History Of Criminal Convictions Research Articles

Hospitalisation following therapeutic community drug and alcohol treatment for young people with and without a history of criminal conviction

IntroductionThis study examines the association between treatment in a therapeutic community for adolescents with drug and alcohol problems on hospitalisation outcomes up to 15 years later for all clients, and separately for those with and without a history of criminal conviction. MethodA quasi-experimental design was used to examine the linked administrative health and criminal justice records for all adolescents admitted to the Program for Adolescent Life Management (PALM) from January 2001 to December 2016 (n = 3059) in Sydney, Australia. ICD-10AM codes were used to designate hospitalisation outcomes as either physical injury, mental health problems, substance use disorders, or organic illness. The treatment and comparison groups were matched on factors associated with program retention, resulting in a final sample of 1266 clients. We examined the rate of hospitalisation up to 15 years posttreatment for all clients and stratified by prior conviction status using Cox regression analyses. ResultsThe treatment group had significantly lower rates of hospitalisation for a physical injury (HR = 0.77 [95% CI = 0.61–0.98]), mental health problem (HR = 0.62 [95% CI = 0.47–0.81]), substance use disorder (HR = 0.59 [95% CI = 0.47–0.75]), and organic illness (HR = 0.71 [95% CI = 0.55–0.92]). There was a significant interaction between treatment and prior criminal conviction status on rate of hospitalisation for physical injury, suggesting that the effect of treatment on physical injury was significantly greater for clients with a prior criminal conviction. ConclusionsAdolescents who engage in a therapeutic community treatment program may have a long-lasting reduction in the risk of subsequent hospitalisation. This also appears to apply to those with a history of criminal conviction.

Dark Tetrad and psychological distress among male violent offenders and male community adults

The first aim of this study was to explore differences between male violent offenders and male community adults in Dark Tetrad traits and psychological distress. The second aim was to investigate moderation effects of dark traits in the prediction of psychological distress based on the membership of violent offenders or community adults. The sample included 142 male violent offenders (M = 40.73, SD = 11.43) convicted of murder, severe murder, or rape, and 573 men from the community population in Serbia without a history of criminal convictions (M = 41.71, SD = 15.11). Serbian adaptations of the Short Dark Triad (SD3), Comprehensive Assessment of Sadistic Tendencies (CAST), and Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) were used. Results showed that violent offenders had higher scores on psychopathy and problems in social and general functioning, while community adults had higher scores on narcissism. Furthermore, moderation analyses showed that physical sadism was significantly correlated with risk behaviors in the community adults, but not in violent offenders.

Association of Methadone Treatment With Substance-Related Hospital Admissions Among a Population in Canada With a History of Criminal Convictions

People with criminal histories experience high rates of opioid dependence and are frequent users of acute health care services. It is unclear whether methadone adherence prevents hospitalizations. To compare hospital admissions during medicated and nonmedicated methadone periods. A retrospective cohort study involving linked population-level administrative data among individuals in British Columbia, Canada, with provincial justice contacts (n= 250 884) and who filled a methadone prescription between April 1, 2001, and March 31, 2015. Participants were followed from the date of first dispensed methadone prescription until censoring (date of death, or March 31, 2015). Data analysis was conducted from May 1 to August 31, 2018. Methadone treatment was divided into medicated (methadone was dispensed) and nonmedicated (methadone was not dispensed) periods and analyzed as a time-varying exposure. Adjusted hazard ratios (aHRs) of acute hospitalizations for any cause and cause-specific (substance use disorder [SUD], non-substance-related mental disorders [NSMDs], and medical diagnoses [MEDs]) were estimated using multivariable Cox proportional hazards regression. A total of 11 401 people (mean [SD] age, 34.9 [9.4] years; 8230 [72.2%] men) met inclusion criteria and were followed up for a total of 69 279.3 person-years. During a median follow-up time of 5.5 years (interquartile range, 2.8-9.1 years), there were 19 160 acute hospital admissions. Dispensed methadone was associated with a 50% lower rate of hospitalization for any cause (aHR, 0.50; 95% CI, 0.46-0.53) during the first 2 years (≤2.0 years) following methadone initiation, demonstrating significantly lower rates of admission for SUD (aHR, 0.32; 95% CI, 0.27-0.38), NSMD (aHR, 0.41; 95% CI, 0.34-0.50), and MED (aHR, 0.57; 95% CI, 0.52-0.62). As duration of time increased (2.1 to ≤5.0 years; 5.1 to ≤10.0 years), methadone was associated with a significant but smaller magnitude of effect: SUD (aHR, 0.43; 95% CI, 0.36-0.52; aHR, 0.47; 95% CI, 0.37-0.61), NSMD (aHR, 0.51; 95% CI, 0.41-0.64; aHR, 0.60; 95% CI, 0.47-0.78), and MED (aHR, 0.71; 95% CI, 0.65-0.77; aHR, 0.85; 95% CI, 0.76-0.95). In this study, methadone was associated with a lower rate of hospitalization among a large cohort of Canadian individuals with histories of convictions and prevalent concurrent health and social needs. Practices to improve methadone adherence are warranted.

The influence of mental illness and criminality self-stigmas and racial self-concept on outcomes in a forensic psychiatric sample.

Research has increasingly explored mental illness self-stigma: when people with mental illness believe that society's negative beliefs are true of them. Self-stigma predicts poorer functional and treatment outcomes. Stigma research has typically investigated the impact of a single stigma on people, without considering the potential effects of multiple stigmatizing labels. People with mental illness and a history of criminal conviction, however, may experience multiple stigmas related to mental illness and criminal history. This study investigated the impact of the combination of multiple stigmatized identities on self-esteem, depression, therapeutic alliance, and treatment adherence in a forensic psychiatric sample. It extended previous research on mental illness self-stigma to a forensic psychiatric sample. Participants (N = 82) were people with mental illness and a history of criminal conviction recruited from their treatment sites. Participants completed self-report questionnaires focused on mental illness and criminality self-stigma, racial self- concept, self-esteem, depression, working alliance, and medication/psychosocial treatment adherence. Researchers confirmed demographics through a chart review and treatment adherence from participants' clinicians. Multiple regression analyses examined the relationship between self-stigma and outcome variables. Mental illness self-stigma, racial self-concept, and to a lesser extent criminality self-stigma were associated with reduced self-esteem (p ≤ .05) and medication adherence (p ≤ .05). Criminality self-stigma also appeared to magnify the effects of racial and mental illness self-stigma on outcomes. This study shows that self-stigma related to involvement in the criminal justice system may further contribute to the impact of mental illness self-stigma on important outcomes. Future research and interventions may tailor self-stigma interventions to a forensic psychiatric population.

Factors associated with the use of community treatment orders.

In his article Curtis1 highlights one of the limitations of the OCTET study,2 in that patients selected for randomisation may not have been suitable for community treatment order (CTO) placement in the first place. In his conclusions he suggests there may be a small subgroup of patients for whom CTOs are enormously beneficial. Perhaps clinicians need more clarity of the characteristics of the ‘revolving door’ patient better to assess suitability for supervised community treatment. Most clinicians will have a personal construct of the epidemiological and clinical characteristics of revolving door patients, although this may not be explicitly defined. There is no consistency in the literature as to the definition of revolving door, and previous research in the UK has shown that predictors of readmission are varied and not consistently replicated across studies. Research carried out when the practice of ‘long leash’ Section 17 leave was widespread showed that those placed on extended leave had a history of more frequent compulsory admissions, increased recent dangerousness to others, and decreased adherence to their out-patient follow-up prior to admission.3 A case-control study was conducted at Leeds Partnership NHS Foundation Trust in 2010, and approved by the local research and development department as a service evaluation. The aim was to compare characteristics of patients placed on CTOs and those discharged from Section 3, to elicit which factors were associated with CTO placement. All patients placed on a CTO between November 2008 and February 2010 were included as cases, and controls were randomly selected from patients who had been detained under Section 3 of the Mental Health Act, but whose Section was rescinded within the same week that the CTO was commenced. A ratio of two controls for each case increased the power of the study. This amounted to 56 cases and 112 controls. Characteristics chosen for analysis were those which previous research had suggested may be of importance and where collection was feasible. The characteristics of the patients placed on CTOs were broadly similar to those recruited into OCTET. Analysing variables individually, patients on CTOs were significantly more likely (P<0.05) to be single, have a principal diagnosis of schizophrenia, a history of violence, a higher number of previous admissions, a history of criminal conviction and a higher number of convictions within the past year. On logistic regression analysis, patients on CTOs were significantly more likely to have a principal diagnosis of schizophrenia and a higher number of previous admissions. There remains the outstanding question of who belongs to the elusive group of patients for which CTOs are effective, if indeed this group exists. This study provides insight into the demographic and historical factors that are influencing clinicians’ decisions to implement CTOs. There is no proof so far that CTOs are effective in their aims. Perhaps we need to look again at who the truly ‘revolving door’ patients are and take this objective evidence into consideration at the point of deciding whether to initiate supervised community treatment.

Narcissism and Empathy in Young Offenders and Non–Offenders

Understanding the individual factors that predispose persons to criminal behaviour is vital to reducing offending and rehabilitating those who have been sentenced to prison. This study examined the roles of narcissism (at both clinical and subclinical trait levels) and empathy, by comparing levels in young adult males currently serving a prison sentence to those with no history of criminal convictions. Prison participants had significantly higher levels of narcissism—in particular entitlement—than control participants, and this link was sequentially mediated by lower perspective–taking and subsequently lack of empathic concern. Trait narcissism showed stronger effects than narcissistic personality disorder symptoms. Narcissistic young men's feelings of entitlement and ensuing lack of empathy for others may account for their greater likelihood of criminal behaviour. Copyright © 2013 John Wiley &amp; Sons, Ltd.

Gender differences in emotional risk for self- and other-directed violence among externalizing adults.

Women and men generally differ in how frequently they engage in other- and self-directed physical violence and may show distinct emotional risk factors for engagement in these high-impact behaviors. To inform this area, we investigated gender differences in the relationship of emotional tendencies (i.e., anger, hostility, and anhedonic depression) that may represent risk for other-directed violence (i.e., physical fighting, attacking others unprovoked) and self-directed violence (i.e., self-injury, suicide attempts). The ethnically diverse sample consisted of 372 adults (252 men and 120 women age 18-55) with a history of criminal convictions. Facets of emotional risk assessed with the Aggression Questionnaire (Buss & Warren, 2000) and Mood and Anxiety Symptom Questionnaire (Watson et al., 1995) were entered simultaneously as explanatory variables in regression analyses to investigate their unique contributions to other- and self-directed physical violence in men and women. Analyses revealed that anhedonic depressive tendencies negatively predicted other-directed violence and positively predicted self-directed violence in men and women, consistent with a model of depression in which aggression is turned inward (Henriksson et al., 1993). Gender differences, however, emerged for the differential contributions of anger and hostility to other- and self-directed violence. Trait anger (i.e., difficulty controlling one's temper) was associated with other-directed violence selectively in men, whereas trait hostility (i.e., suspiciousness and alienation) was associated with self- and other-directed violence among women. The divergent findings for trait anger and hostility underscore the need to examine gender-specific risk factors for physical violence to avoid excluding potentially useful clinical features of these mental health outcomes.

Commentary: Smoking during pregnancy--genes and environment weigh in

Commentary: Smoking during pregnancy--genes and environment weigh in

Original Research

The researchers sought to determine what factors might affect the outcomes of remediation, including the likelihood of recidivism, among nurses who had been the subject of disciplinary action and had been put on probation by a state board of nursing.Boards of nursing in six states, Arizona, Maryland, Massachusetts, Minnesota, Nebraska, and North Carolina, chose to participate in this exploratory study. A 29-item questionnaire was used to investigate the records of 207 RNs, LPNs, and advanced practice RNs (APRNs) who were disciplined and put on probation by a state nursing board in 2001, as well as to collect data on their employment settings, the boards' actions, and remediation outcomes (the presence or absence of recidivism); 491 nurses who had not been disciplined served as controls.Among the disciplined nurses studied, 57% were RNs, 36% were LPNs, 3% held both RN and LPN licenses, and 3% were APRNs. Of the disciplined group, 39% recidivated between 2001 and 2005. Three factors were shown to influence the recidivism rate: having a history of criminal conviction, having committed more than one violation before the 2001 probation, and changing employers during the probationary period.Data on history of criminal conviction prior to state board disciplinary action were available for 112 (54%) of the 207 nurses. Among those 112, 35% (n = 39) had a history of criminal conviction, whereas only 3% of the control group reported one. The recidivism rate among those with a history of criminal conviction (56%; 22 of 39 nurses) was nearly twice as high as the rate among those without such a history (33%; 24 of 73). Also, 33% of the disciplined nurses changed employers during their probation; the recidivism rate among them was more than twice the rate among the disciplined nurses who stayed with the same employer. The recidivism rate of the 45 disciplined nurses who committed more than one practice-related violation from 1996 through 2001 was twice as high as the rate of those who committed only a single violation.The proportion of men who had been disciplined was more than twice the proportion of men in the national nursing workforce. Younger nurses (both men and women) were more likely to recidivate.All health care regulators and nursing employers should be aware of the association between a history of criminal conviction and the likelihood of committing a violation that requires state nursing board disciplinary action.

Youth Violence: An Exploratory Study of a Treatment Program in a Central Illinois County

A local treatment provider has developed an OPTIONS program to prevent adolescent aggression. The program is designed for youths who displayed threatening or abusive behaviors, particularly toward family members. This study described the characteristics of juveniles and their families who were referred to the program and if the program participation helped reduce the severity of violence and improve the communication skills among program participants. Referrals came from law enforcement, juvenile court services, school resource officers, and parents. Information on 100 juveniles and their families were provided by the counselors of the program. The findings showed that a large percentage of juveniles came from unstable families with a family history of criminal convictions, substance abuse, or mental illness. Program participants showed an improvement in communication skills and reduction in their levels of dangerousness.

Offending and risky behaviour in community services for people with intellectual disabilities in one local authority

The total population of adults with intellectual disabilities known to health and social services in one local authority was surveyed to establish the extent of risky and offending behaviour. Face-to-face structured interviews established that of the 1,326 adults known to services, 348 (26%) showed risky behaviours that had been or might be construed as offences, 128 (9.7%) had a history of contact with the criminal justice system (CJS) and 38 (2.9%) had a history of criminal convictions, while 11 (0.83%) had a current conviction. Of the 84 settings surveyed, 48% had experienced caring for clients with a history of CJS contact, as had 93% of social services/health staff. There were some significant differences between private and voluntary sector residential homes and between day centres and residential settings. There were also significant differences between individuals with and without CJS contact and between those with CJS contact who had and had not been convicted. The findings have implications for the assessment and management of risk by intellectual disability services and the further education and training of care staff.

Female offenders referred for community-based mental health service as compared to other service-referred youth: correlates of conviction

Data from a large federally supported national evaluation of system-of-care community mental health services were analysed to identify correlates of conviction. Female adolescents with a reported history of criminal conviction ( n=88) were compared to three other service-referred youth groups: females without conviction histories ( n=664), males with conviction histories ( n=199), and males without conviction histories ( n=1230) for possible differences in number and type of family, individual, and school-related life challenges. Multinomial regression analyses were first used to compare the quantity of child and family correlates in each conviction group, and then to test specific correlates in the individual, family, and school domains. The conditional odds of reporting a high vs. low number of child correlates was found to be significantly greater for females with a history of conviction compared to all other groups, over and above the number of family risk factors. Further, service-referred females with a conviction history, when compared to other service-referred youth groups, were much more likely to report having experienced a living instability (e.g. history of running away, multiple living arrangements) and personal adverse life events (e.g. history of drug and alcohol use, sexual abuse). Implications for community-based interventions and treatment are discussed.

Stalking Victims Endure Severe Psychological Stress

Stalking Victims Endure Severe Psychological Stress

Assessing Violent Thoughts: The Relationship between Thought Processes and Violent Behavior

Preliminary findings from the pilot development of the Firestone Assessment of Violent Thoughts (FAVT) demonstrating significant relationships between the concept of internal voice and self-other destructive behavior are presented in this article. The “voice” is defined as a systematized, integrated pattern of negative thoughts, accompanied by angry affect, that is the basis of an individual’s maladaptive behavior toward the self and others. This study applied the theoretical construct of the voice to the development of the FAVT—item identification and selection, subscale construction. Five hundred seventy-six participants made up the pilot sample (incarcerated, parolee, outpatient, and non-clinical participants). A hierarchical logistic regression using the FAVT subscales, demographic variables, and history of criminal convictions is presented. Results of this analysis revealed significant predictive power beyond demographic and background descriptors and history of criminal and violent behavior after adding the FAVT to the model. This paper also addresses the utility of the voice concept in addressing violence potential as well as its utility in addressing prevention, as opposed to the more traditional focus on the risk management of individuals with a history of violent behavior.

Dual Diagnosis Patients in the Modified Therapeutic Community

ABSTRACT The efficacy of the drug-free therapeutic community (TC) in treating patients with chemical dependence and in rehabilitating persons with criminal histories has been extensively studied and is well established since the late 1960's. More recently, this format has been modified in order to treat individuals suffering from both addictive disorders and chronic, severe mental illness. In an indigent inner-city population, this latter group includes many patients who also have significant histories of criminal behavior. To date, there have been no systematic attempts to assess the impact of a history of criminality on the course of treatment of these patients, as they might be thought less adaptable to the milieu of a TC. In the current study, data from a sample of homeless male MICA patients were analyzed to determine if those patients with a history of criminal convictions were as likely as non-criminal patients to adjust effectively to the social milieu of a modified drug-free therapeutic community. Of 183 sequential admissions studied, 76 had never been convicted of a crime, 46 had 1 conviction, and 61 had 2 or more. No differences were observed between the groups with respect to length of stay, social adjustment on admission, and change in social adjustment during the first two months of treatment. These findings suggest that a history of criminal conduct does not compromise a dually diagnosed patient's likelihood of engaging in the social contract necessary for successful treatment in a TC.

Emergency Department Patients With Assault Injuries: Previous Injury and Assault Convictions

Study objective: To compare the incidence of previous assault injury and assault conviction of patients presenting to the ED with assault injuries and the incidence of assault injury and conviction in nonassaulted control patients. Methods: We conducted a retrospective, medical record–based case-control study of ED patients with assault injuries and matched controls presenting with medical and surgical problems unrelated to assault. The setting was the ED of a 900-bed teaching hospital and Level I trauma center in an urban area. Our subjects were 50 patients who presented as victims of blunt trauma, 50 patients who presented with penetrating trauma, and 100 control subjects matched by age, sex, and ZIP code who presented concurrently with nonassault complaints. Results: The overall rate of previous assault injury was 35% and did not differ between cases and controls. Fifty-three patients had a history of criminal conviction, and 23 had a history of conviction for assault. Fewer patients presenting with assault injuries than controls had a history of conviction for assault (odds ratio [OR], .3; P<.02). Patients with penetrating injuries had the lowest incidence of assault conviction (OR, .13; P<.02). The subgroup of case subjects with criminal records had a higher rate of previous injury than those without records ( P<.003). Conclusion: ED patients with assault injuries did not have a history of assault injuries exceeding that of controls and were less likely to have been convicted of assault. Violence-prevention programs should be directed toward a broader population of ED patients instead of narrowly focusing on victims of assault. [Moscovitz H, Degutis L, Bruno GR, Schriver J: Emergency department patients with assault injuries: Previous injury and assault convictions. Ann Emerg Med June 1997; 29:770-775.]