Predictors of re-offending in German substance-abusers in legal detention: a prospective population-based cohort study

This study aimed to evaluate whether the elapsed time after release to first re-offense is longer for those who complete coerced forensic addiction treatment than for those who fail to complete the treatment. It is also aimed to identify predictors of re-offending for both those who complete such treatments as compared with those who do not. Two hundred and sixty-one patients discharged from five German forensic addiction clinics were investigated on 65 anamnestic, socio-demographic, and therapeutic process variables. One hundred and fifty-one patients were prematurely discharged and returned to prison (group A; time at risk [TAR] = 58.7 months), 110 finished treatment successfully (group B; TAR = 44.2 months). Federal Criminal Register data were used for follow-up. Univariate survival analyses and multivariate stepwise Cox-regression models were computed. Twelve predictors in group A revealed a four-factor model: age at admission to treatment, duration of concurrent prison sentence, number of entries in the criminal register, and attendance at prior substitution programs. The model for group B covered five out of eight predictors: regular working activities before first diagnosis of mental illness, type of main offense, (secondary) traffic offenses, outpatient rehabilitation treatments, and escapes during treatment. Successful completers of forensic addiction treatment are slower to re-offend than non-completers.     

The impact of an intensive inpatient violent offender treatment programme on intermediary treatment targets,violence risk and aggressive behaviour in a sample of mentally disordered offenders*

This study examined the impact of an intensive inpatient violent offender treatment programme, Life Minus Violence-Enhanced (LMV-E), on intermediary treatment targets, risk for violence, and aggressive behaviour during treatment in a sample of male mentally disordered offenders. Using quasi-experimental design, offenders who completed LMV-E and a comparison group showed reduced problems with impulsivity and anger regulation and improvements in social problem solving. Aggregate risk for future violence lessened in both treatment and comparison groups, although by a significantly greater degree for the comparison group. The aggressive behaviour of both groups reduced. Completion of the LMV-E conferred additional improvements in some facets of social problem solving and anger regulation. Neither group showed improvements in empathic responses, coping skills or problematic interpersonal style. Overall, these results suggest anger regulation, impulsivity and social problem solving are most amenable to change, that reductions in certain facets of these dynamic risk factors transpires with nonspecific psychiatric inpatient treatment, but that the LMV-E, a cognitive behavioural violence specific psychological treatment, confers greater change in some facets of social problem solving and anger regulation.