The Role of Substance Abuse in Psychotic Versus Personality Disordered Offenders Detained Under the Dutch Entrustment Act (TBS): An Exploratory Study

Mentally disordered patients that abuse drugs or alcohol have a larger number of criminal convictions. Early starters who had their first conviction before the age of 18, especially, more often have a diagnosis of substance abuse and are more often intoxicated at the time of the offense compared to late starters. The present study involved four groups of Dutch patients (n = 137): three groups of violent offenders (psychotic and personality disordered patients) and one group of non-delinquent psychotic patients from general psychiatry. All data were retrieved retrospectively. The results showed that early starters were intoxicated more often, started with substance abuse at an earlier age and more often had a diagnosis of substance abuse at the time of the index offense than late starters. Personality disordered offenders were intoxicated more often and more often had a prior diagnosis of substance abuse at the time of the offense than psychotic offenders. To a limited extent, psychotic offenders with a diagnosis of a substance-related disorder or intoxication at the time of the offense had a more extensive criminal history than personality disordered offenders. Substance abuse has an aggravating effect on criminogenic behavior, depending on the age at first conviction and diagnosis.     

A longitudinal analysis of early risk factors for adult‐onset offending: What predicts a delayed criminal career?

Background Late‐onset offending, at the age of 21 or thereafter, is an underexplored dimension of the criminal career. Aims Our aims were to explore which factors are precursors of late‐onset offending, and the extent to which adult criminality can be predicted in childhood and adolescence. Method This is the first study that defines late‐onset offending based on a combination of official records and self‐reports. Longitudinal data from the Cambridge Study in Delinquent Development (CSDD) were used. Four hundred and three South London men, followed from ages 8–10 to ages 48–50, were divided into late‐starters (LS, n = 51), early‐starters (ES, n = 140) and non‐offenders (NO, n = 212). Results LS men were more likely than NO men to have been neurotic, truants or in poor housing at ages 8–10. At ages 12–14, they tended to be neurotic, and at ages 16–18, they had high unemployment and spent time hanging about on the streets. Compared with ES, LS were nervous at ages 8–10, and at age 18 they were more likely to be sexual virgins. Overall, LS men were more similar to NO men before age 21, but more similar to ES men by age 32. Conclusions Our hypotheses that late‐onset offenders would be particularly characterised by neuroticism or nervousness, but that this would buffer rather than fully protect over the life course, were sustained. Intervention to increase the resilience of children and adolescents who are rated as high on neurotic characteristics may lessen the burden that these factors impose in adult life and reduce the risk of a deteriorating quality of life and late onset criminal careers. Copyright © 2010 John Wiley & Sons, Ltd.     

Men with schizophrenia who behave violently: the usefulness of an early- versus late-start offender typology

Persons who develop schizophrenia are more likely than nondisordered persons to commit crimes. It is important to investigate those who offend, in order to develop treatment programs that effectively prevent recidivism, and eventually, early childhood violence prevention programs. Recent studies have shown that among offenders with major mental disorders, there are two groups: early starters, who begin their criminal careers in adolescence; and late starters, who first offend as adults. The present study examined 272 violent male offenders with schizophrenia in Sweden who underwent a pretrial psychiatric assessment between 1988 and 1995. Early- and late-start offenders were found to present differences in behavior, comorbid disorders, personality traits, and referrals for treatment in childhood, adolescence, and adulthood. Their parents also differed. The findings have implications for treatment and management of offenders with schizophrenia, for risk assessment, and for prevention.     

The prediction of criminal recidivism

Background Instruments based on actuarial forensic risk assessment models are sensitive to the calibration sample, and the inclusion criteria for the subjects of a study population will influence the features of the resulting model. If the same instrument is used in populations that are not part of the calibration sample, the discriminative validity of the instrument is jeopardized; thus the definition of the calibration sample is very important. The aim of this study was to examine how sensitive prognostic models are to the calibration sample. Method Two samples (N = 773) of offenders sentenced to at least 10 months in prison for a violent or sexual offense were used in this study. The “sanction sample” (recruited during August 2000, N = 515) consisted of all violent and sexual offenders actively administrated by the Criminal Justice System of Zurich, Switzerland. The “verdict sample” (recruited over two years, N = 258) included all offenders convicted in the Canton of Zurich during a two-year period. Both samples were unbiased, since all subjects that met the study criteria were included. In the first analysis, differences between the two samples were shown with respect to socio-demographic, criminological, and psychiatric variables using bivariate logistic regressions. In the second analysis, recidivism was estimated separately for both samples, using a logistic regression model as a function of a set of psychiatric, socio-demographic and criminological variables. Results Bivariate logistic regression showed that different risk factors for recidivism existed for both samples. Conclusion Forensic risk assessment models are very sensitive to the calibration sample. There is strong evidence that, even when index-offenses and the socio-cultural background are the same, risk factors for recidivism differ depending on the stage of the judicial process in which the subjects are (e.g. whether a subject is indicted, on conditional release, on parole, or no longer under the supervision of a parole board). Unfortunately, none of the currently available actuarial risk assessment instruments that have been validated in European countries consider the different stages of the judiciary process.     

Psychometric evaluation of a Dutch version of the Mini PAS‐ADD for assessing psychiatric disorders in adults with different levels of intellectual disability

Background People with intellectual disabilities (ID) have an increased vulnerability to develop psychiatric problems. Moreover, the early recognition and the accurate diagnosis of psychiatric disorders in the population of persons with ID are challenging. Method A Dutch version of the Mini PAS‐ADD, which is a screening instrument for identification of mental health problems in people with ID, was evaluated in terms of internal consistency, interinformant reliability, item grouping and criterion validity based on a large‐scale random sample (n = 377) and a clinical sample (n = 99) of adults with ID. Results The Dutch version of the Mini PAS‐ADD showed moderate internal consistency, and moderate concordance among informants. Both aspects of the reliability were comparable for different levels of ID. A factor analysis largely confirmed the scale structure. Concurrent validity with the Reiss Screen for Maladaptive Behavior was high for the Depression, Psychosis and Autism scale. The outcome of the criterion‐validity analysis indicated high specificity. The sensitivity for specific psychiatric disorders by the corresponding scales was moderate, but the general sensitivity for the presence of psychopathology on the basis of any of the scales was satisfying. Conclusions The present research reconfirmed the use of the Mini PAS‐ADD as a primary screening device for the identification of mental health problems among people with ID.     

Behaviour problems in childhood and adolescence in psychotic offenders: an exploratory study

Background Several studies have shown that adults who develop schizophrenia and commit a criminal offence may already have shown behaviour problems in childhood or adolescence. It is less clear whether such problems follow a particular pattern in such patients. Aims To examine the utility of the Child Behavior Checklist (CBCL) among offenders, to test whether externalizing behaviour problems, as measured by the CBCL, are more frequent in psychotic offenders than in non‐offenders with psychosis, and to investigate relationships between early behavioural problems and adult personality disorder in psychotic offenders. Methods Three groups of violent offenders detained under the Dutch Entrustment Act (TBS‐detainees)(n = 78) and one group of psychotic patients in general psychiatry (n = 16) were rated from case records on the CBCL. Results There was a significant difference between psychotic offenders with a personality disorder (n = 25) and the non‐offender patients with psychosis (n = 16) on the ‘delinquent behavior’ scale, but no such difference between psychotic offenders with (n = 25) and without (n = 21) personality disorder. A hierarchic cluster analysis revealed significantly higher scores for externalizing behaviour in all TBS‐detainees with a personality disorder. Those starting to offend early had higher scores for externalizing behaviour than late starters. Conclusions Psychotic and non‐psychotic offenders with personality disorder resemble one another in their early childhood behaviour problems; psychotic offenders without a personality disorder differ from these two groups but resemble non‐offenders with psychosis. In contrast to findings in non‐forensic populations, there were no differences on other problem scales of the CBCL. Given the small sample sizes, replication is needed, but the findings lend weight to treatment models which focus on the psychosis in the latter two groups but extend also to personality disorder in the former. Copyright © 2008 John Wiley & Sons, Ltd.     

Psychopathology in adolescent and young adult criminal offenders (15–21 years) in Sweden

Background This study examined rates of psychopathology among adolescent and young adult serious offenders referred to pre-sentence forensic psychiatric services and compared patterns of psychiatric morbidity with adult forensic referrals and age-matched general psychiatric inpatients. Methods In Sweden, criminal offenders can be referred for an extensive court-ordered pre-sentence inpatient forensic psychiatric examination (FPE). Data on all 3,058 of these offenders (90% male, mean age = 35.3 years) during 1997–2001 were obtained from the National Board of Forensic Medicine. We compared DSM-IV psychiatric diagnoses across age bands 15–17 years (N = 60), 18–21 years (N = 300) and 22 years and older (N = 2,698). Comparative data by age bands were also obtained for inpatient diagnoses among individuals admitted to general psychiatric hospitals. Results Compared with the adult forensic psychiatric examinees, those aged 15–17 years and 18–21 years had higher rates of depression, and childhood and developmental disorders but lower rates of psychosis, bipolar disorder, and substance use disorders. Compared with general psychiatric inpatients, offenders aged 15–17 years had higher prevalences of depression and attention-deficit or disruptive disorders and lower ones of alcohol and drug misuse disorders. Conclusions There are significant differences in patterns of psychiatric morbidity in adolescent and young adult offenders that come into contact with psychiatric services compared with older offenders and adolescent psychiatric inpatients. This suggests that the development of health services addressing the psychiatric needs of younger offenders needs to draw on information on their specific mental health needs.     

Mentally disordered offenders in Sweden: differentiating recidivists from non-recidivists in a 10-year follow-up study

Background: Forensic psychiatric patients present a challenge as they manifest severe mental disorders together with criminal behaviour. There are well-known risk factors for criminal behaviour in the general population, yet knowledge of what predicts reconviction in the Swedish forensic population in the long-term perspective is still insufficient.

Aims: The study aims to (1) describe background and clinical characteristics of forensic psychiatric patients in a 10-year follow-up, (2) analyse risk factors associated with recidivism, and (3) test the predictive validity of risk factors for general and violent criminality.

Methods: Detailed information on all offenders from the Malmö University Hospital catchment area sentenced to forensic psychiatric in-patient treatment from 1999–2005 (n?=?125) was collected. Court decisions were collected up until the end of 2008 (median follow-up time?=?6.2 years, range?=?0.6–9.7 years).

Results: Relapse in general crime (n?=?30) was predicted by low educational attainment, mental disorder in a first degree relative, and low age at first sentenced crime. Relapse in violent crime (n?=?16) was predicted by low educational attainment and low GAF scores. Patients with a restriction order were less likely to relapse in both crime categories.

Conclusions: Signs of childhood adversities together with early debut in criminality appeared as important risk factors for general and violent recidivism. Forensic psychiatric treatment combined with a restriction order was demonstrated as a protective factor against recidivism, suggesting that the risk of recidivism is strongly related to the level of supervision. Although the low number of recidivism cases is highly desirable, it unfortunately reduces the power of the analyses in this paper.     

Psychiatric admissions at different levels of the national health care services and male criminality: the Northern Finland 1966 Birth Cohort study

  Background: It has earlier been suggested that one-third of violent offenders are recorded in psychiatric case registers. Our aim was to study whether violent and non-violent offenders differ with respect to admissions to any health care inpatient service due to psychiatric disorders. Methods: We used a genetically homogeneous, general population database from the Northern Finland 1966 Birth Cohort, together with the Finnish Hospital Discharge Register and national crime registers. Results: We found that one-third of violent and one-fourth of non-violent male offenders had at least one hospital admission due to a psychiatric disorder before the age of 32. Sixty-five violent criminals – 1.2% of all cohort males (n=5636) – accounted for 14.4% of all psychiatric treatment days. The admission rates among both violent and non-violent male offenders were significantly higher when compared with males with no criminal history. Among violent males, only half (55.5%) of the inpatient hospital days due to psychiatric disorders occurred in psychiatric hospitals. The corresponding percentages for non-violent criminals and non-criminals were 64.9% and 74.1%, respectively. Among the violent offenders, one-third of hospital inpatient days occurred in university hospitals or central hospitals, and only 1.9% of them occurred in a comprehensive community care system. Conclusions: Violent offenders' admission rates due to a psychiatric diagnosis are high, and they are frequently treated at an inappropriate health care level. Accepted: 23 February 2000     

A revised sexual knowledge assessment tool for people with intellectual disabilities: is sexual knowledge related to sexual offending behaviour?

Background The aim of the current study was to update an existing short measure of sexual knowledge and generate some initial reliability and normative data. Comparisons of sexual knowledge across several groups were made to examine whether or not a lack of sexual knowledge is related to sexual offending. Methods The Bender Sexual Knowledge Questionnaire (BSKQ) was revised, and a new questionnaire, the General Sexual Knowledge Questionnaire (GSKQ), was created and administered to four groups of participants: (1) sex offenders with an intellectual disability (ID) and a history of engagement in treatment (n = 12); (2) sex offenders with an ID and no history of treatment (n = 13); (3) non‐offenders with an ID (n = 28); and (4) non‐offenders without an ID (n = 10). Between‐group comparisons were made; internal consistency, split‐half reliability and correlations were examined. Results The internal consistency and the split‐half reliability of the entire questionnaire was good. Non‐offenders without an ID scored significantly higher than non‐offenders with an ID on all sections of the GSKQ. Sex offenders who had undergone treatment scored significantly higher than non‐offenders with an ID on several sections of this questionnaire. Conclusions The initial findings from this study suggest that the psychometric properties of the GSKQ are promising. The assumption that lower sexual knowledge may be related to the risk of committing a sexual offence by people with IDs is possibly erroneous, and further research is required to clarify this possibility.     

Neurocognitive profiles of marginally housed persons with comorbid substance dependence,viral infection,and psychiatric illness

Introduction: Individuals living in single-room occupancy (SRO) hotels constitute a socially marginalized group with exposure to multiple factors with adverse effects on neurocognition, including substance use, viral infection, psychiatric illness, and brain injury. Consequently, marked heterogeneity in neurocognitive functioning is observed. This study aimed to identify and describe distinct neurocognitive profiles within a marginally housed sample. Method: Two hundred and forty-nine (N = 249) SRO hotel residents (mean age = 43.5 years) were recruited. A battery of tests assessed neurocognition across six domains: premorbid IQ, verbal memory, attention, inhibition, mental flexibility, and decision making. Clinical examinations collected information pertaining to substance use and psychiatric diagnoses, viral infection, psychiatric symptoms, risk behaviors, and everyday functioning. Cluster analysis was used to identify subgroups of individuals with similar neurocognitive profiles and was supplemented with a discriminant function analysis. Analyses of variance and chi-square tests were used to validate the derived clusters on key clinical and functional variables. Results: A three-cluster solution was found to be optimal. Cluster 1 (n = 59) presented as overall higher functioning, whereas Cluster 3 (n = 87) exhibited overall lower functioning with a relative strength in decision-making skills. Cluster 2 (n = 103) was characterized by neurocognitive abilities that generally bisected the performance of the other groups, but with a relative weakness in decision-making skills. Discriminant function analysis indicated the six neurocognitive variables comprised two underlying dimensions that accounted for between-group variance. Clusters meaningfully differed on demographics, substance use, viral exposure, psychiatric symptoms, neurological soft signs, and risk behavior. Conclusion: Neurocognitive functioning provides the basis for identifying meaningful subgroups of marginally housed individuals, which can be reliably differentiated on key variables. This approach facilitates an understanding of the neurocognitive dysfunction and associated vulnerabilities of marginalized persons and ultimately may elucidate intervention targets.     

Psychiatric disorders in adult children of parents with a history of psychopathology

Background The relation between major categories of psychiatric problems in parents and psychiatric disorders in their adult children has been investigated in only a few community studies. Methods In this study, data from a representative sample of the Dutch population (N = 7147) (response rate: 69.7 %) were used to examine this relation. DSM-III-R disorders were assessed using the CIDI. Parental psychiatric symptoms and childhood adversities were assessed using self-report measures. Results It was found that psychiatric symptoms in parents are strongly related to psychiatric disorders in their (adult) children, independent of type of parental psychiatric symptom. Only maternal problem drinking was not significantly related to an increased risk for their children. When controlled for childhood adversities and demographic variables, most relations between psychiatric disorders and parental psychiatric symptoms remained significant. Parental anxiety symptoms, however, were not significantly related to psychiatric disorders in the children, including anxiety disorders. It was also found that anxiety disorders in the children were not related to most parental psychiatric symptoms. Conclusions This study has once more made it clear that children whose parents have psychiatric problems constitute an important high-risk group and that prevention and early intervention in these children constitute an important public health issue. Accepted: 26 September 2001     

Late Preterm Birth,Maternal Depression,and Risk of Preschool Psychiatric Disorders

ObjectivePreterm children are at greater risk for psychiatric disorders, including anxiety disorders and attention-deficit/hyperactivity disorder (ADHD), than their term-born peers. Prior research has focused primarily on children born at early gestational ages. Less is known about the rate of psychiatric disorders among late preterm or early term children. In addition, whether a history of maternal depression also associated with prematurity has an impact on the risk for psychiatric disorders remains underexplored.MethodPreschoolers between ages 3 and 6 years (N = 306) were recruited for a study examining preschool depression that included healthy and disruptive preschoolers. Preschoolers were placed in the following groups: late preterm (34–36 weeks, n = 39), early term (37–39 weeks, n = 78), and full term (40–41 weeks, n = 154). DSM-IV psychiatric disorders were assessed via the Preschool Age Psychiatric Assessment. Maternal history of psychiatric disorders was assessed using the Family Interview for Genetic Studies.ResultsLate preterm children had higher rates of any Axis I psychiatric diagnosis (odds ratio = 3.18, 95% confidence interval = 1.09–4.76) and of any anxiety disorder (odds ratio = 3.74, 95% confidence interval = 1.59–8.78) than full term children after adjusting for gender, ethnicity, family income, and IQ. There were no differences in rates of psychiatric diagnoses between early term and full term children. A history of maternal depression mediated the relationship between late preterm birth and anxiety disorders in preschoolers.ConclusionsLate preterm children were at increased risk for anxiety disorders at preschool age. A history of maternal depression mediated this association. Findings confirm the extension of the risk of psychiatric disorders associated with prematurity to the late preterm group, and suggest that maternal depression may play a key role in this risk trajectory.     

Male criminals with organic brain syndrome: two distinct types based on age at first arrest.

OBJECTIVE: This study examined whether criminals with organic brain syndrome could be divided into two distinct types. The authors proposed that early starters (onset of criminal activity by age 18) would display a persistent, long-lasting pattern of deviance that was largely independent of their brain disorder, whereas late starters (onset at age 19 or after) would exhibit deviant behaviors that began late in life and were more directly related to their brain disorder. METHOD: Subjects were 1,130 male criminal offenders drawn from a birth cohort of all individuals born between January 1, 1944, and December 31, 1947, in Denmark. The main study group included all men with both a history of criminal arrest and a hospitalization for organic brain syndrome (N=565). In addition, for a subset of analyses, the authors examined a randomly selected, same-size comparison group of men with a history of criminal arrest who were not hospitalized for organic brain syndrome. Data were available on all arrests and all psychiatric hospitalizations for individuals in this cohort through the age of 44. RESULTS: Among those with organic brain syndrome, early starters were significantly more likely than late starters to 1) be arrested before the onset of organic brain syndrome, 2) show a higher rate of offending before but not after the onset of organic brain syndrome, 3) be both recidivists and violent recidivists, and 4) have a diagnosis of antisocial personality disorder. CONCLUSIONS: Male criminals with organic brain syndrome can be meaningfully divided into two distinct types on the basis of age at first arrest. Early starters show a more global, persistent, and stable pattern of offending than late starters. These results have implications for treatment and risk assessment.     

Preventive Detention Versus Civil Commitment: Alternative Policies for Public Protection in New Zealand and California

There has been a resurgence in the use of indefinite civil commitment of dangerous sexual offenders in the United States since the early 1990s. This current generation of civil commitment laws differs from previous statutory schemes in the underlying approach to dangerousness and the conditions under which they can be applied. As implemented in California, the law results in the post-sentence detention of approximately 1% of the registered sexual offenders released from prison since the law came into effect in 1996, representing those seen as most at risk for sexual recidivism. New Zealand has taken a different approach to the indefinite detention of dangerous sexual offenders through the use of preventive detention sentencing. In recent years the relevant New Zealand statutes have broadened their criteria to allow application to a wider range of offenders. While both approaches appear to identify a similar group of high risk offenders, preventive detention appears less legally ambiguous, more clinically practical, and a better allocation of resources.     

Follow-up and family study of postpartum psychoses

Patients suffering from a severe psychiatric postpartum disorder (n=119) were classified according to early onset (EO) of symptoms, i.e. onset within 2 weeks postpartum, versus late onset (LO) in the 3-month period following delivery. The patients were admitted for the first time in their life to a psychiatric hospital. The EO cases more often had a manic syndrome, the symptomatology of cycloid psychoses, signs of confusion and an abrupt onset of illness. They were also younger at the index delivery and at the first episode of illness. No important difference in the distribution of diagnoses considering the long-term course was found in the two groups. The global psychopathological outcome was also similar. There is no definite evidence that different diseases are provoked in the early and later postpartum period.     

Intended effects and actual outcome of the Forensic Mental Care Act of 1992: A study of 367 cases of forensic psychiatric investigation in Sweden

The legislation regulating sanctions for offenders with mental disorders has been under parliamentary review in Sweden, and major changes have been discussed. In the present study, we have explored the expectations and effects of the previous change in legislation, introduced in 1992 and aimed at reducing coercive psychiatric treatment. Two cohorts of male subjects, admitted for forensic psychiatric investigation before (1988–90, n=187) and after (1993–95, n=180) 1992, were compared regarding sanctions, diagnoses and background data with a possible impact on the study populations. Contrary to expectations, the 1993–95 cohort was characterized by increased proportions of psychotic disorders and sentences to forensic psychiatric treatment. In both cohorts, few cases had an adequate outpatient treatment. A tendency to shorter compulsory inpatient treatment periods during the last year before the index crimes was found for those with psychotic disorders in the 1993–95 cohort. The frequency of immigrants with psychotic disorders was markedly increased in the later cohort. The intention of the new legislation to minimize forensic psychiatric treatment was thus counteracted by an unexpected increase in number of offenders with psychotic disorders. To what extent these findings are ascribable to factors other than the new legislation, such as reduced inpatient treatment facilities and generally decreased economic growth rate that coincided with the observation period, cannot be estimated in a limited study population such as ours.     

Pathways to child and adolescent psychiatric clinics: a multilevel study of the significance of ethnicity and neighbourhood social characteristics on source of referral

Background

This study aims to identify risk factors for level of offending among childhood offenders from different socio-economic status (SES) neighborhoods and ethnic origins.

Method

Three groups of childhood first time police arrestees were studied using standardized instruments for individual and parental characteristics: native Dutch offenders from moderate to high SES neighborhoods, native Dutch offenders from low SES neighborhoods, and offenders of non-Western origin from low SES neighborhoods.

Results

All subgroups showed high rates of externalizing disorders (27.2% to 41.8%) and familial difficulties (25.7% to 50.5%). Few differences between neighborhoods were found in the prevalence and impact of risk factors. However, the impact of some family risk factors on offending seemed stronger in the low SES groups. Regarding ethnical differences, family risk factors were more prevalent among non-Western childhood offenders. However, the association of these factors with level of offending seemed lower in the non-Western low SES group, while the association of some individual risk factors were stronger in the non-Western low SES group. Turning to the independent correlation of risk factors within each of the groups, in the Dutch moderate to high SES group, 23.1% of the variance in level of offending was explained by ADHD and behavioral problems; in the Dutch low SES group, 29.0% of the variance was explained by behavioral problems and proactive aggression; and in the non-Western low SES group, 41.2% of the variance was explained by substance use, sensation seeking, behavioral peer problems, and parental mental health problems.

Conclusions

Thereby, the study indicates few neighborhood differences in the impact of individual and parental risk factors on offending, while individual and parental risk factors may differ between ethnic groups.     

Outcome of drug abuse in a 20-year follow-up study of drug-experimenting schoolchildren in Finland

The fate of 119 drug-experimenting schoolchildren who had been interrogated by the narcotics police of Helsinki, Finland, during 1 year, 1971-72, was studied 20 years later. The material was divided in two groups: those with a favourable outcome (n = 49) and those with a poor outcome (n =70). Nineteen had died. Criteria for poor outcome were death, prison sentence, psychiatric hospitalization, or continuation of crimes. The group with a favourable outcome was alive, did not have prison sentences or psychiatric hospitalizations, and had not been caught by the police after the initial phase of the study. Offences against property in early adolescence and intravenous drug use were predictive factors for imprisonment, psychiatric hospitalization, and death. A poor atmosphere at home and the occupation of the father as labourer were predictive factors for imprisonment, psychiatric hospitalization, and death for boys. For girls low education was predictive of imprisonment and psychiatric hospitalization. Drug use in adolescence is a signal of greater risk for adjustment problems in later life.     

Validating the EDI-2 in three Swedish female samples: Eating disorders patients,psychiatric outpatients and normal controls

The aim of the current study was to validate the Eating Disorders Inventory 2 (EDI-2) in a Swedish population by investigating how it discriminates between three female samples aged 18 to 50 years: patients with eating disorders (n=978), psychiatric outpatients (n=106) and normal controls (n=602), as well as between different eating disorder diagnoses. The internal consistency of the EDI-2 was above 0.70 for most subscales. The EDI-2 discriminated well between patients with eating disorders and normal controls on all subscales. On the symptom-related subscales, eating disorder patients scored highest followed by psychiatric controls and normals. All subscales except Perfectionism, Interoceptive awareness and Asceticism discriminated eating disorder patients and psychiatric controls. Bulimia patients scored higher than anorexics on the symptom subscales. It is concluded that the EDI-2 discriminates well between eating disorder patients and both psychiatric and normal controls.