Offenders with mental health problems and problematic substance use : treatment interventions and crime relapse
Author: Durbeej, Natalie
Date: 2014-06-12
Location: 90-salen, plan 6, Centrum för Psykiatriforskning, Norra Stationsgatan 69, Stockholm
Time: 10.00
Department: Inst för klinisk neurovetenskap / Dept of Clinical Neuroscience
Abstract
Background: The relationships between problematic substance use, mental health problems and criminal behavior have been firmly established in research. Offenders with mental health problems and concurrent problematic substance use have high risk of reoffending and may display low rates of treatment retention. The overall aim of this thesis was to explore treatment needs, treatment participation and crime relapse among Swedish offenders with mental health problems and problematic substance use.
Methods: The studies composing this thesis were part of the larger ongoing prospective follow-up project: Mental Disorder, Substance Abuse and Crime (MSAC) (n = 207) including offenders with mental health problems and problematic substance use in Stockholm County. Data from the baseline assessment and follow-up assessments of the MSAC-project were analyzed, as well as data gathered from Swedish registers and semi structured in-depth interviews. The participants were followed for approximately three years. Both quantitative and qualitative methodological approaches were used.
Results: The following main findings emerged: (1) Participation in planned substance abuse outpatient visits was associated with a significantly reduced risk of criminal recidivism in the study population. (2) Higher scores of the Antisocial Psychopathy Checklist-Revised (PCL-R) facet and membership of a subgroup described as “Triply troubled with medical problems” were associated with an increased risk of criminal recidivism. (3) The Affective PCL-R facet was negatively related with participation in planned outpatient substance abuse visits and dry housing residence. (4) Among participants with various degrees of psychopathic personality traits, there were more similarities than differences in perceptions of substance abuse treatment. However, participants with a low degree of such traits stated that control requirements in treatment were rather manageable; whereas those with a high degree of psychopathic personality traits expressed that those requirements were difficult to fulfill. (5) All participants of the four previously defined subgroups/clusters of the study population showed improvements with regard to problem severity over the course of time, but the improvements were cluster-specific rather than sample specific. Cluster membership could also predict treatment participation and quality of life. (6) The Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) showed reliability and concurrent validity in screening for substance dependence of alcohol and illicit drugs, as well as problem severity with regard to alcohol, drugs and illegal areas.
Conclusions: Among offenders with mental health problems and problematic substance use, participation in planned outpatient substance abuse interventions should be considered important from a clinical risk management perspective, and be encouraged. Some personality traits as well as subgroup membership (based on specific problem profiles) could be considered in order to individualize treatment planning and improve outcomes. In order to identify problematic substance use, the AUDIT and the DUDIT questionnaires could be used.
Methods: The studies composing this thesis were part of the larger ongoing prospective follow-up project: Mental Disorder, Substance Abuse and Crime (MSAC) (n = 207) including offenders with mental health problems and problematic substance use in Stockholm County. Data from the baseline assessment and follow-up assessments of the MSAC-project were analyzed, as well as data gathered from Swedish registers and semi structured in-depth interviews. The participants were followed for approximately three years. Both quantitative and qualitative methodological approaches were used.
Results: The following main findings emerged: (1) Participation in planned substance abuse outpatient visits was associated with a significantly reduced risk of criminal recidivism in the study population. (2) Higher scores of the Antisocial Psychopathy Checklist-Revised (PCL-R) facet and membership of a subgroup described as “Triply troubled with medical problems” were associated with an increased risk of criminal recidivism. (3) The Affective PCL-R facet was negatively related with participation in planned outpatient substance abuse visits and dry housing residence. (4) Among participants with various degrees of psychopathic personality traits, there were more similarities than differences in perceptions of substance abuse treatment. However, participants with a low degree of such traits stated that control requirements in treatment were rather manageable; whereas those with a high degree of psychopathic personality traits expressed that those requirements were difficult to fulfill. (5) All participants of the four previously defined subgroups/clusters of the study population showed improvements with regard to problem severity over the course of time, but the improvements were cluster-specific rather than sample specific. Cluster membership could also predict treatment participation and quality of life. (6) The Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) showed reliability and concurrent validity in screening for substance dependence of alcohol and illicit drugs, as well as problem severity with regard to alcohol, drugs and illegal areas.
Conclusions: Among offenders with mental health problems and problematic substance use, participation in planned outpatient substance abuse interventions should be considered important from a clinical risk management perspective, and be encouraged. Some personality traits as well as subgroup membership (based on specific problem profiles) could be considered in order to individualize treatment planning and improve outcomes. In order to identify problematic substance use, the AUDIT and the DUDIT questionnaires could be used.
List of papers:
I. Durbeej, N., Berman, A.H., Gumpert, C.H., Palmstierna, T., Kristiansson. M., & Alm, C. (2010). Validation of the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test in a Swedish sample of suspected offenders with signs of mental health problems: Results from the Mental disorder, Substance Abuse and Crime study. Journal of Substance Abuse Treatment, 39, 364–377.
Fulltext (DOI)
Pubmed
View record in Web of Science®
II. Durbeej, N., Alm, C., & Gumpert, C.H. (2014). Perceptions of treatment among offenders with mental health problems and problematic substance use - The possible relevance of psychopathic personality traits. Open Journal of Psychiatry, 4, 79–90.
Fulltext (DOI)
III. Durbeej, N., Palmstierna, T., Berman, A.H., Kristiansson, M., & Gumpert, C.H. (2014). Offenders with mental health problems and problematic substance use: Affective psychopathic personality traits as potential barriers to participation in substance abuse interventions. Journal of Substance Abuse Treatment, 46, 574–583.
Fulltext (DOI)
Pubmed
View record in Web of Science®
IV. Alm, C., Eriksson, Å., Durbeej, N., Palmstierna, T., Berman, A.H., Kristiansson, M., & Gumpert, C.H. (2014). Classification of offenders with mental health problems and problematic substance use using the Addiction Severity Index version 6: analysis of three year follow-up data and predictive validity. Mental Health and Substance use.
Fulltext (DOI)
V. Durbeej, N., Palmstierna, T., Rosendahl, I., Berman, A.H., Kristiansson, M., & Gumpert, C.H. Participation in substance abuse outpatient visits and crime relapse among offenders with mental health problems and problematic substance use: Findings from the Mental Disorder, Substance Abuse, and Crime study. [Manuscript]
I. Durbeej, N., Berman, A.H., Gumpert, C.H., Palmstierna, T., Kristiansson. M., & Alm, C. (2010). Validation of the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test in a Swedish sample of suspected offenders with signs of mental health problems: Results from the Mental disorder, Substance Abuse and Crime study. Journal of Substance Abuse Treatment, 39, 364–377.
Fulltext (DOI)
Pubmed
View record in Web of Science®
II. Durbeej, N., Alm, C., & Gumpert, C.H. (2014). Perceptions of treatment among offenders with mental health problems and problematic substance use - The possible relevance of psychopathic personality traits. Open Journal of Psychiatry, 4, 79–90.
Fulltext (DOI)
III. Durbeej, N., Palmstierna, T., Berman, A.H., Kristiansson, M., & Gumpert, C.H. (2014). Offenders with mental health problems and problematic substance use: Affective psychopathic personality traits as potential barriers to participation in substance abuse interventions. Journal of Substance Abuse Treatment, 46, 574–583.
Fulltext (DOI)
Pubmed
View record in Web of Science®
IV. Alm, C., Eriksson, Å., Durbeej, N., Palmstierna, T., Berman, A.H., Kristiansson, M., & Gumpert, C.H. (2014). Classification of offenders with mental health problems and problematic substance use using the Addiction Severity Index version 6: analysis of three year follow-up data and predictive validity. Mental Health and Substance use.
Fulltext (DOI)
V. Durbeej, N., Palmstierna, T., Rosendahl, I., Berman, A.H., Kristiansson, M., & Gumpert, C.H. Participation in substance abuse outpatient visits and crime relapse among offenders with mental health problems and problematic substance use: Findings from the Mental Disorder, Substance Abuse, and Crime study. [Manuscript]
Institution: Karolinska Institutet
Supervisor: Hellner Gumpert, Clara
Issue date: 2014-05-22
Rights:
Publication year: 2014
ISBN: 978-91-7549-585-9
Statistics
Total Visits
Views | |
---|---|
Offenders ...(legacy) | 1281 |
Offenders ... | 245 |
Total Visits Per Month
September 2023 | October 2023 | November 2023 | December 2023 | January 2024 | February 2024 | March 2024 | |
---|---|---|---|---|---|---|---|
Offenders ... | 2 | 1 | 2 | 1 | 1 | 1 | 1 |
File Visits
Views | |
---|---|
Thesis_Natalie_Durbeej.pdf(legacy) | 847 |
Thesis_Natalie_Durbeej.pdf | 448 |
Spikblad_Natalie_Durbeej.pdf(legacy) | 210 |
Spikblad_Natalie_Durbeej.pdf | 52 |
Top country views
Views | |
---|---|
United States | 488 |
Sweden | 241 |
China | 205 |
Germany | 67 |
United Kingdom | 38 |
Canada | 20 |
Australia | 19 |
France | 18 |
Finland | 16 |
Netherlands | 15 |
Top cities views
Views | |
---|---|
Sunnyvale | 111 |
Shenzhen | 96 |
Ashburn | 66 |
Stockholm | 43 |
Kiez | 26 |
Amsterdam | 11 |
Seoul | 11 |
Washington | 11 |
Linköping | 10 |
London | 10 |