Forensic criteria, clinical and theoretical issues of the indication of court-ordered treatment: A comparative survey among experts in forensic psychiatry and sentencing judges in France.

Following the French law n° 98-468 of 17 June 1998 relative to the prevention of sexual offenses and the protection of minors, social and judicial follow-up and court-ordered treatment were introduced with the aim of reinforcing the prevention of recidivism. Court-ordered treatment is one of the possible obligatory measures provided for by social and judicial follow-up. However, there is no consensus between the different professionals concerning the criteria of indication and the final purpose of this measure. Most of the few available studies are retrospective. Only rare studies have assessed the influence of criminological factors on the indication of court-ordered treatment. We carried out a nation-wide qualitative comparative study in two populations, psychiatric experts and sentencing judges, by means of e-mail questionnaires. The aim was to determine the criteria for court-ordered treatment according to psychiatric experts and to sentencing judges, to identify the criteria that gave rise to differences in appreciation between these professionals, and to attempt to explain these differences. The secondary aim of the study was to determine the methods and tools used in expert practice to evaluate dangerousness and risk of recidivism. We obtained 20 responses in each of the two populations. The great majority of psychiatric experts and sentencing judges considered that court-ordered treatment was appropriate when the offender presented with psychiatric dangerousness, and so with an underlying mental disorder. When a subject had no identified mental disorder, the psychiatrists were divided in their opinion, whereas the majority of sentencing judges were in favor of court-ordered treatment. Opinions differed particularly significantly between the two populations in four circumstances: a subject with an antisocial/psychopathic personality disorder, a subject who denied the alleged acts, the influence of precarious social circumstances and the influence of instability in intimate relationships. The majority of experts used international classifications (DSM-5 and ICD-10) as a basis for their psychiatric diagnosis. Just under half of those surveyed used structured or semi-structured interview guides and only a few stated that they used standardized actuarial tools to assess risk of recidivism. The concepts of care, dangerousness and mental disorder are associated with multiple representations that certainly play a part in the disagreements between the different professionals. It is of prime importance to define these concepts more clearly in order to encourage the use of a common language and to clarify the indications and purpose of court-ordered treatment. We also hypothesize that disagreements between professionals regarding the criteria for court-ordered treatment may be related to certain difficulties raised by the management of the convicted person. The development of guidelines that could be used by all professionals would help to reduce some of these difficulties. Psychiatric experts remain attached to clinical evaluation. Their limited use of assessment tools may relate to the material constraints and time constraints involved. The issue at stake in court-ordered treatment and social and judicial follow-up is to promote cooperation between the various professionals by creating a space for exchange of ideas where the fundamental questions raised by these measures can be discussed, fears shared and knowledge pooled.

A pilot study regarding the feasibility and efficacy of an outpatient treatment program for young adult high-risk offenders (YAHOP).

This pilot study examines whether the Young Adult Habitual Offender Program (YAHOP), an intensive and outpatient program, is related to a reduction in the general risk of recidivism, common forensic symptomology as well as cognitive distortions. The program integrity (PI) was assessed, with the intent to explore the relationship between the level of PI and any changes in several outcome variables. Additionally, the study examines whether participants with a migration background benefitted equally from YAHOP compared to participants with a native Dutch background. The sample comprised n = 90 high-risk young adult offenders. Results show a decrease in general risk of recidivism. The dynamic risk factors delinquent social network, insufficient impulse control, and dysfunctional problem-solving skills also show a decrease, as well as the forensic symptoms of aggression and anger. Effect sizes are small, except for anger, which has a medium effect size. We found no change in cognitive distortions and problematic substance use. YAHOP shows to be responsive and culturally sensitive, as the participants with a migration background show a significant decrease in general risk of recidivism. No moderator analysis was conducted due to an overall low level of program integrity. After improving program integrity, full-scale quantitative research is needed as YAHOP has the potential as a promising desistance program for high-risk offenders, as in this study the 56 non-completers were also included.

Cognitive Flexibility and Reaction Time Improvements After Cognitive Training Designed for Men Perpetrators of Intimate Partner Violence: Results of a Pilot Randomized Controlled Trial.

Purpose Current interventions for intimate partner violence (IPV) perpetrators are designed to reduce IPV recidivism by treating risk factors and increasing protective factors. However, these interventions pay less attention to cognitive functioning in IPV perpetrators and how these variables interfere with the future risk of recidivism. Therefore, the main objective of this research was to compare the effectiveness of Standard Intervention Programs for men who perpetrate IPV [SIP] + cognitive training vs SIP + placebo training in promoting cognitive improvements and reducing recidivism. Furthermore, we also aimed to assess whether changes in the risk of recidivism would be related to cognitive changes after the intervention. Method IPV perpetrators who agreed to participate were randomly allocated to receive SIP + cognitive training or SIP + placebo training. Several cognitive variables were assessed before and after the interventions with a complete battery of neuropsychological tests assessing processing speed, memory, attention, executive functions, and emotion decoding abilities. Moreover, we also assessed the risk of recidivism. Results Our data pointed out that only the IPV perpetrators who received the SIP + cognitive training improved their processing speed and cognitive flexibility after this intervention. Furthermore, these participants presented the lowest risk of recidivism after the intervention. Nonetheless, cognitive improvements and reductions in the risk of recidivism after the intervention were unrelated. Conclusions Our study reinforces the importance of implementing cognitive training to reduce risk of recidivism after SIP. Hence, these results might encourage professionals to incorporate neuropsychological variables in IPV intervention programs.

When punishment goals moderate and mediate the effect of clinical reports on the recidivism risk on prison sentences.

This research examined whether an individual's endorsement of punishment goals moderates and mediates the effect of a clinical assessment of recidivism risk on the length of prison sentences. We measured participants' endorsement of punishment goals, both before they read a criminal case (i.e. a priori endorsement), and after they had read it (i.e. case-specific endorsement). As expected, the effect of the clinical report's conclusion on participants' sentencing decisions was moderated by a priori endorsement of incapacitation as a punishment goal. Participants who expressed strong (versus weak) a priori endorsement of this punishment goal were influenced by the report's conclusion on the risk of recidivism. In addition, when the clinical report concluded that the offender had a high risk of recidivating, participants expressed greater case-specific motivation to incapacitate him. Finally, the clinical report's conclusion had an indirect effect on the severity of the sentence through case-specific endorsement of the incapacitation punishment goal.

Responsive Aggression Regulation Therapy (Re-ART): An Evaluation Study in a Dutch Juvenile Justice Institution in Terms of Recidivism.

This article describes a quasi-experimental study of the effectiveness of Responsive Aggression Regulation Therapy (Re-ART) in terms of recidivism for 16- to 21-year-old juveniles with aggression problems and high risk of recidivism. In a Dutch juvenile justice institution, an experimental group received Re-ART ( n = 63, Re-ART group) and a waitlist control group received Treatment as Usual ( n = 28, TAU group). Results indicated that Re-ART is significantly more effective than TAU in reducing the juveniles' recidivism risk for violent offending. Compared with the TAU group, the Re-ART group showed significantly less violent crimes after 2 and 3 years, less property crimes after 2 years, and less general recidivism after 2 and 3 years. There was no significant difference between groups in recidivism of property crimes with violence. Ethnicity, mild intellectual disabilities, substance abuse, and age did not moderate the effects on recidivism outcome, which indicates that Re-ART was equally effective for various groups.

The 2D:4D Ratio as a Predictor of the Risk of Recidivism after Court-mandated Intervention Program for Intimate Partner Violence Perpetrators.

Differences in aggressive behavior could be partially explained by differential prenatal exposure to testosterone (T). A peripheral marker of prenatal T exposure is the 2D:4D ratio, which has shown a negative correlation with self-reported aggression in violent men. This study tested the direct association of the 2D:4D ratio with anger expression and the risk of recidivism in intimate partner violence (IPV) perpetrators after psychotherapeutic intervention program. The sample consisted of IPV perpetrators, whose 2D:4D ratio was measured before the intervention. Moreover, after the intervention, anger expression and risk of recidivism in IPV were assessed. Smaller 2D:4D ratio, especially of the right hand, was related to higher anger expression and risk of recidivism in IPV perpetrators. The contribution of this prenatal marker together with other psychobiological variables could play a key role in the propensity to react aggressively when coping with environmental demands.

Profile of partner aggressors as a function of risk of recidivism.

Partner aggressors present psychopathological, criminal, and sociodemographic characteristics that have been used for classification in typologies. The goal of the present work was to identify profile of aggressors as a function of the risk of recidivism, and assess whether there correspondence with type of offenders proposed by Holtzworth-Munroe and Stuart. The sample was made up of 90 men condemned for partner violence, of whom 50 were serving a prison sentence, and 40 mandatory community intervention/programs. The risk of recidivism was assessed with the SARA - Spousal Assault Risk Assessment Guide, completed with information obtained from prison records, clinical interviews for the assessment of personality disorders, and self-reports. The results reveal three profile of aggressors according to their risk of recidivism, related to the above-mentioned classification: high-risk aggressors coincide with the Dysphoric/Borderline (DB) type, medium-risk aggressors with the low-level antisocial type (LLA), and the low-risk group with the type of aggressors family only (FO). The implications are discussed in the penitentiary intervention of these results.

Los agresores contra la pareja presentan características psicopatológicas, delictivas y sociodemográficas que han sido utilizadas para su clasificación en tipologías. El objetivo del presente trabajo ha sido identificar el perfil de estos agresores según el riesgo de reincidencia, y valorar si existe coincidencia con la tipología de agresores propuesta por Holtzworth­Munroe y Stuart. La muestra fue de 90 hombres condenados por violencia contra la pareja, de los que 50 cumplían pena de prisión y 40 una medida alternativa: intervención/programa. El riesgo de reincidencia se evaluó con la guía SARA-Spousal Assault Risk Assessment Guide, cumplimentada con la información obtenida de los expedientes penitenciarios, entrevistas clínicas para la evaluación de trastornos de personalidad y autoinformes. Los resultados muestran tres perfiles de agresores según su riesgo de reincidencia que se relacionan con la mencionada clasificación, ya que los agresores de alto riesgo coinciden con el tipo disfóricos/borderline (DB), los agresores de riesgo medio con el tipo antisocial de bajo nivel (LLA) y el grupo de menor riesgo con el tipo de agresores limitados al ámbito familiar (FO). Se discuten las implicaciones en la intervención penitenciaria de estos resultados.