[Forensic (F)ACT: a study exploring indication, risk assessment and recidivism]. / Forensische (F)ACT: een onderzoek naar indicatiestelling, risicotaxatie en recidive.

BACKGROUND: Cutbacks in clinical beds in regular and forensic psychiatry increase the burden on outpatient forensic care in The Netherlands.
AIM: Since 2007, Dutch forensic (flexible) assertive community treatment (For(F)ACT) teams offer outpatient, intensive treatment to forensic clients with complex mental health issues. As the need for this form of intensive treatment increases, so does the need for unambiguous indication criteria to facilitate adequate care and accompanied reduction in criminal behavior.
METHOD: The present study investigated the correlation between the clinical indication criteria and risk factors for criminal behavior in 76 For(F)ACT-clients, reviewing which criteria best predicted recidivism.
RESULTS: A weak correlation was found between the indication criteria and risk factors. Further receiver operating characteristic (ROC) analysis showed that a combination of clinical indication criteria best predicted recidivism.
CONCLUSION: The influential risk factors for For(F)ACT-clients are different compared to those for other groups of delinquents. Important treatment factors are breaking patterns, increasing safety and offering social and financial support. The clinical indication criteria should not be replaced by the START risk factors.

Neurofeedback and meditation technology in outpatient offender treatment: a feasibility and usability pilot study.

Introduction: Although Cognitive Behavioral Therapy (CBT) is the most often used intervention in forensic treatment, its effectivity is not consistently supported. Interventions incorporating knowledge from neuroscience could provide for more successful intervention methods. Methods: The current pilot study set out to assess the feasibility and usability of the study protocol of a 4-week neuromeditation training in adult forensic outpatients with impulse control problems. The neuromeditation training, which prompts awareness and control over brain states of restlessness with EEG neurofeedback, was offered in addition to treatment as usual (predominantly CBT). Results: Eight patients completed the neuromeditation training under guidance of their therapists. Despite some emerging obstacles, overall, the training was rated sufficiently usable and feasible by patients and their therapists. Discussion: The provided suggestions for improvement can be used to implement the intervention in treatment and set up future trials to study the effectiveness of neuromeditation in offender treatment.

[Psychopathology and recidivism among violent offenders with a dual diagnosis. A comparison with other subgroups of violent offenders]. / Psychiatrische stoornissen en recidive bij geweldplegers met dubbele diagnose; vergelijking met andere subgroepen geweldplegers.

BACKGROUND: Offenders with a dual diagnose (DD) are more likely than other offenders to repeat delinquent behavior. AIM: To investigate whether male violent offenders with substance-related disorders and co-occurring disorders differed from other subgroups of violent offenders in terms of substance disorders, psychopathology, and recidivism. We expected to find that persons with a dual diagnosis would more often be diagnosed with an anxiety or mood disorder and antisocial personality disorder. We also expected that they could have the highest recidivism rates. METHOD: Our sample consisted of 148 (domestic) violent offenders subdivided into offenders with a substance-related disorder and comorbid disorders (dual diagnosis group; n = 50), offenders without an axis I or axis II disorder (n = 28), offenders with a substance-related disorder (n = 23), and offenders with one or several comorbid axis I disorders (excluding substance related disorders) and/or axis II disorders (n = 47). RESULTS: Survival analyses showed - with an average follow-up period of 79,6 months - significantly higher general (60%) and violent (44,9%) recidivism rates in the DD-group than in the other subgroups in which the rates were lower than 40% for both general and violent recidivism. Results of Cox regression analyses indicated that merely belonging to the DD-group increased the risk of violent recidivism by a factor of 5.21. CONCLUSIONS: The DD-delinquents under study did not differ fundamentally from other subgroups of (domestic) violent offenders as far as substance-related disorders and psychopathology were concerned. However, they did engage more often in recidivism, committing general or violent offences.

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.

Full and Short Versions of the Coping Inventory for Stressful Situations and Social Problem-Solving Inventory-Revised: Examining Their Factor Structure in a Dutch Outpatient Sex Offender Sample.

Inadequate problem solving is associated with recidivism in sex offenders. However, the psychometric properties of two of the most widely used coping self-report questionnaires, the Social Problem-Solving Inventory-Revised and Coping Inventory for Stressful Situations, have not been established for outpatient sex offenders. Using structural equation modeling, the present study aims to contribute to an empirically based decision as to which version of the Coping Inventory for Stressful Situations or Social Problem-Solving Inventory-Revised is best suited to use with forensic outpatient sex offenders. The sample consisted of 530 Dutch sex offenders treated in an outpatient forensic facility. Results support the use of the Coping Inventory for Stressful Situations-Short Form 20 for identifying problem-solving deficits among outpatient sex offenders, consequently facilitating the assessment of treatment needs.

A Canadian-Dutch comparison of teachers' burnout.

Scores on burnout among 631 Canadian and 1,180 Dutch teachers were compared with various demographic variables (sex and age) and factors related to work (experience in teaching, type of school, and number of hours employed). Burnout was assessed with the Maslach Burnout Inventory of three dimensions, Emotional Exhaustion, Depersonalization, and Personal Accomplishment. Analysis indicated that, over-all, Canadian teachers reported higher scores on Emotional Exhaustion and Depersonalization than their Dutch peers. Differences in the number of hours employed were also significant: full-time Canadian teachers scored higher on Depersonalization than their Dutch colleagues. Across countries, sex and type of school appeared significantly related to burnout. Male teachers rated higher on Emotional Exhaustion and Depersonalization than the women. Especially with regard to the attitudinal components of burnout, i.e., Depersonalization and Personal Accomplishment, secondary school teachers reported higher scores than elementary school teachers. Age was not significantly related to measures.