scholarly journals Strong Associations Between Childhood Victimization and Community Violence in Male Forensic Mental Health Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Roar Fosse ◽  
Gunnar Eidhammer ◽  
Lars Erik Selmer ◽  
Maria Knutzen ◽  
Stål Bjørkly

Background: Childhood abuse and neglect increase the risk of both mental disorders and violent behavior. Associations between child relational adversities and violent behavior have not been extensively investigated in forensic mental health settings. We asked whether the extent of child adversities predicts the extent of violence in the community in forensic mental health patients.Methods: We included 52 male patients at a medium security forensic mental health ward, with diagnoses of predominantly paranoid schizophrenia and other schizophrenia and psychotic disorders. Seventy-five percent had comorbid substance abuse. We extracted information on six types of child adversities based on clinicians' administrations of the Historical Clinical Risk Management 20 version 3 (HCR 20) scale and summary notes in electronic patient journals. These same sources were used to extract information on war trauma and interpersonal violence in the community. We established cumulative scales for exposure to number of types of child adversities and number of incidents of community violence.Results: Physical and emotional abuse, emotional and physical neglect, and bullying were associated with higher levels of community violence. We observed a linear, significant increase in the frequency of community violence with cumulative numbers of child adversity types.Conclusions: Cumulative exposure to child adversities may be associated with higher degrees of violence in forensic mental health patients, with the most violent patients having the most extensive exposures to adversities. An enhanced focus on child adversities in risk assessment and management of violence may be considered in forensic inpatient settings.

2019 ◽  
Vol 18 (1) ◽  
pp. 12-20
Author(s):  
Andrew Day ◽  
Michael Daffern ◽  
Ashley Dunne ◽  
Nina Papalia ◽  
Kylie Thomson

2021 ◽  
pp. 1-17
Author(s):  
Suzanne Estrada ◽  
Dylan G. Gee ◽  
Ivana Bozic ◽  
Michelle Cinguina ◽  
Jutta Joormann ◽  
...  

Abstract Background Childhood maltreatment (CM) and exposure to community violence (ETV) are correlated with physical/mental health and psychosocial problems. Typically, CM and ETV are examined separately, by subtypes within category, or collapsed across both into one category of adversity. Consequently, research is limited in identifying subgroups of individuals with different amounts of exposure to both CM and ETV. Accordingly, we lack sufficient understanding of the extent to which problems associated with CM and ETV vary based on the amount (i.e. dose) of exposure to both of these experiences. Methods We used 20 samples (28,300 individuals) to estimate person-centered profiles of CM and ETV occurrence and co-occurrence within each sample. An individual data multilevel meta-analytic framework was used to determine the average effect size across samples for different profiles and conditional probability correlations within sociodemographic, neighborhood, health, mental health, and psychosocial domains. Results The profile characterized by high levels of CM and high levels of ETV correlated with stressful life events, depression and anxiety symptoms, and general indicators of externalizing behaviors. CM predominant profiles were associated with mental health diagnoses and treatment. ETV predominant profiles associated with risk-taking/violent behavior and neighborhood-level disadvantage. However, nuance based on the dose of CM or ETV was evident. Conclusions It is important to identify subgroups based on the amount of exposure to CM and ETV. These subgroups have differential relationships with correlates across domains. Greater delineation and description of the lived experience will allow for more precision in addressing the burden of childhood adversity.


2019 ◽  
Vol 12 (1) ◽  
pp. 30-40
Author(s):  
Eglantina Dervishi ◽  
Elisabeta Mujaj ◽  
Silva Ibrahimi

The aim of this study was the exploration of early traumatic experiences related to emotional abuse, physical abuse, sexual abuse, emotional and physical neglect, as well as the connection of the dimensions of these early traumatic experiences with the experiencing of depressive symptoms in adulthood. A sample of 331 University students in Tirana, 60 males (N = 60) or 18.1% and 271 females (N = 271) or 81.9% completed the online Beck Inventory for Depression (BDI), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). The minimum age of the youth participating in the study was 18 years and the maximum age was 32 years, with an average of 20 years (M = 20.07) and the standard deviation (SD = 1.5). Descriptive, correlational and linear regression analysis were used for data processing through the SPSS 22. The study confirmed the connection between early traumatic experiences and the appearance of depressive symptoms in adulthood (r(329) = .333, p < .001). Among the dimensions of early traumatic experiences, it seems that a stronger connection with the occurrence of depressive symptoms relates to the size of emotional trauma. The size of child sexual trauma is connected to feelings of punishment and suicidal thoughts in adulthood. Early traumatic experiences seem to have a significant impact on how adults express themselves and choose to interact with their environment. Coping with problems of mental health and depression today can be closely related to the early traumatic experiences of juveniles and adults.


2020 ◽  
Vol 31 (5) ◽  
pp. 667-698
Author(s):  
Sandra Oziel ◽  
Lisa A. Marshall ◽  
David M. Day

2021 ◽  
Vol 12 ◽  
Author(s):  
Elnike Brand ◽  
Angela Ratsch ◽  
Edward Heffernan

The recovery-based approach to forensic mental health rehabilitation is to support the patient to achieve a fulfilling life—a principle which should include achieving a fulfilling sexual life. This paper presents four vignettes from forensic mental health patients. The four cases demonstrate the omission, avoidance and then judgement by forensic mental health clinicians around the intimate and sensitive, yet important domain of the patient's sexual life. The cases illustrate that gap in the clinical domain and demonstrate the requirement for forensic mental health clinicians to have a greater awareness, acknowledgment, and assessment of their patient's sexuality and sexual health needs. Incorporating sexual health into standard clinical assessments will contribute to improved patient management in addition to supporting the principles of holistic forensic mental health recovery and rehabilitation.


2021 ◽  
Author(s):  
Sandra Oziel

Assessing and managing level of risk among forensic mental health patients is a primary role of clinical forensic psychologists. Forensic assessments are focused on risk factors and deficits, whereas patient strengths and protective factors are either partially included or overlooked altogether by forensic psychologists. As a result, less is known about protective factors in general and how they may serve to inform risk management practices. The Structured Assessment of Protective Factors for Violence Risk (SAPROF) is the first tool to exclusively rely on protective factors and was investigated for the current study. The psychometric properties of the SAPROF were examined using a sample of 50 Canadian patients found Not Criminally Responsible (NCR) at a psychiatric hospital using both file information and semi-structured interviews. Outcome variables included risk management decisions (change in privilege level and security level) and indicators of recidivism (psychiatric medication administration, institutional misconduct and disposition breaches). The study found some evidence for intrarater and interrater reliability, construct validity, predictive validity and incremental predictive validity. The SAPROF approached significance for adding incremental predictive validity to the HCR-20 V3, a measure of violence risk, for disposition breaches and institutional misconduct, and effect sizes doubled. Given that the addition of the SAPROF increased the accuracy of the violence risk assessment, there are considerable implications for informing clinical practice. Implications for risk assessment, treatment planning, intervention and risk management decisions implemented by review boards and clinical practitioners are discussed. It is recommended that the SAPROF be added as an adjunct measure to risk assessment batteries and included in hospital reports, given that it predicted several patient behaviours.


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