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1.
Crim Behav Ment Health ; 30(2-3): 141-150, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32483870

RESUMO

Dialectical behaviour therapy (DBT) is a therapy model incorporating elements of Eastern philosophies and cognitive behavioural principles. Originally designed for people struggling with chronic suicidality and borderline personality disorder (BPD), it has been adapted to treat complex, multi-diagnostic presentations, such as those in forensic mental health settings. To date, there has been little evaluation when the primary diagnosis is of psychosis. To explore the effectiveness of DBT, with patients, with multiple comorbidities, including psychosis, in a forensic psychiatric inpatient setting. A descriptive outcome study with a cohort of offender-patients in one specialist forensic mental health unit. Before and after treatment change scores were compared on anger, aggression, hopefulness, coping abilities, emotional intelligence, insight and subjective symptom severity scales, as well as staff-rated risk, and length of stay. Nine men and five women residents in one Canadian secure hospital completed a standard DBT programme, and self-ratings, over about 1 year. Scale scores indicated significantly increased insight and acknowledgment of problems. Apparently increased anger and vengeance scores were clinically associated. Independent staff ratings indicated reductions in risk and most patients achieved early release. This study provides support for extension of the use of DBT to offender-patients with psychosis among the complex mix in their presentation. It suggests that a randomised controlled trial with cost-benefit analysis is warranted, as well as further work, to promote understanding of mechanisms of effectiveness.


Assuntos
Transtorno da Personalidade Borderline/terapia , Criminosos/psicologia , Terapia do Comportamento Dialético/métodos , Psiquiatria Legal/métodos , Prisioneiros/psicologia , Violência/prevenção & controle , Adaptação Psicológica , Adulto , Agressão , Ira , Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/psicologia , Canadá , Inteligência Emocional , Emoções , Feminino , Esperança , Humanos , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade , Transtornos Psicóticos , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento
2.
Crim Behav Ment Health ; 30(2-3): 105-116, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32515096

RESUMO

BACKGROUND: Case formulation plays a key role in effective management of offenders' needs, particularly on the Offender Personality Disorder Pathway (OPDP). AIMS: To validate a method of investigating formulations with offenders still in prison but in the OPD Pathway and investigate agreement over the content of formulations between each of the main dyadic pairs: offender-clinician, offender-key worker and clinician-key worker. METHODS: We developed a checklist of the main features of a formulation from a review of initial formulations in the files of prisoners in two prisons which operate within the OPD Pathway system. We then recruited 30 violent offenders in each OPD wing of two prisons, and asked each of them, their clinically qualified worker (usually a psychologist) and the criminal justice system key worker to complete a formulation summary according to a card-sort process based on this checklist. We calculated the level of agreement between pairs of raters (e.g. offender and key worker) about the importance of aspects of each domain to the case using intraclass correlation coefficients. RESULTS: The rating tool showed good internal validity. Analysis of inter-rater ratings showed agreement among teams on aspects relating to prisoners' observable actions, experiences and external support domains, but little agreement on cognitions, feelings, risky situations or staff/self-support, mainly affecting the prisoner-key worker dyad. There were, however, significant differences in agreement rates between the two sites. CONCLUSIONS: Agreement within teams about formulations is strong where content relates to overt behaviours and points of fact, but weaker on risk, cognitions and support. The appropriateness of this approach to formulation across cultural groups may need further evaluation as the main measured difference between the prisons was in distribution of ethnic and cultural groups.


Assuntos
Criminosos , Transtornos da Personalidade/psicologia , Prisioneiros , Prisões/organização & administração , Humanos , Masculino
5.
Wiad Lek ; 73(5): 1032-1036, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32386390

RESUMO

OBJECTIVE: The aim of the study: 1) to determine the features of temporary access to documents containing information that may be a medical confidentiality; 2) to identify legislative gaps regarding the regulation of the measure of criminal proceedings; 3) to formulate proposals for improvement of legislation in the part of the investigated issue. PATIENTS AND METHODS: Materials and methods: The legal basis for the protection of information that may be a medical confidentiality is provided. Legislative provisions have been identified and analyzed, which provide for particulars of access to documents containing information that may be a medical confidentiality. It is argued that the evidence collected in violation of the procedural order of the measure of criminal proceedings is inadmissible and therefore cannot be taken into account by the court in the future. Writing the article, the authors used both general and special methods of scientific knowledge, namely: formal-legal, formal-logical, comparative analysis and logical-normative. The complex application of these methods has made it possible to formulate science-based conclusions and proposals. CONCLUSION: Conclusions: Exemption of documents containing information that may constitute medical confidentiality should be done exclusively by temporary access to them. In order to eliminate the legislative gaps of the investigated issue, it is proposed to amend the current legislation accordingly.


Assuntos
Criminosos , Confidencialidade , Direitos Humanos , Humanos
6.
Crim Behav Ment Health ; 30(2-3): 95-104, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32383313

RESUMO

BACKGROUND: Indeterminate sentences for Public Protection (IPPs) were introduced in England and Wales under the Criminal Justice Act 2003 for offenders not eligible for a life sentence but considered to pose a serious risk to the public. In 2012, new IPPs became illegal, in part after the European Court of Human Rights ruled in three cases that failure to make appropriate provision for rehabilitation services while the men were in prison breached their rights under Article 5 of the Convention and thus from arbitrary detention. People already sentenced under this provision, however, remained in the system. Humberside Indeterminate Public Protection Project (HIPPP) supports intensive case management of male IPP offenders still serving this sentence. AIMS: To examine variables associated with pathway outcome among men under IPPs in one English region-Humberside. Our primary hypothesis was that programme engagement in prison would be significantly associated with release. METHODS: The HM Prison and Probation Services National Delius (nDelius) and Offender Assessment System (OASys) were used to identify all men from the region subject to IPPs and beyond tariff (the fixed, punishment part of their sentence) and to retrieve data on the sentence, pathway status and specific risk factors. We used content analysis to identify variables of interest, and logistic regression models to explore associations of variables with different types of pathway outcome. RESULTS: A total of 82 men were identified, 34 of whom had ever been recorded as having been given a diagnosis of anti-social personality disorder (ASPD). Men experiencing relationship difficulties with professionals were significantly more likely to be denied release [Odds Ratio (OR) = 7.75, Confidence Interval (CI) 2.08-28.57], have a deferred parole (OR = 7.81, CI 1.59-38.46) or be awaiting parole (OR = 4.46, CI 1.09-18.18) compared with men released to the community or serving in an open prison. Completion of programmes was not associated with pathway outcome. A modest association between diagnosis of anti-social personality disorder and pathway outcome association was confounded by other variables. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: While programme completion did not have the expected association with release, relational difficulties with professionals proved significant barriers to release. This suggests that ambitions for the Offender Personality Disorder (OPD) pathway in supporting professionals to develop collaborative relationships with offenders are well founded. Part of this approach lies in sophisticated, psychologically informed case formulations which may help to discriminate between risk factors and personality disorder traits which have social rather than risk implications.


Assuntos
Transtorno da Personalidade Antissocial/psicologia , Direito Penal , Criminosos , Direitos Humanos , Prisioneiros , Adulto , Inglaterra , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade , Prisões , Estudos Retrospectivos , País de Gales
7.
Clin Ter ; 171(3): e216-e224, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32323708

RESUMO

From the criminologic standpoint, as a crime committed against a psychological background of depression, homicide-suicide is a "dual death" whose significance transcends the specificity of the two events taken singly. Although diametrically opposite phenomena, in fact they share the same pulsions, to be found in aggressiveness, or the desire to eliminate the tensions underlying it. From this perspective, various attempts have been made to classify the homicide-suicide phenomenon, which have indicated that those who, through homicide, deprive themselves of their primary source of gratification may then decide to commit suicide as a result of this unbearable loss. Therefore, suicide post-homicide is a marker of the importance of the bond between the murderer and the victim. Indeed, some Authors have confirmed that the strong attachment between the two increases the likelihood of suicide of the former after the death of the latter; that the crime develops in a relational context featuring abuse and maltreatments; that it also stems from the fear of betrayal and the loss of an object that escapes all attempts to possess it, and that in many cases the destruction of the object through the crime is followed by the self-destruction of the criminal.


Assuntos
Criminosos/psicologia , Homicídio/psicologia , Suicídio/psicologia , Adulto , Vítimas de Crime , Transtorno Depressivo , Feminino , Psicologia Forense , Humanos , Masculino
8.
J R Soc Med ; 113(3): 110-118, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32160121

RESUMO

OBJECTIVES: Research suggests that antisocial lifestyles constitute significant health risks. However, there are marked individual differences in the stability of antisocial behaviour. These different offending pathways may bear differential risks for adult health. DESIGN: Injury and illness data were collected prospectively in the longitudinal Cambridge Study in Delinquent Development. SETTING: Working-class inner-city area of South London. PARTICIPANTS: Participants included the 411 men from the Cambridge Study in Delinquent Development, with interview data collected at ages 18, 32 and 48 years for each individual. MAIN OUTCOME MEASURES: Organic illness, hospitalisation and injuries. RESULTS: By age 48, adjusted odds ratios showed that the incidence of organic illness was higher among Life-Course-Persistent, Late-Onset offenders and offenders in general. Based on adjusted odds ratios at age 32, the incidence of hospitalisations was higher for Late-Onset offenders. Adjusted odds ratios at age 48 also showed that the incidence of hospitalisations was higher for all three offender types and offenders in general. Our results also provide evidence that offenders were more likely to suffer injuries than non-offenders. CONCLUSIONS: The findings of this study imply that preventing individuals from offending is likely to have substantial benefits for health.


Assuntos
Transtorno da Personalidade Antissocial/epidemiologia , Crime/estatística & dados numéricos , Criminosos/estatística & dados numéricos , Estilo de Vida , Saúde Mental , Admissão do Paciente/tendências , Medição de Risco , Adolescente , Adulto , Criança , Feminino , Seguimentos , Humanos , Incidência , Londres/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Meio Social , Adulto Jovem
9.
Crim Behav Ment Health ; 30(2-3): 68-78, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32212284

RESUMO

Throughout the world, women involved in criminal justice systems often present with substantial needs and vulnerabilities. Diverting vulnerable people away from prison is government policy in England and Wales, but full psychiatric and social assessments are expensive and hard to access. A screening and quick response initiative - alternatives to custodial remand for women (ACRW) - was implemented across three areas of London (West, South and East) to supplement existing court liaison and diversion services, to assess the feasibility of a supplementary custodial remand service as part of a women's specialist service pathway in the criminal justice system in England. Three mental health trusts and two voluntary sector providers offered this service enhancement - a screening and service link provision in three London boroughs between 2012 and 2014. We conducted a service evaluation using routinely collected service use record data. The service made 809 contacts, of whom 104 had contact on multiple occasions. Many were identified as at risk of self-harm (46%) or had histories of hospital admission for mental disorder (36%), but few were referred either to the liaison and diversion service or specialist mental health services. The largest group of referrals was to women's community services outside the health service (e.g. counselling, domestic violence or sexual abuse services). 180 women had dependent children and 22 were pregnant, increasing the urgency to find non-custodial alternatives. As well as confirming high levels of need amongst women entering the criminal justice system, this evaluation confirms the feasibility of working across sectors in this field, providing an extra layer of service that can complement existing liaison and diversion service provision. The service was responsive and most women using it were kept out of custody. Research is now required to understand the appropriateness of the referrals, the extent to which women follow them through and the impact on their mental health and desistance from offending.


Assuntos
Crime/estatística & dados numéricos , Direito Penal , Criminosos/psicologia , Psiquiatria Legal/organização & administração , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Encaminhamento e Consulta/estatística & dados numéricos , Adolescente , Adulto , Criança , Crime/legislação & jurisprudência , Inglaterra , Estudos de Viabilidade , Feminino , Humanos , Masculino , Competência Mental , Saúde Mental , Pessoas Mentalmente Doentes , Prisões , Medição de Risco , País de Gales , Adulto Jovem
10.
Wiad Lek ; 73(1): 113-118, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32124819

RESUMO

OBJECTIVE: The aim: The paper is aimed at creation of a procedure for determining the loss of any body organ or its functions, genital mutilation, as the signs of grievous bodily harm, penalty for which is stipulated by the Article 121 of the Criminal Code of Ukraine, as well as establishing the possibilities of legal setting of the concept of "genital mutilation". PATIENTS AND METHODS: Materials and methods: Over 100 criminal proceedings, involving forensic medical examination, under the Article 121 of the Criminal Code of Ukraine for the period from 2007 to 19.05.2019 have been studied. Common methods of research have been used, namely, the analysis and synthesis, statistical method, as well as own observations of the process of judicial examination of the above criminal proceedings, as well as individual interviews, survey of the victims and their family members in total of 39 people. RESULTS: Results and conclusions: The findings of the investigation enabled detecting the gaps in the regulation of the procedure to define genital mutilation as a characteristic feature of grievous bodily harm. The ways of further improvement of the procedure of conducting expert studies of genital mutilation as a characteristic feature of bodily harm, which facilitates avoiding of errors in forensic medical and judicial practices have been found. The process of criminalization of the illegal conduct of surgical operations, resulted in mutilation of genitalia, must take place with the mandatory involvement of specialists in the field of practical medicine, as well as medical scientists specializing in sexopathology, gynecology, oncogynecology, forensic medicine in order to avoid errors in the lawmaking.


Assuntos
Genitália , Criminosos , Medicina Legal , Humanos , Ucrânia
11.
PLoS One ; 15(3): e0229876, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32142531

RESUMO

INTRODUCTION: Aggression is a clinical symptom of various psychiatric disorders that can be conceptualised as a physical act towards another person with the intent to cause harm. In antisocial personality disorder (ASPD), aggression is a frequent manifestation that differently compromise therapeutic and prognostic goals according to its impulsive or premeditated categorisation. ASPD is characterised by high levels of impulsivity, psychopathic traits, and a high prevalence of co-morbid substance use disorders (SUDs). Aggression in ASPD patients may determine long and recurrent imprisonment thus representing a challenge clinicians and legal experts face. OBJECTIVES: Our aims were to characterise impulsive and premeditated aggression in male ASPD offenders as well as to determine the potential role of SUDs, impulsivity, and psychopathic traits as predictors. MATERIALS AND METHODS: In this cross-sectional study we evaluated a sample of ASPD offenders with a battery of clinical and psychometric, standardised instruments: the Psychopathy Checklist-Revised (PCL-R), the European Version of the Addiction Severity Index (EuropASI), the Barratt Impulsivity Scale Version 11 (BIS-11), and the Impulsive/Premeditated Aggression Scale (IPAS). RESULTS: We used a total sample of 134 offenders, all of whom were male. ASPD patients (n = 96) had a 71.9% prevalence of impulsive aggression and a 28.1% prevalence of premeditated aggression. ASPD patients with impulsive aggression had significantly lower scores of total PCL-R (p<0.01) factor 1 and interpersonal facet 1 (p<0.05), compared with ASPD patients with premeditated aggression. ASPD patients with impulsive aggression and ASPD patients with premeditated aggression had comparable BIS-11 mean scores, and exhibited an equal prevalence of SUDs. The interpersonal facet 1of the PCL-R predicted the aggression type (p<0.05) in ASPD patients, and the exponential beta value for facet 1 was 1.42 (CI = 1.03; 1.95). CONCLUSIONS: The aggression type that is associated with ASPD is mainly impulsive in nature. ASPD patients who have higher scores of psychopathic traits have a lower probability of exhibiting impulsive aggression and a higher probability of exhibiting premeditated aggression. Although ASPD patients have high levels of impulsivity and a high frequency of SUDs, these two variables were not predictors of the aggression type.


Assuntos
Agressão/psicologia , Transtorno da Personalidade Antissocial/epidemiologia , Comportamento Impulsivo , Psicometria , Adulto , Transtorno da Personalidade Antissocial/psicologia , Criminosos/psicologia , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Prisioneiros/psicologia , Escalas de Graduação Psiquiátrica
12.
Z Kinder Jugendpsychiatr Psychother ; 48(4): 318-327, 2020 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-32096700

RESUMO

Assessment of the maturity of juvenile and young adult offenders according to §105 of German juvenile law: a developmental psychology perspective Abstract. Since 1953, according to § 105 of the German JGG (Jugendgerichtsgesetz/Juvenile Court Act), it has been possible to convict offenders aged 18.0 y-20y 11 mo either as juveniles or as adults, depending on their developmental status. Yet unambiguous criteria defining the individual stages of development are available neither to judges nor to experts. Thus, for this age group this may lead judges to make arbitrary decisions impairing the right of equal treatment before the law in Germany. In the absence of clear criteria for assessing maturity, experts nearly always recommend judging such offenders as juveniles. Recent findings from the neurosciences and developmental psychology show that not only juveniles but adolescents and young adults up to the age of 25y usually have significant potential for development. After an overview of the legal practices pertaining to juveniles in Germany and throughout Europe, we propose alternatives for the individual assessment of maturity.


Assuntos
Criminosos/psicologia , Delinquência Juvenil/psicologia , Psicologia do Desenvolvimento , Adolescente , Criminosos/legislação & jurisprudência , Alemanha , Humanos , Delinquência Juvenil/legislação & jurisprudência , Adulto Jovem
13.
Am J Public Health ; 110(3): 378-384, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31944850

RESUMO

Objectives. To quantify the association between personal and family history of criminal justice system (CJS) involvement (PHJI and FHJI, respectively), health outcomes, and health-related behaviors.Methods. We examined 2017 New York City Community Health Survey data (n = 10 005) with multivariable logistic regression. We defined PHJI as ever incarcerated or under probation or parole. FHJI was CJS involvement of spouse or partner, child, sibling, or parent.Results. We found that 8.9% reported only FHJI, 5.4% only PHJI, and 2.9% both FHJI and PHJI (mean age = 45.4 years). Compared with no CJS involvement, individuals with only FHJI were more likely to report fair or poor health, hypertension, diabetes, obesity, depression, heavy drinking, and binge drinking. Respondents with only PHJI reported more fair or poor health, asthma, depression, heavy drinking, and binge drinking. Those with both FHJI and PHJI were more likely to report asthma, depression, heavy drinking, and binge drinking.Conclusions. New York City adults with personal or family CJS involvement, or both, were more likely to report adverse health outcomes and behaviors.Public Health Implications. Measuring CJS involvement in public health monitoring systems can help to identify important health needs, guiding the provision of health care and resource allocation.


Assuntos
Criminosos/estatística & dados numéricos , Saúde da Família , Comportamentos Relacionados com a Saúde , Nível de Saúde , Alcoolismo/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Cidade de Nova Iorque/epidemiologia , Inquéritos e Questionários
16.
J Forensic Sci ; 65(2): 526-534, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31532844

RESUMO

Researchers have examined a number of typologies of juvenile sex offenders, including victim age. Using data from psychological evaluations and the Multiphasic Sex Inventory-II (MSI-II; [Psychological assessment of sex offenders, 2010]), this study compared child offenders (i.e., victims were more than 4 years younger), peer offenders (i.e., victims were 4 years younger or less), and mixed offenders (i.e., both child and peer victims) on variables including victim, offender, and offense characteristics, and psychosexual development. Peer offenders had more severe sexual offenses, prior status/nonviolent charges, and issues with sexual functioning. Mixed offenders began offending at a younger age and were indiscriminate in gender and relationship of the victim. Mixed offenders were also more likely than child and peer offenders to have prior sex offender treatment, meaning they had previously failed treatment. As juvenile sex offenders are a heterogeneous group, these research findings suggest that child offenders, peer offenders, and mixed offenders' treatment needs differ from each other.


Assuntos
Vítimas de Crime , Criminosos/psicologia , Delinquência Juvenil/psicologia , Desenvolvimento Psicossexual , Delitos Sexuais/psicologia , Adolescente , Criança , Feminino , Psiquiatria Legal , Humanos , Masculino , Adulto Jovem
19.
Psychopharmacology (Berl) ; 237(1): 177-187, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31511917

RESUMO

BACKGROUND: With driving while impaired by alcohol (DWI) representing a persistent burden on global health, better understanding and prevention of recidivism following a first-time DWI conviction are needed. Progress towards these goals is challenged by the marked heterogeneity in offender characteristics and a traffic safety literature that relies on subjective self-report measures and cross-sectional study designs. The present study tested the hypothesis that an objective neurobiological marker of behavioural maladjustment, the cortisol stress response (CSR), predicts future DWI and other traffic convictions over a 9-year follow-up period. METHODS: One hundred thirty-two male first-time DWI offenders and 31 non-offender comparators were recruited and assessed at intake for their substance use, psychosocial and psychological characteristics and CSR. Traffic conviction data were obtained from provincial driving records. Survival analysis estimated the association between CSR and risk of a traffic conviction over time. RESULTS: In support of our hypothesis, blunted CSR predicted traffic convictions during the follow-up duration. This effect generalized to both DWI offenders and non-DWI drivers. While CSR was lower in DWI offenders compared to non-offenders, it did not specifically predict recidivism in DWI offenders. Modelling results indicated that blunted CSR, along with DWI offender group membership, experience seeking and drug use frequency, may demarcate a high-risk driver phenotype. CONCLUSIONS: CSR is a neurobiological marker of a driver phenotype with elevated generalized driving risk. For drivers with characteristics consistent with this phenotype, expanding the focus of intervention to address multiple forms of risky driving may be necessary to curb their overall threat to traffic safety.


Assuntos
Intoxicação Alcoólica/fisiopatologia , Criminosos , Dirigir sob a Influência/fisiologia , Hidrocortisona/análise , Adulto , Estudos Transversais , Dirigir sob a Influência/legislação & jurisprudência , Humanos , Masculino , Saliva/química , Adulto Jovem
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