Hjalmar van Marle

Review of Risk Assessment Instruments for Juvenile Sex Offenders What is Next

Risk assessment is considered to be a key element in the prevention of recidivism among juvenile sex offenders (JSOs), often by imposing long-term consequences based on that assessment. The authors reviewed the literature on the predictive accuracy of six well-known risk assessment instruments used to appraise risk among JSOs: the Juvenile Sex Offender Assessment Protocol-II (J-SOAP-II), Juvenile Sexual Offence Recidivism Risk Assessment Tool-II (J-SORRAT-II), Estimate of Risk of Adolescent Sexual Offence Recidivism (ERASOR), Juvenile Risk Assessment Scale (JRAS), Structured Assessment of Violent Risk in Youth (SAVRY), and Hare Psychopathy Checklist:Youth Version (PCL:YV). Through a systematic search, 19 studies were reviewed. Studies showed differences in the predictive accuracies for general, violent, and sexual recidivism, and none of the instruments showed unequivocal positive results in predicting future offending. Not unexpectedly, the accuracy of the SAVRY and PCL:YV appeared to be weaker for sexual recidivism compared with specialized tools such as the J-SOAP-II or the ERASOR. Because of the rapid development of juveniles, it is questionable to impose long-term restrictions based on a risk assessment only. New challenges in improving risk assessment are discussed.

Saved by structure? The course of psychosis within a prison population

About 4% of all prisoners can be diagnosed with a psychotic disorder, but it is largely unknown how these prisoners function during imprisonment. The present study aimed to describe symptoms of psychotic prisoners during imprisonment and incidents caused by them as well as care provided to these prisoners. A total of 61 prisoners were observed for a maximum of 12 weeks. Results show that poverty of speech and blunted affect significantly decreased over time. The largest group of psychotic prisoners either did not suffer from positive psychotic symptoms or the encountered positive psychotic symptoms exhibited a steady or decreasing pattern during their imprisonment. Reasons for these findings still remain unclear.

Unravelling offending in schizophrenia: Factors characterising subgroups of offenders

BACKGROUND Previous studies have led to suggestions that there are at least three sub-types of offenders with schizophrenia, but these have not previously been examined simultaneously in one sample. AIMS The aims of this study were to investigate categorisation of offenders with psychosis as early or late starters or late first offenders, and test the hypotheses that, compared with non-offenders with psychosis, early starters would be characterised by low educational or occupational achievement, negative childhood experiences and early substance use, whereas positive psychotic symptoms would characterise late starters or late first offenders. METHODS A retrospective file study was conducted, yielding 97 early starters, 100 late starters and 26 late first offenders identified from a specialist inpatient forensic mental health assessment service and 129 non-offenders identified from general psychiatric services in the same geographic region, all with schizophreniform psychoses. RESULTS We found little difference between early and later starters in terms of measured antecedents, but substance misuse was up to 20 times less likely among late first offenders. Persecutory and/or grandiose delusions were more strongly associated with each offender group compared with non-offenders, most so with late first offenders. CONCLUSIONS Our findings underscore the importance of treating delusions--for safety as well as health. Childhood antecedents may be less important indicators of offender sub-types among people with psychosis than previously thought. When patients present with grandiose or persecutory delusions over the age of 35 years without co-morbid substance misuse disorders, but with a history of childhood neglect and low educational achievement, particular care should be taken to assess risk of violence.

The Role of Substance Abuse in Psychotic Versus Personality Disordered Offenders Detained Under the Dutch Entrustment Act (TBS): An Exploratory Study

Mentally disordered patients that abuse drugs or alcohol have a larger number of criminal convictions. Early starters who had their first conviction before the age of 18, especially, more often have a diagnosis of substance abuse and are more often intoxicated at the time of the offense compared to late starters. The present study involved four groups of Dutch patients (n = 137): three groups of violent offenders (psychotic and personality disordered patients) and one group of non-delinquent psychotic patients from general psychiatry. All data were retrieved retrospectively. The results showed that early starters were intoxicated more often, started with substance abuse at an earlier age and more often had a diagnosis of substance abuse at the time of the index offense than late starters. Personality disordered offenders were intoxicated more often and more often had a prior diagnosis of substance abuse at the time of the offense than psychotic offenders. To a limited extent, psychotic offenders with a diagnosis of a substance-related disorder or intoxication at the time of the offense had a more extensive criminal history than personality disordered offenders. Substance abuse has an aggravating effect on criminogenic behavior, depending on the age at first conviction and diagnosis.

Implicit attitudes toward violence and their relation to psychopathy, aggression, and socially adaptive behaviors in forensic psychiatric inpatients

In order to investigate the relation between implicit attitudes toward violence and different aspects of violent and social behavior in Dutch forensic psychiatric inpatients, an implicit association test was related to measures of psychopathy, aggression, and socially adaptive behaviors. Results indicated that all patients had negative implicit attitudes toward violence. Although implicit attitudes toward violence were unrelated to several self-report measures of aggression, there was a significant positive relation between these attitudes and the antisocial facet of psychopathy. Furthermore, it was found that implicit attitudes toward violence were significantly negatively associated with coping behaviors and the level of moral awareness, indicating that patients with more negative implicit attitudes toward violence more often reported these behaviors, which can be assumed to inhibit aggression. As the present study was only correlational in nature, our findings need to be further explored in prospective research.

Toward a Classification of Juvenile Offenders: Subgroups of Serious Juvenile Offenders and Severity of Recidivism

The aim of this study was to identify subgroups of serious juvenile offenders on the basis of their risk profiles, using a data-driven approach. The sample consists of 1,147 of the top 5% most serious juvenile offenders in the Netherlands. A part of the sample, 728 juvenile offenders who had been released from the institution for at least 2 years, was included in analyses on recidivism and the prediction of recidivism. Six subgroups of serious juvenile offenders were identified with cluster analysis on the basis of their scores on 70 static and dynamic risk factors: Cluster 1, antisocial identity; Cluster 2, frequent offenders; Cluster 3, flat profile; Cluster 4, sexual problems and weak social identity; Cluster 5, sexual problems; and Cluster 6, problematic family background. Clusters 4 and 5 are the most serious offenders before treatment, committing mainly sex offences. However, they have significantly lower rates of recidivism than the other four groups. For each of the six clusters, a unique set of risk factors was found to predict severity of recidivism. The results suggest that intervention should aim at different risk factors for each subgroup.

The psychometric properties of the Anger Bodily Sensations Questionnaire (ABSQ)

The Anger Bodily Sensations Questionnaire (ABSQ) is a newly developed self-report instrument for measuring bodily sensations related to anger in interpersonal situations. In this study, we investigated the psychometric properties of the ABSQ in a sample of 70 offenders and a sample of 100 secondary vocational students. Results indicated that the internal consistency and test-retest reliability of the instrument were good. An explorative factor analysis carried out on the ABSQ data of the combined sample yielded three factors. Support was found for the concurrent validity of the instrument. In both samples, the total score of the ABSQ showed positive correlations with measures of bodily awareness, social anxiety, anger, and aggression. Altogether, results suggest that the ABSQ appears to be a reliable and valid questionnaire. Further research is needed to examine the psychometric properties of the ABSQ in larger offender and non-clinical samples.

Possible correlations between the deficient affective experience and negative symptoms of psychosis: An exploratory study in (forensic) psychiatric patients

BACKGROUND Deficient affective experience (DAE), the affective and perhaps fundamental component of psychopathy, has some resemblance to the core affective disturbances of schizophrenia. There has, however, been little attempt to test relationships between these concepts, but this could be useful because of the high prevalence of schizophrenia among people in forensic mental health services and evidence that the DAE may be a useful predictor of violent behaviour. AIMS Our primary aim was to explore possible correlations between DAE and negative symptoms of schizophrenia and to test the hypotheses that the DAE would differentiate people with and without personality disorder co-morbidity in a sample with psychosis and, separately, people with main diagnoses of personality disorder or schizophrenia. METHOD On the basis of an interview and a review of institutional files, DAE total and facet scores were calculated and compared with scores on the negative symptom scale of the Positive and Negative Syndrome Scale among forensic and general psychiatric patients. Partial correlation and rank order coefficients were calculated. RESULTS We found no correlation between total DAE scores and total negative Positive and Negative Syndrome Scale scores among patients with psychosis, suggesting that the concepts probably do not overlap. Our hypotheses on diagnostic associations with the DAE were partially sustained. DAE scores differentiated psychosis and personality disorder groups but did not differentiate psychosis groups with and without personality pathology. CONCLUSIONS AND IMPLICATIONS This study, using typical clinical samples, suggested that one aspect of the affective disturbance of schizophrenia has little in common with the deficient emotional experience of psychopath. Measurement of DAE is unlikely to help detect co-morbid personality disorder among people with psychosis, but given our small sample size and the rarity of study in this field, further research would be warranted, perhaps also including a measure of incongruity of affect.

Childhood Psychopathology Predicts Adolescence-Onset Offending: A Longitudinal Study

Moffitt, Caspi, Harrington, and Milne (2002) found in a follow-up study that many of the supposedly adolescence-limited offenders had committed offenses past adolescence. This finding raises the question of whether adulthood starts later or whether there are two distinct delinquency types, adolescence limited and adolescence onset, each with its own etiology. The present study tested whether the adolescence-onset group could be predicted by childhood psychopathology, as compared to the adolescence-limited and no-offender groups. In sum, 355 boys and girls were included, who reported on their emotional and behavioral problems when they were 11 to 13 years old and on their self-reported criminal behavior 8 to 13 years later. The findings lend support tothe hypothesis that adolescence-onset offenders can be distinguished from adolescence-limited offenders.

Legal Approaches to Criminal Responsibility of Mentally Disordered Offenders in Europe

The moral tradition of not holding mentally disordered criminally responsible for certain offences seems to have similar roots across Europe, in Hebrew and Roman law and Greek philosophy, while the church influenced its further development. However, the legal context and the national perspective on the contents of the tradition create a wide variety of doctrines and consequent assessment practices. This chapter explains a few major distinctions in the legal approaches to criminal responsibility of mentally disordered offenders in European jurisdictions and its implications for assessment practice. First of all, differences in the ‘form’ of the responsibility doctrine are related to the context within criminal law and procedure, as well as the context within sentencing law and mental health law. Secondly, differences in the ‘substance’ of the responsibility doctrine are explained on three dimensions: the definition of insanity, legal versus medical competence; the test of insanity, a general versus a specific relation between disorder and offence; and the scale of responsibility, gradual versus dichotomous. In the discussion, the implications for the behavioural scientific disciplines that are generally asked to assess criminal responsibility will be discussed, as well as recent debates about the doctrine.