Violent behavior is difficult to treat in forensic settings, and it remains unclear which individuals benefit most from aggression treatment. This study examined individual change and moderators of virtual reality aggression prevention training (VRAPT) in 94 forensic inpatients randomized to VRAPT (n = 43) or treatment as usual (n = 51). Individual change was assessed using the Reliable Change Index. Moderation analyses examined sociodemographic, clinical, and forensic characteristics, including age, diagnosis, violent index offense, childhood trauma, anger, provocation, impulsivity, aggression, and hostility. Although most participants improved in self-reported aggression, no significant moderators emerged, highlighting the complexity and heterogeneity of treatment outcomes.
A substantial proportion of patients found not criminally responsible on account of mental disorder (NCRMD) do not complete treatment. Treament engagement has been identified as a key element in completion, yet it is typically assessed by forensic professionnals, leaving patients own perspectives largely unexamined. This study explores how NCRMD patients understand their engagement in treatment from their own perspective. Sixteen patients participed in interviews, analyzed using a descriptive interpretative approach. Findings reveal that participants primarily defined engagement as a sense of obligation or compliance, while also identifying elements shaping engagement within a conceptual model, offering guidance for tailoing interventions.
Sexually Violent Predator (SVP) statutes permit post-prison civil commitment of sex offenders. The U.S. Supreme Court has ruled that evaluators must distinguish the sexually dangerous person from the ordinary criminal recidivist. Antisocial personality disorder (ASPD) as the sole qualifying diagnosis has been controversial. In 4,585 SVP California referrals from July 1, 2012, to June 30, 2017 we found few cases where evaluators opined ASPD to be the SVP qualifying condition (16/4,585 or 0.35%). In evaluators' consideration of ASPD as qualifying or not, we observed shortcomings in clinical reasoning and analysis. We discuss implications for SVP practice.
Men comprise the majority of the worldwide prison population, and mental health difficulties are disproportionately prevalent among men in prison compared with the general population. The current study aimed to explore the perceived barriers that men have in accessing and utilizing mental health support in prison. Eight electronic databases were searched, which identified 14 studies that met the inclusion criteria and were included in the final review. An established framework for thematic synthesis was used, and quality appraisal was facilitated, using an adapted version of the Critical Appraisal Skills Program for qualitative research. Six analytic themes were identified: systemic, structural, and institutional constraints; relationship blockers; being a man in prison; positively breaking down barriers; predisposition to distrust; and disparities for ethnically marginalized groups. The themes identified highlighted potential areas for improvement in prison mental health care services. Limitations of the review are discussed alongside avenues for future research.
