Abstract
The long-term changes of dynamic risk and protective factors have rarely been studied in forensic psychiatric patients. We utilized a latent growth curve analysis to investigate trajectories of risk and protective factors over time in all 722 male forensic psychiatric patients who were unconditionally released between 2004 and 2014 from any of 12 Dutch forensic psychiatric centers (FPCs). The study covered the period from juridical observation until unconditional release. Moreover, we investigated whether these trajectories differ between patients depending on their psychiatric diagnosis namely substance use disorders (SUD), psychotic disorders, and cluster B personality disorders (PDs). In addition, we also investigated whether SUD may influence changes in risk and protective factors in a group of psychotic and cluster B PDs patients, respectively. Overall, findings suggest that all changes in dynamic risk and protective factors could be depicted by two phases of patients' stay in the FPCs. Specifically, most changes on dynamic risk and protective factors occurred at the beginning of treatment, that is, from the time of juridical assessment up to the time of unguided leave. Moreover, the moment of unguided leave could be considered the ‘turning point’ in the treatment of offenders. We also found that SUD and psychotic patients changed the most in the first phase of their stay, while cluster B PDs patients changed the most in the second phase. However, SUD did not modify changes in risk and protective factors in psychotic and cluster B PDs patients. These findings may help improve offender treatment and crime prevention strategies.
Highlights
In recent years, there has been a growing interest in longitudinal research on changes in dynamic risk and protective factors in forensic psychiatric patients
To our knowledge, no prior studies have examined whether these trajectories differ between patients depending on their psychiatric diagnosis, namely substance use disorders (SUD), psychotic disorders, and cluster B personality disorders (PDs)
The main goal of this study was to investigate the changes in dynamic risk and protective factors over time utilizing latent growth curve analysis (LGCA) in all male forensic psychiatric patients who were unconditionally released between 2004 and 2014 from one of the 12 Dutch forensic psychiatric centers (FPCs)
Summary
There has been a growing interest in longitudinal research on changes in dynamic risk and protective factors in forensic psychiatric patients. Long-Term Changes in Risk and Protective Factors forensic correctional practice; they can help set reasonable goals for interventions that reduce the likelihood of reoffending [e.g., criminogenic needs; [1], or primary goods; [5]], determine whether meaningful progress is being made toward treatment goals, and inform risk management strategies [6, 7] For these reasons, dynamic risk and protective factors are routinely evaluated in structured risk assessment tools [7,8,9], such as the Historical, Clinical, and Future–Revised [HKT-R [Historisch Klinisch Toekomst–Revised]; [10]]. The HKTR is developed in the Netherlands and should be mandatorily used for all admitted forensic patients and prisoners to investigate the future risk of recidivism and changes in recidivism risk
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