Predicting physically violent misconduct in prison: A comparison of four risk assessment instruments

Violence in correctional facilities is an important issue for both prisoners and prison staff. Risk assessment instruments have demonstrated their accuracy in predicting the risk of (re) offending and institutional violence in psychiatric settings, but less is known about their ability to predict violent misconduct in prison. The present study applied four risk assessment instruments (Structured Assessment of Protective Factors for violence risk, Historical Clinical Risk Management‐20, Psychopathy checklist – Revised, and Violent Risk Appraisal Guide) to 52 violent offenders in a Swiss prison in order to evaluate the instruments' predictive validities. Outcomes were instances of physically violent, other and any misconduct as recorded in prison files during the 12 months following the prisoners' assessments. Approximately 15% of offenders committed physically violent misconduct and approximately 42% committed any misconduct. The results show that mainly dynamic assessment tools are as good predictors of physically violent misconduct as mainly static assessment tools. Targeting dynamic factors could increase the effectiveness of interventions to reduce the risk of physical violence in prison.     

Violent and disruptive behavior among drug-involved prisoners: relationship with psychiatric symptoms

This study examines the relationship between psychiatric symptoms and violent/disruptive behavior among 192 inmates who participated in prison-based substance abuse treatment. Participants came from two sites able to provide narrative reports of disciplinary actions in the Criminal Justice Drug Abuse Treatment Studies' Co-Occurring Disorders Screening Instrument study. In multivariate logistic models, a lifetime history of thought insertion/control ideation (OR, 11.6; 95% CI, 1.8-75.2), antisocial personality disorder (OR, 3.3; 95% CI, 1.2-8.9), and disciplinary action related to possession of controlled substances or contraband (OR, 4.9; 95% CI, 1.9-12.3) were associated with increased risk for violent or disruptive behavior while in prison, whereas lifetime phobic symptoms (OR, 0.2; 95% CI, 0.1-0.54) and high school graduation (OR, 0.4; 95% CI, 0.2-1.0) were associated with a decreased risk of violence and disruptive behavior in general. We conclude that, among inmates in substance abuse treatment, symptoms that increase risk for violence or disruptive behavior include thought control/insertion ideation and disciplinary infractions related to controlled substances, contraband, or failure to participate in assigned programs, as well a history of antisocial personality disorder.     

An empirical typology of violent incidents reported by prison inmates with convictions for violence

Forty-four male prison inmates convicted for violent offences were interviewed, and details of current offence, previous convictions for violence, prison incidents, and violent situations outside of prison were obtained from each offender. Information on victim, circumstances, precipitating events, type of violence, emotions at the time, and the like, was derived for 246 violent incidents. Cluster analysis revealed eight clusters: “criminal” violence to familiar victims, peer violence within prison, domestic violence, peer violence in pubs, gang violence, violence to staff in prison, “criminal” violence to unknown victims with accomplices, and public violence against younger victims. Results were discussed in terms of treatment of violent offenders, with special emphasis on Social Skills Training.     

Psychopathie,antisoziale Persönlichkeitsstörung und Sexualdelinquenz

In today’s field of forensic psychiatry, psychopathy is seen as a subtype of antisocial personality disorder and includes manipulative behavior, egocentric and arrogant characteristics, high-risk behavior as well as a lack of empathy. Empirical data on the prevalence of psychopathy and antisocial personality disorder among offenders greatly vary depending on the study design and the composition of the sampled population. Offenders who committed both violent and sex offenses seem to have antisocial traits with a higher probability than offenders who committed only violent or only sex offenses. In the context of criminal responsibility and risk assessment for sex offenders, antisocial and psychopathic traits have a negative impact on the prediction of recidivism. Many study results, even though not all, additionally indicate that the combination of psychopathic traits and sexual deviance (i.?e. for example a paraphilic disorder such as sexual sadism) in sex offenders may be associated with a particularly high risk to reoffend. Due to the specific interpersonal characteristics (e.?g., dominant, provocative behavior, exaggerated self-esteem), therapeutic treatment of sex offenders with antisocial and psychopathic traits is often difficult. The regular supervision by the therapist is considered to be crucial to avoid harmful relationship dynamics or distorted perception of the therapist.     

The Role of Exposure to Violence and Psychopathy on Violent Crime Perpetration

Exposure to violence strongly predicts violent behavior. However, not all individuals who are exposed to violence engage in violent behavior. Personality is one factor that influences the translation from exposure to violence to engagement in violent behavior. Previous research in adolescents showed that psychopathy (a personality disorder) mediated the relationship between exposure to violence and violent behavior. However, this research has not: been conducted in adults, despite evidence of instability in exposure to violence and psychopathy across the lifespan; examined the specificity of this relationship to different expressions of psychopathy, such as subcomponent Factors and primary/secondary subtypes; and, considered other environmental experiences that may impact this relationship. In two samples of adults (community [N?=?232] and prison [N?=?313]), psychopathy affected the relationship between exposure to violence and violence (community indirect effect?=?0.03, SE?=?0.02, 95% CI?=?0.004, 0.07; prison indirect effect?=?0.14, SE?=?0.05, 95% CI?=?0.05, 0.25). These effects appeared to be related more strongly to the impulsive-antisocial traits of psychopathy and the secondary (high-anxious) subtype of psychopathy. Results were robust against demographic and other environmental experiences. Ultimately, our findings indicate that psychopathy is an important factor affecting the link between exposure to violence and violent behavior.

     

A comparative study of adolescent risk assessment instruments: predictive and incremental validity

Promising new adolescent risk assessment tools are being incorporated into clinical practice but currently possess limited evidence of predictive validity regarding their individual and/or combined use in risk assessments. The current study compares three structured adolescent risk instruments, Youth Level of Service/Case Management Inventory (YLS/CMI), Structured Assessment of Violence Risk in Youth (SAVRY), and Psychopathy Checklist: Youth Version (PCL:YV), for both predictive and incremental validity with respect to general and violent recidivism. Receiver operating characteristic and hierarchical logistic regression analyses revealed that the risk tools predicted general and violent recidivism to varying degrees of accuracy, but the SAVRY offered the most in incremental validity. Clinical implications and future directions for youth risk assessment are discussed.     

New directions in offender typology design,development, and implementation: Can we balance risk,treatment and control?

It should come as no surprise that there is no “one-stop shopping” offender typology available that can identify the risk level, targeted treatment protocols, and control levels of the offender groups examined in this special issue: murderers, sex offenders, batterers, violent prisoners, and violent mentally ill offenders. We are in desperate need of further research establishing the links between offender risk level, offender treatment needs, and offender control requirements for each of these offender groups. This article provides a “state of the art” discussion of the key issues that must be addressed by policymakers, practitioners, and ultimately, the public, vis-à-vis the design, development, and implementation of typologies for each of these targeted groups of offenders. This is followed by our assessment of the lessons learned from the great prison classification experiment. We conclude by providing an assessment of new directions in the development of typologies of offenders and the communities in which offenders reside, based on the simple notion that offender change–not offender control–needs to be the primary focus of the next generation of correctional classification systems.     

Schizophrene Patienten der forensischen Psychiatrie im Vergleich zu schizophrenen Patienten der Allgemeinpsychiatrie

Background

The number of schizophrenic patients admitted to forensic hospitals according to section 63 of the German Criminal Code has increased continuously over the past years. Some researchers assume that these forensic patients form a group of patients with very complex mental disorders, a number of risk factors and insufficient pretreatment in general psychiatry. This study aimed to identify differences regarding the history of treatment of forensic and general psychiatric patients diagnosed with schizophrenia.

Method

The matched samples included 72 male patients from forensic wards and 72 male patients from general psychiatric institutions diagnosed with schizophrenia. The history of psychiatric treatment was reconstructed by interviewing the patients as well as outpatient psychiatrists and patients’ legal custodians and by analyzing patient medical records.

Results

In contrast to the general psychiatric patients, prior to admission forensic patients were less integrated into psychiatric care and showed a lower rate of treatment compliance. They also showed a higher rate of previous compulsory treatment because of aggressive behavior towards other persons as well as higher rates of treatment difficulties and violent behavior during previous inpatient treatment. Furthermore, forensic patients had a higher number of previous criminal convictions and had been convicted more often for violent offences. With regard to other relevant risk factors (e.g. comorbid substance abuse disorder, age, education, conduct disorder, antisocial personality disorder, previous exposure to violent and abusive behavior) the two patient groups were, however, comparable.

Conclusions

Regarding schizophrenic patients with comorbid substance abuse disorders, previous violent delinquency and violent behavior during previous inpatient treatment, an intensive outpatient aftercare should be arranged before they are discharged from general psychiatric institutions.     

A longitudinal examination of the relation between co‐offending with violent accomplices and violent crime

Although the idea that youthful offenders are affected by the company they keep is widely accepted, evidence in support of this idea is based primarily on reports provided by offenders and their peers. As an alternative to relying on reports of criminal behavior, a method that may overestimate the role that peers play in criminal behavior, the current research on co‐offending uses court records to identify and track over time individuals who are known to commit crimes together. The present investigation is the first co‐offending study to track patterns of violent criminal behavior (over an 18‐year period) among a sample of urban offenders and their accomplices. The study tests whether violence “spreads” from violent offenders to those inexperienced in violence. Results indicate that nonviolent offenders who commit their first co‐offense with violent accomplices are at increased risk for subsequent serious violent crime. Findings suggest that lessons of violence can be learned “on the street,” where knowledge is passed along through impromptu social contexts, including those in which offenders commit crimes together. Aggr. Behav. 28:97–108, 2002. © 2002 Wiley‐Liss, Inc.     

Pathways to violence in the children of mothers who were depressed postpartum

The impact of postnatal depression on a child's risk for violent behavior was evaluated in an urban British community sample (N=122 families). Mothers were interviewed during pregnancy, at 3 months postpartum, and when the child was 1, 4, and 11 years of age. Mothers, teachers, and children reported on violent symptoms at age 11. Structural equation modeling revealed that the child's violence was predicted by the mother's postnatal depression even when her depression during pregnancy, her later history of depression, and family characteristics were taken into account. Violence was associated with symptoms of attention-deficit/hyperactivity disorder and problems with anger management. Children were most violent if mothers had been depressed at 3 months and at least once thereafter.     

Informed Consent: An Ethical Issue in Conducting Research with Male Partner Violent Offenders

Ethical codes help guide the methods of research that involves samples gathered from “at-risk” populations. The current article reviews general as well as specific ethical principles related to gathering informed consent from partner violent offenders mandated to outpatient treatment, a group that may be at increased risk of unintentional coercion in behavioral sciences research due to court mandates that require outpatient treatment without the ethical protections imbued upon prison populations. Recommendations are advanced to improve the process of informed consent within this special population and data supporting the utility of the recommendations in a sample 70 partner violent offenders are provided. Data demonstrate that participants were capable of comprehending all essential elements of consent.     

Individual characteristics related to prison violence: A critical review of the literature

At the end of 2010, prisons in the United States incarcerated over 1,605,127 inmates, yielding an imprisonment rate of 497 per 100,000 residents (Guerino, Harrison, & Sabol, 2011). Approximately 15.6% of correctional officers have been the victim of an inmate assault (Duhart, 2001) and 21% of inmates reported being victims of violence in prison (Wolff, Blitz, Shi, Siegel, & Bachman, 2007). However, which inmates are more likely to perpetuate these violent acts while incarcerated? The present paper critically reviews the empirical literature on the relation between individual characteristics of inmates and prison violence. Variables are divided into three general categories: demographic, criminal history, and psychological variables. From over 500 studies, a representative sample of 20 studies from 1990 to 2011 was reviewed based on specified inclusion criteria, such as adult males incarcerated in English-speaking countries. Although there are some discrepant findings, a general conclusion can be reached regarding most variables. These characteristics are compiled into a prototype of an inmate at “high” risk and an inmate at “low” risk for prison violence. Methodological limitations of the research are presented, as well as suggestions for future research directions.     

Assessment of accused juvenile sex offenders in Germany: a comparison of five different measures

The present study examines the relationship between risk and protective factors among young alleged sexual offenders (N = 66) in pre-trial and pre-treatment settings. For risk assessment purposes, the Screening Tool for the Assessment of Young Sexual Offenders' Risk (STAYSOR), the Structured Assessment of Violence Risk in Youth (SAVRY), and the Structured Assessment of Protective Factors for violence risk (SAPROF) were used. Psychopathological indicators measured with the Basis Raads Onderzoek (BARO) and the German adaption of the Reynolds Adolescent Adjustment Screening Inventory (RAASI) were used to examine the relationship between the risk assessment scales and instruments measuring risk-relevant psychopathological constructs. Risk and protective factors were significantly negatively correlated. Psychopathological measures were positively correlated with risk factors and negatively with protective factors. Although further studies on the predictive validity of the instruments are needed, the results of the present explorative pilot study indicate that the use of all five instruments may be clinically meaningful for the assessment of young persons who are at risk of sexual offending.     

An actuarial model for assessment of prison violence risk among maximum security inmates

An experimental scale for the assessment of prison violence risk among maximum security inmates was developed from a logistic regression analysis involving inmates serving parole-eligible terms of varying length (n = 1,503), life-without-parole inmates (n = 960), and death-sentenced inmates who were mainstreamed into the general prison population (n = 132). Records of institutional violent misconduct of these 2,595 inmates were retrospectively examined for an 11-year period (1991 to 2002). Predictors affecting the likelihood of such misconduct included age, type and length of sentence, education, prior prison terms, prior probated sentences, and years served. The scale was modestly successful, as demonstrated by an overall omnibus area under the curve of .719. Double cross-validation demonstrated minimal shrinkage. The authors have termed this experimental scale the Risk Assessment Scale for Prison.     

Interview with Jonathan Asser

In this interview, Jonathan Asser recounts how working in prisons with violent male inmates was the inspiration behind ‘Starred Up’, his acclaimed film about a young man who enters adult prison for the first time. The film offers an insight into the innovative Shame/Violence Intervention (SVI) that Asser pioneered whilst working as a group therapist at HMP Wandsworth. Asser’s approach included getting members of his groups to acknowledge the shame they felt before these feelings became unbearable and escalated into violence. Drawing on the ideas of American psychiatrist James Gilligan, Asser found he was able to work with the most violent and institutionalised prisoners by developing a technique that relied on a particular use of his counter-transference. Asser also talks about the personal experiences that led him into working therapeutically with this client group.     

The splitting between separate and symbiotic stätes of the self in the psychodynamic of schizophrenia

Abstract

We explore the problematic dynamics in the relationship between societal systems of care and the chronically excluded, with particular reference to severe personality disorder and the “difficult-to-reach” patient. The individual who “refuses” is often met with a violent response: yet his violence must be understood as related to an experience of being violently excluded. We reformulate personality disorder as a disturbance of “groupishness” and suggest, as a paradigm for the problem of refusal, the story of Diogenes the Cynic, who “holed himself up” in a barrel; and of his legendary encounter with Alexander the Great, who tried unsuccessfully to persuade him to “come in from the cold.” We suggest it may be as important to focus on Alexander's violence as on that of Diogenes, and we examine modes of violence deployed by society against the excluded outsider, with particular reference to the hostile attribution of intentionality to the personality disordered individual's acts of violence and self-harm. We conclude by considering both the merits of the democratic therapeutic community model as a response to severe personality disorder and the dangers, inherent in this model among others, in an unconscious identification with Diogenes in his barrel.     

Prognostische Validität des Level of Service Inventory-Revised

This study examined the validity of the level of service inventory-revised (LSI-R) for a sample of young violent offenders in Germany (N?=199) who were sentenced to more than 2 years imprisonment using a retrospective study design. Offenders with a migrant background from a predominantly Muslim country were compared to native German offenders. Both groups were similar regarding age, criminal history, socioeconomic status, education, current risk of subsequent offending and recidivism. For the group of young offenders with a migrant background from a predominantly Muslim country (n?=85), the LSI-R failed to validly predict problem behavior during imprisonment as well as to validly predict recidivism within 2 and 5 years after release from prison. In contrast, for native German offenders (n?=114) the LSI-R performed satisfactorily in predicting problematic behavior during imprisonment and achieved a moderate to high level of predictive power in predicting recidivism after release from prison. These findings stress the necessity for research on influencing factors, developmental dynamics and prognosis among young violent offenders with a migrant background from a predominantly Muslim culture.     

Violence,research, and non-identity in the psychiatric clinic

Violence in psychiatric clinics has been a consistent problem since the birth of modern psychiatry. In this paper, I examine current efforts to understand and reduce both violence and coercive responses to violence in psychiatry, arguing that these efforts are destined to fall short. By and large, scholarship on psychiatric violence reduction has focused on identifying discrete factors that are statistically associated with violence, such as patient demographics and clinical qualities, in an effort to quantify risk and predict violent acts before they happen. Using the work of Horkheimer and Adorno, I characterize the theoretical orientation of such efforts as identity thinking. I then argue that these approaches lead to epistemic imperceptiveness and a subtle form of conceptual restraint on patients. I suggest a reorientation in psychiatric research, away from identity thinking and toward a more productive and just approach to the problem of violence in psychiatric clinics.     

Health and Care Related Risk Factors for Suicide Among Nursing Home Residents: A Data Linkage Study

This study aimed to examine associations between health status and care needs of nursing home residents and risk of death from suicide compared to other causes through a retrospective data linkage cohort study examining nursing home resident deaths in Australia between 2000 and 2013. Data linkage was performed between aged care assessment tools—Resident Classification System and Aged Care Funding Instrument—and the National Coronial Information System. A competing risks survival analysis was performed to determine the association between care assessment variables (activities of daily living (ADL), behavior, and complex health care) and the risk of death from suicide and any other cause. Of the 146 nursing home residents who died from suicide, 130 (89%) were matched to their assessment data, with comparable information available for 95 residents (65%). Residents who required high levels of care with ADL, physical health care, and cognitive and behavioral issues had a higher risk of dying from all other causes, yet lower risk of dying from suicide. The study findings demonstrate the feasibility and value of linking these two data sets; highlight a need for improved data collection processes; and support a person‐centered care approach for prevention of suicide among nursing home residents.     

The compelling case for low-violence-risk preclusion in American prison policy

This article recommends the development of broad policies of preclusion regarding the use of incarceration for offenders who are highly unlikely to commit a violent crime in the future. The proposal builds on the new Model Penal Code: Sentencing's provision on the limited utilitarian purposes of incarceration. Such low-violence-risk-preclusion strategies (LVRPs) would stand on the most powerful predictive capabilities of today's risk assessment technology. If implemented properly, there is reason to believe that substantial drops in prison rates could be realized in most states. The preclusion groups would include defendants who should not be sent to prison or jail by sentencing judges even though the law allows for such penalties; those serving prison sentences who should be released by parole boards or other releasing authorities at the earliest opportunity; and probation and parole violators who should not be revoked to prison or jail. The strongest objection to the LVRP proposal is the fear of racial or other unacceptable biases in its apportionment of reduced-incarceration benefits. Given current high levels of disproportionality in prison and jail populations, however, there is reason to think that the benefits of LVRP would be especially pronounced in disadvantaged communities.