Exploration of socio-family and psychological characteristics of young males convicted of murder or attempted murder in the province of Buenos Aires, Argentina / Exploración de las características sociofamiliares y psicológicas en jóvenes con comportamiento homicida de la provincia de Buenos Aires, Argentina

Abstract Introduction: Different developmental and environmental vulnerability conditions can influence violent behavior in young people. Objectives: To describe the characteristics of young males who were convicted of murder or attempted murder in the province of Buenos Aires, based on indicators of maturity, impulsivity, and socio-family vulnerability. Materials and Methods: Descriptive and exploratory study. The sample consisted of 195 young men (mean: 16.8 years) imprisoned in reformatory institutions of the Province of Buenos Aires, Argentina, as they were convicted of murder (n=130), repeated murder (n=15), or attempted murder (n=50). Self and hetero-informed instruments, and professional assessment scales were used, namely: the Consideration of Future Consequences Scale (CFC); the Psychosocial Maturity Inventory (PSM); the Weinberg Adjustment Inventory (WAI); the Resistance to Peer Influence Questionnaire (RPIQ); the Psychopathy Checklist: Youth Version (PCL:YV); the Inventory of Callous Unemotional Traits (ICU), and the Barrat Impulsiveness Scale version 11 (BIS-11). Results: The distribution of the total BIS 11 and the PSM Individual Adaptation were normal (mean: 62.33 and 6.38, respectively). The mean of the total PCL:YV was 25.87. In 32.8% of the cases a first degree relative was also imprisoned. "Impulsive" and "Non-impulsive" clusters were empirically established. Conclusions: The participants' profile is characterized by several psychological and socio-family vulnerabilities that should be targeted in preventive interventions aimed at preventing violent recidivism.

Resumen Introducción. Diversas condiciones de vulnerabilidad dependientes del desarrollo y de las influencias medioambientales pueden influir en las conductas violentas juveniles. Objetivos. Describir las características de jóvenes que cometieron homicidio o intento de homicidio atendiendo a indicadores de madurez, impulsividad y vulnerabilidad sociofamiliar. Materiales y métodos. Estudio de diseño descriptivo y exploratorio. Los participantes fueron 195 varones jóvenes (media: 16.8 años) institucionalizados en la provincia de Buenos Aires, Argentina, por orden judicial por haber cometido homicidio (n=130), homicidio reiterado (n=15) o tentativa de homicidio (n=50). Se utilizaron instrumentos auto y heteroinformados y las escalas de evaluación profesional Consideration of Future Consequences Scale (CFC), Psychosocial Maturity Inventory (PSM), Weinberg Adjustment Inventory (WAI), Resistance to Peer Influence (RPI), Psychopathy Checklist: Youth Version (PCL:YV), Inventory of Callous Unemotional Traits (ICU) y Barrat Impulsiveness Scale version 11 (BIS 11). Resultados. La distribución de BIS 11 total y de PSM Adecuación Individual fueron normales, con medias de 62.33 y 6.38, respectivamente; la media de PCL: YV total fue 25.87. El 32.8% de los jóvenes tenía familiares de primer grado presos. Se configuraron empíricamente los clusters "impulsivo" y "no impulsivo". Conclusiones. El perfil de los participantes se caracteriza por diversas vulnerabilidades psicológicas y sociofamiliares que deberían ser blanco de intervención preventiva de recidiva violenta.

Structural equation modeling of psychopathic traits in Chilean female offenders using the Self-Report Psychopathy-Short Form (SRP-SF) Scale: a comparison of gender-based item modifications versus standard items

Objective: To examine the utility of the Self-Report Psychopathy-Short Form (SRP-SF) to assess psychopathic traits in female offenders and to test gender-based item modifications. Method: A South American sample of female offenders (n=210) was assessed with the Psychopathy Checklist-Revised (PCL-R); 110 subjects also completed the standard SRP-SF, while 109 completed a version with items rewritten to be more relevant for females. The underlying latent structure of the PCL-R and both versions of the SRP-SF were examined. Results: Most of the modified items showed higher average item responses. The PCL-R showed a stronger association with the modified SRP-SF than with the standard SRP-SF. The four-factor model showed very good fit in accounting for the PCL-R data, consistent with previous research. For both SRP-SF versions, the results indicated good model fit. Structural equation models were tested separately, in which a superordinate SRP-SF factor was set to predict a broad factor reflecting chronic misconduct. Both versions showed good model fit, and the SRP-SF superordinate factor significantly predicted a chronic misconduct factor. Conclusions: Both versions of the SRP-SF adequately reflected psychopathic features in this female sample; the modified items added robustness to representation of these features.

Servicios universitarios en la interfaz del derecho y la salud mental: el caso de la Universidad de Cuenca, Ecuador / University services in the interface of the law and mental health: the case of the University of Cuenca, Ecuador / Serviços universitários na interface do direito e a saúde mental: o caso da Universidade da Cuenca, Equador

Introducción: Los sistemas de salud mental forense incluyen servicios universitarios relevantes para la prevención de la violencia y la protección de los derechos humanos. Objetivos: Describir el servicio del Instituto de Criminología, Criminalística e Intervención Psicosocial Familiar de la Universidad de Cuenca, Ecuador. Material y métodos: Estudio con diseño mixto, sección cuantitativa descriptiva de serie consecutiva de casos ingresados al instituto entre el 01/01/2015 y el 30/06/2015, y sección cualitativa con exploración de sus expedientes. Resultados: 52 casos ingresaron al instituto durante el período. Se estudiaron 72 personas, con promedio de edad de 22,6 años y distribución por sexo equitativa. El 88,5 % tuvieron requerimiento de intervención. Los temas principales detectados cualitativamente fueron"violencia intrafamiliar","protección infantil","protección juvenil","protección al discapacitado","asistencia a víctimas de abuso sexual","consulta comunitaria directa","fortalezas y debilidades del servicio pericial" y"consumo de alcohol". Conclusiones: Evaluados y asistidos presentan problemas complejos relacionados con la violencia y sus secuelas. El instituto brinda servicios a instituciones judiciales, municipales y directamente a la comunidad, y es una excelente fuente de experiencia académica.

Introduction: Forensic mental health systems include relevant university services for the prevention of violence and the protection of human services. Objectives: Describe the service offered by the"Instituto de Criminologia, Criminalística e Intervencion Psicosocial Familiar" of the Universidad de Cuenca, Ecuador. Material and methods: A study with a mixed design, a descriptive quantitative section with a consecutive series of cases admitted to the Institute between 01/01/2015 and 30/06/2015, and a qualitative one including its dossier exploration. Results: 52 persons were admitted to the institute during that period. 72 individuals with an average age of 22.6 years and an equitable distribution by genders were analyzed in that period. 88.5 % had an intervention requirement. The main subjects detected on a qualitative basis were"domestic violence","child protection","youth protection","protection of the disabled", assistance to victims of sexual abuse","direct community consultation","strengths and weakness of expertise services", and"alcohol consumption". Conclusions: Both evaluated and assisted individuals exhibit complex problems relating to violence and its negative effects. The Institute offers services to judicial and municipal institutions, and directly to the community itself. It is an excellent source of academic experience.

Introdução: Os sistemas da saúde mental forense incluem serviços universitários relevantes para a prevenção da violência e a proteção dos direitos humanos. Objetivos: Descrever o serviço do Instituto de Criminologia, Criminalística e Intervenção Psicosocial Familiar da Universidade de Cuenca, Equador. Material e métodos: Estudo com projeto misturado, seção quantitativa descritiva da série consecutiva dos casos ingressados ao instituto entre o 01/01/2015 e o 30/06/2015, e à seção qualitativa com exploração dos seus processos. Resultados. 52 casos ingressaram no instituto durante o período. 72 pessoas foram examinadas, com médio de idade de 22,6 anos e distribuição pelo sexo equitativa. O 88,5% tiveram exigência de intervenção. Os assuntos principais detectados qualitativamente foram"violência intrafamiliar","proteção infantil","proteção jovem","proteção á pessoa com deficiência","assistência às vítimas do abuso sexual","consulta comunitária direta","forças e fraquezas do serviço pericial" e"o consumo álcool". Conclusões. As pessoas avaliadas e assistidas apresentam-problemas complexos relacionados à violência e a suas sequelas. O instituto oferece serviços às instituições judiciais, municipais e diretamente à comunidade, e é uma fonte excelente da experiência académica.

The construct of psychopathy in a Chilean prison population

Objective:To test the four-factor model of the Hare Psychopathy Checklist - Revised (PCL-R) empirical construct of psychopathy in a Chilean prison population by using instruments that supply different types of data.Methods:Two hundred and nine male inmates of the Prison of Los Andes, Chile, were evaluated. Confirmatory factor analysis was carried out with the PCL-R and the Self-Report of Psychopathy - III - Short Form (SRP-III-SF).Results:The distributions of total PCL-R and SRP-III-SF scores were normal (Kolmorogov-Smirnov [K-S] = 1.04, p = 0.230; K-S = 0.812, p = 0.525, respectively), with means of 20.9±6.8 for the former and 61.6±15.2 for the latter. Model fit was good for the PCL-R (Tucker Lewis index [TLI] = 0.96; root mean square error of approximation [RMSEA] = 0.04) and for the SRP-SF (TLI = 0.94, RMSEA = 0.04).Conclusions:The results obtained with the PCL-R and the SRP-SF showed adequate fit to the empirical four-factor model of psychopathy and support this model. As foreseeable, fit was better for the PCL-R, which combines several sources of information.

La práctica de la evaluación del riesgo de violencia en España / The practice of violence risk assessment in Spain

Antecedentes. La valoración del riesgo de violencia es un requisito fundamental en la toma de decisiones profesionales que implican prevenir, intervenir o informar sobre la conducta de las personas. El uso de herramientas estructuradas de evaluación del riesgo de violencia ha mostrado mejoría en la precisión de las evaluaciones basadas exclusivamente en el juicio clínico o en la pericia de un experto en contextos psiquiátricos, penitenciarios y jurídicos. Objetivo. Este estudio presenta los resultados de la primera encuesta sobre las prácticas profesionales asociadas al uso de herramientas de evaluación del riesgo de violencia en España. Materiales y métodos. La información fue recogida mediante la administración de una encuesta en internet que fue distribuida por correo electrónico a los miembros de organizaciones profesionales. Resultados. De manera similar a los contextos profesionales del resto del mundo, las escalas de psicopatía de Robert Hare (Psychopathy Checklist-Revised y Psychopathy Checklist: Screening Version) y el Historical-Clinical-Risk Management-20 encabezaron la lista de las herramientas más usadas tanto por elección personal como por requisito institucional. Conclusiones. Se ofrecen datos novedosos sobre la prevalencia de uso y la utilidad percibida de las herramientas estructuradas, así como sobre otras cuestiones relacionadas a las prácticas profesionales de evaluación del riesgo de violencia en España que pueden orientar tanto a los profesionales de contextos sanitarios, correccionales y forenses, como a los responsables de las instituciones en la elección de las herramientas a implementar para asistirlos en la toma de decisiones.

Background. Violence risk assessment is a key requirement in professional decision making involving prevention, intervention or reporting on human behavior. The use of structured tools for violence risk assessment has shown to improve the accuracy of assessments based exclusively on clinical judgment or expertise in psychiatric, correctional and legal settings. Objectives. This study presents results of the first survey about professional practices associated with tools for violence risk assessment in Spain. Materials and methods. The information was collected by administering an online-based survey that was distributed by e-mail to members of professional organizations around the country. Results. As in professional contexts worldwide, the Robert Hare's psychopathy scales (Psychopathy Checklist-Revised and Psychopathy Checklist: Screening Version) and the Historical-Clinical-Risk Management-20 topped the list of the most used tools both by professional choice and institutional requirement. Conclusions. We provide novel data on the prevalence of use and the perceived utility of specific tools, as well as on other issues related to the professional practice of violence risk assessment in Spain, which can guide professional in the health care, correctional and forensic settings, as well as those responsible for decisions in institutions about choosing which tool to implement.

Homicidas juveniles en Bogotá, estudio de grupos focales / Young murderers in Bogotá, a focus groups study

Antecedentes. La violencia ha sido declarada un problema de salud pública mundial. En los últimos años, se ha visto un incremento alarmante de la violencia causada por adolescentes, reflejado en indicadores como el número de homicidios. Los adolescentes son victimarios y víctimas de muchos de estos actos violentos. Colombia no escapa a este fenómeno -donde el homicidio es la principal manera de muerte violenta- y se cuenta con pocos estudios en población homicida juvenil. Objetivo. Explorar comportamientos asociados a cometer homicidio en jóvenes escolarizados y población no escolarizada. Materiales y métodos. Estudio cualitativo mediante técnica de grupos focales. Resultados. Se encontró como el factor de riesgo más implicado la disponibilidad y uso de armas. Otros factores de riesgo afectan la disposición del joven homicida para tener un comportamiento criminal y las estrategias de control que son elegidas por el individuo. Dichos factores son apreciados de maneras distintas por los jóvenes homicidas y los no homicidas. Conclusión. Este estudio arroja información clave que puede ser utilizada en el diseño e implementación de estrategias para enfrentar el homicidio juvenil como problema de salud pública.

Background. Violence has been declared as a public health problem in the world. In the last years, there has been an alarming increase of the violence caused by adolescents. This has been reflected in several indicators as the number of homicides. Adolescents are both criminals and victims of many of these violent acts. Colombia has not escaped this phenomenon -being homicide its main way of violent death- and there is little specific data on juvenile homicidal population. Objective. To explore likely risk factors linked to homicide committed by two young populations: a schooled one and non-schooled one. Materials and methods. A qualitative study of two focus groups: one composed by young murderers and another by young non-murderers. Results. Studies show that the main risk factor is the access to and the use of weapons. Other risk factors affect the young's murder disposition to develop a criminal behaviour and the control strategies chosen by them. Such factors are interpreted in different ways by young murderers and non-murderers. Conclusions. This study gives important data which can be used in order to design and establish strategies to handle juvenile murder as a public health issue.

Tópicos actuales de la investigación internacional sobre riesgo de violencia / Current topics regarding international research on the violence risk / Temas atuais da investigação internacional sobre o risco da violência

Introducción: La producción de investigación sobre riesgo de violencia muestra gran heterogeneidad internacional y, especialmente, escasez y lenta difusión en Latinoamérica. Objetivos: Obtener una visión configurativa de los tópicos pertinentes al riesgo y prevención secundaria de la violencia, que son focos actuales de la investigación internacional. Método: Revisión de artículos científicos publicados en inglés durante agosto-octubre del 2013 y de artículos en español que se publicaron durante el 2013-2014. La selección se realizó con base en los trabajos en inglés detectados por la "Alliance for International Risk Research", y en los publicados en español hallados con búsqueda en LILACS y SciELO con las palabras clave "riesgo" y "violencia", además de consulta a red de expertos. Resultados: 45 artículos en inglés y siete en español resultaron pertinentes para los objetivos del estudio. Se verificó amplia preocupación por la sistematización de la evaluación del riesgo de violencia y por la planificación y el monitoreo de las intervenciones de prevención secundaria. Predominaron los tópicos relacionados con la confiabilidad, validez y utilidad práctica de los instrumentos de evaluación de riesgo de violencia.

Introduction: The production of research dealing with the violence risk shows significant international heterogeneity and, particularly, scarce results and a slow dissemination in Latin America. Objectives: To obtain a configurative vision of topics that are relevant to risk assessment and secondary prevention of violence that are the present matters on which international research is focused. Method: The review of scientific articles published in English during August-October 2013 and in Spanish through 2013-2014. The selection made was based on the works written in English as found by the "Alliance for International Risk Research", and on those published in Spanish observed through searches in LILACS and SciELO with the Key Words "riesgo" y "violencia" ("risk and violence"), apart from expert-network consultations. Results: 45 articles in English and seven in Spanish were found relevant for the study purposes. Widespread concern was confirmed with respect to the systematization of violence risk assessment and the planning and monitoring of secondary prevention interventions. Topics relating to reliability, validity and practical usefulness of violence-risk assessment instruments prevailed.

Introdução: A produção da investigação sobre o risco da violência mostra a grande heterogeneidade internacional e, especialmente, escassez e a difusão lenta em América Latina. Objetivos: Para obter uma visão configurativa dos temas pertinentes ao risco e à prevenção secundária da violência, que são focos atuais da investigação internacional. Método: Revisão de artigos científicos publicada em inglês durante agosto-outubro do 2013 e de artigos no espanhol que foram publicados durante 2013-2014. A seleção foi feita com base nos trabalhos em inglês detectados pela "Alliance for International Risk Research", e nos publicadas no espanhol encontrados com busca em LILACS e SciELO com as palavras chaves "risco" e "violência", além da consulta à rede dos especialistas. Resultados: 45 artigos em inglês e sete em espanhol resultaram pertinentes para os objetivos do estudo. Verificou-se ampla preocupação pela sistematização da avaliação do risco da violência e pelo planejamento e pelo monitoramento das intervenções da prevenção secundária. Predominaram os temas relacionados à confiança, à validez e à utilidade prática dos instrumentos da avaliação do risco da violência.

Confiabilidad de la versión chilena de la Hare PCL-R y validez convergente con otros instrumentos de evaluación de psicopatía / [Reliability of the chilean version of the Hare PCL-R and convergent validity with other assessment tools for psychopathy].

INTRODUCTION: Evaluation of mental health in forensic field is relevant in order to plan interventions and diminish institutional risks. The procedure includes the evaluation of psychopathic traits, which should be assessed by reliable and valid instruments. OBJECTIVES: To evaluate the internal congruence of the Chilean version of the PCL-R, and the convergent validity with the PCL: SV, the SRP-III-SF and the IM-P. To explore the utility of the PCL: SV as screening tool. MATERIAL AND METHOD: The population of sentenced inmates of the Jail of Los Andes, Chile, was evaluated in a cross sectional study (N=209 inmates of a universe of 235 eligible subjects). Data was obtained from different sources and the interviews were video-recorded. The PCL-R, PCL: SV, IM-P and SRP-III-SF were used. RESULTS: Cronbach Alpha for the PCL-R total score was 0.97. The correlation of the total PCL-R score with the PCL: SV was 0.87; 0.37 with the SRP-III-SF and 0.75 with the IM-P. Sensibility of the PCL: SV was 1 and specificity 0.90 thus concluding that it is an excellent screening test.

El uso de instrumentos de evaluación de riesgo de violencia en Argentina y Chile / The use of violence risk assessment instruments in Argentina and Chile / O uso dos instrumentos da avaliação do risco da violência na Argentina e no Chile

Introducción: En las últimas décadas hubo importantes avances científicos en la sistematización de la evaluación del riesgo de violencia, pero esas contribuciones no se implementan de manera rápida ni uniforme en la práctica latinoamericana. Objetivos: Describir qué instrumentos de evaluación de riesgo de violencia se utilizan en Chile y Argentina, y qué características tiene esa práctica profesional. Material y método: Se realizó una encuesta a través de la web, a profesionales relacionados con la salud mental registrados en listas nacionales e internacionales de 17 países, entre septiembre y diciembre del 2012. En el estudio se informan resultados de 46 respondientes de Chile y Argentina. Resultados: El 78% de los psiquiatras, el 93% de los psicólogos y el 100% de los trabajadores sociales utilizaron instrumentos para ERV; la amplia mayoría los consideró relativamente útiles. Los instrumentos más utilizados fueron HCR-20, PCL-R y PCL-SV.

Introdução: Nas últimas décadas houve avanços científicos importantes na sistematização da avaliação do risco da violência, mas aquelas contribuições não são executadas rapidamente nem uniformemente na prática latino-americana. Objetivos: Descrever que instrumentos da avaliação do risco da violência são usados no Chile e na Argentina, e que características tem essa prática profissional. Material e método: Uma pesquisa foi feita através da Web, aos profissionais relacionados à saúde mental registrados nas listas nacionais e internacionais de 17 países, entre setembro e dezembro do 2012. No estudo os resultados de 46 respondentes do Chile e da Argentina são informados. Resultados: 78% dos psiquiatra, 93% dos psicólogos e o 100% dos trabalhadores sociais usaram instrumentos para ERV; a ampla maioria os considerou relativamente úteis. Os instrumentos mais usados foram HCR-20, PCL-R e PCL-SV.

Introduction: The last decades revealed important scientific advances in the systemization of violence risk assessment; nevertheless, the implementation in practice of these contributions have neither been fast nor uniform in Latin America. Objectives: The article is aimed at describing the instruments for violence risk assessment used in Chile and Argentina and the features of this professional practice. Material and method: A web survey was carried out among mental health-related professionals registered in the national and international lists of 17 countries between September and December 2012. The results obtained from 46 respondents from Chile and Argentina are reported in this study: 78% of the psychiatrists, 93% of the psychologists and 100% of the social workers involved have employed violence risk assessment (VRA) instruments deemed relatively useful by a wide majority, being HCR-20, PCL-R and PCL-SV the most commonly used.

Aproximación diagnóstica de psicopatía mediante instrumento autoinformado / A diagnose approach to psychopathy using a self-report instrument / Aproximação diagnóstica da psicopatia por meio do instrumento autoinformado

Introducción: Dada la relevancia clínica y social que tiene la psicopatía, resulta útil contar con instrumentos autoinformados para la aproximación diagnóstica a la psicopatía. Objetivos: Evaluar la congruencia interna y la validez convergente del Self Report of Psychopathy-Short Form. Material y métodos: Se evaluaron 208 personas condenadas, alojadas en el Centro de Cumplimiento Penal de la Provincia de Los Andes, Chile. Se utilizaron el SRP-III-SF, el PCL-R y la HCR-20. Resultados: La distribución de valores del SRP-III-SF tuvo una media de 61,6 y fue normal. El Coeficiente de Alfa de Cronbach para el total fue 0,8 y para los factores 1, 2, 3 y 4 fue 0,7, 0, 4, 0,7 y 0,5, respectivamente. La correlación del SRP-III-SF con el PCL-R fue 0,4 (p = 0,01) y con HCR 20, 0,5 (p < 0,001). El riesgo de diagnóstico de psicopatía con el PCL-R aumentó en forma lineal para cada cuartil de la distribución del SRP-SF. El área bajo la curva ROC fue 0,66 (p = 0,05; 95% IC 0,5; 0,8).

Introduction: Given the clinical and social relevance of psychopathy, it is desirable to have self-report instruments for a proper diagnostic approach. Objectives: Assess the internal congruence and convergent validity of the Self Report of Psychopathy Scale III-Short Form. Material and Methods: 208 convicts housed at the “Centro de Cumplimiento Penal” detention center in the Province of Los Andes, Chile, were evaluated using the SRP-III-SF, PCL-R, and HCR-20 schemes. Results: the SRP-III-SF distribution was normal, with a mean of 61.6. The Cronbach’s Alpha Coefficient for the total was 0.8, and 0.7, 0.4, 0.7 and 0.5 for the 1, 2, 3, and 4 factors respectively, while the correlations of SRP-III-SF with PCL-R and HCR 20 were, respectively, 0.4 (p = 0.01) and 0.5 (p < 0,001). The scores of the PCL-R diagnosed psychopathy were linearly higher for each quartile of the SRP-SF distribution. The area under the ROC curve was 0.66 (p = 0.05; 95% IC 0.5; 0.8).

Introdução: Dada a relevância clínica e social que tem a psicopatia, é útil contar com instrumentos autoinformados para a aproximação diagnóstica à psicopatia. Objetivos: Avaliar a congruência interna e a validez convergente do Self Report of Psychopathy-Short Form. Material e métodos: Avaliaram-se 208 pessoas condenadas, alojadas no Centro de Cumprimento Penal da Província dos Andes, Chile. SRP-III-SF, PCL-R e HCR-20 foram usados. Resultados: A distribuição dos valores do SRP-III-SF teve uma média de 61.6 e foi normal. O Coeficiente do Alfa de Cronbach para o total foi 0.8 e para os fatores 1, 2, 3 e 4 foi 0.7, 0.4, 0.7 e 0.5, respectivamente. A correlação do SRP-III-SF com PCL-R foi 0.4 (p = 0.01) e com HCR 20, 0.5 (p < 0.001). O risco do diagnóstico de psicopatia com o PCL-R aumentou em forma linear para cada quartil da distribuição do SRP-SF. A área sob a curva ROC foi 0.66 (p = 0.05; 95% IC 0.5; 0.8).

El juego patológico, las conductas ilegales y la potencialidad preventiva del servicio de ayuda telefónica en Argentina / [Pathological gambling, illegal behavior and the preventive potentiality of a helpline in Argentina].

INTRODUCTION: The evolution of Pathological Gambling has some important landmarks such as the age of onset, time elapse between onset and the perception of gambling consequences and their severity. These events encourage the exploration of the preventive potential of a helpline service for gamblers, thus the contact with this service might be the beginning of opportune intervention. OBJECTIVES: To describe and to compare the course and complications due to gambling reported by two Argentineans gambler population with access to different services: a sample of participants of a self-help group; and a sample of helpline clients. METHOD: A total of 268 gamblers were surveyed using a structured interview that included the Brief Questionnaire of Pathological Gambling. The sample was composed by 174 subjects attending self-help groups (Anonymous Gamblers); and 94 consecutive callers to a gambling helpline in Argentina. RESULTS: 76

of Anonymous Gamblers and 33

IC 3.6; 11.6). The disorder and the negative consequences were more severe in the Anonymous Gamblers group. Mean age of onset of gambling for helpline clients was 35 years and for Anonymous Gamblers 28. The mean time elapsed to perceiving economic problems was 5 years for helpline clients and 7 for Anonymous Gamblers. The findings support that helpline services promote the seek for help in those gamblers that have not yet reached the summit of the disorder.

Sistema de justicia juvenil en la provincia de Buenos Aires y métodos de evaluación / The Juvenile Justice System in the Province of Buenos Aires and evaluation methods

Los objetivos del presente artículo son describir el sistema de justicia juvenil en la provincia de Buenos Aires (Argentina) desde las perspectivas jurídica y ejecutiva, y comunicar avances científicos globales en la evaluación de los jóvenes que cometen actos disociales. En la provincia de Buenos Aires el sistema ha sido profundamente modificado en los últimos 15 años siguiendo las premisas de la Convención Internacional sobre los Derechos del Niño y dejando relegado el modelo del Patronato, que había regido previamente. Las instituciones encargadas de la ejecución de la intervención dispuesta por el Poder Judicial dependen actualmente de la Subsecretaria de Niñez y Adolescencia del Ministerio de Desarrollo Social y constan de centros cerrados, centros con régimen de semilibertad y centros de intervención ambulatoria (medidas alternativas a la prisión, tales como suspensión de juicio a prueba o tareas comunitarias). Las ciencias relacionadas con la salud mental y con el comportamiento vienen contribuyendo a la identificación de diversos factores influyentes en la conducta disocial y con el diseño de tipos de intervención para cada nivel de prevención. Sin embargo, hay una distancia importante entre las potencialidades del estado actual del conocimiento y la implementación. En las condiciones expuestas, queda configurado un período de transición que aún requiere optimización de la política de infancia con ajustes legislativos, judiciales y administrativos y con la capitalización de los aportes científicos.

The aim of this article is to describe the Justice System for juveniles in the Province of Buenos Aires, Argentina, from a legal and administrative perspective; and to review recent contributions to the assessment of youth with dissocial behaviors. During the last 15 years, the system has been deeply modified in order to fit the recommendations of the Convention on the Rights of the Child's. At present, the dispositions of the Courts are carried out by the Sub - Secretariat of Childhood and Youngsters of the Ministry of Social Development. This Secretariat has different facilities, such as closed, mixed centers that combine indoors and outdoors detention centers, open centers (in charge of the application of the sentences that bear alternatives to prison dispositions and community enforced services, etc). Studies from mental health and behavioral sciences have contributed to the identification of risk factors for dissocial behavior and for developing adequate interventions for each specific level of prevention. However, there is still a big gap between the state of the art and the practical issues related to it. Thus, the local system can be considered to be in transition period, and in need of adjustments not only in the legal codes but also in the application of the law, if policy improvement and better use of scientific knowledge is intended.

Incidência de conduta violenta e antissocial em população psiquiátrica forense / Incidence of violent and antisocial behavior in a forensic psychiatric population

INTRODUÇÃO: As consequências de comportamentos violentos e antissociais de internos em hospitais psiquiátricos são graves e podem determinar prejuízo ao tratamento do agressor. A falta de conhecimento sobre a incidência desse fenômeno e suas características favorece sua perpetuação. OBJETIVOS: Apresentar uma revisão bibliográfica atualizada do tema, informar a incidência de conduta violenta e antissocial em uma população manicomial e descrever a implementação de um método de registro sistematizado desse fenômeno. MÉTODO: A coorte foi selecionada dentro da população de pacientes do Instituto Psiquiátrico Forense Maurício Cardoso (IPFMC). Foi utilizada a Escala de Agressividade Declarada de Yudofsky (Overt Aggression Scale, OAS) e o Questionário de Seguimento de Tengström et al. Durante o período de seguimento de 1 ano, foram avaliados diariamente episódios de conduta violenta e antissocial, registrando-se os mesmos na escala e no questionário. A amostra em estudo foi composta de 68 pacientes homens selecionados de forma aleatória entre a população em cumprimento de medida de segurança no IPFMC. RESULTADOS: A incidência de comportamento violento/antissocial no período estudado foi de 200 episódios, envolvendo 50 pacientes. Houve predomínio de agressões e conduta antissocial durante o dia. As intervenções mais utilizadas foram manejo verbal, isolamento do paciente e aplicação de medicação intramuscular. CONCLUSÃO: Foi possível, pela primeira vez, medir a ocorrência de conduta violenta e antissocial em uma população psiquiátrica forense.

INTRODUCTION: The consequences of violent and antisocial behaviors among psychiatric hospital inpatients are serious and may affect the treatment of the aggressor. Lack of knowledge concerning the incidence of this phenomenon and its characteristics helps perpetuate the current scenario. OBJECTIVES: To present an updated literature review on the topic, to estimate the incidence of violent and antisocial behaviors in a mental hospital population, and to describe the implementation of a systematic method to record this phenomenon. METHOD: A cohort was selected among the psychiatric inpatients at Maurício Cardoso Forensic Psychiatry Institute (Instituto Psiquiátrico Forense Maurício Cardoso, IPFMC). Yudofsky's Overt Aggression Scale (OAS) and Tengström et al.'s Follow-Up Questionnaire were used. During a 1-year follow-up period, episodes of violent and antisocial behavior were evaluated daily and recorded on both the scale and the questionnaire. The population sample included 68 male patients randomly selected among the committed inpatients at IPFMC. RESULTS: The incidence of violent/antisocial behavior along the period assessed was 200 episodes involving 50 patients. Aggressions and antisocial behavior occurred mainly in daytime. The interventions most commonly used were verbal management, patient isolation, and intramuscular medication. CONCLUSION: For the first time, the occurrence of violent and antisocial behavior was measured in a forensic psychiatric population.

Association between Intimate Partner Violence and Posttraumatic Stress Disorder: A Case-Control Study

Introduction: Intimate partner violence (IPV) against women is a common form of interpersonal violence in both developed and developing countries, and represents a forensic and public health problem. IPV is related to Post-traumatic Stress Disorder (PTSD). This relationship however, has not been investigated in Colombian population. Objective: To determine the strength of the association between IPV and PTSD in women referred for forensic psychiatric evaluation in Bucaramanga, Colombia. Method: A case-control study was designed. A total of 132 cases involving women referred for forensic psychiatric evaluation met criteria for PSTD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). A group of 262 women without PTSD were taken as controls. First, odds ratio (OR) was computed. Logistic regression was used to control confounding variables. Results: A total of 76 (56.6%) in the case group reported IPV during the past year compared to 85 (32.6%) in the control group. IPV and PTSD were associated (OR=3.09, 95%CI: 1.58-6.03) after controlling for age, employment, medico-legal loss or injury, and current aggressor (partner). Conclusions: IPV increased the risk for PTSD three-fold among women attending forensic assessment in Bucaramanga, Colombia...

Introducción: La violencia doméstica por la pareja (VDP) contra las mujeres es un evento frecuente de violencia interpersonal en países en desarrollo y desarrollados y representa un problema médico-legal y de la salud pública. La VDP se relaciona con el trastorno de estrés postraumático (TEP); sin embargo, esta asociación no se ha investigado en Colombia. Objetivo: Establecer la fortaleza de la asociación entre VDP y TEP en mujeres remitidas a evaluación psiquiátrica forense en Bucaramanga, Colombia. Método: Se diseñó un estudio de casos y controles. Se tomaron como casos 132 mujeres que reunieron criterios para TEP, según los criterios de la Asociación Psiquiátrica Americana, y como controles a un grupo de 262 mujeres sin TEP. Primero se calculó la razón de oportunidad (OR); posteriormente, se usó la regresión logística para controlar variables confusoras. Resultados: Un total de 76 (56,6%) mujeres en el grupo de casos informó VDP durante el último año, comparado con 85 (32,6%) en el grupo control. La VDP se asoció significativamente con TEP (OR=3,09; IC95%: 1,58-6,03), aun después de controlar por edad, empleo, incapacidad médico-legal y pareja agresora actual. Conclusiones: La VDP incrementa tres veces el riesgo de TEP en mujeres que asisten a evaluación psiquiátrica forense en Bucaramanga, Colombia...

Reliability of the Brazilian version of HCR-20 Assessing Risk for Violence / Confiabilidade da versão brasileira do HCR-20 Assessing Risk for Violence

OBJECTIVE: Assessing risk for violence is a complex task often based on not objective or structured clinical evaluations. HCR-20 Assessing Risk for Violence has been used in several countries to increase the accuracy of this exam. The purpose of this study was to inform on central aspects of this instrument, as well as the results of the reliability assessment of the HCR-20 Assessing Risk for Violence in a Brazilian inpatient criminal population. METHOD: Two examiners independently assessed a random sample of 30 patients that were under criminal commitment at the Mauricio Cardoso Forensic Psychiatric Institute RESULTS: Mean consensus values means were as follows: Historical = 13.1; Clinical = 4.8 and Risk management = 5.8. The value of the Intraclass Correlation Coefficient for the score of subscale Historical was 0.97, for subscale Clinical it was 0.94, and for subscale Risk management, 0.96. As to the individual items of the HCR-20 Assessing Risk for Violence, the result of the Intraclass Correlation Coefficient was good to excellent (mean = 0.97; interval, from 0.60 to 0.99). CONCLUSION: The interrater reliability of the Brazilian version of the HCR-20 Assessing Risk for Violence scale was similar to the results of studies in other countries.

OBJETIVO: A avaliação de risco de violência é uma tarefa complexa baseada muitas vezes em critérios clínicos pouco objetivos e estruturados. O HCR-20 Assessing Risk for Violence tem sido usado em diversos países para aumentar a precisão deste exame. O presente estudo tem como objetivo informar aspectos nucleares deste instrumento, bem como os resultados da avaliação da confiabilidade do HCR-20 Assessing Risk for Violence em uma amostra da população manicomial brasileira. MÉTODO: Dois examinadores avaliaram independentemente uma amostra de 30 pacientes selecionada aleatoriamente da população em cumprimento de Medida de Segurança no Instituto Psiquiátrico Forense Maurício Cardoso. RESULTADOS: Os valores das médias de consenso entre os entrevistadores foram os seguintes: Histórica = 13,1; Clínica = 4,8 e Manejo de risco = 5,8. O valor do Coeficiente de Correlação Interno para a pontuação da subescala Histórica foi 0,97; para a pontuação da subescala Clínica foi 0,94; e para a subescala Manejo de risco foi 0,96. Quanto aos itens individuais do HCR-20 Assessing Risk for Violence, o resultado do Coeficiente de Correlação Interno foi de bom a excelente (média = 0,97; intervalo de 0,60 a 0,99). CONCLUSÃO: A confiabilidade entre os avaliadores da versão brasileira da escala HCR-20 Assessing Risk for Violence foi similar aos resultados de estudos em outros países.

Jóvenes homicidas: estudio de rasgos distintivos con jóvenes que han cometido otro tipo de delitos en la Provincia de Buenos Aires, Argentina / Young killers: study of distinctive features with youth that have committed other crimes in the province of Buenos Aires, Argentina

La violencia, en sus diferentes formas, constituye un problema social que convoca a enfoques multidisciplinarios en acciones tendientes a su prevención. Entre los conocimientos necesarios para orientar a las políticas preventivas se destacan los factores de riesgo y los factores protectores de las conductas violentas. Este estudio tiene como objetivo contribuir, desde la perspectiva psiquiátrica, a la exploración de factores influyentes en las conductas homicida de adolescentes. Se estudió un grupo de casos (n = 15) de jóvenes homicidas y un grupo control (n = 35) de menores que cometieron otros tipos de delitos (robo simple o calificado o violación), todos ellos jóvenes institucionalizados por orden judicial en la ciudad de La Plata, Buenos Aires, Argentina. En ambos grupos se evaluaron características sociodemográficas, criminológicas y psicosociales a través de cuestionario ad hoc, así como variables clínico-psiquiátricas por medio del MINI (Mini International Neuropsychiatric Interview). Los resultados obtenidos mostraron que los múltiples factores estudiados no se asociaron significativamente con la condición de ser joven homicida. Los hallazgos orientan a sostener que, en esta población de jóvenes vulnerables, la conducta homicida depende más de las circunstancias que de peculiaridades personales. Los autores sugieren que las acciones preventivas en adolescentes con estos factores de riesgo podrían tener efecto tanto en las conductas delictivas en general, como en la conducta homicida en particular.

The violence in its different forms, is a social problem that calls for multidisciplinary approaches in actions aimed at prevention. Among the skills needed to guide preventive policies, the highlights are risk and protective factors for violent behavior. This study aims to contribute, from the psychiatric perspective, in exploring factors influencing the behavior of homicidal adolescents. We studied a group of cases (n = 15) of young killers and a control group (n = 35) of juveniles who committed other crimes (simple or qualified theft or rape), all of them institutionalized by court order in La Plata city, Buenos Aires, Argentina. In both groups were evaluated sociodemographic, criminological and psychosocial characteristics through ad hoc questionnaire, as well as psychiatric clinical variables through the MINI (Mini International Neuropsychiatric Interview). The results showed that the multiple factors studied were not significantly associated with the condition of being young murderer.The findings aim to sustain that, in this vulnerable population of youth, homicidal behavior depends more on the circumstances than of personal peculiarities. The authors suggest that preventive actions in adolescents with these risk factors could have an effect on criminal behavior in general, as in homicidal behavior in particular.

Delincuencia infantojuvenil y sistema judicial en la Provincia de Buenos Aires, Argentina / Child and juvenile delinquency and legal system in the Province of Buenos Aires, Argentina

Considerando la relevancia social de la delincuencia infanto-juvenil, la escasa disponibilidad de evidencias científicas locales y el momento de cambio en el sistema, este artículo tiene el propósito de comentar el sistema de responsabilidad penal en la Provincia de Buenos Aires, Argentina, y explorar aspectos relacionados con la salud mental de los jóvenes que cometieron delitos y se encuentran institucionalizados en la jurisdicción del Departamento Judicial La Plata.

Taking into account the social relevance of child and juvenile delinquency, the little availability of local scientific evidence concerning the subject and the moment of change in the system, this article is intended to describe the criminal system of responsibility in the Province of Buenos Aires, Argentina. Psychiatric and psychological aspects of youth involved in crimes and of those who are institutionalized in the Legal Department of La Plata shall be explored.

Síntomas de estrés postraumático y trastornos del sueño en un grupo de mujeres adultas de Bogotá / Sleep disorders and posttraumatic stress symptoms in adult women in Bogotá

Objetivo. Determinar la prevalencia de las alteraciones del sueño, síntomas por estrés postraumático y calidad del sueño en una muestra de mujeres adultas en Bogotá. Material y métodos. Es un estudio descriptivo transversal, realizado en 2004, en una muestra de mujeres adultas jóvenes que aceptaron participar en la investigación mediante consentimiento informado. Se aplicaron las escalas de autoevaluación validadas nacionalmente, el índice de calidad de sueño de Pittsburgh, la escala de somnolencia de Epworth y la escala de impacto de eventos. Resultados. Las mujeres estudiadas fueron adultas jóvenes, de estrato socioeconómico bajo y medio, la mayoría sin relación estable de pareja, con talla de 1,6 m en promedio (IC95 1,56-1,63), peso de 53 kg en promedio (IC95).

Exploración de la validez de la escala de impulsividad de Barratt (BIS 11) en la población carcelaria argentina / Exploring the Validity of the Barratt Impulsiveness Scale (BIS 11) in Argentinean Penitentiary Population.

Objetivo: revisar la utilidad y aspectos de la confiabilidad y validez de la Versión 11 de la Escala de Impulsividad de Barratt (BIS 11) en la población comprometida judicialmente. Materiales y método: se evaluaron 180 penados, candidatos a liberación anticipada y sobrese ídos por inimputabilidad, aspirantes a alta consecutivos, en el Programa Piloto de Evaluaci ón de Riesgo de Liberados de la Procuración General de la Suprema Corte de Justicia de la Provincia de Buenos Aires, en la ciudad de La Plata, durante el período 2001-2004, a ciegas de la autoadministración de la BIS 11. Se calcularon indicadores de la congruencia y de la validez concurrente y predictiva de la BIS 11. Resultados: los resultados con la escala BIS 11 mostraron una distribución alejada de la normal y una media de 63 puntos para la escala total. El coeficiente alfa de Cronbach para la puntuación total fue 0,68; la escala de impulsividad motora fue la que tuvo el valor más alto, que alcanzó 0,70. La puntuación total tuvo una correlación de 0,28 y altamente significativa con la evaluación clínica del ítem impulsividad de la HCR-20. La correlación también fue significativa con otros instrumentos de evaluación de psicopatía y de riesgo de violencia. La categorización de la muestra, según la puntuación de la BIS 11, fuera alta o baja, tuvo un acuerdo mediano (kappa = 0,55) con clasificación clínica dicotómica del grado de impulsividad. La validez predictiva no resultó significativa. Conclusiones: la utilización de la escala autoadministrada BIS 11 no es absolutamente confiable en el contexto carcelario, pero puede resultar útil en numerosos casos, especialmente, enmarcada en un enfoque multitáctico de evaluación psiquiátrico forense.

Objective: To review the usefulness and examine various reliability and validity aspects of the Barratt Impulsiveness Scale Version 11 (BIS 11) in penitentiary population. Material and Methods: One hundred and eighty convicts and forensic patients who were candidates for conditional release or discharge were assessed within the Risk Assessment Pilot Program of the General Attorney’s Office of the Province of Buenos Aires, in the city of La Plata, Argentina, from 2001 to 2004. Clinical assessment was performed blinded to the results of the self-administered BIS 11. Indicators of consistency and concurrent as well as predictive validity were also estimated. Results: The distribution of the results obtained with the BIS 11 was not normal. In addition, results yielded a mean of 63 for total score. Cronbach’s alpha coefficient for total score was 0.68; the motor impulsivity scale showed the highest value (0.70). Total score was significantly correlated (r = 0.28) with the clinical assessment of the HCR-20 impulsivity item. There was also a significant correlation with the results of other instruments measuring risk of violence and psychopathy. There was a moderate agreement (kappa = 0.55) between high and low impulsive groups as defined by BIS 11 and the clinical dichotomical classification of impulsiveness. Predictive validity was not significant. Conclusions: Although the selfadministered BIS 11 may not be completely reliable in penitentiary settings, it could be useful in several cases especially when administered as part of a forensic psychiatric assessment with a multitactical approach.