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- Alm, Charlotta, et al.
(författare)
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Classification of offenders with mental health problems and problematic substance use using the Addiction Severity Index version 6 : Analysis of three-year follow-up data and predictive validity
- 2014
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Ingår i: Mental Health and Substance Use. - Abingdon : Routledge. - 1752-3281 .- 1752-3273. ; 7:4, s. 431-445
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Tidskriftsartikel (refereegranskat)abstract
- Previous research is scarce on the problems and needs of the “triply troubled” – among offenders with mental health problems and problematic substance use. Classifying this population into clusters based on problem profiles may provide information about individual needs for treatment. In a previous study, we identified four clusters of triply troubled: less troubled, severely triply troubled, triply troubled with medical problems, and working triply troubled. The present study explored the stability and predictive validity of these clusters in a naturalistic design. In total, 125 triply troubled individuals included in any of the four clusters were followed for approximately three years with regard to their inpatient and outpatient treatment participation. They were also interviewed with the 6th version of the Addiction Severity Index, the Psychopathy Checklist–Revised, and the World Health Organization Quality of Life–Bref. The main finding of the study was that on average the participants of all four clusters exhibited substantial improvements over the course of time but that improvements were cluster-specific rather than sample-specific. Implications of the study are discussed.
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| 2. |
- Alm, Charlotte, et al.
(författare)
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Gender differences in re-offending among psychiatrically examined Swedish offenders
- 2010
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Ingår i: CBMH. Criminal behaviour and mental health. - : Wiley. - 0957-9664 .- 1471-2857. ; 20:5, s. 323-334
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Tidskriftsartikel (refereegranskat)abstract
- Background: The gender gap for violent offending is narrowing in the general population. Substance abuse and mental health problems are known risk factors for criminality. While substance abuse treatment has been associated with reduced risk of re-offending, women seem less likely to engage than men. People misusing substances tend to be high users of emergency room (ER) services. Such use may be an indicator both of treatment failure for substance misuse and offending. Little is known about gender differences in this respect. Aims: This study aims to test for gender differences in re-offending, use of substance abuse treatment, and hospital ER visits among offenders referred for forensic psychiatric assessment in Sweden. Method: The study used a longitudinal retrospective design. Data on all 31 women from a 2-year (2000–2001) cohort of serious offenders referred for forensic psychiatric assessment in Stockholm county, and 31 men from the same cohort, were extracted from forensic service and national records. Selection of the men was by initial random sampling followed by matching on age and substance misuse. The two resulting samples were compared on health service use and re-offending data between release and the census date (30 April 2004). Results: There were no gender differences for violent re-offending or for engagement in planned substance abuse treatment, in spite of longer time at risk for the men. Re-offending was reduced for women but not men who did not present in the ER with physical health problems. Conclusions: Our study is limited by sample size, although it included all women referred to the specialist forensic psychiatric service over 2 years, but it does indicate that differences between men and women in this situation are likely, and worthy of further study. The only way of achieving adequate sample sizes is likely to be through multi-centre collaboration.
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| 5. |
- Dahlin, Moa Kindstrom, et al.
(författare)
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Mentally disordered criminal offenders : Legal and criminological perspectives
- 2009
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 32:6, s. 377-382
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Tidskriftsartikel (refereegranskat)abstract
- Legal research in Sweden has traditionally focused on a systematization of the legal rules and their practical application, while the task of studying the effects of the application of the laws has been handed over to other branches of the social sciences. In contrast, new legal theories focusing on proactive and therapeutic dimensions in law have gained increasing attention in the international arena. These approaches may be better suited for evaluating legislation governing compulsory psychiatric care. Theoretical discussions and studies of causal mechanisms underlying criminal behaviour, as well as the implementation and value of instruments for predicting behaviour, are relevant to contemporary criminological research. Criminal behaviour varies across different groups of perpetrators, and the causes can be sought in the interplay between the individual and social factors. Multi-disciplinary efforts, integrating research from forensic psychiatry, psychology, sociology, and criminology, would be beneficial in leading to a better understanding of the causes underlying criminal behaviour.
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| 6. |
- Donahue, Kelly L, et al.
(författare)
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Childhood Behavior Problems and Adolescent Sexual Risk Behavior: Familial Confounding in the Child and Adolescent Twin Study in Sweden (CATSS).
- 2013
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Ingår i: The Journal of adolescent health : official publication of the Society for Adolescent Medicine. - : Elsevier BV. - 1879-1972. ; 52:5, s. 606-612
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Previous studies have found associations between childhood behavior problems and adolescent sexual risk behavior. Using a quasi-experimental approach, we examined the extent to which this association may be due to between-family differences (i.e., unmeasured familial confounds) not adequately explored in prior research. METHODS: We used data from a longitudinal, population-based cohort of young twins in Sweden (first assessment: age 9 or 12 years; second assessment: age 15; n= 2,388). We explored the nature of the association between symptom scores for attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) at age 9 or 12 and the likelihood of having had sexual intercourse and number of sexual partners by age 15. Two-level mixed-effects models were used to estimate the effect of symptom score on each outcome after controlling for potential unmeasured familial confounds. RESULTS: Higher ADHD, ODD, and CD scores were associated with significantly increased likelihood of sexual intercourse by age 15. Higher ADHD and ODD scores were also associated with increased number of sexual partners. After controlling for unmeasured familial confounds, however, behavior problems were no longer significantly associated with either outcome. CONCLUSION: The association between childhood behavior problems and sexual risk behaviors may be due to characteristics shared within families. Hence, prevention strategies aimed at reducing these behaviors might need to address broader risk factors that contribute to both behavior problems and a greater likelihood of sexual risk behavior.
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| 8. |
- Durbeej, Natalie, et al.
(författare)
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Perceptions of treatment among offenders with mental health problems and problematic substance use : the possible relevance of psychopathic personality traits
- 2014
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Ingår i: Open Journal of Psychiatry. - Irvine : Scientific Research Publishing. - 2161-7325 .- 2161-7333. ; 4:1, s. 79-90
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Tidskriftsartikel (refereegranskat)abstract
- Substance abuse is related to reoffending, and substance abuse treatment may be effective in reducing criminal recidivism. Psychopathy, however, another factor that strongly correlates with reoffending, may be negatively associated with treatment utilization. This qualitative study explored perceptions of substance abuse treatment among offenders with mental health problems, problematic substance use, and various degrees of psychopathic personality traits. An Interpretative Phenomenological Analysis (IPA) revealed that some treatment perceptions may vary with degree of psychopathic traits. For instance, participants with low and high degrees of psychopathic personality traits had different views on treatment requirements imposed upon them. Many treatment perceptions were also similar between the two participant groups. Thus, treatment perceptions may not be explained by degree of psychopathic personality traits alone, but the presence of some particular psychopathic traits may be relevant in explaining certain treatment perceptions. The results highlight the complex relationship between the individual and the treatment system, and may give input to future studies on rehabilitation of offenders with multiple treatment needs.
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| 9. |
- Eriksson, Åsa, et al.
(författare)
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Offenders with mental health problems and substance misuse : cluster analysis based on the Addiction Severity Index version 6 (ASI-6)
- 2013
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Ingår i: Mental Health and Substance Use. - : Informa UK Limited. - 1752-3281 .- 1752-3273. ; 6:1, s. 15-28
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Tidskriftsartikel (refereegranskat)abstract
- There is an urgent need to improve assessment and treatment among offenders with mental health problems and substance misuse (the “triply troubled”). An examination of the usefulness of the recently published Addiction Severity Index version 6 (ASI-6; Cacciola, J.S., Alterman, A.I., Habing, B., & McLellan, A.T. (2011). Recent status scores for version 6 of the Addiction Severity Index (ASI-6). Addiction, 106, 1588–1602) in classifying offenders with mental health problems and substance misuse was undertaken. A total of 207 offenders with suspect mental disorder and substance misuse about to go through a forensic psychiatric evaluation in Sweden were interviewed with the ASI-6. Data were cluster analyzed. Four distinct clusters emerged: (1) “less troubled” (n=35), (2) “severely triply troubled” (nfl30), (3) “triply troubled with medical problems” (n=52) and (4) “working triply troubled” (n=87). The ASI-6 proved useful in the classification of offenders with mental health problems and substance misuse. The authors suggest that the ASI-6 be used in research on the classification of the triply troubled.
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| 10. |
- Gumpert, Clara Hellner
(författare)
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Alleged child sexual abuse : the expert witness and the court
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: During the past decades, the evaluation of alleged sexual abuse has manifested itself as a major challenge for professionals working within the field of child maltreatment. A new role for psychologists and psychiatrists has been to give expert opinions regarding the credibility and reliability of child witnesses in legal proceedings. Although some aspects of evaluating suspected sexual abuse cases are close to traditional clinical work, other aspects necessitate new kinds of empirical and theoretical knowledge. Consulted experts have sometimes been accused of not meeting the new and different demands connected to such assignments. Professional efforts to determine whether a child has been the victim of sexual abuse or not has been the focus of an ongoing and heated debate in popular as well as scientific media. The overall aim of this study was to systematically explore how expert witnesses consulted in legal cases concerning alleged child sexual abuse have performed their task and collaborated with the courts. Method: The study was based on reviews of court files and written expert testimony (mainly focusing psychological expert testimony). Data from 800 court cases of alleged child sexual abuse was included (all cases from Swedish district courts during four different years; 1985, 1989, 1992 and 1997). A combination of quantitative and qualitative methods were applied. Results: The participation of expert witnesses decreased during the study period, from 25% of the cases (1985 and 1989) to 15% (1992) and 6% (1997). Logistic regression analyses showed that psychological expert participation was significantly associated with cases with young victims (< 7 years of age), cases with intra-familial abuse, and cases in which the suspect denied the charges (Paper I). The findings of the second study indicated that there have been communicative difficulties between expert witnesses and the courts. It appeared as if certain basic prerequisites for reaching a level of meaningful communication were not always achieved. Such prerequisites included a legally relevant focus for the expert's evaluation, a mutual understanding of certain central concepts, and a thorough description of the expert's reasoning, which would allow the court to review and analyse the expert's conclusions. The concept of 'quality' with regard to written psychological expert testimony (formal structure and content) was systematically approached in the third study, through the development of a reliable 12-item assessment tool (Structured Quality assessment of eXpert witness testimony [SQX-121, Paper III). In the fourth study, this assessment tool was applied on 121 (all available) expert witness reports from four different years, focusing the credibility or reliability of the child witness. Although the quality assessments according to the SQX- 12 improved over the study period, the results indicated that testimony concerning alleged child sexual abuse failed to follow many of the recommended standards. Expert reports produced by professionals applying statement analysis usually scored higher on the SQX-12 than did those written by more clinically oriented professionals. Published guidelines appeared to have had limited influence on actual practice (Paper IV). Professionals applying statement analysis as an assessment tool varied with regard to what features of the child's statements were emphasised and how such characteristics were evaluated. Special difficulties were connected to the interpretation of 'low quality' statements (Paper V). Conclusions: The results of the study illustrates various complex aspects of the evaluation of alleged child sexual abuse in a legal context. Different interventions are discussed and suggestions are given for further development of collaboration between psychological experts and the courts. In addition to an apparent need for improved quality with regard to written psychological testimony, other major issues concern how experts can provide the courts with legally relevant information, and how courts can makeuse of complex expert knowledge and still uphold the integrity of the legal process.
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