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老年缓刑人员的精神障碍、物质使用与执行功能

Psychiatric disorders, substance use, and executive functioning in older probationers.

作者信息

Fitton Lucy, Bates Andrew, Hayes Adrian, Fazel Seena

机构信息

Oxford Institute of Clinical Psychology Training, University of Oxford, Warneford Hospital, Oxford, UK.

National Probation Service, Bicester, UK.

出版信息

Crim Behav Ment Health. 2018 Dec;28(6):447-459. doi: 10.1002/cbm.2094. Epub 2018 Nov 8.

Abstract

BACKGROUND

Although the number of older people serving community sentences (probation) after conviction for a criminal offence in England and Wales has increased rapidly since about 2006, this population has received little research attention.

AIM

To examine the mental health, substance use, and executive functioning of older probationers.

METHODS

Thirty‐two male probationers aged 50 years and older were recruited from probation services in the Thames Valley, England, and administered validated semistructured interviews for psychiatric disorders, symptom checklists for depression and substance use, cognitive impairment screens, and neuropsychological tests of executive functioning (examining verbal fluency and response inhibition).

RESULTS

We found that older probationers presented with a high prevalence of mental health difficulties (overall caseness n = 22; 69%, 95% CI [53–85]) that exceed estimates in the older general population. Prevalences of depression (25%) or alcohol abuse or dependence (19%) were found to be high. In comparison with normative data, however, older probationers did not present with deficits in tested executive functioning.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Mental health and substance use problems were more prominent than cognitive deficits in this sample of older probationers. Further work should include older community controls to inform service planning and to determine how these mental health factors interact with offending.

摘要

背景

自2006年左右以来,在英格兰和威尔士因刑事犯罪被定罪后接受社区刑罚(缓刑)的老年人数量迅速增加,但这一群体很少受到研究关注。

目的

研究老年缓刑犯的心理健康、物质使用和执行功能。

方法

从英格兰泰晤士河谷的缓刑服务机构招募了32名年龄在50岁及以上的男性缓刑犯,对他们进行了针对精神障碍的有效半结构化访谈、抑郁和物质使用症状清单、认知障碍筛查以及执行功能的神经心理学测试(检查言语流畅性和反应抑制)。

结果

我们发现老年缓刑犯心理健康问题的患病率很高(总体病例数n = 22;69%,95%置信区间[53 - 85]),超过了老年普通人群的估计患病率。发现抑郁症(25%)或酒精滥用或依赖(19%)的患病率很高。然而,与标准数据相比,老年缓刑犯在测试的执行功能方面没有表现出缺陷。

结论及对实践的启示

在这个老年缓刑犯样本中,心理健康和物质使用问题比认知缺陷更为突出。进一步的工作应纳入老年社区对照人群,以为服务规划提供信息,并确定这些心理健康因素与犯罪行为是如何相互作用的。

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