Trajectories of Dynamic Risk Factors During Forensic Treatment: Growth Trajectory of Clinical Risk Factors in a Sample of Dutch Forensic Patients.

In this study, growth trajectories (from admission until unconditional release) of crime-related dynamic risk factors were investigated in a sample of Dutch forensic patients (N = 317), using latent growth curve modeling. After testing the unconditional model, three predictors were added: first-time offender versus recidivist, age, and treatment duration. Postanalyses were chi-square difference tests, t tests, and analyses of variance (ANOVAs) to assess differences in trajectories. Overall, on scale level, a decrease of risk factors over time was found. The predictors showed no significant slope differences although age and treatment duration differed significantly at some time points. The oldest age group performed worse, especially at later time points. Treatment duration effects were found at the second time point. Our results that forensic patients show a decrease in crime-related risk factors may indicate that treatment is effective. This study also found differences in growth rates, indicating the effect of individual differences.

Recidivism and predictors of recidivism among female high level persistent offenders after a special court order for persistent offenders in the Netherlands.

Previous research has shown that female persistent offenders have multiple psychiatric and psychosocial problems, such as substance use disorders, other mental disorders, financial problems and housing problems. The present study examined recidivism and predictors of recidivism in a sample of 74 Dutch female high level persistent offenders who had been subjected to a special court order for persistent offenders, called ISD [Inrichting Stelselmatige Daders]. The criminal records were studied to gain insight in the criminal charges against women after release from the ISD. Results showed that 43% of the persistent female offenders had registered justice contacts within one year after release, of which the majority concerned non-violent property offences. However, the number of offences was found to be significantly reduced after their release. No offence-related, demographic, substance-related, psychiatric or personal history characteristics were found to be predictive for general recidivism.

The Influence of a Short Message Service Reminder on Non-Attendance in Addiction Care.

Backgrounds: Non-attendance in mental healthcare is a substantial problem. Research has shown that sending a short message service (SMS) reminder could reduce non-attendance by 50 percent in general health services and by 25 percent in mental health institutions. However, no studies exist on the effect of sending SMS reminders in mental healthcare for addiction. Objectives: To examine the influence of SMS reminders on non-attendance in mental health care for addiction and to examine whether different effects occur between appointments for intake or for treatment. Methods. In a specialized institution for addiction care in the north of the Netherlands 193.474 appointments of outpatient patients, representing 12.797 unique patients, were analyzed for non-attendance and related to registered SMS reminders. Results: Non-attendance was statistically significantly lower for appointments of patients who had received an SMS reminder (20.5%) than for appointments of patients who had not received a reminder (21.9%). Effects were found to be greater for intake appointments in several analyses. Conclusions: Sending an SMS reminder is associated with a statistically significant lower non-attendance at appointments by patients with a substance use disorder, but the differences have hardly any clinical significance. Special characteristics of the population of patients with substance use disorders may explain this small clinical effect.

Parental substance use disorder and child abuse: risk factors for child maltreatment?

Although the literature consistently shows an association between parental substance use disorders (SUDs) and child abuse, it is unknown what factors discern non-abusive and abusive parents with SUDs. This study aims to investigate which specific risk factors are associated with child abuse in clinically treated parents with SUDs in the Netherlands. It examines two groups of parents with SUDs in a clinical setting, with and without known instances of child abuse. These groups were compared on SUD-related factors such as the type and severity of the SUDs, and variables addressing psychological disability such as comorbid diagnoses and quality of life. Other than a marginally significant difference in severity of addiction and a lower mean age of the parents in the child abuse group, no significant differences were found. The small sample size and the inherent difficulty of studying SUDs in a clinical sample is likely to have affected the results.

Substance use disorders and sexual behavior; the effects of alcohol and drugs on patients' sexual thoughts, feelings and behavior.

INTRODUCTION: Hardly any research exists on the relationship between substance use and sexual behaviors in patients with a substance use disorder. This study aimed to examine this relation by looking into perceived positive effects on sexual behavior, perceived negative effects and risky sexual behavior due to substance use in patient groups of users of alcohol, stimulants, sedatives and Gamma hydroxybutyrate (GHB). In addition, the current study aimed to address the question whether sexual behavior (e.g. number of sexual partners, sexual activity) differs between these patient groups. METHOD: A total of 180 patients with a substance use disorder (i.e. alcohol, amphetamine, cannabis, cocaine, GHB and opiates) participated. A self-report questionnaire was administered with questions on substance use, sexual behaviors (e.g. sexual activity, masturbation, use of pornography) and statements about the perceived changes in sexual functioning and behavior under influence of the primary substance of abuse. RESULTS: All four groups reported changes in sexual thoughts, feelings and behavior due to the use of their primary substance. More than half of the patients reported enhancements in sexual domains (i.e. sexual pleasure, sexual arousal, sexual behavior), but also decrements or risky behaviors and about a quarter stated that their sexual thoughts, feelings and behaviors were often associated with the use of their primary substance of abuse. Patients with a GHB use disorder reported the strongest relation between drug use and sexual behavior. Users of GHB not only reported more enhancement in several sexual domains, but also less decline in sexual domains compared to the other patient groups and more risky behavior or more sexual activity than some of the other groups of patients. CONCLUSIONS: The results underline the importance of addressing the relationship between substance use and sexual behavior in treatment programs, as patients may be hesitant to stop their use of substances when they experience many positive effects in their sexual behavior. Future research directions are suggested.

Demographic, criminal, and psychiatric factors related to inmate suicide.

A review of 19 studies suggests that it may be feasible to identify prisoners with suicide risk on the basis of demographic, psychiatric, and criminal characteristics. The present study aimed to identify combinations of characteristics that are capable of identifying potential suicide victims. Characteristics of 95 suicide victims in the Dutch prison system were compared with those of a random sample of 247 inmates in ten jails. Combinations of indicators for suicide risk were also tested for their capability of identifying 209 suicides in U.S. jails and 279 prison suicides in England and Wales. A combination of six characteristics (age 40+, homelessness, history of psychiatric care, history of drug abuse, one prior incarceration, violent offence) was capable of correctly classifying 82% of the Dutch suicide victims (82% specificity). Less powerful combinations correctly classified 53% of the U.S. suicides and 47% of the U.K. suicides. It is concluded that a set of demographic and criminal characteristics and indicators of psychiatric problems is useful for the identification of suicide risk in jails and prisons.

Police referral to victim support: the predictive and diagnostic value of the RISK (10) screening instrument.

One of the basic rights of crime victims granted under victim-orientated legislation introduced during the last 20 years in more than 100 countries worldwide is the right to be referred to victim support by the police. The under-utilization of psychological services by crime victims who are objectively in need of external support is substantial. Current legal procedures tend to perpetuate this unwanted condition. Programs aimed at the early detection and prevention of persistent postvictimization distress are more in line with the ideals of therapeutic jurisprudence. The RISK (10) screening instrument, which was specifically developed to be administered by police officers, may provide a basis for early detection. RISK (10) consists of a selection of 10 Risk factors with prior empirical evidence and theoretical significance. The focus of the present study was to examine the predictive and diagnostic power of RISK (10) components to detect persistent future psychological distress, among other things, in terms of Adjustment Disorder. Analyses were based on a sample of 93 crime victims who participated in the police and (3 months) follow-up parts of the study. Findings provided initial validation for the predictive accuracy of most RISK (10) components, and confirm the diagnostic value (in terms of specificity, sensitivity, positive and negative predictive power) of risk factors, such as engaging in character attributions, upward comparison processes, fatalistic appraisals of the episode, and the initial reporting of expected deficiencies in social support. The clinical utility of RISK (10) for early detection in police stations is confirmed.

Stalking: knowns and unknowns.

The current work reviews literature on the nature of stalking. Despite its nebulous nature and differing legal and clinical definitions of stalking, researchers and practitioners are referring to the same phenomenon. Stalking is chronic, consisting of a number of nuisance behaviors that appear consistent over countries and samples. Different categorizations of stalkers and their victims exist, but ex-partner stalkers are a distinctive category with respect to their prevalence, violence risk, and attrition rate. Different samples and definitions and false victimization reports obscure reliable lifetime prevalence estimates, but these appear to be around 12%-16% among women and 4%-7% among men. Stalking has deleterious effects on victims but some of the effects may be the result of stalking's exacerbating of existing vulnerabilities. Future research should focus on subgroups of stalkers and their victims, on cross-cultural investigations, and on the co-occurrence of stalking with other crimes.

'There's no smoke without fire': are male ex-partners perceived as more 'entitled' to stalk than acquaintance or stranger stalkers?

In a stalking scenario, the prior relationship between and the gender of stalker and victim were systematically manipulated in order to judge culpability and consequences for the persons involved. Written vignettes were presented to 168 participants who responded via seven Likert scales. Stalker-victim relationship had three levels: ex-partner, acquaintance and stranger. In accordance with the 'Just World' hypothesis (Lerner, 1980), the victim was judged as having greater responsibility for the stalking when their harasser was an ex-partner or a prior acquaintance rather than a stranger, and police intervention was felt to be most necessary when the stalker was a stranger. Sex of stalker and victim was manipulated, and the following comparisons proved significant: when the perpetrator was male, bodily injury to the victim was seen as more likely and police intervention as more necessary than when the perpetrator was female; and male victims were viewed as more responsible for the scenario and as possessing greater powers to alleviate it. The Just World hypothesis and gender stereotypes provide a plausible account for these findings. Future research should determine whether criminal convictions show similar biases towards convicting male and stranger stalkers more often than female and ex-partner stalkers.