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Examining violence among Not Guilty by Reason of Insanity state hospital inpatients across multiple time points: the roles of criminogenic risk factors and psychiatric symptoms

Published online by Cambridge University Press:  08 January 2020

Darci Delgado Open the ORCID record for Darci Delgado [Opens in a new window] ,
Sean M. Mitchell ,
Robert D. Morgan Open the ORCID record for Robert D. Morgan [Opens in a new window]  and
Faith Scanlon
Darci Delgado*
Affiliation:
California Department of State Hospitals, Sacramento, California, USA
Sean M. Mitchell
Affiliation:
Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
Robert D. Morgan
Affiliation:
Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
Faith Scanlon
Affiliation:
Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
*
*Author for correspondence: Darci Delgado (Email: [email protected])
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Abstract

Objective

Institutional violence in state hospitals is a public health problem that has been severely understudied. Given the personal (ie, staff and patients) and fiscal harms associated with institutional violence, more research into contributing factors for violence is needed. The overarching aim of this study then was to examine associations among psychiatric symptoms, criminal risk factors, and institutional violence.

Methods

Participants were 200 male, female, and transgender forensic mental health inpatients adjudicated Not Guilty by Reason of Insanity and committed to the California Department of State Hospitals. Participants completed a psychiatric symptom measure, and measures of and associated with criminal risk. Institutional violence was recorded from file review and includes physical violence toward staff or patients for 6-months prior to and post patient participation in this study.

Results

After adjusting for previous institutional violence, results indicated that psychiatric symptoms were not associated with follow-up institutional violence; however, criminal risk was associated with follow-up institutional violence. Unexpectedly, 2 aspects of criminal risk, antisocial cognitions and associates, were not associated with follow-up institutional violence after adjusting for previous institutional violence. Results also provided a tentative cutoff score on the Self-Appraisal Questionnaire for predicting follow-up institutional violence.

Conclusions

These results have important implications for treating and managing patients at risk for institutional violence, including the need to assess criminogenic risk and leverage treatments that target these risk factors as a best practice approach.

Keywords

Violencecriminal riskpsychiatric symptomsstate hospitalNGRIinpatient.
Type
Original Research
Information
CNS Spectrums , Volume 25 , Issue 5 , October 2020 , pp. 714 - 722
Copyright
© Cambridge University Press 2020

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Footnotes

The findings and conclusions in “Examining violence among Not Guilty by Reason of Insanity state hospital inpatients across multiple time points: the roles of criminogenic risk factors and psychiatric symptoms,” are those of the authors and do not necessarily represent the views or opinions of the California Department of State Hospitals or the California Health and Human Services Agency.

References

References:

Broderick, C, Azizian, A, Kornbluh, R, Warburton, K. Prevalence of physical violence in a forensic psychiatric hospital system during 2011–2013: patient assaults, staff assaults, and repeatedly violent patients. CNS Spectr. 2015;20(3):319–330.CrossRefGoogle Scholar
§ CA Penal Code 1026.Google Scholar
Vitacco, MJ, Balduzzi, E, Rideout, K, Banfe, S, Britton, J. Reconsidering risk assessment with insanity acquittees. Law Hum Behav. 2018;42(5):403.CrossRefGoogle ScholarPubMed
Almeida, F, Moreira, D, Moura, H, Mota, V. Psychiatric monitoring of Not Guilty by Reason of Insanity outpatients. J Forensic Legal Med. 2016;38:58–63.CrossRefGoogle Scholar
McDermott, BE, Edens, JF, Quanbeck, CD, Busse, D, Scott, CL. Examining the role of static and dynamic risk factors in the prediction of inpatient violence: variable-and person-focused analyses. Law Hum Behav. 2008;32(4):325–338.CrossRefGoogle ScholarPubMed
Grevatt, M, Thomas-Peter, B, Hughes, G. Violence, mental disorder and risk assessment: can structured clinical assessments predict the short-term risk of inpatient violence?. J Forensic Psychiatry Psychol. 2004;15(2):278–292.CrossRefGoogle Scholar
Ross, D, Hart, S, Webster, C. Aggression in Psychiatric Patients: Using the HCR-20 to Assess Risk for Violence in Hospital and in the Community. Port Coquitlam, Canada: Riverview Hospital; 1998.Google Scholar
Douglas, KS, Guy, LS, Hart, SD. Psychosis as a risk factor for violence to others: a meta-analysis. Psychol Bull. 2009;135(5):679.CrossRefGoogle ScholarPubMed
Iozzino, L, Ferrari, C, Large, M, Nielssen, O, De Girolamo, G. Prevalence and risk factors of violence by psychiatric acute inpatients: a systematic review and meta-analysis. PLoS ONE. 2015;10(6):e0128536.CrossRefGoogle ScholarPubMed
Flannery, RB, Wyshak, G, Tecce, JJ, Flannery, GJ. Characteristics of American assaultive psychiatric patients: review of published findings, 2000–2012. Psychiatric Q. 2014;85(3):319–328.CrossRefGoogle ScholarPubMed
Schenk, AM, Fremouw, WJ. Individual characteristics related to prison violence: a critical review of the literature. Aggress Violent Behav. 2012;17(5):430–442.CrossRefGoogle Scholar
Morgan, RD, Flora, DB, Kroner, DG, Mills, JF, Varghese, F, Steffan, JS. Treating offenders with mental illness: a research synthesis. Law Hum Behav. 2012;36(1):37.CrossRefGoogle ScholarPubMed
Skeem, JL, Steadman, HJ, Manchak, SM. Applicability of the risk-need-responsivity model to persons with mental illness involved in the criminal justice system. Psychiatric Serv. 2015;66(9):916–922.CrossRefGoogle ScholarPubMed
Draine, J, Salzer, MS, Culhane, DP, Hadley, TR. Role of social disadvantage in crime, joblessness, and homelessness among persons with serious mental illness. Psychiatric Serv. 2002;53(5):565–573.CrossRefGoogle ScholarPubMed
Andrews, DAB, The Psychology of Criminal Conduct . 5th ed. Cincinnati, OH: Anderson Publishing Company; 2010.Google Scholar
Dack, C, Ross, J, Papadopoulos, C, Stewart, D, Bowers, L. A review and meta‐analysis of the patient factors associated with psychiatric in‐patient aggression. Acta Psychiatr Scand. 2013;127(4):255–268.CrossRefGoogle ScholarPubMed
Walters, GD. Predicting institutional adjustment and recidivism with the psychopathy checklist factor scores: a meta-analysis. Law Hum Behav. 2003;27(5):541–558.CrossRefGoogle ScholarPubMed
Douglas, KS, Strand, S, Belfrage, H, Fransson, G, Levander, S. Reliability and validity evaluation of the Psychopathy Checklist: Screening Version (PCL: SV) in Swedish correctional and forensic psychiatric samples. Assessment. 2005;12(2):145–161.CrossRefGoogle ScholarPubMed
Loza, W. Self-Appraisal Questionnaire (SAQ): a tool for assessing violent and non-violent recidivism. In: Handbook of Recidivism Risk/Needs Assessment Tools. Hoboken, NJ: Wiley; 2018:165.Google Scholar
Loza, W, Conley, M, Warren, B. Concurrent cross-validation of the Self-Appraisal Questionnaire: a tool for assessing violent and nonviolent recidivism and institutional adjustment on a sample of North Carolina offenders. Int J Offender Ther Comp Criminol. 2004;48(1):85–95.CrossRefGoogle ScholarPubMed
Mitchell, O, Caudy, MS, MacKenzie, DL. A reanalysis of the Self-Appraisal Questionnaire: psychometric properties and predictive validity. Int J Offender Ther Comp Criminol. 2013;57(4):445–459.CrossRefGoogle ScholarPubMed
Loza, W, Neo, LH, Shahinfar, A, Loza-Fanous, A. Cross-validation of the Self-Appraisal Questionnaire: a tool for assessing violent and nonviolent recidivism with female offenders. Int J Offender Ther Comp Criminol. 2005;49(5):547–560.CrossRefGoogle ScholarPubMed
Derogatis, LR, Melisaratos, N. The brief symptom inventory: an introductory report. Psychol Med. 1983;13(3):595–605.CrossRefGoogle Scholar
Derogatis, LR. BSI brief symptom inventory. Administration, scoring, and procedures manual; 1993.Google Scholar
Mills, K. Measures of criminal attitudes and associates: user guide. Unpublished instrument and user guide; 1999.Google Scholar
Mills, K. Measures of Criminal Attitudes and Associates (MCAA) development, factor structure, reliability, and validity. Assessment. 2002;9(3):240–253.CrossRefGoogle ScholarPubMed
LaPray, M, Ross, H. San Diego quick assessment. J Reading. 1969;12:305–307.Google Scholar
Tabachnick, BG, Fidell, LS. Using Multivariate Statistics. 6th ed. Boston, MA: Pearson; 2013.Google Scholar
Lussier, P, Verdun-Jones, S, Deslauriers-Varin, N, Nicholls, T, Brink, J. Chronic violent patients in an inpatient psychiatric hospital: Prevalence, description, and identification. Crim Justice Behav. 2010;37(1):5–29.CrossRefGoogle Scholar
Broderick, C. Violence Report: DSH Violence 2010–2017. Sacramento, CA: Department of State Hospitals; 2019.Google Scholar
Warburton, K. The new mission of forensic mental health systems: managing violence as a medical syndrome in an environment that balances treatment and safety. CNS Spectr. 2014;19(5):368–373.CrossRefGoogle Scholar
Morgan, RD, Fisher, WH, Duan, N, Mandracchia, JT, Murray, D. Prevalence of criminal thinking among state prison inmates with serious mental illness. Law Hum Behav. 2010;34(4):324–336.Google ScholarPubMed
Skeem, JL, Winter, E, Kennealy, PJ, Louden, JE, Tatar, I, Joseph, R. Offenders with mental illness have criminogenic needs, too: toward recidivism reduction. Law Hum Behav. 2014;38(3):212.CrossRefGoogle ScholarPubMed
Bjørkly, S, Hartvig, P, Heggen, F-A, Brauer, H, Moger, T. Development of a brief screen for violence risk (V-RISK-10) in acute and general psychiatry: an introduction with emphasis on findings from a naturalistic test of interrater reliability. Eur Psychiatry. 2009;24(6):388–394.CrossRefGoogle ScholarPubMed
Douglas, KS, Hart, SD, Webster, CD, Belfrage, H. HCR-20V3: Assessing Risk for Violence: User Guide. British Columbia, Canada: Simon Fraser University; 2013.Google Scholar
Webster, C, Martin, M, Brink, J, Nicholls, T, Desmarais, S. Manual for the Short-Term Assessment of Risk and Treatability (START; Version 1.1). Coquitlam, Canada: British Columbia Mental Health & Addiction Services; 2009.Google Scholar
Morgan, RD, Kroner, D, Mills, JF. A Treatment Manual for Justice Involved Persons with Mental Illness: Changing Lives and Changing Outcomes: Abingdon, UK: Routledge; 2017.CrossRefGoogle Scholar
Morgan, RD, Kroner, DG, Mills, JF, Bauer, RL, Serna, C. Treating justice involved persons with mental illness: preliminary evaluation of a comprehensive treatment program. Crim Justice Behav. 2014;41(7):902–916.CrossRefGoogle Scholar
Gaspar, M, Brown, L, Ramler, T, et al. Therapeutic outcomes of changing lives and changing outcomes for male and female justice involved persons with mental illness. Crim Justice Behav . 2019:0093854819879743.CrossRefGoogle Scholar
Skeem, JL, Schubert, C, Odgers, C, Mulvey, EP, Gardner, W, Lidz, C. Psychiatric symptoms and community violence among high-risk patients: a test of the relationship at the weekly level. J Consult Clin Psychol. 2006;74(5):967.CrossRefGoogle ScholarPubMed