Dark and bright personality dimensions as predictors of criminal behavior and recidivism.

A growing body of research highlights the continuum between dark and bright personality traits impacting individual prosocial or antisocial tendencies. However, the interplay between personality dimensions and actual criminal behavior and its reoccurrence is not fully elucidated. We aimed to explore the cumulative predictive value of the bright and dark core of personality for criminal history in differentiating a general community sample (N = 282) from a large sample of inmates (N = 296), with (n = 129) or without (n = 167) criminal history while controlling for age, sex and impression management. Predictors of first-time offending were higher levels of Neuroticism, Openness, Dark Factor, Sadism, and Deceitfulness. Criminal recidivism was predicted by high Neuroticism and Deceitfulness. Finally, higher levels of Extraversion were negatively related to criminal behavior and history, highlighting a potential protective effect of displaying assertive and sociable tendencies. The findings highlight the relevance of considering the dark personality core complementary to the typical personality dimensions in the risk assessment, prediction, and reduction of criminal behavior.

Contribuições psicanalíticas ao tema da responsabilização de adolescentes nas políticas socioeducativas / Psychoanalytical contributions to the theme of accountability of adolescents in socio-educational policies / Contribuciones psicoanalíticas al tema de la rendición de cuentas de los adolescentes en las políticas socioeducativas

Desde a promulgação do Estatuto da Criança e do Adolescente (ECA), assistimos a avanços significativos no campo das políticas voltadas para a população infantojuvenil. Dentre esses, destacamos as medidas socioeducativas, intervenção que veio romper com práticas higienistas e repressoras legitimadas por legislações anteriores. De todo modo, apesar do vanguardismo de suas propostas, a socioeducação, mesmo através das medidas socioeducativas, segue apresentando altos índices de reincidência infracional. Tal retrato nos faz questionar: o que leva tantos desses jovens a retornarem ao chamado "mundo do crime" mesmo após o cumprimento de uma medida? A fim de compreender melhor a responsabilização juvenil, problematizamos, a partir da psicanálise, três de suas dimensões: a jurídica, a subjetiva e a social. (AU)

Since the enactment of the Statute for Children and Adolescents (ECA), we have witnessed significant advances in the field of policies aimed at the children and adolescents. Among these, we highlight the socio-educational measures, an intervention that came to break with hygienist and repressive practices legitimized by previous legislation. In any case, despite the vanguard of its proposals, socio-education, even through socio-educational measures, continues to show Since the enactment of the Statute for Children and Adolescents (ECA), we have witnessed significant advances in the field of policies aimed at the children and adolescents. Among these, we highlight the socio-educational measures, an intervention that came to break with hygienist and repressive practices legitimized by previous legislation. In any case, despite the vanguard of its proposals, socio-education, even through socio-educational measures, continues to show. (AU)

Desde la promulgación del Estatuto para Niños, Niñas y Adolescentes (ECA), hemos sido testigos de avances significativos en el campo de las políticas dirigidas a niños, niñas y adolescentes. Entre estos, destacamos las medidas socioeducativas, una intervención que rompió con las prácticas higienistas y represivas legitimadas por la legislación anterior. En cualquier caso, a pesar de la vanguardia de sus propuestas, la socioeducación, incluso a través de medidas socioeducativas, sigue mostrando altas tasas de infracción. Tal retrato nos hace preguntarnos: ¿qué impulsa a tantos de estos jóvenes a regresar al llamado "mundo del crimen" incluso después del cumplimiento de una medida? Para comprender mejor la responsabilidad juvenil, problematizamos, en base al psicoanálisis, tres de sus dimensiones: legal, subjetiva y social.Creemos que tal discusión es fundamental para la creación de acciones socioeducativas de carácter crítico, emancipatorio y realmente capaces de impactar en la reducción de la reincidencia delictiva en la vida de los jóvenes. (AU)

Clients' current presentation yields best prediction of criminal recidivism: Jointly modeling repeated assessments of risk and recidivism outcomes in a community sample of paroled New Zealanders.

OBJECTIVE: Clinicians often rely on readily observable intermediate outcomes (e.g., symptoms) to assess the likelihood of events that occur outside of treatment (e.g., relapse). Similarly, those monitoring clients with histories of criminal involvement attempt to prevent adverse outcomes considered likely and intervene when symptoms/risk factors fluctuate. Our aim was to develop a stronger understanding of associations between evolving symptoms/risk factors and case outcomes, yielding clearer practice implications. METHOD: We used longitudinal, multiple reassessment risk data from 3,421 individuals paroled in New Zealand. We used joint modeling to test the association between individual trajectories of psychosocial risk factor scores, assessed using Dynamic Risk Assessment for Offender Re-entry, and recidivism (official records of parole violations or criminal charges resulting in reconviction). We examined whether recent clinically relevant features of risk presentation (e.g., current levels, recent rate of change) predicted recidivism better than the entirety of the risk assessment trajectory. RESULTS: Although each model demonstrated similar predictive validity, measures of model fit indicated that models using current trajectory features outperformed those using the entire assessment history to predict recidivism. CONCLUSIONS: Change in dynamic risk factors is consistently associated with recidivism outcomes. When using changeable factors to monitor clients' current risk for recidivism, practitioners should focus on current presentation rather than the entire assessment history, although differences in predictive discrimination are small. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A randomized controlled trial of moral reconation therapy to reduce risk for criminal recidivism among justice-involved adults in mental health residential treatment.

OBJECTIVE: Moral reconation therapy (MRT) is a cognitive-behavioral intervention to reduce risk for criminal recidivism. Despite being implemented widely in correctional settings, there are no randomized controlled trials of MRT, and its effectiveness for reducing recidivism among justice-involved adults in noncorrectional settings is unknown. METHOD: In a pragmatic trial, 341 justice-involved patients (95.3% male; 57.8% White/non-Hispanic) admitted to one of three mental health residential treatment programs were randomly assigned to usual care (UC) or UC plus two MRT groups per week for 12 weeks. Follow-ups were conducted at 6- and 12-month postbaseline (71.3% and 74.8% retention, respectively). Primary outcomes were criminal thinking and criminal associates. Secondary outcomes were legal problem severity, days incarcerated in the past 30, rearrested/charged (per official records), substance use, and employment and family/social problems. The study design, analysis, and outcomes were preregistered (ClinicalTrials.gov; ID: NCT02524171). RESULTS: Patients in both conditions improved over time on most outcomes. In intent-to-treat analyses, the rate of change in outcomes over time did not differ by condition, nor did the prevalence of being rearrested and charged within 1 year of baseline (UC = 20.2%, MRT = 24.9%; OR = 1.14; 95% CI [0.67, 1.94], p = .63). MRT engagement was low; 37% of those randomized to MRT received a minimum dose-that is, completed at least Step 3. In per-protocol analyses, this subgroup, relative to UC, improved more on criminal associates, days incarcerated, legal problem severity, and alcohol use severity. CONCLUSIONS: In this study, MRT was not more effective than UC at reducing recidivism risk for patients in mental health residential treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Assessing dynamic violence risk: Common language risk levels and recidivism rates for the Violence Risk Scale.

The present study features the development of new risk categories and recidivism estimates for the Violence Risk Scale (VRS), a violence risk assessment and treatment planning tool. We employed a combined North American multisite sample (k = 6, N = 1,338) of adult mostly male offenders, many with violent criminal histories, from correctional or forensic mental health settings that had complete VRS scores from archival or field ratings and outcome data from police records (N = 1,100). There were two key objectives: (a) to identify the rates of violent recidivism associated with VRS scores and (b) to generate updated evidence-based VRS violence risk categories with external validation. To achieve the first objective, logistic regression was applied using VRS pretreatment and change scores on treated samples with a minimum 5-year follow-up (k = 5, N = 472) to model 2-, 3-, and 5-year violent and general recidivism estimates, with the resulting logistic regression algorithms retained to generate a VRS recidivism rates calculator. To achieve the second objective, the Council of State Governments' guidelines were applied to generate five risk levels using the common language framework using percentiles, risk ratios (from Cox regression), and absolute violent and general recidivism estimates (from logistic regression). Construct validity of the five risk levels was examined through group comparisons on measures of risk, need, protection, and psychopathy obtained from the constituent samples. VRS applications to enhance risk communication, treatment planning, and violence prevention in light of the updated recidivism estimates and risk categories are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Protective factors as uni- or bipolar factors and their incremental validity and accuracy in predicting general recidivism.

This study examined whether protective factors are unique or the opposite of risk factors and whether they have incremental validity in the prediction of general recidivism. Using a sample of 3306 Dutch forensic outpatients, this study was the first large-sample study ever performed on this topic. Results from exploratory factor analyses demonstrated a relatively stable factor structure of 14 factors, consisting of 32 of the initially included 68 risk factors and 11 of the initially included 17 protective items. The protective factors were found to be either bipolar (i.e., mirror images of risk factors) or responsivity characteristics (i.e., motivation for treatment, cognitive disability). Incremental validity for the recidivism prediction was found in one factor with internal protective items (e.g., empathy, financial management, life goals). This factor decreased the recidivism risk by 6%. However, weak predictive accuracy was found for this factor. Implications for clinical forensic practice are discussed with special focus on the risk-need-responsivity model.

Field validity of Static-99R and STABLE-2007 with 4,433 men serving sentences for sexual offences in British Columbia: New findings and meta-analysis.

Many forensic assessment measures are developed and validated under research conditions but applied in the field, where professionals or paraprofessionals have varied training, unknown fidelity to administration procedures, and contextual pressures related to their institutions or legal system. Yet few studies examine the generalizability of psychometric properties of these scales as actually applied in field settings. This study examined 4,433 individuals assessed by probation officers on the Static-99R or STABLE-2007 sexual recidivism risk scales in British Columbia, Canada. Sexual, violent, and any recidivism were examined. Static-99R and STABLE-2007 had moderate accuracy in discriminating recidivists from non-recidivists, and both scales added incrementally in predicting all three outcomes (with Static-99R demonstrating higher accuracy). Organizing the items into constructs, sexual criminality, general criminality, and youthful stranger aggression incrementally predicted all three outcomes. For violent and any recidivism, the incremental effect of sexual criminality was in the negative direction (i.e., high sexual criminality was associated with relatively lower rates of violent and any recidivism). Calibration analyses indicated that recidivism rates were lower than what would be predicted by the norms for the scales. The current study also presented a meta-analysis of 15 field validity studies of Static-99R and 4 field validity studies of STABLE-2007. Results of the current study and meta-analysis support the field application of Static-99R and STABLE-2007, while emphasizing the importance of training and proper implementation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psicopatia e autores de violência sexual contra crianças e adolescentes / Psychopathy and sex offences against children and adolescents / Psicopatía en los autores de violencia Sexual contra niños y adolescentes

O objetivo do presente estudo foi avaliar diferenças no perfil criminal de autores de violência sexual contra crianças e adolescentes (AVS) considerados psicopatas e não psicopatas. Participaram 30 reeducandos cumprindo pena em regime fechado, que foram divididos em dois grupos: G1, composto pelos AVS considerados psicopatas (PCL-R ≥ 30); e G2, composto pelos AVS considerados não psicopatas (PCL-R < 30). Para a coleta de dados, foi utilizado o Psychopathy Checklist - Revised (PCL-R), e as análises foram feitas por meio de estatísticas descritiva e comparativa. Os resultados apontaram diferenças significativas entre os grupos com relação ao tempo de pena, à quantidade de fuga e rebelião, assim como o número de processos e de vítimas, mostrando que os AVS psicopatas são mais indisciplinados e têm mais chances de reincidir criminalmente do que os não psicopatas, e que, comumente, costumam vitimizar mais pessoas e cometer uma maior variedade de crimes do que os não psicopatas. (AU)

The aim of the present study was to evaluate differences in the profiles of sex offenders considered psychopaths and non-psychopaths that committed crimes against children and adolescents. The subjects of this study were 30 re-educated criminals serving a prison sentence, organized into two groups: G1, consisting of sex offenders considered psychopaths (PCL-R ≥ 30); and G2, consisting of non-psychopaths (PCL-R <30). The Psychopathy Checklist-Revised (PCL-R) was used to collect data, and the analyses were performed using descriptive and comparative statistics. The results presented significant differences between the two groups in terms of the amount of time spent in incarceration, the quantity of prison breaks and rebellions, and the number of cases and victims. This shows that psychopathic sex offenders are more undisciplined and more recidivists than non-psychopaths, and that they often victimize more people and commit a greater variety of crimes than non-psychopaths. (AU)

El objetivo del presente estudio fue evaluar diferencias en el perfil criminal de los autores de violencia sexual contra niños y adolescentes (AVS) considerados psicópatas y no psicópatas. Participaron 30 reclusos con sentencia de régimen cerrado, organizados en dos equipos. G1, compuesto por los AVS considerados psicópatas (PCL-R ≥ 30); y G2, formado por los AVS, considerados no psicópatas (PCL-R < 30). Para la recopilación de datos, se utilizó el Psychopathy Checklist-Revised (PCL-R), y los análisis se realizaron utilizando estadísticas descriptivas y comparativas. Los resultados señalaron distinciones significativas entre los grupos con relación al tiempo de condena, la cantidad de fugas y rebeliones; así como el número de demandas y de víctimas; demostrando que los AVS psicópatas son más indisciplinados y tienen más probabilidades de reincidir al crimen, además de victimizar a más personas y cometer a una mayor variedad de delitos que los no psicópatas. (AU)

[Osteoporosis in androgen deprivation therapy: finding the balance between social and individual interests]. / Osteoporose bij androgeendeprivatie: afweging tussen maatschappij en individu.

Androgen deprivation therapy (ADT) is a libido-inhibiting medication that may be necessary to reduce recidivism in the treatment of paraphilic disorders, especially in those with a pedophilic disorder. However, there is a significant risk to develop osteoporosis while using ADT and thereby an increased risk to develop fractures. These risks and benefits must be carefully weighed in the treatment of these patients. We describe a case in which this dilemma is further explained and clarified. We recommend to request a second opinion and a structured risk assessment. If the risk for recidivism remains increased, despite psychotherapeutic interventions, we advise to suspend further rehabilitation into society, and let the reduction of the risk of recidivism prevail over the wishes of the patient.

Estimating Lifetime and Residual Risk for Individuals Who Remain Sexual Offense Free in the Community: Practical Applications.

Although individuals with a history of sexual crime are often viewed as a lifelong risk, recent research has drawn attention to consistent declines in recidivism risk for those who remain offense free in the community. Because these declines are predictable, this article demonstrates how evaluators can use the amount of time individuals have remained offense free to (a) extrapolate to lifetime recidivism rates from rates observed for shorter time periods, (b) estimate the risk of sexual recidivism for individuals whose current offense is nonsexual but who have a history of sexual offending, and (c) calculate yearly reductions in risk for individuals who remain offense free in the community. In addition to their practical utility for case-specific decision making, these estimates also provide researchers an objective, empirical method of quantifying the extent to which individuals have desisted from sexual crime.

To Reoffend or Not to Reoffend? An Investigation of Recidivism Among Individuals With Sexual Offense Histories and Psychopathy.

Although psychopathy is a well-established risk factor for recidivism among those who have committed sexual offenses, there are nonetheless some individuals with sexual offense histories who are high in psychopathy but do not recidivate. This population-nonrecidivating psychopathic sex offenders (NRP-SOs)-was the focus of the current investigation. Data from 111 individuals with sexual offense histories who received a Hare Psychopathy Checklist-Revised (PCL-R) rating of at least 25 (suggesting the presence of psychopathy) were analyzed. With recidivism operationalized as the accrual of any new serious-that is, violent or sexual-charges, 39 recidivated (RP-SOs), whereas 72 did not (NRP-SOs). A logistic regression was conducted to assess whether NRP-SOs could be differentiated from RP-SOs. Being older at the time of release, a lesser criminal history, and being married predicted nonrecidivism. PCL-R factor scores and sexual deviance were not predictive. These findings highlight the heterogeneity that exists, even among those high in psychopathy.

Effectiveness of a Modular Cognitive-Behavioral Skills Curriculum in High-Risk Justice-Involved Youth.

The aim of this study was to evaluate the effectiveness of a flexible modular cognitive-behavioral theory (CBT) skills curriculum delivered by paraprofessionals in a community organization targeting high-risk justice-involved youth. Programmatic data were collected from 980 high-risk young men (Mage, 21.12; SD, 2.30), and Cox proportional hazards regression was used. The results showed that compared with young men with no CBT encounters, those with one or more CBT encounters had a 66% (hazard ratio [HR], 0.34; 95% confidence interval [CI], 0.28-0.42; p < 0.001) lower risk of unenrolling from programming, 65% (HR, 1.65; 95% CI, 1.29-2.12; p < 0.001) higher risk of obtaining a job, and no difference in risk of engaging in new criminal activity while enrolled in programming (HR, 0.99; 95% CI, 0.78-1.25; p = 0.918), despite higher risk factors. Training paraprofessionals to deliver CBT skills to high-risk populations is effective and has scalability potential.

The utility of self-reported psychopathic traits in predicting recidivism among a sample of incarcerated female youths.

Only a few studies have prospectively examined the utility of self-reported measures of psychopathic traits in predicting criminal behavior among forensic samples of female youth offenders. The main aim of this study is to compare the utility of two self-report measures of psychopathic-like traits in predicting criminal recidivism among a sample of incarcerated female youths. Participants (N = 76) from the three nation-wide Portuguese juvenile detention centers that admit female youths were followed over two years and prospectively classified as recidivists versus non-recidivists. Logistic regression models controlling for crime frequency and ethnicity revealed that neither the Antisocial Process Screening Device - Self-Report (APSD-SR) nor the Youth Psychopathic Traits Inventory (YPI) and their respective dimensions significantly predicted one- and two-year general recidivism and violent recidivism. Findings mostly suggest there are clear limitations in terms of the incremental utility of self-report measures of psychopathic traits in predicting criminal recidivism among incarcerated female juveniles.

Mental illness and social exclusion: assessment of the risk of violence after release.

OBJECTIVES: To examine the predictive validity of the HCR-20 (The Historical Clinical Risk Management-20) to predict future violent incidents in a representative sample of patients with severe mental disorders and with a history of previous admission to prison, who after release are in a situation of extreme social exclusion. MATERIAL AND METHOD: The study sample was selected from the 235 patients treated by the Mental Health Street Team of Madrid (ECASAM) from June 2014 to June 2017, including those with a previous history of a previous internment in a penitentiary (about which, the HCR-20 was completed). RESULTS: Of the 44 patients included, 29.6% (n=13) ended up participating in a violent incident after the release. The ROC curves (Receiver Operating Characteristic) analysis indicated that the total score of HCR-20 (AUC 0.98, p=0.01) has a high predictive validity. CONCLUSIONS: The social and medical changes that take place after the release of patients with severe mental illness justify the need to reassess the risk of violence. In this evaluation, the HCR-20 guide is a useful tool for predicting the risk of involvement in future violent incidents, and the inclusion of factors such as social exclusion and its consequences, as well as problems with substance use is especially important.

Predicting risk of recidivism in Spanish young offenders: Comparative analysis of the SAVRY and YLS/CMI.

BACKGROUND: This study offers a comparative analysis of evidence for the predictive validity of SAVRY and YLS/CMI scores in predicting risk of recidivism in a group of young people who received a Juvenile Justice order. METHODS: The sample was made up of 594 youths aged between 14 and 18 (M=15.63, SD=1.08) at the time they committed an offense. RESULTS: Both instruments showed high accuracy in predicting recidivism, with the greatest accuracy observed in the SAVRY and YLS/CMI total scores, as well as in the Individual domain of the SAVRY. Comparative analysis of the AUCs of both instruments indicated no statistically significant differences between total scores from the two instruments. Results showed statistically significant differences in comparisons of means and AUCs between the groups of young reoffenders and non-reoffenders in all cases. Our results did not support the hypothesis that dynamic risk factors are a better predictors of recidivism in young offenders. CONCLUSIONS: This study offers empirical evidence of the predictive capacity and differential functioning of the SAVRY and YLS/CMI instruments in the Spanish context.

Predictive validity of the Structured Assessment of Violence Risk in Youth (SAVRY) with Indigenous and Caucasian female and male adolescents on probation.

Indigenous people and the courts have emphasized that it is important to examine whether scores from violence risk assessment tools are valid and appropriate for Indigenous youth. However, studies are scarce. Therefore, we examined the predictive validity of youth probation officers' Structured Assessment of Violence Risk in Youth (SAVRY) ratings for 744 Canadian youth, including 299 Indigenous youth (219 male, 80 female), and 445 Caucasian youth (357 male, 88 female) in a prospective field study. The SAVRY summary risk ratings and risk total scores significantly predicted violent and any reoffending for Indigenous female and male youth with medium effect sizes. Relatively few significant differences in the predictive validity emerged for Indigenous and Caucasian youth. However, Historical, Protective, and Risk Total scores predicted any recidivism better for Caucasian males than Indigenous males. Also, Indigenous youth scored significantly higher on all risk domains than Caucasian youth. Opposite to predictions, the rates of false positives were higher for Caucasian youth than for Indigenous youth. Based on the results, the SAVRY appears to be a reasonable tool to use for assessing risk in Indigenous youth. However, assessors should take steps to ensure that they use the SAVRY in a culturally appropriate manner, such as considering cultural factors in case formulations and treatment planning as the SAVRY does not ground assessments in an understanding of factors such as colonialism. In addition, future research should examine culturally salient risk factors (e.g., discrimination) and examine potential causes of higher risk scores in Indigenous youth, particularly the role of both past and present-day colonialism. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Reassessment improves prediction of criminal recidivism: A prospective study of 3,421 individuals in New Zealand.

A dynamic risk factor is a variable that can change across time, and as it changes, there is a corresponding change in the likelihood of the outcome. In corrections, there is evidence for dynamic risk factors when relatively more proximal reassessments enhance predictive validity for recidivism. In this article, we tested the proximity hypothesis with longitudinal, multiple-reassessment data gathered from 3,421 individuals supervised on parole in New Zealand (N = 68,667 assessments of theoretically dynamic risk factors conducted by corrections case managers). In this sample, reassessments consistently improved prediction as demonstrated by (1) incremental prediction over initial baseline scores and (2) improved model fit of the most recent assessment compared with the average of earlier scores. These results contribute to a growing body of evidence that support community corrections agencies conducting repeated assessments of the risk for imminent recidivism using a dynamic risk instrument. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Recidivism and predictors of recidivism among female high level persistent offenders after a special court order for persistent offenders in the Netherlands.

Previous research has shown that female persistent offenders have multiple psychiatric and psychosocial problems, such as substance use disorders, other mental disorders, financial problems and housing problems. The present study examined recidivism and predictors of recidivism in a sample of 74 Dutch female high level persistent offenders who had been subjected to a special court order for persistent offenders, called ISD [Inrichting Stelselmatige Daders]. The criminal records were studied to gain insight in the criminal charges against women after release from the ISD. Results showed that 43% of the persistent female offenders had registered justice contacts within one year after release, of which the majority concerned non-violent property offences. However, the number of offences was found to be significantly reduced after their release. No offence-related, demographic, substance-related, psychiatric or personal history characteristics were found to be predictive for general recidivism.

A prospective multisite examination of dynamic sexual violence risk: Extension and update to Olver, Nicholaichuk, Kingston, and Wong (2014).

OBJECTIVE: The present study is an extension and update of Olver, Nicholaichuk, Kingston, and Wong's (2014) prospective multisite examination of sexual violence risk and treatment change on a large federal Canadian sample of 570 treated sexual offenders rated pretreatment and posttreatment on the Violence Risk Scale-Sexual Offense version (VRS-SO). METHOD: The present study featured the clinical application of a risk assessment and treatment planning tool, the VRS-SO, with recidivism outcome data updated by 4 years to a total of 10.2 years. VRS-SO change scores, representing reductions in sexual violence risk from treatment or other change agents (e.g., aging), were reanalyzed in terms of their associations with community sexual, violent, and general recidivism postrelease. RESULTS: Recidivism base rates increased with the concordant increase in follow-up time. VRS-SO risk scores significantly predicted all recidivism outcomes, whereas change scores were consistently associated with decreases in sexual and violent recidivism after controlling for baseline risk through bivariate (d = -.24 to -.61) and Cox regression survival analyses (eB = .878 to .938). CONCLUSIONS: The results affirm the dynamic nature of sexual violence risk and demonstrate that structured assessments of change, linked to participation in sexual offense specific treatment, to be associated with decreases in future sexual offending as well as other recidivism outcomes. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Interpersonal violence and violent re-injury in the Northern Territory.

OBJECTIVES: To analyse incidence of prior emergency department presentations for interpersonal violence and demographics for a series of hospital admissions for interpersonal violence injuries. DESIGN: Retrospective analysis of trauma registry. SETTING: A tertiary hospital and primary referral centre for trauma in the Top End of the Northern Territory. PARTICIPANTS: Patients hospitalised from 2010 to 2015 for injuries due to interpersonal violence with an injury severity score > 9. MAIN OUTCOME MEASURES: Patient demographics, injury location, assault mechanism, alleged perpetrator, time/day of event, alcohol involvement, clinical outcome and prior emergency department presentations for interpersonal violence. RESULTS: A total of 248 admissions for patients with Injury Severity Score > 9 due to interpersonal violence were identified. Indigenous females over-represented non-Indigenous females (35.4% vs 5.0%, P < .001). The majority of victims had evidence of alcohol intake at presentation. Victims of single-punch head injuries were mostly male and non-Indigenous, whilst Indigenous persons experienced significantly more blunt and penetrating weapon injuries (66.7% and 68.1%). Forty-three per cent of patients had a preceding emergency department presentation for interpersonal violence; female gender, Indigenous ethnicity, evidence of alcohol intake, and urban location of injury were independent risk factors for prior interpersonal violence presentation. CONCLUSIONS: Interpersonal violence is a recurring disease for a just under half of those presenting to a Top End hospital with moderate to severe injuries. Indigenous ethnicity, female gender and evidence of alcohol intake are predictive of prior interpersonal violence presentations. Patient under-reporting and incomplete data may underestimate the true prevalence of interpersonal violence presentations in rural and remote locales.