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Vicenzutto A, Joyal CC, Telle É, Pham TH. Risk Factors for Sexual Offenses Committed by Men With or Without a Low IQ: An Exploratory Study. Front Psychiatry 2022; 13:820249. [PMID: 35546929 PMCID: PMC9081977 DOI: 10.3389/fpsyt.2022.820249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Although risk factors associated with offending and recidivism are relatively well-established for mainstream sexual offenses, much less is known about men with a low IQ who have sexually offended (MIQSO), let alone those with forensic involvement. In this exploratory study, 137 convicted for the commission of at least one sexual offense and found not criminally responsible because a mental disorder were recruited in a maximum-security hospital. They were all assessed with the SORAG (static risk factors) and the RSVP (dynamic risk factors). Compared with MIQSO (N = 76), men with an average or higher IQ who have sexually offended (MSO, N = 61) obtained significantly higher scores on static factors related with general delinquency (histories of alcohol abuse, non-violent criminality, violent criminality, and sexual offense) and dynamic factors related with sexual delinquency, paraphilia, and recidivism (chronicity, psychological coercion, escalation, sexual deviance, and substance abuse). In contrast, MIQSO obtained significantly higher scores on major mental illness, problems with planning and problems with self-awareness. Logistic regressions revealed that both the SORAG and RSVP were useful to predict group membership. It is concluded that risk factors related with general and sexual delinquency better describe offenses committed by MSO, whereas risk factors related with mental disorder, lack of insight and contextual impulsivity better describe offenses committed by MIQSO.
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Affiliation(s)
- Audrey Vicenzutto
- Forensic Psychology Department, University of Mons (UMONS), Mons, Belgium
| | - Christian C Joyal
- Psychology Department, University of Québec at Trois-Rivières (UQTR), Trois-Rivières, QC, Canada.,International Center of Comparative Criminology, University of Montreal, Montreal, QC, Canada.,Research Center, Philippe Pinel National Institute of Forensic Psychiatry, Montréal, QC, Canada
| | - Émilie Telle
- Forensic Psychology Department, University of Mons (UMONS), Mons, Belgium
| | - Thierry H Pham
- Forensic Psychology Department, University of Mons (UMONS), Mons, Belgium.,Research Center, Philippe Pinel National Institute of Forensic Psychiatry, Montréal, QC, Canada.,Social Defense Research Center (CRDS), Tournai, Belgium
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Edberg H, Chen Q, Andiné P, Larsson H, Hirvikoski T. Criminal recidivism in offenders with and without intellectual disability sentenced to forensic psychiatric care in Sweden-A 17-year follow-up study. Front Psychiatry 2022; 13:1011984. [PMID: 36213925 PMCID: PMC9533124 DOI: 10.3389/fpsyt.2022.1011984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Offenders with intellectual disability (ID) constitute a distinct subgroup of offenders with mental disorders. Regarding criminal recidivism, it is unclear whether or not offenders with ID in forensic psychiatric settings differ from offenders without ID. Factors associated with criminal recidivism among offenders with ID have been scarcely investigated. AIM To investigate the association between ID and criminal recidivism among offenders sentenced to forensic psychiatric care and to explore the impact of clinical, sociodemographic and offense variables. MATERIALS AND METHODS We conducted a retrospective cohort study based on Swedish nationwide registers. A total of 3,365 individuals being sentenced to forensic psychiatric care in Sweden in 1997-2013 were followed from the forensic psychiatric assessment until first reconviction, death, emigration, or 31 December 2013, whichever occurred first. Cox regression models compared rates of recidivism in individuals with and without ID. Impact of clinical, sociodemographic, and offense variables on risk of criminal recidivism was presented as hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS Out of 3,365 offenders sentenced to forensic psychiatric care, 259 (7.7%) were diagnosed with ID. During follow-up (0-17 years, median 6 years), one third (n = 1,099) of the study population relapsed into criminality, giving a recidivism rate of 50.5 per 1,000 person-years. We observed an association between ID and a decreased risk of recidivism (HR 0.8, 95% CI 0.6-1.0, p = 0.063), although this reached statistical significance only for the subgroup of male offenders (HR 0.8, 95% CI 0.6-1.0, p = 0.040) and not females (HR 1.0, 95% CI 0.6-1.8). ID offenders with concurrent ADHD tended to have a higher rate of recidivism (73.9 per 1,000 person-years, HR 1.2, 95% CI 0.6-2.4) than ID offenders without ADHD (42.5 per 1,000 person-years, HR 0.8, 95% CI 0.6-1.1). Amongst ID offenders, concurrent autism spectrum disorder, young age or male sex were not associated with recidivism, while previous criminal convictions were strongly associated with recidivism. CONCLUSION A diagnosis of ID was associated with a lower risk of criminal recidivism among male offenders sentenced to forensic psychiatric care. The association between ADHD and recidivism among ID offenders highlights eligible focus areas in the management of offenders with ID.
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Affiliation(s)
- Hanna Edberg
- Paediatric Neuropsychiatry Unit, Department of Women's and Children's Health, Centre for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Stockholm, Sweden.,Swedish Prison and Probation Services, Norrköping, Sweden.,Northern Stockholm Psychiatric Clinic, Region Stockholm, Stockholm, Sweden.,Centre for Psychiatry Research, Region Stockholm, Stockholm, Sweden
| | - Qi Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Peter Andiné
- Centre for Ethics, Law and Mental Health (CELAM), Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Tatja Hirvikoski
- Paediatric Neuropsychiatry Unit, Department of Women's and Children's Health, Centre for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Stockholm, Sweden.,Centre for Psychiatry Research, Region Stockholm, Stockholm, Sweden.,Habilitation & Health, Region Stockholm, Stockholm, Sweden
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Lofthouse R, Golding L, Totsika V, Hastings R, Lindsay W. How effective are risk assessments/measures for predicting future aggressive behaviour in adults with intellectual disabilities (ID): A systematic review and meta-analysis. Clin Psychol Rev 2017; 58:76-85. [PMID: 29066047 DOI: 10.1016/j.cpr.2017.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 10/11/2017] [Accepted: 10/12/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Risk assessments assist professionals in the identification and management of risk of aggression. The present study aimed to systematically review evidence on the efficacy of assessments for managing the risk of physical aggression in adults with intellectual disabilities (ID). METHODS A literature search was conducted using the databases PsycINFO, EMBASE, MEDLINE, Web of Science, and Google Scholar. Electronic and hand searches identified 14 studies that met the inclusion criteria. Standardised mean difference effect sizes Area Under Curve (AUC) were calculated for studies. Random effects subgroup analysis was used to compare different types of risk measures (Actuarial, Structured Professional Judgment and dynamic), and prospective vs. catch-up longitudinal study designs. RESULTS Overall, evidence of predictive validity was found for risk measures with ID populations: (AUC)=0.724, 95% CI [0.681, 0.768]. There was no variation in the performance of different types of risk measures, or different study design. CONCLUSIONS Risk assessment measures predict the likelihood of aggression in ID population and are comparable to those in mainstream populations. Further meta-analysis is necessary when risk measures are more established in this population.
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Affiliation(s)
- Rachael Lofthouse
- The Harbour, Blackpool, Preston New Road, Blackpool FY4 4FE, United Kingdom.
| | | | - Vasiliki Totsika
- CEDAR and Centre for Education Studies (CES), University of Warwick, United Kingdom; Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, United Kingdom
| | - Richard Hastings
- CEDAR and Centre for Education Studies (CES), University of Warwick, United Kingdom; Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, United Kingdom
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Hounsome J, Whittington R, Brown A, Greenhill B, McGuire J. The Structured Assessment of Violence Risk in Adults with Intellectual Disability: A Systematic Review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 31:e1-e17. [PMID: 27891723 DOI: 10.1111/jar.12295] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND While structured professional judgement approaches to assessing and managing the risk of violence have been extensively examined in mental health/forensic settings, the application of the findings to people with an intellectual disability is less extensively researched and reviewed. This review aimed to assess whether risk assessment tools have adequate predictive validity for violence in adults with an intellectual disability. METHODS Standard systematic review methodology was used to identify and synthesize appropriate studies. RESULTS A total of 14 studies were identified as meeting the inclusion criteria. These studies assessed the predictive validity of 18 different risk assessment tools, mainly in forensic settings. All studies concluded that the tools assessed were successful in predicting violence. Studies were generally of a high quality. CONCLUSIONS There is good quality evidence that risk assessment tools are valid for people with intellectual disability who offend but further research is required to validate tools for use with people with intellectual disability who offend.
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Affiliation(s)
- J Hounsome
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - R Whittington
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,Brøset Centre for Research & Education in Forensic Psychiatry, St. Olav's Hospital, Trondheim, Norway.,Department of Neuroscience, Norwegian University of Science & Technology (NTNU), Trondheim, Norway
| | - A Brown
- Mersey Care NHS Trust, Merseyside, UK
| | - B Greenhill
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,Mersey Care NHS Trust, Merseyside, UK
| | - J McGuire
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
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O'Shea LE, Picchioni MM, McCarthy J, Mason FL, Dickens GL. Predictive validity of the HCR-20 for inpatient aggression: the effect of intellectual disability on accuracy. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:1042-1054. [PMID: 25683589 DOI: 10.1111/jir.12184] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 08/19/2014] [Accepted: 12/07/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND People with intellectual disability (ID) account for a large proportion of aggressive incidents in secure and forensic psychiatric services. Although the Historical, Clinical, Risk Management 20 (HCR-20) has good predictive validity in inpatient settings, it does not perform equally in all groups and there is little evidence for its efficacy in those with ID. METHOD A pseudo-prospective cohort study of the predictive efficacy of the HCR-20 for those with ID (n = 109) was conducted in a UK secure mental health setting using routinely collected risk data. Performance of the HCR-20 in the ID group was compared with a comparison group of adult inpatients without an ID (n = 504). Analysis controlled for potential covariates including security level, length of stay, gender and diagnosis. RESULTS The HCR-20 total score was a significant predictor of any aggression and of physical aggression for both groups, although the area under the curve values did not reach the threshold for a large effect size. The clinical subscale performed significantly better in those without an ID compared with those with. The ID group had a greater number of relevant historical and risk management items. The clinicians' summary judgment significantly predicted both types of aggressive outcomes in the ID group, but did not predict either in those without an ID. CONCLUSIONS This study demonstrates that, after controlling for a range of potential covariates, the HCR-20 is a significant predictor of inpatient aggression in people with an ID and performs as well as for a comparison group of mentally disordered individuals without ID. The potency of HCR-20 subscales and items varied between the ID and comparison groups suggesting important target areas for improved prediction and risk management interventions in those with ID.
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Affiliation(s)
- L E O'Shea
- Academic Department, St. Andrew's, Northampton, UK
- Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
| | - M M Picchioni
- Academic Department, St. Andrew's, Northampton, UK
- Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
| | - J McCarthy
- Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
| | - F L Mason
- Academic Department, St. Andrew's, Northampton, UK
| | - G L Dickens
- Academic Department, St. Andrew's, Northampton, UK
- School of Social and Health Sciences, Abertay University, Dundee, UK
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