Prospective Field Validation of the START:AV in a Dutch Secure Youth Care Sample

The Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) is a risk assessment instrument for adolescents that estimates the risk of multiple adverse outcomes. Prior research into its predictive validity is limited to a handful of studies conducted with the START:AV pilot version and often by the instrument's developers. The present study examines the START:AV's field validity in a secure youth care sample in the Netherlands. Using a prospective design, we investigated whether the total scores, lifetime history, and the final risk judgments of 106 START:AVs predicted inpatient incidents during a 4-month follow-up. Final risk judgments and lifetime history predicted multiple adverse outcomes, including physical aggression, institutional violations, substance use, self-injury, and victimization. The predictive validity of the total scores was significant only for physical aggression and institutional violations. Hence, the short-term predictive validity of the START:AV for inpatient incidents in a residential youth care setting was partially demonstrated and the START:AV final risk judgments can be used to guide treatment planning and decision-making regarding furlough or discharge in this setting.

The Structured Assessment of Protective Factors for violence risk (SAPROF): A meta-analysis of its predictive and incremental validity

Although the inclusion of protective factors in risk assessment is believed to improve prediction, most risk assessment tools emphasize risk factors. In response, the Structured Assessment of Protective Factors for violence risk (SAPROF) has been developed, which focuses exclusively on protective factors and is used in conjunction with a structured risk assessment tool. It has received increasing attention from both researchers and forensic mental health practitioners, and additional versions have been developed for use with adolescents (SAPROF-YV) and sex offenders (SAPROF-SO). To assess their psychometric performance, we conducted a meta-analysis of validation studies. Our final sample included 39 articles with 5,434 subjects from 16 countries. Overall, the SAPROF(-YV/-SO) showed good interrater reliability and moderate-to-good predictive performance for the absence of recidivism and institutional misconduct. All three instruments exhibited incremental validity when used in conjunction with a risk-focused assessment tool. Our meta-analysis additionally showed that changes on the SAPROF are associated with decreased violent and general recidivism after controlling for baseline risk. We also uncovered several shortcomings in current research with the SAPROF(-YV/-SO). Studies did not report calibration indices and most studies were retrospective and limited to male offenders. The present findings provide support for the relevance of protective factors in risk assessment, but future research should focus on their hypothesized role in treatment and risk management. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Group Cognitive-Behavioral Therapy in a Sample of Dutch Intimate Partner Violence Perpetrators: Development of a Coding Manual for Therapist Interventions

This qualitative study investigated which types of interventions are made by group therapists during group cognitive-behavioral therapy (GCBT) with individuals who have perpetrated intimate partner violence (IPV) in the "Not 'Losing It' Anymore"(NLIA) outpatient programs across the Netherlands. Audio recordings of group sessions (N = 60) facilitated by 13 co-therapist teams across 25 different groups were analyzed using the general inductive approach. Fifteen distinct therapist interventions were identified, categorized, and described using examples from the data. Two categories of interventions could be distinguished: CBT interventions and process-oriented interventions. In future research the coding manual can be tested for interrater reliability and might be used in research on the effectiveness of GCBT therapist interventions.

International perspective on guidelines and policies for child custody and child maltreatment risk evaluations: A preliminary comparative analysis across selected countries in Europe and North America

Little knowledge exists on how evaluators in child custody and child maltreatment cases are informed by guidelines, the kinds of qualifications required and the types of training provided in different countries. The purpose of this paper is to provide an international preliminary comparison on how child custody and child maltreatment risk assessments are conducted in selected Western countries, and how the assessments are informed by best practice guidelines. Another aim is to increase knowledge on how the guidelines and best-practice standards could be developed further to reflect recent research findings. A total number of 18 guidelines were included in the analyses: four from Canada, five from the United States, three from the United Kingdom, three from the Netherlands, two from Finland, and one from Germany. We conducted a content analysis of the included guidelines in the database, focusing on how the guidelines address the best interest of the child criteria, guidelines for conducting the assessments, considerations for evaluative criteria, and specific guidance for conducting specific assessment procedures (e.g., interviews and observations). Findings show that the qualifications of and training provided to evaluators in child custody and child maltreatment risk evaluations are largely heterogeneous across the countries represented. Guidelines differ in whether and how they highlight the importance of evidence-based practices and scientifically validated assessment measures. Implications are drawn from the review and contextualized by international expert authors in the fields of forensic psychology, and family law. After the content analysis, discussion sessions within the expert group were held. The authors provide both commentaries and suggestions to improve the development of standard methods for conducting both child custody and child maltreatment risk evaluations and to consider a more transparent and judicious use of social science research to guide methods and the recommendations offered within these assessments.

A meta-analysis of childhood maltreatment in relation to psychopathic traits

Psychopathy is a personality disorder characterized by a mix of traits belonging to four facets: affective (e.g., callous/lack of empathy), interpersonal (e.g., grandiosity), behavioral instability (e.g., impulsivity, poor behavioral controls), and social deviance (e.g., juvenile delinquency, criminal versatility). Several scholars have argued that early childhood maltreatment impacts the development of psychopathy, although views regarding its role in the four facets differ. We conducted a meta-analysis including 47 studies comprising a total of 389 effect sizes and 12,737 participants, to investigate the association between psychopathy and four types of child maltreatment: physical abuse, emotional abuse, neglect, and sexual abuse. We found support for a moderate link between overall psychopathy and childhood physical abuse, emotional abuse, and neglect, as well as overall childhood maltreatment. The link between psychopathy and childhood sexual abuse was small, but still statistically significant. These associations were stronger for the behavioral and antisocial facets than for the affective and interpersonal facets of psychopathy, but nearly all associations were statistically significant. Our findings are consistent with recently developed theories on the role of complex trauma in the development of severe personality disorders. Trauma-focused preventive and therapeutic interventions can provide further tests of the trauma-psychopathy hypothesis.

The link between attitudes toward probationers and job burnout in Turkish probation officers

The goal of the current study was to investigate individual-level factors associated with job burnout among probation officers (POs) and, specifically, to examine if attitudes toward probationers were linked with job burnout in the context of the recently established probation system in Turkey. Participants (N = 115) were recruited from a probation office in Istanbul. Job burnout was assessed via three components: emotional exhaustion, depersonalization, and professional accomplishment. Results of structural equation modeling indicated that more favorable attitudes toward probationers were related to a lower sense of depersonalization and higher experience of professional accomplishment. However, POs' attitudes toward probationers were not associated with emotional exhaustion. Our findings are discussed in light of the present empirical literature on the contextual factors influential in job burnout. Practical implications for burnout prevention point to the potential effectiveness of working on attitudes among POs toward the people they supervise.

Personality Assessment in Legal Contexts: Introduction to the Special Issue

This special issue addresses a major gap in the literature by providing comprehensive, credible reviews of the psychometric evidence for and legal status of some of the most commonly-used psychological and personality assessment measures used in forensic evaluations. It responds to Neal and colleagues' (2019) call for research to improve the state of and access to knowledge about psychological assessments in legal contexts, and encourages critical thinking about forensic assessment in the spirit of improvement. These articles offer clarity about the strengths and weaknesses of a number of assessment instruments to inform psychologists' preparation for expert testimony, lawyers' preparation for direct and cross-examination, judges' evidence admissibility determinations, and scholars' future research. We assembled teams of authors with different perspectives and areas of expertise to review each tool fairly, including several adversarial collaborations. Articles on the Rorschach and R-PAS, MMPI-3, PCL-R, MCMI-IV and MACI-II, PAI and PAI-A, SIRS-2, HCR-20^V3, TSI and TSI-2, and the MacCAT-CA, ECST-R, and CAST*MR are included. To increase visibility, accessibility, and impact, this issue is published as free access, meaning the articles are available to download without charge. We anticipate these articles will be widely read and useful to scholars and practitioners in both psychology and law.

Legal Admissibility of the Rorschach and R-PAS: A Review of Research, Practice, and Case Law

The special issue editors selected us to form an "adversarial collaboration" because our publications and teaching encompass both supportive and critical attitudes toward the Rorschach and its recently developed system for use, the Rorschach Performance Assessment System (R-PAS). We reviewed the research literature and case law to determine if the Rorschach and specifically R-PAS meet legal standards for admissibility in court. We included evidence on norms, reliability, validity, utility, general acceptance, forensic evaluator use, and response style assessment, as well as United States and selected European case law addressing challenges to mental examination motions, admissibility, and weight. Compared to other psychological tests, the Rorschach is not challenged at unusually high rates. Although the recently introduced R-PAS is not widely referenced in case law, evidence suggests that information from it is likely to be ruled admissible when used by a competent evaluator and selected variables yield scores that are sufficiently reliable and valid to evaluate psychological processes that inform functional psycholegal capacities. We identify effective and ethical but also inappropriate uses (e.g., psychological profiling) of R-PAS in criminal, civil, juvenile, and family court. We recommend specific research to clarify important aspects of R-PAS and advance its utility in forensic mental health assessment.

Taking "the boss" into the real world: Field interrater reliability of the Short-Term Assessment of Risk and Treatability: Adolescent Version

There is emerging evidence that the performance of risk assessment instruments is weaker when used for clinical decision-making than for research purposes. For instance, research has found lower agreement between evaluators when the risk assessments are conducted during routine practice. We examined the field interrater reliability of the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV). Clinicians in a Dutch secure youth care facility completed START:AV assessments as part of the treatment routine. Consistent with previous literature, interrater reliability of the items and total scores was lower than previously reported in non-field studies. Nevertheless, moderate to good interrater reliability was found for final risk judgments on most adverse outcomes. Field studies provide insights into the actual performance of structured risk assessment in real-world settings, exposing factors that affect reliability. This information is relevant for those who wish to implement structured risk assessment with a level of reliability that is defensible considering the high stakes.

The Relevance of Certain Case Characteristics in the Successful Prosecution of Child Sexual Abuse Cases in Indonesia

Successful prosecution in child sexual abuse (CSA) cases is an essential purpose of law enforcement agencies to ensure accountability of perpetrators and children's safety. However, research has shown that legal prosecution of CSA cases is a highly complex endeavor resulting in only a limited percentage of cases being prosecuted and ultimately proven in court. Most attrition occurs at the stage of the police investigation. The current study is the first study of CSA prosecution in an Asian country. We aimed to identify factors, which contribute to Indonesian CSA cases prosecution. We examined police files of CSA cases (N = 179) from three police units in greater Jakarta. We found that only 32% (n = 58) of cases were prosecuted. The following factors increased the odds of prosecution: victim being threatened, the suspect confessed, medical examination report being present, duration of investigations between one to 2 months, and the case being charged under the Child Protection Law. These findings (threat, suspect confession, and the presence of a medical examination report) correspond to previous studies in other jurisdictions.

Beliefs About Children's Memory and Child Investigative Interviewing Practices: A Survey in Dutch Child Protection Professionals from 'Safe Home'

Knowledge of children’s memory and forensic interviewing skills are crucial in child abuse investigations. Safe Home is the Dutch hotline where both professionals and citizens can report concerns about child abuse or domestic violence. Professionals at Safe Home often serve as first responders to determine the need for a child abuse investigation, protective measures and/or further police investigation. In this study, child protection professionals (N = 158) employed at Safe Home (i.e., behavioral scientists, medical doctors, and social workers) completed an online survey on beliefs about memory functioning and forensic interviewing. In line with earlier studies, we expected to find a lack of knowledge about memory functioning among Safe Home workers. Furthermore, we expected limited use of forensic interviewing methods that have received empirical support. Indeed, we found many professionals endorsed beliefs not in line with current memory research, especially beliefs about repressed and recovered memories. Still, high percentages of professionals also reported memory beliefs related to false memory formation and suggestion that were in line with scientific evidence. Some professionals reported using interviewing methods for which there is no empirical validation. Because child protection professionals are often the first to interview children about allegations of abuse, the current findings identify a need for training in child forensic interviewing, including knowledge of human memory.

The impact of a brief RNR-based training on Turkish juvenile probation officers' punitive and rehabilitative attitudes and recidivism risk perceptions

The present quasi-experimental study examined the impact of a brief training program based on the risk-need-responsivity (RNR) model on Turkish juvenile probation officers' (JPOs) punitive and rehabilitative attitudes toward justice-involved youth and recidivism risk perceptions. Fifty-nine JPOs were recruited through three probation offices in Istanbul, Turkey. Thirty-six JPOs, who received a 1-day training in the RNR model of offending behavior, were compared to JPOs in a wait-list control condition (n = 23). Participants in both conditions completed surveys at baseline and 1-week posttraining. Mixed-factorial analysis of variances revealed a significantly higher decrease in JPOs' punitive attitudes from pre- to posttest, in the training condition compared to the control group, with a medium effect size. Rehabilitative attitudes decreased in both conditions, while recidivism risk perceptions did not change from pre- to posttest in either condition. Future research could expand on these promising results using a more intensive training program and a randomized-controlled design in a larger sample of JPOs.

Factor analysis and predictive validity of the Early Risks of Physical Abuse and Neglect Scale (ERPANS): A prospective study in Dutch public youth healthcare

Early detection of child abuse risk factors in families of new-born babies is an important task of the public youth health care system in the Netherlands. The Early Risks of Physical Abuse and Neglect Scale (ERPANS) was originally developed in Belgium as an observation scale for public child healthcare nurses. The present longitudinal study is an independent prospective validation of the ERPANS in a Dutch community sample (N = 1257) of families with a new-born. Results showed a commonality of underlying subsets of items belonging to the 'Disturbed parent-child relationship' and 'Psychological problems' factors, but the factor 'Communication problems' of the original ERPANS could not be replicated. We found that parental psychological problems were a significant predictor of family problems, including involvement of child protection authorities, at an average follow-up of 22 months. Parents who reported feeling unloved by their own parents were at higher risk of reports of serious concern to child protection authorities at 22 months after birth. These findings support the utility of at least a subset of the ERPANS items as a screening tool for child abuse risk in preventive public youth health care for new-born babies. Our research adds to a growing body of evidence which points to the importance of parental mental health problems and adverse childhood experiences as precursors to child abuse risk.

A paedophile scan to prevent child sexual abuse in child care? A thought experiment to problematize the notion of alignment in Responsible Research and Innovation

Responsible Research and Innovation (RRI) is a science policy concept that gained traction from 2000 onwards in the EU and US, in which alignment on purposes and values between different stakeholders is a key aspect. This thought experiment problematizes this particular notion: ethically acceptable and societally desirable outcomes are not necessarily achieved when alignment is a consequence of early closure. To argue this point, we took the example of the potential development of scanning technology for the detection of paedophilia among job applicants, for which indicators of broad societal support were found in an RRI project on neuroimaging. We analysed this case by looking through several lenses, obtained by structured and non-structured literature searches. We explored how facts and values are masked when a taboo topic is considered. This results in the black boxing of the problem definition, potential solutions and development trajectories. Complex unstructured problems can thus be perceived as manageable structured problems, which can in turn lead to irresponsible policies surrounding technology development. Responsible processes of research and technology development thus require the involvement of a critical reflector who is alert to signs of early closure and who prevents foreclosure of ongoing reflexive deliberation. There is an important role for ethical, legal and societal aspect studies within the framework of RRI. This paper shows that the concepts of "value/fact diversity masking" and "early discursive closure" are new avenues for RRI research.

The Questionnaire of Cognitive and Affective Empathy: A Comparison Between Paper-and-Pencil Versus Online Formats in Italian Samples

The most recent conceptualizations of empathy recognize affective empathy as distinct from cognitive empathy. Consequently, instruments that assess these 2 types of empathy have been developed. Among them, the Questionnaire of Cognitive and Affective Empathy (QCAE) is a particularly promising, relatively new, self-report measure consisting of 31 items. To examine the cross-cultural adaptability of the QCAE, we investigated the psychometric properties of an Italian version in 2 samples and with 2 different formats of administration. Study 1 (n = 407) used archival data collected via paper and pencil; Study 2 (n = 285) used newly collected data, obtained with an online format. In these studies, in addition to the QCAE, 6 other instruments measuring empathy-related constructs (i.e., interpersonal competence, well-being, personality traits, emotion regulation, alexithymia, and emotion recognition) were administered, too. Data analysis focused on factor structure, internal consistency, and convergent validity. The findings of both studies provide support for the cross-cultural applicability of the QCAE, and reveal interesting associations between empathy and the other constructs under examination.

Detecting Inconsistent Responding on the Youth Psychopathic Traits Inventory-Short Form

The Youth Psychopathic Traits Inventory-Short Form (YPI-S) is a convenient measure for assessing psychopathy in settings with constraints on resources. However, the YPI-S does not contain a means of detecting careless or random response styles. The present study describes the development and evaluation of an inconsistent responding scale for the YPI-S using five archival samples that vary in language (English, German, Italian, Dutch) and other participant characteristics (juvenile offenders, adolescent students). Inconsistency scores resulting from the new scale effectively distinguished genuine participant responses from randomly generated cases (area under the ROC curve [AUC] = .85-.90) and from cases in which 50% of original responses were replaced with random data (AUC = .75-.82). The associations between the YPI-S and theoretically relevant correlates were reduced among participants exceeding proposed cutoff scores for profile validity compared with associations among more consistent respondents.

Spousal Assaulters in Outpatient Mental Health Care: The Relevance of Structured Risk Assessment

This study examined whether a typology of perpetrators of intimate partner violence (IPV) could be replicated in a Dutch sample ( N = 154) of self-referred IPV perpetrators using a structured risk assessment tool for relational violence (Brief Spousal Assault Form for the Evaluation of Risk [B-SAFER]). Our findings support the previous IPV perpetrator subtypes: low-level antisocial (LLA), family only (FO), psychopathology (PP), and generally violent/antisocial (GVA). The subtypes differed on the descriptive dimensions general criminality, substance use, and mental health problems. The prevalence rates for each subtype were roughly comparable with those in previous studies. Contrary to expectation, the prevalence of the GVA subtype was relatively high in our self-referred sample compared with court-referred samples. Our findings suggest that structured risk assessment should be an integral part of the intake procedure for IPV perpetrators entering treatment, to assess their level of risk and to arrive at a tailored risk management strategy, regardless of setting or referral source.

Treatment Fidelity during Therapist Initial Training is related to Subsequent Effectiveness of Parent Management Training-Oregon Model

The present study examined the association between treatment fidelity during therapist initial training and subsequent treatment outcome of Parent Management Training - Oregon model (PMTO) in The Netherlands. Clinically referred children (N = 86) aged 4 to 11 years and their parents received PMTO and were assessed at four time points: at baseline, and after 6, 12, and 18 months. Difference scores between baseline and follow-up assessments of externalizing behavior problems, parenting practices, and parental psychopathology and parents' overall ratings of working alliance, were correlated with treatment fidelity scores measured prior to the intervention. Furthermore, differences in therapists' fidelity scores between treatment completers and drop-outs were examined. Results showed that higher fidelity scores of PMTO therapists during initial training were associated with larger improvements in externalizing behavior, parenting practices, and parental psychopathology, especially after 18 months. In addition, parents who completed the treatment had a significantly more adherent therapist than families who dropped out. However, the correlations between treatment fidelity and working alliance were non-significant. These findings indicate that therapists' high adherence to the PMTO treatment principles during initial training decreases the chance of treatment drop-out and positively affects the longterm effectiveness of PMTO.

The Effectiveness of Parent Management Training-Oregon Model in Clinically Referred Children with Externalizing Behavior Problems in The Netherlands

The present study examined the effectiveness of parent management training-Oregon model (PMTO) as a treatment for children with externalizing behavior problems in The Netherlands. Clinically referred children (N = 146) aged 4-11 years and their parents were partly randomized to either PMTO (n = 91) or Care As Usual (CAU; n = 55). Families were assessed at four time points: at pretreatment, and after 6, 12, and 18 months. Results showed that both PMTO and CAU were effective in reducing child externalizing behavior, parenting stress and parental psychopathology, with no significant differences between the two treatment conditions. PMTO and CAU interventions also produced some improvements in self-reported parenting skills, but not in observed parenting skills. According to the Reliable Change Index, 16.9 and 45.8 % of the children within the PMTO group showed full recovery or improvement in externalizing behavior, respectively, versus 9.7 and 42.8 % in the CAU condition. Finally, the effect size of PMTO on parent-reported externalizing behavior problems as found in the present study was comparable to that found in previous studies evaluating PMTO as an intervention for this type of child psychopathology.

Kriminalprognosen in der Praxis

Zusammenfassung. Einschätzungen über das Risiko zukünftiger Gewalttätigkeit sind ein fester Bestandteil der Arbeit von Psychologinnen und Psychologen, wobei bis heute wenig darüber bekannt ist, in welcher Form kriminalprognostische Einschätzungen in der alltäglichen Berufspraxis vorgenommen werden. Durch die vorliegende Forschungsarbeit wird erstmals ein Einblick in die kriminalprognostische Praxis in Deutschland gegeben. In der vorliegenden Studie werden die Ergebnisse des International Risk Surveys (IRiS; Singh et al., 2014 ) ausgewertet, an der weltweit 2135 Personen aus 44 Ländern teilgenommen haben. Aus Deutschland wurden 97 Psychologinnen und Psychologen sowie Angehörige anderer Berufsgruppen über ihre kriminalprognostischen Tätigkeiten befragt. Die Daten zeigen, dass mittlerweile in der Praxis mehrheitlich auf standardisierte Prognoseinstrumente zurückgegriffen wird. Die Instrumente werden nicht nur für die prognostische Einschätzung über das zukünftige Gewaltrisiko als nützlich eingestuft, sondern auch im Hinblick auf die Therapieindikation sowie die verlaufsdiagnostische Untersuchung von Behandlungs- und Betreuungsfällen als hilfreich beurteilt.

The Perceived Impact of Trauma-Focused Research on Forensic Psychiatric Patients With Lifetime Victimization Histories

This study examined the perceived costs, benefits, and motivations for participating in individual trauma-focused interviews among forensic psychiatric patients ( N = 74). The majority of our participants were male, and 100% endorsed adverse childhood experiences (e.g., abuse, neglect) or exposure to potentially traumatic events (e.g., assault). Levels of posttraumatic avoidance (41.9%), reexperiencing (59.5%), and increased arousal (51.3%) were high. In line with previous studies, our findings suggest an overall positive research experience in this sample. In spite of extensive histories of lifetime victimization we did not find an association between victimization, posttraumatic symptomatology, and a negative research experience. Our findings suggest that participation in trauma-focused research is not only possible with, but also potentially beneficial for forensic patients.

A Case Concerning Children's False Memories of Abuse: Recommendations Regarding Expert Witness Work

Expert witnesses can play a major role in legal cases concerning the reliability of statements. Abuse cases frequently contain only the memories of eyewitnesses/victims without the presence of physical evidence. Here, it is of the utmost importance that expert witnesses use scientific evidence for their expert opinion. In this case report, a case is described in which 20 children reported being sexually abused by the same teachers at their elementary school. The investigative steps that were taken by the police and school authorities are reviewed, including how they probably affected memory. In order to provide a sound expert opinion regarding the reliability of these statements, three recommendations are proposed. To reduce the effect of confirmation bias and increase objectivity, it is argued that expert witnesses' reports should contain alternative scenarios, be checked by another expert, and focus on the origin and context of the first statement.

Short report: self-reported psychopathic traits in Finnish and Dutch samples of non-referred adolescents: exploration of cultural differences

BACKGROUND

Culture-related differences in psychopathic traits have been reported for adults, but for adolescents such knowledge is lacking. The aim of this cross-national study was to compare self-reported psychopathic traits between Finnish and Dutch samples of mid-adolescent community youth.

METHODS

The Youth Psychopathic traits Inventory (YPI) was filled in by 372 Finnish and 474 Dutch 15- to 16-year-old pupils. As gender-specific differences exist in psychopathic traits, we analyzed the data separately for boys and girls.

RESULTS

Dutch boys scored significantly higher than Finnish boys on total and all dimensional scores of the YPI as well as on most sub-dimensional scores. Dutch girls scored significantly higher than Finnish girls on the Affective dimension and on the two corresponding sub-dimensions: remorselessness and callousness. Finnish girls scored significantly higher on grandiosity, which loads to the Interpersonal dimension of the YPI.

CONCLUSIONS

Our findings suggest that culture influences the manifestation of psychopathic traits already in adolescence and that this relation is more prominent in boys.

Child maltreatment victimization by type in relation to criminal recidivism in juvenile offenders

BACKGROUND

This study aimed to examine the relation between different types of child abuse victimization and criminal recidivism among juvenile offenders.

METHOD

Secondary analyses were conducted on data collected with the Washington State Juvenile Court Assessment and general recidivism. The sample consisted of female (n = 3502) and male (n = 10,111) juvenile offenders.

RESULTS

For male juvenile offenders, neglect and physical abuse victimization were significantly but rather weakly associated with both general and violent recidivism. For female juvenile offenders, neglect and physical abuse were weakly associated with general recidivism, but not with violent recidivism. Sexual abuse was not related to either general or violent recidivism in both male and female juvenile offenders. Most associations between dynamic (treatable) risk domains and recidivism were stronger in male juvenile offenders than in female juvenile offenders. In addition, most risk domains were more strongly related to general recidivism than to violent felony recidivism. For male juvenile offenders, neglect victimization was uniquely related to general recidivism whereas physical abuse victimization was uniquely related to violent recidivism, over and above dynamic risk factors for recidivism. For female juvenile offenders none of the maltreatment variables were uniquely related to general or violent felony recidivism.

CONCLUSIONS

Childhood experiences of neglect and physical abuse predict reoffending in male juvenile offenders, pointing at a possible need to address these in risk management interventions.

Violence Risk Assessment Practices in Denmark: A Multidisciplinary National Survey

With a quadrupling of forensic psychiatric patients in Denmark over the past 20 years, focus on violence risk assessment practices across the country has increased. However, information is lacking regarding Danish risk assessment practice across professional disciplines and clinical settings; little is known about how violence risk assessments are conducted, which instruments are used for what purposes, and how mental health professionals rate their utility and costs. As part of a global survey exploring the application of violence risk assessment across 44 countries, the current study investigated Danish practice across several professional disciplines and settings in which forensic and high-risk mental health patients are assessed and treated. In total, 125 mental health professionals across the country completed the survey. The five instruments that respondents reported most commonly using for risk assessment, risk management planning and risk monitoring were Broset, HCR-20, the START, the PCL-R, and the PCL:SV. Whereas the HCR-20 was rated highest in usefulness for risk assessment, the START was rated most useful for risk management and risk monitoring. No significant differences in utility were observed across professional groups. Unstructured clinical judgments were reported to be faster but more expensive to conduct than using a risk assessment instrument. Implications for clinical practice are discussed.

Child maltreatment among boy and girl probationers: does type of maltreatment make a difference in offending behavior and psychosocial problems?

This study examined differences in offending behavior and psychosocial problems between juvenile offenders who have been sexually abused (n=231), physically abused (n=1,568), neglected (n=1,555), exposed to multiple forms of maltreatment (n=1,767), and non-victims (n=8,492). In addition, the moderating effect of gender in the association between type of maltreatment and offending behavior/psychosocial problems was examined. Results showed that violent offenses were more common in victims of physical abuse and victims of multiple forms of abuse than in non-victims, both in boys and girls. In boys, sexual offenses were far more common in victims of sexual abuse than in victims of other or multiple forms of maltreatment or in non-victims. In girls, no group differences were found in sexual offending behavior. For both boys and girls, externalizing problems were relatively common in victims of physical abuse and neglect whereas internalizing problems were relatively common in victims of sexual abuse. In victims of multiple forms of maltreatment, both internalizing and externalizing problems were relatively common. Implications for clinical practice are discussed.

Parental and family-related influences on dental caries in children of Dutch, Moroccan and Turkish origin

OBJECTIVES

The aim of this cross-sectional study was to investigate the relationship between parental and family-related factors and childhood dental caries in a sample of 5- to 6-year-old children of Dutch, Moroccan and Turkish origin. Furthermore, the relationship of parental and family-related factors with social class and ethnicity was examined.

METHODS

The study sample included 92 parent-child dyads (46 cases and 46 controls), which were recruited from a large paediatric dental centre in The Hague, the Netherlands. Cases were children with four or more decayed, missing or filled teeth, and controls were caries free. Validated questionnaires were used to collect data on sociodemographic characteristics, oral health behaviours, parents' dental self-efficacy and locus of control (LoC), parenting practices and family functioning. Parenting practices were also assessed using structured video observations of parent-child interactions.

RESULTS

Parents of controls had a more internal LoC, and they were more likely to show positive (observed) parenting in terms of positive involvement, encouragement and problem-solving, compared to cases (P < 0.05). Lower social class was significantly associated with a lower dental self-efficacy, a more external LoC and poorer parenting practices. Furthermore, LoC was more external in Moroccan and Turkish parents, compared to Dutch parents.

CONCLUSION

Parents' internal LoC and observed positive parenting practices on the dimensions positive involvement, encouragement and problem-solving were important indicators of dental health in children of Dutch, Moroccan and Turkish origin. Findings suggest that these parental factors are potential mediators of socioeconomic inequalities in children's dental health.

How do public child healthcare professionals and primary school teachers identify and handle child abuse cases? A qualitative study

Background

Public child healthcare doctors and nurses, and primary school teachers play a pivotal role in the detection and reporting of child abuse, because they encounter almost all children in the population during their daily work. However, they report relatively few cases of suspected child abuse to child protective agencies. The aim of this qualitative study was to investigate Dutch frontline workers’ child abuse detection and reporting behaviors.

Methods

Focus group interviews were held among 16 primary school teachers and 17 public health nurses and physicians. The interviews were audio recorded, transcribed, and thematically analyzed according to factors of the Integrated Change model, such as knowledge, attitude, self-efficacy, skills, social influences and barriers influencing detection and reporting of child abuse.

Results

Findings showed that although both groups of professionals are aware of child abuse signs and risks, they are also lacking specific knowledge. The most salient differences between the two professional groups are related to attitude and (communication) skills.

Conclusion

The results suggest that frontline workers are in need of supportive tools in the child abuse detection and reporting process. On the basis of our findings, directions for improvement of child abuse detection and reporting are discussed.

Psychopathic traits and change on indicators of dynamic risk factors during inpatient forensic psychiatric treatment

The main objective of the present study was to investigate the impact of treatment on forensic psychiatric inpatients, examining changes on 22 indicators of five dynamic risk factors for violence (i.e., egocentrism, hostility, impulsivity, lack of insight, and negative distrustful attitudes), and to relate these potential changes to level of psychopathy assessed with the Hare Psychopathy Checklist - Revised (PCL-R). Also, we studied the relationship between psychopathy and treatment compliance, as indicated by the attendance rate of therapeutic activities. Eighty-seven male patients (due to missing data on at least one measure, sample size varies from 58 to 87; 42 patients have complete datasets) were administered a standardized psychological assessment battery (self-report inventories, performance-based personality test, observer ratings) upon admission (T1) and after on average 20 months of treatment (T2). Upon admission, psychopathy (median split, PCL-R score≥22) was significantly related to a higher score on five of the 22 indicators of dynamic risk. The analyses showed no significant differences between psychopathic and non-psychopathic patients on the indicators of dynamic risk factors during 20 months of inpatient forensic psychiatric treatment. However, psychopaths showed the expected pattern of treatment noncompliance, compared to non-psychopaths. The clinical and research implications of these findings are discussed.

"We are also normal humans, you know?" Views and attitudes of juvenile delinquents on antisocial behavior, neurobiology and prevention

This paper presents and discusses the views and attitudes of juvenile delinquents regarding the implications of genomics and neurobiology research findings for the prevention and treatment of antisocial behavior. Scientific developments in these disciplines are considered to be of increasing importance for understanding the causes and the course of antisocial behavior and related mental disorders. High expectations exist with regard to the development of more effective prevention and intervention. Whether this is a desirable development does not only depend on science, but also on the ethical and social implications of potential applications of current and future research findings. As this pilot study points out, juvenile delinquents themselves have rather mixed views on the goals and means of early identification, prevention and treatment. Some welcome the potential support and help that could arise from biologically informed preventive and therapeutic measures. Others, however, reject the very goals of prevention and treatment and express worries concerning the risk of labeling and stigmatization and the possibility of false positives. Furthermore, interventions could aim at equalizing people and taking away socially disapproved capacities they themselves value. Moreover, most juvenile delinquents are hardly convinced that their crime could have been caused by some features of their brain or that a mental disorder has played a role. Instead, they provide social explanations such as living in a deprived neighborhood or having antisocial friends. We suggest that the hopes and expectations as well as the concerns and worries of juvenile delinquents are relevant not only for genomics and neurobiology of antisocial behavior, but also for prevention and intervention measures informed by social scientific and psychological research. The range of patterns of thought of juvenile delinquents is of great heuristic value and may lead to subsequent research that could further enhance our understanding of these patterns.

Emotional memory for central and peripheral details in children with callous-unemotional traits

A limited number of studies have shown that adults and adolescents with psychopathic traits suffer from emotional memory impairment. The present study examined whether this finding could be replicated in a sample of children between 8 and 12 years of age with callous-unemotional (CU) traits. Children with high CU traits (n=24) were compared with children with low CU traits (n=18) with regard to performance on a peripheral memory recognition test that examined memory for central and peripheral components of neutral and negative pictures. Results showed that overall recognition rates did not differ between the high- and low-CU groups. For negative pictures, both groups demonstrated better recognition of the central component at the expense of the peripheral component, while for neutral pictures, the peripheral component was better recognized than the central component. This study is the first to demonstrate that children with high CU traits do not suffer from an impaired emotional memory.

Identifying subtypes of spousal assaulters Using the B-SAFER

In the present study, a structured risk assessment instrument for intimate partner violence, the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER), was coded for 146 files of spousal assault cases from the Dutch probation service, dating from 2004 and 2005. The aim of the study was twofold: (a) to validate Holtzworth-Munroe and Stuart's typology using the risk factors of the B-SAFER and (b) to examine the relationship between the subtypes found and recidivism rates. Four subtypes of assaulters were identified: family only, generally violent/antisocial, low-level antisocial, and psychopathology. These subtypes were comparable to the subtypes found in previous studies. The generally violent/antisocial subtype had the highest recidivism rate, although not significantly different from the other three subtypes.

The impact of protective factors in desistance from violent reoffending: a study in three samples of adolescent offenders

This study examined the impact of protective factors, assessed by means of the Structured Assessment of Violence Risk in Youth (SAVRY), on desistance from violent reoffending in adolescents. Three samples included male adolescents in different stages of the judicial process: pre-trial (n = 111); during residential treatment (n = 66); and after release from a juvenile justice facility ( n = 47). The results lend support to the hypothesis that protective factors buffer or mitigate the risk of violent reoffending. Using regression analyses, in all samples, the addition of protective factors yielded a significant increment in the amount of variance explained by dynamic risk factors alone. Furthermore, in medium to high risk subgroups, the violent reoffending rate was significantly higher when protective factors were absent, compared to when protective factors were present. These findings are discussed in terms of their implications for risk assessment and risk management practice with adolescent offenders.

Recent life events and subjective well-being of personality disordered forensic outpatients

PURPOSE

The majority of patients treated at forensic psychiatric outpatient facilities suffer from personality disorders, especially Cluster B disorders. Life events have been shown to influence subjective well-being, severity of psychopathology and delinquent behaviour of patients with different personality disorders. However, the influence of life events on subjective well-being of patients suffering from Cluster B personality disorders has rarely been studied. Following General Strain Theory and the dynamic equilibrium model, we hypothesised that negative life events would negatively influence subjective well-being, and that subjective well-being would change when an instability of life events occurs.

METHODS

Fifty-six adult male forensic psychiatric outpatients were interviewed on their subjective well-being and filled out a self-report life event questionnaire, at three time-points, with an interval of three months. Life events were categorized along two dimensions: positive / negative and controllable / uncontrollable.

RESULTS

Patients had a stable pattern of positive, negative controllable and uncontrollable life events. Positive controllable events did not have a stable pattern. Results indicated that only negative controllable events correlated negatively with subjective well-being. Furthermore, positive and positive controllable events correlated with a positive change in subjective well-being and uncontrollable events correlated negatively with this change.

CONCLUSIONS

Forensic psychiatric outpatients seem to experience a relatively stable 'load' of stressful life events, that does not influence change in subjective well-being. We did not find unequivocal support for General Strain Theory. In line with the dynamic equilibrium model, forensic outpatients seemed less used to positive controllable life events, which influenced positive change in subjective well-being. In outpatient forensic treatment, attempts to limit negative life events together with enhancing behaviour which results in positive events should be targeted. This might result in better lives for patients and in reduced criminal behaviour.

Reliability and validity of the Dutch version of the Behavioural Status Index: a nurse-rated forensic assessment tool

The Behavioural Status Index (BEST-Index) has been introduced into Dutch forensic psychiatry to measure change in risk level of future violence. The BEST-Index is a structured observational measure that assesses aggressive behavior, degree of insight, social skills, self-care, and work and leisure skills during inpatient treatment. Thus far, limited information regarding the psychometric properties of the Dutch version of the BEST-Index is available. The present study examines the reliability and validity of the Dutch BEST-Index in a sample of 291 mentally disordered offenders admitted to a forensic psychiatric hospital. Interrater reliability was investigated in a sample of 182 raters. Findings show that the Dutch BEST-Index can be used reliably and is significantly associated with risk of future violence and institutional aggression. Furthermore, this study revealed a different and clearer factor structure compared with the original one. Further research is needed to examine how these derived factors predict future recidivism.

The Youth Psychopathic traits Inventory: psychometric properties and its relation to substance use and interpersonal style in a Dutch sample of non-referred adolescents

This study presents evidence on the reliability and construct validity of the Dutch version of the Youth Psychopathic traits Inventory (YPI), a self-report instrument for psychopathic traits in adolescent boys and girls. In a sample of 776 Dutch non-referred adolescents, the YPI was found to have good internal consistency. Furthermore, exploratory Principal Components Analysis (PCA) indicated a three-factor structure for the YPI, including a Grandiose-manipulative, Callous-unemotional, and Impulsive-irresponsible dimension. Good internal consistency was demonstrated for all dimensions in boys as well as girls, except for the Callous-unemotional dimension. Results further indicated strong correlations between psychopathic traits and dominant and hostile interpersonal style. The Grandiose-manipulative dimension predicted dominant interpersonal behavior in boys, but not in girls. In girls, a dominant interpersonal style was predicted by the Impulsive-irresponsible dimension. Psychopathic traits, mainly the Impulsive-irresponsible dimension, were related to a higher frequency of self-reported drug and alcohol use in boys and girls.

Reliability and construct validity of the Dutch psychopathy checklist: youth version: findings from a sample of male adolescents in a juvenile justice treatment institution

The present study examines the reliability and construct validity of the Dutch version of the Psychopathy Check List: Youth Version (PCL:YV) in a sample of male adolescents admitted to a secure juvenile justice treatment institution (N = 98). Hare's four-factor model is used to examine reliability and validity of the separate dimensions of psychopathy. Interrater reliabilities are good to excellent for the PCL:YV total score and most factor scores, except for the affective factor. Several suggestions are offered for optimizing reliability of this factor. Finally, meaningful associations between PCL:YV scores and scores on the Minnesota Multiphasic Personality Inventory-Adolescent and the Interpersonal Checklist-Revised support the construct validity of the PCL:YV total score as well as the four factors in the Dutch context.

Predictive validity of the Structured Assessment of Violence Risk in Youth (SAVRY) during residential treatment

This prospective study examines the predictive validity of the Dutch version of the Structured Assessment of Violence Risk in Youth (SAVRY) by examining relationships between SAVRY scores and various types of disruptive behavior during residential treatment. The SAVRY, a risk assessment instrument, was coded for 66 male adolescents on the basis of file information and interviews. The adolescents were referred to Rentray, a juvenile correctional and treatment facility, by the Dutch juvenile courts because of severe behavioral problems or serious offenses. Institutional infractions were retrieved from incident registration files, which included acts of physical violence, verbal threat, verbal abuse, and violation of institutional rules. The interrater reliability of the SAVRY scores was good. The predictive validity of the SAVRY for physical violence against persons was excellent (Risk Total: AUC=.80, r =.33; Summery Risk Rating: AUC =.86, r =.48). The SAVRY also had good predictive validity for violence against objects, verbal threats and violations of rules, but not for verbal abuse. Implications for assessment and management of violent behavior among adolescents in residential treatment are discussed.

Reliability and validity of the Psychopathy Checklist: Youth Version in Dutch female adolescents

In the present study, the reliability and construct validity of the Dutch version of the Psychopathy Check List: Youth Version (Psychopathie Checklist: Jeugd Versie; De Ruiter, Kuin, De Vries & Das, 2002) were examined in a sample of female adolescents admitted to a secure treatment institution (N=67). The study provides mixed support for the internal reliability of the PCL:YV in female adolescents. Interrater reliability was found to be adequate at the level of factor and total PCL:YV scores. Poor reliability was demonstrated for the behavioral items of the PCL:YV in particular. Finally, the construct validity of the PCL:YV total and factor scores was supported by theoretically meaningful and significant associations with scores on the Minnesota Multiphasic Personality Inventory (MMPI) and the Interpersonal Checklist-Revised (ICL-R). The applicability of PCL:YV items to female adolescents is discussed.

Rorschach Comprehensive System data for a sample of 108 normative subjects from The Netherlands

The current study is part of a two-wave normative data collection study with the Rorschach Comprehensive System (CS; Exner, 2003) in The Netherlands. The first data wave yielded 108 valid Rorschach protocols for which descriptive data on CS variables were calculated. Interrater reliability between two raters for 10 response segments on a subset of 24 protocols was good to excellent. The findings show that mean values for a number of important CS variables, such as EA, Egocentricity index, and WDA% in the Dutch sample are highly similar to those found in a recent U.S. study by Shaffer and colleagues (2007/this issue). On the other hand, the Dutch sample contains a higher percentage of subjects with positive scores on the DEPI and CDI, compared with the Shaffer et al. data, but to an even greater extent in comparison with Exner's (2001) nonpatient data. We argue, on the basis of findings from psychiatric epidemiology, that the exclusion of subjects with a history of mental disorder or mental health treatment from Rorschach normative data bases yields a dataset that is nonrepresentative of the general population.

Predictive validity of the Dutch PCL:YV for institutional disruptive behavior: findings from two samples of male adolescents in a juvenile justice treatment institution

The present prospective study examined the predictive validity of the Dutch version of the Psychopathy Check List: Youth Version for disruptive behavior in male adolescents during treatment. The study comprised two samples admitted to different secure treatment institutions in The Netherlands, Jongerenhuis Harreveld (n = 81) and Rentray (n = 66). Overall, the results demonstrate that psychopathy is a significant predictor of institutional disruptive behavior, and physical violence in particular. Furthermore, Hare's traditional Factor 2 was more strongly related to disruptive incidents than Factor 1. By using the recently proposed three- and four-factor models of psychopathy, insight into the pattern of associations between psychopathy dimensions and different types of disruptive behavior was obtained. The antisocial dimension of psychopathy appeared to be more strongly related to severe incidents than the lifestyle dimension. Regression analyses identified significant contributions of the antisocial and lifestyle dimensions to the prediction of incidents. The relatively small degree of variance explained underlines the importance of other risk factors to identify adolescents at risk of disruptive behavior during institutional treatment.