Abuso sexual contra niños, niñas y adolescentes en Lima, Perú: una aproximación general a los patrones de personalidad, características sociodemográficas y el riesgo de violencia de los perpetradores / Sexual abuse of children and adolescents in Lima, Peru: an overview of personality patterns, socio-demographic characteristics and perpetrators' risk of violence / Abuso sexual de crianças e adolescentes em Lima, Peru: uma visão geral dos padrões de personalidade, características sociodemográficas e risco de violência por parte dos perpetradores

El riesgo de abuso sexual contra niños, niñas y adolescentes es un problema generalizado de salud pública y de derechos humanos que enfrentan todos los países. Este estudio tiene como objetivo determinar si las características sociodemográficas, el riesgo de violencia y los patrones de personalidad del perpetrador podrían predecir futuros episodios de abuso sexual infantil. Se realizó un estudio descriptivo transversal-correlacional en 32 personas privadas de la libertad (PPL) en un establecimiento penitenciario en Lima, Perú. Se utilizó la Ficha Sociodemográfica, el Inventario Clínico Multiaxial de Millon II y la Guía de Valoración del Riesgo de Violencia. Los participantes tenían una edad promedio de 41,5 ± 8,50 años; la mayoría mantenía una relación: convivientes (31,3%) y casados (21,9%); y tiene secundaria completa (56,3%). Los trastornos de personalidad predominantes fue-ron el dependiente (56,3%) y el compulsivo (84,4%). El 79% presentó riesgo moderado de violencia futura. Existen correlaciones modera-das y fuertes entre las variables de estudio; y la regresión logística multivariada reveló que la edad y algunos trastornos de personalidad podrían ser predictores del riesgo de abuso sexual infantil. Estos hallazgos son de utilidad para realizar perfiles delictivos de futuros agresores o reincidentes; y contribuyen al diseño de programas de prevención y tratamiento.

The risk of sexual abuse against children and adolescents is a widespread public health and human rights problem facing all countries. This study aims to determine whether socio-demographic characteristics, risk of violence and personality patterns of the perpetrator could predict future episodes of child sexual abuse. A descriptive cross-sectional-correlational study was conducted in 32 persons deprived of liberty (PPL) in a penitentiary establishment in Lima, Peru. The Sociodemographic Form, the Millon's Multiaxial Clinical Inventory II and the Violence Risk Assessment Guide were used. Participants had an average age of 41.5 ± 8.50 years; most were in a relationship: cohabiting (31.3%) and married (21.9%); and had completed secondary school (56.3%). The predominant personality disorders were dependent (56.3%) and compulsive (84.4%). Seventy-nine per cent were at moderate risk of future violence. There are moderate and strong correlations between the study variables; and multivariate logistic regression revealed that age and some personality disorders could be predictors of child sexual abuse risk. These findings are useful for criminal profiling of future offenders or repeat offenders; and contribute to the design of prevention and treatment programmes.

O risco de abuso sexual contra crianças e adolescentes é um problema generalizado de saúde pública e de direitos humanos enfrentado por todos os países. Este estudo visa determinar se as características sociodemográficas, o risco de violência e os padrões de personalidade do perpe-trador poderiam prever futuros episódios de abuso sexual infantil. Um estudo descritivo de corte transversal foi realizado em 32 pessoas privadas de liberdade (PPL) em um estabelecimento pe-nitenciário em Lima, Peru. Foram utilizados o Formulário Sociodemográfico, o Inventário Clínico Multiaxial II da Millon e o Guia de Avaliação de Risco de Violência. Os participantes tinham uma idade média de 41,5 ± 8,50 anos; a maioria estava em uma relação: coabitada (31,3%) e casada (21,9%); e tinha concluído o ensino médio (56,3%). Os distúrbios de personalidade predominantes eram dependentes (56,3%) e compulsivos (84,4%). Setenta e nove por cento estavam em risco moderado de violência futura. Há correlações moderadas e fortes entre as variáveis do estudo; e a regressão logística multivariada revelou que a idade e alguns distúrbios de personalidade poderiam ser preditores do risco de abuso sexual infantil. Estas descobertas são úteis para a caracterização criminal de futuros infratores ou reincidentes; e contribuem para a concepção de programas de prevenção e tratamento.

Asociación del riesgo de violencia de pareja y dependencia afectiva con la preeclampsia / Association of the risk of violence in couple and affective dependence with the preeclampsia

Objetivo principal: asociar comparativamente el riesgo de violencia de pareja y la dependencia afectiva con el diagnóstico de preeclampsia en gestantes que fueron atendidas en el Centro de Salud Santa Rosa en la ciudad de Riobamba, Ecuador, durante el período abril-agosto 2019. Metodología: se utilizó un diseño no experimental, de tipo correlacional, con 60 participantes divididas en dos grupos de estudio de 30 individuos cada uno. Los datos fueron recolectados mediante la aplicación de la Guía de evaluación de riesgos de agresión conyugal, Spouse Abuse Risk Assessment (SARA, por sus siglas en inglés) y el cuestionario de dependencia emocional (CDE). Resultados principales: en el grupo de preeclámticas predominaron aquellas con un alto nivel de riesgo de violencia en la pareja (56,7%) y el 90% fueron valoradas con elevado nivel de dependencia emocional. La distribución de los datos resultó normal. Las diferencias entre ambos grupos resultaron significativas bilateralmente (p=0,000), a partir de la prueba de T-Students. También, la relación resultó estadísticamente muy significativa (p≤0,01) según el test chi cuadrado. Conclusión principal: el diagnóstico de preeclampsia se relacionó significativamente con los niveles de dependencia emocional y riesgo de violencia. Además, se establecieron diferencias estadísticamente significativas entre ambos grupos estudiados, según los niveles de dependencia emocional y riesgo de violencia.(AU)

Objective: To associate comparatively the risk of violence couple and affective dependency with the diagnosis of preeclampsia in pregnant women who were attended at the Santa Rosa Health Center in Riobamba, Ecuador, during April-August 2019 period. Methods: a non-experimental design of correlational type was used with 60 participants. They were divided into two study groups of 30 individuals each. Data was collected using the Spouse Abuse Risk Assessment (SARA) Guide and the Emotional Dependency Questionnaire (CDE). Results: In preeclamptic women group, those with a high level of risk of intimate partner violence predominated (56.7%) and 90% were assessed with a high level of emotional dependence. The distribution of data was normal. Differences between both groups were significant bilaterally (p = 0.000), from T-students test. Also, relationship was statistically very significant (p≤0.01) according to Chi square test. Conclusions: The diagnosis of pre-eclampsia was significant relationship related to levels of emotional dependence and the risk of violence. In addition, statistically significant differences were established between both groups studied, according to the levels of emotional dependence and risk of violence.(AU)

[Violence risk assessment in forensic patients using HCR-20v3: interrater reliability and concurrent validity]. / Valoración del riesgo de violencia en pacientes forenses con el HCR-20V3: análisis de fiabilidad interevaluador y validez concurrente.

This study provides evidence on the inter-rater reliability and concurrent validity of the Historical, Clinical and Risk Management-20, Version 3 (HCR-20V3) in a sample of 35 patients admitted to a forensic psychiatric unit in Argentina. The HCR-20V3 showed significant correlations with the VRAG-R and the PCL: SV. HCR-20V3 was independently coded by two evaluators in 15 patients. The inter-rater reliability indices were moderate to excellent in the coding of presence of risk factors and in the estimation of the summary risk ratings of future violence and imminent violence, although ICC were non-significant for the summary risk rating of serious physical damage. These findings have implications for the HCR-20V3 implementation in local professional contexts and raise future research possibilities which could be relevant for decision-making in violence risk management with patients committed to legal security measures.

Aggressive behavior and metacognitive functions: a longitudinal study on patients with mental disorders.

BACKGROUND: Metacognitive functions play a key role in understanding which psychological variables underlying the personality might lead a person with a severe mental disorder to commit violent acts against others. The aims of this study were to: (a) investigate the differences between patients with poor metacognitive functioning (PM group) and patients with good metacognitive functioning (GM group) in relation to a history of violence; (b) investigate the differences between the two groups in relation to aggressive behavior during a 1-year follow-up; and (c) analyze the predictors of aggressive behavior. METHODS: In a prospective cohort study, patients with severe mental disorders with and without a lifetime history of serious violence were assessed with a large set of standardized instruments and were evaluated bi-monthly with MOAS in order to monitor any aggressive behavior. The total sample included 180 patients: 56% outpatients and 44% inpatients, and the majority were male (75%) with a mean age of 44 (± 9.8) years, and half of them had a history of violence. The sample was split into two groups: poor metacognition (PM) group and good metacognition (GM) group, according to MAI evaluation scores. RESULTS: The PM patients reported a history of violence more frequently than GM patients, during the 1-year follow-up, but no differences between groups in aggressive and violent behavior were found. The strongest predictors of aggressive behavior were: borderline and passive-aggressive personality traits and a history of violence, anger, and hostility. The metacognitive functions alone did not predict aggressive behavior, but metacognitive functions interacted with hostility and angry reactions in predicting aggressive behavior. CONCLUSIONS: This study led to some important conclusions: (a) some aspects closely related to violence are predictive of aggressive behavior only in patients with poor metacognition, thus good metacognition is a protective factor; (b) poor metacognition is associated with a history of violence, which in turn increases the risk of committing aggressive behavior.

Attention Problems Predict Risk of Violence and Rehabilitative Engagement in Mentally Disordered Offenders.

Mentally disordered offenders (MDOs) endorse difficulties with attention, impulsivity, and hyperactivity. Assessing these difficulties among MDOs may confer practical benefits for the management and provision of care for this population, by informing strategies to improve rehabilitative engagement and risk assessments for violence. However, there is a dearth of literature exploring these cognitive problems in MDOs in relation to outcome factors. Forty-eight MDOs from a high-security hospital completed the QbTest, which measures the domains of inattention, impulsivity, and hyperactivity. Comprehensive file review of clinical and occupational/vocational rehabilitative engagement and Historical Clinical Risk Management-20 (HCR-20) were used as outcome measures of interest. Participants displayed greater cognitive deficits in attention, impulsivity, and hyperactivity compared to the general population. The domain of inattention and omission errors was related to occupational/vocational therapy engagement as well as a higher risk of present and future violence as measured by the HCR-20. The findings suggest that QbTest is a helpful objective tool that could be incorporated into the assessment of MDOs. Specifically, inattention emerged as a strong predictor of patients' risk of violence as well as patient's vocational therapy engagement. Therefore, cognitive skills programs targeting attention problems should be introduced to improve outcomes for this population.