Longitudinal Network Structure and Changes of Clinical Risk and Protective Factors in a Nationwide Sample of Forensic Psychiatric Patients

Abstract

In this study, we investigated network configurations of 14 Clinical risk and protective factors in a sample of 317 male forensic psychiatric patients across two time points: at the time of admission to the forensic psychiatric centers (T1) and at the time of unconditional release (T2). In terms of network structure, the strongest risk edge was between “hostility–violation of terms” at T1, and between “hostility–impulsivity” at T2. “Problem insight–crime responsibility” was the strongest protective edge, and “impulsivity–coping skills” was the strongest between-cluster edge, at both time points, respectively. In terms of strength centrality, “cooperation with treatment” had the highest strength centrality at both measurement occasions. This study expands the risk assessment field toward a better understanding of dynamic relationships between individual clinical risk and protective factors and points to the highly central risk and protective factors, which would be the best for future treatment targets.

A Latent Class Analysis of Forensic Psychiatric Patients in Relation to Risk and Protective Factors

“…In contrast, historical factors are irreversible and static, while future factors are solely related to the post-release situation. The original clinical scale was divided into seven risk and seven protective factors as was done in the study by Bogaerts et al ( 2020 ).…”

“…The HKT-R represents an extension of the HCR-20 (Webster et al, 1997), which is the most widely used risk assessment instrument in the world to assess violent risk. In many countries, as well as in the Netherlands, a risk assessment must be performed at least once a year to estimate the future risk of recidivism and change in risk level compared to the previous 12 months of stay in the institution (Bogaerts et al, 2020). In this study, only the 14 Clinical items were used because they are changeable and potentially amenable to treatment.…”

“…On the contrary, protective factors have been less investigated (Schuringa et al, 2014 ; Serin et al, 2016 ), although there is some evidence that increasing offender's motivation and establishing a positive therapeutic alliance are crucial components of effective treatment, anchored in the principles of the GLM (Ward and Brown, 2004 ; Bogaerts et al, 2020 ). The GLM is a strength-based approach attempting to reduce the risk of reoffending by helping offenders living a more fulfilling and meaningful life (Ward and Brown, 2004 ).…”

“…The GLM is a strength-based approach attempting to reduce the risk of reoffending by helping offenders living a more fulfilling and meaningful life (Ward and Brown, 2004 ). Nowadays, there is consensus that both risk and protective factors should be targeted during treatment (e.g., De Vries Robbé et al, 2015 ; Bogaerts et al, 2020 ). Gaining more insight into dynamic risk and protective factors is, therefore, the first and most important step in establishing effective offender treatment.…”

Associations Between Resilience, Psychological Well-Being, Work-Related Stress and Covid-19 Fear in Forensic Healthcare Workers Using a Network Analysis

“…Hence, to study these associations comprehensively, we will adopt a network approach because it provides insight to understand item-level relationships to improve psychological science and clinical practice. This approach has been already applied in forensic psychiatry (29) as well as in other areas, such as psychopathology (30), and personality research (31). Network analysis can help us to visualize and quantify complex associations between different symptoms/constructs and mental health outcomes.…”