Static and dynamic predictors of forensic mental health decision-making.

In Canada, individuals found not criminally responsible on account of mental disorder (NCR) fall under the supervision of a jurisdictional review board (RB) per the Criminal Code. Limited research has examined whether RB decisions balance the needs of public safety with social reintegration as intended by federal legislation. To fill this gap, the present study determined whether forensic decisional outcomes in one provincial RB system accounted for information relevant to violence risk. Study instruments included the Level of Service/Case Management Inventory (LS/CMI), Historical Clinical Risk Management-20 Version 3, and the Revised Violence Risk Appraisal Guide. A retrospective longitudinal design was employed to examine an NCR cohort (N = 109) that entered the RB system between 2005 and 2010 and their respective RB hearings (N = 327) until 2015. Results indicated that risk-relevant information was supplied to the RB by forensic professionals; however, key criminogenic risk and need factors as defined by the LS/CMI were absent in clinical reports. RB decisions were still strongly predicted by empirically supported risk factors linked to violent recidivism. Higher release likelihoods corresponded to a proportionally greater reliance on dynamic risk factors to enact dispositions. Forensic risk instruments are central aspects of correctional rehabilitation, and the results demonstrated their relevance to forensic tribunals. It is recommended that information from a forensic risk instrument be routinely delivered to RBs to support evidence-based decision-making. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Older people in custody in a forensic psychiatric facility, prevalence of dementia, and community reintegration needs: an exploratory analysis.

BACKGROUND: Across much of the developed world, the number of older people in custody has been increasing, which presents challenges for correctional systems due to the complex social, medical and mental health needs of this subgroup, especially those living with dementia. The present study therefore aimed to increase insight into the extent to which older people in custody are (a) potentially living with dementia and (b) receiving appropriate supports/services (particularly, with respect to community reintegration). RESULTS: Cross-sectional data were drawn from a sample of 29 older people in custody and 20 correctional health care professionals at a regional forensic psychiatric hospital in a medium-sized Canadian city. In general, analyses revealed that: (a) scores from a modified version of the Community Screening Instrument for Dementia (CSI'D') suggest that 45% of older individuals screened positive for dementia; (b) 35% of Social Workers and 25% of Primary Nurses (i.e., RNs/RPNs) suspected that at least one older individual on their caseload has dementia, and there was adequate agreement between health staffs' perception of the presence or absence of dementia and the CSI'D' assessment; (c) varying supports/services may be required for older individuals' successful community reintegration and living; and (d) Social Workers and Primary Nurses generally lack training/education to adequately support older people in custody. CONCLUSIONS: A substantial number of older people in custody may experience age-related challenges, including dementia. This necessitates the development and implementation of programming to effectively address older individuals' needs during incarceration and community reintegration and living.

Working Alliance and Psychopathy: Linkages to Treatment Outcome in a Sample of Treated Sexual Offenders.

The present study examined the working alliance, as measured by the full-length Working Alliance Inventory (WAI), and its association with psychopathy, treatment completion, and recidivism in a sample of 111 incarcerated adult male sexual offenders. The men completed the WAI 3 months into their treatment program, while psychopathy was measured via file-based ratings of the Hare's Psychopathy Checklist-Revised (PCL-R), and outcome data were collected via the Canadian Police Information Centre. The majority (85%) of high PCL-R scoring men (PCL-R 25+) successfully completed their treatment program, and by and large, the men demonstrated strong working alliances with their primary therapists. The WAI scale components showed differential associations with the structural features of psychopathy. Specifically, the Affective facet was significantly associated with weaker Bond scores, while the Lifestyle facet was associated with lower Task scores; these results were upheld after controlling for scores on the other PCL-R facets. Strength of alliance, however, was not significantly associated with any recidivism outcomes, irrespective of controls for psychopathy. Implications for the treatment of offenders with high levels of psychopathic traits are discussed in light of extant findings and unique features of the therapeutic alliance.

Assessing the Relationship Between Religiosity and Recidivism Among Adult Probationers in Pakistan.

Although empirical evidence supports a relationship between religiosity and criminal behavior, debate continues about the theoretical mechanisms by which they are related. Moreover, the topic has been largely ignored by practicing clinicians and correctional workers. The Muslim Religiosity-Personality Inventory: Abridged was administered to low-risk Pakistani probationers and factor analyzed, after which probationers' recidivism was monitored. Five oblique factors were obtained, three of which were correlated with recidivism (Religious Practice, Religious-Moral Values, and Fundamental Religious Beliefs), as was the full scale, while two were not (Importance of Religion and Rejection of Nonbeliever). In a logistic regression, Religious-Moral Values and Religious Practices contributed to the prediction of probationer recidivism. However, when demographic characteristics were introduced, education and marital status replaced Religious Practices. This study supports the religiosity-crime link in a non-Western, Muslim culture. Implications for assessing religiosity and for practitioners in the justice system are discussed.

Bridging Neuropsychology and Forensic Psychology: Executive Function Overlaps With the Central Eight Risk and Need Factors.

Recent research expanded theoretical frameworks of criminality to include biosocial perspectives. This article advances the biosocial integration into traditional criminological theories by focusing on the potential contribution of executive function (EF) to Andrews and Bonta's risk-need-responsivity (RNR) model. EF encompasses a collection of abilities critical to adaptive human functioning, many of which seem to underlie criminogenic risk and need factors. Although the assessment of EF can be elusive, research suggests that offenders with antisocial personality disorder (ASPD) experience EF deficits. Theoretical analysis on neuropsychological and forensic concepts suggests that unitary and discrete EF domains underlie the "Central Eight" criminogenic factors that are related to criminal behavior and, by extension, the RNR model of forensic assessment and treatment. Research and conceptual limitations of the current neuropsychological and forensic literature are discussed along with the limits of our theoretical analysis. A call for more theoretical and applied forensic neuropsychological research is presented.

Working Alliance and Its Relationship With Treatment Outcome in a Sample of Aboriginal and Non-Aboriginal Sexual Offenders.

The relationship that develops between a client and therapist is arguably one of the most important factors toward achieving positive outcomes from therapy. The present study examined the therapeutic alliance, as measured by Horvath and Greenberg's Working Alliance Inventory (WAI), as a function of Aboriginal ancestry and the relationship of alliance to important program outcomes, in a Canadian correctional sample of 423 treated sexual offenders. The men rated their primary therapists on the WAI 3 months into treatment. Higher self-report ratings on the WAI and its Task, Bond, and Goal subscales were associated with lower rates of treatment non-completion and longer stay in treatment. Aboriginal men scored significantly lower on the WAI's Bond subscale (i.e., the emotional connection between client and therapist) than non-Aboriginal men, although by and large, the offender sample as a whole otherwise registered fairly high mean scores on the tool. Aboriginal men scoring below the median on WAI total score had the highest rates of treatment non-completion. WAI total score and scores on the three subscales were unrelated to post-program recidivism in the community. Cultural implications for correctional client engagement and service delivery within the context of the risk-needs-responsivity model are discussed.

Thirty years of research on the level of service scales: a meta-analytic examination of predictive accuracy and sources of variability.

We conducted a comprehensive meta-analysis of the Level of Service (LS) scales, their predictive accuracy and group-based differences in risk/need, across 128 studies comprising 151 independent samples and a total of 137,931 offenders. Important potential moderators were examined including ethnicity, gender, LS scale variant, geographic region, and type of recidivism used to measure outcome. Results supported the predictive accuracy of the LS scales and their criminogenic need domains for general and violent recidivism overall, and among broad subgroups of interest, including females and ethnic minorities. Although results indicated that gender and ethnicity were not substantive sources of effect size variability, significant differences in effect size magnitude were found when analyses were conducted by geographic region. Canadian samples consistently demonstrated the largest effect sizes, followed by studies conducted outside North America, and then studies conducted in the United States. This pattern was observed irrespective of gender, ethnicity, LS domain, LS variant, or type of recidivism outcome, suggesting geographic region may be an important source of effect size variation. We discuss possible factors underlying this pattern of results and identify areas for future research.

A meta-analysis of moral reconation therapy.

This study reports on a meta-analysis of moral reconation therapy (MRT). Recipients of MRT included adult and juvenile offenders who were in custody or in the community, typically on parole or probation. The study considered criminal offending subsequent to treatment as the outcome variable. The overall effect size measured by the correlation across 33 studies and 30,259 offenders was significant (r = .16), indicating that MRT had a small but important effect on recidivism. Moderator analyses were conducted to detect the possible factors affecting the relationship between MRT and recidivism. Moderators included setting, age, gender, research design, sample size, type of recidivism, follow-up period, publisher, and year of publication. Moderator analysis demonstrated that MRT was more successful with adult than juvenile offenders in institutional settings as opposed to the community, and where researchers in the primary studies used randomization to allocate participants to either a treatment or control condition. The treatment effect size was greater when the type of recidivism used was rearrest rather than rearrest followed by conviction or reincarceration. The benefits of MRT were strongest with a relatively short follow-up period. MRT was more successful for relatively small samples and for large samples rather than medium-sized samples. The effect size was smaller for studies published by the owners of MRT than by other independent studies. The effect size was also smaller for studies published after 1999.

Are the major risk/need factors predictive of both female and male reoffending?: a test with the eight domains of the level of service/case management inventory.

The Level of Service/Case Management Inventory (LS/CMI) and the Youth version (YLS/CMI) generate an assessment of risk/need across eight domains that are considered to be relevant for girls and boys and for women and men. Aggregated across five data sets, the predictive validity of each of the eight domains was gender-neutral. The composite total score (LS/CMI total risk/need) was strongly associated with the recidivism of males (mean r = .39, mean AUC = .746) and very strongly associated with the recidivism of females (mean r = .53, mean AUC = .827). The enhanced validity of LS total risk/need with females was traced to the exceptional validity of Substance Abuse with females. The intra-data set conclusions survived the introduction of two very large samples composed of female offenders exclusively. Finally, the mean incremental contributions of gender and the gender-by-risk level interactions in the prediction of criminal recidivism were minimal compared to the relatively strong validity of the LS/CMI risk level. Although the variance explained by gender was minimal and although high-risk cases were high-risk cases regardless of gender, the recidivism rates of lower risk females were lower than the recidivism rates of lower risk males, suggesting possible implications for test interpretation and policy.

A meta-analysis of predictors of offender treatment attrition and its relationship to recidivism.

OBJECTIVE: The failure of offenders to complete psychological treatment can pose significant concerns, including increased risk for recidivism. Although a large literature identifying predictors of offender treatment attrition has accumulated, there has yet to be a comprehensive quantitative review. METHOD: A meta-analysis of the offender treatment literature was conducted to identify predictors of offender treatment attrition and examine its relationship to recidivism. The review covered 114 studies representing 41,438 offenders. Sex offender and domestic violence programs were also examined separately given their large independent literatures. RESULTS: The overall attrition rate was 27.1% across all programs (k = 96), 27.6% from sex offender programs (k = 34), and 37.8% from domestic violence programs (k = 35). Rates increased when preprogram attrition was considered. Significant predictors included demographic characteristics (e.g., age, rw = -.10), criminal history and personality variables (e.g., prior offenses, rw = .14; antisocial personality, rw = .14), psychological concerns (e.g., intelligence, rw = -.14), risk assessment measures (e.g., Statistical Information on Recidivism scale, rw =.18), and treatment-related attitudes and behaviors (e.g., motivation, rw = -.13). Results indicated that treatment noncompleters were higher risk offenders and attrition from all programs significantly predicted several recidivism outcomes ranging from rw = .08 to .23. CONCLUSIONS: The clients who stand to benefit the most from treatment (i.e., high-risk, high-needs) are the least likely to complete it. Offender treatment attrition can be managed and clients can be retained through an awareness of, and attention to, key predictors of attrition and adherence to responsivity considerations.