[Substance use and criminality: a review]. / Middelengebruik en criminaliteit: een overzicht.

BACKGROUND: Substance use regularly co-occurs with many types of criminality, including violent behaviour. AIM: To review the relationships between substance abuse and criminality, which can involve violent behaviour. METHOD: We searched the literature for meta-analyses, reviews and empirical articles about relationships between the problematic use of and addiction to psychoactive substances on the one hand and antisocial and aggressive behaviour and recidivism on the other hand. RESULTS: In the case of both men and women there are significant relationships between substance abuse and criminal behavior. The majority of substance users, however, are not criminals and most of the offences they commit can be termed 'acquisitive offences'. The relationship between alcohol and violence is stronger than the relationship between substance abuse and violence. Furthermore, it is only in cocaine users that we find indications that psychopharmacological effects stimulate violent behaviour. A number of factors, particularly interactions, determine whether substance abusers are criminal and are violent. Violent behaviour can result from interactions between the severity of illness caused by substance abuse, individual psychological, social and neurobiological characteristics, situational factors and expectancies regarding the psychopharmacological effects of a particular substance. CONCLUSION: Substance abuse, particularly the combination of alcohol and drugs, is a predictor of criminality and criminal recidivism.

[Behavioural changes during forensic psychiatric treatment: a multicenter study]. / Gedragsveranderingen tijdens tbs-behandeling: een multicenteronderzoek.

BACKGROUND: In forensic psychiatry it is essential that patients' risks of reoffending are assessed as reliably as possible. The risk assessment instrument hkt-30 assesses both static and dynamic risk factors. It is assumed that dynamic risk factors should change when a patient receives treatment. AIM: To find out whether dynamic risk factors changed during the course of forensic psychiatric treatment. METHOD: The hkt-30 was administered 984 times for forensic psychiatric patients in 3 different forensic psychiatric centres, in the period June 2003-November 2006. For 513 patients the instrument was administered at least once, for 313 this was done at least twice and for 158 patients for three years in succession. By subdividing the research group into 'new', 'old' and 'transferred' patients we were able to examine in which phase of treatment the largest changes in hkt-30 scores occurred. RESULTS: More than half the scores for dynamic risk factors, as well as the total score, declined significantly as treatment progressed, but the differences were small in absolute terms. The three subgroups of patients hardly differed from each other with regard to the degree of change. CONCLUSION: The scores for the risk factors, assumed in theory to be changeable, seemed to become lower as the treatment progressed. However, it is not yet certain whether these lower scores were in fact directly linked to a reduction on the risk of reoffending.

Compulsive smoking: the development of a Rasch homogeneous scale of nicotine dependence.

The unidimensionality of nicotine dependence has not been established firmly yet. The aim of this study was to assess the dimensionality of nicotine dependence, preferably meeting the strict assumptions of the Rasch model. First, we examined the validity of the Fagerström Test for Nicotine Dependence (FTND) [Br. J. Addict. 86 (1991) 1119.] in 1525 smokers who participated in a national survey considering smoking behavior. Two factors were found, suggesting that the FTND does not measure a unidimensional construct. Factor analysis of 19 other dependence items in 512 smokers resulted in four factors of which three were interpretable: compulsive smoking, social problems due to smoking, and physical dependence. We focused on smoking compulsivity. This factor turned out to consist of a four-item Rasch homogeneous scale. Two items of the FTND with face validity of smoking compulsivity were found to fit into the scale. The results of Rasch analysis were in support of a continuum of compulsivity. Difficulty refraining from smoking in places where it is forbidden was found to indicate highest compulsivity. Several correlates with smoking compulsivity were found. We conclude that compulsive smoking is one important dimension of nicotine dependence, which may account for the considerable relapse of this disorder.

Submission and rebellion: excessive drinking of women in problematic heterosexual partner relationships.

Functionality of alcohol use for coping with partner relationship problems was explored in a group of 45 alcohol-dependent women with semistructured interviews. Six functions were categorized, three of them referring to adjustment and three to opposition to the partner. Respondents who had started excessive drinking mainly in response to problems with the partner reported more partner-related functions than respondents for whom a problematic partner relationship was not an important factor in the development of excessive drinking. Respondents of the first group also reported other characteristics of their relationship, notably they said more often that their partner was dominant. It was concluded that for a subgroup of women with alcohol problems, alcohol use may be a way of coping with a situation of powerlessness toward the partner.

Do alcohol pharmacokinetics in women vary due to the menstrual cycle?

Many authors in the alcohol field believe that the physiological responsiveness of women to alcohol varies during the menstrual cycle, due to changes in levels of sex steroid hormones. Statements about this issue are very contradictory, however. The aim of this review was to decide what valid evidence was available on this issue. Three criteria were set to assess the validity of the reviewed studies: (1) was a within-subjects design used with normally cycling subjects, (2) were the time points selected for testing characterized by significant variations in sex steroid activity, and (3) was it verified whether ovulation occurred in the subjects by measuring levels of sex steroids? Two of the 11 studies we examined met these criteria. These studies, emanating from the same laboratory, found that alcohol elimination increased, by about 14%, during the luteal phase compared to other phases of the cycle. The results were discussed in relation to other research regarding effects of sex steroids on alcohol metabolism. It is concluded that there is no evidence that menstrual cycle causes significant instability in alcohol pharmacokinetics in women.