Psychopathy and violent recidivism among young criminal offenders

OBJECTIVE: To investigate the predictive validity of psychopathic personality traits (assessed with the revised psychopathy checklist, PCL-R; Hare, 1991) for violent criminal recidivism among young offenders. METHOD: The relationship between PCL-R psychopathy and violent re-offending was studied in 98 young (M=18.40, range 15-20 years) violent and sex offenders subjected to forensic psychiatric evaluation in Sweden during 1988-95. Subjects were followed during detainment and for 24 months in the community to first reconviction for a violent offence. RESULTS: We found a modest but significant association between PCL-R scores and violent recidivism, almost exclusively accounted for by behavioural criteria. Among 13 possible confounders tested, conduct disorder before age 15 and a young age at first conviction eliminated the relationship between psychopathy and violent recidivism in pair-wise logistic regression models. CONCLUSION: PCL-R psychopathy may be a less valid predictor for violent criminal recidivism among severe youthful offenders than among adult offenders.     

The impact of surgical castration on sexual recidivism risk among sexually violent predatory offenders

The relationship of surgical castration to sexual recidivism in a sexually violent predator/sexually dangerous person (SVP/SDP) population is reviewed. A review of the literature on castrated sex offenders reveals a very low incidence of sexual recidivism. The low sexual recidivism rates reported are critiqued in light of the methodologic limitations of the studies. Better designed testicular/prostate cancer studies have demonstrated that, while sexual desire is reduced by orchiectomy, the capacity to develop an erection in response to sexually stimulating material is not eliminated. The relevance of this literature to SVP/SDP commitment decisions and ethics is discussed. Two vignettes of castrated, high-risk sex offenders illustrate how to address risk reduction. Two tables are presented: the first outlines individual case data from a difficult-to-obtain report, and the second summarizes the most frequently cited castration studies on sexual recidivism. Orchiectomy may have a role in risk assessments; however, other variables should be considered, particularly as the effects can be reversed by replacement testosterone.     

Predictors of violent behavior among acute psychiatric patients: clinical study

Aim:  Violence risk prediction is a priority issue for clinicians working with mentally disordered offenders . The aim of the present study was to determine violence risk factors in acute psychiatric inpatients.
Methods:  The study was conducted in a locked, short-term psychiatric inpatient unit and involved 374 patients consecutively admitted in a 1-year period. Sociodemographic and clinical data were obtained through a review of the medical records and patient interviews. Psychiatric symptoms at admission were assessed using the Brief Psychiatric Rating Scale (BPRS). Psychiatric diagnosis was formulated using the Structured Clinical Interview for DSM-IV. Past aggressive behavior was evaluated by interviewing patients, caregivers or other collateral informants. Aggressive behaviors in the ward were assessed using the Overt Aggression Scale. Patients who perpetrated verbal and against-object aggression or physical aggression in the month before admission were compared to non-aggressive patients, moreover, aggressive behavior during hospitalization and persistence of physical violence after admission were evaluated.
Results:  Violent behavior in the month before admission was associated with male sex, substance abuse and positive symptoms. The most significant risk factor for physical violence was a past history of physically aggressive behavior. The persistent physical assaultiveness before and during hospitalization was related to higher BPRS total scores and to more severe thought disturbances. Higher levels of hostility–suspiciousness BPRS scores predicted a change for the worse in violent behavior, from verbal to physical.
Conclusion:  A comprehensive evaluation of the history of past aggressive behavior and psychopathological variables has important implications for the prediction of violence in psychiatric settings.     

The effect of discordance among violence and general recidivism risk estimates on predictive accuracy

Introduction Previous research has shown that the prediction of short‐term inpatient violence is negatively affected when clinicians' inter‐rater agreement is low and when confidence in the estimate of risk is low. This study examined the effect of discordance between risk assessment instruments used to predict long‐term general and violence risk in offenders. Methods The Psychopathy Checklist – Revised (PCL–R), Level of Service Inventory – Revised (LSI–R), Violence Risk Appraisal Guide (VRAG), and the General Statistical Information on Recidivism (GSIR) were the four risk‐prediction instruments used to predict post‐release general and violent recidivism within a sample of 209 offenders. Results The findings lend empirical support to the assumption that predictive accuracy is threatened where there is discordance between risk estimates. Discordance between instruments had the impact of reducing predictive accuracy for all instruments except the GSIR. Further, the influence of discordance was shown to be greater on certain instruments over others. Discordance had a moderating effect on both the PCL–R and LSI–R but not on the VRAG and GSIR. Conclusions There is a distinct advantage when attempting to predict recidivism to employing measures such as the LSI‐R, which includes dynamic variables and intervention‐related criminogenic domains, over a measure purely of fixed characteristics, such as the GSIR; however, if there is discordance between the risk estimates, caution should be exercised and more reliance on the more static historically based instrument may be indicated. Copyright © 2006 John Wiley & Sons, Ltd.     

Relationship of psychobiological variables to recidivism in violent offenders and impulsive fire setters. A follow-up study

Fifty-eight violent offenders and impulsive fire setters were followed up for an average of 3 years after release from prison. Recidivists who committed a new violent offense or arson had significantly lower cerebrospinal fluid 5-hydroxyindoleacetic acid and homovanillic acid concentrations and blood glucose nadirs after oral glucose challenge than did nonrecidivists. A discriminant analysis, based on the blood glucose nadir and cerebrospinal fluid 5-hydroxyindoleacetic acid concentration, correctly classified 84.2% of the subjects.