Center for Innovation to Implementation, Department of Veterans Affairs Palo Alto Health Care System.
Department of Medicine, University of Massachusetts Chan Medical School.
Law Hum Behav. 2023 Oct;47(5):579-590. doi: 10.1037/lhb0000542.
Posttraumatic stress disorder (PTSD) is positively associated with involvement in the criminal justice system among veterans. Research that examines whether this association is confounded by risk factors ("criminogenic needs") from the risk-need-responsivity model of correctional rehabilitation can inform risk management with this population.
We hypothesized that (a) veterans with probable PTSD would score higher on all criminogenic needs than veterans without PTSD and (b) probable PTSD would be associated with criminal history but not after accounting for criminogenic needs.
We conducted secondary analyses of data from 341 veterans (95.3% male; 57.8% White/non-Hispanic/Latinx; M = 46.2 years) with a history of criminal justice system involvement who were admitted to mental health residential treatment. At treatment entry, participants completed interviews to assess criminal history, risk-need-responsivity-based criminogenic needs, and PTSD symptom severity. Cross-sectional analyses tested for differences between participants with and without probable PTSD on criminogenic needs and criminal history, and a multiple regression model examined the unique contributions of probable PTSD and criminogenic needs on criminal history.
The majority of the sample (74%, n = 251) met probable criteria for PTSD. Compared with veterans without PTSD, those with probable PTSD scored significantly higher on criminogenic needs of antisocial personality patterns, antisocial cognitions, antisocial associates, substance use, and family/marital dysfunction but did not differ on multiple indices of criminal history (Cohen's ds = 0.60-0.86). In the regression model, higher age (β = 0.52, p < .001) and higher scores on measures of antisocial personality patterns (β = 0.19, p = .04) and antisocial cognitions (β = 0.22, p = .02) were significantly associated with higher scores on a criminal history index.
The findings suggest that veterans with probable PTSD may score higher on a number of criminogenic needs that are known to be drivers of recidivism. An approach that integrates trauma-informed and risk-need-responsivity principles to address veterans' dynamic criminogenic and clinical needs may be critical to risk management in this population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
创伤后应激障碍(PTSD)与退伍军人参与刑事司法系统呈正相关。研究表明,风险-需求-反应模型中的矫正康复中的风险因素(“犯罪倾向需求”)是否会混淆这种关联,可以为该人群的风险管理提供信息。
我们假设 (a) 患有 PTSD 的退伍军人在所有犯罪倾向需求方面的得分都高于没有 PTSD 的退伍军人,以及 (b) 可能患有 PTSD 与犯罪史相关,但在考虑到犯罪倾向需求后则不相关。
我们对 341 名有刑事司法系统参与史的退伍军人(95.3%为男性;57.8%为白种人/非西班牙裔/拉丁裔;平均年龄为 46.2 岁)的数据进行了二次分析,这些退伍军人曾接受过心理健康住院治疗。在治疗开始时,参与者完成了访谈,以评估犯罪史、基于风险-需求-反应的犯罪倾向需求和 PTSD 症状严重程度。横断面分析检验了在犯罪倾向需求和犯罪史方面,有和没有可能患有 PTSD 的参与者之间的差异,多元回归模型检验了可能患有 PTSD 和犯罪倾向需求对犯罪史的独特贡献。
样本中的大多数(74%,n=251)符合 PTSD 的可能标准。与没有 PTSD 的退伍军人相比,患有 PTSD 的退伍军人在反社会人格模式、反社会认知、反社会同伴、药物使用和家庭/婚姻功能障碍等犯罪倾向需求方面的得分明显更高,但在多个犯罪史指标上没有差异(Cohen's ds=0.60-0.86)。在回归模型中,较高的年龄(β=0.52,p<.001)和较高的反社会人格模式(β=0.19,p=0.04)和反社会认知(β=0.22,p=0.02)得分与犯罪史指数得分较高显著相关。
这些发现表明,患有 PTSD 的退伍军人可能在许多已知是累犯驱动因素的犯罪倾向需求方面得分较高。一种将创伤知情和风险-需求-反应原则相结合的方法,以满足退伍军人动态犯罪倾向和临床需求,可能对该人群的风险管理至关重要。(PsycInfo 数据库记录(c)2023 APA,保留所有权利)。