UNASSIGNED: Attention-deficit/hyperactivity disorder (ADHD) is prevalent amongst offenders, increasing risks for aggressive and delinquent behaviors. Since ADHD and its symptoms can persist into adulthood, accurately diagnosing and maintaining diagnoses in offenders is crucial to ensure appropriate treatment and reduce recidivism.
UNASSIGNED: This study employed a retrospective longitudinal design to investigate ADHD amongst adult offenders with a confirmed diagnosis of ADHD during childhood or adolescence at a Swiss forensic outpatient clinic between 2008 and 2021. N = 181 patient files were reviewed, including forensic expert witness assessments and treatment reports. We charted the adulthood trajectory of patients with a confirmed childhood/adolescence ADHD diagnosis, examining the course of their diagnoses.
UNASSIGNED: Of 181 patients, evidence indicated that 12 (7%) had an ADHD diagnosis in childhood/adolescence. In 1 (8%) of these 12 cases, the diagnosis was maintained throughout the observation period. For 4 patients (33%), a diagnosis was given in the first forensic psychiatric expert witness assessment in adulthood but subsequently dropped. In another 4 cases (33%), the diagnosis was dropped in adulthood but later re-assigned, whereas in 3 cases (25%), the diagnosis was discontinued throughout the observation period. In 50% of cases with a diagnostic change, the discontinuation of an adult ADHD diagnosis coincided with a newly diagnosed personality disorder (or vice versa).
UNASSIGNED: Our findings highlighted considerable inconsistencies in the assignment of adult ADHD diagnoses amongst offenders. Whilst ADHD remission in adulthood occurs, the diagnostic variability in our results warrants detailed scrutiny. One possibility is that ADHD has similar fluctuations to conditions like depression, as argued elsewhere. Equally, diagnoses may become \"lost\", meaning they are not given even when applicable and replaced by other diagnoses. Additionally, residual symptoms may remain but beyond the diagnostic threshold. This is significant because untreated ADHD can increase re-offending risks and adverse health outcomes.

Criminal offending and mental health problems often co-occur. This study examined competing models to understand bidirectional associations between crime and mental health problems over time among at-risk men in the U.S. It was hypothesized that there would be significant cross-lagged associations of offending and mental health problems in early adulthood. Longitudinal data were drawn from 206 at-risk men enrolled in the Oregon Youth Study. Random intercept cross-lagged models examined bidirectional associations between mental health problems (assessed with the 53-item Brief Symptom Inventory) and self-reported offending in early adulthood across 6 time points from ages 19-20 to 29-30 years. Sociodemographic factors, prior levels, and common risk factors (i.e., parents\' criminality, mental health problems, and socioeconomic status, as well as child age, antisocial propensity, and internalizing behaviors) were controlled during analysis. A robust association between mental health problems and offending was found for the early adult period, especially for total and violence offenses. Findings did not support the hypothesized positive cross-lagged effects. Instead, two cross-lagged effects emerged indicating that offending was inversely related to subsequent mental health problems. Childhood antisocial propensity and internalizing behaviors emerged as important predictors of stable between-person level differences in offending and mental health problems, respectively, although results differed as a function of offense categories (total, violence, property, drug). Findings indicate that the relation between mental health problems and offending is unidirectional, temporal, and partially spurious. Preventing child internalizing behaviors and child antisocial behaviors holds promise for reducing early adult mental health problems and offending.

The relationship between schizophrenia spectrum disorders (SSD) and violent offending has long been the subject of research. The present study attempts to identify the content of delusions, an understudied factor in this regard, that differentiates between violent and non-violent offenses. Limitations, clinical relevance, and future directions are discussed. Employing a retrospective study design, machine learning algorithms and a comprehensive set of variables were applied to a sample of 366 offenders with a schizophrenia spectrum disorder in a Swiss forensic psychiatry department. Taking into account the different contents and affects associated with delusions, eight variables were identified as having an impact on discriminating between violent and non-violent offenses with an AUC of 0.68, a sensitivity of 30.8%, and a specificity of 91.9%, suggesting that the variables found are useful for discriminating between violent and non-violent offenses. Delusions of grandiosity, delusional police and/or army pursuit, delusional perceived physical and/or mental injury, and delusions of control or passivity were more predictive of non-violent offenses, while delusions with aggressive content or delusions associated with the emotions of anger, distress, or agitation were more frequently associated with violent offenses. Our findings extend and confirm current research on the content of delusions in patients with SSD. In particular, we found that the symptoms of threat/control override (TCO) do not directly lead to violent behavior but are mediated by other variables such as anger. Notably, delusions traditionally seen as symptoms of TCO, appear to have a protective value against violent behavior. These findings will hopefully help to reduce the stigma commonly and erroneously associated with mental illness, while supporting the development of effective therapeutic approaches.

BACKGROUND: Autism spectrum disorder (hereafter referred to as autism) is characterised by difficulties with (i) social communication, social interaction, and (ii) restricted and repetitive interests and behaviours. Estimates of autism prevalence within the criminal justice system (CJS) vary considerably, but there is evidence to suggest that the condition can be missed or misidentified within this population. Autism has implications for an individual\'s journey through the CJS, from police questioning and engagement in court proceedings through to risk assessment, formulation, therapeutic approaches, engagement with support services, and long-term social and legal outcomes.
METHODS: This consensus based on professional opinion with input from lived experience aims to provide general principles for consideration by United Kingdom (UK) CJS personnel when working with autistic individuals, focusing on autistic offenders and those suspected of offences. Principles may be transferable to countries beyond the UK. Multidisciplinary professionals and two service users were approached for their input to address the effective identification and support strategies for autistic individuals within the CJS.
RESULTS: The authors provide a consensus statement including recommendations on the general principles of effective identification, and support strategies for autistic individuals across different levels of the CJS.
CONCLUSIONS: Greater attention needs to be given to this population as they navigate the CJS.

UNASSIGNED: Comorbid substance use disorder (SUD) is linked to a higher risk of violence in patients with schizophrenia spectrum disorder (SSD). The objective of this study is to explore the most distinguishing factors between offending and non-offending patients diagnosed with SSD and comorbid SUD using supervised machine learning.
UNASSIGNED: A total of 269 offender patients and 184 non-offender patients, all diagnosed with SSD and SUD, were assessed using supervised machine learning algorithms.
UNASSIGNED: Failures during opening, referring to rule violations during a permitted temporary leave from an inpatient ward or during the opening of an otherwise closed ward, was found to be the most influential distinguishing factor, closely followed by non-compliance with medication (in the psychiatric history). Following in succession were social isolation in the past, no antipsychotics prescribed (in the psychiatric history), and no outpatient psychiatric treatments before the current hospitalization.
UNASSIGNED: This research identifies critical factors distinguishing offending patients from non-offending patients with SSD and SUD. Among various risk factors considered in prior research, this study emphasizes treatment-related differences between the groups, indicating the potential for improvement regarding access and maintenance of treatment in this particular population. Further research is warranted to explore the relationship between social isolation and delinquency in this patient population.

Previous studies on exposure to violence lack a nuanced understanding of the causal effects of different exposure types on offending behaviors. This study, drawing on Pathways to Desistance Study (PDS) data tracking 1354 adjudicated youths aged 14-18 over 7 years, explores the contemporaneous (cross-sectional), acute (after 1 year), enduring (after 3 years), and long-term (after 6 years) causal effects of violence exposure on property and violent offending. The sample, predominantly male (86%), consisted of White (20%), Black (42%), and other (38%) individuals. The generalized propensity score is used to match unbalanced covariates across multiple exposure types, namely noninvolved (n = 392), witnessed (n = 577), experienced (n = 31), and experienced-witnessed violence (n = 305). Results demonstrate the contemporaneous, acute, enduring, and long-term effects of violence exposure on both violent and property offending, with varying durations and strengths across exposure types. The most pronounced risk effects are immediate, diminishing over time and potentially reversing in the long term as youth transition into adulthood. Among exposure types, experienced-witnessed violence exhibits the most potent effects on offending, followed by witnessed violence and then experienced violence-a pattern consistent across the observed time points. Noteworthy is the finding that the impact of violence exposure is more pronounced for violent offending, diminishing more rapidly compared to the effects on property offending.

OBJECTIVE: Clinical services for early psychosis seek to improve prognosis for a range of adverse outcomes. For some individuals, perpetration of violence is an important potential outcome to reduce. How these clinical services currently assess this risk however is uncertain. This study aimed to address this gap by using qualitative methods to examine in depth current approaches, attitudes and challenges to assessing violence risk in this clinical setting, from the perspectives of multidisciplinary clinicians, patients and carers.
METHODS: Participants were recruited from two UK Early Intervention in Psychosis services. Semi-structured individual interviews were undertaken using a topic guide. In addition, clinical vignettes were presented to clinician participants as a probe to prompt discussion. Data were analysed using thematic analysis, informed by the constant comparative method.
RESULTS: We conducted 30 qualitative interviews, of 18 clinicians and 12 patients and carers. Themes developed from clinician interviews included key difficulties of low confidence, limited training, accessing collateral information and variation in how risk is appraised and communicated. Potential stigma and sensitivity of the topic of violence were perceived as barriers to its discussion. Patient and carer perspectives provided insight into how to address barriers, and highlighted the importance of an open approach, including with families.
CONCLUSIONS: We recommend developing contextually appropriate pathways to collaboratively assess violence risk and identify modifiable needs to reduce this risk, and for practical improvements in training and information-sharing.

OBJECTIVE: The primary objective was to conduct a comparative analysis of homicide cases and their perpetrators with psychotic illnesses in samples from Turkiye and Russia to elucidate contextual similarities and differences, and providing novel perspectives to enhance international research in this field.
METHODS: This cross-national retrospective study, conducted at forensic psychiatric centers in Istanbul, Turkiye, and Chuvashia, Russia, involved individuals with psychotic illnesses (ICD-10 F20-F29) who were deemed criminally non-responsible for index homicide offenses between December 2012 and December 2022. The sample included 92 Turkish patients and 29 Russian patients who were compared for background, clinical characteristics, and each homicidal act.
RESULTS: Binary analyses revealed that Russian subjects were more educated, had more lifetime suicide attempts, longer illness duration, had acquaintances as victims more frequently, higher rates of blunt traumatic homicides, higher rates of intoxication with alcohol or substances, and lower rates of experiencing delusions at the time of the index homicide compared to their Turkish counterparts. Multivariate analyses indicated that more years of education, a greater frequency of lifetime suicide attempts, higher prevalence of intoxication and a lower rate of delusions at the time of the homicide were associated with belonging to the Russian group.
CONCLUSIONS: Despite several similarities, the remarkable differences between the two samples underscore the importance of international research in enhancing our understanding of mental health, homicidal offense and offender characteristics in the sociocultural context.

UNASSIGNED: Females are the fastest growing justice involved population in the United States, yet there is relatively little empirical research on the collateral consequences of juvenile justice involvement specifically for females. A growing body of empirical research underscores linkages between juvenile justice involvement and negative health and psychosocial outcomes, both in the short and long term.
UNASSIGNED: The current study describes the long-term collateral consequences of juvenile justice involvement for females previously involved in the juvenile justice system, drawing from a longitudinal dataset of 166 women who were initially recruited in adolescence due to chronic and severe justice system involvement. Participants were 15 years-old on average at study enrollment and 35 years-old on average at the current assessment. This paper describes the adolescent and adult experiences of the sample, therefore depicting the developmental trajectories of risk and protective factors for females involved with juvenile justice.
UNASSIGNED: As adults, 73% of the sample experienced arrest and 36% experienced incarceration. High rates of mental and physical health problems were reported, including that 50% of the sample met diagnostic criteria for posttraumatic stress disorder. Over 400 children were born to the sample, with high rates of documented intergenerational child welfare involvement.
UNASSIGNED: Study findings are discussed in the context of best practices for supporting adolescent girls involved with the juvenile justice system.

Research has established a relationship between trauma exposure, often conceptualized as Adverse Childhood Experiences (ACEs), and offending, with some evidence suggesting that both trauma and offending can be transmitted from one generation to the next. Further, while some evidence suggests that experiencing a high number of ACEs is associated with different types of offenses, it is not known whether these associations are similar across generations. The current study aims to address this gap in knowledge by examining the effects of ACEs on different offense types across two generations, utilizing data from a longitudinal study of British male participants and their male children. Results suggest that high ACE scores are associated with several offense types within generations, but the effect of parental ACEs on the subsequent generation\'s offending was weak. Alongside a discussion of these findings, study limitations and future research directions are also presented.