The interrogator-suspect dynamic in custodial interrogations for high-stakes crimes in Sweden: An application of the interrogation taxonomy framework.

This archival study was the first in Sweden, and the first outside of the US and the UK, to apply the (Kelly et al., Psychology, Public Policy, and Law, 9, 165-178, 2013) taxonomy of interrogation methods framework to repeated police interrogations of adult suspects in high-stakes crimes. Audio/video recordings (N = 19) were collected from the Swedish Police Authority of repeated interrogations of three suspects in three criminal cases. The interaction between interrogators and suspects were scored according to the taxonomy framework (Kelly et al., Psychology, Public Policy, and Law, 9, 165-178, 2013; Kelly et al., Law and Human Behavior, 40, 295-309, 2016). First, there was an association between the use of different domains. Rapport and relationship building was moderately and negatively associated with confrontation/competition and presentation of evidence. Moreover, confrontation/competition was moderately and positively related to emotion provocation and presentation of evidence. Second, changes were observed during the interrogations. Presentation of evidence was lower in the beginning than in the middle block. Suspect cooperation was higher in the beginning than both the middle and end blocks. Third, an ordered logistic regression showed that rapport and relationship building were associated with increased suspect cooperation, and confrontation/competition and presentation of evidence were associated with decreased cooperation. The study's results are mostly in line with other taxonomy studies on high-stakes crimes from the US and the UK. The findings are discussed in light of theoretical frameworks, empirical findings, and current police practice. We also highlight the need for further research.

Police-suspect interactions and confession rates are affected by suspects' alcohol and drug use status in low-stakes crime interrogations.

Background: Low-stakes crimes related to alcohol and/or drugs are common around the world, but research is lacking on police-suspect interactions of such crimes. A large proportion of these suspects are intoxicated during interrogations, and many may have substance use disorder, making them potentially vulnerable to interrogative pressure. Methods: To address this lack of knowledge, the taxonomy of interrogation methods framework (i.e., 60+ interrogation techniques classified into five domains) and a common classification of question types (appropriate vs. inappropriate) were applied in the coding of written police interrogations. Two archival studies, one pilot (Study 1, N = 39) and one main study (Study 2, N = 97) analyzed police interrogations with suspects of alcohol- and drug-related crimes in Sweden. Results: For both Study 1 and 2, suspects showed signs of alcohol and/or drug intoxication, hangover or withdrawal in more than 50% of all interrogations. In Study 2, additional coding indicated that suspects displayed signs of substance use disorder in 57% of the interrogations. The main results from both studies revealed a large number of direct questions asked by the police across all interrogations, and relatively little use of the strategic interrogation techniques from the taxonomy of interrogation methods framework. In fact, when it came to interrogation techniques, law enforcement used more confrontational techniques in their interactions with intoxicated suspects compared to sober suspects. Furthermore, suspects displaying signs of substance use disorder were significantly more cooperative and prone to confess than suspects without indicators of substance use disorder. Conclusion: As the first novel study on low-stakes crime interrogations related to alcohol and/or drugs, the present study provides useful information about current Swedish interrogation practices and areas for improvement. The study results indicate that suspects displaying signs of intoxication or substance use disorder may be more vulnerable during police interrogations. This may in turn have the potential to inform the development of new interrogation policies. Due to the novelty of this research, more studies are needed, both on a national and international level, to examine interrogations in low-stakes crimes further.

Examining Treatment Climate Across Prison-Based Substance Abuse Treatment Groups.

BACKGROUND: With notable exceptions, few studies have looked critically at the role and effects of factors other than individual or programmatic differences that contribute to the climate within substance abuse treatment programs. De Leon's work on the therapeutic community, however, indicates that factors beyond the individual and program can contribute to the overall functioning of similarly situated communities. OBJECTIVES: In this study, we introduce and examine the concept of the "treatment group," the level of aggregation between the individual who participates in treatment and the organization that provides it. The treatment group refers to the social context and dynamics that operate among treatment participants, and we sought to study differences in treatment climate across 12 prison-based treatment groups within a single prison. METHODS: Using data from 604 participants who were assigned at random to one of the 12 groups, we analyzed differences on seven treatment climate indicators from one month and six months into the program across the treatment groups. RESULTS: No differences were found among the treatment groups at after one month; however, after 6 months, significant differences emerged across the groups on three treatment climate variables: program structure, counselor rapport, and counselor competence. CONCLUSIONS/IMPORTANCE: This study is among the first of its kind to conceptualize and examine treatment climate across otherwise similar groups and find that differences emerge on several indicators of climate. As such, we argue that the treatment group may be important to consider in both the delivery and evaluation of substance abuse treatment.

The dynamic nature of interrogation.

Building on a substantial body of literature examining interrogation methods employed by police investigators and their relationship to suspect behaviors, we analyzed a sample of audio and video interrogation recordings of individuals suspected of serious violent crimes. Existing survey research has focused on the tactics reportedly used, at what rate, and under what conditions; observational studies detail which methods are actually employed. With a few notable exceptions, these foundational studies were static examinations of interrogation methods that documented the absence or presence of various approaches. In the present study, we cast interrogation as a dynamic phenomenon and code the recordings in 5-min intervals to examine how interrogation methods and suspect cooperation change over time. Employing the interrogation taxonomy framework, particularly 4 discrete domains-rapport and relationship building, emotion provocation, presentation of evidence, and confrontation/competition-we found that the emphasis of the domains varied across interrogations and were significantly different when suspects confessed versus when they denied involvement. In regression models, suspect cooperation was positively influenced by the rapport and relationship building domain, though it was negatively impacted by presentation of evidence and confrontation/competition. Moreover, we found that the negative effects of confrontation/competition on suspect cooperation lasted for up to 15 min. The implications of the findings for practice and future research include the benefits of a rapport-based approach, the deleterious effects of accusatorial methods, and the importance of studying when, not just if, certain interrogation techniques are employed. (PsycINFO Database Record

Comparison of urodynamic findings in women with anatomical versus functional bladder outlet obstruction.

OBJECTIVES: To characterize the symptoms and urodynamic findings of anatomical bladder outlet obstruction (AO) and functional bladder outlet obstruction (FO) in women and to determine if future endeavors at defining bladder outlet obstruction in women can group these entities together. METHODS: Retrospective review of all videourodynamic studies was performed on women from March 2003 to July 2009. Women with diagnosis of obstruction were categorized based on the cause of obstruction into 2 groups: AO and FO. Demographic data, symptoms, and urodynamic findings were compared between the 2 groups. RESULTS: One hundred fifty-seven women were identified of which 86 (54.8%) were classified as having AO and 71 (45.2%) were classified as having FO. There were no differences in symptoms between the 2 groups. There was no difference (P=0.5789) in the mean detrusor pressure at maximum flow rate Qmax between AO (38.9 cm H20) and FO (41.0 cm H20). There was a difference in the Qmax between AO and FO (10.6 [0-41.7] and 7.4 [0-35.7] mL/s, respectively; P=0.0044), but there was considerable overlap between the values in these 2 groups. CONCLUSIONS: Anatomical bladder outlet obstruction and FO have similar urodynamic voiding pressure findings, but Qmax was statistically significantly lower in AO. However, there is a large overlap in the Qmax values between the 2 groups. Therefore, future studies that attempt to characterize bladder outlet obstruction in women need not exclude either group.

The relationship between pressure flow studies and ultrasound-estimated bladder wall mass.

The basic evaluation of suspected voiding dysfunction involves fundamental objective tools such as the pressure-flow study. Although accurate, the several drawbacks to this invasive study of bladder outlet obstruction (BOO) are discussed and evaluated. Other non-invasive and/or minimally invasive ways of diagnosing BOO continue to be the subject of investigation. The ultrasound-estimated bladder wall thickness and bladder wall mass indices are 2 parameters that may be useful for screening and diagnosing BOO. Preliminary results are presented from the prospective clinical trial comparing the diagnosing capabilities and results obtained with pressure-flow studies (the historic gold standard for BOO diagnosing) with that of ultrasound-estimated bladder weight.

Evaluation of voiding dysfunction and measurement of bladder volume.

When evaluating patients with voiding dysfunction, noninvasive tests such as uroflowmetry and measurement of postvoid residual urine volume (PVR) can help to determine whether additional testing is warranted. PVR can be measured by 2 methods: catheterization or bedside bladder ultrasonography. Although both methods have advantages, the convenience, efficiency, and safety of bladder ultrasound makes its use beneficial in a wide variety of populations, including hospitalized patients, children, and the elderly. More recently, bladder ultrasound has been used for other procedures, such as suprapubic aspiration, evaluation of intravesical masses, and to determine bladder wall thickness and bladder wall mass, both of which have been associated with outflow obstruction.

Which questionnaires should be used in female urology practice?

The evaluation and treatment of female pelvic floor disorders is an evolving sub-specialty in urology. Recent attention has been directed toward more rigorous evaluation of treatment efficacy and durability of female urologic procedures. Throughout the past few decades, questionnaires have emerged as important subjective instruments for evaluation. Today, practitioners must choose from a burgeoning amount of questionnaires. This staggering number of questionnaires has raised two important issues: which questionnaire should be used in a female urology practice and should more refined criteria be developed for evaluating questionnaires to make the decision easier?