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Turhan A, Roest JJ, Delforterie MJ, Van der Helm GHP, Neimeijer EG, Didden R. Measurement invariance of the group climate inventory across adults with and without mild intellectual disability in secure residential facilities. J Appl Res Intellect Disabil 2024; 37:e13166. [PMID: 37875164 DOI: 10.1111/jar.13166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/26/2023] [Accepted: 09/11/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND The Group Climate Inventory (GCI) was tested for measurement invariance across 332 adults with and 225 adults without mild intellectual disabilities in Dutch forensic treatment, and for latent mean differences on its Support, Growth, Repression, and Atmosphere subscales. METHOD Multigroup confirmatory factor analysis was used to evaluate the configural, threshold, and loading and threshold invariance of the GCI across both groups, and to compare group latent means on each subscale. RESULTS Measurement invariance was found across groups. Latent mean group comparisons showed small but significant differences reflected in lower scores on Support and Atmosphere in the group with mild intellectual disabilities. CONCLUSION The GCI allows meaningful comparisons between clients with and without mild intellectual disabilities in secure facilities. Results from the between-group comparisons suggest that consideration should be given as to whether, and why, the support and atmosphere perceptions of clients with mild intellectual disabilities might be less good.
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Affiliation(s)
- Abdullah Turhan
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Trajectum, Zwolle, The Netherlands
| | - Jesse J Roest
- Research Group Residential Youth Care, Leiden University of Applied Sciences, Leiden, The Netherlands
| | - Monique J Delforterie
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Trajectum, Zwolle, The Netherlands
| | - G H Peer Van der Helm
- Research Group Residential Youth Care, Leiden University of Applied Sciences, Leiden, The Netherlands
- University of Amsterdam, Faculty of Social and Behavioural Sciences, Amsterdam, The Netherlands
| | | | - Robert Didden
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Trajectum, Zwolle, The Netherlands
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Turhan A, Delforterie MJ, Roest JJ, Van der Helm GHP, Neimeijer EG, Didden R. Relationships between dynamic risk factors for externalising problem behaviour and group climate in adults with mild intellectual disability in forensic treatment. J Appl Res Intellect Disabil 2023; 36:641-652. [PMID: 36883307 DOI: 10.1111/jar.13088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/21/2022] [Accepted: 01/31/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND Relationships between dynamic risk factors for externalising problem behaviour and group climate were investigated in 151 adult in-patients with mild intellectual disability or borderline intellectual functioning in a Dutch secure residential facility. METHOD Regression analysis was used to predict total group climate score and Support, Growth, Repression, and Atmosphere subscales of the 'Group Climate Inventory'. Predictor variables were Coping Skills, Attitude towards current treatment, Hostility, and Criminogenic attitudes subscales of the 'Dynamic Risk Outcome Scales'. RESULTS Less hostility predicted a better overall group climate, better support and atmosphere, and less repression. A positive attitude towards current treatment predicted better growth. CONCLUSION Results indicate relationships of hostility and attitude towards current treatment with group climate. A focus on both dynamic risk factors and group climate may provide a basis for improving treatment for this target group.
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Affiliation(s)
- A Turhan
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Trajectum, Zwolle, The Netherlands
| | - M J Delforterie
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Trajectum, Zwolle, The Netherlands
| | - J J Roest
- Research group Residential Youth care, Leiden University of Applied Sciences, Leiden, The Netherlands
| | - G H P Van der Helm
- Research group Residential Youth care, Leiden University of Applied Sciences, Leiden, The Netherlands.,Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | | | - R Didden
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Trajectum, Zwolle, The Netherlands
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Gottfried ED, Vitacco MJ, Mamak M. Editorial: Mental illnesses within correctional populations. Front Psychiatry 2023; 14:1145921. [PMID: 36890986 PMCID: PMC9986583 DOI: 10.3389/fpsyt.2023.1145921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 01/27/2023] [Indexed: 02/22/2023] Open
Affiliation(s)
- Emily D Gottfried
- Community and Public Safety Psychiatry Division, Medical University of South Carolina, Charleston, SC, United States
| | - Michael J Vitacco
- Department of Psychiatry and Health Behavior, Institute of Public and Preventive Health, Augusta University, Augusta, GA, United States
| | - Mini Mamak
- Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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À Campo JMLG, van Impelen A, Hamakers N, Nijman HLI. Transforensic psychiatry: Addressing inpatient aggression in the "gray zone" between general and forensic psychiatric care. Behav Sci Law 2022. [PMID: 36349387 DOI: 10.1002/bsl.2602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 10/03/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
A minority of psychiatric patients are unfit for general psychiatric care due to offensive behavior that renders them at risk of coming into contact with the criminal justice system. In the absence of criminal proceedings, these patients find themselves in the "gray zone" between general and forensic psychiatric care. To accommodate these patients, we established a "transforensic" ward. Instead of applying forensic treatment elements reactively (as part of a criminal sentence, after an offense has been committed), we applied it preventively (so as to avert offending behavior and resultant criminal sentences). Psychometric psychopathology and violence risk assessment scores were substantially lower at discharge than at admission (Cohen's ds = -0.3 to -0.6). These results offer ground for cautious optimism about the efficacy of transforensic care in serving as a safety net for psychiatric patients who are found to be unfit for general psychiatric care on account of their aggressive behavior.
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Affiliation(s)
- Joost M L G À Campo
- Mondriaan Mental Health Care Institute, Heerlen, The Netherlands
- Maastricht University, Faculty of Law, Maastricht, The Netherlands
| | | | - Nicole Hamakers
- Mondriaan Mental Health Care Institute, Heerlen, The Netherlands
| | - Henk L I Nijman
- Mondriaan Mental Health Care Institute, Heerlen, The Netherlands
- Radboud University, Faculty of Social Sciences, Nijmegen, The Netherlands
- Fivoor Forensic Mental Health Care Institute, Rotterdam, The Netherlands
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Páv M, Vňuková M, Sebalo I. Factors Affecting Length of Inpatient Forensic Stay: Retrospective Study From Czechia. Front Psychiatry 2022; 13:825615. [PMID: 35599778 PMCID: PMC9114463 DOI: 10.3389/fpsyt.2022.825615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The length of forensic stay (LoS) is a subject to country-specific legal and service systems. Therefore, the identification of common factors targetable by treatment is at the forefront of forensic psychiatric research. In this study, we present the first reports of forensic characteristics of patients from the Czechia. METHODS We conducted a retrospective analysis of data from 260 inpatients discharged from the Bohnice Hospital (Prague) and obtained a set of sociodemographic and clinical variables as well as the Health of the Nation Outcome Scale (HoNOS) and HoNOS-secure scores. RESULTS The following variables were identified as significantly associated with a longer LoS: older age, length of previous psychiatric hospitalization, olanzapine equivalent, clozapine treatment, psychosocial dysfunction, psychotic or paraphilic disorder diagnosis, and sexual offense. A shorter LoS was associated with being in a relationship, being employed before hospitalization, receiving personal support, and committing an index offense under the influence of substance. While the HoNOS score and HoNOS symptom subscale predicted a longer LoS, the HoNOS-secure subscale predicted a shorter stay. CONCLUSION In the European context, our hospital has a relatively low LoS. The results are consistent with findings linking psychotic disorders and paraphilia with a longer LoS in forensic treatment. Higher doses of antipsychotic medication or clozapine prescriptions were associated with a longer LoS. The results show a high level of unmet needs in this population, highlighting the importance of the availability of follow-up service.
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Affiliation(s)
- Marek Páv
- Psychiatric Hospital Bohnice, Prague, Czechia.,Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Martina Vňuková
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Ivan Sebalo
- School of Psychology and Computer Science, University of Central Lancashire, Preston, United Kingdom.,Ashworth Research Centre, Ashworth High Secure Hospital, Mersey Care NHS Foundation Trust, Liverpool, United Kingdom
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Gosek P, Kotowska J, Rowińska-Garbień E, Bartczak D, Tomlin J, Heitzman J. Longer than prison? A comparison of length of stay in a medium security hospital and prison for perpetrators of violent crimes other than homicide or attempted homicide. Crim Behav Ment Health 2021; 31:162-170. [PMID: 34109687 DOI: 10.1002/cbm.2202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Concerns have been raised that people detained in secure hospitals after a criminal act spend longer in a locked institution than people sent to prison for similar offending, but research evidence is scarce and conflicting. AIMS To compare the length of secure hospitalisation of people convicted of crimes for which flexible sentencing is allowed with length of time in prison for people serving a prison sentence for similar crimes who were not found mentally ill. METHODS A records-based, retrospective study was conducted comparing length of stay of all inpatients in one medium security hospital in Poland, hospitalised between 2014 and 2018, who had been convicted of any interpersonal crime other than homicide or attempted homicide, and data on all sentenced prisoners in Poland on 09.05.2018 convicted of a similar range of offences. Homicide was excluded because, in Poland, it usually attracts a fixed sentence-a life sentence until the 1970s and currently a 25-year imprisonment-so disrupting comparisons. RESULTS Eighty-two patients completed their secure hospital stay within the study period or were still hospitalised at the census point 09.05.2018, only 10 of them women. Male patients convicted of stalking or similar threatening offence or 'mistreatment' spent, on average, almost twice as long confined to hospital than men sentenced to imprisonment spent in prison (28.8 months, respectively). By contrast, men hospitalised after sex offences were confined for over three years less than those sentenced to prison. Only bodily harm offences attracted comparable lengths of stay in hospital and prison. CONCLUSIONS Our findings confirm significant disparities in length of time spent in a closed institution after offences of serious interpersonal violence, according to whether that institution was prison or hospital, but not all in the same direction. Next steps should explore reasons for this and relative longer-term outcomes.
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Affiliation(s)
- Paweł Gosek
- Department of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Justyna Kotowska
- Department of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
- Chair of Psychiatry, Medical College, Jagiellonian University, Krakow, Poland
| | | | - Dariusz Bartczak
- Department of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Jack Tomlin
- Department of Forensic Psychiatry, University of Rostock, Rostock, Germany
| | - Janusz Heitzman
- Department of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
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Gosek P, Kotowska J, Rowińska-Garbień E, Bartczak D, Heitzman J. Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting. Front Psychiatry 2020; 11:810. [PMID: 32922318 PMCID: PMC7457126 DOI: 10.3389/fpsyt.2020.00810] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 07/28/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Forensic psychiatric care has two, often contradictory, aims-the treatment of mentally ill offenders and the isolation of the perpetrators to ensure public safety. It is essential to ensure that any periods of liberty deprivation do not last longer than necessary to provide appropriate treatment. Therefore, identifying the factors affecting the length of stay (LoS) is one of the most important research areas in the forensic psychiatry. The literature on this subject is scarce and to date there no data available on LoS for patients in Eastern or Central European patients. METHODS We conducted a retrospective analysis of data for 150 inpatients in a medium secure unit. Based on a literature review and clinical experience, variables potentially influencing LoS were identified and included in the analysis. RESULTS The variables that were significantly associated with LoS included duration of mental illness; severity of index offense; whether a crime was committed as a result of hallucinations or during drug treatment discontinuation; if the index offenses was a continuous crime (crimes committed over an extended period of time); persistent psychosis; multiple antipsychotic treatments; as well as a diagnosis of schizophrenia and schizoaffective disorder. CONCLUSIONS Our findings are highly consistent with observations made by other researchers. However, contrary the majority of previous studies our project incorporates data concerning the clinical presentation of patients. For example, we demonstrate that variables measuring treatment resistance might be one of the crucial determinants of LoS, which is a novel research finding.
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Affiliation(s)
- Paweł Gosek
- Department of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Justyna Kotowska
- Department of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
- Chair of Psychiatry, Medical College, Jagiellonian University, Krakow, Poland
| | | | - Dariusz Bartczak
- Department of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Janusz Heitzman
- Department of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
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Probst T, Bezzel A, Hochstadt M, Pieh C, Mache W. Criminal Recidivism After Forensic Psychiatric Treatment. A Multicenter Study on the Role of Pretreatment, Treatment-Related, and Follow-Up Variables. J Forensic Sci 2020; 65:1221-1224. [PMID: 31961952 PMCID: PMC7383671 DOI: 10.1111/1556-4029.14281] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/02/2020] [Accepted: 01/02/2020] [Indexed: 11/30/2022]
Abstract
This study examined associations between criminal recidivism after discharge from forensic treatment and variables related to either the time before the current forensic treatment, or the current forensic treatment, or the follow-up after discharge. Participants were treated in 12 forensic clinics according to section 63 of the German penal code. A patient was classified as a criminal recidivist when the patient or the aftercare reported that the patient was delinquent at follow-up. Patients without criminal recidivism were patients for which both perspectives (patient and aftercare) reported no delinquency at follow-up. Mann-Whitney U-tests and Fisher's exact tests were performed. Data to classify patients were available for N = 249 patients. Fifteen patients (6%) were classified as criminal recidivists. The follow-up was M = 12.58 (SD = 1.84) months, and the criminal acts occurred M = 6.00 (SD = 5.55) months after discharge. Differences between patients with and without criminal recidivism were found in pretreatment (young age at first crime, early onset of mental disorder, previous forensic treatments), treatment-related (disorder due to psychoactive substance use, gradual release abuses, outbreaks, assaults against staff, criminal act during treatment, type of discharge, outcome ratings), as well as follow-up variables (no specified housing situation, not being abstinent from psychoactive substances, inpatient readmission, course of outpatient treatment, course of mental disorder) (all p < 0.05). To conclude, it is important to consider variables related to the time before the current treatment, treatment-related variables, and variables related to the follow-up to identify the patients at risk of criminal recidivism after discharge from forensic treatment.
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Affiliation(s)
- Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Dr.-Karl-Dorrek-Str. 30, Krems, 3500, Austria
| | - Adelheid Bezzel
- IFQM, Medbo (KU), Universitätsstr. 84, Regensburg, 93053, Germany
| | | | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Dr.-Karl-Dorrek-Str. 30, Krems, 3500, Austria
| | - Wolfgang Mache
- IFQM, Medbo (KU), Universitätsstr. 84, Regensburg, 93053, Germany
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