Clients' current presentation yields best prediction of criminal recidivism: Jointly modeling repeated assessments of risk and recidivism outcomes in a community sample of paroled New Zealanders.

OBJECTIVE: Clinicians often rely on readily observable intermediate outcomes (e.g., symptoms) to assess the likelihood of events that occur outside of treatment (e.g., relapse). Similarly, those monitoring clients with histories of criminal involvement attempt to prevent adverse outcomes considered likely and intervene when symptoms/risk factors fluctuate. Our aim was to develop a stronger understanding of associations between evolving symptoms/risk factors and case outcomes, yielding clearer practice implications. METHOD: We used longitudinal, multiple reassessment risk data from 3,421 individuals paroled in New Zealand. We used joint modeling to test the association between individual trajectories of psychosocial risk factor scores, assessed using Dynamic Risk Assessment for Offender Re-entry, and recidivism (official records of parole violations or criminal charges resulting in reconviction). We examined whether recent clinically relevant features of risk presentation (e.g., current levels, recent rate of change) predicted recidivism better than the entirety of the risk assessment trajectory. RESULTS: Although each model demonstrated similar predictive validity, measures of model fit indicated that models using current trajectory features outperformed those using the entire assessment history to predict recidivism. CONCLUSIONS: Change in dynamic risk factors is consistently associated with recidivism outcomes. When using changeable factors to monitor clients' current risk for recidivism, practitioners should focus on current presentation rather than the entire assessment history, although differences in predictive discrimination are small. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Further victimization of child sexual abuse victims: A latent class typology of re-victimization trajectories.

The association between child sexual abuse (CSA) and risk for re-victimization is well-documented; however, less is known about the temporal progression of re-victimization experiences over the early life-course among CSA survivors, and whether this differs from that of those without known sexual abuse histories. This study investigated whether there are distinct temporal pathways of interpersonal re-victimization between the ages of 10-25 years among medically confirmed CSA cases, and considered whether abuse variables, re-victimization variables, and the presence of other adverse outcomes, were associated with heterogeneity in re-victimization pathways. The data were collected as part of a large-scale data-linkage study in which the medical records of 2759 cases of contact-CSA between 1964 and 1995 were linked, between 13 and 44 years following abuse, to police and public psychiatric databases; cases were compared to a matched community sample (n=2677). Using a subsample of 510 (401 victims; 109 comparisons) individuals with an interpersonal (re)victimization history, we examined the aggregate 'age-(re)victimization' curves for CSA victims and comparisons, respectively. Further, we applied longitudinal latent class analysis to explore heterogeneity in re-victimization trajectories among abuse survivors across their early life-course. Four latent pathways were identified, labeled: Normative; Childhood-Limited; Emerging-Adulthood; and Chronic re-victimization trajectories. Older age at abuse, a criminal history, and mental health problems were uniquely predictive of membership to the more problematic and persistent re-victimization trajectories. Findings indicate that individuals exposed to CSA during adolescence may be particularly vulnerable to poorer re-victimization trajectories, characterized by multiple risk indices, and thus may warrant increased service provision.

Exploring the longitudinal offending pathways of child sexual abuse victims: A preliminary analysis using latent variable modeling.

Very little research has been conducted to show the way in which criminal behavior unfolds over the life-course in children who have been sexually abused, and whether it differs from the 'age-crime' patterns consistently documented in the criminology literature. This study investigated the temporal pathways of criminal offending between the ages of 10-25 years among medically confirmed cases of child sexual abuse (CSA), and considered whether abuse variables, offense variables, and the presence of other adverse outcomes, were associated with heterogeneity in offending pathways among CSA survivors. This study utilized data gathered as part of a large-scale study involving the linkage of forensic examinations on 2759 cases of medically ascertained CSA between 1964 and 1995, to criminal justice and public psychiatric databases 13-44 years following abuse, together with a matched comparison sample of 2677 individuals. We used the subsample of 283 offending individuals (191 victims; 92 comparisons) for whom complete offending data were available. We compared the aggregate age-crime curves for CSA victims and comparisons, and applied longitudinal latent class analysis to identify distinct subgroups of offending pathways between ages 10-25 years within the abuse sample. Four latent pathways emerged among sexually abused offenders, labeled: Early-Onset/High-Risk/Adolescence-Limited; Intermediate-Onset/Low-Risk/Adolescence-Limited; Late-Onset/Low-Risk/Slow-Declining; and Early-Onset/High-Risk/Persistent offenders. Age at abuse, the nature and frequency of offending, and mental health problems, were associated with the offending pathway followed by CSA victims. Consistent with criminological literature, findings indicate considerable heterogeneity in the longitudinal offending patterns of offenders exposed to CSA. Implications for clinical practice and directions for research are highlighted.

The long-term co-occurrence of psychiatric illness and behavioral problems following child sexual abuse.

OBJECTIVES: There is a growing body of research investigating the relationship between child sexual abuse and a range of adverse outcomes. However, very little is known about the long-term co-occurrence of psychiatric disorders and behavioral problems among this vulnerable population, or the interaction between characteristics of the abuse, such as the nature and timing of the child sexual abuse, and the extent of subsequent adversities. This study aimed to determine the rate and co-occurrence of mental health morbidity, criminal justice system contact, and fatal self-harm among medically confirmed victims of child sexual abuse, and to identify abuse variables associated with a greater likelihood of cumulative adverse experiences. METHODS: The forensic medical records of 2759 cases of child sexual abuse assessed between 1964 and 1995 were linked with public psychiatric, criminal justice and coronial administrative databases between 13 and 44 years following abuse. Cases were compared to 2677 matched comparisons from the general population. RESULTS: Abuse victims were more likely (odds ratio = 7.2, 95% confidence interval = [4.9, 10.4], p < 0.001) to experience cumulative adverse psychiatric and behavioral problems relative to comparisons. Almost half (47.6%) of victims who died of suicide or drug overdose had a history of offending, further victimization and mental illness. Relative to comparisons, female victims demonstrated the largest increase in odds for cumulative outcomes (odds ratio = 9.8, 95% confidence interval = [5.8, 16.8], p < 0.001), whereas in absolute terms, male victims were at an elevated risk for all types and combinations of adverse outcomes, except fatal self-harm. Boys who were older at abuse, had multiple abuse episodes or who were abused by an extra-familial perpetrator were most likely to experience poorer clinical trajectories. Only being older at abuse was associated with cumulative adverse experiences for females. CONCLUSIONS: Sexual abuse, particularly during adolescence (ages 12-16 years), appears to be a risk factor for co-occurring adverse experiences. This study identifies particular groups of child sexual abuse victims as at-risk and requiring targeted intervention.