Charlotte Alm

Validation of the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test in a Swedish sample of suspected offenders with signs of mental health problems: Results from the Mental Disorder, Substance Abuse and Crime study

Substance abuse is common among offenders. One method widely used for the detection of substance abuse is screening. This study explored the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) screening tools in relation to (a) substance abuse and dependency diagnoses and (b) three problem severity domains of the sixth version of the Addiction Severity Index in a sample of 181 suspected offenders with signs of mental health problems. The screening tools showed moderate to high accuracy for identification of dependency diagnoses. The AUDIT was associated with alcohol problem severity, whereas the DUDIT was associated with drug and legal problem severity. Administering the screening tools in the current population yields valid results. However, the suggested cutoff scores should be applied with caution due to the discrepancy between present and previous findings.

Investigative interviewing of alleged child abuse victims: an evaluation of a new training programme for investigative interviewers

This evaluation focused on the developing interviewing skills of 104 active crime investigators in Sweden who participated in six different half-year courses between 2007 and 2010. The courses emphasised a combined model of the National Institute of Child Health and Human Development Protocol and the PEACE model of investigative interviewing. The teaching was interdisciplinary. The evaluation involved interviews of 208 children, most of whom were suspected victims of physical abuse. The investigators used two-thirds fewer option-posing questions and three times as many invitations after training as they did before training. These data show that the training was very effective in shaping the interviewers’ behaviour into better compliance with internationally recognised guidelines.

Adolescent girls exploited in the sex trade: informativeness and evasiveness in investigative interviews

This study explores the informativeness of 24 adolescents exploited in sex trade in Sweden when they were interviewed by police officers about their experiences. The questions and responses were analysed using coding types developed for research on forensic interviews. Qualitative analyses of the questions resulting in evasive responses and the court files were also done. The findings show that the adolescents were informative yet evasive, specifically when asked open questions. Experiences of violence and interviews conducted soon after the police intervention may result in higher levels of evasiveness. Concurrently, evasiveness seems to be intimately connected to unique circumstances in each case.

Treatment Patterns Among Offenders with Mental Health Problems and Substance Use Problems

Research on treatment utilization among offenders with mental health problems and substance use problems, i.e. the ‘triply troubled’, is scarce. The aim was to contribute to the general knowledge about treatment patterns among the triply troubled. This register-based study explored treatment patterns during a 3-year follow-up among 157 Swedish offenders with substance use problems who had undergone forensic psychiatric assessment. There were three subgroups of treatment users: low treatment, planned substance abuse treatment and substance abuse emergency room visits, and planned psychiatric treatment. About 40% of the participants displayed a stable treatment pattern. Outcomes were less successful for those participants displaying a non-stable treatment pattern. Allocation of treatment resources should take into account the associations between treatment patterns and recidivism into criminality. Also, it should be valuable for clinicians to gather information on treatment history in order to meet various treatment needs.

Gender differences in re-offending among psychiatrically examined Swedish offenders.

BACKGROUND The gender gap for violent offending is narrowing in the general population. Substance abuse and mental health problems are known risk factors for criminality. While substance abuse treatment has been associated with reduced risk of re-offending, women seem less likely to engage than men. People misusing substances tend to be high users of emergency room (ER) services. Such use may be an indicator both of treatment failure for substance misuse and offending. Little is known about gender differences in this respect. AIMS This study aims to test for gender differences in re-offending, use of substance abuse treatment, and hospital ER visits among offenders referred for forensic psychiatric assessment in Sweden. METHOD The study used a longitudinal retrospective design. Data on all 31 women from a 2-year (2000-2001) cohort of serious offenders referred for forensic psychiatric assessment in Stockholm county, and 31 men from the same cohort, were extracted from forensic service and national records. Selection of the men was by initial random sampling followed by matching on age and substance misuse. The two resulting samples were compared on health service use and re-offending data between release and the census date (30 April 2004). RESULTS There were no gender differences for violent re-offending or for engagement in planned substance abuse treatment, in spite of longer time at risk for the men. Re-offending was reduced for women but not men who did not present in the ER with physical health problems. CONCLUSIONS Our study is limited by sample size, although it included all women referred to the specialist forensic psychiatric service over 2 years, but it does indicate that differences between men and women in this situation are likely, and worthy of further study. The only way of achieving adequate sample sizes is likely to be through multi-centre collaboration.

Classification of offenders with mental health problems and problematic substance use using the Addiction Severity Index version 6: analysis of three-year follow-up data and predictive validity

Previous research is scarce on the problems and needs of the “triply troubled” – among offenders with mental health problems and problematic substance use. Classifying this population into clusters based on problem profiles may provide information about individual needs for treatment. In a previous study, we identified four clusters of triply troubled: less troubled, severely triply troubled, triply troubled with medical problems, and working triply troubled. The present study explored the stability and predictive validity of these clusters in a naturalistic design. In total, 125 triply troubled individuals included in any of the four clusters were followed for approximately three years with regard to their inpatient and outpatient treatment participation. They were also interviewed with the 6th version of the Addiction Severity Index, the Psychopathy Checklist–Revised, and the World Health Organization Quality of Life–Bref. The main finding of the study was that on average the participants of all four cl...

P02-54 - Is outpatient-based substance abuse treatment a predictor of re-offending and other outcomes among Swedish offenders subjected to psychiatric assessment?

Introduction: Substance abuse is associated with criminal recidivism. Substance abuse treatment has been found to correlate negatively with re-offending among treatment utilizers. However, for offe ...

S13-01 - Substance abuse treatment as a predictor of criminal recidivism among psychiatrically examined Swedish offenders

Background: Substance abuse is clearly associated with criminal recidivism among offenders with and without mental disorder. Treatment for substance abuse correlates with lower rates of re-offendin ...