Trajectories of Dynamic Risk Factors During Forensic Treatment: Growth Trajectory of Clinical Risk Factors in a Sample of Dutch Forensic Patients

Linde, Robin van der; Bogaerts, Stefan; Garofalo, Carlo; Blaauw, Eric; Caluwé, Elien De; Billen, Eva; Spreen, Marinus

doi:10.1177/0306624x20909219

Cited by 9 publications

(20 citation statements)

References 37 publications

(56 reference statements)

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“…Although previous research has shown that psychiatric treatment is effective in reducing the risk of criminal recidivism, there is also variability in treatment outcomes, pointing toward individual differences (Gannon et al, 2019;Van der Linde et al, 2020). Therefore, research should focus more on what works for whom to reduce criminal recidivism.…”

Section: Introductionmentioning

confidence: 99%

Risk classes of patients diagnosed with substance use disorders in Dutch forensic psychiatric centers

Schmitter

Vermunt

Blaauw

et al. 2021

JFP

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Purpose Given the complex association between substance use disorders (SUD), comorbid mental health problems and criminal recidivism in forensic patients, homogenous patient classes can contribute to a refined treatment. This paper aims to construct those classes in forensic patients (N = 286) diagnosed with SUD, unconditionally released between 2004 and 2013 of one of ten Dutch forensic psychiatric centers. Design/methodology/approach Retrospective data were derived from electronic patient files. Classes were based on the Dutch risk assessment tool, the Historisch Klinisch Toekomst-Revisie (Historical Clinical Future–Revised [HKT-R]) and identified by means of explorative Latent Class Analysis in Latent Gold version 5.1. In a three-step approach, posterior class memberships were related to external variables (i.e. diagnoses, type of drug and type of offence). Findings Four classes were identified that differ in the risk of recidivism, as well as Axis I and II diagnoses and type of drug consumption. Practical implications This study informed on the heterogeneity of forensic patients with SUD and identified four homogenous classes that differ in important variables for the treatment approach. Based on these classes, a more refined treatment approach can be developed. Possible treatment approaches are discussed, but future research is needed to provide evidence. Originality/value This study is the first to identify classes within forensic patients with SUD and, therefore, sets the first step to develop a tailored treatment approach based on characteristics informative for treatment.

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Section: Introductionmentioning

confidence: 99%

Risk classes of patients diagnosed with substance use disorders in Dutch forensic psychiatric centers

Schmitter

Vermunt

Blaauw

et al. 2021

JFP

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“…Although the great importance of longitudinal research on the changeability of dynamic risk and protective factors has been recognized by many scholars, the trajectories of these factors during forensic treatment have so far rarely been investigated ( 7 , 13 ). One reason for this is that the length of stay in forensic clinics is usually very long, thus collecting repeated measurements can be quite intensive and time-consuming.…”

Section: Introductionmentioning

confidence: 99%

“…Another reason has to do with obtaining sufficient statistical power due to the specificity of high-risk psychiatric patients staying in secure forensic facilities. For example, forensic psychiatric patients are very often unwilling to participate in a study or do not take the research seriously; there is also a high drop-out rate among patients, along with their limited understanding of the items, and a tendency for socially desirable answers ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

“…Recently, long-term trajectories related to the change of dynamic risk factors have been investigated in a relatively large sample of Dutch forensic psychiatric patients. The results showed a significant linear decrease in dynamic HKT-R risk factors, from judicial assessment until unconditional release [i.e., over five time points; ( 13 )]. However, due to inconsistencies in findings in these few studies and scarcity of empirical evidence, further research is needed to better understand longitudinal changes in dynamic risk and protective factors in forensic psychiatric patients.…”

Section: Introductionmentioning

confidence: 99%

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The Long-Term Changes in Dynamic Risk and Protective Factors Over Time in a Nationwide Sample of Dutch Forensic Psychiatric Patients

et al. 2021

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The long-term changes of dynamic risk and protective factors have rarely been studied in forensic psychiatric patients. We utilized a latent growth curve analysis to investigate trajectories of risk and protective factors over time in all 722 male forensic psychiatric patients who were unconditionally released between 2004 and 2014 from any of 12 Dutch forensic psychiatric centers (FPCs). The study covered the period from juridical observation until unconditional release. Moreover, we investigated whether these trajectories differ between patients depending on their psychiatric diagnosis namely substance use disorders (SUD), psychotic disorders, and cluster B personality disorders (PDs). In addition, we also investigated whether SUD may influence changes in risk and protective factors in a group of psychotic and cluster B PDs patients, respectively. Overall, findings suggest that all changes in dynamic risk and protective factors could be depicted by two phases of patients' stay in the FPCs. Specifically, most changes on dynamic risk and protective factors occurred at the beginning of treatment, that is, from the time of juridical assessment up to the time of unguided leave. Moreover, the moment of unguided leave could be considered the ‘turning point’ in the treatment of offenders. We also found that SUD and psychotic patients changed the most in the first phase of their stay, while cluster B PDs patients changed the most in the second phase. However, SUD did not modify changes in risk and protective factors in psychotic and cluster B PDs patients. These findings may help improve offender treatment and crime prevention strategies.

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“…Considering the higher load on risk assessments in the intervention group, the similar recidivism rates of severely disordered offenders to offenders with less severe psychiatric disorder leads to the assumption, that therapy was effective in reducing recidivism rates. Therefore, it is our understanding, that through successful therapeutic interventions, recidivism rates can be reduced ( 35 – 37 ).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Recidivism of Mentally Disordered Offenders Considered “Dangerous to the Public” in Switzerland

et al. 2021

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Objectives: The commissions for risk assessment of offenders dangerous to the public were established in 1995 in Switzerland. The main goal was to reduce recidivism of offenders released into the community by means of identifying high-risk offenders and recommending measures for offender management. This study investigates long-term recidivism data of this high-risk cohort of offenders.Methods: Baseline data included risk assessment of one of the commissions, the type of index offense, and psychiatric disorders according to ICD-10 for the total cohort of offenders examined by the commissions between 1995 and 2009. Criminal records were drawn in 2019 for all offenders from the Swiss Federal Office of Justice.Results: From a total of 147 offenders 35 recidivated within a median time at risk of 9.1 years (31.8%), of which 10 (9.1%) recommitted a severe offense. Within the treatment status, sentences (imprisonment and preventive detention) were compared to court-ordered measures (in- or outpatient court ordered treatment, civil court mandated treatment, vocational training facility). There were no significant differences comparing treatment status, different diagnostic groups, type of index offense and other risk factors. Except of age at release (or relapse), which predicted recidivism with younger subjects showing higher recidivism rates (p = 0.014).Conclusion: Our study showed that over a long-term time at risk this high-risk cohort showed a similar recidivism rate as many other studies with different cohorts. With appropriate management recidivism rates in high-risk offenders can be lowered allowing them being consecutively reintegrated into society. The finding that younger subjects have higher recidivism rate was reproduced in this population.

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Trajectories of Dynamic Risk Factors During Forensic Treatment: Growth Trajectory of Clinical Risk Factors in a Sample of Dutch Forensic Patients

Cited by 9 publications

References 37 publications

Risk classes of patients diagnosed with substance use disorders in Dutch forensic psychiatric centers

Risk classes of patients diagnosed with substance use disorders in Dutch forensic psychiatric centers

The Long-Term Changes in Dynamic Risk and Protective Factors Over Time in a Nationwide Sample of Dutch Forensic Psychiatric Patients

Long-Term Recidivism of Mentally Disordered Offenders Considered “Dangerous to the Public” in Switzerland

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