| 1. |
- Andersson, Frida, et al.
(författare)
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A life-course perspective on girls' criminality
- 2012
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Ingår i: Girls at risk. - New York, NY : Springer. - 9781461441298 - 9781461441304 ; , s. 119-137
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This chapter explores the female patterning of crime and factors that differentiate between these patterns. The theoretical frame considers the developmental course of criminality and some common developmental pathways or trajectories. This perspective is concerned with identifying factors across people’s lives that account for both stability and change in antisocial behavior and crime. The family, school, and peer groups, expressed in social bonds and social networks, are the dominant sources of social control during childhood and adolescence and although childhood oppositional behavior tends to attenuate these important sources of social control, this is not invariably the case. The chapter has a special focus on a female pattern of crime that has not previously been given so much attention in research, namely an adulthood-onset trajectory. The overall aim is to contribute to a better understanding of factors that contribute to the development of different criminal careers among females by studying individual and social characteristics and how such factors interact to change and shape criminal involvement over two critical developmental phases: early adolescence and the transition into young adulthood for a cohort of Swedish girls.
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| 2. |
- Andersson, Frida, et al.
(författare)
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Sex differences in offending trajectories in a Swedish cohort
- 2012
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Ingår i: CBMH. Criminal behaviour and mental health. - : John Wiley & Sons. - 0957-9664 .- 1471-2857. ; 22:2, s. 108-121
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Tidskriftsartikel (refereegranskat)abstract
- Background Despite the increased interest in female offending trajectories over the last decades, knowledge is still limited. Aim To meet the need for more knowledge on female offending trajectories by studying sex differences in criminal career patterns. Method Data on 518 female and 2567 male offenders up to age 30 from the Swedish longitudinal Project Metropolitan study were analysed using latent class analysis. Results The female offenders were much less predisposed to offend than the males, but when they did, they tended to follow a similar set of trajectories to males in their criminal development over time. Four criminal career patterns were identified for each sex. Two patterns were the same between the sexes, and two were gender unique. All career patterns had meaningful and distinct associations with crime characteristics. Conclusions Our study presents indicators relating both to gender differences and to heterogeneity within the group of female offenders. One important finding was the identification of an adult-onset offender group unique to females. This group was characterised by high criminal activity over the years following their late onset. Further research will focus on the childhood origins, pathways and outcomes of different female antisocial and criminal careers.
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| 3. |
- Ivert, Anna-Karin, et al.
(författare)
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Criminality among Former Child and Adolescent Psychiatric Patients and Matched Controls
- 2016
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Ingår i: Open Journal of Medical Psychology. - : Scientific Research Publishing. - 2165-9370 .- 2165-9389. ; :6, s. 16-30
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Tidskriftsartikel (refereegranskat)abstract
- Background: Externalizing symptoms in children (aggression, oppositionality, prop- erty and status violations), and the Attention Deficit Hyperactivity Disorder (ADHD) triad of problems (inattention, hyperactivity, impulsivity) display a substantial co- morbidity. The “short temper” problem is common to these syndromes, which are predictive of a range of negative life outcomes including substance abuse and crimi- nality in adulthood. There is a gender gap for the syndromes (boys are more af- fected), for criminality (men are more criminal) and knowledge (we know less about girls’ criminal careers). Aims: The main aim was to compare crime rates and crime profiles among former Child and Adolescent Psychiatric (CAP) patients with cor- responding data for matched controls, focusing externalizing and internalizing psy- chiatric symptoms, sex and adverse social factors. Method: Data for 6055 former CAP-Stockholm outpatients were extracted from available treatment registers. For each CAP patient, two matched controls from the general population were randomly selected from the same area of residence, of the same sex and with the same year of birth (N approx. 12,000). Data on criminality for these individuals were obtained from a Swedish police register which also includes crimes committed prior to age 15. Results: Overall, twice as many former CAP patients were registered for crimes at a mean age of 21.4 compared to the controls. The over-representation was larger for crimes of violence. Females were registered for a much lower number of crimes, par- ticularly crimes of violence (gender gap). The gender gap among the CAP patients was smaller than among controls. Compared with controls, CAP patients character- ized by externalizing problems at referral had an odds ratio (OR) for crimes of 5 for males and 10 for females. Neglect was the only adverse social factor which was asso- ciated with a higher crime rate and affected boys more than girls. Compared to pre- vious Swedish CAP cohorts, the criminality of the current cohort was much higher. Conclusion: In-depth studies of female crime careers characterized by externalising problems are needed. Child psychiatric services must find new and more effective ways of identifying and treating children with such problems, regardless of sex. The findings can guide the choice of strategies which will reduce crime rate.
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| 4. |
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| 5. |
- Ivert, Anna-Karin, et al.
(författare)
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Pathways to child and adolescent psychiatric clinics : a multilevel study of the significance of ethnicity and neighbourhood social characteristics on source of referral
- 2011
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : BioMed Central. - 1753-2000. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Background In the Swedish society, as in many other societies, many children and adolescents with mental health problems do not receive the help they need. As the Swedish society becomes increasingly multicultural, and as ethnic and economic residential segregation become more pronounced, this study utilises ethnicity and neighbourhood context to examine referral pathways to child and adolescent psychiatric (CAP) clinics. Methods The analysis examines four different sources of referrals: family referrals, social/legal agency referrals, school referrals and health/mental health referrals. The referrals of 2054 children aged 11-19 from the Stockholm Child-Psychiatric Database were studied using multilevel logistic regression analyses. Results Results indicate that ethnicity played an important role in how children and adolescents were referred to CAP-clinics. Family referrals were more common among children and adolescents with a Swedish background than among those with an immigrant background. Referrals by social/legal agencies were more common among children and adolescents with African and Asian backgrounds. Children with Asian or South American backgrounds were more likely to have been referred by schools or by the health/mental health care sector. A significant neighbourhood effect was found in relation to family referrals. Children and adolescents from neighbourhoods with low levels of socioeconomic deprivation were more likely to be referred to psychiatric child and youth clinics by their families in comparison to children from other neighbourhoods. Such differences were not found in relation in relation to the other sources of referral. Conclusions This article reports findings that can be an important first step toward increasing knowledge on reasons behind differential referral rates and uptake of psychiatric care in an ethnically diverse Swedish sample. These findings have implications for the design and evaluation of community mental health outreach programs and should be considered when developing measures and strategies intended to reach and help children with mental health problems. This might involve providing information about the availability and accessibility of health care for children and adolescents with mental health problems to families in certain neighbourhoods and with different ethnic backgrounds.
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| 6. |
- Levander, Sten, et al.
(författare)
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Behandling inom kriminalvården
- 2010
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Ingår i: Kriminalvård i praktiken. - : Studentlitteratur AB. - 9789144028422 ; , s. 99-119
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 7. |
- Levander, Sten, et al.
(författare)
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Self-control in criminology : we need a broader conceptualization and links to psychiatric diagnoses
- 2024
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Ingår i: Frontiers in psychology. - : Frontiers Media S.A.. - 1664-1078. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Poor self-control is a strong correlate of criminal propensity. It is conceptualized and operationalized differently in criminology than in other scientific traditions.AIMS: (1) To verify the dimensionality of the criminological Grasmick self-control items, other self-regulation items and morality ones. (2) To re-interpret the dimensions using a clinical perspective, a taxonomic/diagnostic model and references to possible "biological underpinnings." (3) Validate the dimensions by associations with crime.METHOD: Population: all persons born 1995 in Malmö and living there at age 12. A random sample (N = 525) filled in a comprehensive self-report questionnaire on themes like personality, crime/abuse and social aspects at age 15, 16 and 18. Age 18 data were analysed: 191 men and 220 women.RESULTS: Self-regulation items were 4-dimensional: ADHD problems (Behavior control and Executive skills) and two Aggression factors. Morality items formed a fifth dimension. Negative Affect and Social interaction factors covered the rest of the variance. The validity of these factors was backed up by correlations with similar items/factors. Self-regulation subscales predicted crimes better than the Grasmick scale; an interaction with morality improved prediction still further. Sex differences were over-all small with three exceptions: Aggression, Morality and Negative affect.CONCLUSION: We identified four dimensions of the 20-item Grasmick instrument: Cognitive action control (impulsiveness/sensation seeking, response inhibition), Executive skills/future orientation, Affective/aggression reactivity and Aggression control. All should be possible to link to brain functional modules. Much can be gained if we are able to formulate an integrated model of self-regulation including distinct brain functional modules, process-and trait-oriented models, relevant diagnoses and clinical experiences of individual cases.
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| 8. |
- Lögdberg, Bengt, et al.
(författare)
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Schizophreina, Neighbourhood and Crime. The relation between social desorganisation, mental disorder and crime
- 2004
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Ingår i: Acta Psychiatrica Scandinavica. - : Blackwell Munksgaard. - 0001-690X .- 1600-0447. ; 110:2, s. 92-97
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study was designed to explore the concentration of schizophrenic patients to socially disadvantaged areas in Malmö. Method: A case-finding study of schizophrenia was combined with a victimisation survey. Data was factor-analysed and visualised using geographical information system software. Results: The schizophrenic patients lived predominantly in socially disorganised areas characterised by high levels of disorder, fear of crime and victimisation. Regression analyses showed that local informal social control and concrete fear of crime explained one-third of the variance in schizophrenia prevalence. Measures of victimisation and social disorder, together with schizophrenia prevalence, were found to explain 52% of the variance of concrete fear of crime in the neighbourhood. Conclusions: Our hypothesis is that these circumstances cause vicious circles that tend to maintain or worsen an already negative situation, with detrimental effects on psychosocial functioning and on the quality of life of the persons with schizophrenia. Key words: schizophrenia, crime, fear of crime, victimisation, social disorganisation
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| 9. |
- Lögdberg, Bengt, et al.
(författare)
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Schizophrenia, neighbourhood, and crime.
- 2004
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Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 110:2, s. 92-97
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Tidskriftsartikel (refereegranskat)
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| 10. |
- Mellgren, Caroline, et al.
(författare)
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Riskanalys i polisverksamhet : utvärdering av riskanalys för våld på individnivå: check-10(+)
- 2014
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I följande rapport sammanfattas resultatet från en utvärdering av Check-10(+). Check-10(+) är en av de strukturerade checklistor för bedömning av risk för upprepat våld på individnivå som används inom svensk polis. Rikspolisstyrelsen föreslog efter en inspektion av polismyndigheternas rutiner vid riskanalys (Rikspolisstyrelsen, 2010) att de metoder och verktyg som används inom svensk polis för att bedöma risken för upprepat våld på individnivå bör utvärderas. Detta baserades på att de olika metoder för riskanalys och specifika verktyg för riskbedömning som tillämpas inom svensk polis har utvärderats i begränsad utsträckning, och att kunskapen om hur verktygen fungerar är bristfällig. I en uppföljande inspektion av myndigheternas arbete med riskanalys (Rikspolisstyrelsen 2014:9) rekommenderas att verktygen SARA, SAM, PATRIARK och eventuellt Check-10(+) ska användas nationellt. Utvärderingen bygger på en genomgång av 98 ärenden i vilka en riskbedömning med Check-10(+) genomfördes i Polismyndigheten i Uppsala län. Arbetssättet och verktyget studeras avseende den initiala bedömningen där ärenden som sedan går vidare till strukturerad bedömning sorteras ut, internt bortfall, rekommenderade och genomförda stöd- och skyddsåtgärder, återfall i brott samt fördelning av risknivåer. De ärenden som bedömdes med Check-10(+) var olika och inkluderade brottstyper som olaga hot, och misshandel men även mordbrand och utpressning för att nämna några. Det interna bortfallet var stort främst avseende faktorer som var associerade med gärningspersonen med det gemensamt att de rörde personlighetsrelaterade egenskaper som kriminell attityd, impulskontroll och bristande medkänsla. Bortfallet var så stort (mer än 30%) att instrumentets validitet var hotad. De flesta ärenden bedöms i mitten av den skala på vilken risken och hotbilden bedöms. Det vanligaste är att det föreligger viss risk eller risk och låg hotbild eller förhöjd hotbild (2 eller 3). Få ärenden bedöms som ringa risk eller ingen hotbild och antalet ärenden där risken bedöms som betydande och hotbilden som hög är mycket få. Antalet riskfaktorer stiger med risknivån och hotbildsnivån. Ju fler riskfaktorer som föreligger desto högre bedöms alltså risken och hotbilden. I knappt hälften av ärendena rekommenderas någon stöd- och/eller skyddsåtgärd och i ungefär en fjärdedel av det totala antalet ärenden genomfördes den rekommenderade åtgärden. De åtgärder som rekommenderas är i huvudsak samtal som innehåller information om brottsofferstöd och riskanalysens resultat, motiverande samtal (gäller främst vittnen), säkerhetssamtal och säkerhetsbesiktning av bostaden. Det är inte möjligt att identifiera något mönster i siffrorna. Oavsett risknivå rekommenderas åtgärder i ungefär hälften av ärendena. Oavsett allvarlighetsgrad i befarat återfall rekommenderas åtgärder i ca 40% av ärendena. Åtgärder på basen av rekommendationerna genomförs i ca 60% av fallen, också oavsett risk och allvarlighetsgrad. Det finns alltså inte någon systematik i detta och riskbedömningen styr inte åtgärdsrekommendationerna. Detta är den enda utvärdering av verktyget som hittills genomförts. Den viktigaste slutsatsen är därför att kunskapen om hur Check-10(+) fungerar i polisverksamhet måste öka innan verktyget rekommenderas som en nationell modell för bedömning av risk för generellt våld på individnivå. Resultaten från föreliggande utvärdering pekar på brister som måste åtgärdas och det bör föras en diskussion kring möjligheterna att bedöma risken för upprepat våld för så olika brottstyper som de som bedöms med verktyget i den här studien.
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| 11. |
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| 12. |
- Mellgren, Caroline, et al.
(författare)
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Riskanalys i polisverksamhet : fungerar det? Slutrapport från ett utvärderingsprojekt
- 2014
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- De olika verktyg för riskbedömning av upprepat våld på individnivå som används inom svensk polis idag och hur de fungerar i rutinverksamhet har hittills utvärderats i begränsad utsträckning. I föreliggande rapport sammanfattas resultat från fyra studier i vilka verktygen Check-10(+), SARA:SV och Skånemodellen har utvärderats (Mellgren m.fl ., 2012; 2014a; 2014b; Svalin m.fl ., 2014). Samtliga verktyg bygger på kunskap om riskfaktorer för de olika brottstyper för vilka återfallsrisken ska bedömas och stöd- och skyddsåtgärder sättas in. Den mesta kunskapen kommer dock från andra verksamheter än polisverksamhet. Följande frågor diskuteras i rapporten: *Vilka är de ärenden som blir föremål för strukturerad bedömning och hur fungerar den initiala bedömningen som sorteringsgrund? * Bidrar processen med riskanalys till minskad upprepad utsatthet? * Kan riskanalys anses fungera väl i polisverksamhet? Den initiala bedömningen är det första steget i riskanalysens process. Om den inte fungerar är sannolikheten större att inte heller den strukturerade bedömningen i steg två fungerar. Genomgången av de ärenden som blir föremål för riskanalys med Skånemodellen, Check-10(+) och SARA:SV visar att få av alla de ärenden som anmäls under ett år bedöms strukturerat. Av dem är det endast ett fåtal där det bedöms föreligga särskilt förhöjd risk, de fl esta bedöms som låg eller medelhög risk. För att vidare svara på frågan om de mest allvarliga ärendena blir bedömda bör en uppföljning göras för ett urval av de ärenden som inte går vidare till strukturerad bedömning för att kunna jämföra återfallsfrekvensen med och utan bedömning och tillhörande stöd- och skyddsåtgärder. För samtliga undersökta verktyg och de bedömningar som genomförts utifrån dessa är det interna bortfallet stort för vissa faktorer, särskilt för de som rör gärningspersonens psykiska hälsa. * Detta innebär i praktiken att bedömningar av risk görs utan ett komplett underlag. Det i sin tur innebär att den träffsäkerhet man haft i de vetenskapliga studierna av verktygen inom andra verksamheter inte går att uppnå i polisens vardagsarbete. Förlusten i träffsäkerhet kan vara så stor att bedömningen närmar sig slumpnivån. Då är det meningslöst att alls göra riskbedömningar. * Verktygen visar låg prediktiv validitet, andelen upprepat utsatta bland ärenden som bedömts med Skånemodellen och SARA:SV är stor, till- gången till åtgärder är begränsad och åtgärdernas preventiva förmåga förefaller vara svag och kan i vissa fall antagligen öka brottsrisken. Riskbedömningarna kan vara mycket bra men om de åtgärder som vidtas på basen av riskbedömningar och ekonomiska kalkyler inte har någon effekt, t.ex. en viss brottspreventiv åtgärd som enligt kriminologisk forskning inte fungerar brottspreventivt på en viss grupp av kriminella – då är vinsterna med verksamheten små. När de första moderna riskbedömningsmetoderna lanserades i mitten av 1990-talet fokuserade man ute slutande på riskbedömningen – inte vad som skulle göras utifrån den. I dag är riskbedömningar av detta slag alltid sammankopplade med riskhanteringsåtgärder. Om ambitionen är att basera denna typ av verksamhet på vetenskap räcker det inte att utvärdera om riskbedömningarna är tillräckligt bra – vi måste också utvärdera effekten av de åtgärder som styrs av riskbedömningen. Mot bakgrund av detta är en av de viktigaste slutsatserna – och rekommendationerna – att kunskapen om hur verktygen fungerar måste öka innan rekommendationer görs. Sammanfattningsvis, leder riskanalys till minskad upprepad utsatthet för brott och kan verktygen anses fungera väl i svensk polisverksamhet? Ett kortfattat svar på frågan är: Nej, inte baserat på de utvärderingar som genomförts inom detta projekt. Kunskapen om vilka ärenden som inte bedöms är begränsad och vi vet inte om ”rätt” ärenden går vidare. Baserat på att fl est ärenden bedöms som låg eller medelhög risk är en rimlig slutsats att många högriskärenden missas. Bortfallet är ibland så högt att bedömningens validitet måste ifrågasättas, dvs. man mäter inte det man avser att mäta och en bedömning baserad på bristfällig information riskerar att bli felaktig. Detta bekräftas av att träffsäkerheten är låg och andelen upprepat utsatta hög. I tillägg är interbedömarreliabiliteten i vissa avseenden låg, både för Skånemodellen och för SARA:SV. En kritisk faktor är det första steget i riskbedömningen (screening), dvs. procedurerna för att välja ut ett begränsat antal av alla inkommande ärenden, som sedan går vidare till en strukturerad riskbedömning. Det bör vara möjligt att skapa välfungerande screening-rutiner på basen av redan kända sakförhållanden och befi ntliga databaser, dvs. aktuariska riskfaktorer som är omedelbart tillgängliga för polisen vid screeningen. Sådana riskfaktorer är ålder, kön, tidigare kriminalitet i allmänhet och våldskriminalitet i synnerhet, offer (närstående och/eller andra), brottsbredd (många olika typer av tidigare brott), vårddomar och indikatorer på missbruk. Polismyndigheten bör genomföra större utbildnings- och implementeringsinsatser samt följa upp, utvärdera och anpassa arbetet med riskbedömning av våld på individnivå. Därefter bör nationella verktyg rekommenderas och riktlinjer för arbetet tas fram. Detta kräver resurser, men menar man allvar med satsningen på riskbedömningar är detta nödvändigt. Punktinsatsernas tid bör vara förbi och det långsiktiga förbättringsarbetet inledas omgående.
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| 13. |
- Svalin, Klara, et al.
(författare)
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Assessing and managing risk for intimate partner violence : Police employees’ use of the Police Screening Tool for Violent Crimes in Scania
- 2017
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Ingår i: Journal of Scandinavian Studies in Criminology and Crime Prevention. - : Taylor & Francis. - 1404-3858 .- 1651-2340. ; 18:1, s. 84-92
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Tidskriftsartikel (refereegranskat)abstract
- Relapse into intimate partner violence (IPV) can potentially be predicted and counter-measures applied. This study examines the predictive validity of a violence risk assessment tool: the Police Screening Tool for Violent Crimes (PST-VC) among a sample of 65 offenders. All PST-VC assessments regarding IPV that were conducted at the Scania police department in 2010 were included in the sample. Follow-up time was 16–28 months, and all reported incidents with the same victim and suspected offender were recorded. The PST-VC demonstrated limited effect in the ability to identify high-risk offenders and predict repeat victimization. Interventions against the offender and victim protective actions were more often recommended in high-risk cases but did not lower the number of IPV relapses. The study suggests that the PST-VC is not a promising instrument.
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| 14. |
- Svalin, Klara, et al.
(författare)
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Inter-Rater Reliability of the Police Screening Tool for Violent Crime (PST-VC)
- 2015
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Risk assessments are used by the police in order to identify the need for victim protection. In Sweden, two kinds of methods are used in police settings – variants of instruments developed in the HCR-20 tradition, and an instrument designed within one regional police authority: the Police screening Tool for Violent Crime (PST-VC). Aim: To study the reliability and validity of the PST-VC as a general tool for assessing and managing threat and violence in police settings. Method: Seventeen cases were evaluated by ten police employees. Each case was evaluated by two assessors randomly paired and blind to each other´s assessments. All cases were also assessed previously at the time of the police report, together 51 pairs of assessments. Results: The inter-rater agreement was examined for five variables: the suspected offenders’ access to weapons, previous offences, previous violence/threat against the victim, the global risk assessments and the recommended protective actions. Inter-rater agreement was highest for the global assessments and the recommended protective actions. However, agreeing about these global ratings was associated with widely varying scores for the structured variables among the raters. The fairly high reliability was most likely due to similar “gut feelings” induced by the police culture.
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| 15. |
- Svalin, Klara, et al.
(författare)
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Police employees' violence risk assessments : the predictive validity of the B-SAFER and the significance of protective actions
- 2018
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier. - 0160-2527 .- 1873-6386. ; 56, s. 71-79
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Tidskriftsartikel (refereegranskat)abstract
- Violence risk assessment and management is conducted in police settings in order to prevent repeat victimization. One of the most frequently used violence risk assessment tools in this specific context is called the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER), which focuses on intimate partner violence (IPV). The present study examines B-SAFER assessments conducted by police employees, related protective actions and repeat IPV crimes in order to study: 1) to what extent risk- and victim vulnerability factors in the B-SAFER predicted global risk assessments, 2) the predictive accuracy of each B-SAFER item and the global risk assessments with regard to repeat IPV, 3) to what extent recommended protective actions were implemented and 4) the preventive effect of the implemented protective actions on repeat IPV. There were a large number of missing cases in the assessments and the risk and victim vulnerability factors only contributed to the global risk assessments to a minor extent. The predictive validity was low overall, few protective actions were implemented and those which were actually implemented did not appear to prevent repeat IPV. The continuous education and training of assessors is required to improve the work of violence risk assessment and management in police settings.
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| 16. |
- Svalin, Klara, et al.
(författare)
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The Inter-Rater Reliability of Violence Risk Assessment Tools Used by Police Employees in Swedish Police Settings
- 2017
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Ingår i: Nordisk Politiforskning. - : Universitetsforlaget. - 1894-8693. ; 4:1, s. 9-28
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Tidskriftsartikel (refereegranskat)abstract
- Risk assessments are used by the police in order to identify the need for victim protection. The aim of this study was to examine the inter-rater reliability of two violence risk assessment tools; the Police Screening Tool for Violent Crimes (PST-VC) and the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER), used by police employees in two different police authorities in Sweden. The inter-rater agreement was evaluated for both tools, with respect to global risk assessments, recommended protective actions and risk- and victim vulnerability factors. The main results showed that the inter-rater agreement was highest for the global assessments and widely varying, from very low to fairly high, for the structured variables. The fairly high reliability for the global risk assessments was most likely due to shared assumptions (heuristics, tacit knowledge) among the assessors rather than being based on the information obtained by the tools.
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| 17. |
- Svalin, Klara, et al.
(författare)
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Utvärdering av SARA: SV
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Föreliggande rapport presenterar resultatet från en utvärderingsstudie av polisens arbete med riskbedömning och riskhantering (samlingsnamn riskanalys) utifrån riskbedömningsverktyget SARA:SV som används för att bedöma risken för upprepat våld i nära relationer på individnivå. Materialet som analyserats omfattar 320 ärenden som efter initial bedömning blev föremål för SARA:SV-bedömning av riskanalytiker vid Polismyndigheten i Uppsala under åren 2011 och 2012. Fokus för utvärderingen är resultatet av de riskanalyser som genomförts, inte arbetets organisering, även om den aspekten berörs. Verktyget har främst utvärderats avseende internt bortfall, prediktiv validitet, rekommenderade och genomförda stöd- och skyddsåtgärder samt interbedömarreliabilitet. Resultaten visar att det interna bortfallet för riskfaktorerna varierar mellan drygt fyra procent för faktorn tidigare våld (aktuell situation) och 53 % för faktorn psykiska problem (bakgrund). Variationerna mellan variablerna är stora men bortfallet är systematiskt lägre för riskfaktorerna rörande gärningspersonens bakgrund (4-39 %) jämfört med faktorerna som rör gärningspersonens psykosociala situation (10-53 %). Jämfört med liknande studier är bortfallet högt. I praktiken innebär det stora interna bortfallet att ett alltför stort antal bedömningar baseras på otillräcklig information om gärningsperson och brottsoffer. Detta leder till att validiteten inte kan garanteras eftersom bedömningen av risken inte bygger på den information som krävs för att bedöma risken. Ju högre bedömd risk, både för bedömning av sannolikhet och allvarlighetsgrad i aktuell situation och bakgrund, desto fler var de föreliggande riskfaktorerna. En dryg tredjedel av hela undersökningsgruppen blir upprepat utsatta för något brott. I flertalet fall är alltså de åtgärder som sätts in inte tillräckliga för att förhindra ytterligare brott. Vi noterar också att kategorin låg/viss risk är störst, att bedömarna inte använder hela bedömningsskalan samt att återfallen är vanligare i ärenden som inte bedömts med hög risk. En stor andel av de upprepade brotten begicks kort tid efter bedömningen. Detta innebär sammantaget att verktyget SARA:SV har låg grad av prediktiv validitet i föreliggande studie och fungerar dåligt för att inom polisverksamhet predicera återfall i brott i föreliggande studie (dvs. diskriminera mellan grupperna återfall/ej återfall) eftersom antalet korrekta förutsägelser endast är ungefär 7 av 50. Den vanligaste rekommenderade åtgärden är kontaktförbud (en dryg fjärdedel av fallen) och information om brottsofferstödjande verksamheter i ungefär lika många fall. Säkerhetssamtal och säkerhetsbesiktning rekommenderas i drygt 20 % av ärendena. Övriga åtgärder än dessa förekommer sällan. Totalt rekommenderades 355 åtgärder. I 42 % av ärendena rekommenderades inga åtgärder, i 30 % en åtgärd, i 10 % två eller tre åtgärder och i ett litet antal fall (färre än 5 %) fyra eller maxantalet fem åtgärder. Samtliga åtgärder rekommenderas i större utsträckning än de genomförs. Kontaktförbud beviljas av åklagare endast i knappt hälften av de fall där de rekommenderas av den som gör riskbedömningen. Interbedömmarreliabiliteten är god för de sammanfattande bedömningarna men detta är skenbart. Samstämmigheten uppkommer genom den magkänsla som är gemensam för bedömarna: polisutbildningen, gemensamma erfarenheter, poliskulturen och lokala kulturer (t.ex. bland polisanställda som arbetar med riskbedömningar). Tittar vi på hur två bedömare motiverar att de bedömde ett visst fall på ett visst sätt (utifrån svaren på huruvida de enskilda faktorerna föreligger helt eller delvis eller inte föreligger) är dessa helt olika. Eftersom man är osäker på sin bedömning håller man sig i mitten av bedömningsskalorna. Man använder sig i huvudsak av två (av fem) skalsteg för den sammanfattande bedömningen. Ytterst syftar riskbedömning och riskhantering i detta sammanhang till att förhindra återfall och upprepad viktimisering av brottsoffren. Vår undersökning kan inte ge några definitiva svar på om detta syfte uppfylls. Detta med anledning av att det är omöjligt att med strikt vetenskaplig metod studera huruvida riskbedömning förhindrar brott. Detta är ett problem som vidhäftar alla studier inom området. Vi kan inte identifiera en risk och sedan inte göra något åt den. Det går inte att slumpa riskbedömningen, dvs. singla slant om en viss gärningsperson har hög eller låg risk och sedan agera utifrån detta när åtgärder vidtas. Kortfattat visar utvärderingen att bortfallet är stort och att vissa faktorer, särskilt de personlighetsmässiga faktorerna, är svåra att bedöma, och att riskbedömning i sig är ett svårt uppdrag som utan rätt implementering och utbildning blir mycket svårt att lyckas med. Dessutom är evidensbasen för den preventiva förmågan hos de åtgärder som finns tillgängliga svag.
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| 18. |
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| 19. |
- Torstensson Levander, Marie, et al.
(författare)
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kriminella karriärmönster hos kvinnor
- 2007
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Ingår i: Tvärsnitt. - : vetenskapsrådet. ; :2
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Att män begår betydligt fler brott än kvinnor och också utvecklar mer varaktiga brottskarriärer är sedan länge känt, men vad ligger bakom dessa skillnader mellan könen? Ser orsaksmekanismerna bakom kvinnors brott annorlunda ut än för männen
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| 20. |
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| 21. |
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| 22. |
- Andershed, Henrik
(författare)
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Antisocial behavior in adolescence : the role of individual characteristics
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main aim of this dissertation is to investigate whether traits on the level of the individual are important in understanding violent, frequent antisocial behavior among adolescents. The first of the four studies included in this dissertation asks whether individual-level explanations are going to be a fruitful approach at all. The other three studies speak to the question which particular individual characteristics are related to violent, frequent antisocial behavior. Two different large samples of 14 to 16-year-old male and female non-referred adolescents were assessed. The adolescents were mainly assessed with self-report questionnaires but information from parents and teachers was also incorporated in one of the samples. Results show that aggressive, antisocial behavior for a subgroup of adolescents cuts across social contexts, indicating that their aggressive behavior is largely dependent on individual characteristics, more than on situational factors. It is further shown that a constellation of personality traits involving a grandiose, manipulative interpersonal disposition, callous, unemotional affective traits, and an impulsive, irresponsible behavioral style, characterizes a subgroup of antisocial adolescents who have more violent, frequent antisocial behavior than antisocial adolescents without this personality constellation. This same subgroup also shows more pronounced problem behaviors of other kinds — early behavioral problems, problems with inhibiting aggressive behaviors, and problems with hyperactivity, impulsivity, and attention. Moreover, the results show that the affective facet of this particular personality constellation, involving callous, unemotional traits, plays an important role in violent, frequent antisocial behavior independently of other antisocial-related dimensions such as impulsivity, hyperactivity, and sensation seeking traits. Importantly, the main findings were similar for males and females. It is concluded that specific personality traits are important to consider when moving further toward an understanding of violent, frequent antisocial behavior and that research on non-referred, community samples of youths can be particularly helpful for this purpose. Implications for prevention and intervention and directions for future research are discussed.
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| 23. |
- Dalteg, Arne, et al.
(författare)
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Psychosis in adulthood is associated with high rates of ADHD and CD problems during childhood
- 2014
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 68:8, s. 560-566
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients diagnosed with schizophrenia display poor premorbid adjustment (PPA) in half of the cases. Attention deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) are common child psychiatric disorders. These two facts have not previously been linked in the literature. Aims: To determine the prevalence of ADHD/CD problems retrospectively among patients with psychoses, and whether and to what extent the high frequency of substance abuse problems among such patients may be linked to ADHD/CD problems. Method: ADHD and CD problems/diagnoses were retrospectively recorded in one forensic (n = 149) and two non-forensic samples (n = 98 and n = 231) of patients with a psychotic illness: schizophrenia, bipolar or other, excluding drug-induced psychoses. Results: ADHD and CD were much more common among the patients than in the general population-the odds ratio was estimated to be greater than 5. There was no significant difference in this respect between forensic and non-forensic patients. Substance abuse was common, but substantially more common among patients with premorbid ADHD/CD problems. Conclusions: Previous views regarding PPA among patients with a psychotic illness may reflect an association between childhood ADHD/CD and later psychosis. The nature of this association remains uncertain: two disorders sharing some generative mechanisms or one disorder with two main clinical manifestations. Childhood ADHD and particularly CD problems contribute to the high frequency of substance abuse in such groups.
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| 24. |
- Douglas, S Kevin, et al.
(författare)
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Reliability and validity evaluation of the psychopathy checklist: Screening version (PCL : SV) in Swedish correctional and forensic psychiatric samples
- 2005
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Ingår i: Assessment. - : SAGE Publications. - 1552-3489 .- 1073-1911. ; 12:2, s. 145-161
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated the structural reliability, construct-related validity, and cultural validity generalization of the Hare Psychopathy Checklist: Screening Version (PCL:SV) in a sample of more than 560 male and female Swedish forensic psychiatric treatment patients, forensic evaluation patients, and criminal offenders. Structural reliability was excellent for most indices. PCL:SV scores were higher for males than females for total and Part 1 scores (interpersonal/affective features) but not for Part 2 (behavioral features). With some exceptions, PCL:SV scores were meaningfully related to aggression to others, a measure of risk for violence, substance use problems, personality disorder (positive), and psychosis (negative). Correlations between PCL:SV and aggression were larger for females than males, although the difference was smaller when personality disorder was held constant. The structural reliability and pattern of validity coefficients were comparable in these Swedish samples to other non-North American samples. Implications for the cross-cultural manifestation and correlates of psychopathy are discussed.
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| 25. |
- Dåderman, Anna Maria, 1953-
(författare)
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“Dr Jekyll and Mr Hyde?” : Abuse of potent benzodiazepines, exemplified by flunitrazepam, in mentally disordered male offenders
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Flunitrazepam (FZ) is an example of a sedative-hypnotic benzodiazepine whose pharmacokinetic properties include a rapid onset of action and an intermediate duration of action. It has a high affinity to central benzodiazepine receptors and affects them profoundly. These properties, and its profile of activity, increase the probability of abuse by those who have access to it. Known side effects of FZ are abuse and amnesia. FZ is widely abused and it has become a drug of choice among opioid abusers, as a club drug, and as a classic “date-rape” drug. FZ is often involved in fatal intoxication. It is therefore expected that FZ abuse is common in serious offenders. I have studied the reasons for FZ abuse and mapped the prevalence of the abuse, with the objective of studying the personalities and the background factors of the abusers, and of drawing some conclusions about assessment procedures of FZ abuse and the position of FZ in society.The participants in the studies summarised here were fifty-six juvenile delinquents from Swedish youth correctional institutions, aged 14-20 years, and sixty non-psychotic male offenders referred for a forensic psychiatric evaluation (FPE), aged 16-35 years. The participants answered questions regarding their abuse, and this enabled us to understand why they abused just FZ (and not another substance). The participants also completed a number of self-reported inventories, which enabled us to obtain measures of personality traits. They were also rated for psychopathy. Five forensic psychiatric cases of FZ abusers were studied in more detail. Furthermore, the forensic psychiatric participants’ psychiatric diagnoses, and both groups’ crime-related measures, were obtained from their files.About 40% of the juvenile delinquents and 30% of the offenders referred for a forensic psychiatric evaluation abused FZ. The main reason for the FZ abuse was to change a perception of reality and to obtain an increased feeling of power and self-esteem, a feeling that everything was possible. Both samples of offenders differed from the normal population in many personality traits, suggesting that the participants possessed a high level of vulnerability for developing mental disorders, but only a few differences in personality traits were found between FZ abusers and non-FZ abusers. The juvenile delinquent FZ abusers had higher scores than non-FZ abusers in the verbal aggression and sensation-seeking boredom susceptibility scales. In the juvenile sample, FZ abuse was associated with the abuse of amphetamines and/or cocaine, cannabis, and opiates, and with childhood psychological/psychiatrical contact, with living in a metropolitan housing area, and with recidivism into crimes leading to care in a juvenile correctional institution. In this sample, FZ abuse was also associated with weapons offences and narcotics-related crimes. In the forensic psychiatric sample, FZ abuse was significantly associated with previous admission to an FPE, and convictions for robbery, for weapons-related offences, for narcotics-related offences and for theft. The results show that FZ is more common in offenders who score high on Facet 4 (Antisocial) in the Hare psychopathy model, and that FZ abuse has high correlation with Item 20 (Criminal versatility). All of the FZ abusers reported side effects from FZ that resulted in the brutality of their violent acts and anterograde amnesia. FZ abusers, when intoxicated with FZ, had a reduced capacity for both empathy and anticipatory anxiety, in contrast to their “daily” behaviour and “ordinary” (i.e., without the influence of the FZ) personality characteristics. They were not characterised by classic characteristics of psychopathy, such as lack of empathy. This may indicate that FZ induces psychopathic-like state-dependant (FZ intoxication) traits, and temporary dissociate states (“Dr Jekyll and Mr Hyde”?).In conclusion, FZ abuse is common in the population of young offenders with mental disorders, and FZ is often used for nonmedical purposes. The practical implications of these conclusions are that clinicians and those who develop or manage therapeutic programs should be aware of FZ abuse when choosing the most effective treatment for male offenders. General practitioners who prescribe potent sedative compounds should be aware of their possible adverse effects. The availability of FZ should be limited further, because FZ is frequently abused in vulnerable male offenders, and because FZ has serious adverse mental health-related effects and is related to robbery and weapons‑related crimes.
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| 26. |
- Dåderman, Anna Maria, 1953-, et al.
(författare)
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Flunitrazepam intake in male offenders
- 2012
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Ingår i: Nordic Journal of Psychiatry. - : Informa Healthcare. - 0803-9488 .- 1502-4725. ; 66:2, s. 131-140
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Tidskriftsartikel (refereegranskat)abstract
- The abuse of flunitrazepam (FZ) compounds is worldwide, and several studies have reflected on the consequences with regard to violence, aggression and criminal lifestyle of FZ users. Criminals take high doses of FZ or some other benzodiazepines to "calm down" before the planned crime. There is support from earlier studies that most likely, all benzodiazepines may increase aggression in vulnerable males. Chronic intake of high doses of FZ increases aggression in male rats. Because psychopathy involves aggression, we have examined whether psychopathy as well as any of the four facets of the Psychopathy Checklist-Revised (PCL-R) (Interpersonal, Affective, Lifestyle and Antisocial) are related to different substance use disorders, with the focus on FZ. We have also examined the relationship between each PCL-R item and FZ use. Participants were 114 male offenders aged 14-35 years, all of whom were convicted for severe, predominantly violent, offences. Substance use, including FZ, was not more common in those who scored high in psychopathy. Use of FZ was more common in offenders who scored high in Facet 4 (Antisocial) of the PCL-R (odds ratio = 4.30, 95% CI 1.86-9.94). Only one of the PCL-R items, "Criminal versatility", was significantly associated with FZ use (odds ratio = 3.7). It may be concluded that intake of FZ has a specific relationship to only one of the facets and not to psychopathy per se. ; The findings have also important theoretical implications because Facet 4 is not a key factor of the construct of psychopathy. Clinical implications of the article: We have used the new two-factor and four-facet theoretical model of psychopathy in the young offender population, many of them with one or more substance use disorders. The present results suggest that antisocial behavior defined by Facet 4 (poor behavioral control, early behavior problems, juvenile delinquency, revocation of conditional release and criminal versatility) in the studied subjects is more typical for FZ users than it is for non-FZ users. This may have implications for assessment and treatment. Clinicians should be aware that criminals with high scores on Facet 4 have a more than fourfold odds of being a FZ user. This conclusion has an important clinical implication because FZ abuse is very common and is not always the focus of a forensic psychiatric assessment. ;
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| 27. |
- Dåderman, Anna Maria, 1953-, et al.
(författare)
-
"I Dislike my Body, I am Unhappy, But my Parents are not Disappointed in Me" : Self-Esteem in Young Women with Dyslexia
- 2014
-
Ingår i: Applied Psychological Research Journal. - Coventry University : Conventry University. - 2057-570X. ; 1:1, s. 50-58
-
Tidskriftsartikel (refereegranskat)abstract
- Strong self-esteem is related to good psychological health. Dyslexia has a negative effect on self-esteem, but this effect depends on support levels at home and/or school. Women with dyslexia are an under investigated group, and it has been suggested that female dyslexics should be given special attention from teachers with a view to improving their self-esteem. This paper set out to compare levels of self-esteem in women with dyslexia and normative women, and to investigate relationships between dyslexic problems and self-esteem. It was hypothesized that women with dyslexia would have a weaker self-esteem. We have assessed dyslexia, using a Swedish battery of standardised pedagogical, IQ, and neuropsychological tests, and the self-esteem of twelve young women (mean age 19 years; range 16-30), using a Swedish questionnaire that distinguishes between different dimensions of self-esteem (physical characteristics, talents and gifts, psychological health, relationships with parents and family, and relationships with others). Comparative (t-tests) and correlational (Pearson’s correlations and stepwise multiple regression analyses) statistical methods were performed. The study subjects had a weaker self-esteem than that of a normative sample of females (N = 313) in all dimensions, except for the dimension of relationships with parents and family. Spelling ability was related to “Physical characteristics” (negative) and to “Relations with parents and family” (positive). Moreover, speed of reading was related to “Psychological health” (positive). The use of questionnaires that distinguish between different dimensions of self-esteem and a larger sample is recommended in future studies.
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| 28. |
- Dåderman, Anna Maria, 1953-, et al.
(författare)
-
Psychopathic traits and lifestyle in flunitrazepam abusers
- 2005
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The abuse of flunitrazepam (FZ) compounds is world-wide. We have examined whether any of the four facets of the Psychopathy Checklist-Revised (PCL-R) (Interpersonal, Affective, Lifestyle, and Antisocial) (Hare, 2003) is related to different substance use disorders, with the focus on FZ abuse. Participants were 114 male offenders aged 14-35 years, all of whom were convicted for severe, predominantly violent, offences. Abuse of FZ was more common in offenders who scored high in Facet 4 (Antisocial) of the PCL-R (odds ratio = 4.30, 95% C.I. 1.86 - 9.94). Using all 20 PCL‑R items as individual predictors of being an FZ abuser, only one of the items, Item 20) (Criminal versatility) was significantly associated with FZ abuse (odds ratio = 3.72, 95% C.I. 1.85 - 7.50). We suggest that abuse of FZ is more common in offenders who score high in Facet 4, and that FZ abuse is significantly associated with Item 20. Our results show that clinicians and those who develop or manage therapeutic programs should be aware of FZ abuse when choosing the most effective treatment for young mentally disordered severe offenders.
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| 29. |
- Dåderman, Anna Maria, 1953-, et al.
(författare)
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Speedy action over goal orientation' : cognitive impulsivity in male forensic patients with dyslexia
- 2012
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Ingår i: Dyslexia. - : John Wiley & Sons, Ltd.. - 1076-9242 .- 1099-0909. ; 18:4, s. 226-235
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Tidskriftsartikel (refereegranskat)abstract
- Previous neuropsychiatric studies suggest a relationship between reading disability and cognitive impulsivity. This relationship is not entirely explained by the high comorbidity between reading disability and attention deficit hyperactivity disorder (ADHD), as children with a co-occurrence of these disorders tend to be more impulsive than those with ADHD only. Other research has demonstrated that poor verbal skill (irrespective of the presence of dyslexia) deficits in executive functions and impulsivity are important risk factors for criminal behaviour. The present study bridges these two research traditions by examining whether patients undergoing forensic psychiatric investigation who also have dyslexia, have a cognitive style characterized by impulsivity. Male forensic patients (mean age 27 years, range 16–35) with (n = 9) and without (n = 13) dyslexia were evaluated on the computerized EuroCog test battery. The findings suggest that patients with dyslexia tend to use a cognitive impulsive style and suggest a more direct link between dyslexia and cognitive impulsivity that is not mediated by the presence of ADHD. In order to identify treatment needs and tailor treatment accordingly, forensic patients should be assessed with respect to poor verbal skill, dyslexia and impulsivity.
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| 30. |
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| 31. |
- Eberhard, Jonas, et al.
(författare)
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Prolactin level during 5 years of risperidone treatment in patients with psychotic disorders
- 2007
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Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447. ; 115:4, s. 268-276
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate prolactin levels and related side effects in 128 men and 90 women initially treated with risperidone. Method: Patients initially treated with risperidone were followed over 5 years, during which 45% were switched to other antipsychotic drugs. Results: Initially, prolactin levels were fivefold the norm in women, and threefold in men. Diagnosis did not affect the prolactin level if adjustment for sex, current age, and age at onset of psychosis was applied. Prolactin levels did not correlate significantly neither with any Positive and Negative Symptom Scale item or subscale, nor with side effects. Drugs other than risperidone were not associated with high prolactin levels. For patients on continuous monotherapy risperidone treatment, there was a marked linear reduction of prolactin level over all 5 years. Conclusion: Risperidone induces a higher prolactin elevation than other atypical antipsychotics, but the effect adapts over time. Prolactin was not associated with expected side effects (e.g. sexual, mental, or weight gain).
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| 32. |
- Eberhard, Jonas, et al.
(författare)
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Remission in schizophrenia: analysis in a naturalistic setting.
- 2009
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Ingår i: Comprehensive Psychiatry. - : Elsevier BV. - 0010-440X .- 1532-8384. ; 50:3, s. 200-208
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the recently defined Positive and Negative Syndrome Scale for Schizophrenia remission criteria in a naturalistic setting of psychotic patients; to identify causal factors that change remission status; and to validate the criteria against global indices of illness, cognitive functions, and social outcome. METHODS: This was a longitudinal naturalistic study of 162 patients, diagnosed with schizophrenia or schizophrenia-related psychotic disorders (mean illness duration, 11 years) and treated with risperidone at study entry. Symptoms, drug treatment, cognitive function, and social outcome were measured at baseline and annually for 5 years. Remission was constructed retrospectively with only indirect data on stability over time. RESULTS: At study entry, 40% of the patients with schizophrenia were in symptomatic remission, stabilizing between 55% and 60% after a few years. The need for hospitalization became less frequent over time; initially 31%, dropping to 7% by years 4 and 5. Many patients went in and out of remission. Remission was strongly associated with global indices of illness, with intact insight and with social outcome (except work/studies) but not with cognition or medication. CONCLUSIONS: In spite of certain weaknesses of the study, we may conclude that current definition of remission is primarily a symptomatic measure, covering a subset of symptoms, some of which are not schizophrenia-specific. Although the definition may be clinically relevant, we must be aware of the risk that the connotation of the word could induce too much focus on symptom control.
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| 33. |
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| 34. |
- Hodgins, Sheelagh, et al.
(författare)
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A multisite study of community treatment programs for mentally ill offenders with major mental disorders : Design, measures, and the forensic sample
- 2007
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Ingår i: Criminal justice and behavior. - : SAGE Publications. - 0093-8548 .- 1552-3594. ; 34:2, s. 211-228
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Tidskriftsartikel (refereegranskat)abstract
- This article presents reasons for undertaking ""The Comparative Study of the Prevention of Crime and Violence by Mentally Ill Persons"" and reasons for decisions regarding the study design and choice of measures. A brief portrait of the forensic patients that have been recruited is also presented. Community treatment programs could offer long-term cost-effective care for offenders with major mental disorders (MMDs). The study aims to identify the necessary ingredients of an effective program. Sites are selected in four countries where identification of most, if not all, persons with MMD who commit crimes within the catchment area was possible. Within each site, two samples of patients with MMD are recruited, one from a forensic hospital and one from a general psychiatric hospital. Assessments are completed prior to discharge. Participants are followed during a 5-year period. Comparisons of the forensic patients recruited in the four sites indicate many more similarities than differences.
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| 35. |
- Höglund, Pontus, et al.
(författare)
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Accountability and psychiatric disorders: How do forensic psychiatric professionals think?
- 2009
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Ingår i: International journal of law and psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 32:6, s. 355-361
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Tidskriftsartikel (refereegranskat)abstract
- Swedish penal law does not exculpate on the grounds of diminished accountability; persons judged to suffer from severe mental disorder are sentenced to forensic psychiatric care instead of prison. Re-introduction of accountability as a condition for legal responsibility has been advocated, not least by forensic psychiatric professionals. To investigate how professionals in forensic psychiatry would assess degree of accountability based on psychiatric diagnoses and case vignettes, 30 psychiatrists, 30 psychologists, 45 nurses, and 45 ward attendants from five forensic psychiatric clinics were interviewed. They were asked (i) to judge to which degree (on a dimensional scale from 1 to 5) each of 12 psychiatric diagnoses might affect accountability, (ii) to assess accountability from five case vignettes, and (iii) to list further factors they regarded as relevant for their assessment of accountability. All informants accepted to provide a dimensional assessment of accountability on this basis and consistently found most types of mental disorders to reduce accountability, especially psychotic disorders and dementia. Other factors thought to be relevant were substance abuse, social network, personality traits, social stress, and level of education.
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| 36. |
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| 37. |
- Jensen, Jimmy, et al.
(författare)
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Neurocognitive and psychopathological correlates of self-monitoring ability in schizophrenia.
- 2004
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Ingår i: European Archives of Psychiatry and Clinical Neuroscience. - : Springer. - 0940-1334 .- 1433-8491. ; 254:5, s. 312-317
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Tidskriftsartikel (refereegranskat)abstract
- In a previous study reported by our group one salient finding was that many patients with schizophrenia appeared to be unable to judge their own quality of life (QoL) and that this inability was associated with negative symptoms. The association between negative symptoms, poor self-monitoring capacity and lack of insight might be explained by a common underlying factor, i.e. neurocognitive impairment. Fifty schizophrenic patients were examined by symptom ratings and a comprehensive neuropsychological test battery. The cognitive performance of the patients was very poor. The major findings of the present study were the association between clinically rated Lack of judgement (PANSS G12) and 1) a set of standard performance and executive indices of the computerised tests, and 2) difference scores between objective performance/strategies and self-ratings of the same attributes. There appears to be a substantial contribution of cognitive and executive problems to the poor judgement and lack of insight of schizophrenic patients, and these problems can to some extent be assessed objectively.
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| 38. |
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| 39. |
- Johansson, Peter, et al.
(författare)
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On the operationalization of psychopathy : further support for a three-faceted personality oriented model
- 2002
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Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447. ; 106:suppl. s412, s. 81-85
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:This study is an attempt to compare two alternative models of psychopathy (PCL-R); (i) the traditional 17-item two-factor model where the first factor describes a deceitful, manipulative and callous, unemotional dimension and the second factor describes the impulsive, irresponsible and antisocial behavioral lifestyle dimension; and (ii) a recently proposed 13-item three-factor model involving an interpersonal facet, an affective facet and a behavioral facet.METHOD:Exploratory and confirmatory factor analyses of PCL-R scores on a sample of 293 adult male violent offenders were conducted.RESULTS:The results of the exploratory factor analysis showed that the 13 items yielded three easily interpretable factors: an interpersonal factor, an affective factor and a behavioral/lifestyle factor. Through confirmatory factor analysis we showed that this model had a significantly closer fit to the data than the classical 17-item, two-factor model of the PCL-R.CONCLUSION:The study supports the three-faceted model of psychopathy.
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| 40. |
- Johansson, Peter, 1953-
(författare)
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Understanding psychopathy trough the study of long-term violent offenders
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Psychopathy describes a collection of personality traits that logically would facilitate violent, criminal behavior. This dissertation deals with issues that might shed light on how to treat or prevent this socially devastating personality disorder: the conceptualization of the disorder; how psychopathic offenders compare with nonpsychopathic offenders; and whether there are some psychopathic offenders who might be more amenable to treatment than others. The four studies use data from a sample of about 400 violent offenders who were assessed in a national prison unit. The first study dealt with the definition of psychopathy. Using exploratory and confirmatory factor analyses of PCL-R scores, we compared the traditional 17- item, two-factor model with a more recently proposed 13-item, three-factor model. Exploratory factor analysis showed that the 13 items yielded three easily interpretable factors: an interpersonal factor, an affective factor, and a behavioral/lifestyle factor. Confirmatory factor analysis showed that this model had a significantly closer fit to the data than the traditional 17-item, two-factor model. The second and third studies compared psychopathic with nonpsychopathic offenders. In the second study we tested whether psychopathic more than nonpsychopathic offenders had histories of hyperactivityimpulsivity- attention problems (HIA) and conduct problems (CP). We used their retrospective reports of conduct problems before the age of 15 and HIA before the age of 10. The results showed that a combination of childhood HIA and CP was typical for psychopathic but not nonpsychopathic offenders. The third study tested the hypothesis that intelligence is positively correlated with severity of criminal development in psychopathic criminals and negatively correlated in nonpsychopathic criminals. That pattern would provide a way of explaining the discrepancy between Cleckley’s view and later empirical work and open the door to new ideas about prevention and treatment. For non-psychopaths, higher total intelligence scores, particularly verbal intelligence, meant a later start in violent crime. For those diagnosed as psychopaths, however, this association was reversed. The fourth study investigated whether meaningful subtypes of psychopathy could be identified. Model-based cluster analysis of Revised Psychopathy Checklist (PCLR Hare, 2003) and trait anxiety scores in the psychopathic subgroup (n = 124; PCL-R > 29) revealed two clusters, which we labeled primary and secondary. Secondary psychopaths had greater trait anxiety and fewer psychopathic traits than primary psychopaths, but comparable levels of antisocial behavior. They also had more borderline personality features, poorer interpersonal functioning, and more symptoms of major mental disorder than primary psychopaths. Psychopathy is a complex and in some ways mysterious disorder, and little is known about how it develops. Taken together, these studies provide some clues that might ultimately lead to ways of preventing the development of psychopathy. Early HIA problems apparently put children in a risk group. Apparently, high intelligence plays a role in the most problematic cases, and the disorder can develop in the presence of anxiety. Although the idea is not without problems, adult psychopaths who are high on anxiety might be more amenable to treatment than those who are not.
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| 41. |
- Jonsson, Erik G., et al.
(författare)
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Use of antipsychotics - An analysis of lifetime treatment in 66 patients with psychoses
- 2011
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Ingår i: Psychiatry Research. - : Elsevier BV. - 1872-7123 .- 0165-1781. ; 187:1-2, s. 80-88
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Tidskriftsartikel (refereegranskat)abstract
- Only a minority of patients treated with antipsychotics in clinical studies continue their treatments throughout a longer study period. Few studies address this issue from a lifetime perspective. In this naturalistic study, we aimed at analysing the prescription pattern of antipsychotic drugs among a sample of Swedish patients with a diagnosis of psychotic illness, from the first contact with psychiatry (typically between 1973 and 1997) until the last written note in the case history documents. A retrospective descriptive analysis was performed of all case history data of 66 patients diagnosed with schizophrenia or related psychotic disorders. Patients with schizophrenia were prescribed antipsychotic medication more than 90% of the time. Each patient generally had been prescribed several (up to 16) different antipsychotic drugs and a quarter of the patients had been prescribed two or more antipsychotics for a third of their prescription time. Patients with psychosis were exposed to a cumulatively growing number of antipsychotics. Various factors, including clinician and patient expectations, and specific strengths and limitations of available antipsychotics may account for frequent medication changes over time. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
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| 42. |
- Khoshnood, Ardavan, et al.
(författare)
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”Sverige behöver en statskriminolog”
- 2020
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Ingår i: Svenska Dagbladet. - 1101-2412.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- To address the catastrophe we are witnessing in Sweden today with respect to serious violent crimes, the government should appoint a State Criminologist, writes Ardavan Khoshnood and Sten Levander.
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| 43. |
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| 44. |
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| 45. |
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| 46. |
- Levander, Sten, et al.
(författare)
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Clinical decision-making during 5 years of antipsychotic treatment
- 2007
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Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447 .- 0065-1591 .- 1600-5473. ; 116, s. 17-26
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Explore how clinicians select drug treatment based on symptoms, side effects and patient factors, including patient participation in the process, and the association between these factors and attitudes towards drugs. Method: A cohort of 166 patients initially treated with risperidone was followed with yearly assessments over 5 years. At the end of the study, 101 patients were evaluated of whom 58 were still treated with risperidone. Results: More women than men remained in the study, and on the initial medication. The most common reason for medication switch was lack of efficacy. Clinicians and patients agreed well in their global ratings of medication effects and side effects. Robust associations between switch decisions and patient characteristics including symptoms and side effects could not be identified. The effects of switches were rated as better by the clinicians than by the patients. Negative drug attitudes were associated with pronounced positive symptoms (threshold effect), whereas the corresponding association with 'lack of judgment and insight' was linear over the whole range. Conclusion: The decision-making process appears to have many unknown components, and may benefit from more active patient involvement by using structured clinician and patient rating scales for monitoring the treatment. Such shared decision-making may improve compliance.
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| 47. |
- Levander, Sten
(författare)
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Costas värld och min
- 2007
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 44:104
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 48. |
- Levander, Sten, et al.
(författare)
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Costs of schizophrenia during five years
- 2007
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Ingår i: Schizophrenia Bulletin. - : Oxford University Press (OUP). - 1745-1701 .- 0586-7614. ; 33:2, s. 485-485
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Konferensbidrag (refereegranskat)
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| 49. |
- Levander, Sten
(författare)
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Criminality & mental illness
- 2012
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Ingår i: Ethical aspects of mental health. - : Nordic Council of Ministers. ; , s. 21-21
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The relation between criminality and mental illness is very sensitive, stated Sten Levander. Usually people do not want to add to the stigma of mental illness. Also, social and psychological explanations of mental illness are preferred over biological or – even worse – genetic explanations.
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| 50. |
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