Patterns of recidivism and relapse among groups of mentally disordered offenders

The management and treatment of mentally disordered offenders is significantly hindered by our lack of detailed knowledge of this population. The present investigation attempted to identify five groups of male, mentally disordered offenders that are distinctive with respect to treatment needs: career criminals, chronic schizophrenics, violent psychotics, violent middleclass individuals, and intellectually handicapped subjects. It was hypothesized that patterns of recidivism and relapse would be different for each of these groups. A sample of 181 males previously judged unfit to stand trial or not guilty by reason of insanity were followed for an average of 6.1 years after discharge to the community. Factors relating to recidivism but not to relapse were found to distinguish the five groups.     

The relationship between sociomoral reasoning and intelligence in mentally disordered offenders

To date research has been inconclusive in explaining the relationship between sociomoral reasoning and adult offending, with some researchers suggesting that this relationship is mediated by intelligence. This study investigated sociomoral reasoning among 100 mentally disordered offenders in a maximum security hospital, 50 with a primary diagnosis of personality disorder (PD) including psychopathy and 50 with severe mental illness (SMI). Participants completed a battery of measures including the Gough Socialisation Scale, the Wechsler Abbreviated Scale of Intelligence, and the Sociomoral Reflection Measure – Short Form. Between-group differences showed that, compared with the PD group, the SMI group had significantly fewer antisocial personality traits, lower IQ, and lower-level sociomoral reasoning. Hierarchical multiple regressions showed that IQ was the most powerful predictor of sociomoral reasoning after controlling for a number of other variables including social desirability. While psychiatric diagnosis may appear to predict sociomoral reasoning, intellectual function is an important mediator of the process.     

Assessing treatability in mentally disordered offenders: A conceptual and methodological note

The assessment of treatability in mentally disordered offenders has rarely been addressed through empirical research, despite its frequent use in clinical and legal decision-making. We describe four necessary steps for establishing the requisite research base for treatability evaluations: (a) criterion specification, (b) the development of reliable measures, (c) the validation of these measures with treatment outcome data, and (d) the incorporation of environmental and base rate information.     

Self-efficacy among hospitalized mentally ill patients.

General self-efficacy and social self-efficacy were measured in a psychiatric inpatient population of 105 and compared with Sherer's 477 college students. Patients have lower self-efficacy than college students. A small but significant correlation of .38 was noted between general self-efficacy and social self-efficacy. Age was related to general self-efficacy but not social self-efficacy in this population.     

Transition planning and recidivism among mentally ill juvenile offenders

OBJECTIVES: To determine the extent to which transition planning and community service would predict lower levels of recidivism among mentally ill juvenile offenders. DESIGN: Review of legal, medical and social service records including examination of 3-month period following community release. PARTICIPANTS: Juvenile offenders incarcerated for 6 months or more (N = 44) transitioning to community. MEASURES: Child and Adolescent Functional Assessment Scale (CAFAS), sum of different documented pre- and post-release discharge planning contacts, documented community service contacts. OUTCOMES: Re-offense during the first year post-release. RESULTS: Documented community service contacts in the 3 months following discharge were rare for mental health (20.5%), substance abuse (38.6%), financial assistance (29.5%), and school placement (34.1%). The average number of different pre-release and post-release discharge planning contacts was also low, M(SD)=1.86(1.68) and M(SD)= 2.34(1.71) respectively. Post-release discharge planning and the receipt of financial assistance and mental health services were all associated with lower levels of reoffending. CONCLUSIONS: Community transition planning, including the coordination and provision of community services, is an essential component of community reintegration for juvenile offenders and is associated with lower rates of recidivism during the first year post-discharge.     

A theoretically informed meta-analysis of the risk for general and violent recidivism for mentally disordered offenders

Mentally disordered offenders (MDOs) pose a significant challenge for forensic and correctional staff charged with managing them in a safe and humane manner. As with non-disordered offenders, it is important to identify the factors that are predictive of recidivism and can serve as treatment targets for MDOs. The present meta-analysis evaluated the relative predictive validity of the risk/need domains from the General Personality and Cognitive Social Learning (GPCSL) perspective and variables taken from the clinical perspective. The search yielded a total of 126 studies reporting on 96 unique samples (N = 23,900). Results indicated that all risk/need domains under the GPCSL perspective were significantly related to both general and violent recidivism. In contrast, the majority of clinical variables (with the exception of antisocial personality/psychopathy) were not predictive of either outcome. These findings emphasize the importance of identifying appropriate risk factors for MDOs.     

The psychometric identification of psychopathy in mentally abnormal offenders

This study addressed the question of the degree of commonality, at a psychometric trait level, shared between two distinct concepts of psychopathy: a North American concept, defined in terms of chronic antisocial behaviour with early onset; and a European concept, defined in terms of personality deviation. Four groups of Broadmoor patients were identified who conformed to DSM-III criteria for the following diagnostic categories: Antisocial Personality Disorder (APD) (n = 12); Other Personality Disorders (OPD) (n = 9); Schizophrenic Disorders (SD) (n = 10); and a Mixed (M) group who met the criteria for both Schizophrenic Disorders and Antisocial Personality Disorder (n = 12). Thus subjects in both the APD and M groups, having a DSM-III diagnosis of Antisocial Personality Disorder, conformed to the North American concept of psychopathy. All diagnostic groups, together with a non-psychiatric control group of psychiatric nurses, were investigated using a composite battery of psychometric measures which tapped the two concepts of psychopathy. The only measure to discriminate successfully between patient groups with an APD diagnosis and other groups was Gough's (1969) Socialisation, which is itself a measure of the North American concept. Measures of personality deviation, including Blackburn's (1987) Belligerence and Withdrawal measures, failed to successfully discriminate DSM-III APD's from others. Thus the degree of trait commonality between the two concepts was found to be minimal. The study also addresses a fundamental question raised recently by both Hare and Harpur (1986) and Raine (1986) in criticism of a study by Howard, Bailey and Newman (1984): Are Broadmoor psychopaths “psychopathic” in the North American sense? Results of the study clearly indicate that they indeed are.     

Frontal lobe functions and personality in mentally abnormal offenders

This study addresses the recent controversy regarding frontal lobe deficits in psychopaths (Gorenstein, 1982; Hare, 1984) and more generally the question of a relationship between psychopathy as variously attributed (by legal criteria, by clinical-behavioural criteria, and by psychometric criteria) and performance on a task used in the assessment of frontal lobe function, Nelson's Modified Wisconsin Card Sorting Test (MWCST). Two samples of Special Hospital patients were tested as well as a small group of normal healthy volunteers. Patients classified legally as suffering from a ‘Psychopathic Disorder’ did not differ on MWCST measures from patients classified legally as ‘Mentally Ill’. There were no differences on performance measures comparing patients assessed as ‘high’ or ‘low’ on Hare's Psychopathy Checklist. Comparison between psychometrically derived patient groups corresponding to Blackburn's (1974) ‘primary’ and ‘secondary’ psychopathic types yielded statistically significant results: ‘secondary’ psychopaths showed significantly more total errors and achieved significantly fewer categories than did ‘primary’ psychopaths and controls. This suggests that the discrepancy between Gorenstein's (1982) and Hare's (1984) results can parsimoniously be explained by their use of different selection criteria to select their ‘psychopaths’. However, it is suggested that performance deficits on the MWCST such as were obtained in ‘secondary’ psychopaths are not a correlate of ‘psychopathy’ (however defined), but rather reflect an inability to maintain set resulting from an over-appraisal of threat on the part of the anxious, socially withdrawn individual.     

Convergent and discriminative validity of interview and questionnaire measures of personality disorder in mentally disordered offenders: a multitrait-multimethod analysis using confirmatory factor analysis

Measures of personality disorder from the International Personality Disorder Examination, Personality Diagnostic Questionnaire, and Millon Clinical Multiaxial Inventory (MCMI-II) were obtained from detained male mentally disordered offenders (N = 156), and convergent and discriminant validity were examined by confirmatory factor analysis of the multitrait-multimethod matrix. Hierarchical comparisons of models varying in their specification of trait and method variance established the appropriateness of a model supporting both convergence and discrimination across methods, but these were variable across constructs and measures. Convergence was good for avoidant, schizoid, and antisocial disorders, but poor for histrionic, narcissistic, and obsessive-compulsive disorders. Avoidant, schizoid, and schizotypal disorders were not clearly distinguishable from each other. Measurement error attributable to method variance was substantial for all instruments and for most disorders. The commonly alleged superiority of interview over questionnaire methods was not supported, and the MCMI-II demonstrated proportionately more "true" variance. However, assessment methods may be differentially sensitive to different kinds of personality disorder problems.     

Patterns of imitation in mentally retarded children

Abstract.— In this report, the interchange theory of imitation was extended to mentally retarded children. Retardates were expected to observe and copy adults, using external cues and internal controls as aids. In Experiment I external cues were studied. Twenty-four speaking and 24 non-speaking retardates were paired with adults who gave half the children instructions to copy and the other half additional verbal and gestural cues. Non-speaking retardates receiving frequent cues attended and copied better than those getting initial instructions, gestural cues being equally or more effective than verbal ones. Speaking retardates getting repeated cues finished copying sooner than those getting only instructions, verbal and gestural cues being equally effective. In Experiment II internal controls over appropriate imitation were studied. Twenty-two retardates were trained to sit, observe and copy their teachers in a two-month program. Training was evaluated in situations where copying or playing was signalled. Overall, children attended and copied more in the appropriate situation. However, sitting, attention, and copying increased non-specifically in both situations, and initial situational differences in copying were not observed after treatment. The interchange theory was revised, and implications for attention-deficit and verbal self-control theories were discussed. Notions of "generalized imitation" were criticized.     

Recidivism of disordered offenders who were conditionally vs. unconditionally released

Postinstitutional arrests and state hospitalizations of 191 patients placed on conditional release (CONREP group) were compared to those of 44 patients released from the same California state hospital with no aftercare due to expiration of commitment terms (MAXOUT group). The two groups were not randomly determined but were comparable in demographic characteristics and rates of preprogram arrest. The CONREP group had a significantly lower community-period arrest rate than did the MAXOUT group (p <.001). Survival rate analyses, using time until arrest and time until revocation as dependent variables, suggested that revocations during the first 240 days of community re-entry reduced the potential arrest rate within the CONREP group. Results were discussed in terms of the “criminalization hypothesis” as well as the crime-preventive possibilities of the conditional release mechanism.     

Patterns of suicide mortality in Russia

While Russia perennially has one of the highest suicide rates in the world, researchers had little access to valid data during the Soviet era to examine this issue. Transparency increased following the dissolution of the USSR, and this article employs newly available vital statistics data to describe the demographic, temporal, and spatial patterns of suicide in Russia. The discussion reveals that suicide mortality in Russia is among the highest in the world and is more than three times higher than in the United States; exhibited radical changes between 1984 and 1994; varies widely within the country, with a general increase in rates from west to east; and is highest among working-age males.     

Neural correlates of deficient response inhibition in mentally disordered violent individuals

In this study, response inhibition and associated neural activation during a motor inhibition paradigm were investigated in (i) men with antisocial personality disorder (APD) with a history of violence (n = 14), (ii) men with schizophrenia with a history of violence (n = 12), (iii) men with schizophrenia without a history of violence (n = 12), and (iv) healthy control subjects (n = 14) using functional magnetic resonance imaging (fMRI). At the behavioural level, individuals with schizophrenia showed impaired performance across all conditions, whereas an increased error rate was seen in the APD group only during the conditions requiring inhibition. At the neural level, both violent groups showed reduced thalamic activity, compared with controls, in association with modulation of inhibition by task demands. In addition, the violent schizophrenia group, compared with controls, showed reduced activity in the caudate nucleus during the condition requiring inhibition. It is concluded that violence may not be specifically associated with impaired voluntary inhibition in schizophrenia but this is likely in APD. Reduced thalamic function, perhaps due to its known association with sensorimotor disturbances, is implicated in violent behaviour across both disorders. In addition, caudate dysfunction may contribute, given its role in timing and temporal processing as well as suppression of motor actions, to deficient inhibition and violent behaviour in schizophrenia.     

Denial and minimization among sex offenders

A review of empirical studies of offenders—particularly sex offenders, and more particularly those who offend against children—demonstrates that denial of offenses and minimization of offending behavior are quite common at every stage of the criminal justice process. This is true during police interviews, during pretrial and presentencing mental health evaluations, among incarcerated offenders, among offenders seeking treatment, among offenders facing parole review, and among offenders already released into the community. This review highlights gaps in the research literature arising from inconsistencies in the definitions and measurement of denial and minimization, from the stage of adjudication or treatment at which measurements are made, and from the use of polygraphy to increase disclosures. Despite these limitations on the generalizability of empirical findings, it appears beyond dispute that many sex offenders maintain their innocence in the face of evidence to the contrary or even criminal conviction, and that many are able to recite additional crimes they have committed when they believe it is in their self-interest to do so.     

Moral/conventional transgression distinction and psychopathy in conduct disordered adolescent offenders

To date there are no studies examining the ability to make a moral/conventional transgression distinction in adolescent offenders with psychopathic traits. Based on the Psychopathy Checklist: Youth Version, we compared males with high (HP, n = 45), medium (MP, n = 31) and low psychopathy scores (LP, n = 39) on the moral convention distinction task. Under normal rule conditions the psychopathy groups did not differ in their ability to make a moral/conventional distinction. The HP group tended to view both transgression types as more permissible and conventional transgressions as less serious, than the LP group. Under modified rule conditions, the HP group exhibited reduced moral/conventional distinction scores compared to the MP group. The findings only partially replicate findings from previous M/C studies in children and adults with psychopathic traits. The work fits with more recent reports suggesting that psychopathy is not strongly associated with marked difficulties in cognitive theory of mind, perspective taking and moral judgements. Future studies should focus on the affective aspects of moral reasoning in offender samples.     

Risk and protective factors among youth offenders

This exploratory study examined the risk and protective factors of youth offenders and their relation to recidivism. The sample consisted of 76 male and female juvenile probationers within a large metropolitan area. Archival records on probationers provided data on prior offenses, personal characteristics, familial conditions, drug use, peer selection, school performance, role models, and activities and hobbies. It was found that protective factors, specifically personal characteristics, familial conditions, and peer selection, differentiated nonrepeat offenders and repeat offenders. The present body of findings supports the adaptive model of resiliency and reinforces the importance of enhancing protective factors in youth offenders as a means of deterring delinquent behavior.