Explanations for violent behaviour—An interview study among forensic in-patients

The alleged relation between mental disorder and violent criminal behaviour has been investigated mainly from an epidemiological perspective. Population-based registry studies have shown that violence occurs more frequently among people with mental disorders, like schizophrenia and bipolar disorder, compared with control subjects, but that the increased risk is largely mediated by drug abuse and socio-economic deprivation. The aim of this study was to explore how patients who have committed violent or sexual crimes and have been sentenced to forensic psychiatric care by a Swedish court of law construed their criminal actions in terms of causes. Forty-six participants from six different Swedish forensic psychiatric clinics were included in the study. A semi-structured interview study was conducted and the data was analysed using a thematic analysis. A large group of the participants did not believe that the mental disorder played any role in the criminal events. Contributing causes that were mentioned were drug abuse and social factors.     

Integrating risk,the Good Lives Model and recovery for mentally disordered sexual offenders

Abstract

Personality disordered and mentally disordered sexual offenders (MDSOs) with complex diagnoses such as schizophrenia, developmental disorders and mood disorders face challenges of restoring their mental health, living more safely with personality- and offence-related risks, while addressing concerns about their capacity to reintegrate into society; this has been termed “secure recovery”. This paper reviews the literature on recovery, demonstrating its commonality with the Good Lives Model (GLM) as applied to MDSOs' offending treatment. GLM appears to provide a better fit with the recovery needs of MDSOs than the Risk–Need–Responsivity model because it emphasises approach goals, enhanced responsivity and skills acquisition. Recovery needs to integrate coping with mental disorders with risk management and a healthy, future lifestyle. Both secure recovery and GLM support the need for client–clinician collaboration, promoting self-determination and a shared narrative about coping with enduring risk and the hope of sustained well-being.     

“SEEING” MINORITIES AND PERCEPTIONS OF DISORDER: EXPLICATING THE MEDIATING AND MODERATING MECHANISMS OF SOCIAL COHESION

Research shows that residents report high levels of disorder in places with greater concentrations of minorities even after controlling for objective indicators of crime or disorder. Less understood, however, are the mechanisms that explain this relationship. Drawing on a survey of nearly 10,000 residents nested within 297 neighborhoods across two cities, we use a multiple indicators–multiple causes model to examine the cues that lead individuals to distort the presence of minorities in neighborhoods. We then employ multilevel models to test whether these distortions influence perceptions of disorder. Furthermore, we assess whether living in a socially cohesive neighborhood mediates and/or moderates the relationship between “seeing” minorities and perceiving disorder. We find that when residents overestimate the proportion of minorities living in their neighborhood, perceptions of disorder are heightened. Yet social cohesion moderates and partially mediates this relationship: Residents living in socially cohesive neighborhoods not only report less disorder than those living in less cohesive communities, but also they “see” fewer minorities when compared with residents living in less socially cohesive neighborhoods. These results suggest that social cohesion is an important mechanism for explaining how residents internalize the presence of minorities in their neighborhoods and how this then leads to perceived neighborhood disorder.     

Posttraumatic Stress Disorder: Protective and Risk Factors in 18 Survivors of a Plane Crash

The aim of this study is to identify protective and risk factors related to the development of posttraumatic stress disorder (PTSD) on a sample of survivors from a single plane crash. Eighteen survivors were examined 6 months following the event. The subjects all underwent psychiatric interviews, Clinician‐Administered PTSD Scale structured interviews, personality and cognitive tests. Only 38.9% of them presented with all of the symptoms of PTSD; 22.2% showed no symptoms for PTSD; remaining survivors exhibited emotional/affective symptoms related to the event. In addition to the severity of the traumatic event itself, other risk factors identified were the loss of a relative, the manifestation of depressive symptoms, and the severity of physical injuries sustained. Low levels of hostility and high levels of self‐efficacy represented protective factors against developing PTSD.     

Drug Court through the Lenses of African American Women: Improving Graduation Rates with Gender-Responsive Interventions

Drug courts began in the United States in 1989, and nearly three decades of evidence has shown that drug courts are more effective than other criminal justice interventions at reducing criminal recidivism. There has, however, been a trend in some drug courts where African Americans are less likely to graduate than their White counterparts, which is concerning because evidence has also shown that graduating the program reduces the odds of recidivating. Little is known about African Americans’ experiences in drug court, and this is the first known qualitative study to ask African American women (N?=?8) about the most helpful aspects of drug court that support them in graduating and how the drug court could be more helpful in supporting them to graduate. The women felt that the drug court judge was their advocate and understood the unique challenges they faced with balancing the demands of drug court with motherhood. Conversely, the women felt that they were not receiving effective, gender-responsive treatment for their substance use disorders, which was a barrier to them graduating drug court. The findings are discussed in reference to drug court practice and future research.     

Bestiality in Forensically Committed Sexual Offenders: A Case Series

Although bestiality has occurred since prehistoric times, it remains a poorly understood aspect of human sexuality. Prevalence studies in the mid‐20th century suggested that bestiality was a relatively common phenomenon. Since that time, researchers have studied bestiality among specific populations, including self‐identified “zoophiles” and inmates who report a history of bestiality. Findings from inmate research suggest that bestiality may represent a risk factor for future interpersonal violence. This study presents a case series of bestiality among sexual offenders committed under forensic commitment schemes. The case series demonstrates the range of animal partners, sexual acts, and comorbid paraphilic and nonparaphilic diagnoses in individuals who report a history of bestiality. In addition, it helps clarify potential motivations for sex with animals and how such motivations may influence the forensic psychiatric assessment of offenders who have sex with animals.     

How do professionals experience working with offenders diagnosed with personality disorder within a prison environment?

To explore the different experiences of a Multidisciplinary Team working with offenders diagnosed with personality disorder (PD) and produce a substantive model of the Offender PD Pathway strategy from a staff perspective. Fourteen participants were recruited from ‘Unit A’ located within a high security prison. Semi-structured interviews were conducted with participants and the data collected were analysed using constructivist grounded theory. A model was constructed depicting the experiences of those working with offenders with PD. Main themes identified were: prison environment; synergy of the workforce; understanding of the client; individual perceptions; support; and personal change. Although there was enough similarity within the participants’ responses to consider them to be a homogenous population, there were some noticeable differences in trends of responses evident between the two sub-groups of health service-based clinical staff and prison staff as expressed in the model. There is interplay between factors which influence an individual’s experience of working with offenders with PD. How a member of staff experiences working with offenders with PD depends on more than just the nature of the client and the challenges they pose. These factors external to the client group appear to have a significant impact on the professional and their emotional experiences of their work.     

Finding our way: early learning from the Compass Project,an Intensive Intervention Risk Management service for women

Abstract

Intensive Intervention Risk Management (IIRM) services are commissioned under the Offender Personality Disorder strategy to contribute to a psychologically informed pathway by supporting individuals ‘through the gate’. This paper reports some of the learning from the first IIRM service for women and outlines how those involved have sought to understand the challenges that were faced by this project in its early days. This paper argues that these challenges help to clarify the role of IIRM services for women and that the ambition for these services should be to facilitate coherent, holistic management. We suggest that IIRM services for women offenders are likely to be most effective if they are well integrated and responsive to the social context, underpinned by a partnership approach and have clear processes for service delivery. Finally, we argue that IIRM services for women should be characterised by a commitment to involvement at every level.     

Personality disorder and violence in the national household population of Britain

Background: Antisocial personality disorder (ASPD) is strongly associated with violence but the effects of other personality disorder (PD) categories are uncertain. Purpose: To investigate associations between 10 DSM-IV PD categories and effects of co-occurring disorders on self-reported violence. Method: Cross-sectional survey of 8397 adults aged 16–74 years in households in Great Britain. Results: ASPD contributed strongly to the burden of violence in the British population. Paranoid and obsessive–compulsive PD made additional independent contributions, and narcissistic PD contributed to intimate partner violence. The prevalence of violence correlated with the number of PD categories. Comorbid alcohol dependence further increased the risk. Conclusions: Risk of violence increases with increasing severity of PD, measured by the number of PD categories, and with co-occurring alcohol dependence. Not all PD categories are associated with violence, and avoidant PD was protective. Identification of targets for future interventions may be obscured using a classification based solely on severity.