有神经发育障碍的囚犯：患精神疾病和自我伤害的易感性。
Prisoners with neurodevelopmental difficulties: Vulnerabilities for mental illness and self-harm.
作者信息
McCarthy Jane, Chaplin Eddie, Forrester Andrew, Underwood Lisa, Hayward Hannah, Sabet Jess, Young Susan, Mills Richard, Asherson Philip, Murphy Declan
机构信息
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
London South Bank University School of Health and Social Care, Ringgold Standard Institution, 103 Borough Road, London, SE1 0AA, United Kingdom of Great Britain and Northern Ireland.
出版信息
Crim Behav Ment Health. 2019 Dec;29(5-6):308-320. doi: 10.1002/cbm.2132.
BACKGROUND
Research into neurodevelopmental disorders in adult offenders has tended to be disorder specific, so hindering service planning for a group of offenders with similar vulnerabilities.
AIM
To examine vulnerabilities for mental illness and self-harming behaviours among male prisoners screening positive for a range of neurodevelopmental difficulties-including but not confined to disorders of intellectual ability, attention deficit hyperactivity, and in the autistic spectrum.
METHOD
In a cross-sectional study, prisoners who screened positive for neurodevelopmental difficulties were compared to prisoners who screened negative for the same on indicators of suicide-related and self-harm behaviours, mental illness, and substance misuse using the Mini International Neuropsychiatric Interview (MINI).
RESULTS
Of 87 prisoners who screened positive for neurodevelopmental difficulties, 69 had full MINI mental health data. In comparison with 69 neurotypical men in the same prison, the neurodevelopmental difficulties group was significantly more likely to have thought about self-harm and suicide in the last month and to have significantly higher rates of concurrent mental disorders including psychosis, anxiety, depression, personality disorder, and substance dependency disorders.
CONCLUSIONS
This is one of the first studies to examine the mental health of adults with neurodevelopmental difficulties in a prison setting. This group, unlike those who meet diagnostic threshold, is not routinely considered by mental health or correctional services. The study found prisoners with neurodevelopmental difficulties showed greater vulnerability to mental disorder and thoughts of suicide and suicide-related behaviours than other prisoners. Accordingly, we recommend routine early screening across the criminal justice system for any neurodevelopmental difficulties to inform decision-making on the most appropriate disposal and support.
背景
针对成年罪犯神经发育障碍的研究往往局限于特定障碍，这不利于为一群具有相似脆弱性的罪犯制定服务计划。
目的
研究在一系列神经发育困难筛查呈阳性的男性囚犯中，精神疾病和自我伤害行为的脆弱性，这些困难包括但不限于智力障碍、注意力缺陷多动障碍以及自闭症谱系障碍。
方法
在一项横断面研究中，使用迷你国际神经精神访谈量表（MINI），将神经发育困难筛查呈阳性的囚犯与筛查呈阴性的囚犯在自杀相关行为、自我伤害行为、精神疾病和药物滥用指标方面进行比较。
结果
在87名神经发育困难筛查呈阳性的囚犯中，69名有完整的MINI心理健康数据。与同一监狱中的69名神经发育正常的男性相比，神经发育困难组在过去一个月内更有可能考虑过自我伤害和自杀，并且并发精神障碍的发生率显著更高，包括精神病、焦虑症、抑郁症、人格障碍和药物依赖障碍。
结论
这是首批在监狱环境中研究有神经发育困难的成年人心理健康状况的研究之一。与那些达到诊断阈值的人不同，这一群体通常未被心理健康或惩教服务机构纳入考虑范围。研究发现，有神经发育困难的囚犯比其他囚犯更容易出现精神障碍、自杀念头及与自杀相关的行为。因此，我们建议在整个刑事司法系统中对任何神经发育困难进行常规早期筛查，以便为做出最合适的处置和支持决策提供依据。
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