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Gu H, Yu W, Cheng Y. Pattern of non-suicidal self-injury in Chinese male prisoners: A latent class analysis. J Clin Psychol 2024; 80:86-96. [PMID: 37705343 DOI: 10.1002/jclp.23595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/25/2023] [Accepted: 09/06/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVES Nonsuicidal self-injury (NSSI) occurs more frequently in the prisoner population than in the general population. Monitoring and management of this behavior is challenging because NSSI may present in diverse ways. People often use more than one method of NSSI, and there are many possible combinations of these behaviors. We used latent class analysis (LCA) to identify subgroups of male inmates based on methods and frequency of NSSI. METHODS A total of 1042 male prisoners in China (Mage = 38.45, SD = 10.67) completed measures of hopelessness, sensation seeking, identity integration, and suicidal ideation, and NSSI was assessed in a structured interview. RESULTS Results of the LCA supported a three-class model: high-NSSI (1.8%), moderate-NSSI (8.0%), and no-or-negligible NSSI (90.2%). Multinomial logistic regression analyses showed that prisoners in the high-NSSI and moderate-NSSI classes were significantly more likely than those in the no-or-negligible NSSI class to show high hopelessness, high sensation seeking, and low identity. Furthermore, suicidal ideation was significantly higher in the high-NSSI and moderate-NSSI classes than in the no-or-negligible NSSI class. CONCLUSIONS Classifying groups of prisoners based on features of NSSI is potentially useful for understanding risk factors and for developing tailored prevention and treatment strategies.
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Affiliation(s)
- Honglei Gu
- Department of Psychology, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Weiming Yu
- Department of Psychology, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Yufang Cheng
- Department of Psychology, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
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2
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Pedrola-Pons A, Sanchez-Carro Y, Pemau A, Garcia-Ramos A, De la Torre-Luque A. Efficiency of psychological interventions in the prevention of suicidal behavior and self-injury in penitentiary population: A systematic review. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2024; 92:101948. [PMID: 38219472 DOI: 10.1016/j.ijlp.2023.101948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Suicidal behavior is an important public health problem, with a high prevalence in penitentiary context. Nowadays, there is a wide variety of specific treatment programs, aimed to prevent suicidal and self-injurious behavior in incarcerated people. These programs show relative efficiency depending on the model of the psychological intervention applied. This systematic review evaluates the efficiency of suicidal and self-injurious behavior prevention programs in prisons. METHOD Empirical studies, evaluating prevention programs for suicidal and self-injurious behavior in penitentiary context were considered for inclusion. PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) directives were followed. Studies from 1990 to 2022 were reviewed, based on the review developed by Winicov (2019) that covered the time lapse between 1990 and 2015. Articles from 2015 to 2022 were located by database research (EBSCOHost, ScienceDirect, PubMed & ProQuest). RESULTS 44,050 potential studies were identified. Eighteen were included in this systematic review (9 studies by Winicov, 2019). 14 studies showed efficacy of intervention programs on self-injury behavior. The use of Cognitive Behavioral Therapy (CBT) reduced suicidal ideation. In addition, positive results were observed in 3 studies using third-generation therapies as an intervention. CONCLUSIONS Suicidal and self-injurious behavior in prison shows lower levels of incidence when specific treatment programs are applied. It's crucial to increase the evaluation in relation to the implementation of new treatment models (i.e., Dialectical Behavior Therapy - DBT, Acceptance and Commitment Therapy - ACT, Mindfulness, Functional Analytic Psychotherapy - FAP) as to better orientate prevention strategies. Further research is needed in gender sensitive interventions.
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Affiliation(s)
- Anna Pedrola-Pons
- Valencian International University, Spain; Institute of Social Work and Social Services (INTRESS), Spain
| | - Yolanda Sanchez-Carro
- Center for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute, Spain
| | | | | | - Alejandro De la Torre-Luque
- Complutense University of Madrid, Spain; Center for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute, Spain
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3
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Zhang J, Zheng Z, Wang L, Luberto CM, Sophie Zhang M, Wen Y, Su Q, Jiao C. Effectiveness of a 4-Day Mindfulness-Based Intervention in a 2-Month Follow-Up for Chinese Incarcerated People. Behav Ther 2022; 53:981-994. [PMID: 35987553 DOI: 10.1016/j.beth.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 03/26/2022] [Accepted: 04/05/2022] [Indexed: 11/02/2022]
Abstract
Mindfulness-based interventions, an evidence-based stress reduction approach, may help incarcerated people cope with stress-related problems in the challenging environment of prison. However, due to their unique living environment, the duration and instructor guidance required by standard mindfulness-based interventions would be infeasible in most prisons. Therefore, the aims of the current study were to test the effects of two different 4-day interventions (i.e., instructor-guided and audio-based) with content similar to Mindfulness-Based Cognitive Therapy for newly incarcerated males, and to compare the effectiveness of the two interventions relative to a no-intervention control group. Using daily assessments, we explored changes in perceived stress, insomnia, and negative affect in the 56 days following the instructor-guided (N = 25), audio-based (N = 21), and control (N = 44) intervention; length of mindfulness practice during the follow-up was also compared between the two intervention groups. Hierarchical linear model results showed significantly greater linear decreases in perceived stress after both mindfulness interventions during the 56-day follow-up (γ11 = -0.011, p < .001, 95% CI [-0.017, -0.004] for instructor-guided intervention; γ12 = -0.013, p < .001, 95% CI [-0.018, -0.006] for audio-based intervention), as compared to the control group. Compared to the control group, the instructor-guided group reported a significantly greater decrease in insomnia (γ11 = -0.007, p < .001, 95% CI [-0.014, -0.002]), but the audio-based group did not (γ12 = -0.002, p = .160, 95% CI [-.007, .004]). Neither mindfulness-based intervention group reported a significantly greater decrease in negative affect compared to the control group (γ11 = -0.002, p = .170, 95% CI [-0.005, 0.001] for instructor-guided intervention; γ12 = -0.002, p = .150, 95% CI [-0.006, 0.002] for audio-based intervention). No significant difference between the two intervention groups was found in the change of outcomes (γ11 = 0.002, -0.005 and 0.000, p = .350, .130 and .390, 95% CI [-0.008, 0.011], 95% CI [-0.014, 0.004] and 95% CI [-0.004, 0.006] subsequently for perceived stress, insomnia and negative affect). Daily mindfulness practice was significantly longer for the audio-based group on the first day of follow-up (γ02 = -0.758, p < .05, 95% CI [-1.333, -0.129]), but it gradually decreased to the same amount as the instructor-guided group (t (32) = 0.051, p = .959). Short-term mindfulness interventions, either instructor-guided or audio-based, appear to be beneficial for Chinese prisoners in reducing stress. Live instruction may have potential benefit in reducing insomnia and sustaining daily practice.
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Affiliation(s)
- Jieting Zhang
- School of Psychology, Shenzhen University; The Shenzhen Humanities & Social Sciences, Key Research Bases of the Center for Mental Health, Shenzhen University.
| | | | - Lina Wang
- School of Design and Art, Beijing Institute of Technology, Zhuhai
| | | | | | - Yuhua Wen
- Dongguan Prison of Guangdong Province
| | - Qi Su
- Dongguan Prison of Guangdong Province
| | - Can Jiao
- School of Psychology, Shenzhen University; The Shenzhen Humanities & Social Sciences, Key Research Bases of the Center for Mental Health, Shenzhen University.
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D'Souza S, Lane R, Jacob J, Livanou M, Riches W, Rogers A, Ullman R, Rashid A, Singleton R, Wheeler J, Bevington D, Deighton J, Fonagy P, Fuggle P, Law D, Edbrooke-Childs J. Realist Process Evaluation of the implementation and impact of an organisational cultural transformation programme in the Children and Young People's Secure Estate (CYPSE) in England: study protocol. BMJ Open 2021; 11:e045680. [PMID: 34049914 PMCID: PMC8166603 DOI: 10.1136/bmjopen-2020-045680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 05/18/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Young people in contact with the youth justice system are more likely to present with complex ongoing needs than young people in the general population. To address this, the Framework for Integrated Care (SECURE STAIRS) is being implemented in the Children and Young People's Secure Estate: a 'whole systems' approach to support secure settings to develop trauma-informed and relationally based environments, supporting staff to provide consistent, therapeutic care. This paper aims to present the protocol for a national cohort study examining the impact and implementation of this cultural transformation programme. METHODS AND ANALYSIS A mixed-methods realist evaluation will be conducted. Data collection will take place between August 2018 and December 2020. Eighteen sites will collect routine service activity data and questionnaires completed by young people, parents/guardians and staff. Semi-structured interviews and non-participant observations will be conducted across five qualitative focus sites with young people and staff. An economic evaluation will examine value for money. The results will be triangulated at the analysis stage to gain an in-depth understanding of experiences. ETHICS AND DISSEMINATION Ethical approval was granted by the Health Research Authority, Her Majesty's Prison and Probation Service and UCL Ethics Committee. Findings will be disseminated via project reports, site feedback, peer-reviewed journal publications and conference presentations.
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Affiliation(s)
- Sophie D'Souza
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
- Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Rebecca Lane
- Department of Clinical, Educational and Health Psychology, UCL, London, UK
- Anna Freud Centre, London, UK
| | - Jenna Jacob
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
- Department of Clinical, Educational and Health Psychology, UCL, London, UK
- Anna Freud Centre, London, UK
| | - Maria Livanou
- Anna Freud Centre, London, UK
- Department of Psychology, Kingston University, Kingston-Upon-Thames, UK
| | | | | | | | - Anisatu Rashid
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
- Department of Clinical, Educational and Health Psychology, UCL, London, UK
- Anna Freud Centre, London, UK
| | - Rosie Singleton
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
- Anna Freud Centre, London, UK
| | | | | | - Jessica Deighton
- Department of Clinical, Educational and Health Psychology, UCL, London, UK
- Anna Freud Centre, London, UK
| | - Peter Fonagy
- Department of Clinical, Educational and Health Psychology, UCL, London, UK
- Anna Freud Centre, London, UK
| | | | - Duncan Law
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
- Anna Freud Centre, London, UK
- MindMonkey Associates Ltd, London, UK
| | - Julian Edbrooke-Childs
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
- Department of Clinical, Educational and Health Psychology, UCL, London, UK
- Anna Freud Centre, London, UK
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Castillo-Eito L, Armitage CJ, Norman P, Day MR, Dogru OC, Rowe R. How can adolescent aggression be reduced? A multi-level meta-analysis. Clin Psychol Rev 2020; 78:101853. [PMID: 32402919 DOI: 10.1016/j.cpr.2020.101853] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 02/27/2020] [Accepted: 04/09/2020] [Indexed: 12/12/2022]
Abstract
Aggressive behaviour among adolescents has significant social and economic costs. Numerous attempts have been made to intervene to reduce aggression in adolescents. However, little is known about what factors enhance or diminish intervention effectiveness. The present systematic review and meta-analysis, therefore, seeks to quantify the effectiveness of interventions to reduce aggressive behaviour in adolescents and to identify when and for whom such interventions work best. Sixteen databases were searched for randomised controlled trials that assessed interventions to reduce aggression among adolescents. After screening 9795 records, 95 studies were included. A multi-level meta-analysis found a significant overall small-to-medium effect size (d = 0.28; 95% CI [0.17, 0.39]). More effective interventions were of shorter duration, were conducted in the Middle East, were targeted at adolescents with higher levels of risk, and were facilitated by intervention professionals. Potentially active ingredients were classified using the Behaviour Change Technique Taxonomy. Behavioural practice and problem solving were components of more effective interventions targeted at the general population. Overall the findings indicate that psychosocial interventions are effective in reducing adolescent aggression. Future trials need to assess the effect of individual techniques and their combination to identify the key components that can reduce aggression in adolescents.
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Affiliation(s)
- Laura Castillo-Eito
- Department of Psychology, The University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield S1 2LT, United Kingdom.
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, M13 9PL, United Kingdom; Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9PL, United Kingdom.
| | - Paul Norman
- Department of Psychology, The University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield S1 2LT, United Kingdom.
| | - Marianne R Day
- Department of Psychology, The University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield S1 2LT, United Kingdom.
| | - Onur C Dogru
- Department of Psychology, The University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield S1 2LT, United Kingdom.
| | - Richard Rowe
- Department of Psychology, The University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield S1 2LT, United Kingdom.
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A systematic review of behavioral health interventions for suicidal and self-harming individuals in prisons and jails. Heliyon 2019; 5:e02379. [PMID: 31517115 PMCID: PMC6734330 DOI: 10.1016/j.heliyon.2019.e02379] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 05/24/2019] [Accepted: 08/23/2019] [Indexed: 11/20/2022] Open
Abstract
This article reviews evaluation studies of interventions aimed at preventing and reducing incidents of suicide and self-harm among incarcerated individuals. Study design, sample characteristics, intervention procedures, study measures, and relevant results of each study are reviewed. The outcomes of interest include severity and frequency of self-harm episodes and suicidal ideation, scores on adaptive coping methods, scoring on the Beck Hopelessness scale and risk scores. The six evaluated studies are peer-reviewed, published between 1990 and 2015, and took place in the United States, the United Kingdom, and Pakistan. Treatment modalities widely vary across studies and include cognitive behavioral therapy, dialectical behavioral therapy, peer programming, staff intervention training, and uniquely-designed courses that incorporate various aspects from other treatment modalities. Due to the nature of the studies, only one multi-randomized controlled trial was identified. All identified studies had a pre- and post-treatment design either lacking a comparison group or containing 1–2 comparison groups and conduct follow-up of varying times. While Cognitive Behavioral Therapy (CBT) interventions and uniquely-tailored intervention programs suggest promising results, the general absence of comparison groups, the shortage of relevant evaluation studies and the inconsistency of behavioral outcome measurements compromise the capacity of this review. Further, definitional variances, particularly for self-injury (self-harm, non-suicidal self-injury [NSSI], deliberate self-harm, suicidal behavior, etc.) affect the ability to synthesize study results. This article aims to synthesize the literature results to identify the most effective interventions that would benefit from additional research.
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Yoon IA, Slade K, Fazel S. Outcomes of psychological therapies for prisoners with mental health problems: A systematic review and meta-analysis. J Consult Clin Psychol 2017; 85:783-802. [PMID: 28569518 PMCID: PMC5518650 DOI: 10.1037/ccp0000214] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Prisoners worldwide have substantial mental health needs, but the efficacy of psychological therapy in prisons is unknown. We aimed to systematically review psychological therapies with mental health outcomes in prisoners and qualitatively summarize difficulties in conducting randomized clinical trials (RCTs). METHOD We systematically identified RCTs of psychological therapies with mental health outcomes in prisoners (37 studies). Effect sizes were calculated and meta-analyzed. Eligible studies were assessed for quality. Subgroup and metaregression analyses were conducted to examine sources of between-study heterogeneity. Thematic analysis reviewed difficulties in conducting prison RCTs. RESULTS In 37 identified studies, psychological therapies showed a medium effect size (0.50, 95% CI [0.34, 0.66]) with high levels of heterogeneity with the most evidence for CBT and mindfulness-based trials. Studies that used no treatment (0.77, 95% CI [0.50, 1.03]) or waitlist controls (0.71, 95% CI [0.43, 1.00]) had larger effect sizes than those that had treatment-as-usual or other psychological therapies as controls (0.21, 95% CI [0.01, 0.41]). Effects were not sustained on follow-up at 3 and 6 months. No differences were found between group and individual therapy, or different treatment types. The use of a fidelity measure was associated with lower effect sizes. Qualitative analysis identified difficulties with follow-up and institutional constraints on scheduling and implementation of trials. CONCLUSIONS CBT and mindfulness-based therapies are modestly effective in prisoners for depression and anxiety outcomes. In prisons with existing psychological therapies, more evidence is required before additional therapies can be recommended. (PsycINFO Database Record
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Affiliation(s)
| | - Karen Slade
- Division of Psychology, Nottingham Trent University
| | - Seena Fazel
- Department of Psychiatry, University of Oxford
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Young S, Greer B, Church R. Juvenile delinquency, welfare, justice and therapeutic interventions: a global perspective. BJPsych Bull 2017; 41:21-29. [PMID: 28184313 PMCID: PMC5288089 DOI: 10.1192/pb.bp.115.052274] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 02/15/2016] [Accepted: 04/07/2016] [Indexed: 11/23/2022] Open
Abstract
This review considers juvenile delinquency and justice from an international perspective. Youth crime is a growing concern. Many young offenders are also victims with complex needs, leading to a public health approach that requires a balance of welfare and justice models. However, around the world there are variable and inadequate legal frameworks and a lack of a specialist workforce. The UK and other high-income countries worldwide have established forensic child and adolescent psychiatry, a multifaceted discipline incorporating legal, psychiatric and developmental fields. Its adoption of an evidence-based therapeutic intervention philosophy has been associated with greater reductions in recidivism compared with punitive approaches prevalent in some countries worldwide, and it is therefore a superior approach to dealing with the problem of juvenile delinquency.
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Affiliation(s)
- Susan Young
- Imperial College London, London, UK
- Broadmoor Hospital, Crowthorne, UK
| | | | - Richard Church
- South London and Maudsley NHS Foundation Trust, London, UK
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Kok L, van der Waa A, Klip H, Staal W. The effectiveness of psychosocial interventions for children with a psychiatric disorder and mild intellectual disability to borderline intellectual functioning: A systematic literature review and meta-analysis. Clin Child Psychol Psychiatry 2016; 21:156-71. [PMID: 25633367 DOI: 10.1177/1359104514567579] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children with intellectual disability frequently have difficulties in adapting to their environment. The extent of the experienced problems does not only depend on cognitive functioning but is influenced by other factors, such as the presence of a psychiatric disorder or other brain disorders, or adverse environmental factors. Several epidemiological studies show that children with intellectual disabilities are at an increased risk to develop psychiatric disorders. This is also true for youth with a mild intellectual disability and even those with borderline intellectual functioning (mild to borderline intellectual disability (MBID)). Psychiatric disorders are often overlooked because behavioral problems are rather attributed to the intellectual disability. Consequently, effective psychiatric interventions, which are needed to improve the level of functioning, are not applied. This review aimed to systematically evaluate the currently available, qualitatively sound research concerning the effectiveness of psychosocial interventions, specifically directed at psychiatric disorders in children with MBID. Assessed for eligibility were 1409 unique reports, and the review ultimately included only 12 reports. Review of the results and meta-analyses showed that the majority of studies suffer from multiple limitations and that methodological variations between studies are extensive. This possibly reflects the high variance of factors that may be involved in MBID. It will be important in future research to address multi-causality.
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Affiliation(s)
- Lidwien Kok
- Department of Mild Intellectual Disabilities, Karakter Child and Adolescent Psychiatry, The Netherlands
| | - Anne van der Waa
- Department of Mild Intellectual Disabilities, Karakter Child and Adolescent Psychiatry, The Netherlands
| | - Helen Klip
- Karakter Child and Adolescent Psychiatry University Centre, The Netherlands
| | - Wouter Staal
- Karakter Child and Adolescent Psychiatry University Centre, The Netherlands Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, The Netherlands
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Richardson R, Trépel D, Perry A, Ali S, Duffy S, Gabe R, Gilbody S, Glanville J, Hewitt C, Manea L, Palmer S, Wright B, McMillan D. Screening for psychological and mental health difficulties in young people who offend: a systematic review and decision model. Health Technol Assess 2015; 19:1-128. [PMID: 25580671 DOI: 10.3310/hta19010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND There is policy interest in the screening and treatment of mental health problems in young people who offend, but the value of such screening is not yet known. OBJECTIVES To assess the diagnostic test accuracy of screening measures for mental health problems in young people who offend; to evaluate the clinical effectiveness and cost-effectiveness of screening and treatment; to model estimates of cost; to assess the evidence base for screening against UK National Screening Committee criteria; and to identify future research priorities. DATA SOURCES In total, 25 electronic databases including MEDLINE, PsycINFO, EMBASE and The Cochrane Library were searched from inception until April 2011. Reverse citation searches of included studies were undertaken and reference list of included studies were examined. REVIEW METHODS Two reviewers independently examined titles and abstracts and extracted data from included studies using a standardised form. The inclusion criteria for the review were (1) population - young offenders (aged 10-21 years); (2) intervention/instrument - screening instruments for mental health problems, implementation of a screening programme or a psychological or pharmacological intervention as part of a clinical trial; (3) comparator - for diagnostic test accuracy studies, any standardised diagnostic interview; for trials, any comparator; (4) outcomes - details of diagnostic test accuracy, mental health outcomes over the short or longer term or measurement of cost data; and (5) study design - for diagnostic test accuracy studies, any design; for screening programmes, randomised controlled trials or controlled trials; for clinical effectiveness studies, randomised controlled trials; for economic studies, economic evaluations of screening strategies or interventions. RESULTS Of 13,580 studies identified, nine, including eight independent samples, met the inclusion criteria for the diagnostic test accuracy and validity of screening measures review. Screening accuracy was typically modest. No studies examined the clinical effectiveness of screening, although 10 studies were identified that examined the clinical effectiveness of interventions for mental health problems. There were too few studies to make firm conclusions about the clinical effectiveness of treatments in this population. No studies met the inclusion criteria for the assessment of the cost-effectiveness of screening or treatment. An exemplar decision model was developed for depression, which identified a number of the likely key drivers of uncertainty, including the prevalence of unidentified mental health problems, the severity of mental health problems and their relationship to generic measures of outcome and the impact of treatment on recidivism. The information evaluated as part of the review was relevant to five of the UK National Screening Committee criteria. On the basis of the above results, none of the five criteria was met. LIMITATIONS The conclusions of the review are based on limited evidence. Conclusions are tentative and the decision model should be treated as an exemplar. CONCLUSIONS Evidence on the clinical effectiveness and cost-effectiveness of screening for mental health problems in young people who offend is currently lacking. Future research should consider feasibility trials of clinical interventions to establish important parameters ahead of conducting definitive trials. Future diagnostic studies should compare the diagnostic test accuracy of a range of screening instruments, including those recommended for use in the UK in this population. These studies should be designed to reduce the decision uncertainty identified by the exemplar decision model. REGISTRATION This study is registered as PROSPERO CRD42011001466. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
| | - Dominic Trépel
- Department of Health Sciences, University of York, York, UK
| | - Amanda Perry
- Department of Health Sciences, University of York, York, UK
| | - Shehzad Ali
- Department of Health Sciences, University of York, York, UK
| | | | - Rhian Gabe
- Department of Health Sciences, University of York, York, UK
| | - Simon Gilbody
- Department of Health Sciences, University of York, York, UK
| | | | | | - Laura Manea
- Department of Health Sciences, University of York, York, UK
| | - Stephen Palmer
- Centre for Health Economics, University of York, York, UK
| | - Barry Wright
- Department of Health Sciences, University of York, York, UK
| | - Dean McMillan
- Department of Health Sciences, University of York, York, UK
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Zhou J, Witt K, Zhang Y, Chen C, Qiu C, Cao L, Wang X. Anxiety, depression, impulsivity and substance misuse in violent and non-violent adolescent boys in detention in China. Psychiatry Res 2014; 216:379-84. [PMID: 24612970 DOI: 10.1016/j.psychres.2014.01.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 01/12/2014] [Accepted: 01/16/2014] [Indexed: 11/26/2022]
Abstract
The present investigation aims to identify the factors which differentiate violent from non-violent juvenile offenders, with a particular emphasis on the association between internalizing psychiatric morbidity (i.e. anxiety and depression), impulsivity, substance misuse, and violence. A total of 323 incarcerated male juvenile offenders from one of three Youth Detention Centers (YDCs) in China were recruited between August 2007 and November 2008. Interviews were conducted by trained psychiatrists using the Barratt Impulsivity Scale (BIS-11), the Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Birleson Depression Self-Rating Scale (DSRS) to assess impulsivity, anxiety and depression, respectively. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) was also used to assess psychiatric diagnoses. Violent offenders had significantly higher BIS-11 total scores, and attention and nonplanning subscale scores (p<0.05). In the multiple logistic regression model, substance use disorders (SUD) and BIS-11 total scores independently predicted violence. Prison-based treatment services designed to reduce impulsivity and substance misuse in juvenile detention facilities should be prioritized.
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Affiliation(s)
- Jiansong Zhou
- Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, Shanghai 200063, China; Mental Health Institute, Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Number 139 Renming Road, Changsha, Hunan 410011, China
| | - Katrina Witt
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK
| | - Yingdong Zhang
- Mental Health Institute, Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Number 139 Renming Road, Changsha, Hunan 410011, China
| | - Chen Chen
- Mental Health Institute, Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Number 139 Renming Road, Changsha, Hunan 410011, China
| | - Changjian Qiu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Liping Cao
- Guangzhou Psychiatric Hospital, 36 Mingxin Road, Guangzhou 510370, China
| | - Xiaoping Wang
- Mental Health Institute, Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Number 139 Renming Road, Changsha, Hunan 410011, China.
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