Mentally disordered offenders in Sweden: differentiating recidivists from non-recidivists in a 10-year follow-up study

Krona, Hedvig; Nyman, Marielle; Andreasson, Helena; Vicencio, Nicolás; Anckarsäter, Henrik; Wallinius, Märta; Nilsson, Thomas; Hofvander, Björn

doi:10.1080/08039488.2016.1236400

Cited by 27 publications

(15 citation statements)

References 61 publications

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“…A cluster B personality disorder, age at first crime and age at FPI emerged as important in both models, similar to previously published findings from the full UPPRÄTT-Malmö cohort [45]. Partial dependence plots revealed that younger age at first crime as well as younger age at FPI increased the probability of being classified as a recidivist in both the Baseline and the Extended model.…”

Section: Discussionsupporting

confidence: 85%

“…The UPPRÄTT-Malmö study is a nationally representative, total cohort of patients living in the Malmö University Hospital catchment area who, after committing a crime, underwent either a major forensic psychiatric investigation (FPI, N = 97) or a minor forensic psychiatric screening report ( N = 28) between 1999 and 2005, and subsequently were sentenced to involuntary forensic psychiatric in-patient treatment. One previous study has investigated recidivism using traditional risk factors [45], and one previous study has investigated predictors of length of stay [46], both using the full UPPRÄTT-Malmö sample. When study inclusion commenced, FPI investigees were routinely being referred for a neuroimaging assessment, but due to changes in the local FPI procedures during study inclusion, only 50 participants underwent this assessment.…”

Section: Methodsmentioning

confidence: 99%

“…Nine traditional risk factors were selected based on previous literature [1–6,14,45] to be included in the Baseline model: age at FPI, age at first crime, degree of psychopathic traits, sex, substance use disorder, cluster B personality disorder, educational attainment, mental disorder in first-degree relative, and previous criminality. Note that we opted to include both age at FPI and age at first crime as baseline risk factors not only because both are associated with recidivism, but also because prior research suggests that both global and regional CBF tends to decrease with age [55–61].…”

Section: Methodsmentioning

confidence: 99%

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Prediction of recidivism in a long-term follow-up of forensic psychiatric patients: Incremental effects of neuroimaging data

et al. 2019

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One of the primary objectives in forensic psychiatry, distinguishing it from other psychiatric disciplines, is risk management. Assessments of the risk of criminal recidivism are performed on a routine basis, as a baseline for risk management for populations involved in the criminal justice system. However, the risk assessment tools available to clinical practice are limited in their ability to predict recidivism. Recently, the prospect of incorporating neuroimaging data to improve the prediction of criminal behavior has received increased attention. In this study we investigated the feasibility of including neuroimaging data in the prediction of recidivism by studying whether the inclusion of resting-state regional cerebral blood flow measurements leads to an incremental increase in predictive performance over traditional risk factors. A subsample ( N = 44) from a cohort of forensic psychiatric patients who underwent single-photon emission computed tomography neuroimaging and clinical psychiatric assessment during their court-ordered forensic psychiatric investigation were included in a long-term (ten year average time at risk) follow-up. A Baseline model with eight empirically established risk factors, and an Extended model which also included resting-state regional cerebral blood flow measurements from eight brain regions were estimated using random forest classification and compared using several predictive performance metrics. Including neuroimaging data in the Extended model increased the area under the receiver operating characteristic curve (AUC) from .69 to .81, increased accuracy from .64 to .82 and increased the scaled Brier score from .08 to .25, supporting the feasibility of including neuroimaging data in the prediction of recidivism in forensic psychiatric patients. Although our results hint at potential benefits in the domain of risk assessment, several limitations and ethical challenges are discussed. Further studies with larger, carefully characterized clinical samples utilizing higher-resolution neuroimaging techniques are warranted.

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Section: Discussionsupporting

confidence: 85%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Prediction of recidivism in a long-term follow-up of forensic psychiatric patients: Incremental effects of neuroimaging data

et al. 2019

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“…Despite being a combined subset of psychiatric patients and criminal offenders, the assessment and treatment of FP patients cannot simply be extrapolated from general psychiatry or programs within prison and probation services. For example, FP patients frequently have poor literacy skills (7), low motivation for assessment and treatment (8), suffer from multiple psychiatric disorders (6,9), and are involuntarily restricted in their interactions with their community. Unfortunately, for former FP patients and for society at large, reoffending and readmission are common after discharge (10), and increase with length of follow-up (11,12).…”

Section: Introductionmentioning

confidence: 99%

Immersive Virtual Reality Simulation in Forensic Psychiatry and Adjacent Clinical Fields: A Review of Current Assessment and Treatment Methods for Practitioners

Sygel

Wallinius

2021

Front. Psychiatry

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Background: Research has indicated that interactive, computerized case simulations using immersive virtual reality (VR) technology may be beneficial in the augmentation of conventional methods of assessment and treatment in forensic psychiatry, primarily through providing an engaging and safe environment in which the user can practice and learn skills and behaviors. However, there does not appear to be an overview of current developments available in the field, which may be an obstacle to clinicians considering the use of VR in their clinical practice.Objectives: Current, clinically relevant assessment and treatment methods applying immersive VR in forensic or adjacent clinical settings, were analyzed.Methods: This review surveyed the practical use of immersive VR in forensic psychiatry and relevant adjacent psychiatric and forensic fields from 2016 to 2020 and was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results: Out of the 1,105 journal articles screened, 14 met criteria for inclusion. Four articles described VR interventions directly addressing forensic psychiatric settings (treatment of general aggression and assessment of sexual offenders against children). The majority of the remaining articles were in the clinical domain of psychosis treatment. Several interventions were designed as part of comprehensive treatment programs, and others were intended as one-off assessments or paired with pre-existing psychological treatment. The degree to which the VR simulations were individualized to the user appeared to be largely dependent upon the extent of provider input. A variety of research methodologies were used in the included articles and the majority had limitations common to small-scale, non-randomized studies. None of the studies reported serious adverse effects.Discussion: There is a lack of large randomized controlled trials of current assessments or treatments using VR simulation in forensic psychiatry, let alone those with long-term follow-up, showing clear advantages of VR over standard practice. The evidence thus far is insufficient to recommend immediate and large-scale implementation of any one VR intervention, however, several have been shown to be feasible and acceptable to the participants and to provide insights and inspiration for future research and development.

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“…Although the frequency of medication prescribed upon release was already high in the first group, there was still a significant increase, leading to almost all former detainees receiving psychotropic medication in the second group. The prison governors (interviews 2 + 3) as well as the psychiatric expert (interview 5) emphasised their importance in supporting the avoidance of recidivism, especially concerning detainees suffering from schizophrenia (Fazel, Zetterqvist, Larsson, Långström, & Lichtenstein, 2014; Krona et al, 2017; Seifert, Klink & Landwehr, 2018). In their view, the detainees' compliance had increased over the years due to the reduction of side effects and the extension of the time between the administrations of the medication.…”

Section: Discussionmentioning

confidence: 99%

Professionalising release management for mentally disordered perpetrators: Benefits in terms of recidivism rates—Results from a study within the Austrian prison system

Stempkowski

2020

Criminal Behav Ment Health

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Background: In Austria, mentally ill perpetrators not guilty for reasons of insanity are committed into a custodial measure to receive treatment. The rate of these detainees returning after their conditional release because of reoffending or revocation decreased significantly over a period of 15 years. Aims: This study aims at examining this system and the adjustments made over a period of 10 years, in order to identify changes responsible for the observable decline of the recidivism rate. Method: Therefore, a quantitative study of 807 prison and court files was conducted, extracting information concerning former detainees either released in 2001 & 2002 (n ¼ 67) or 2011 & 2012 (n ¼ 134) and subsequently comparing the groups. Additionally, expert interviews were conducted. Results: As one major change, the data revealed improvements regarding the preparation and management of the time on parole. The possibility for detainees to test their readiness for life outside the confinement through temporary interruptions of custody was enhanced, as were post-This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Mentally disordered offenders in Sweden: differentiating recidivists from non-recidivists in a 10-year follow-up study

Cited by 27 publications

References 61 publications

Prediction of recidivism in a long-term follow-up of forensic psychiatric patients: Incremental effects of neuroimaging data

Prediction of recidivism in a long-term follow-up of forensic psychiatric patients: Incremental effects of neuroimaging data

Immersive Virtual Reality Simulation in Forensic Psychiatry and Adjacent Clinical Fields: A Review of Current Assessment and Treatment Methods for Practitioners

Professionalising release management for mentally disordered perpetrators: Benefits in terms of recidivism rates—Results from a study within the Austrian prison system

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