scholarly journals Patterns of Lifetime Criminality in Mentally Disordered Offenders – Findings From a Nationally Representative Cohort

2021 ◽  
Vol 12 ◽  
Author(s):  
Hedvig Krona ◽  
Henrik Anckarsäter ◽  
Thomas Nilsson ◽  
Björn Hofvander
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Criminal Behavior ◽  
Treatment Time ◽  
University Hospital ◽  
Patient Treatment ◽  
Negative Events ◽  
Mentally Disordered Offenders ◽  
Childhood Adversities ◽  
Mentally Disordered

Background: Treatment of mentally disordered offenders (MDOs) is challenging as their behavior and clinical conditions can be traced to a complex constellation of major mental disorders, substance use and antisocial lifestyle. Finding subgroups of these offenders, which could guide treatment and risk assessment, is desirable. There are few long-term, prospective studies of risk factors for persistent criminal behavior among MDOs.Aims: The aims are (1) to provide a map of lifetime criminality in MDOs, (2) to identify subgroups of offenders, and (3), if such clusters exist, to test whether they differ in lifetime criminality and patterns of negative events during in-patient treatment.Methods: Background data on all offenders from the Malmö University Hospital catchment area sentenced to forensic psychiatric in-patient treatment 1999–2005 (n = 125) was collected. Data on negative events during treatment (violence, threats, absconding and substance use) from date of admittance until discharge or until June 30, 2008 was gathered. Court decisions for 118 of the cohort-individuals were collected from the 1st of January 1973 until December 31, 2013. We used hierarchical cluster analysis to identify subgroups and MANOVA-analysis to examine differences between these clusters on lifetime criminality variables and negative events. A MANCOVA was used to control for time in treatment.Results: The cohort was sentenced to a total of 3,380 crimes (944 violent) during the study period. Median age at first crime was 20 years (range 15–72), and at first violent crime 27 years (range 15–72). A subgroup (n = 26) was characterized by childhood adversities, neurodevelopmental disorders and later substance use disorders and was more often associated with substance-related crimes, financial crimes and lower age at first crime. During treatment, this cluster showed higher rates of substance use and threats. When controlling for treatment time, no differences in negative events were found.Conclusions: This study replicated findings from prison populations of the existence of a more criminally persistent phenotype characterized by early-onset neurodevelopmental and behavior disorders, childhood adversities and later substance use disorders. We did not find this cluster of variables to be related to negative events during inpatient treatment when controlling for length of stay.

Facets of psychopathy among mentally disordered offenders: Clinical comorbidity patterns and prediction of violent and criminal behavior

2012 ◽  
Vol 198 (2) ◽  
pp. 279-284 ◽  
Author(s):  
Märta Wallinius ◽  
Thomas Nilsson ◽  
Björn Hofvander ◽  
Henrik Anckarsäter ◽  
Gunilla Stålenheim
Keyword(s):  
Criminal Behavior ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered

scholarly journals Relationships between residents in secure psychiatric units: are safety and sensitivity really incompatible?

2008 ◽  
Vol 32 (8) ◽  
pp. 284-287 ◽  
Author(s):  
Kalpana Dein ◽  
Paul Simon Williams
Keyword(s):  
Western Society ◽  
Patient Treatment ◽  
Substantial Part ◽  
Individual Choice ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
Attitudes And Practices ◽  
Psychiatric Units ◽  
Liberal Attitude ◽  
State Prisons

Since the 1960s, Western society has adopted a more liberal attitude to sexuality. Choice of sexual partners, sexual preferences, attitudes and practices are increasingly a matter of individual choice and freedom. These changes, however, have had little impact on the lives of psychiatric in-patients (Eiguer et al, 1974; Akhtar et al, 1977; Taylor & Swan, 1999). ‘Mental illness,’ it has been suggested, ‘is one of the few disabilities where people run the risk of losing their freedom in order to receive in-patient treatment’ (Cook, 2000). This loss of liberty and rights becomes more pronounced in secure settings where mentally disordered offenders can spend a substantial part of their adult (sexual/reproductive) lives. Prisoners in some US state prisons (of medium and low security) are afforded conjugal visits from their married partners, in view of the rights of the latter. Paradoxically, detention in secure units, which we consider a therapeutic and not a punitive measure, places constraints on the formation of new relationships and the maintenance of previously existing ones. New relationships are, in our experience, viewed with more concern than previously existing ones.

Strengthening the Working Alliance for Clients With Substance Use Disorders and Child Maltreatment Histories

2018 ◽  
Vol 40 (1) ◽  
pp. 58-74 ◽  
Author(s):  
Justin R. Watts ◽  
Deirdre O'Sullivan ◽  
SeriaShia J. Chatters
Keyword(s):  
Substance Use ◽  
Emotion Regulation ◽  
Child Maltreatment ◽  
Working Alliance ◽  
Substance Use Disorders ◽  
Treatment Time ◽  
Clinical Sample ◽  
Strong Predictor ◽  
Length Of Treatment ◽  
History Of

Individuals seeking treatment for substance use disorders frequently have child maltreatment histories. These clients often present with a unique set of characteristics, which may interfere with treatment retention and treatment engagement. A strong working alliance protects against premature discontinuation of counseling services and is a strong predictor of positive outcomes in counseling. Individuals with a history of child maltreatment are more likely to present with characteristics that can interfere with the counseling working alliance. This study assessed the relationships among maltreatment severity, emotion regulation, length of treatment time, and interpersonal trust in a clinical sample of adults receiving residential treatment for a substance use disorder who also met criteria for child maltreatment (n = 113). Results suggest that emotion regulation and trust significantly relate to the counseling working alliance, but only trust significantly and uniquely contributed to the regression model. Included are trauma-informed counseling recommendations for assessment of maltreatment and interventions to enhance trust and the working alliance.

scholarly journals Exploring Relationships between Adult Attachment, Spirituality and Personality Disorder Traits among Individuals in In-patient Treatment for Substance Use Disorders

2016 ◽  
Vol 3 (1) ◽  
pp. 16
Author(s):  
Gail Horton ◽  
Nealys Luna ◽  
Tammy Malloy
Keyword(s):  
Substance Use ◽  
Personality Disorder ◽  
Substance Use Disorders ◽  
Attachment Style ◽  
Meaning In Life ◽  
Well Being ◽  
Attachment Anxiety ◽  
Patient Treatment ◽  
Secure Attachment ◽  
Attachment Dimensions

<p>Both secure attachment style and higher levels of spirituality have been shown to be protective factors in the treatment of substance use disorders. However, very little is known about how either of these factors is related to personality disorder (PD) traits that are commonly co-morbid with substance use disorders. The purpose of this study was to explore the relative importance of spirituality (existential purpose/meaning in life and religious well-being) and attachment dimensions (attachment avoidance and attachment anxiety) as predictors of personality disorder trait levels among individuals receiving treatment for substance use disorders. Results showed that existential purpose and meaning in life was the best predictor of clinical/subclinical levels of borderline and antisocial PD traits and that attachment anxiety was the best predictor of clinical/subclinical levels of avoidant and dependent PD traits. None of the other PD traits was significantly associated with either attachment dimensions or spirituality dimensions.</p>

scholarly journals Childhood adversities and 5-HTTLPR polymorphism as risk factors of substance use disorders: retrospective case-control study in Murcia (Spain)

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030328
Author(s):  
Fernando Navarro-Mateu ◽  
Mari Paz Quesada ◽  
Teresa Escámez ◽  
Mª José Alcaráz ◽  
Catherine Seiquer de la Peña ◽  
...  
Keyword(s):  
Substance Use ◽  
General Population ◽  
Substance Use Disorders ◽  
Case Control Study ◽  
Case Control ◽  
Elevated Risk ◽  
Retrospective Case ◽  
Childhood Adversities ◽  
Gene Environment ◽  
Control Study

ObjectiveTo explore the separate and joint associations of childhood adversities and 5-HTTLPR polymorphism as risk factors for substance use disorders among adults.DesignRetrospective case-control study.SettingCases from the substance unit and controls from a representative sample of the adult general population in the metropolitan area of Murcia (Spain).ParticipantsCases were defined as outpatients 18 years old or older currently in the treatment for alcohol, opioids or cocaine use disorders in the clinical unit. Controls were randomly selected among individuals without substance use disorders who participated in the Psychiatric Enquiry to General Population in Southeast Spain-Murcia (PEGASUS-Murcia) project, a cross-sectional study of a representative sample of the adult general population. In all, 142 cases and 531 controls were interviewed and a subsample of 114 cases (80.3%) and 329 controls (62%) provided a biological sample.ExposureA history of 12 childhood adversities, lifetime mental disorders and sociodemographic variables was assessed with the Composite International Diagnostic Interview (CIDI)version 3.0). Buccal swabs were obtained to genotype the 5-HTTLPR polymorphism with the biallelic and the triallelic classification.Main outcome and measureMultivariable logistic regression models were performed to estimate adjusted ORs and 95% CI.ResultsChildhood adversities were associated with an elevated risk of substance use disorders (OR=5.77, 95% CI 3.46 to 9.61). Homozygotes for the short allele of the 5-HTTLPR polymorphism also showed the elevated risk of substance use disorders for the biallelic and triallelic classification: (1.97 (1.10 to 3.55) and 2.01 (1.11 to 3.64), respectively). No evidence for gene × environment interactions was found.ConclusionsChildhood adversities and the 5-HTTLPR polymorphism are involved in the aetiology of substance use disorders though findings exploring the existence of a gene–environment interaction were inconclusive.

“A new horizon?”: evaluation of an integrated Substance Use Treatment Programme (SUTP) for mentally disordered offenders

2015 ◽  
Vol 8 (2) ◽  
pp. 90-101 ◽  
Author(s):  
Helen Miles
Keyword(s):  
Substance Use ◽  
Substance Use Treatment ◽  
Treatment Programme ◽  
Mentally Disordered Offenders ◽  
Male And Female ◽  
Content Type ◽  
Mentally Disordered ◽  
Significant Difference ◽  
One Year

Purpose – The treatment of substance use amongst mentally disordered offenders (MDOs) remains a challenge for secure forensic mental health services. The purpose of this paper is to present an integrated three-stage substance use treatment programme (SUTP) for male and female MDO’s in medium security. Design/methodology/approach – In total, 45 (72.6 per cent) MDO’s were referred (39 males/6 females). Standardised outcome measures were administered pre-SUTP, post-SUTP and at one year follow-up. Abstinence rates and location was determined via case notes at three year follow-up. Findings – All MDO’s had a past history of substance use, approximately three-quarters reporting problematic use prior to admission. Over half completed all three SUTP stages, less than 5 per cent dropping out during active treatment. The SUTP supported abstinence throughout the one year follow-up period and significantly improved MDO’s adaptive beliefs about substances and craving by one year follow-up amongst attendees. At three years, most MDO’s were in the community and almost three-quarters were abstinent. There was no significant difference in abstinent rates between community and hospital. There was a non-significant trend suggesting SUTP attendance supported abstinence. Both male and female participants appear to have benefited from treatment and satisfaction was high, reflecting the specific aims and objectives of treatment. Research limitations/implications – The small non-randomised sample from one area limits the generalisability of findings and statistical power. Originality/value – Findings indicate further support for the limited evidence base that small but clinically meaningful and maintained changes to problematic substance use are possible following integrated substance use treatment for male and female MDO’s.

scholarly journals Substance use amongst mentally disordered offenders in medium security: prevalence and relationship to offending behaviour

2013 ◽  
Vol 15 (4) ◽  
pp. 259-268 ◽  
Author(s):  
Calem De Burca ◽  
Helen Louise Miles ◽  
Eduardo Antonio Vasquez
Keyword(s):  
Substance Use ◽  
Mental Health Problems ◽  
Small Sample ◽  
Case Note ◽  
Self Report ◽  
Mentally Disordered Offenders ◽  
Research Attention ◽  
Content Type ◽  
Mentally Disordered ◽  
Offending Behaviour

Purpose – Substance use contributes to the development of criminogenic behaviour and mental health problems. However, the extent and severity of substance use and the relationship to offending in mentally disordered offenders (MDOs) admitted to regional medium secure units has received relatively limited research attention. Design/methodology/approach – Case note reviews (n=57) and semi-structured interviews (n=21) of past substance use levels, substance use problems and forensic history were conducted at a medium secure unit in South East England. Findings – Results highlighted the high prevalence of substance use among MDOs, especially when determined by self-report. At least one-third (case note review) or almost half (self-report) used alcohol at the time of their index offence, although many failed to recognise use as problematic. Significant correlations were found between heavy past use of alcohol and use of alcohol at time of offending. Past heavy use of alcohol significantly predicted whether or not the individual was convicted of a violent offence. Research limitations/implications – The small sample from one area limits the generalisability of findings as substance use demographics vary. Methodological shortcomings were noted when comparing data from self-report and case note information. Retrospective recall bias may influence past perceptions of substance use. Practical implications – These preliminary findings indicate the importance of assessing substance use in MDOs and considering its relationship to offending behaviour in treatment and risk management. Originality/value – Although anecdotally substance use is known to be high and likely to be related to offending behaviour amongst MDOs, there is little previous research highlighting this.

Sign in / Sign up

Export Citation Format

Share Document