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- Berlin, Johan, 1975, et al.
(författare)
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Exploring the psychometric properties of the externalizing spectrum inventory-brief form in a Swedish forensic psychiatric inpatient sample
- 2023
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Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The Externalizing Spectrum Inventory-Brief Form (ESI-BF) [1] is a 160-item self-report instrument designed for the assessment of externalizing psychopathology, yet few studies to date have evaluated its psychometric properties, structural fit, and criterion validity in forensic psychiatric settings. Methods Here, we investigated these aspects in a sample of forensic psychiatric inpatients (n = 77) from a maximumsecurity forensic psychiatric hospital in Sweden. We firstly investigated the reliability. Secondly, using confirmatory factor analysis, the structure of the ESI-BF. And thirdly, using a Bayesian approach, assessed how the three ESI-BF subfactors relate to criterion measures of antisocial behaviors, substance use, and lifetime externalizing spectrum diagnoses. Results The ESI-BF demonstrated good to adequate reliability and internal consistency, with all but four facet scales exhibiting a and. values = 0.80. Average inter-item correlations for the facet scales ranged from 0.31 to 0.74. However, all structural models exhibited poor to mediocre fit, with model fit values for the CFI being 0.66, 0.79 and 0.87 and RMSEA values of 0.14, 0.12 and 0.09. for the unidimensional correlated factors and bifactor model, respectively. Regarding criterion validity, all subscales of the item-based ESI-BF three-factor model exhibited robust correlations with the Life History of Aggression total, aggression and antisocial/consequences subscales, with correlations ranging from 0.29 to 0.55. All ESI-BF subfactors demonstrated robust associations, yet with different externalizing outcomes, lending tentative support to its criterion validity. Conclusion Despite remaining ambiguities regarding its structural fit, the ESI-BF may be promising for assessing externalizing psychopathology in forensic psychiatric populations. However, further investigation of the ESI-BF is needed before any firm conclusions can be drawn about its appropriateness in forensic psychiatric settings.
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- Bolund Lauenstein, Emma, 1978, et al.
(författare)
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Identifying associations between TCI personality dimensions and PCL-R psychopathy facets in young male offenders
- 2019
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Ingår i: The International Academy of Law and Mental Health (IALMH).
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The psychopathy construct includes prominent maladaptive personality traits and behaviors. One of the most widely used instruments to asses this construct is the Psychopathy Checklist-Revised (PCL-R). However, little empirical evidence exists regarding how this construct, according to PCL-R, can be understood in relation to theories of personality. Aim: To examine the relationships between components of psychopathy according to PCL-R, and personality dimensions as defined by Cloninger’s Temperament and Character Inventory (TCI). Method: Young violent incarcerated offenders (n = 270) aged 18-25 years were assessed with both PCL R and TCI. A canonical correlation analysis (CCA), a multivariate analysis model, was used to obtain latent covariation between the four components of psychopathy from PCL-R and the seven personality dimensions of TCI to identify the variables that most strongly contributed to an association between these constructs. Results: The CCA resulted in two pairs of significant canonical variates (Rc2 = 0.32 and 0.17), where the full model was significant, Wilk’s λ = 0.51, F(28, 488.17) = 3.61, p < 0.001, indicating that a substantial proportion (i.e., 49 %) of the shared variance between PCL-R and TCI was explained. Overall the latent shared construct between TCI and PCL-R was construed of the temperament dimension Novelty seeking, and the character dimensions Self-directedness and Cooperativeness, and by the psychopathy facets Interpersonal, Lifestyle and Antisocial. Conclusion: Within the present sample, results suggest strong associations between TCI personality dimensions and psychopathy, indicating that psychopathy is possible to describe in more general personality terms. Moreover, the PCL-R psychopathy concept seemed to be more influenced by character than temperament dimensions, a finding important to investigate in future research since character have emerged as susceptible to influence by psychological interventions.
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- Bolund Lauenstein, Emma, 1978, et al.
(författare)
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PERSONALITY and PSYCHOPATHY – Identifying associations between Temperament and Character Inventory (TCI) dimensions and PCL-R psychopathy facets in young male offenders
- 2019
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Ingår i: 13th Nordic Symposium on Forensic Psychiatry.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Personality is a wide concept and how to best capture and describe personality depends on the purpose of the investigation. When to investigate whether an individual has psychopathic features, use of Hare Psychopathic Checklist-Revised (PCL‑R) is common. However, this kind of instrument emphasizes personality traits and socially deviant behaviors which together may form maladaptive characteristics, but leaves other personality traits unspecified. Evidence-based personality assessments recommends to use a comprehensive design, collecting data from multiple theoretical perspectives and data sources to prevent bias and trawling for supporting evidence (Bornstein, 2017). This is especially problematic when it comes to differential diagnosis within personality disorders, due to the considerable overlap of traits between these disorders (Ryder et al., 2007) as well as poor interrater reliability (Kotov et al., 2017). The aim was to investigating the extent of construct overlap between dimensional personality traits according to TCI and psychopathy according to PCL-R among young violent offenders. The study cohort consists of male offenders, aged 18-25 years, convicted for hands-on violent and/or sexual criminality and sentenced to prison in western Sweden between March 2010 and July 2012. The response rate was 71% (n=270, mean age: 22.3 years), and of all these had 148 given valid answers to Cloninger’s Temperament and Character Inventory (TCI), while 146had been assessed with the PCL-R. A canonical correlation analysis (CCA) was used to explore how personality traits (TCI) were related to psychopathic traits (PCL-R) in this sample. The CCA entails three steps: 1) zero-order correlations; 2) unique associations based on regression, and 3) investigating the multivariate shared relationship between the different PCL-R facets and TCI-traits with a CCA. The overlap found in the CCA consisted of four functions, but only two were significant. Since only the first two functions were significant only these were interpreted, and shared approximately 49% of the variance. Function 1. Illustrated a conceptual overlap consisting of being intolerant, selfish and vindictive, being practical, distanced, cold and socially insensitive, as well as having a proneness to violate society’s rules and norms and the propensity for unethical behaviour. Function 2. Illustrated a conceptual overlap consisting of being superficially charming, grandiose, having an inflated ego and being voluble, deceitful and manipulative but also being grounded, strong, determined, purposeful, bold and exploratory. Both temperamental and character dimensions contributed to the observed overlap with psychopathy, of which Harm Avoidance and Novelty Seeking stood out among the former and Cooperativeness and Self-Directedness among the latter. However, compared to the considerably larger overlap found between personality disorders (DSM-IV-TR) and PCL-R facets (89%, see Daver, 2018), the results imply that a broader and not only pathological focus when assessing personality can contribute with important information. The results supports the importance of a broad focus in personality assessments, and to use a dimensional approach when describing personality features. The former can lead to a more complete picture of the assessed person, and the latter to a more versatile interpretation. Together, it can diminish stigma and may open up for more treatment options.
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- Green, Johan, et al.
(författare)
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A latent class analysis of mental disorders, substance use, and aggressive antisocial behavior among Swedish forensic psychiatric patients
- 2023
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Ingår i: Comprehensive Psychiatry. - 0010-440X .- 1532-8384. ; 127
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients in the forensic mental health services (FMHS) with a mental disorder, a co-occurring substance use disorder (SUD), and high risk of aggressive antisocial behavior (AAB) are sometimes referred to as the ‘triply troubled’. They suffer poor treatment outcomes, high rates of criminal recidivism, and increased risk of drug related mortality. To improve treatment for this heterogeneous patient group, more insight is needed concerning their co-occurring mental disorders, types of substances used, and the consequent risk of AAB. Methods: A three-step latent class analysis (LCA) was used to identify clinically relevant subgroups in a sample of patients (n = 98) from a high-security FMHS clinic in Sweden based on patterns in their history of mental disorders, SUD, types of substances used, and AAB. Results: A four-class model best fit our data: class 1 (42%) had a high probability of SUD, psychosis, and having used all substances; class 2 (26%) had a high probability of psychosis and cannabis use; class 3 (22%) had a high probability of autism and no substance use; and class 4 (10%) had a high probability of personality disorders and having used all substances. Both polysubstance classes (1 and 4) had a significantly more extensive history of AAB compared to classes 2 and 3. Class 3 and class 4 had extensive histories of self-directed aggression. Conclusions: The present study helps disentangle the heterogeneity of the ‘triply troubled’ patient group in FMHS. The results provide an illustration of a more person-oriented perspective on patient comorbidity and types of substances used which could benefit clinical assessment, treatment planning, and risk-management among patients in forensic psychiatric care.
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| 7. |
- Green, Johan, et al.
(författare)
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Implementing clinical guidelines for co-occurring substance use and major mental disorders in Swedish forensic psychiatry: An exploratory, qualitative interview study with mental health care staff
- 2023
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Ingår i: Journal of Substance Abuse Treatment. - : Elsevier BV. - 0740-5472 .- 1873-6483. ; 144
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Patients with substance use disorders (SUD) and co-occurring mental disorders (COD) within forensic psychiatric care often suffer poor treatment outcomes and high rates of criminal recidivism, substance use, and psychiatric problems. This study aimed to describe the conditions for, and mental health care staff's experiences with, implementing integrated SUD-focused clinical guidelines, including assessment and treatment for patients with COD at a high-security forensic mental health services (FMHS) facility in Sweden. Methods: Study staff conducted nineteen semi-structured interviews with health care staff experienced in administering the new SUD assessment and treatment. The study conducted a thematic analysis to describe the health care staff's experiences with these guidelines and suggestions for improvement. Results: Most participants reported appreciation for the implementation of clinical guidelines with an SUD focus, an area they considered to have previously been neglected, but also noted the need for more practical guidance in the administration of the assessments. Participants reported the dual roles of caregiver and warden as difficult to reconcile and a similar, hindering division was also present in the health care staff's attitudes toward SUD. Participants' reports also described an imbalance prior to the implementation, whereby SUD was rarely assessed but treatment was still initiated. One year after the implementation, an imbalance still existed, but in reverse: SUD was more frequently assessed, but treatment was difficult to initiate. Conclusions: Despite indications of some ambivalence among staff regarding the necessity of the assessment and treatment guidelines, many participants considered it helpful to have a structured way to assess and treat SUD in this patient group. The imbalance between frequent assessment and infrequent treatment may have been due to difficulties transitioning patients across the “gap” between assessment and treatment. To bridge this gap, mental health services should make efforts to increase patients' insight concerning their SUD, flexibility in the administration of treatment, and the motivational skills of the health care staff working with this patient group. Participants considered important for enhancing treatment quality a shared knowledge base regarding SUD, and increased collaboration between different professions and between in- and outpatient services.
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- Göranson, Lizel, et al.
(författare)
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Decision-Making Within Forensic Psychiatric Investigations: The Use of Various Information Sources by Different Expert Groups to Reach Conclusions on Legal Insanity
- 2022
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Which type of information experts use to make decisions regarding legal insanity within forensic psychiatric investigations (FPI) is relatively unknown, both in general and when considering variations due to case context. It is important to explore this area to be able to counteract the effects of various kinds of cognitive bias. Method: The aim was to explore whether FPI expert groups differed regarding case-specific as well as general use of information types required to make decisions on severe mental disorder (SMD). Three FPI case vignettes were presented to three professional groups involved in FPIs in Sweden (n = 41): forensic psychiatrists (n = 15), psychologists (n = 15), and social workers (n = 11). The participants reported which types of information they required to reach conclusions regarding SMD in each case. They also reported which types of information they had used within general FPI praxis during the previous year and the information types’ perceived usefulness. Results: The expert groups differed somewhat regarding what type of information they required for the cases (e.g., results from cognitive testing), but some information was required in all cases (e.g., client’s self-report). Regarding the preliminary assessment of SMD in the three cases, minor differences were found. Within the general FPI praxis, experts reported using several information types, while the general perceived usefulness of these sources varied. Discussion: The professional groups relied partly on a “core” of information sources, but some case-specific adaptations were found. The professional groups’ inclination to suspect SMD also varied somewhat. This indicates a need to explore the potential consequences of these similarities and differences.
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| 9. |
- Hagsand, Angelica, 1985, et al.
(författare)
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Alkoholpåverkade vittnens minne
- 2014
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Ingår i: Rättspsykologiskt symposium - Känslor och minne i rättsprocessen. Arrangerad av forskargruppen Criminal, Leval, and Investigative Psychology (CLIP), 2014-11-28, Göteborg. Symposium for domare m.m..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- I detta föredrag presenterade vi hur kunskapsfältet ser ut gällande alkoholpåverkade vittnen.
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Handbok i missbruks- och beroendepsykologi
- 2023
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- I boken beskrivs hur begreppen missbruk och beroende har utvecklats över tid i interaktion med samhällsförändringar. Grundläggande neurobiologiska och beteendemässiga aspekter av missbruks- och beroendetillstånd presenteras, liksom det aktuella forskningsläget för klinisk utredning och bemötande av missbruks- och beroendetillstånd. Flera kapitel berör både teoretiska och kliniska aspekter av samsjuklighet och hur missbruks- och beroendebehandling kan behöva anpassas till olika former av samtidig psykiatrisk problematik. Handboken ger en översikt över rekommenderade behandlingsinsatser vid substansbruksyndrom utifrån aktuell forskning, och hur man inom missbruks- och beroendevård kan förhålla sig till begreppet evidensbaserad psykologisk praktik. Författarna behandlar missbruks- och beroendepsykologiska frågor på en samhälls- och organisatorisk nivå, och diskuterar hur vården kan organiseras för att optimera utredning och behandling. Denna bok vänder sig till studenter på alla utbildningsnivåer inom högre utbildning, särskilt till studerande inom psykologi, medicin och socialt arbete. Boken är också aktuell för personer som av personliga eller yrkesmässiga skäl är intresserade av missbruks- och beroendefrågor.
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