Childhood maltreatment, shame, and self-esteem: an exploratory analysis of influencing factors on criminal behavior in juvenile female offenders.

OBJECTIVE: This study aimed to investigate the relationships between childhood maltreatment, shame, and self-esteem among juvenile female offenders and to explore the potential influencing factors on their criminal behavior. METHODS: Using a stratified cluster sampling method, 1,227 juvenile female offenders from 11 provinces in China were surveyed using the Childhood Trauma Questionnaire (CTQ), Self-Esteem Scale (SES), and a self-developed Shame Questionnaire for Juvenile Offenders. Data were analyzed using descriptive statistics, correlation analysis, chi-square tests, t-tests, and structural equation modeling with mediation analysis. RESULTS: (1) Childhood maltreatment have a significant potential influencing factors on criminal behavior; (2) Childhood maltreatment was positively correlated with self-esteem(ß = 0.351, p < 0.001); (3) shame (ß = 0.042, p < 0.001) mediate the relationship between Childhood maltreatment and self-esteem (childhood maltreatment → shame → self-esteem (95% Cl: 0.033, 0.052)). CONCLUSION: This study demonstrates that childhood maltreatment is a significant predictor of criminal behavior among juvenile female offenders. childhood maltreatment can directly influence of self-esteem, which can also affect juvenile female offenders'self-esteem indirectly through shame. The findings suggest that shame are important variables that mediate the effect of the juvenile female offenders'childhood maltreatment on their self-esteem.

Prefrontal tDCS modulates risk-taking in male violent offenders.

Detrimental decision-making is a major problem among violent offenders. Non-invasive brain stimulation offers a promising method to directly influence decision-making and has already been shown to modulate risk-taking in non-violent controls. We hypothesize that anodal transcranial direct current stimulation (tDCS) over the right dorsolateral prefrontal cortex beneficially modulates the neural and behavioral correlates of risk-taking in a sample of violent offenders. We expect offenders to show more risky decision-making than non-violent controls and that prefrontal tDCS will induce stronger changes in the offender group. In the current study, 22 male violent offenders and 24 male non-violent controls took part in a randomized double-blind sham-controlled cross-over study applying tDCS over the right dorsolateral prefrontal cortex. Subsequently, participants performed the Balloon Analogue Risk Task (BART) during functional magnetic resonance imaging (fMRI). Violent offenders showed significantly less optimal decision-making compared to non-violent controls. Active tDCS increased prefrontal activity and improved decision-making only in violent offenders but not in the control group. Also, in offenders only, prefrontal tDCS influenced functional connectivity between the stimulated area and other brain regions such as the thalamus. These results suggest baseline dependent effects of tDCS and pave the way for treatment options of disadvantageous decision-making behavior in this population.

The Reintegration of Men into Society after a Sexual Offense: A Hermeneutic Phenomenology Study.

The purpose of this study was to describe the lived experience and meaning of being a 'sex offender' for the individual who is reintegrating into society, considering issues associated with self-perception, perception of others, stigma and humanization. Fourteen male adults were invited to participate in this hermeneutic phenomenological study. Data analysis was completed using an iterative process as described by van Manen. Five major themes were identified: exposed secret leads to humiliation; being considered a sex offender is living in fear of the unknown; stigma and shame consume the identity of the individual charged with a sexual offense; reframing and "leveling" of the crime are coping strategies; and the path toward healing and forgiveness is complex. Contextualizing individuals' experiences and examining barriers and motivators post-charge are essential to minimize stigma and risk factors linked to recidivism, as well as to facilitate recovery and healing.

Examining the effectiveness of the Gateway conditional caution on health and well-being of young adults committing low-level offences: a randomised controlled trial.

BACKGROUND: Young adults who commit low-level offences commonly have a range of health and social needs and are significantly over-represented in the criminal justice system. These young adults may need to attend court and potentially receive penalties including imprisonment. Alternative routes exist, which can help address the underlying causes of offending. Some feel more should be done to help young adults entering the criminal justice system. The Gateway programme was a type of out-of-court disposal developed by Hampshire Constabulary, which aimed to address the complex needs of young adults who commit low-level crimes. This study aimed to evaluate the effectiveness and cost-effectiveness of the Gateway programme, issued as a conditional caution, compared with usual process. METHODS: The Gateway study was a pragmatic, parallel-group, superiority randomised controlled trial that recruited young adults who had committed a low-level offence from four sites covering Hampshire and Isle of Wight. The primary outcome was mental health and well-being measured using the Warwick-Edinburgh Mental Well-being Scale. Secondary outcomes were quality of life, alcohol and drug use, and recidivism. Outcomes were measured at 4, 16 and 52 weeks postrandomisation. RESULTS: Due to issues with retention of participants and low data collection rates, recruitment ended early, with 191 eligible participants randomised (Gateway 109; usual process 82). The primary outcome was obtained for 93 (48.7%) participants at 4 weeks, 93 (48.7%) at 16 weeks and 43 (22.5%) at 1 year. The high attrition rates meant that effectiveness could not be assessed as planned. CONCLUSIONS: Gateway is the first trial in a UK police setting to have a health-related primary outcome requiring individual data collection, rather than focusing solely on recidivism. We demonstrated that it is possible to recruit and randomise from the study population, however follow-up rates were low. Further work is needed to identify ways to facilitate engagement between researchers and vulnerable populations to collect data. TRIAL REGISTRATION NUMBER: ISRCTN11888938.

Screening and identification of fetal alcohol spectrum disorder in criminal legal settings: A realist review.

BACKGROUND: Screening for fetal alcohol spectrum disorder (FASD) has been identified as a promising approach to improve recognition, understanding and effective response to the unique needs of those with FASD in criminal legal settings. However, to date, there has been limited synthesis of relevant screening tools, indicators, or implementation considerations in this context. AIMS: The present review aimed to synthesise evidence and develop a conceptual framework for understanding how, when, why, for whom and by whom FASD screening tools, items and/or indicators and characteristics serve to accurately identify people with FASD in criminal legal contexts, with consideration of individual and system needs relevant to effective implementation and response. METHODS: A preregistered search was conducted using a modified realist review framework for both peer-reviewed articles and grey literature. Included sources were available in English, which focused on individuals with prenatal alcohol exposure and/or FASD with criminal legal involvement and offered new empirical evidence. Sources were reviewed using the Quality Control Tool for Screening Titles and Abstracts by Second Reviewer framework, extracted using a structured coding form and narratively synthesised. RESULTS: The search yielded 52 sources, 11 FASD screening tools designed for or applied in criminal legal settings and 38 potential FASD indicators or characteristics relevant to identifying people who may have FASD in criminal legal settings, organised into six conceptually related domains. There was limited evidence supporting the psychometric properties of screening tools across populations or settings, though growing evidence highlights the promise of some instruments. Although few studies characterised potential considerations to be made when implementing a screening tool or approach, both system and individual level needs related to recognising and effectively responding to FASD in criminal legal contexts were identified, and findings revealed strong support among legal and clinical professionals regarding the need for FASD screening in these settings. CONCLUSIONS: Findings of this review can be used to inform the development, selection, implementation and evaluation of FASD screening tools in criminal legal settings and underscore a continued need for enhanced resources, policy and cross-sectoral response to better support the needs of people with FASD in the criminal legal contexts.

Factors influencing the length of stay in forensic psychiatric settings: a systematic review.

BACKGROUND: Forensic psychiatry is often associated with long admissions and has a high cost of care. There is little known about factors influencing length of stay (LOS), and no previous systematic review has synthesised the available data. This paper aims to identify factors influencing the LOS in forensic psychiatry hospitals to inform care and interventions that may reduce the length of admissions. METHODOLOGY: A systematic review was conducted by searching major databases, including PubMed, EMBASE and PsycInfo, from inception until May 2022. Observational studies conducted in forensic hospitals that examined associations between variables of interest and LOS were included. Following data extraction, the Newcastle‒Ottawa Scale was used for quality appraisal. No meta-analysis was conducted due to heterogeneity of information; a quantitative measure to assess the strength of evidence was developed and reported. RESULTS: A total of 28 studies met the inclusion criteria out of 1606 citations. A detailed quantitative synthesis was performed using robust criteria. Having committed homicide/attempted homicide, a criminal legal status with restrictions, and a diagnosis of schizophrenia-spectrum disorders were all associated with longer LOS. Higher Global Assessment of Functioning (GAF) scores were associated with a shorter LOS. CONCLUSION: High-quality research examining factors associated with LOS in forensic psychiatry is lacking, and studies are heterogeneous. No modifiable characteristics were identified, and thus, practice recommendations were not made. There is an increasing necessity to understand the factors associated with longer admissions to inform care and increase success in reintegration and rehabilitation. This paper provides recommendations for future research.

Childhood maltreatment and psychopathy in Chinese juvenile offenders: person-centered perspective.

BACKGROUND: Childhood maltreatment stands as a salient risk factor in the etiology of juvenile delinquency, with a profound impact on the behavioral trajectories of young offenders. However, there is limited research on latent profile analysis to explore distinctive patterns of childhood maltreatment in Chinese juvenile offenders. Consequently, there is a lack of understanding regarding the associations between maltreatment profiles and relevant variables in this context. The present study aimed to explore meaningful subgroups of childhood maltreatment in juvenile offenders, and we further examined the associations between subgroups and multiple outcomes especially psychopathy. METHODS: The data was obtained from a sample of Chinese juvenile offenders (N = 625, M age = 17.22, SD = 1.23). This study employed a latent profile analysis (LPA) based on factor scores of the Childhood Trauma Questionnaire-Short Form to identify the subgroups and examined the differences across subgroups using outcomes variables including psychopathy, callous-unemotional traits, aggression and anxiety. This study includes three self-report measures to evaluate psychopathy, with due regard for the nuanced considerations on the factor structure inherent in the conceptualization of psychopathy. RESULTS: Two subgroups were identified, including the non-maltreatment subgroup (80.2%) and the maltreatment subgroup (19.8%). Maltreatment subgroup was characterized by a greater level of all types of maltreatment with particularly higher of emotion neglect. Besides, we found that maltreatment subgroup showed a significantly higher level of psychopathy across multiple self-report measures, and greater callous-unemotional traits, lack of empathy, aggression and anxiety. We found two subgroups of child maltreatment in Chinese juvenile offenders. CONCLUSIONS: These findings may provide a further understanding of childhood maltreatment and the clinical intervention on psychopathy in the early period.

I'm Great! I'm no good .: A case illustration of drama therapeutic work with a male offender of domestic violence in a forensic outpatient setting.

Treating perpetrators of aggressive behavior, like verbal aggression, intimidation, and bullying behavior resulting in aggressive incidents with others, is difficult. This group is often diagnosed with personality disorders and when legal measures applied, they are more often treated in a forensic setting for their problems. This article presents the case of a 54-year-old man, diagnosed with Borderline personality disorder, narcissistic and antisocial traits, mild depressive symptoms, and loss and grief, who has voluntarily had treatment in a forensic outpatient center to reduce aggression and change destructive patterns in relationships. Hating, judging, and self-defeating were the main reasons why the patient found himself ending up in the same situation repeatedly. The client received individual drama therapy sessions. The drama therapeutic approach included schema therapeutic elements, such as schema mode work with cards, as well as roleplay, imagery (with rescripting), improvisation, and psycho drama elements. As a result of drama therapy, the client reported less (active) aggression, less aggression in his relationships (partners/children/friends), but also an increased level of loneliness, and mild depressive symptoms. The client was more in touch with his vulnerability and was able to behave in a more adequate healthy way in relationships. Although self-esteem was still building up, there was a decrease of aggression and less conflict-seeking behavior as a result. Risk assessment tools (FARE-2 & HONOS) and Schema therapy scales (YSQ and SMI) were used pre- and posttreatment confirming the improvements. This case promotes the use of dramatherapy in forensic outpatient care to be valuable in lowering risk recidivism and changing deeply rooted behavioral patterns.

Mediators of change in psychological interventions for adult offenders with personality disorders: A scoping review of the literature.

Offenders with personality disorder cause disproportionate harm to society and pose significant challenges for those responsible for their care and rehabilitation. Personality disorders are heterogeneous in terms of symptoms, as well as their pathways to offending behaviour. Thus, there is limited evidence regarding effective interventions. One solution might be to focus on how interventions are delivered as well as what is delivered. Within the non-offender personality disorder literature, the identification of potential mediators of change has enabled interventions to focus on 'how' they are delivered (e.g., therapeutic alliance) rather than the intervention itself. We explore the evidence and present a scoping review of the available literature on the mechanisms of change in psychological treatments for offenders with personality disorder. Only one study was found in the scoping review, highlighting a significant gap in the evidence base. We discuss the implications of this finding and potential future directions.

Diagnosing psychopathy in an intercultural setting: Applications and implications in postcolonial contemporary Mayotte.

International scientific research has extensively studied psychopathy, but few studies focus on an intercultural and postcolonial context. Mayotte, a French overseas collectivity located in East Africa, offers a unique opportunity to study the application and effects of psychopathy diagnosis in the criminal justice field within a social context shaped by colonial legacy. This research uses a mixed-method approach, combining quantitative and qualitative data, to show that in Mayotte, the majority of individuals diagnosed with psychopathy are young, low-income individuals who act in groups. Among them are minors, and the majority have no prior criminal history. This article provides a complementarist reflection on this phenomenon, informed by immersive field anthropology and theoretical contributions from psychology, sociology, and criminology. Through an inductive research process, this study posits the hypothesis that diagnoses of psychopathy in post-colonial contexts may be influenced by complex determinants rooted in collective history and contemporary power relations.

Forensic psychiatric and criminal dimensions of juvenile homicide/attempted homicide cases in Turkey.

OBJECTIVE: This study aimed to analyze a sample (n = 65) of juvenile homicide/attempted homicide cases in terms of psychiatric, demographic, criminal characteristics, IQ scores, and Rorschach test (where available) characteristics and decisions on criminal responsibility. METHOD: Data were collected through a retrospective chart review of cases between the ages of 12 and 18 at the time of the offense, who were referred to the Observation Department of the Council of Forensic Medicine (Adli Tip Kurumu Baskanligi, Gözlem Ihtisas Dairesi) for determination of criminal responsibility between 2014 and 2019 and who were assessed under inpatient status by law. RESULTS: There were 65 juvenile homicide/attempted homicide offenders (7 female, 58 male). Reduced or no criminal liability was found in seven cases (10.7 %). Recent and past trauma was found in 21.5 % and 16.9 % of our cases respectively. The percentage of alcohol or illicit drug use disorder was 35.4 %. Non-suicidal self-injury was found in 38.5 % of our cases, and 6.4 % of these had a concurrent suicide attempt. Most of our cases (55.4 %) were neither in employment nor in education at the time of the offense. CONCLUSION: The juvenile homicide/attempted homicide offenders were a heterogeneous group. Rates of serious mental illness were low. School and working functionality were low. Antisocial personality traits, alcohol/substance use disorders, past and recent trauma, emotional regulation problems, and poor school and work functioning appear to be important in the development of this serious offending.

Autism spectrum disorder, extremism and risk assessment.

BACKGROUND: To date, there is no evidence supporting the existence of an association between Autism Spectrum Disorder (ASD) and extremism in the general population. However, there is increasing recognition that several features of ASD may provide the context of vulnerability to engage in extremist behaviour. AIMS: This paper sets out the case for a dedicated clinical approach to better integrate clinical risk appraisal processes with an assessment of ASD individuals' vulnerabilities within the Criminal Justice System. METHODS AND RESULTS: In this paper the Framework for the Assessment of Risk & Protection in Offenders on the Autistic Spectrum (FARAS): A Guide for Risk Assessors Working with Offenders on the Autistic Spectrum is explored. In developing the FARAS, Al-Attar proposed seven facets of ASD that 'may have different functional links with push and pull factors to terrorism' (p. 928), which include circumscribed interests; rich vivid fantasy and impaired social imagination; need for order, rules, rituals, routine and predictability; obsessionality, repetition and collecting; social interaction and communication difficulties; cognitive styles and Sensory processing. DISCUSSION AND CONCLUSION: We describe the FARAS within the context of the most widely used clinical risk appraisal 'aide memoire' instruments integral to the Structured Professional Judgement of risk process, namely the HCR20v3.

Elusive cases in forensic psychiatry? Exploring subgroups of schizophrenia spectrum disorder patients in Germany.

BACKGROUND: The relationship between schizophrenia spectrum disorders (SSD) and criminal behaviour is a central issue in forensic psychiatry. People with mental illness face some of the same types of criminogenic factors as people without mental illness, albeit more frequently. The research question of this study is the extent to which a framework of early and late offender typology can be empirically reconstructed in a forensic psychiatric population, and whether there are any practical implications. METHOD: For N = 733 patients in six different forensic hospitals in Germany, the age at first psychiatric admission and the age at first registered offence were documented, as well as a number of other patient-related characteristics. Two clustering procedures were used to investigate whether forensic psychiatric patients could be classified according to these characteristics. RESULTS: A k-means cluster analysis using age at first psychiatric admission, age at first recorded offence, sociodemographic, clinical and criminological characteristics supported a 4-cluster solution. MANOVA analyses revealed further differences between the identified types. CONCLUSION: This study empirically confirms some of the sub-groups of the early and late starter typology described in the literature. In particular, the "early starters", "late starters" and "first presenters" were identified, but cluster four comprises individuals not previously described in the scientific literature. Each of these classes has group-specific characteristics that may have implications for forensic treatment, post-release aftercare, and the legal system.

Narrative Discourse in Youth Offenders: Examining Individual Differences.

PURPOSE: This study examined narrative discourse in youth offenders, focusing on quality of story retelling, story comprehension, critical thinking, and the use of complex syntax. METHOD: The participants were 15 incarcerated adolescents, ages 13-18 years (Mage = 16 years). Each was evaluated at their detention center via Zoom, using a standardized language test and language samples that elicited narrative speaking with fables. After retelling a fable, the participant answered questions that examined story comprehension and critical thinking. RESULTS: Most participants performed below average on the standardized language test and had difficulty on one or more of the language sampling measures. Areas of concern included quality of story retelling, story comprehension, critical thinking, and the use of complex syntax. Had language sampling not been employed, those weaknesses might have been overlooked. CONCLUSIONS: When evaluating youth offenders, it is important to elicit language samples that can provide detailed information about an adolescent's ability to communicate for genuine purposes. In this regard, the tasks employed in the current study could be helpful to speech-language pathologists in working with youth offenders, enabling them to pinpoint deficits and offer targeted intervention.

Well-being in institutionalised adolescents.

BACKGROUND: For adolescents who have criminal convictions, achieving a positive progress including desistance from offending may depend on a sense of well-being. Factors associated with growth in well-being are not widely researched, but there is some work that suggests that qualities in other internal states as well as in the environment may foster well-being. AIMS: To examine the well-being of young male incarcerated offenders, and its relationship with frequency of contacts with the family, perceptions of socio-educational environment, feelings about the future and self-efficacy. METHODS: Participants were recruited from three secure education institutions in the Federal District of Brasília, Brazil, under the management of the Secretariat of Justice. They were invited to complete anonymous self-report questionnaires, which included the Psychological Well-Being Scale, the Perception of the Socio-Educational Environment Scale, the Feelings about the Future Scale and the Multidimensional Scale of Perceived Self-Efficacy, and to provide limited sociodemographic data. RESULTS: 195 young male offenders participated and their mean age was 16.8 years (SD = 1.58, range 14-20). There was a positive correlation between well-being and perceptions of the socio-educational environment, positive feelings about the future and self-efficacy self-ratings. Multiple linear regression analyses confirmed that the frequency of family contacts, positive perceptions of the socio-educational environment, positive feelings about the future, and self-efficacy in leisure and social activities independently contributed to the well-being of young offenders. CONCLUSION: Although well-being has been associated with desistance from committing crimes, the factors that may predispose to well-being have been researched less and never before examined among inmates in Brazil. While longitudinal work is needed to be certain of the direction of the relationship, the fact that the results are broadly consistent with a similar study carried out on the other side of the world is encouraging in terms of indicating ways forward in rehabilitation. It is necessary to develop interventions that support family relationships and promote personal relationships and personal development, not only of useful skills but also of personal confidence in those skills.

Promotive, Mixed, and Risk Effects of Individual Items Comprising the SAPROF Assessment Tool With Justice-Involved Youth.

The Structured Assessment of PROtective Factors for violence risk (SAPROF) is a widely used structured professional judgment (SPJ) tool. Its indices have predictive validity regarding desistance from future violence in adult correctional/forensic psychiatric populations. Although not intended for applied use with youth, SAPROF items lend themselves to an investigation of whether their operationalizations capture only strengths or also risks. With 229 justice-involved male adolescents followed for a fixed 3-year period, promotive, risk, and mixed effects were found. Most SAPROF items exerted a mixed effect, being associated with higher and lower likelihoods of violent and any reoffending at opposite ends of their trichotomous ratings. Summing items weighted using their promotive and risk odds ratios produced statistically significant improvements in predictive accuracy, improvements found also with a cross-validation sample of 171 justice-involved youth. The nature of strengths and implications for the development of SPJ tools and training in their use were discussed.

Effects of two treatments on interpersonal, affective, and lifestyle features of psychopathy and emotion dysregulation.

This study investigated the relative efficacy of Mentalization-based therapy (MBT) and United Protocol (UP) in reducing symptoms of psychopathy and emotion dysregulation in a sample of Iranian community residents with concurrent diagnoses of antisocial and borderline personality disorders (PDs). Interpersonal, affective, and lifestyle features of psychopathy were measured post-treatment and at 6-, 12-, 18-, 24-, and 36-months follow-up using the 13-item version of the Psychopathy Revised-Checklist (PCL-R), which excluded, by design, criminal history features. Emotion dysregulation was measured using the Deficits in Emotion Regulation Scale (DERS) developed by Gratz and Roemer (2004). After treatment, both UP- and MBT-treated individuals showed significantly fewer features of psychopathy and significantly less emotion dysregulation. Compared with those treated with MBT, UP-treated individuals showed significantly less emotion dysregulation in all DERS subscales and a greater reduction in psychopathy features, particularly affective features. It is suggested that this likely reflected the particular emphasis placed by UP on improving emotional self-regulation and facilitating the therapeutic alliance. These results suggest that, despite the traditional pessimism that surrounds psychopathic individuals' treatability, they can be successfully treated.

Experts' decision-making processes in Swedish forensic psychiatric investigations: A case vignette study.

It has previously been demonstrated that decisions made by forensic experts can suffer from issues with both bias and poor reliability. The outcome of Swedish forensic psychiatric investigations can have a major impact on the courts' choice of sanction for a mentally disordered offender. These investigations are performed by multi-professional teams of experts, where each expert is obliged to state their opinion on whether the client has a severe mental disorder (SMD) or not. In the present study, a case vignette design was used to simulate the decision-making process of forensic psychiatric investigations. Of the 73 Swedish experts working with forensic psychiatric investigations, a total of 27 (37%) participated in the study. The results showed that the Swedish experts formulated multiple diagnostic hypotheses about cases throughout the process and revised these hypotheses when presented with new information. There was substantial variation between the experts in which hypotheses were seen as most relevant. While the experts grew more certain of their opinions on SMD during the simulated investigation, there was considerable variation in their opinions both throughout and at the end of the process. Although low statistical power and the sample not being randomized limit generalizations, the results indicate no idiosyncratic patterns in the decision-making processes of Swedish experts or signs of confirmation bias. If used properly, the variation in both process and outcome could be used to safeguard and possibly increase the reliability and validity of the final decision of Swedish forensic psychiatric investigations.