BACKGROUND:Mental health courts divert individuals with serious mental illness away from imprisonment into community-based treatment and supervision. Early research indicates that such treatment contracts can reduce recidivism and provide various other benefits. Aspects of eligibility for this diversion option are still under-researched. AIMS:To explore the nature of alleged offences against people accepted into mental health courts (on mental health court dockets), and their demographic and mental health context and their perceived relevance to eligibility for such diversion. METHODS:We used a sequential mixed-methods design in which semi-structured interviews were conducted after completion of quantitative data collection from the State of Virginia's behavioural and therapeutic court docket cases in 2022-2023. The State provides open online data on demographics and the nature of alleged offences for all mental health court-adjudicated cases. The qualitative part of the study involved semi-structured interviews with behavioural health docket coordinators across Virginia about their perceptions of how the nature of alleged criminal offences affects potential mental health court participation and the dynamics with other disciplines in the system that may be relevant to decision-making here. RESULTS:The most commonly alleged offence was assault-on-law-enforcement officers, an offence that, if convicted, carries a mandatory prison sentence. This was disproportionately charged against Black men. Qualitative findings revealed that the coordinators viewed assault-on-law-enforcement officers as likely to have occurred when defendants were in a state of mental health crisis, with resultant perceptions of law enforcement as a threat, and thus, usually, a mental health solution was likely to be in the best interests of all parties. There was local variation in processing, but a sense that local prosecutors hold disproportionate power, and defence lawyers are constrained by ideological advice rather than knowledge of optimal outcomes for their client. CONCLUSIONS:The punitive 6-month mandatory minimum jail term that must follow a conviction for an assault-on-law-enforcement officer may put both justice and safety at risk. Black men are disproportionately likely to be subject to such allegations, suggesting that disadvantage at every level of health and justice has reached this point. When mental disorder is manifestly a relevant factor in alleged offending, it makes sense to order disposals that will maximise restoration of health and social functioning in order to safeguard such officers, the wider community and the alleged offender. At present, the structured diversion option is only open in Virginia when a mental health court is willing to accept violent felony charges. We recommend wider dissemination of data on mental health court outcomes, including longer-term outcomes, to law enforcers and politicians with a view to change in the relevant law.
BACKGROUND:Rehabilitation is a central objective of correctional services in South Africa, intended to support behavioural change, reduce recidivism and contribute to successful reintegration. Despite this mandate, concerns regarding persistent recidivism and prison overcrowding remain. Less is known about how incarcerated individuals themselves experience rehabilitation and make sense of it. AIM:To explore how incarcerated individuals describe and make sense of their experiences of rehabilitation within a South African correctional setting. METHODS:Forty repeat-offending men serving custodial sentences at Leeuwkop Correctional Centre, South Africa, and having taken part in some rehabilitation programmes there, agreed to participate in semi-structured interviews about their experiences of the rehabilitation work. Data were analysed using inductive thematic analysis. Findings were partially validated through interviews with eight professional staff members who had been delivering aspects of the rehabilitation work. Themes were subsequently interpreted using the Sense of Coherence framework. RESULTS:Prisoner participants described shifts in self-perception, including increased self-awareness, a greater sense of personal responsibility and more future-oriented perspectives. These experiences broadly fit with the Sense of Coherence components of comprehensibility, manageability and meaningfulness. Such shifts were not, however, uniform and were often described as tentative and shaped by contextual constraints. CONCLUSION:Rehabilitation was experienced not only as a behavioural intervention but also as a process of meaning-making and identity reconstruction. By applying the Sense of Coherence framework as a postanalytic interpretive lens, this study offers a novel way of understanding how incarcerated individuals experience rehabilitation and perhaps internalise key aspects of it. Further longitudinal research is needed to examine the sustainability of these perceived changes over time.
INTRODUCTION:Criminal behaviour by people with schizophrenia has been attributed variously to direct effects of the illness, an interplay between clinical features and social circumstances or neither. A difficulty in the interpretation of the relevance of the illness may lie in the focus on the more clearly psychotic features and the relative neglect of emotional dysregulation or deficits in social cognition. We, therefore, aimed to examine whether psychological and social cognitive factors-such as alexithymia, impulsivity, aggression and facial emotion recognition-differ between individuals with schizophrenia who have a criminal history and those who do not. METHOD:Forty-seven patients with schizophrenia and a criminal record were recruited from consecutive admissions to a specialist forensic mental health inpatient unit and 73 patients with schizophrenia but no criminal record were recruited from a general psychiatry unit in the same hospital. All participants, aged 18-65 years, completed a battery of assessments, including the facial emotion recognition test, the Toronto Alexithymia Scale, the Barratt Impulsiveness Scale and the Buss-Perry Aggression Questionnaire, between October 2023 and June 2025. RESULTS:The offender-patients showed significantly higher average motor impulsivity scores, significantly higher alexithymia scores-particularly externally oriented thinking-and significantly higher anger scores, but significantly superior performance in facial emotion recognition tests, specifically identifying shame, fear, surprise and happiness more accurately than the noncriminal group. Clinically, individuals with a criminal history had a significantly later onset of disorder (30.78 vs. 23.42 years), shorter disorder duration (8.85 vs. 12.36 years) and fewer psychotic episodes (2.48 vs. 3.21) and were more prone to self-harm. The offender-patients appeared to have been less treatment-adherent; specifically, they were less likely to have sustained treatment with depot antipsychotic medication. These findings remained significant in regression analyses, with offending as the dependent variable and these other characteristics as independent variables. CONCLUSION:This study adds evidence on links between criminal behaviour and schizophrenia other than, or over and above, positive psychotic symptoms. Emotional dysregulation, substance use and poor treatment adherence were problematic, but facial emotion recognition was not. Thus, forensic risk assessments should include tests of emotion dysregulation to inform clinical interventions. Attention is also needed to improve treatment engagement and substance use management. Future research is needed to better understand the apparent disconnection between intact emotion recognition and criminal behaviour in this population.
BACKGROUND:Depression, anxiety and criminal behaviour are often correlated, but the direction and nature of these associations remain contested. AIMS:To investigate the temporal relationships between depression and/or anxiety and criminal behaviour at age 32 and depression and/or anxiety and criminal behaviour at age 48. METHODS:Using prospective, longitudinal data from the Cambridge Study in Delinquent Development, we applied propensity score matching to estimate the associations between (a) depression and/or anxiety at age 32 and criminal convictions at age 48 and (b) criminal convictions at age 32 and mental health problems at age 48. Propensity score matching (PSM) was used to adjust for a wide range of childhood and adolescent risk factors for offending or illness. RESULTS:Overall, a significant association between depression and anxiety and much later offending was evident, but after allowing for childhood adversities by propensity score matching, these relationships disappeared, suggesting that they are best explained by the common antecedent of childhood adversities. There was no relationship between any offending up to age 32 and depression or anxiety measured at age 48. CONCLUSIONS:Although our findings were limited by the very large time gap between measures of mental health and offending, it is clear that depression and anxiety may be important in the pathway to crime, but that this association is largely accounted for by shared early-life risk factors. Our findings also, however, caution against assuming any direct relationship between these symptoms and crime, regardless of direction. Recognising early developmental vulnerabilities and intervening appropriately may be the most effective way of preventing later ill health and criminal behaviour.
BACKGROUND:Adverse childhood experiences (ACEs) are traumatic events occurring before the age of 18 that may undermine a child's sense of safety, stability and attachment. ACEs can have lifelong consequences, including an elevated risk of developing psychological disorders and an increased likelihood of engaging in delinquent or violent behaviour later in life. Clinical practice suggests that many forensic psychiatric patients have a history of ACEs, but scientific research on ACEs within this population remains limited. AIM:To study the prevalence of ACEs before the age of 18 within a large Dutch forensic psychiatric prison cohort and the relationship between repeated ACEs and psychopathology or violent criminal behaviour. METHODS:Data collected from 3421 adults (91% men) who had been admitted to one of the four penitentiary psychiatric centres (PPCs) in the Netherlands were used to examine the prevalence of ACEs and their association with different clusters of psychological disorders or violent criminal behaviour. RESULTS:Over half of the men (1,633, 53%) and nearly two thirds of the women (198, 62%) had experienced repeated ACEs. The men with repeated ACEs had greater odds of having a neurobiological developmental disorder, having committed a violent offence and developing a substance use or addiction disorder, a personality disorder and/or a trauma- or stress-related disorder. The women with repeated ACEs had greater odds of developing a personality disorder. CONCLUSIONS:Our findings underscore the importance of incorporating assessment of trauma histories and trauma-informed service for forensic psychiatric offenders. We also add evidence for the potential for early intervention, given that repeated ACEs were associated with certain mental disorders and with violent offending, in particular for men.
BACKGROUND:Empathy deficits are linked to antisocial behaviour and low prosocial abilities. Improving capacity for empathy may help reduce aggression and support positive social engagement. AIMS:To evaluate the impact of empathy training among women in prison in Iran. METHODS:Thirty female prisoners from Kermanshah Prison, Iran, volunteered to take part and were assigned to two groups. Fifteen participants received empathy training, whereas 15 served as a control group and only completed assessments. The intervention was of eight group sessions (45-60 min each). Standardised questionnaires were administered pre- and post-intervention to assess empathy, aggression, moral identity, moral disengagement and social desirability. Gain scores for social desirability were treated as covariates in a multivariate analysis of covariance (MANCOVA). RESULTS:MANCOVA did not reveal statistically significant effects of empathy training. However, individual ANOVA analyses showed a significant increase in moral disengagement among the intervention group, suggesting unintended consequences. CONCLUSIONS:This study adds to existing literature by highlighting both the challenges and risks of implementing empathy training in a prison context. Whereas results do not confirm effectiveness, at least partly because of sample size limitations, they confirm that such intervention can be implemented and evaluated safely in prison. They also show the importance of monitoring and interpreting apparent side effects. They pave the way towards larger samples and exploration of intensive interventions to foster psychological change among people in prison.
BACKGROUND:Incarceration often disrupts an individual's sense of purpose and connectedness, contributing to loneliness and psychological distress. Identifying psychological resources that might buffer these effects is especially relevant in correctional settings. One such resource, emphasised in Viktor Frankl's existential theory, is search for meaning-a motivation to pursue existential purpose. AIMS:To investigate whether search for meaning moderates associations between loneliness and (a) presence of meaning and (b) psychological distress. We also explored whether presence of meaning mediates the link between loneliness and distress and whether any such indirect association varies by levels of search for meaning. METHODS:A total of 114 male prisoners aged 18-65 years (mean 37.25, SD = 9.52) were recruited from two correctional facilities encompassing closed and semi-open units. Participants completed the revised UCLA Loneliness Scale, the Perceived Stress Scale and both subscales of the Meaning in Life Questionnaire (MLQ). RESULTS:Higher loneliness scores were associated with lower presence of meaning and higher distress. Presence of meaning mediated the relationship between loneliness and distress. Search for meaning moderated the link between loneliness and presence of meaning: The association was weaker at higher levels of search. CONCLUSIONS:Identification of presence of meaning as a key mechanism relating loneliness and distress among these incarcerated men extends research on meaning in life to a setting where management of loneliness and distress may be key to safety and underscores the potential relevance of meaning-centred interventions in prison settings.
BACKGROUND:Recent studies suggest an increased prevalence of primary psychotic disorders among sentenced prisoners in Finland. Exploring the extent and correlates of lifetime primary psychoses through high-quality data is crucial for early identification and effective interventions within correctional settings. AIMS:To establish the current lifetime prevalence and comorbidities of primary psychotic disorders among sentenced prisoners in Finland and to explore associations between these and sex, solitary confinement, forensic mental health examination, index offence and total days imprisoned. METHODS:Data were derived from a subsample (n = 295) of the Health and Wellbeing of Prisoners 2023 (Wattu IV) study (n = 529). Assessments included Structured Clinical Interview for the US Diagnostic and Statistical Manual for Mental Disorders (DSM-IV; SCID I and II). Details of offending to date and imprisonment history from official records and self-reported solitary confinement were included in the database. Logistic regression analysis was used to examine associations between lifetime primary psychotic disorders and variables significantly related in binary analyses. RESULTS:Twenty-four (8%) participants had a lifetime primary psychotic disorder, according to SCID-based data. A further 100 (34%) had a lifetime substance-induced psychotic disorder. The odds of primary psychotic disorder were over five times (OR 5.22) higher among women than men. For more detailed analyses, prisoners with a drug-related psychosis could not be separated from prisoners without psychosis. The odds of disciplinary solitary confinement were over three times (OR 3.36) higher among those with lifetime primary psychosis than among all other sentenced prisoners and over four and a half times (OR 4.61) higher among those requesting it. Neither index offence nor total lifetime days imprisoned had any relationship with primary psychosis. CONCLUSIONS:This study updates the understanding of lifetime primary psychotic disorders and their correlates in Finnish prisons, descriptively suggesting a likely rise in their prevalence from 6% in 2017 to 8% in 2023, a 33% increase. The finding that twice as many female as male prisoners have primary psychosis aligns with previous research. The higher use of solitary confinement among sentenced prisoners with lifetime primary psychosis than among other sentenced prisoners, including those with substance-related psychosis, is new and troubling. As only one third of these prisoners with primary psychosis had had a court-ordered forensic mental health examination to determine the need for psychiatric treatment and, specifically, compulsory treatment instead of a prison sentence, our findings suggest an urgent case for re-examining pathways into healthcare for prisoners both during pretrial detention and after sentencing.
BACKGROUND:In-prison treatment of persons who committed sexual offences often showed nonsignificant, small or sometimes even negative effects, particularly in sexual recidivism. Various reasons for this situation seem to be relatively short and standardised group-based programmes, isolated implementations and insufficient attention to context factors and needs for replication. AIMS:This study contains a controlled evaluation of males who had committed serious sexual offences and received treatment in German social-therapeutic prison units (STUs) versus a control group from regular prisons without treatment. STUs offer a broad range of treatment (including CBT) and rehabilitation measures during about 2 years of incarceration. METHODS:Valid recidivism data were available for 1245 individuals, of which 710 were treated (TG) and 535 were not treated (CG). In addition to the individuals from STUs, there was also a subsample that received individual or group treatment in normal prisons. The mean follow-up period after release was 9.3 years. As there were expectable differences between treated and untreated persons, a comprehensive propensity score matching (PSM) of relevant variables was applied that led to balanced equivalence of TGs and CGs. In addition to various criteria of recidivism (e.g., general, sexual, violent), we developed a harm index of seriousness. Offender characteristics were assessed by the regular documentation form of the Criminological Service in Bavaria that also contained the Static-99 risk measure. For the assessment of therapeutic context factors, prisoners and staff filled in the EssenCES on the institutional climate in the STUs. RESULTS:There were significant treatment effects on general recidivism (TG = 35.9% vs. CG = 41.4%) and nonsignificant tendencies on sexual recidivism (6.0% vs. 8.0%) and other outcomes. In contrast to general recidivism, sexual recidivism did not occur later after release. There were more promising results in a more recent cohort than in a previous cohort, and the sexual harm of treated persons decreased post-treatment (as compared to pretreatment). Men who had committed rape of adult victims showed more violent and less sexual recidivism than individuals who had victimised children. The seven STUs differed substantially in recidivism and dropout rates. These differences were related to the risk level of the inmates, but prison climate was also associated with outcome differences. On average, there were both similarities and differences in the climate ratings by inmates and staff. Most individuals from the STUs got a legal order for relapse prevention in community treatment centres after release. However, this did not lead to a booster effect, whereas persons who were not treated in custody benefitted from therapeutic aftercare. CONCLUSIONS:The results of a comprehensive social-therapeutic treatment of prison inmates who had been sentenced for sexual offences showed multifaceted patterns of results. Offender variables played an important role in the outcomes. Individuals who had victimised children were particularly assigned to STUs, and persons with a not generally assessed paraphilic disorder may be relevant for less promising results in sexual recidivism. There were also hints that the intensive treatment in STUs may not be superior to therapeutic interventions in regular prisons. Based on our findings, differentiated selections of groups, treatment contexts and outcome measures are suggested for further development of successful treatment strategies in custody.
BACKGROUND:Forensic risk and needs assessment interviews are commonly conducted for incarcerated sex offenders to inform treatment planning. Despite strong evidence showing the positive influence of rapport-based investigative interviews on sex offenders' cooperation, disclosure and confession, the impact of rapport-based interviews on treatment readiness has yet to be examined. AIMS:As rapport features are mostly addressed in offender treatment and less in pre-treatment assessments, this study aimed to examine the influence of perceived rapport features and personal factors on treatment readiness of incarcerated sex offenders after forensic risk and needs assessment interviews. We hypothesised that sex offenders' perceived rapport levels of the interviewers and personal factors significantly moderate positive change in their treatment readiness after the interviews. METHODS:Incarcerated male sex offenders (n = 80) participated in interviews conducted by trained correctional professionals (n = 33). Treatment readiness ratings (pre- and post-interview) and rapport features ratings (post-interview) were collected from the sex offenders using pen and paper questionnaires. Personal data of interviewers and sex offenders were obtained from prison records and case files. RESULTS:All ratings of rapport features (expertise, trust/respect, connected flow, cultural similarity, and attentiveness) and sex offending risk level (moderate and high) significantly moderated the change in treatment readiness of sex offenders after the interview. CONCLUSION:Rapport formed during forensic risk and needs assessment interviews can positively influence the treatment readiness of moderate and high risk sex offenders. Results suggest that correctional agencies may implement policies and training to apply rapport-based interviewing techniques during forensic risk and needs assessment interviews to increase the likelihood of sex offenders starting and engaging in treatment.
BACKGROUND:In England and Wales, the primary treatments for individuals convicted of sexual offences are psychological. However, medication to manage problematic sexual arousal (MMPSA) is gaining importance as an alternative. This article reviews the current evidence surrounding the MMPSA approach. AIM:This paper synthesises challenges encountered, advancements achieved and learnings accumulated over 16 years of the MMPSA treatment pathway from 2009 to 2025 in England and Wales. METHODS:Drawing on a programme of mixed-methods research, including cohort studies, case studies, qualitative interviews with patients and professionals and implementation evaluations, this paper seeks to bring together key findings to present a consolidated picture of the research on the MMPSA pathway to date. The focus is on synthesising findings and identifying implications for service delivery. RESULTS:Evaluations of treatment outcomes showed promising results regarding the effectiveness of the MMPSA service. Qualitative analyses and case studies provided insightful details regarding patient and staff concerns that may hinder the efficiency and reach of the treatment pathway. Research with community clinicians highlighted issues regarding the 'off-label' use of medication for this purpose. CONCLUSIONS:The MMPSA treatment service is available in a limited number of prisons in England and Wales. Supported by promising service evaluations and existing literature, a larger population could benefit from MMPSA treatment. Furthermore, the MMPSA service would benefit from improvements to create smoother transitions for individuals leaving prison and entering the community, and it should ideally be expanded to ensure that those in the community can also access the MMPSA service.
BACKGROUND:Prospective associations between distinctive offender trajectory groups and early health indicators have been quite well studied, but health in middle adulthood much less so. AIMS:To test associations between membership of distinctive offender trajectory groups and physical and mental health at age 37/38 years, controlling for baseline risks and earlier health indicators. METHODS:Longitudinal data from the Oregon Youth Study (OYS) were used, yielding a community living sample of 206 men aged 37/38 years. The OYS is a study of boys aged 9/10 years on study entry and from high-crime areas, followed from 1983/4 to the present. For the study reported here, annual counts of arrests and periods of imprisonment were derived from court records. Self-report and objective measurements provided indicators of physical (general physical health, cardiovascular health, body mass index, traumatic injury) and mental (hostility/aggression, psychosis, depression, attention problems, social problems) health at age 37/38 years. RESULTS:Heterogeneity in latent group-based arrest trajectories was modelled using semiparametric group-based modelling and yielded three groups: 141 (69%) rare offenders, 43 (22%) low-level chronic offenders and 19 (9%) high-level chronic offenders. High-level and low-level chronic offenders showed significantly poorer mental (but not physical) health at ages 37/38 compared to rare offenders. Unexpectedly, few health differences emerged between the lower- and higher-level repeat offender groups. Child body mass index significantly predicted middle adulthood body mass index, regardless of offending trajectory. CONCLUSIONS:Distinctive offender trajectory groups are not associated with physical health indicators in middle adulthood, but they are associated with a subset of indicators of mental ill-health at age 37/38, suggesting a need for greater investment in resources to address mental health problems for men showing chronic offending; this may even help prevent recidivism.
AIMS:This article examines how offenders with mental disorders are managed within Brunei Darussalam's dual criminal procedure system, which operates through both common law and Sharī'ah frameworks. It seeks to identify the structural and procedural difficulties that arise at the intersection of mental health, criminal responsibility, and religiously grounded legal principles, and to advance practical and doctrinal reforms suited to Brunei's institutional context. METHODS:The study adopts a doctrinal and comparative approach, analysing the Criminal Procedure Code, Mental Health Act 2014, Sharī'ah Court Criminal Procedure Code, and Sharī'ah Courts Evidence Order 2001. Provisions concerning fitness to plead, insanity, detention, consent to treatment, confidentiality, and expert testimony are examined alongside Islamic jurisprudential concepts such as taklīf (moral accountability) and maqāṣid al-Sharī'ah (the higher objectives of Islamic law). Comparative reference is made to England and Wales to illuminate structural contrasts. RESULTS:Four interconnected challenges emerge. First, the absence of specialist forensic psychiatric facilities restricts assessment and diversion options and limits compulsory treatment pathways. Second, the Sharī'ah criminal process lacks a dedicated internal mechanism for psychiatric evaluation. Third, statutory safeguards governing detention review and treatment consent remain underdeveloped. Fourth, the absence of a recognised forensic psychiatry specialty and clear guidance on expert admissibility generates uncertainty, particularly in religiously sensitive cases. CONCLUSION AND IMPLICATIONS:While both legal traditions recognise impaired mental capacity as relevant to criminal liability, effective implementation is constrained by institutional fragmentation. The article proposes coordinated legislative reform, development of forensic psychiatric capacity, structured expert witness guidance, strengthened procedural safeguards, and the establishment of a national advisory framework to ensure a coherent, rights-compliant, and culturally grounded approach to mentally disordered offenders in Brunei.
BACKGROUND:In most countries, a criminal conviction requires evidence that the individual committed the act and that they had the mental capacity to understand what they were doing and that it was wrong. Youth, as an indicator of brain development, is one factor affecting criminal capacity. Worldwide, this has commonly been managed in part by setting in law an age below which criminal incapacity is presumed, so no prosecution is possible. Considerable variation in the MACR was confirmed across 195 countries. Some countries have no MACR. Otherwise, the MACR ranges from 7 years (some African and South Asian countries) to 18 (some South American countries); many North Asian, European and a few African countries set theirs at 14 which is the most frequently found level, and also the minimum age recommended by the United Nations Convention on the Rights of the Child. Therefore, how do countries set or change their MACR? AIMS:To explore change, efforts to change and impact of change in MACR internationally. METHODS:Between February 1st 2022 and December 31st 2023, members of an international research group (GIRAF-Group of International Researchers in Adolescent Forensics) were asked to complete an emailed questionnaire about changes in the MACR, or efforts to change it, in their country since 2000. Reports were then collated, circulated and discussed within the group. RESULTS:Among the 14 countries responding in detail about the MACR, efforts to raise the MACR had been successful in three, but in nine such efforts had been unsuccessful; in at least two countries pressures were to lower their MACR, but in only one, Denmark, did that happen (from 15 to 14) in the data collection period (though this change was subsequently reversed). Factors most influencing retention of a lower age were exceptional individual cases, which triggered press and political interest in retaining a higher age, and well-evidenced and developed arguments from legal, social and medical or other clinical bodies. CONCLUSIONS AND IMPLICATIONS:The wide differences in the MACR between countries suggest under-use of evidence in deciding it. We need more governmental willingness to bring the MACR at least to the UN-recommended level-but accompanied by research into the impact of this. Efforts targeted exclusively on child and adolescent welfare may have less effect if they also force children through the criminal justice system, with consequent impact on self-identity and sense of citizenship. A low MACR is also likely to be more directly and indirectly costly than a higher one.
BACKGROUND:Police interview interpreting often requires conveying emotionally charged content. Although interpreters are expected to maintain neutrality, exposure to such material may heighten empathy and increase vulnerability to vicarious trauma. Few empirical studies have examined how empathy levels change during simulated police interview interpreting, particularly among interpreter trainees. AIMS:This study explored whether exposure to emotionally charged information in a simulated police interview affects interpreters' empathy levels. Specific questions were: (1) are empathy scores significantly different after interpreting than before and (2) what kind of emotionally charged information in police interview contributes to this change. METHODS:A mixed-methods design was adopted with 25 postgraduate interpreter trainees. Participants completed the basic empathy scale (BES) immediately before and after interpreting a simulated police interview containing emotionally charged material. Quantitative data were analysed using paired-samples t-tests. In addition, three randomly selected participants took part in semi-structured interviews, which were transcribed verbatim and analysed thematically. RESULTS:Mean overall empathy scores increased significantly after the simulation, from a mean of 3.2 (SD 1.0) to 4.0 (SD 0.9; p < 0.001). Subscale analysis indicated that this increase was driven by affective empathy (means pre: 3.1, post 4.4; p < 0.001); cognitive empathy showed no significant change. Thematic analysis of interview data suggested three interrelated mechanisms underlying empathy change: (1) emotional contagion from the suspect's distress, (2) ethical conflicts between neutrality and personal moral response and (3) personal identification with the suspect's circumstances. CONCLUSIONS:Interpreting emotionally charged material in simulated police interviews significantly heightens interpreters' affective empathy. Whereas this may support engagement, it also poses risks of emotional strain and vicarious trauma if sustained over time. These findings highlight the need for interpreter training to integrate emotional regulation strategies, and structured support systems. Future research should extend to professional interpreters and examine long-term effects of repeated exposure in real-world legal contexts.
BACKGROUND:Life expectancy is increasing globally. A substantial expected rise in older age groups in the population is reflected in prisons, but focus on elderly offenders remains limited compared to other age groups. This is of concern, as cognitive impairments are often present among elderly offenders, possibly affecting their behaviour, criminal responsibility and responsiveness to treatment. AIMS:The objective of this study was to explore the associations between various cognitive variables, neurological diagnosis and different types of crime by offenders of 60 years or older. METHODS:In this retrospective records-based clinical study, we used the reports about adult defendants who underwent a full forensic psychiatric evaluation at the request of the court to assess criminal responsibility for serious crime. Individuals aged 60 and over were included, resulting in a sample of 81 persons, just seven of them women. A homogeneity analysis (HOMALS) was conducted to examine the possibility of classifying such people according to cognitive and offence status. RESULTS:Nearly two-thirds of these people under criminal charges had some evidence of cognitive impairment. Three main neurocognitive groups were apparent: those with clear cognitive deficiencies, and usually a clinical diagnosis of dementia, those with some cognitive impairment and those with equivocal or not cognitive impairment. The first group was older and most likely to have violence charge(s), the second to be characterised by both violent and sexual charge(s) and the third more various offending, albeit including violence. CONCLUSIONS:This first study of detailed neurocognitive assessment of older people under trial for a serious criminal offence indicates that it is important for older people charged with offences to have sound cognitive assessment, in their interests, and for planning effective management of risk of any further offending. Future studies should investigate relationships between cognitive problems and type of crime in a larger and perhaps more varied group.
