associated with severe violence. Patients showing both a high psychopathy score and antisocial/borderline comorbidity had a significantly greater VI than those without these characteristics. Conclusion: PD patients with high psychopathy co-occurring with borderline and antisocial PDs show a criminal profile characterised by a high degree of serious violence.     

Offenders as victims: post-traumatic stress disorder and substance use disorder among male prisoners

Background: Comorbid substance use disorder(s) and post-traumatic stress disorder (SUD-PTSD) is common among prisoners and linked to an increased risk of criminal recidivism; however, little is known about the characteristics of prisoners with this comorbidity. Aim: This study provides a preliminary examination of the clinical and criminal profile of male inmates with symptoms of SUD-PTSD, and examines whether this profile differs according to whether a person has experienced a trauma while in prison. Methods: Thirty male inmates from two correctional centres in Sydney, Australia, were recruited and assessed using a structured interview. Results: The sample reported extensive criminal, substance use and trauma histories. A history of substance dependence was almost universal (90%) and 56.7% met diagnostic criteria for PTSD with the remainder experiencing sub-threshold symptoms. Forty-three per cent reported a traumatic event while in prison. Those who had experienced trauma in prison, compared to those who had not, were more likely to nominate heroin as their main drug of concern and to be receiving drug treatment in prison. There was also a trend toward inmates who had experienced a trauma in prison being more likely than inmates who had no prison trauma to have experienced a physical assault. Conclusion: Male prisoners with SUD-PTSD are a high-needs group yet treatment responses are poor. Further research examining treatment options for this comorbidity may improve prisoner well-being and reduce recidivism.     

VARIETIES OF VIOLENT BEHAVIOR

There is an implicit assumption of homogeneity across violent behaviors and offenders in the criminology literature. Arguing against this assumption, I draw on three distinct literatures [child abuse and neglect (CAN) and violence, violence and post‐traumatic stress disorder (PTSD), and CAN and PTSD] to provide a rationale for an examination of varieties of violent behaviors. I use data from my prospective cohort design study of the long‐term consequences of CAN to define three varieties of violent offenders using age of documented cases of CAN, onset of PTSD, and first violent arrest in a temporally correct manner [CAN → to violence, CAN → PTSD → violence (PTSD first), and CAN → violence → PTSD (violence first)], and a fourth variety, violence only. The results illustrate meaningful heterogeneity in violent behavior and different developmental patterns and characteristics. There are three major implications: First, programs and policies that target violence need to recognize the heterogeneity and move away from a “one‐size‐fits‐all” approach. Second, violence prevention policies and programs that target abused and neglected children are warranted, given the prominent role of CAN in the backgrounds of these violent offenders. Third, criminologists and others interested in violence need to attend to the role of PTSD, which is present in about one fifth (21 percent) of these violent offenders, and not relegate the study of these offenders to the psychiatric and psychological literatures.