Hofmann Lena A, Lau Steffen, Kirchebner Johannes
Department of Forensic Psychiatry, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.
Front Psychiatry. 2022 Oct 20;13:945732. doi: 10.3389/fpsyt.2022.945732. eCollection 2022.
The importance of "social capital" in offender rehabilitation has been well established: Stable family and community relationships offer practical assistance in the resettlement process after being released from custody and can serve as motivation for building a new sense of self off the criminal past, thus reducing the risk of re-offending. This also applies to offenders with severe mental disorders. The aim of this study was to identify factors that promote or hinder the establishment or maintenance of social relationships upon release from a court-ordered inpatient treatment using a modern statistical method-machine learning (ML)-on a dataset of 369 offenders with schizophrenia spectrum disorder (SSD). With an AUC of 0.73, support vector machines (SVM) outperformed all the other ML algorithms. The following factors were identified as most important for the outcome in respect of a successful re-integration into society: Social integration and living situation prior to the hospitalization, a low risk of re-offending at time of discharge from the institution, insight in the wrongfulness of the offense as well as into the underlying psychiatric illness and need for treatment, addressing future perspectives in psychotherapy, the improvement of antisocial behavior during treatment as well as a detention period of less than 1 year emerged as the most predictive out of over 500 variables in distinguishing patients who had a social network after discharge from those who did not. Surprisingly, neither severity and type of offense nor severity of the psychiatric illness proved to affect whether the patient had social contacts upon discharge or not. The fact that the majority of determinants which promote the maintenance of social contacts can be influenced by therapeutic interventions emphasizes the importance of the rehabilitative approach in forensic-psychiatric therapy.
“社会资本”在罪犯改造中的重要性已得到充分证实：稳定的家庭和社区关系在罪犯从拘留所释放后的重新安置过程中提供实际帮助，并可作为他们摆脱犯罪过往、建立新的自我意识的动力，从而降低再次犯罪的风险。这同样适用于患有严重精神障碍的罪犯。本研究的目的是，运用一种现代统计方法——机器学习（ML），对369名患有精神分裂症谱系障碍（SSD）的罪犯数据集进行分析，以确定在法院命令的住院治疗出院后，促进或阻碍社会关系建立或维持的因素。支持向量机（SVM）的曲线下面积（AUC）为0.73，优于所有其他ML算法。以下因素被确定为对于成功重新融入社会的结果最为重要：住院前的社会融入和生活状况、机构出院时再次犯罪的低风险、对犯罪不法性以及潜在精神疾病和治疗需求的洞察、心理治疗中对未来前景的探讨、治疗期间反社会行为的改善，以及在区分出院后有社交网络的患者和没有社交网络的患者的500多个变量中，拘留期少于1年是最具预测性的因素。令人惊讶的是，犯罪的严重程度和类型以及精神疾病的严重程度均未被证明会影响患者出院后是否有社会交往。大多数促进维持社会交往的决定因素可受治疗干预影响，这一事实强调了康复方法在法医精神病治疗中的重要性。
