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Hodgins S. Female Forensic Patients May Be an Atypical Sub-type of Females Presenting Aggressive and Antisocial Behavior. Front Psychiatry 2022; 13:809901. [PMID: 35222118 PMCID: PMC8869424 DOI: 10.3389/fpsyt.2022.809901] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/17/2022] [Indexed: 01/24/2023] Open
Abstract
The percentage of forensic psychiatric patients who are female varies from 5 to 13% in Europe, rises to 18% in England and Wales, and sits at 15% in Canada. Similarly, many fewer women than men are incarcerated in correctional facilities. While these statistics supposedly reflect less antisocial and aggressive behavior (AAB) among females than males, not all findings support this supposition. Data from prospective longitudinal studies show that aggressive and antisocial behavior onsets in childhood, and in a small group of females it remains stable across the life-span. Unlike similar males, few of these females are convicted of crimes. This article begins with a review of descriptive studies of females sentenced by criminal courts to treatment in forensic psychiatric hospitals and moves on to present evidence showing that most female AAB does not lead to criminal prosecution. Next, studies of female AAB are reviewed, noting that it onsets in early childhood and, that in a small group remains stable across the life-span. Subsequent sections of the article focus on the two most common mental disorders presented by female forensic patients, schizophrenia and borderline personality disorder, highlighting what is known about the sub-groups of women with these disorders who present AAB. The article concludes with recommendations for earlier identification by psychiatric services of women presenting mental disorders and AAB, treatments to reduce both the symptoms of their mental disorders and their life-long AAB, and the research that is needed in order to improve the effectiveness of these treatments. The real possibilities of prevention of the development of AAB, and even perhaps aspects of the mental disorders that plague female forensic patients, are described.
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Affiliation(s)
- Sheilagh Hodgins
- Département de Psychiatrie et Addictologie, Université de Montréal, et Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada.,Haina Forensic Psychiatric Institute, Haina, Germany
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Abstract
Psychopathy is a personality disorder characterized by a constellation of affective, interpersonal, lifestyle and antisocial features whose antecedents can be identified in a subgroup of young people showing severe antisocial behaviour. The prevalence of psychopathy in the general population is thought to be ~1%, but is up to 25% in prisoners. The aetiology of psychopathy is complex, with contributions of both genetic and environmental risk factors, and gene-environment interactions and correlations. Psychopathy is characterized by structural and functional brain abnormalities in cortical (such as the prefrontal and insular cortices) and subcortical (for example, the amygdala and striatum) regions leading to neurocognitive disruption in emotional responsiveness, reinforcement-based decision-making and attention. Although no effective treatment exists for adults with psychopathy, preliminary intervention studies targeting key neurocognitive disturbances have shown promising results. Given that psychopathy is often comorbid with other psychiatric disorders and increases the risk of physical health problems, educational and employment failure, accidents and criminality, the identification of children and young people at risk for this personality disorder and preventative work are important. Indeed, interventions that target the antecedents of psychopathic features in children and adolescents have been found to be effective.
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Whipp AM, Vuoksimaa E, Bolhuis K, de Zeeuw EL, Korhonen T, Mauri M, Pulkkinen L, Rimfeld K, Rose RJ, van Beijsterveldt C(TEM, Bartels M, Plomin R, Tiemeier H, Kaprio J, Boomsma DI. Teacher-rated aggression and co-occurring behaviors and emotional problems among schoolchildren in four population-based European cohorts. PLoS One 2021; 16:e0238667. [PMID: 33914742 PMCID: PMC8084195 DOI: 10.1371/journal.pone.0238667] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/31/2021] [Indexed: 11/18/2022] Open
Abstract
Aggressive behavior in school is an ongoing concern. The current focus is on specific manifestations such as bullying, but the behavior is broad and heterogenous. Children spend a substantial amount of time in school, but their behaviors in the school setting tend to be less well characterized than at home. Because aggression may index multiple behavioral problems, we used three validated instruments to assess means, correlations and gender differences of teacher-rated aggressive behavior with co-occurring externalizing/internalizing problems and social behavior in 39,936 schoolchildren aged 7-14 from 4 population-based cohorts from Finland, the Netherlands, and the UK. Correlations of aggressive behavior were high with all other externalizing problems (r: 0.47-0.80) and lower with internalizing problems (r: 0.02-0.39). A negative association was observed with prosocial behavior (r: -0.33 to -0.54). Mean levels of aggressive behavior differed significantly by gender. Despite the higher mean levels of aggressive behavior in boys, the correlations were notably similar for boys and girls (e.g., aggressive-hyperactivity correlations: 0.51-0.75 boys, 0.47-0.70 girls) and did not vary greatly with respect to age, instrument or cohort. Thus, teacher-rated aggressive behavior rarely occurs in isolation; boys and girls with problems of aggressive behavior likely require help with other behavioral and emotional problems. Important to note, higher aggressive behavior is not only associated with higher amounts of other externalizing and internalizing problems but also with lower levels of prosocial behavior.
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Affiliation(s)
- Alyce M. Whipp
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
- * E-mail:
| | - Eero Vuoksimaa
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Koen Bolhuis
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Eveline L. de Zeeuw
- Department of Biological Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Tellervo Korhonen
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
| | | | - Lea Pulkkinen
- Department of Psychology, University of Jyvaskyla, Jyvaskyla, Finland
| | - Kaili Rimfeld
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
| | - Richard J. Rose
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, Indiana, United States of America
| | | | - Meike Bartels
- Department of Biological Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Robert Plomin
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
| | - Henning Tiemeier
- Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Dorret I. Boomsma
- Department of Biological Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Findlay LC, Beasley E, Park J, Kohen DE, Algan Y, Vitaro F, Tremblay RE. Longitudinal child data: What can be gained by linking administrative data and cohort data? Int J Popul Data Sci 2018; 3:451. [PMID: 32935011 PMCID: PMC7299460 DOI: 10.23889/ijpds.v3i1.451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction Linked administrative data sets are an emerging tool for studying the health and well-being of the population. Previous papers have described methods for linking Canadian data, although few have specifically focused on children, nor have they described linkage between tax outcomes and a cohort of children who are particularly at risk for poor financial outcomes. Objective and methods This paper describes a probabilistic linkage performed by Statistics Canada linking the Montreal Longitudinal Experimental Study (MLES) and the Quebec Longitudinal Study of Kindergarten Children (QLSKC) survey cohorts and administrative tax data from 1992 through 2012. Results The number of valid cases in the original cohort file with valid tax records was approximately 84%. Rates of false positives, false negatives, sensitivity, and specificity of the linkage were all acceptable. Using the linked file, the relationship of childhood behavioural indicators and adult income can be investigated in future studies. Conclusions Innovative methods for creating longitudinal datasets on children will assist in examining long-term outcomes associated with early childhood risk and protective factors as well as an evidence base for interventions that promote child well-being and positive outcomes.
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Affiliation(s)
- Leanne C Findlay
- Statistics Canada 150 Tunney's Pasture Driveway Ottawa, Ontario K1A 0T6
| | | | - Jungwee Park
- Statistics Canada 150 Tunney's Pasture Driveway Ottawa, Ontario K1A 0T6
| | - Dafna E Kohen
- Statistics Canada 150 Tunney's Pasture Driveway Ottawa, Ontario K1A 0T6
| | - Yann Algan
- Sciences Po, 27, rue Saint Guillaume - 75337 Paris
| | - Frank Vitaro
- Groupe de recherche sur l'inadaptation psychosociale chez l'enfant (GRIP) Axe sur les maladies du cerveau Université de Montréal 3050 boul. Édouard-Montpetit, local B-234 Montréal, QC H3T 1J7
| | - Richard E Tremblay
- Groupe de recherche sur l'inadaptation psychosociale chez l'enfant (GRIP) Axe sur les maladies du cerveau Université de Montréal 3050 boul. Édouard-Montpetit, local B-234 Montréal, QC H3T 1J7
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Morpeth L, Blower S, Tobin K, Taylor RS, Bywater T, Edwards RT, Axford N, Lehtonen M, Jones C, Berry V. The effectiveness of the Incredible Years pre-school parenting programme in the United Kingdom: a pragmatic randomised controlled trial. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/13575279.2016.1264366] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Sarah Blower
- Department of Health Sciences, University of York, York, UK
| | - Kate Tobin
- Dartington Social Research Unit, Dartington, UK
| | - Rod S. Taylor
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Tracey Bywater
- Department of Health Sciences, University of York, York, UK
| | | | - Nick Axford
- Dartington Social Research Unit, Dartington, UK
| | | | - Carys Jones
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - Vashti Berry
- Dartington Social Research Unit, Dartington, UK
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
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Larm P, Silva TC, Hodgins S. Adolescent Substance Misusers with and without Delinquency: Death, Mental and Physical Disorders, and Criminal Convictions from Age 21 to 45. J Subst Abuse Treat 2015; 59:1-9. [PMID: 26342514 DOI: 10.1016/j.jsat.2015.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 06/09/2015] [Accepted: 06/10/2015] [Indexed: 11/19/2022]
Abstract
Little is known about adult outcomes of males who as adolescents sought treatment for alcohol misuse or drug use, and who additionally were engaging or not engaging in other forms of delinquency. Since the rates of negative outcomes vary in the general population, the study determined whether the sub-groups of clinic attendees fared differently as compared to males of the same age who had not sought treatment for substance misuse from age 21 to 45. Adolescent males who consulted the only substance misuse clinic in a Swedish city between 1968 and 1971 were divided into four groups: ALCOHOL no drug use, no criminal offending (n=52); ALCOHOL+D no drug use, plus criminal offending (n=105); DRUG use, no criminal offending (n=92); and DRUG+D plus criminal offending (n=474). These four groups were compared to a general population sample (GP) of males matched on age and birthplace, who did not seek treatment for SM in adolescence. National Swedish registers provided data on death, hospitalizations for substance misuse (SM), mental and physical disorders, and criminal convictions. Compared to the GP, and after controlling for co-occurring adult outcomes, ALCOHOL showed elevated risks for SM hospitalization and convictions for violent crimes, and DRUG showed elevated risks for SM hospitalization, convictions for non-violent crimes, and hospitalization for psychosis. ALCOHOL+D and DRUG+D showed increased risk for SM hospitalization, violent and non-violent convictions, and DRUG+D additionally, for death, and hospitalizations for psychosis and physical illness. Misuse of alcohol without drug use or other delinquency in adolescence was associated with increased risk for convictions for violent crimes during the subsequent 25 years, in addition to SM, while adolescent drug use without other forms of delinquency was associated with increased risks for convictions for non-violent crimes, hospitalizations for SM, and non-affective psychosis. Cannabis use, with and without delinquency, was associated with subsequent hospitalization for non-affective psychosis. Consistent with contemporary studies, most adolescents treated for SM from 1968-1971 presented delinquency that was associated with an increase in risk of all adverse outcomes to age 45.
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Affiliation(s)
- Peter Larm
- Maria Ungdom Research Centre, Karolinska Institutet, Stockholm County Council, Stockholm, Sweden; Centre for Clinical Research Västerås, Uppsala University, Västmanland County Hospital Västerås, Västerås, Sweden.
| | - Teresa C Silva
- Center for Developmental Research, Örebro University, Örebro, Sweden
| | - Sheilagh Hodgins
- Maria Ungdom Research Centre, Karolinska Institutet, Stockholm County Council, Stockholm, Sweden; Département de Psychiatrie, Université de Montréal, Montréal, Canada
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Hodgins S, Lövenhag S, Rehn M, Nilsson KW. A 5-year follow-up study of adolescents who sought treatment for substance misuse in Sweden. Eur Child Adolesc Psychiatry 2014; 23:347-60. [PMID: 23989597 DOI: 10.1007/s00787-013-0456-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 07/24/2013] [Indexed: 11/29/2022]
Abstract
Previous studies have shown that substance misuse in adolescence is associated with increased risks of hospitalizations for mental and physical disorders, convictions for crimes, poverty, and premature death from age 21 to 50. The present study examined 180 adolescent boys and girls who sought treatment for substance misuse in Sweden. The adolescents and their parents were assessed independently when the adolescents first contacted the clinic to diagnose mental disorders and collect information on maltreatment and antisocial behavior. Official criminal files were obtained. Five years later, 147 of the ex-clients again completed similar assessments. The objectives were (1) to document the prevalence of alcohol use disorders (AUD) and drug use disorders (DUD) in early adulthood; and (2) to identify family and individual factors measured in adolescence that predicted these disorders, after taking account of AUD and DUD in adolescence and treatment. Results showed that AUD, DUD, and AUD + DUD present in mid-adolescence were in most cases also present in early adulthood. Prediction models detected no positive effect of treatment in limiting persistence of these disorders. Thus, treatment-as-usual provided by the only psychiatric service for adolescents with substance misuse in a large urban center in Sweden failed to prevent the persistence of substance misuse. Despite extensive clinical assessments of the ex-clients and their parents, few factors assessed in mid-adolescence were associated with substance misuse disorders 5 years later. It may be that family and individual factors in early life promote the mental disorders that precede adolescent substance misuse.
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Honkanen M, Määttä H, Hurtig T, Ebeling H, Taanila A, Koivumaa-Honkanen H. Teachers' assessments of children's mental problems with respect to adolescents' subsequent self-reported mental health. J Adolesc Health 2014; 54:81-7. [PMID: 24041443 DOI: 10.1016/j.jadohealth.2013.07.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 06/29/2013] [Accepted: 07/30/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate whether teachers' assessments of children are predictive of subsequent self-reported mental problems in adolescence and how these problems are concurrently linked with adolescents' overall life satisfaction. METHOD The study subjects originated from the prospective population-based Northern Finland Birth Cohort 1986 (N = 9,432). At age 8 years first-grade students' emotional and behavioral problems were assessed by their teachers with Rutter Children's Behavioural Questionnaires for teachers (RB2). At the age of 16 years, adolescents responded to the eight Youth Self-report (YSR) subscales and the one-item overall life satisfaction scale. Multivariate logistic regression was used to study the longitudinal relationship between RB2 and YSR. RESULTS Children who had emotional problems according to their teachers (RB2) were more prone to withdrawal and social problems in adolescence (YSR). Behavioral problems in childhood (RB2) were predictive of attention problems, and delinquent and aggressive behavior (YSR), while hyperactivity (RB2) was only predictive of attention problems and delinquent behavior (YSR). Additionally, each YSR subscale was strongly and linearly associated with concurrent self-reported life satisfaction in adolescence. CONCLUSIONS Teachers' assessments of children were predictive of self-reported mental problems in adolescence, which, in turn, were strongly associated with concurrent self-reported life satisfaction. In order to support favorable growth of children to well-adjusted adolescents and to intervene as early as possible in the event of adverse progression, both teachers' assessments of children and adolescent's self-rated overall life satisfaction should be acknowledged.
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Affiliation(s)
- Meri Honkanen
- Department of Teacher Education, University of Eastern Finland, Kuopio, Finland.
| | - Heidi Määttä
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Tuula Hurtig
- Institute of Health Sciences, University of Oulu, Oulu, Finland; Department of Child Psychiatry, Institute of Clinical Medicine, University of Oulu & University Hospital of Oulu, Oulu, Finland
| | - Hanna Ebeling
- Department of Child Psychiatry, Institute of Clinical Medicine, University of Oulu & University Hospital of Oulu, Oulu, Finland
| | - Anja Taanila
- Institute of Health Sciences, University of Oulu, Oulu, Finland; Primary Health Care Unit, University Hospital of Oulu, Oulu, Finland
| | - Heli Koivumaa-Honkanen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Psychiatry, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Department of Psychiatry, Lapland Hospital District, Rovaniemi, Finland; Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland; Department of Psychiatry, South-Savonia Hospital District, Mikkeli, Finland; Department of Psychiatry, North Karelia Central Hospital, Joensuu, Finland; Department of Psychiatry, SOSTERI, Savonlinna, Finland; Department of Psychiatry, SOTE, Iisalmi, Finland
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