In this study, growth trajectories (from admission until unconditional release) of crime-related dynamic risk factors were investigated in a sample of Dutch forensic patients (N = 317), using latent growth curve modeling. After testing the unconditional model, three predictors were added: first-time offender versus recidivist, age, and treatment duration. Postanalyses were chi-square difference tests, t tests, and analyses of variance (ANOVAs) to assess differences in trajectories. Overall, on scale level, a decrease of risk factors over time was found. The predictors showed no significant slope differences although age and treatment duration differed significantly at some time points. The oldest age group performed worse, especially at later time points. Treatment duration effects were found at the second time point. Our results that forensic patients show a decrease in crime-related risk factors may indicate that treatment is effective. This study also found differences in growth rates, indicating the effect of individual differences
Aims and objectives. The Forensic Early Warning Signs of Aggression Inventory (FESAI) was developed to assist nurses and patients in identifying early warning signs and constructing individual early detection plans (EDP) for the prevention of aggressive incidents. The aims of this research were as follows: First, to study the prevalence of early warning signs of aggression, measured with the FESAI, in a sample of forensic patients, and second, to explore whether there are any types of warning signs typical of diagnostic subgroups or offender subgroups. Background. Reconstructing patients’ changes in behaviour prior to aggressive incidents may contribute to identify early warning signs specific to the individual patient. The EDP comprises an early intervention strategy suggested by the patient and approved by the nurses. Implementation of EDP may enhance efficient risk assessment and management. Design. An explorative design was used to review existing records and to monitor frequencies of early warning signs. Methods. Early detection plans of 171 patients from two forensic hospital wards were examined. Frequency distributions were estimated by recording the early warning signs on the FESAI. Rank order correlation analyses were conducted to compare diagnostic subgroups and offender subgroups concerning types and frequencies of warning signs. Results. The FESAI categories with the highest frequency rank were the following: (1) anger, (2) social withdrawal, (3) superficial contact and (4) non-aggressive antisocial behaviour. There were no significant differences between subgroups of patients concerning the ranks of the four categories of early warning signs. Conclusion. The results suggest that the FESAI covers very well the wide variety of occurred warning signs reported in the EDPs. No group profiles of warning signs were found to be specific to diagnosis or offence type. Relevance to clinical practice. Applying the FESAI to develop individual EDPs appears to be a promising approach to enhance risk assessment and management.
Aggressive incidents occur frequently in health care facilities, such as psychiatric care and forensic psychiatric hospitals. Previous research suggests that civil psychiatric inpatients may display more aggression than forensic inpatients. However, there is a lack of research comparing these groups on the incident severity, even though both frequency and severity of aggression influence the impact on staff members. The purpose of this study is to compare the frequency and severity of inpatient aggression caused by forensic and civil psychiatric inpatients in the same Dutch forensic psychiatric hospital. Data on aggressive incidents occurring between January 1, 2014, and December 31, 2017, were gathered from hospital files and analyzed using the Modified Overt Aggression Scale, including sexual aggression (MOAS+). Multilevel random intercept models were used to analyze differences between forensic and civil psychiatric patients in severity of aggressive incidents. In all, 3,603 aggressive incidents were recorded, caused by 344 different patients. Civil psychiatric patients caused more aggressive incidents than forensic patients and female patients caused more inpatient aggression compared with male patients. Female forensic patients were found to cause the most severe incidents, followed by female civil psychiatric patients. Male forensic patients caused the least severe incidents. The findings have important clinical implications, such as corroborating the need for an intensive treatment program for aggressive and disruptive civil psychiatric patients, as well as emphasizing the importance of gender-responsive treatment
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In het forensisch werkveld staan drie vragen centraal. Het gaat dan om “wie is het”, “wat is er gebeurd” en “wanneer is het gebeurd”. Alle informatie die bijdraagt aan het beantwoorden van deze vragen is waardevol in zaakonderzoeken. Vaak wordt er wel een biologisch spoor gevonden, maar is er geen “match” met de databank. In dit geval kan profileringsinformatie helpen bij het zoeken naar de juiste persoon. Met profilering wordt hier bedoeld een serie stoffen, ook markers genoemd, die informatie geven over de levensstijl van mensen. De levensstijl kan bestaan uit kenmerken, voeding, gewoonten en activiteiten. Een recent voorbeeld van een profileringsmethode is het analyseren van de buitenzijde van mobiele telefoons. Door het hanteren van de telefoon laten mensen zweet en stoffen achter die gekarakteriseerd kunnen worden. Het profiel van deze stoffen geeft een beschrijving van de levensstijl van de eigenaar. In veel zaken zijn er echter geen mobiele telefoon aanwezig, maar wel andere sporen zoals haar. Daarom is er behoefte aan een methode om haar te gebruiken voor profilering. Bovendien geeft haar een indicatie van tijd en gebeurtenissen uit het verleden omdat het langzaam groeit. In principe kan er dan informatie over de drie vragen (wie, wat, wanneer) verzameld worden. Haren worden op dit moment vooral gebruikt voor het meten van drugs, alcohol gebruik, cortisol en nicotine. Er is echter behoefte aan een breder palet van stoffen dat in één keer in haar kan worden gemeten. Het doel van dit onderzoek is daarom het ontwikkelen van een methode waarmee in één analysegang een profiel van circa 15 uiteenlopende markers kan worden gemeten.
