A Latent Class Analysis of Forensic Psychiatric Patients in Relation to Risk and Protective Factors.

Marija Janković,Stefan Bogaerts,Erik Masthoff,Peter De Looff,Marinus Spreen

doi:10.3389/fpsyg.2021.695354

Abstract

Forensic psychiatric patients form a very heterogeneous population regarding psychopathology, criminal history, and risk factors for reoffending. Therefore, the present study aimed to investigate whether there are more homogeneous classes of forensic patients based on DSM-IV-TR Axis I and II diagnoses and previously committed offenses, by means of explorative latent class analysis (LCA). It was also investigated which risk and protective factors are significantly more prevalent in one class compared to other classes. The study sample contained 722 male forensic psychiatric patients who were unconditionally released between 2004 and 2014 from high-security forensic clinics. Data were retrospectively derived from electronic patient files. Five distinctive patient classes emerged: class with only Axis II diagnosis, class with multiple problems, antisocial class, psychotic class, and intellectually disabled class. These classes differed significantly in risk and protective factors. This study contributes to the understanding of patient classes and provides directions for future, class-tailored interventions.

Highlights

In the Netherlands, individuals who committed violent crimes under the influence of a severe mental illness, personality disorder (PD), or deficits in cognitive development can be sentenced by the court to compulsory treatment to be carried out in a range of forensic psychiatric facilities
The present study investigated whether there are patient classes based on psychiatric diagnoses and previously committed offenses, in a nationwide sample of forensic psychiatric patients residing in Dutch high-security forensic psychiatric institutions
We identified the class with only Axis II diagnosis, which was shown to be similar to the maladaptive disordered affective class found by Van Der Veeken et al (2017) and to the patient with sexual problems and sexual crimes found by Van Nieuwenhuizen et al (2011)

Summary

Introduction

In the Netherlands, individuals who committed violent crimes under the influence of a severe mental illness, personality disorder (PD), or deficits in cognitive development can be sentenced by the court to compulsory treatment to be carried out in a range of forensic psychiatric facilities. The aim of this forensic treatment is to protect society from dangerous offenders and to prepare them for successful reintegration into society (De Ruiter and Hildebrand, 2003; De Boer and Gerrits, 2007). According to the RNR model, the Big Four

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