Developing a theory of dynamic risk

ABSTRACT

The Propensities Model is now the dominant applied conceptualization of dynamic risk factors for sexual offending. In this paper five important limitations of this model are identified: it asserts causality but does not explain it; it does not represent human agency; it offers no account of what is involved in the development of propensities; it does not explain stable change in risk; and its account of the operation of static factors is a theoretical leap not supported by the evidence. A more elaborate theoretical framework is developed by integrating ideas from Ward's Good Lives model, Beck's account of schema modes, and Fishbein and Ajzen's Theory of Reasoned Action. This more elaborate framework incorporates the Propensities Model in a way that mitigates its limitations. Implications for research, assessment, and rehabilitation are explored.     

The impact of pre-treatment responsivity and treatment participation on violent recidivism in a violent offender sample

This study assessed whether pre-treatment responsivity (psychopathy, motivation to attend treatment, denial and minimisation of offending behaviour, and feelings of guilt or shame) predicted violent recidivism and/or moderated the effectiveness of a violence intervention programme. Participants were 114 male violent offenders who were referred to a structured violent offender group treatment programme; 84 offenders commenced the programme. Results showed that treatment completion did not have a significant main effect on recidivism but that psychopathy scores moderated the effects of treatment. Offenders with high scores on the Psychopathy Checklist: Screening Version (PCL:SV) who were rated as having good engagement with treatment, or who completed treatment, had similar violent recidivism rates compared to offenders with low PCL:SV scores. In contrast, offenders with high PCL:SV scores who dropped out of treatment or were poorly engaged had significantly higher rates of violent recidivism. These findings indicate that treatment effectiveness could be enhanced, and greater reductions in recidivism achieved, if programmes find ways to engage and maintain psychopathic offenders in treatment.     

精神障碍患者约束和隔离措施的法律规制

约束和隔离是严重剥夺精神障碍患者人身自由的强制措施。约束和隔离实施中所存在的非人道性、危险性和负面效果使得该措施饱受争议,因而法律只允许在例外情况下使用约束和隔离措施,并对其实施条件和程序予以严格限制。即,在实体上明确约束和隔离措施的适用条件和情形,在程序上明确约束和隔离措施的实施步骤,从而构筑起约束、隔离的法律规制体系。     

基于“治养并重”理论，运用推拿联合易筋经治疗 神经根型颈椎病临床观察

[摘要]目的 基于国医大师李业甫“治养并重”理论,观察推拿联合易筋经治疗神经根型颈椎病（cervical spondylotic radiculopathy,CSR）的临床疗效。方法 前瞻性收集60例CSR住院患者,依据其是否愿意接受易筋经习练分别纳入治疗组和对照组,两组各30例。治疗组患者在院接受推拿联合易筋经治疗,出院后1个月继续习练易筋经;对照组在院接受推拿治疗,出院后1个月无任何干预。分别于治疗前、治疗后、出院1个月后观察两组患者颈部肌肉弥散张量成像（diffusion tensor imaging,DTI）参数、疼痛视觉模拟量表（visual analogue scale,VAS）评分、颈椎功能障碍指数（neck disability index,NDI）量表评分,并于出院1个月后评定疗效。结果 与治疗前比较,治疗后两组患者DTI参数中患侧胸锁乳突肌、头夹肌ADC值,VAS评分,NDI评分均明显降低,患侧胸锁乳突肌、头夹肌FA值均明显升高,差异均有统计学意义（P＜0.05）;治疗组胸锁乳突肌、头夹肌ADC值,头夹肌FA值,NDI评分改善程度均明显优于对照组（P＜0.05）。与治疗后比较,出院1个月后除对照组患者患侧胸锁乳突肌、头夹肌FA值差异无统计学意义（P＞0.05）外,两组患者胸锁乳突肌、头夹肌ADC值,VAS评分,NDI评分均明显改善,差异有统计学意义（P＜0.05）;且治疗组DTI参数、VAS评分、NDI评分改善程度均明显优于对照组（P＜0.05）。治疗组临床疗效优于对照组（P<0.05）。结论 “治养并重”指导下推拿联合易筋经治疗CSR可修复颈肌纤维、减轻疼痛、提高颈椎功能及临床疗效,较单纯推拿疗效更佳。     

Heterogeneous effects of adolescent violent victimization on problematic outcomes in early adulthood*

Violent victimization—particularly when it happens to young people—can inflict a wide array of negative consequences across the life course. Nevertheless, some victims are more likely to suffer these consequences than others, and we do not have a very good understanding of why that is. One promising avenue of research is to examine how individuals’ differential risks of being victimized affect the extent to which they experience negative outcomes. By using propensity score matching and data from the National Longitudinal Study of Adolescent to Adult Health (N = 8,323), in this study I estimate the heterogeneous effects of adolescent violent victimization on several problematic outcomes in early adulthood (violent and property offending, subsequent violent victimization, depressive symptoms, hard drug use, and low educational attainment). Individuals’ differential risks of adolescent violent victimization are estimated with a host of personal, social, and contextual factors, including prior experiences with crime and violence. The results show that the consequences of adolescent victimization in early adulthood are more pronounced for youth with the lowest risks of being victimized. These findings have important implications for theory, research, and practice, and they emphasize that the consequences of victimization cannot be understood separately from the sources of victimization.     

Unexpected Human Fatality Associated with Bed Bug (Hemiptera: Cimicidae) Heat Treatment

Thermal insect treatments can be an effective method of controlling cryptic insect pests, particularly bed bugs, in residential settings. The treatments require high heat over a sustained timeframe. Residents are not present during treatment but return after completion. An unexpected death was investigated following heat treatment for bed bugs in the home of an elderly female, found with a postmortem axillary temperature of 106.2°F (41.2°C) approximately 8 h after returning home. The cause of death was classified as hyperthermia with a contributory cause of hypertensive cardiovascular disease. The manner of death was an accident. The decedent had medical history and medications that could have impaired her ability to dissipate heat. Furthermore, the air conditioning inside the residence was not functional following treatment. Recommendations including education regarding heat stroke and treatment, re‐entry timeframes, and/or temperature thresholds are suggested to reduce the risk of heat‐related injury or death in vulnerable populations.     

论社区矫正分级处遇机制的完善

我国社区矫正工作实践已普遍实行分级处遇,但还存在分级前过渡期性质不明、分级标准模糊、分级动态调整评估机制不完善、处遇等级之间的差异过小等缺陷。完善分级处遇机制有利于节约社区矫正行刑资源、增强社区矫正的激励性与威慑性、帮助社区服刑人员回归社会。为此,应当明确分级前过渡期的性质,规范分级评估,完善分级动态调整评估,增强不同处遇等级的差异,对未成年人分级处遇作出特殊规定。     

Mental illness in the eyes of the law: examining perceptions of stigma among judges and attorneys

In response to the increasing numbers of mentally ill persons placed under the care of correctional institutions, community-based diversion programs have been established to address the unique needs and challenges of this vulnerable population. Given that legal personnel may serve as gatekeepers in placement decisions, and the lack of existing research examining their attitudes toward offenders with mental illness, the present study aimed to evaluate perceptions of dangerousness and treatment need among a sample of judges, prosecutors, and public defenders across the state of Mississippi. While controlling for age, results of a factorial MANCOVA revealed that public defenders, relative to both judges and prosecutors, endorsed more compassionate attitudes about defendants with mental illnesses. Furthermore, political ideology did not significantly influence attitudes toward mentally ill offenders. While judges and prosecutors endorsed more negative stereotypes about mental illness and perceived mentally ill defendants as a greater risk to the community, mean scores across groups suggested moderately positive attitudes overall. Study limitations, implications for correctional mental health providers, and directions for future research are discussed.     

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.