Bulten Erik, Nijman Henk, van der Staak Cees
Pompe Foundation, Forensic Psychiatric Centre, Nijmegen, The Netherlands.
Int J Law Psychiatry. 2009 Mar-Apr;32(2):115-9. doi: 10.1016/j.ijlp.2009.01.007. Epub 2009 Feb 13.
Dutch correctional officers are trained to observe prisoners with severe mental disorder. This 'behavioural' approach is assumed to detect psychiatrically disordered prisoners with striking symptoms. On the basis of this screening procedure about 10% of the Dutch prison population is classified as needing special care or control. In the current study, what psychopathology can still be found among the remaining 90% prisoners residing at regular wards is investigated and which personality traits characterize them. When the prevalence of major mental illness would still turn out to be high in this group, the question arises whether the current, rather unstandardized, way of screening prisoners is sufficient.
To assess the prevalence of psychiatric disorders among adult Dutch prisoners on regular wards, and to determine the concurrent and convergent validity of self-report measures and their screening characteristics in such a sample.
191 randomly selected prisoners admitted to the general wards were administered a number of tests (SCL-90, NEO-PI-R, MINI) during the first weeks of their incarceration.
Including substance abuse, 57% of the participants suffered from one or more Axis I disorders. About seven out of ten detainees with psychopathology as assessed with the MINI did not receive professional help. The concurrent and convergent validity of the SCL-90 and the NEO-PI-R turned out to be reasonable. The predictive validity of self-report measures in detecting prisoners with an Axis I disorders or suicide risks was moderate.
The Dutch 'behavioural approach' seems to be quite accurate in detecting prisoners with psychotic disorders. Most prisoners with other mental disorders on regular wards, however, did not receive professional help. The current study suggests that self report scales such as the SCL-90 and the NEO-PI-R may be helpful in screening detainees on important DSM-IV disorders.
荷兰惩教官员接受过观察患有严重精神障碍囚犯的培训。这种“行为”方法被认为能够发现有明显症状的精神障碍囚犯。基于这种筛查程序，约10%的荷兰监狱人口被归类为需要特殊护理或管控。在当前研究中，调查了居住在普通病房的其余90%囚犯中仍能发现哪些精神病理学问题，以及他们具有哪些人格特质。如果在这一群体中重大精神疾病的患病率仍然很高，就会产生当前这种相当不规范的囚犯筛查方式是否足够的问题。
评估荷兰成年普通病房囚犯中精神障碍的患病率，并确定自我报告测量方法在该样本中的同时效度和收敛效度及其筛查特征。
对191名随机选取入住普通病房的囚犯在入狱后的头几周进行了多项测试（症状自评量表90、大五人格量表、简明国际神经精神访谈）。
包括药物滥用在内，57%的参与者患有一种或多种轴I障碍。用简明国际神经精神访谈评估有精神病理学问题的被拘留者中，约十分之七未得到专业帮助。症状自评量表90和大五人格量表的同时效度和收敛效度结果合理。自我报告测量方法在检测患有轴I障碍或有自杀风险的囚犯方面的预测效度中等。
荷兰的“行为方法”在检测患有精神障碍囚犯方面似乎相当准确。然而，普通病房中大多数患有其他精神障碍的囚犯未得到专业帮助。当前研究表明，症状自评量表90和大五人格量表等自我报告量表可能有助于筛查被拘留者是否患有重要的《精神疾病诊断与统计手册》第四版中的疾病。
