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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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| 2. |
- Claesdotter-Knutsson, Emma, et al.
(författare)
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Early onset externalizing behaviors among forensic psychiatric patients: Identification in child and adolescent psychiatric services
- 2021
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Ingår i: Psychiatry Research. - : Elsevier BV. - 0165-1781. ; 305
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Tidskriftsartikel (refereegranskat)abstract
- Forensic psychiatric patients constitute a heterogeneous patient group, with common comorbidity within the externalizing spectrum. Increased knowledge on early antecedents in the pathway to severe mental illness and criminality is needed. In this study, we investigated early onset externalizing behaviors in three groups of forensic psychiatric patients 1) patients without contact with child and adolescent psychiatry (CAP), 2) patients with CAP contact, and 3) patients with both CAP contact and institutional placement. Participants (N = 98) were consecutively recruited from a cohort of forensic psychiatric patients in Sweden between 2016 and 2020. Data were collected through file information and semi-structured interviews and analyzed with a Bayesian approach. A history of CAP together with an institutional placement during childhood or adolescence was associated with more externalizing disorders, a higher number of convictions over the lifetime, a lower age at first conviction, and a lower age at first self-reported crime. Our findings provide further insight into the importance of earlyonset adverse behaviors in the development of later externalizing behaviors, and may be of particular use for practitioners within social services and CAP services.
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| 5. |
- Delfin, Carl, 1986, et al.
(författare)
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Examining Associations Between Psychopathic Traits and Executive Functions in Incarcerated Violent Offenders
- 2018
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Executive functions (EFs) are essential in almost all aspects of daily life and have been robustly related to antisocial behavior. However, the relationship between psychopathy and EFs has remained equivocal. Research investigating lower-level trait dimensions of psychopathy using standardized EF measures could be beneficial in addressing this issue. In this study, we examined associations between four EFs and four dimensions of psychopathic traits (interpersonal, affective, lifestyle, antisocial) using zero-order correlation and a combination of classical and Bayesian statistical methods. Two hundred and fourteen incarcerated male violent offenders were assessed with the Psychopathy Checklist-Revised and completed tests of cognitive flexibility, spatial working memory, response inhibition, and planning and problem-solving using the Cambridge Neuropsychological Test Automated Battery. Lifestyle psychopathic traits were significantly associated with reduced initial thinking time in a planning and problem-solving task, with a Bayes factor indicating substantial evidence for the observed correlation, and antisocial psychopathic traits showed a significant association with reduced initial thinking time in the same task, although the Bayes factor indicated only anecdotal evidence. Significant associations were also found between affective and antisocial psychopathic traits and less efficient strategic thinking in a spatial working memory task, and between affective, lifestyle and antisocial psychopathic traits and fewer problems solved in a planning and problem-solving task, although these findings were not corroborated by the Bayesian analysis. While the observed effects ranged between small and medium, our study suggests that reduced initial thinking times in planning and problem-solving is robustly associated with higher degrees of lifestyle and antisocial psychopathic traits.
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| 7. |
- Delfin, Carl, 1986, et al.
(författare)
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Exploring the Effects of an Acute Dose of Antipsychotic Medication on Motivation-mediated BOLD Activity Using fMRI and a Perceptual Decision-making Task
- 2020
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Ingår i: Neuroscience. - : Elsevier BV. - 0306-4522 .- 1873-7544. ; 440, s. 146-159
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Tidskriftsartikel (refereegranskat)abstract
- The left inferior frontal gyrus and the bilateral ventral striatum are thought to be involved in motivation-mediated decision-making. Antipsychotics may influence this relationship, and atypical antipsychotics improve secondary negative symptoms in schizophrenia, such as loss of motivation, although the acute effects of pharmacological medication on motivation are not fully understood. In this single-blinded, randomized controlled trial, 49 healthy volunteers were randomized into three groups to receive a single dose of haloperidol, aripiprazole or placebo. Between 4.0 and 5.6 h later, participant's brain blood-oxygen-level dependent (BOLD) activity was recorded using functional magnetic resonance imaging (fMRI) while completing a perceptual decision-making fMRI task consisting of one neutral and one motivated condition. Response bias, reflecting the participant's willingness to say that the target stimulus is present, was calculated using signal detection theory. Concurrent with widespread changes in BOLD signal in the motivated vs. neutral condition, a less conservative, mathematically optimal response bias was observed in the motivated condition across the whole sample. Within-group differences in BOLD signal in the left inferior frontal gyrus and bilateral ventral striatum were observed between conditions in the aripiprazole and haloperidol groups, but not in the placebo group. No robust between-group differences in brain activity in the left inferior frontal gyrus or the bilateral ventral striatum were found. Overall, we found no robust evidence for an effect of either aripiprazole or haloperidol on motivationally mediated behavior. An interesting pattern of correlations possibly related to pharmacologically induced alterations in the dopamine system was observed, although findings remain inconclusive and must be replicated in larger samples. (C) 2020 IBRO. Published by Elsevier Ltd. All rights reserved.
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| 8. |
- Delfin, Carl, 1986
(författare)
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Improving the stability of bivariate correlations using informative Bayesian priors: a Monte Carlo simulation study
- 2023
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Ingår i: FRONTIERS IN PSYCHOLOGY. - 1664-1078. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Much of psychological research has suffered from small sample sizes and low statistical power, resulting in unstable parameter estimates. The Bayesian approach offers a promising solution by incorporating prior knowledge into statistical models, which may lead to improved stability compared to a frequentist approach. Methods: Simulated data from four populations with known bivariate correlations (rho = 0.1, 0.2, 0.3, 0.4) was used to estimate the sample correlation as samples were sequentially added from the population, from n = 10 to n = 500. The impact of three different, subjectively defined prior distributions (weakly, moderately, and highly informative) was investigated and compared to a frequentist model. Results: The results show that bivariate correlation estimates are unstable, and that the risk of obtaining an estimate that is exaggerated or in the wrong direction is relatively high, for sample sizes for below 100, and considerably so for sample sizes below 50. However, this instability can be constrained by informative Bayesian priors. Conclusion: Informative Bayesian priors have the potential to significantly reduce sample size requirements and help ensure that obtained estimates are in line with realistic expectations. The combined stabilizing and regularizing effect of a weakly informative prior is particularly useful when conducting research with small samples. The impact of more informative Bayesian priors depends on one's threshold for probability and whether one's goal is to obtain an estimate merely in the correct direction, or to obtain a high precision estimate whose associated interval falls within a narrow range. Implications for sample size requirements and directions for future research are discussed.
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| 11. |
- Delfin, Carl, 1986
(författare)
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Neurobehavioral correlates of disinhibitory psychopathology
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Disinhibitory psychopathology refers to maladaptive behavioral expressions stemming from problems with impulse control. Despite a robust association with antisocial and criminal behavior, knowledge about the neurobehavioral correlates of disinhibitory psychopathology is still lacking. The aims of this thesis were to (1) quantify the prevalence of disinhibitory psychopathology, (2) examine associations between disinhibitory psychopathology and neurocognitive function as well as (3) brain structure and function, and (4) explore how neurobehavioral variables associated with disinhibitory psychopathology may be used in the prediction of recidivism. Four studies, with participants recruited among offenders, mentally disordered offenders, and young adults of the general population, were conducted. Each study used a different, specific set of methods, including clinical and self-report assessments, file review, and register data, as well as neurocognitive tasks probing inhibitory control and neuroimaging techniques such as electrophysiological recordings and structural brain scans. The prevalence of disinhibitory psychopathology was similar to or even higher than previous national and international estimates. Disinhibitory psychopathology was associated with neurocognitive impairments, most prominently an impulsive approach to planning and problem-solving and a reduced capacity for inhibitory control, and with neurobiological alterations in regions involved in monitoring and evaluation of behavior, inhibitory control, working memory, and attention. Finally, a set of neurobehavioral variables associated with disinhibitory psychopathology increased the accuracy of recidivism prediction. In conclusion, this thesis confirms the importance of disinhibitory psychopathology as a clinical construct. It adds to a scarce literature on mentally disordered offenders and provides much needed evidence of specific neurobehavioral correlates that may be used to guide the development of novel diagnostic frameworks and treatment strategies, and that may be useful for targeted interventions in forensic settings.
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| 12. |
- Delfin, Carl, 1986, et al.
(författare)
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Prediction of recidivism in a long-term follow-up of forensic psychiatric patients: Incremental effects of neuroimaging data
- 2019
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Ingår i: PloS One. - : Public Library of Science (PLoS). - 1932-6203. ; 14:5
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Tidskriftsartikel (refereegranskat)abstract
- One of the primary objectives in forensic psychiatry, distinguishing it from other psychiatric disciplines, is risk management. Assessments of the risk of criminal recidivism are performed on a routine basis, as a baseline for risk management for populations involved in the criminal justice system. However, the risk assessment tools available to clinical practice are limited in their ability to predict recidivism. Recently, the prospect of incorporating neuroimaging data to improve the prediction of criminal behavior has received increased attention. In this study we investigated the feasibility of including neuroimaging data in the prediction of recidivism by studying whether the inclusion of resting-state regional cerebral blood flow measurements leads to an incremental increase in predictive performance over traditional risk factors. A subsample (N = 44) from a cohort of forensic psychiatric patients who underwent single-photon emission computed tomography neuroimaging and clinical psychiatric assessment during their court-ordered forensic psychiatric investigation were included in a long-term (ten year average time at risk) follow-up. A Baseline model with eight empirically established risk factors, and an Extended model which also included resting-state regional cerebral blood flow measurements from eight brain regions were estimated using random forest classification and compared using several predictive performance metrics. Including neuroimaging data in the Extended model increased the area under the receiver operating characteristic curve (AUC) from .69 to .81, increased accuracy from .64 to .82 and increased the scaled Brier score from .08 to .25, supporting the feasibility of including neuroimaging data in the prediction of recidivism in forensic psychiatric patients. Although our results hint at potential benefits in the domain of risk assessment, several limitations and ethical challenges are discussed. Further studies with larger, carefully characterized clinical samples utilizing higher-resolution neuroimaging techniques are warranted.
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| 14. |
- Ivarsson, David, et al.
(författare)
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Pinpointing change in virtual reality assisted treatment for violent offenders: a pilot study of Virtual Reality Aggression Prevention Training (VRAPT)
- 2023
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Ingår i: Frontiers in Psychiatry. - 1664-0640. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Preventing relapse into violence and its destructive consequences among persistent re-offenders is a primary concern in forensic settings. The Risk-Need-Responsivity framework models the best current practice for offender treatment, focused on building skills and changing pro-criminal cognitions. However, treatment effects are often modest, and the forensic context can obstruct the delivery of interventions. Developing treatments for offenders should focus on the best method of delivery to make “what works work.” Virtual reality (VR)-assisted treatments such as Virtual Reality Aggression Prevention Training (VRAPT) are a new and innovative approach to offender treatment. This pilot study followed 14 male violent offenders who participated in VRAPT in a Swedish prison context and measured changes from pre-treatment to post-treatment and 3-month follow-up in targeted aggression, emotion regulation, and anger. It also investigated potential impact factors (pro-criminal cognitions, externalizing behaviors, psychosocial background, and childhood adverse experiences). In Bayesian linear mixed effects models, participants showed a high probability of change from pre-treatment to post-treatment and to follow-up on all outcome measures. All outcome measures demonstrated a low probability of change from post-treatment to follow-up. Analysis of reliable change showed that participants’ results ranged from recovery to deterioration. We discuss the implications of the study for VRAPT’s impact on the target group, those who might benefit from the approach, and suggested foci for future studies in the field of VR-assisted offender treatment. The study was preregistered at the International Standard Randomized Controlled Trial Number registry (https://doi.org/10.1186/ISRCTN14916410).
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| 15. |
- Wallinius, Märta, et al.
(författare)
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Offenders in emerging adulthood : School maladjustment, childhood adversities, and prediction of aggressive antisocial behaviors
- 2016
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Ingår i: Law and Human Behavior. - : American Psychological Association (APA). - 0147-7307 .- 1573-661X. ; 40:5, s. 551-563
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Tidskriftsartikel (refereegranskat)abstract
- Early psychosocial adversities and maladjustment, such as childhood maltreatment and school adjustment problems, have been linked to an increased risk of aggressive antisocial behaviors. Yet, clinical studies of subjects at the highest risk of persistence in such behaviors are rare, especially during the life-changing transition years of emerging adulthood. This study describes early predictors of aggressive antisocial behaviors in a large, nationally representative cohort of Swedish, male violent offenders in emerging adulthood (age range = 18-25 years; N = 270). First, data on psychosocial background characteristics and aggressive antisocial behaviors (including age at onset) are provided. Second, early predictors of aggressive antisocial behaviors are tested in bivariate and multivariate interactive models. The offenders demonstrated a diversity of early onset adversities and disruptive behaviors, in line with established risk factors for subsequent criminality and adverse outcomes in a variety of life domains. Severe school adjustment problems, especially bullying others and early onset truancy, were important and interrelated predictors of aggressive antisocial behaviors over the lifetime, whereas childhood adversities such as parental substance or alcohol abuse and repeated exposure to violence at home during childhood were interrelated predictors of aggressive antisocial behaviors, albeit with less statistical importance. The findings stress the importance of early identification of individuals in the risk zone of developing severe and persistent aggressive antisocial behaviors and of early preventive interventions directed toward families with high-risk profiles. The findings also provide initial guidelines on which psychosocial background risk factors that need to be considered first-hand in early interventions. (PsycINFO Database Record
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