There is limited evidence in the literature that hostility, anger, and aggression are involved with social anxiety. The present study examined the relationship of personality traits and aggression with social anxiety and social skills in forensic psychiatric outpatients convicted of a violent crime. Social anxiety was mainly contributed to by neuroticism, state anger, and social skills, while neuroticism and social anxiety were the main contributors to social skills. Anger, next to neuroticism and social skills, appeared to be involved in the outpatients’ social anxiety. Neuroticism and social anxiety were found to be the main contributors to social skills.

The aims of this research were to explore custodial prison staff and male prisoners’ perceptions toward self-harm, prison system responses and environmental impacts on self-harm. Four staff focus groups (thematic analysis) and 12 semi-structured interviews with male prisoners (interpretative phenomenological analysis) took place in three prisons in England. Prison staff attributed manipulative intention to self-harm; self-harming prisoners felt misunderstood. The prison environment and formal response processes were barriers for care access and provision. Recommendations include staff training in understanding and management of self-harm, supported by a care-focused culture, and fostering safety, security, empowerment and value for both prisoners and staff.

In this article, we evaluate the extent to which the International Journal of Forensic Mental Health addresses and incorporates discussion of diversity constructs in its publications. Five years of publishing data from 582 manuscript submissions and 164 published articles were reviewed and coded for the inclusion of several diversity constructs (i.e., sex or gender, race or ethnicity, country, age, culture), how these constructs were included in the research (i.e., part of the hypothesis/aims of the study), and the countries the authors and participants represented. Results indicate that most article submissions, authors, and participant samples came from Europe, North America, and Oceania, and these regions had higher acceptance rates. Most articles included studies of clinical populations, and many authors’ primary affiliations were forensic mental health or correctional services. Less than a third of the article titles and over half of the article abstracts mentioned one of the diversity constructs examined. This is somewhat promising and tells us that the journal is publishing articles reporting and examining aspects of diversity in their samples. However, we argue more can be done. Future research and recommendations for the next steps in improving diversity, equity, and inclusiveness in the publication processes and publications are outlined.

The roots of South Africa’s forensic mental health system are plagued by its colonial and apartheid legacy. Extensive forensic waitlists exist partly due to restrictive criminal justice legislation and an under-funded forensic mental health system, predicated largely on European norms and standards. There are several areas of concern in South Africa’s forensic mental health system, which may be viewed as inequitable to Black Africans and other marginalized groups. Black Africans are over-represented in the forensic mental health system, and many defendants are not fluent in English – the official language of the courts. The absence of competency restoration can result in extended detention in forensic hospitals. People with intellectual disabilities are disproportionately targeted for sexual assault, and face significant barriers in attempts to achieve justice. Further, the colonial legacy of the rebuttable presumption of doli incapax (children presumed incapable of forming criminal intent) can affect determinations of children’s criminal capacity. These issues warrant change, including introducing competency restoration, improving systems for testimony by sexual violence survivors with intellectual disabilities, reconsidering the rebuttable presumption in child justice matters, and using psychologists and outpatient evaluations to address the waitlists for forensic examinations. Comparisons are also made with US standards, challenges, and developments, especially in view of the authors’ knowledge of both systems and the common challenges facing them.

In a study undertaken to examine the content validity of the French-language version of the Comprehensive Assessment of Psychopathic Personality (CAPP), a lexically-based conceptual model and clinical assessment of psychopathy, 204 French-speaking mental health professionals rated the symptoms covered by the CAPP for prototypicality. The majority of the symptoms were deemed to be “moderately” to “highly” prototypical of psychopathy. Of the model’s six domains, Dominance, Attachment and Self were considered more prototypical than Emotional, Behavioral and Cognitive. Results were consistent with those of other prototypicality studies. Descriptives analyses suggested that the ratings of English-speaking mental health professionals were higher than their French-speaking counterparts. However, the effect sizes were small according to the Cohen’s d analyses. Confirmatory factor analysis revealed that Attachment was the only unidimensional domain. Finally, exploratory factor analysis yielded three factors—Egotism, Interpersonal rigidity, and Lack of responsibility. These factors were primarily underpinned by symptoms that entailed interpersonal and social cognitive traits.

Restrictive interventions, such as physical restraint, should be a last resort for managing imminent risk. There has been growing recognition of the harmful effects of them, for both staff and service users. Limited research has considered the impact of physical restraint on the therapeutic relationship between staff and service users. The aim of this research was to address this gap in the literature and explore both service user and staff perspectives of the therapeutic relationship after physical restraint, in a UK-based service that provides low and medium secure care for adults. Ten semi-structured interviews were conducted with five service users and five staff members. All participants had been involved in at least one incident of physical restraint. Interpretative Phenomenological Analysis was used to analyze the data. Three master themes emerged from the service user experiences: emotional impact; changes to the therapeutic relationship; and appraisal of the necessity of physical restraint. A further three master themes were produced from the staff member experiences: emotional response; balancing professional roles and responsibilities within the relationship; and moving forward with the therapeutic relationship after physical restraint. Findings support the need to continue to reduce restrictive interventions including physical restraint in secure mental health services and consider the impact upon those involved, both emotionally and relationally. Contemporary approaches to reducing power imbalances between staff and services users, as well as those that would reduce the likelihood of (re)traumatising service users, are also recommended.

Many people treated in secure inpatient services have a serious mental illness and are obese. This study aimed to assess the predictive power of demographic, clinical and pharmacological factors on secure inpatient weight gain during the initial stages of treatment. Retrospective data pertaining to body weight, sex, diagnosis, and prescribed medication was collected for 209 secure psychiatric inpatients. Lower admission bodyweight and non-antipsychotic medication with a low risk of inducing weight gain were the only significant predictors of weight gain (R2 = .050). Clinical implications of these findings are discussed.

Lifespan is reduced by approximately 15 years in individuals suffering from severe mental illnesses such as schizophrenia spectrum disorders. Contributing to this is an increased prevalence of metabolic syndrome, an assortment of factors that confer risk of diabetes type 2 and cardiovascular disease. Body Mass Index (BMI) is predictive of metabolic syndrome. Previous research indicates that the BMI of incarcerated individuals not suffering from a major mental disorder increase during incarceration, especially amongst females. However, information on the development of BMI during forensic psychiatric care is scarcer, and follow-up periods have been short. Thus, the authors extracted data from the Swedish National Forensic Psychiatric Register regarding the longitudinal development of BMI in 3389 individuals who received court mandated forensic psychiatric care in Sweden during 2009–2020. A significant increase in BMI by 1.1% per year was observed during the first four years of care. After this, changes were no longer significant. Factors associated with a larger increase in BMI were female gender, being prescribed antipsychotics, young age at admission, receiving outpatient care, and access to an external support person. There was an inverse association between BMI and symptom severity. Substantial heterogeneity was observed in longitudinal changes in individual BMI and in comparisons between individuals receiving care at different clinics.

Indigenous individuals are vastly over-represented among people incarcerated in Canada. We collected extensive clinical information and outcome data from Review Board (RB) files and obtained lifetime criminal records for 1800 individuals found Not Criminally Responsible on Account of Mental Disorder (NCRMD) in BC (n = 222), ON (n = 484), and QC (n = 1094). Indigenous and non-Indigenous people were compared on (a) socio-demographic, clinical, and criminal histories; (b) index offenses; (c) processing by the RB; and (d) recidivism. Compared to published rates of the disproportionate incarceration of Indigenous people in prisons in Canada (30%), just 3.9% of people in custody with an NCRMD finding were identified as Indigenous. Compared to non-Indigenous people, Indigenous people had higher rates of substance use disorders, personality disorders, and lower rates of mood disorders at verdict and came from low population density neighborhoods but high population density homes. Indigenous individuals were detained in custody longer and remained under supervision longer than non-Indigenous individuals but recidivated at similar rates. Criminal histories, mental health characteristics, and index offenses of Indigenous people found NCRMD were similar to non-Indigenous people found NCRMD. Further research is required to determine if seriously mentally ill Indigenous people who come into contact with the justice system are considered for the NCRMD defense similarly to non-Indigenous people and to explore why Indigenous individuals receive more restrictive dispositions, yet time to reoffending is similar.