Red-teaming the panopticon* (mobilising adaptive change in secure and forensic settings)

In England and Wales, secure and forensic psychiatric institutions provide a high-cost, low-volume service that imposes significant restrictions upon detainees. Patients may be detained under the Mental Health Act in such settings for several years or even life, as they are deemed to present a significant risk to themselves or the public. Patients under s37/41 require the Home Office to approve any increase in their freedom. Best practice requires reoffending risk to be assessed before a patient is discharged. Evaluation of risk is an inexact actuarial science operating in a political arena, and research has indicated risk assessment tools have little positive predictive validity. There is concern amongst the wider psychiatric and judicial communities about the ethics of current practice. We examine these issues and consider means of improving risk assessment through red-teaming, increased collaboration between clinician and patient and a paradigm shift towards greater emphasis on patient self-agency.     

“Because you’ve got faith it doesn’t mean that you’ve got wings on your back”: a qualitative analysis of the accounts of Christian prisoners serving time for a sexual offence

Religious beliefs have been variously promulgated as both protective and risk factors for sexual reoffending. Moreover, therapists working with religious prisoners struggle with unravelling cognitive distortions embedded within religious views, with concerns about accusations of prejudice salient in their mindset. This paper presents a novel contribution to research by combining the qualitative analysis of the accounts offered by individuals (n?=?12) convicted of sexual offences who describe themselves as Christians. Data were collected through semi-structured interviews and analysed using Interpretative Phenomenological Analysis. This paper focuses on two superordinate themes: (i) The God Effect and (ii) The Shadow Side of Religion. Implications of this research are discussed with reference to the assessment of dynamic risk and protective factors with religious individuals who have been convicted of a sexual offence.     

Sanctions,Perceived Anger,and Criminal Offending

In articulating models of offender decision-making, researchers have tended to focus on either deterrence/rational choice or situational/emotional considerations. In this paper, we merge these two lines of inquiry and examine how rational choice considerations and perceived angry reactions inter-relate in predicting assaultive violence. Using data collected on a random sample of young adults, we assess three hypotheses. First, that both rational choice and perceived anger exhibit additive effects on assault. Second, that perceived anger influences how rational choice considerations are interpreted. Third, that rational choice considerations influence assault under different levels of perceived anger, and in particular, that the effect of sanction threats fall apart under high perceived anger. Future theoretical and empirical directions are outlined.     

Soldier,civilian, criminal: identifying pathways to offending of ex-armed forces personnel in prison

Little is known about why some ex-armed forces personnel become involved in the criminal justice system, however, they represent the largest known occupational group in prison. In-depth interviews were employed to explore possible pathways to offending. Twenty ex-armed forces personnel in prison were recruited from five prisons in England. Data were analysed using a combination of thematic analysis and constant comparison methods rooted in grounded theory. Four predominant themes were identified: experiences of trauma and adversity; belonging; impulsivity and creating a soldier. Participants had experienced a number of traumatic incidents and adversity in their lives, encompassing pre, during and post-service but felt a sense of belonging in the armed forces. Participants demonstrated impulsivity in a number of areas with links to both their service in the armed forces and offending behaviour. The creation of the identity of ‘soldier’ was perceived to impact participants’ lives in a number of ways, including their offending, alcohol use and coping with trauma. The interplay of these themes and their potential impact on participants’ pathways to offending are discussed.     

Portrait of the Accused as a Young Man: New Zealand’s Harsh Treatment of Young People who Commit Serious Crimes

Abstract

This article argues that although New Zealand’s unique youth justice system generally considers the whole picture of a young offender and responds holistically to the offending, in the case of those accused of serious crimes, the system draws a limited picture that depicts the young offender as a ‘young adult’. These young people are sentenced in adult courts, where their youth, inexperience and potential for rehabilitation are far less influential than they are in a youth court. The result is harsh treatment of some extremely vulnerable young people, which breaches New Zealand’s international obligations. That harsh treatment is particularly problematic, given its hugely disproportionate effect on Māori youth.     

消化复宁汤对肝郁脾虚型慢性萎缩性胃炎大鼠ERK1/2和p-ERK1/2的影响

目的 研究消化复宁汤对肝郁脾虚型慢性萎缩性胃炎（chronic atrophic gastritis,CAG）大鼠细胞外调节蛋白激酶（extracellular regulated protein kinases,ERK）信号通路的影响,探讨消化复宁汤防治CAG的机制。方法 将80只雄性Wistar大鼠随机取10只为正常组,其余大鼠随机分为模型组,消化复宁汤高、中、低剂量组和维酶素组。采用脱氧胆酸钠及30%和60%无水乙醇灌胃联合施压束缚和饥饱失常法复制肝郁脾虚证CAG模型。实验结束后,观察各组大鼠一般情况的变化,采用ELISA法检测大鼠血清ERK1/2水平,采用Western Blot法检测大鼠胃组织ERK1/2、p-ERK1/2的表达水平。结果 消化复宁汤能明显改善CAG大鼠肝郁脾虚证候表现。消化复宁汤中剂量组与维酶素组血清ERK1/2水平较模型组显著升高（P<0.05）,消化复宁汤中、低剂量组与维酶素组大鼠胃组织ERK1/2水平显著高于模型组（P＜0.05）;消化复宁汤高、中、低剂量组及维酶素组大鼠胃组织p-ERK1/2表达水平较模型组显著降低（P＜0.05）;消化复宁汤高、中、低剂量组血清ERK1/2水平和胃组织p-ERK1/2表达水平相比较,差异均无统计学意义（P＞0.05）。结论 消化复宁汤可通过激活ERK1/2,抑制p-ERK1/2的水平防治CAG发生,其作用无明显的剂量依赖性。     

益气活血方联合心脏康复治疗慢性心力衰竭疗效观察

目的 观察益气活血方联合心脏康复治疗慢性心力衰竭患者的临床疗效。方法 将80例慢性心力衰竭患者随机分成对照组和治疗组,每组40例。对照组给予西药治疗,治疗组在对照组的基础上给予益气活血方联合心脏康复疗法。治疗前后分别采用中医证候积分法评价中医证候疗效,采用纽约心脏病协会（New York Heart Association,NYHA）心功能分级标准评价心功能疗效,采用双向测流免疫法检测血浆N末端脑利钠肽前体（N-terminal pro-brain natriuretic peptide, NT-proBNP）,进行6分钟步行测试（6-minute walking test, 6MWT）,采用M型心脏超声心动图检测左室舒张末内径(the left ventricular end diastolic diameter, LVEDd）、左室射血分数（left ventricular ejection fraction,LVEF）,采用心肺功能设备检测无氧阈值摄氧量（anaerobic threshold, AT）和峰值摄氧量（peak oxygen uptake, peak VO2）,观察两组临床疗效。结果 两组治疗12周后患者中医证候积分、NT-proBNP、LVEDd均较治疗前明显下降（P＜0.05),且治疗组下降程度更为明显（P＜0.05)。治疗后两组心功能、6MWT、LVEF、AT、peak VO2值均较治疗前明显增加（P＜0.05),且治疗组增加程度更为明显（P＜0.05)。结论 益气活血方联合心脏康复能改善慢性心力衰竭患者的心功能。     

Arsonists Suffering From Schizophrenia—A Description in Comparison with Other Offenders with a Similar Diagnosis

This study aims to describe the small and distinct subgroup of arsonists diagnosed with schizophrenia, their motives, personal, and crime scene characteristics. While prior research identified significant differences to other criminals, firesetters in general, or mentally disordered offenders, there are no comparisons with other offender patients with schizophrenia so far. In a forensic institution in Switzerland, a group of 30 arsonists with schizophrenia spectrum disorder (SSD) was compared to 340 other offender patients with SSD using retrograde file analysis and multiple adapted Fisher´s exact tests. While symptoms of SSD were most defining of both groups, arsonists with SSD were more often single, unemployed, prescribed psychiatric medication at index offense, had a smaller variety of criminal motives, and acted out of anger or revenge in the context of a relationship. In conclusion, symptoms of SSD may be more defining and useful in guiding clinical practice than aspects specific to arsonists.