Investigating heterogeneity in violent offending liability among injection drug users from a developmental perspective

INTRODUCTION:

Violence is a major burden of harm among injecting drug users (IDU), however, the liability to violent offending is not well understood. The current study aimed to better understand differences in the liability to violence by determining whether IDU could be disaggregated into distinct violent offending classes, and determining the correlates of class membership.

METHODS:

A total of 300 IDU from Sydney, Australia were administered a structured interview examining the prevalence and severity of drug use and violent offending histories, as well as early life risk factors (maltreatment, childhood mental disorder, trait personality).

RESULTS:

IDU were disaggregated into four distinct latent classes, comprising a non-violent class (24%), an adolescent-onset persistent class (33%), an adult-onset transient class (24%) and an early-onset, chronic class (19%). Pairwise and group comparisons of classes on predispositional and substance use risks showed that the EARLY class had the poorest psychosocial risk profile, while the NON class had the most favourable. Multinomial logistic regression revealed that higher trait impulsivity and aggression scores, having a history of conduct disorder, frequent childhood abuse, and more problematic alcohol use, were independently associated with more temporally stable and severe violent offending. The model explained 67% of variance in class membership (χ²=207.7, df=51, p<0.001).

CONCLUSIONS:

IDU can be meaningfully disaggregated into distinct violent offending classes using developmental criteria. The age of onset of violence was indicative of class membership insomuch as that the extent of early life risk exposure was differentially associated with greater long-term liability to violence and drug use.

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By:  Torok M¹, Darke S², Shand F³, Kaye S².

¹National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia. Electronic address: m.torok@unsw.edu.au.

²National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.

³Black Dog Institute, University of New South Wales, Sydney, Australia.

Addict Behav. 2016 Apr 22;60:165-170. doi: 10.1016/j.addbeh.2016.04.013. [Epub ahead of print] 

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Alcohol and violence in nightlife and party settings: A qualitative study

INTRODUCTION AND AIMS:

In 'binge drinking' cultures, there is a strong association between alcohol consumption and violence. At the same time, several studies suggest that this link is cultural and contextual. We explore the role of alcohol in incidents of violence in nightlife settings.

DESIGN AND METHODS:

We used qualitative interviews with 104 Norwegians (52 men and 52 women, mean age 25 years) who binge drink and party in nightlife settings.

RESULTS:

Alcohol both sparks and constrains violence in these contexts. When participants use alcohol, they expect conflicts to occur and blame alcohol intoxication for such behaviour. The packed settings of nightlife and parties combined with the effects of alcohol can induce violence through personal affronts, heightened emotions and jealousy. At the same time, nightlife settings constrain violence. That is, binge drinkers excuse misbehaviour when it is attributed to alcohol. In addition, audiences in these setting often go to great lengths to stop fights. Combined, these factors help explain why violence occurs and why it usually does not escalate.

DISCUSSION AND CONCLUSIONS:

The association between alcohol and violence can be understood by more closely examining the cultural and situational context where the events occur. This link is not primarily related to the psychopharmacological properties of alcohol, but rather it is associated with situational factors and cultural norms regarding how to behave while intoxicated. Strategies aiming at reducing violence in nightlife should take such factors into consideration. 

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By:  Pedersen W1, Copes H2, Sandberg S3.

• 1Department of Sociology and Human Geography, University of Oslo, Oslo, Norway.
• 2Department of Justice Sciences, University of Alabama, Birmingham, USA.
• 3Department of Criminology and Sociology of Law, University of Oslo, Oslo, Norway.
• Drug Alcohol Rev. 2016 Apr 7. doi: 10.1111/dar.12395. 

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Effect of Physical Violence on Sexually Transmitted Infections and Treatment Seeking Behaviour among Female Sex Workers in Thane District, Maharashtra, India

Background

Violence against sex workers can heighten their vulnerability to HIV and other sexually transmitted infections (STIs). Evidence suggests the risk of acquiring STI/HIV infections among female sex workers (FSWs) who have experienced violence to be almost three-times higher than FSWs, who have not experienced violence. Moreover, an experience of physical and sexual violence makes it difficult for them to negotiate safer sex with their partners and often act as a barrier to utilization of prevention services.

Methods

This study utilizes data from 2785 FSWs aged 18 years and above who participated in a cross-sectional behavioural study conducted during 2013–14 in Thane district, Maharashtra. A probability-based two-stage cluster sampling method was used for data collection. This study assesses the effect of physical violence on self-reported STI symptoms (any STI and multiple STIs) and treatment seeking for the last STI symptom using propensity score matching method.

Results

About 18% of sampled FSWs reported physical violence at the time of the survey. The likelihood of experiencing such violence was significantly higher among FSWs who solicited clients at public places, engaged in other economic activities apart from sex work, had savings, and reported high client volume per week. FSWs experiencing violence were also inconsistent condom users while engaging in sex with regular partners and clients. The average adjusted effect of violence clearly depicted an increase in the risk of any STI (11%, p<0.05) and multiple STIs (8%, p<0.10) and reduction in treatment seeking (10%, p<0.05).

Conclusions

This study demonstrates a significant effect of physical violence on reporting of any STI symptom and treatment seeking. Findings call for the immediate inclusion of strategies aimed to address violence related challenges in HIV prevention program currently being provided at Thane district. Such strategies would further help in enhancing the access to tailored STI prevention and care services among FSWs in the district.

Below:  Percentage of FSWs experienced physical Violence by type of partners, Thane, 2014

Below:  Predicted probability of experiencing physical violence; matched sample, Thane, 2014

Full article at:   http://goo.gl/BLxyW9

By:  Ravi Prakash,* Suneedh Manthri, Shaikh Tayyaba, Anna Joy, Sunil Saksena Raj, Devender Singh, and Ashok Agarwal

Alash'le G. Abimiku, Editor

HIV/AIDS Partnership for Impact through Prevention, Private Sector and Evidence-based Programming (PIPPSE) Project, Public Health Foundation of India, New Delhi, India

University of Maryland School of Medicine

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Exposure to Violence & Psychological Well-Being Over Time in Children Affected by HIV/AIDS in South Africa & Malawi

Many of the risk factors for violence against children are particularly prevalent in families and communities affected by HIV/AIDS. Yet, in sub-Saharan Africa, where HIV rates are high, efforts to prevent or address violence against children and its long-lasting effects are hampered by a lack of evidence. 

We assessed the relationship between violence exposure and mental health among HIV-affected children attending community-based organisations in South Africa (n = 834) and Malawi (n = 155, total sample n = 989) at baseline and 12-15-month follow-up. Exposure to violence in the home and in the community was high. HIV-negative children who lived with an HIV-positive person experienced most violence overall, followed by HIV-positive children. Children unaffected by HIV experienced least violence (all p < .05). 

Interpersonal violence in the home predicted child depression, trauma symptoms, lower self-esteem, and internalising and externalising behavioural problems, while exposure to community violence predicted trauma symptoms and behavioural problems. Harsh physical discipline predicted lower self-esteem and behavioural problems for children. Exposure to home and community violence predicted risk behaviour. Over time, there was a decrease in depressed mood and problem behaviours, and an increase in self-esteem for children experiencing different types of violence at baseline. This may have been due to ongoing participation in the community-based programme. 

These data highlight the burden of violence in these communities and possibilities for programmes to include violence prevention to improve psychosocial well-being in HIV-affected children.

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By:  Skeen S1,2, Macedo A3, Tomlinson M1, Hensels IS3, Sherr L3.

• 1 Department of Psychology , Stellenbosch University , Stellenbosch , South Africa.
• 2 Department of Psychiatry and Mental Health , University of Cape Town , Cape Town , South Africa.
• 3 Department of Infection and Population Health , University College London , London , UK.
• AIDS Care. 2016 Mar;28 Suppl 1:16-25. doi: 10.1080/09540121.2016.1146219.

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Adolescents as Perpetrators of Aggression within the Family

Although family violence perpetrated by juveniles has been acknowledged as a potentially serious form of violence for over 30 years, scientific studies have been limited to examining the incidence and form of home violence. 


The present study examined the prevalence of family aggression as perpetrated by youths; we examined groups drawn from clinic-referred and forensic samples. Two audits of case files were conducted to systematically document aggression perpetrated by referred youths toward their family members. The purpose of the first audit was fourfold: i) to identify the incidence of the perpetration of family aggression among clinical and forensic samples; ii) to identify whether there were any reports of weapon use during aggressive episodes; iii) to identify the target of family aggression (parents or siblings); and iv) to identify the form of aggression perpetrated (verbal or physical). 

The second audit aimed to replicate the findings and to show that the results were not due to differences in multiple deprivation indices, clinical diagnosis of disruptive behavior disorders, and placement into alternative care. A sampling strategy was designed to audit the case notes of 25 recent forensic Child and Adolescent Mental Health Service (CAMHS) cases and 25 demographically similar clinic-referred CAMHS cases in the first audit; and 35 forensic cases and 35 demographically similar clinic-referred CAMHS cases in the second audit. Using ordinal chi-square, the forensic sample (audit 1=64%; audit 2=82.9%) had greater instances of family violence than the clinical sample (audit 1=32%; audit 2=28.6%). 

They were more likely to use a weapon (audit 1=69%; audit 2=65.5%) compared to the clinical sample (audit 1 and 2=0%). Examining only the aggressive groups, there was more perpetration of aggression toward parents (audit 1, forensic=92%, clinical=75%; audit 2, forensic=55.17%, clinical=40%) than toward siblings (audit 1, forensic=43%, clinical=50%; audit 2, forensic=27.58%, clinical=30%). 

Based on these findings, we would urge professionals who work within the child mental health, particularly the forensic area, to systematically collect reports of aggression perpetrated toward family members.

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By:  Kuay HS1, Lee S2, Centifanti LC3, Parnis AC4, Mrozik JH5, Tiffin PA6.

• 1Department of Psychology, University of Durham, Durham, UK; Tees, Esk & Wear Valleys NHS Foundation Trust, The Adolescent Forensic Outpatient Service, The Westwood Centre, Westlane Hospital, Middlesbrough, UK; School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Electronic address: h.s.kuay@durham.ac.uk.
• 2Tees, Esk & Wear Valleys NHS Foundation Trust, The Adolescent Forensic Outpatient Service, The Westwood Centre, Westlane Hospital, Middlesbrough, UK; Sunderland South Tyneside Community Children and Young People's Service, Monkwearmouth Hospital, Sunderland, UK.
• 3Department of Psychology, University of Durham, Durham, UK.
• 4Tees, Esk & Wear Valleys NHS Foundation Trust, The Adolescent Forensic Outpatient Service, The Westwood Centre, Westlane Hospital, Middlesbrough, UK; Redburn Young Peoples Unit, Ferndene Hospital, Moor Road, Prudhoe, Northumberland, UK.
• 5Tees, Esk & Wear Valleys NHS Foundation Trust, The Adolescent Forensic Outpatient Service, The Westwood Centre, Westlane Hospital, Middlesbrough, UK.
• 6Department of Health Sciences, The University of York, Heslington, York, UK; Tees, Esk & Wear Valleys NHS Foundation Trust, The Adolescent Forensic Outpatient Service, The Westwood Centre, Westlane Hospital, Middlesbrough, UK. 
• Int J Law Psychiatry. 2016 Mar 23. pii: S0160-2527(16)30048-6. doi: 10.1016/j.ijlp.2016.02.035.

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Breaking the Link Between Provocation & Aggression: The Role of Mitigating Information

In two experimental studies, we examine the extent to which strong or weak mitigating information after a provocation alters aggressive responding. 

In Study 1, we randomly assigned 215 (108 female) college-aged participants to a strong or weak provocation by having a research assistant talk to the participant about failing a task in a harsh or confused tone. This was followed by a second research assistant giving a strong or weak excuse to the participant regarding the first research assistant's behavior. Then, aggressive behavior was assessed using a researcher rating task. In Study 2, 63 (25 female) college-aged participants interacted with a confederate on the CRT. All participants were strongly provoked by receiving strong noise blasts. After five CRT trials, the confederate delivered weak or strong mitigating information to the participant regarding the noises blasts. 

The results indicated that: 

1. strong provocations are more likely to increase aggression than weak provocations; 
2. strong mitigating information is more likely to decrease aggression than weak mitigating information; and 
3. (the varying strength of mitigating information is important in situations involving weak, but not strong provocations: 
1. strong mitigating information is more likely than weak mitigating information reduce aggression when provocation is strong, 
2. but not when provocation is weak. 

We discuss the importance of mitigating information in decreasing aggressive behavior and the conditions in which mitigating information is especially likely to be effective.

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By:  Barlett C1, Witkower Z2, Mancini C1, Saleem M3.

• 1Department of Psychology, Gettysburg College, Gettysburg, Pennsylvania.
• 2Department of Psychology, University of British Columbia, British Columbia, Canada.
• 3Department of Communication Studies, University of Michigan, Ann Arbor, Michigan. 
• Aggress Behav. 2016 Mar 10. doi: 10.1002/ab.21650.

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Socioeconomic Marginalisation in the Structural Production of Vulnerability to Violence among People Who Use Illicit Drugs

OBJECTIVE:

Many people who use illicit drugs (PWUD) face challenges to their financial stability. Resulting activities that PWUD undertake to generate income may increase their vulnerability to violence. We therefore examined the relationship between income generation and exposure to violence across a wide range of income generating activities among HIV-positive and HIV-negative PWUD living in Vancouver, Canada.

METHODS:

Data were derived from cohorts of HIV-seropositive and HIV-seronegative PWUD (n=1876) between December 2005 and November 2012. We estimated the relationship between different types of income generation and suffering physical or sexual violence using bivariate and multivariate generalised estimating equations, as well as the characteristics of violent interactions.

RESULTS:

Exposure to violence was reported among 977 (52%) study participants over the study period. In multivariate models controlling for sociodemographic characteristics, mental health status, and drug use patterns, violence was independently and positively associated with participation in street-based income generation activities (ie, recycling, squeegeeing and panhandling), sex work, drug dealing, and theft and other acquisitive criminal activity. Engagement in regular, self-employment or temporary employment was not associated with being exposed to violence. Strangers were the most common perpetrators of violence (46.7%) and beatings the most common type of exposure (70.8%).

CONCLUSIONS:

These results suggest that economic activities expose individuals to contexts associated with social and structural vulnerability to violence. The creation of safe economic opportunities which can minimise vulnerability to violence among PWUD is therefore urgently required.

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By:  Richardson LA1, Long C2, DeBeck K3, Nguyen P4, Milloy MJ5, Wood E5, Kerr TH5.

• 1British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada Department of Sociology, University of British Columbia, Vancouver, British Columbia, Canada.
• 2British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
• 3British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada School of Public Policy, Simon Fraser University, Burnaby, British Columbia, Canada.
• 4British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada.
• 5British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada Faculty of Medicine (Division of AIDS), University of British Columbia, British Columbia, Canada. 
• J Epidemiol Community Health. 2015 Jul;69(7):686-92. doi: 10.1136/jech-2014-205079. Epub 2015 Feb 17.

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Size Matters: Are Physically Large People More Likely to be Violent?

A number of studies suggest that physical size is associated with violent behavior. However, few, if any, studies have examined this relationship using population-based samples. Moreover, limited evidence exists on the relationship between physical size and violence with respect to gender, race/ethnicity, and exposure to childhood maltreatment. 

The present study, using data from Waves I and II (N = 34,653) of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), aims to address these gaps by comparing the prevalence of violent behavior among individuals in the top quintiles in height and weight with that of the general population. 

Significant associations were identified for both males and females between physical size and bullying/intimidation, intentional injury of other persons, and hitting someone so hard that they required medical attention. 

Stratified analyses revealed that the magnitude of the relationship between physical size and violence is greater among Hispanics than among non-Hispanic Whites and African Americans. 

Childhood abuse and neglect significantly moderated the relationship between physical size and violent behavior. While an important degree of variability can be observed with respect to gender, race/ethnicity, and exposure to child maltreatment, results indicate that, in general, physically larger individuals are more likely than their relatively smaller counterparts to be violent.

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By:  Salas-Wright CP1, Vaughn MG2.

• 1The University of Texas at Austin, Austin, TX, USA salaswright@utexas.edu.
• 2Saint Louis University, St. Louis, MO, USA. 
• J Interpers Violence. 2016 Apr;31(7):1274-92. doi: 10.1177/0886260514564159. Epub 2014 Dec 21.

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Genetic Background of Extreme Violent Behavior

In developed countries, the majority of all violent crime is committed by a small group of antisocial recidivistic offenders, but no genes have been shown to contribute to recidivistic violent offending or severe violent behavior, such as homicide. 

Our results, from two independent cohorts of Finnish prisoners, revealed that a monoamine oxidase A (MAOA) low-activity genotype (contributing to low dopamine turnover rate) as well as the CDH13 gene (coding for neuronal membrane adhesion protein) are associated with extremely violent behavior (at least 10 committed homicides, attempted homicides or batteries). No substantial signal was observed for either MAOA or CDH13 among non-violent offenders, indicating that findings were specific for violent offending, and not largely attributable to substance abuse or antisocial personality disorder. 

These results indicate both low monoamine metabolism and neuronal membrane dysfunction as plausible factors in the etiology of extreme criminal violent behavior, and imply that at least about 5–10% of all severe violent crime in Finland is attributable to the aforementioned MAOA and CDH13 genotypes.

Below:  Age- and gender-adjusted odds ratios for low-activity MAOA genotype and CDH13 (rs11649622) as a function of the number of committed violent crimes. The number of individuals, allele frequencies and odds ratios are shown below. The number of control subjects was 1946 for MAOA and 1877 for CDH13 analysis.

Below:  Manhattan plot of extremely violent offenders GWAS. The highest cluster is seen in locus 16q23.3

Full article at:   http://goo.gl/Bbrucl

By:  J Tiihonen,^1,2,3,19 M-R Rautiainen,^3,19 HM Ollila,^3,4 E Repo-Tiihonen,² M Virkkunen,^5,6 A Palotie,^7,8,9,10,11 O Pietiläinen,³ K Kristiansson,³ M Joukamaa,¹² H Lauerma,^3,13,14 J Saarela,¹⁵ S Tyni,¹⁶ H Vartiainen,¹⁶ J Paananen,¹⁷D Goldman,¹⁸ and T Paunio^3,5,6

¹Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

²Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland

³National Institute for Health and Welfare, Helsinki, Finland

⁴Stanford University Center for Sleep Sciences, Palo Alto, CA, USA

⁵Department of Psychiatry, University of Helsinki, Institute of Clinical Medicine, Helsinki, Finland

⁶Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland

⁷Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire, England

⁸Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

⁹Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA

¹⁰Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland

¹¹Psychiatric & Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

¹²Social Psychiatry Unit, School of Health Sciences, University of Tampere, Finland

¹³Psychiatric Hospital for Prisoners, Turku, Finland

¹⁴University of Turku, Turku, Finland

¹⁵Finnish Genome Center, Helsinki, Finland

¹⁶The Criminal Sanctions Agency, Helsinki, Finland

¹⁷University of Eastern Finland, Bioinformatics Center, Kuopio, Finland

¹⁸Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Rockville, MD, USA

Correspondence: Professor J Tiihonen, Karolinska Institutet, Department of Clinical Neuroscience, Byggnad R5, Stockholm, S-171 76, Sweden or Professor T Paunio, National Institute for Health and Welfare, PO Box 30, FI-00271, Finland. Email: es.ik@nenohiit.iraj or ; Email:if.lht@oinuap.aniit

¹⁹These authors contributed equaliy to this work.

Mol Psychiatry. Author manuscript; available in PMC 2016 Mar 3. Mol Psychiatry. 2015 Jun; 20(6): 786–792.

  

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Building on the Evidence: Guiding Policy and Research on Police Encounters with Persons with Mental Illnesses

...During this time of national concern about excessive use of force by police, a range of stakeholders—including communities, federal and state governments, and law enforcement—seek improvements in community partnership, accountability, transparency, and skillful restraint to begin reversing the problems of excessive police use of force, including as they affect persons with mental illnesses. Prevention-oriented policies and programs that offer tools for improving de-escalation of potentially dangerous encounters with persons in a mental-health crisis could help minimize risk for injury during police encounters for all parties involved and reduce the likelihood that force will be needed at all. As an example, a recent trend in state law making broadens police authority to remove guns from persons who are considered to be in danger of harming themselves or others but who have not committed a criminal act and are not prohibited from gun ownership. Connecticut, Indiana, and California are three states with different versions of a law in place to remove guns from potentially dangerous persons. A benefit of this policy approach to managing potential dangerousness among persons in crisis is in removing the focus from mental illnesses per se and placing it instead on demonstrated behaviors by any member of the community that suggest heightened risk. This conceptual and operational shift in focus from mental illnesses to dangerousness is important for reducing stigma around mental illnesses, both in the community and among law enforcement officers.

There has also been increased awareness in law enforcement communities of the need for more in-depth officer training in de-escalation. The New York Times reported on a recent survey conducted by the Police Executive Research Forum (PERF) that highlighted the tradition of a disproportionate focus on training in use of force rather than de-escalation techniques and estimated the following median number of hours spent in various training areas: firearms = 58 hours, defensive tactics = 49 hours, de-escalation = 8 hours, and crisis intervention = 8 hours (Apuzzo, 2015). PERF asserted that some large police departments support the idea of a new approach to training that focuses more heavily on teaching officers the necessary skills to defuse tense situations and avoid violent confrontations; but other departments are resistant. Persons with mental illnesses would undoubtedly benefit during their encounters with police who had more comprehensive training in de-escalation and potentially reduce their chances not only of injury during those encounters but also of being subject to police use of force at all.

Certain jurisdictions have had strong success in implementing prevention-oriented models that include specialized officer response to persons with mental illnesses like CIT. Other successful additions to the community infrastructure provide officers with an alternative to taking a person in crisis to the emergency department or jail. San Antonio, Texas, paired CIT training with a newly constructed Restoration Center, a facility with a 16-bed psychiatric unit, a medical clinic, and a “sobering room” where police can drop off people who are intoxicated rather than taking them to jail. The city reports related savings for the police department of $600,000 a year in overtime pay alone; undoubtedly, many encounters that would have involved use offorce and possible injury were averted.

Morabito and Socia (2015) also call for policy improvements in consistency, quality, and availability of data on encounters during which police use force and the surrounding circumstances, including measures that thoroughly describe the circumstances of a person’s mental-health crisis. While a range of community and government stakeholders are engaged, now is an especially important time to develop and institute progressive policies in an effort to increase accountability for what takes place during police encounters. New policies that require detailed reporting of police use-of-force incidents would also facilitate further rigorous research on the effectiveness of CIT, preemptive gun seizure laws, and other approaches to mitigating dangerousness in encounters with persons in mental-health crisis. To ensure that new reporting policies are sustainable, however, jurisdictions would need to give careful consideration to issues around their implementation. Challenges to be addressed include the acceptability of such policies among police department leadership and their officers, as well as the feasibility of additional reporting and paperwork for officers and data management for administration.

Morabito and Socia (2015) offer salient new evidence about risk for injury during police encounters involving persons with mental illnesses in which force is used. Their study lays a foundation for further research that should extend to include non-CIT police officers to learn more about both CIT-specific outcomes and any unobserved elevated risk for injury during police encounters with persons with mental illnesses. Policy response to these concerns can begin now, starting with improved reporting on police encounters with persons with mental illnesses and a rigorous focus on building officers’ skills in de-escalation...

Full article at:   http://goo.gl/DaHZ0u

By: Allison G. Robertson, 

Direct correspondence to Allison G. Robertson, Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Brightleaf Square, Ste 23B, Durham, NC 27701 (Email:  allison.gilbert@duke.edu).

Allison G. Robertson is an assistant professor in the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine. She received a Ph.D. in health policy and management from the University of North Carolina—Chapel Hill and an MPH in health management and policy from the University of Michigan at Ann Arbor. Professor Robertson conducts mental health law, policy, and services research, with a particular focus on the problem of criminal justice involvement among adults with serious mental illnesses. She is currently the principal investigator on a study of gender differences in a statewide jail-diversion program, principal investigator on a study of medication-assisted treatment for justice-involved adults with co-occurring mental health and substance use disorders, and an investigator on two multisite studies on gun control laws, mental illness, and prevention of violence.

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Violence and Victimization During Incarceration: Relations to Psychosocial Adjustment During Reentry to the Community

We surveyed male ex-offenders (N = 100) about their experiences during and prior to incarceration to assess the role of these factors in psychosocial adjustment postrelease. 

Participants completed measures of preincarceration mental health problems and severe victimization and feelings of safety during incarceration; they also self-reported emotional distress, antisocial behavior, and posttraumatic stress (PTS). Moderator analyses of PTS outcomes revealed two key interactions between preincarceration mental health problems and severe victimization during incarceration as well as preincarceration mental health problems by feelings of safety during incarceration. 

In those without preincarceration mental health problems, victimization and PTS were significantly positively related; this was not the case for those with preexisting mental problems. Furthermore, the positive relation between feeling unsafe and PTS was stronger among those with preexisting mental problems. 

Findings are discussed with respect to implications for reentry services.

Via:   http://goo.gl/oxsrbA

By:  Schappell A, Docherty M, Boxer P.

Rutgers University, New Jersey

Violence Vict. 2016 Jan 29

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