Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany.
School of Health and Social Sciences, AKAD University of Applied Sciences, Stuttgart, Germany.
Eur Psychiatry. 2023 Sep 4;66(1):e74. doi: 10.1192/j.eurpsy.2023.2450.
Violence occurs frequently in the life of forensic psychiatric patients, both as active aggression and in the form of victimization. Undoubtedly, these incidents shape personality, behavior, and affect the ability to interact adequately socially. Thus, such experiences may influence criminal recidivism and serve as forensic psychiatric/psychological predictors upon hospital discharge.
Hence, this study aimed at characterizing two distinct female forensic psychiatric patient populations (nonsubstance use mental disorders [ = 110] versus substance use disorder [ = 415]) regarding their active and passive violent experiences as well as contextualizing these with their individual crime recidivism rates. The analysis followed a record-based, retrospective approach.
While both groups experienced aggression throughout childhood and youth equally often, substance use disorder patients were significantly more often exposed to violence during adulthood. On the other hand, severely mentally ill patients tended to react more often with violence during their hospital confinement. However, regarding their violent recidivism rate, no intergroup effects were observed. Finally, within the addicted group, a violent index crime as well as physical aggression during hospital confinement increased the odds for violent reoffending by approximately 2.4-fold (95% confidence interval 1.3-4.5) and 2.5-fold (95% confidence interval 1.1-5.9), respectively.
In summary, these findings underline the importance of active aggression rather than victimization as an influencing factor on resocialization especially in a substance use disorder patient population.
暴力事件在法医精神病患者的生活中频繁发生,包括主动攻击和受害形式。毫无疑问,这些事件塑造了他们的个性、行为,并影响了他们充分进行社会互动的能力。因此,这些经历可能会影响犯罪累犯,并成为出院后的法医精神病学/心理学预测因素。
因此,本研究旨在对两个不同的女性法医精神病患者群体(无物质使用精神障碍[=110]与物质使用障碍[=415])进行特征描述,了解他们的主动和被动暴力经历,并将这些经历与他们的个人犯罪累犯率联系起来。分析采用基于记录的回顾性方法。
尽管两个群体在儿童和青少年时期同样经常经历攻击性事件,但物质使用障碍患者在成年后更经常遭受暴力。另一方面,严重精神疾病患者在住院期间更倾向于以暴力反应。然而,就他们的暴力累犯率而言,没有观察到组间效应。最后,在成瘾组中,索引犯罪中的暴力行为以及住院期间的身体攻击使暴力再犯罪的几率增加了约 2.4 倍(95%置信区间 1.3-4.5)和 2.5 倍(95%置信区间 1.1-5.9)。
总之,这些发现强调了积极攻击而不是受害作为再社会化的影响因素的重要性,特别是在物质使用障碍患者群体中。