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Rao R(T. Editorial. ADVANCES IN DUAL DIAGNOSIS 2022. [DOI: 10.1108/add-11-2022-049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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2
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Keulen-de Vos M, de Klerk A. Dutch forensic patients with and without intellectual disabilities: A comparison of demographic, offence, and diagnostic characteristics. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 126:104255. [PMID: 35504124 DOI: 10.1016/j.ridd.2022.104255] [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: 08/30/2021] [Revised: 04/25/2022] [Accepted: 04/25/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Patients with an intellectual disability (ID) and offending histories constitute a challenging clinical group. The present study examined commonalities and differences in demographic, diagnostic and offence characteristics in patients with and without intellectual disabilities who were either convicted for violent or sexual offences and who resided in mandated care in the Netherlands. METHOD We compared 165 offenders with an ID to 249 offenders without an ID. We compared both groups by type of offence (i.e., sexual versus violent offence) using Mann-Whitney U-test or independent samples t-tests for continuous variables and Chi-square tests for categorical variables. RESULTS In general, forensic patients with an ID were younger at admission (U=357, z = -12.668, p < .001), had more prior convictions for violent offences (χ2(1)= 6.175, p = .013) and more prevalent diagnoses of substance abuse disorders (χ2(1)= 9.266, p = .002) than those without an ID. Similar results were found for patients with IDs with sexual offence histories. CONCLUSION A clear understanding of distinct characteristics of forensic patients with intellectual disabilities is crucial in understanding (sexual) violent behavior in this population as it mayassistclinicians in prioritizing interventionstrategies.
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Affiliation(s)
- Marije Keulen-de Vos
- Forensic Psychiatric Centre de Rooyse Wissel, Venray, The Netherlands; Radboud University, Faculty of Social Sciences, Nijmegen, The Netherlands.
| | - Anke de Klerk
- Forensic Psychiatric Centre de Rooyse Wissel, Venray, The Netherlands
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3
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Edberg H, Chen Q, Andiné P, Larsson H, Hirvikoski T. Criminal recidivism in offenders with and without intellectual disability sentenced to forensic psychiatric care in Sweden-A 17-year follow-up study. Front Psychiatry 2022; 13:1011984. [PMID: 36213925 PMCID: PMC9533124 DOI: 10.3389/fpsyt.2022.1011984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Offenders with intellectual disability (ID) constitute a distinct subgroup of offenders with mental disorders. Regarding criminal recidivism, it is unclear whether or not offenders with ID in forensic psychiatric settings differ from offenders without ID. Factors associated with criminal recidivism among offenders with ID have been scarcely investigated. AIM To investigate the association between ID and criminal recidivism among offenders sentenced to forensic psychiatric care and to explore the impact of clinical, sociodemographic and offense variables. MATERIALS AND METHODS We conducted a retrospective cohort study based on Swedish nationwide registers. A total of 3,365 individuals being sentenced to forensic psychiatric care in Sweden in 1997-2013 were followed from the forensic psychiatric assessment until first reconviction, death, emigration, or 31 December 2013, whichever occurred first. Cox regression models compared rates of recidivism in individuals with and without ID. Impact of clinical, sociodemographic, and offense variables on risk of criminal recidivism was presented as hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS Out of 3,365 offenders sentenced to forensic psychiatric care, 259 (7.7%) were diagnosed with ID. During follow-up (0-17 years, median 6 years), one third (n = 1,099) of the study population relapsed into criminality, giving a recidivism rate of 50.5 per 1,000 person-years. We observed an association between ID and a decreased risk of recidivism (HR 0.8, 95% CI 0.6-1.0, p = 0.063), although this reached statistical significance only for the subgroup of male offenders (HR 0.8, 95% CI 0.6-1.0, p = 0.040) and not females (HR 1.0, 95% CI 0.6-1.8). ID offenders with concurrent ADHD tended to have a higher rate of recidivism (73.9 per 1,000 person-years, HR 1.2, 95% CI 0.6-2.4) than ID offenders without ADHD (42.5 per 1,000 person-years, HR 0.8, 95% CI 0.6-1.1). Amongst ID offenders, concurrent autism spectrum disorder, young age or male sex were not associated with recidivism, while previous criminal convictions were strongly associated with recidivism. CONCLUSION A diagnosis of ID was associated with a lower risk of criminal recidivism among male offenders sentenced to forensic psychiatric care. The association between ADHD and recidivism among ID offenders highlights eligible focus areas in the management of offenders with ID.
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Affiliation(s)
- Hanna Edberg
- Paediatric Neuropsychiatry Unit, Department of Women's and Children's Health, Centre for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Stockholm, Sweden.,Swedish Prison and Probation Services, Norrköping, Sweden.,Northern Stockholm Psychiatric Clinic, Region Stockholm, Stockholm, Sweden.,Centre for Psychiatry Research, Region Stockholm, Stockholm, Sweden
| | - Qi Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Peter Andiné
- Centre for Ethics, Law and Mental Health (CELAM), Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Tatja Hirvikoski
- Paediatric Neuropsychiatry Unit, Department of Women's and Children's Health, Centre for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Stockholm, Sweden.,Centre for Psychiatry Research, Region Stockholm, Stockholm, Sweden.,Habilitation & Health, Region Stockholm, Stockholm, Sweden
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Moulden HM, Mamak M, Chaimowitz G. A preliminary evaluation of the effectiveness of dialectical behaviour therapy in a forensic psychiatric setting. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2020; 30:141-150. [PMID: 32483870 DOI: 10.1002/cbm.2158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 12/09/2019] [Accepted: 05/09/2020] [Indexed: 06/11/2023]
Abstract
Dialectical behaviour therapy (DBT) is a therapy model incorporating elements of Eastern philosophies and cognitive behavioural principles. Originally designed for people struggling with chronic suicidality and borderline personality disorder (BPD), it has been adapted to treat complex, multi-diagnostic presentations, such as those in forensic mental health settings. To date, there has been little evaluation when the primary diagnosis is of psychosis. To explore the effectiveness of DBT, with patients, with multiple comorbidities, including psychosis, in a forensic psychiatric inpatient setting. A descriptive outcome study with a cohort of offender-patients in one specialist forensic mental health unit. Before and after treatment change scores were compared on anger, aggression, hopefulness, coping abilities, emotional intelligence, insight and subjective symptom severity scales, as well as staff-rated risk, and length of stay. Nine men and five women residents in one Canadian secure hospital completed a standard DBT programme, and self-ratings, over about 1 year. Scale scores indicated significantly increased insight and acknowledgment of problems. Apparently increased anger and vengeance scores were clinically associated. Independent staff ratings indicated reductions in risk and most patients achieved early release. This study provides support for extension of the use of DBT to offender-patients with psychosis among the complex mix in their presentation. It suggests that a randomised controlled trial with cost-benefit analysis is warranted, as well as further work, to promote understanding of mechanisms of effectiveness.
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Affiliation(s)
- Heather M Moulden
- Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
| | - Mini Mamak
- Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
| | - Gary Chaimowitz
- Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
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5
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Vingerhoets C, van Oudenaren MJF, Bloemen OJN, Boot E, van Duin EDA, Evers LJM, Fiksinski AM, Breetvelt EJ, Palmer LD, Vergaelen E, Vogels A, Meijer C, Booij J, de Haan L, Swillen A, Vorstman JAS, Bassett AS, van Amelsvoort TAMJ. Low prevalence of substance use in people with 22q11.2 deletion syndrome. Br J Psychiatry 2019; 215:661-667. [PMID: 30604657 DOI: 10.1192/bjp.2018.258] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND 22q11.2 deletion syndrome (22q11DS), one of the most common recurrent copy number variant disorders, is associated with dopaminergic abnormalities and increased risk for psychotic disorders. AIMS Given the elevated prevalence of substance use and dopaminergic abnormalities in non-deleted patients with psychosis, we investigated the prevalence of substance use in 22q11DS, compared with that in non-deleted patients with psychosis and matched healthy controls. METHOD This cross-sectional study involved 434 patients with 22q11DS, 265 non-deleted patients with psychosis and 134 healthy controls. Psychiatric diagnosis, full-scale IQ and COMT Val158Met genotype were determined in the 22q11DS group. Substance use data were collected according to the Composite International Diagnostic Interview. RESULTS The prevalence of total substance use (36.9%) and substance use disorders (1.2%), and weekly amounts of alcohol and nicotine use, in patients with 22q11DS was significantly lower than in non-deleted patients with psychosis or controls. Compared with patients with 22q11DS, healthy controls were 20 times more likely to use substances in general (P < 0.001); results were also significant for alcohol and nicotine use separately. Within the 22q11DS group, there was no relationship between the prevalence of substance use and psychosis or COMT genotype. Male patients with 22q11DS were more likely to use substances than female patients with 22q11DS. CONCLUSIONS The results suggest that patients with 22q11DS are at decreased risk for substance use and substance use disorders despite the increased risk of psychotic disorders. Further research into neurobiological and environmental factors involved in substance use in 22q11DS is necessary to elucidate the mechanisms involved. DECLARATION OF INTEREST None.
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Affiliation(s)
- Claudia Vingerhoets
- Psychologist, Postdoctoral Researcher, Department of Psychiatry and Psychology, Maastricht University; and Department of Nuclear Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Mathilde J F van Oudenaren
- Psychologist, Research Assistant, Department of Nuclear Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Oswald J N Bloemen
- Psychiatrist, Senior Researcher, Department of Psychiatry and Psychology, Maastricht University; and Center for Mental Health Care Innova, GGz Centraal, the Netherlands
| | - Erik Boot
- Specialist in Intellectual Disability Medicine, Honorary Researcher, Department of Nuclear Medicine, Academic Medical Center, Amsterdam; S Heeren Loo Zorggroep; Department of Psychiatry and Psychology, Maastricht University, the Netherlands; The Dalglish Family 22q Clinic and Centre for Mental Health, University Health Network; Department of Psychiatry, University of Toronto; and Clinical Genetics Research Program, Centre for Addiction and Mental Health, Ontario, Canada
| | - Esther D A van Duin
- Department of Psychiatry and Psychology, Maastricht University; and Department of Nuclear Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Laurens J M Evers
- Psychiatrist, Department of Psychiatry and Psychology, Maastricht University, the Netherlands
| | - Ania M Fiksinski
- Psychologist, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands; and The Dalglish Family 22q Clinic and Centre for Addiction and Mental Health, Canada
| | - Elemi J Breetvelt
- Child Psychiatrist, Epidemiologist, The Dalglish Family 22q Clinic and Centre for Addiction and Mental Health, Canada
| | - Lisa D Palmer
- Social Worker, The Dalglish Family 22q Clinic and Centre for Addiction and Mental Health, Canada
| | - Elfi Vergaelen
- Psychiatrist in training, Center for Human Genetics, KU Leuven, Belgium
| | - Annick Vogels
- Professor, Child Psychiatrist, Center for Human Genetics, University Hospital Gasthuisberg, Department of Human Genetics, KU Leuven, Belgium
| | - Carin Meijer
- Psychologist, Senior Researcher, Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Jan Booij
- Professor of Experimental Nuclear Medicine, Department of Nuclear Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | | | - Liewe de Haan
- Professor, Psychiatrist, Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Ann Swillen
- Professor, Center for Human Genetics, University Hospital Gasthuisberg, Department of Human Genetics, KU Leuven, Belgium
| | - Jacob A S Vorstman
- Associate Professor, Child Psychiatrist, The Hospital for Sick Children, Toronto; and University of Toronto, Canada
| | - Anne S Bassett
- Professor / Psychiatrist, The Dalglish Family 22q Clinic; Clinical Genetics Research Program, Toronto General Hospital; Centre for Addiction and Mental Health, Toronto; and Department of Psychiatry, University of Toronto, Canada
| | - Therese A M J van Amelsvoort
- Professor of Transitional Psychiatry, Psychiatrist, Department of Psychiatry and Psychology, Maastricht University, the Netherlands
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Ray I, Simpson AIF, Jones RM, Shatokhina K, Thakur A, Mulsant BH. Clinical, Demographic, and Criminal Behavior Characteristics of Patients With Intellectual Disabilities in a Canadian Forensic Program. Front Psychiatry 2019; 10:760. [PMID: 31681051 PMCID: PMC6803491 DOI: 10.3389/fpsyt.2019.00760] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 09/20/2019] [Indexed: 11/30/2022] Open
Abstract
Background: People with intellectual disability (ID) and forensic issues constitute a challenging clinical group that has been understudied in forensic settings. Methods: We assessed the characteristics of patients with ID under the authority of the Ontario Review Board (ORB) in a large forensic program of a tertiary psychiatric hospital (excluding those with a cognitive disorder) and compared their characteristics with those of a non-ID control group. Results: Among 510 adult ORB patients, 47 had an ID diagnosis. ID patients were of younger age at index offense, with a lower level of education, and were less likely to have been married or employed, more likely to have committed a sexual offense, more likely to have a diagnosis of paraphilia, less likely to be "not criminally responsible," and more likely to be "unfit to stand trial." They were also more likely to have committed their index offenses against care professionals and be treated in a secure unit. Conclusion: Our findings have major implications for clinicians, clinical leaders, and policymakers about the specific needs of patients with ID presenting with forensic issues and differing needs in terms of treatment and risk management.
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Affiliation(s)
- Ipsita Ray
- Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Alexander I F Simpson
- Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roland M Jones
- Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Anupam Thakur
- Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Benoit H Mulsant
- Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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McCarthy MJ, Behimer G, Anderson JA, Riddle I. Caregiving for youth with co-occurring developmental disabilities and behavioral health issues when caregivers face additional health-related stressors: Analysis of risk and protective factors from a national sample. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 59:399-409. [PMID: 27721195 DOI: 10.1016/j.ridd.2016.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/08/2016] [Accepted: 09/15/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Family caregivers of youth with DD and behavioral health issues experience the highest level of caregiving strain. Many must also deal with their own or another family member's chronic health condition, which may place them at additional risk for poor outcomes. AIMS (1) Provide a "snapshot" of DD family caregivers based on a national sample; (2) identify risk and protective factors among groups of DD caregivers with graduated levels of health-related stressors; (3) examine the impact of risk and protective factors on strain for DD caregivers. METHODS AND PROCEDURES We conducted a secondary analysis of data from N=600 DD caregivers recruited through sites across the United States. Risk and protective factors were compared among three groups of caregivers at study enrollment: (1) those focused on providing care for the target youth with DD, without additional health-related stressors with which to contend; (2) those contending with minor additional health-related stressors; and, (3) those contending with major additional health-related stressors. Predictors of caregiving strain at six months post-enrollment were identified. RESULTS 52% of the overall sample was unemployed and 71% were living at or below poverty. Differences were found among groups on a variety of risk and protective factors. With some exceptions, predictors of caregiving strain were similar to non-DD populations. CONCLUSIONS AND IMPLICATIONS This study provides valuable information about a population of caregivers who are highly vulnerable to poor outcomes. Findings highlight the importance of considering the needs, strengths, and outcomes of family caregivers.
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Affiliation(s)
- Michael J McCarthy
- School of Social Work, College of Allied Health Sciences, University of Cincinnati, PO Box 210108, Cincinnati, OH 45221, United States.
| | - Gretchen Behimer
- Clermont County FAST TRAC, Clermont County Mental Health and Recovery Board, 2337 Clermont Center Drive, Batavia, OH 45103, United States.
| | - Jeffrey A Anderson
- School of Education, Indiana University, W.W. Wright Education Building Room 3232, Bloomington, IN 47405, United States.
| | - Ilka Riddle
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 4002, Cincinnati, OH 45229, United States.
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Hellenbach M, Karatzias T, Brown M. Intellectual Disabilities Among Prisoners: Prevalence and Mental and Physical Health Comorbidities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:230-241. [PMID: 26775928 DOI: 10.1111/jar.12234] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Limited evidence suggests that people with ID (ID) are overrepresented in prisons although prevalence rates of ID among prisoners vary significantly across studies, making it difficult to identify prevalence and assess existing need. METHOD A systematic review of relevant literature was conducted, and results were organized and compared in relation to study aims, design, measures used to screen for ID, sample, limitations and key findings. RESULTS Existing international data suggest a prevalence of prisoners with ID between 7 and 10%. Most frequent coexisting health issues among this population are hearing and vision impairments, obesity, diabetes and a range of mental health disorders, notably anxiety and personality and conduct disorders. CONCLUSION More research is required on prevalence rates and associated comorbidities of ID within prison settings, taking into account the heterogeneity of the population with ID.
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Affiliation(s)
- Mike Hellenbach
- Faculty of Health, Life and Social Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Thanos Karatzias
- Faculty of Health, Life and Social Sciences, Edinburgh Napier University, Edinburgh, UK.,The Rivers Centre, Royal Edinburgh Hospital, NHS Lothian, Edinburgh, UK
| | - Michael Brown
- Faculty of Health, Life and Social Sciences, Edinburgh Napier University, Edinburgh, UK.,Learning Disability Service, NHS Lothian, Edinburgh, UK
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Abstract
Intellectual Disability (ID) can be caused by a variety of factors, which may lead to a variety of signs and symptoms. Individuals with ID are living in societies where during the past decade there is a steady increase in the amount of research focused on civil law, criminal law and mental health. In this chapter, there will be a theoretical presentation of the research on ID regarding criminal law and the different forms of aggressive behavior such as sexual violence, homicide, theft, arson and alcohol-drug abuse. There will be information on research regarding civil law and the most common problems for individuals with ID, such as financial capacity and capacity for medical consent. Finally, there will be a section for the most important issues regarding the trial and conviction for individuals with ID and a presentation of a recent research on attitudes toward ID and legal issues. The above will be examined through the prism of current neuropsychological data, while cross-cultural restrictions will be discussed.
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10
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Haysom L, Indig D, Moore E, Gaskin C. Intellectual disability in young people in custody in New South Wales, Australia - prevalence and markers. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:1004-1014. [PMID: 24422559 DOI: 10.1111/jir.12109] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/25/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND Intellectual disability (ID) is known to be more common in incarcerated groups, especially incarcerated youth. Aboriginal young people have higher rates of ID, and make up half of all youth in juvenile custody in New South Wales (NSW), Australia. We aimed to describe the prevalence of possible ID and borderline intellectual functioning (BIF) in young people in NSW custody, and to describe the association between possible ID and Aboriginality after adjusting for the inequalities in social disadvantage. METHODS Baseline study of all youth in NSW Custodial Centres between August and October 2009, with 18-month follow-up. Using Wechsler Intelligence Scale for Children - Fourth Edition (WISC-IV) and Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV) cognitive assessments, possible ID was defined as Extremely Low Intellectual Quotient range (Full Scale Intellectual Quotient, FSIQ < 70), and possible BIF was defined as Borderline IQ range (FSIQ < 80). Risk factors for possible ID and BIF included age, gender, Aboriginality, socio-economic disadvantage, offending history and psychological disorders. RESULTS N = 295 (65%) of all young people in NSW custody completed cognitive and psychological assessments (87% male, 50% Aboriginal, average age 17 years). Almost one half (45.8%) of young people had borderline or lower intellectual functioning (by IQ assessment), and 14% had an IQ in the extremely low range (FSIQ < 70), indicating a possible ID. Aboriginal participants were three times more likely than non-Aboriginal participants to have a possible ID, but after accounting for the excess disadvantage in the Aboriginal group, Aboriginality was no longer a marker of ID. Incarceration from a young age and psychosis were significantly associated with possible ID in Aboriginal participants, compared with Aboriginal participants first incarcerated at a later age, and Aboriginal participants without psychosis. CONCLUSION The inequalities in criminal justice between Aboriginal and non-Aboriginal youth may exacerbate or contribute to the intellectual impairment of those incarcerated from a young age. Aboriginal young people with psychosis are also at high risk of cognitive impairments that might indicate a possible co-morbid ID, and these patients should be diverted at court into community assessment services, rather than incarcerated. These results highlight a need for better and earlier identification of young people (particularly Aboriginal youth) at risk of ID and other co-morbidities in the juvenile justice system.
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Affiliation(s)
- L Haysom
- Adolescent Health, Justice Health & Forensic Mental Health Network, Sydney, NSW, Australia
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11
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Lindsay WR, Carson D, Holland AJ, Taylor JL, O'Brien G, Wheeler JR, Steptoe L. Alcohol and its relationship to offence variables in a cohort of offenders with intellectual disability. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2013; 38:325-331. [PMID: 24279785 DOI: 10.3109/13668250.2013.837154] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Alcohol use and misuse may be lower in people with intellectual disability (ID) than in the general population but may be related to offending. METHOD Alcohol-related crime and history of alcohol use was recorded in 477 participants with ID referred to forensic ID services and related to offending. RESULTS Level of alcohol-related crime and history of alcohol misuse was lower than in some previous studies at 5.9% and 20.8%, respectively. History of alcohol abuse was associated with alcohol-related offences and theft. Higher rates of alcohol problem history were associated with histories of a number of offences, psychiatric disturbance in adulthood, psychiatric disturbance in childhood, and experiences of childhood adversity. Most effect sizes were weak or moderate. CONCLUSIONS The convergence of childhood adversity, psychiatric problems in childhood and adulthood, and alcohol abuse is consistent with studies that have found these as risk markers for offending.
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12
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Vinkers DJ. Pre-Trial Reported Defendants in the Netherlands with Intellectual Disability, Borderline and Normal Intellectual Functioning. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2013; 26:357-61. [PMID: 23925958 DOI: 10.1111/jar.12030] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 01/21/2013] [Indexed: 11/28/2022]
Affiliation(s)
- David J. Vinkers
- Netherlands Institute for Forensic Psychiatry and Psychology; Rotterdam Netherlands
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13
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Lindsay WR, Carson D, Holland AJ, Taylor JL, O'Brien G, Wheeler JR. The impact of known criminogenic factors on offenders with intellectual disability: previous findings and new results on ADHD. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2013; 26:71-80. [PMID: 23255380 DOI: 10.1111/jar.12011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Developmental and index offence variables have been implicated strongly in later criminal behaviour and service pathways and this paper investigated attention deficit hyperactivity disorder (ADHD) which, with conduct disorder, has emerged from previous studies on offenders. ADHD and conduct disorder are over-represented among criminal populations when compared to the general population. The present authors reviewed the extent to which ADHD affected the presentation of offenders with intellectual disability. METHOD Information related to index behaviour, history of problem behaviours, childhood adversity and psychiatric diagnoses was recorded in 477 referrals to forensic intellectual disability services. Comparisons were made between those with a previous diagnosis of ADHD and those without. RESULTS The ADHD group showed higher proportions of physical aggression, substance use, previous problems including aggression, sexual offences and property offences, birth problems and abuse in childhood. Effect sizes were small. CONCLUSION Attention deficit hyperactivity disorder with conduct disorder is associated with a greater degree and history of problematic behaviour in offenders with intellectual disability.
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Lunsky Y, Raina P, Jones J. Relationship between prior legal involvement and current crisis for adults with intellectual disability. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2012; 37:163-168. [PMID: 22563692 DOI: 10.3109/13668250.2012.685149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Individuals with intellectual disability (ID) and legal involvement are a unique population with complex needs. To date, there has been limited research exploring the demographic and clinical profiles of individuals with ID and legal involvement that are in crisis and how they differ to individuals with ID without legal involvement. METHOD 130 adults with ID and a history of legal involvement were compared to 617 without legal involvement who had experienced at least one crisis in terms of crisis presentation and outcome. RESULTS Overall, those with a known history of legal involvement were younger, higher functioning and more likely to be male and living in unsupported settings. Legal history was not a significant predictor of crisis involving aggression but was a significant predictor of police response to crisis, when other variables were controlled for. CONCLUSIONS Adults with ID and legal history may be more likely to have police respond to their crises than other individuals. Understanding the unique profiles of those with legal history can inform the development of services targeted towards offenders with ID.
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Affiliation(s)
- Yona Lunsky
- Centre for Addiction and Mental Health, Toronto, Canada.
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15
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Horovitz M, Matson JL, Sipes M. The relationship between parents' first concerns and symptoms of autism spectrum disorders. Dev Neurorehabil 2012; 14:372-7. [PMID: 22136121 DOI: 10.3109/17518423.2011.617322] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine the relationship between parents' first concerns and early Autism Spectrum Disorder (ASD) symptoms. METHODS Symptoms of ASD were compared in 1393 toddlers with and without a diagnosis of an ASD, based on the area of parents' first concerns. Communication and behaviour problems were examined in the current study, as they are the most frequently reported first concerns in the literature. A series of one-way, between-subjects ANOVAs were conducted on each sub-scale of the BISCUIT Part-1. RESULTS Symptoms of Autism Spectrum Disorders (ASD) significant differences were found between most groups on all sub-scales. On the Socialization/Non-verbal Communication and Repetitive Behaviour/Restricted Interest sub-scales, those with ASD and behaviour concerns had the highest scores. On the Communication sub-scale, those with ASD and communication concerns had the highest scores. CONCLUSIONS A significant relationship exists between early ASD symptoms and area of first concern. The implications of these results are discussed.
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Affiliation(s)
- Max Horovitz
- Louisiana State University, Baton Rouge, LA 70803, USA
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Uzieblo K, Winter J, Vanderfaeillie J, Rossi G, Magez W. Intelligent diagnosing of intellectual disabilities in offenders: food for thought. BEHAVIORAL SCIENCES & THE LAW 2012; 30:28-48. [PMID: 22241548 DOI: 10.1002/bsl.1990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Research on offenders with intellectual disabilities (IDs) in the criminal justice arena is on the rise, reflected by a growing number of relevant publications each year. However, there is a long recognized methodological problem that hampers the comparability of empirical studies and that raises doubts about the accuracy of prevalence rates, comorbidities, and various correlates and characteristics. In this paper we will argue that the crux of the problem can, on the one hand, be found in the plurality of assessment methods for intelligence and adaptive functioning, which are not all sufficiently reliable and valid. On the other hand, assessment of IQ in criminal justice and mental health-related areas appears to be informed more by practical aspects and needs rather than grounded in a solid theoretical model. Hence, we suggest that the Cattell-Horn-Carroll (CHC) model of intelligence has potential value in this regard, and deserves a closer look. Finally, we will discuss its incorporation into, and possible implications for, criminal justice practice and future study designs.
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Affiliation(s)
- Katarzyna Uzieblo
- Lessius - University College, Department of Applied Psychology, Antwerp.
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Abstract
PURPOSE OF REVIEW This review assesses the impact of recent research on the field of offenders with intellectual disabilities. Research includes work on prevalence, developments in appropriate assessments and investigations into the effectiveness of treatment procedures. RECENT FINDINGS Methodological difficulties continued to beset studies on prevalence, with estimates ranging between 2 and 10% of the offender population having intellectual disabilities. Research on risk assessment has developed quickly in the last 7 years and current studies establish both the framework for assessment and new instruments that have been shown to predict offending incidents. There have been a number of promising studies on sex offender treatment and on the treatment of issues related to general offending. These studies continue to evaluate treatment progress in terms of improvements in behaviour, cognitive distortions and reductions of offending. One notable study had targeted reductions in sexual deviancy. With two exceptions, the main drawback in treatment studies continues to be the lack of control conditions. SUMMARY These research studies will aid clinicians in the implementation of the assessment reviews and treatment programs for offenders with intellectual disabilities.
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Townsend CE. Developing a Comprehensive Research Agenda for People With Intellectual Disability to Inform Policy Development and Reform. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2011. [DOI: 10.1111/j.1741-1130.2011.00297.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Horovitz M, Matson JL, Sipes M, Shoemaker M, Belva B, Bamburg JW. Incidence and trends in psychopathology symptoms over time in adults with severe to profound intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:685-692. [PMID: 21144701 DOI: 10.1016/j.ridd.2010.11.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Accepted: 11/04/2010] [Indexed: 05/30/2023]
Abstract
Individuals with intellectual disability (ID) have a high risk for developing comorbid psychopathology. While researchers have shown that symptoms of psychopathology remain relatively stable in children with ID over time, little research has been conducted to demonstrate symptom stability for adults with ID. Incidence of psychopathology symptoms was examined in 124 adults with severe to profound ID. Then, trends in symptoms of psychopathology over time were studied in 74 of those individuals who had data collected quarterly over the span of one year. Data from the Diagnostic Assessment for the Severely Handicapped-Second Edition (DASH-II) were evaluated for each of the 13 subscales, as well as the total DASH-II score. For all of the scales except PDD/Autism, symptoms did not fluctuate significantly over the one year period. The PDD/Autism scale revealed a significant change in symptoms from Time 1 to Time 3. The implications of these results are discussed.
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Affiliation(s)
- Max Horovitz
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, United States
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Matson JL, Horovitz M, Kozlowski AM, Sipes M, Worley JA, Shoemaker ME. Person characteristics of individuals in functional assessment research. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:621-624. [PMID: 21211941 DOI: 10.1016/j.ridd.2010.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This paper is a review of person characteristics that were present in 173 studies that were reviewed on functional assessment. The purpose was to give the reader an idea about the types of individuals for which functional assessment is appropriate and to outline persons and their characteristics which have the best research support. The majority of participants were diagnosed with intellectual disability and/or autism. Additionally more males that females were included and children were frequently studied versus adolescents and older adults. Finally, while the majority of studies employed experimental functional analysis, the number of participants per study was small. Conversely, functional analysis scales were used in far fewer studies, but with much larger sample sizes. Thus, relatively equal numbers of individuals have been studied with both methods.
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Affiliation(s)
- Johnny L Matson
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, United States.
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Matson JL, Shoemaker ME, Sipes M, Horovitz M, Worley JA, Kozlowski AM. Replacement behaviors for identified functions of challenging behaviors. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:681-684. [PMID: 21144703 DOI: 10.1016/j.ridd.2010.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Accepted: 10/11/2010] [Indexed: 05/30/2023]
Abstract
Functional assessment has become a major feature of learning-based research. A critical element of the majority of these studies includes not only methods and procedures to identify the cause of the challenging behavior, but to establish replacement treatment methods. By far the most common intervention in the 176 studies we reviewed was reinforcement. Noncontingent reinforcement (NCR) was the most common reinforcement method, followed by differential reinforcement of other behavior (DRO). Reinforcement plus extinction was the second most commonly employed treatment followed by functional communication training with or without reinforcement. Researchers proved to be very creative. Forty different treatment methods were employed. The implications of these data are discussed.
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Affiliation(s)
- Johnny L Matson
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, United States.
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