Translating risk factors into treatment needs for juveniles with sex offenses

Shifting the focus from risk prediction to treatment and remediation can benefit public policy by improving juvenile outcomes, reducing management cost, and providing substantially more reliable input for the court and all providers. This is the bottom line of a recently published article in Translational Issues in Psychological Science. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | Translational Issues in Psychological Science | 2019, Vol. 5, No. 2, 154-169

Development of a Risk/Treatment Needs and Progress Protocol for Juveniles With Sex Offenses

Authors

Tamara Kang, Fairleigh Dickinson University
Amanda Beltrani, Fairleigh Dickinson University
Megan Manheim, Fairleigh Dickinson University
Sharron Spriggs, Fairleigh Dickinson University
Bridget Nishimura, Fairleigh Dickinson University
Shantel Sinclair, Fairleigh Dickinson University
Marta Stachniuk, Fairleigh Dickinson University
Elise Pate, Fairleigh Dickinson University
Sue Righthand, University of Maine
James R. Worling, Ontario, Canada
Robert A. Prentky, Fairleigh Dickinson University

Abstract

With the post-Gault trend toward the criminalization of the juvenile court, the demand for risk prediction assessment scales took on newfound importance. The past several decades of research have underscored the limitations of these scales. To address these limitations, and to shift the focus from current and future risk to least restrictive management strategies and effective treatment, we have developed and implemented a new assessment protocol that relies on risk relevant dynamic factors to inform and individualize treatment interventions as a vehicle for reducing recidivism and promoting healthy development among juveniles with sex offenses—without focusing solely on risk prediction. This Treatment Needs and Progress Scale (TNPS) is currently being pilot tested in five states. This article reviews the methodological problems of the extant risk assessment scales, discusses the development of the TNPS and how this protocol seeks to address many of these problems, including shifting the outcome target from reoffense to mitigation of risk factors through treatment and healthy growth and adjustment. We conclude with discussing how the TNPS may improve decision making regarding the management of juveniles with sex offenses, inform public policy and law, and facilitate healthier outcomes.

Keywords

juveniles, sex offenses, treatment, risk prediction, risk management

Summary of the Research

“Extensive research over the past 15 years has shed light on the marked limitations of the extant risk assessment scales used for Juvenile Sex Offenders (JSO), including the three most commonly used scales—the ERASOR, the J-SOAP-II, and the JSORRAT-II. The methodological challenges and the deficiencies of existing scales for these juveniles have been discussed at length elsewhere and in the excellent review by Vincent, Guy, and Grisso (2012) on assessing the risk of delinquent youth in the juvenile justice system” (p. 155).

“In 2016 we began the design, development, and implementation of the Treatment Needs and Progress Scale (TNPS) that focuses on dynamic risk and protective factors that enabled users to assess change as a function of intervention and that provided risk relevant information to a wide range of stakeholders. Although a number of dynamic assessment tools are available to assess youth with nonsexual offenses, JSOs are often statutorily unique in terms of mandated management provisions, including community notification and civil commitment. JSOs, unlike their counterparts who offend nonsexually, may be subject to being labeled as a “sex offender” on public registries, experience barriers to attending public school and gaining employment, and be barred from living in homes with children, including their own siblings. All of these managerial provisions are predicated on an assumption of risk that overshadows other considerations. Not only are these assumptions often flawed, as noted above, but they shift the focus away from health to pathology. This 3-year national study shifts the focus on magnitude of risk to remediation of risk” (p. 157).

The project had five goals: (a) develop and test an evidence-informed treatment needs and progress scale (hereafter referred to as TNPS) for assessing—primarily— dynamic risk and protective factors and limited experimental historical items empirically associated with sexual and nonsexual reoffending by JSOs and identifying related intervention needs associated with those factors; (b) develop a user-friendly data entry software program that enables evaluators to rate risk-relevant factors in their initial assessments, design treatment or case management plans accordingly, monitor progress, and assess readiness for discharge via periodic reassessments, and may assist with internal program evaluations; (c) test the scale with 400–500 youth at multiple sites across the United States and examine reliability and validity of the TNPS items, for example, by analyzing comparisons of scores on the TNPS with deidentified, electronic, routinely collected data reflecting the juveniles’ overall functioning prior to and during the course of treatment; (d) revise the scale accordingly to produce a final version of the TNPS and revise the data entry program; and (e) provide sites with training on the final version of the TNPS, including a train-the-trainers component that can ensure sustainability.

Translating Research into Practice

“Through development of a TNPS, we hoped to shift the goalpost from an outcome focused exclusively on risk of sexual reoffense (or any nonsexual criminal offense) to an outcome focused on adjustment and health. Although many of the dynamic items used in the TNPS are found in extant juvenile sexual and nonsexual risk assessment scales, our objective in including such items in the TNPS is not to capture risk of reoffense but to guide individualized treatment to reduce risk and develop behaviors and lifestyles that are incompatible with delinquent or criminal behavior. The considerable item overlap with other scales is not coincidence. Understanding risk is a sine qua non for reducing risk; accurately assessed risk is our best guide for identifying optimum interventions tailored to individual needs. In sum, we have argued that our efforts to predict risk reliably have fared poorly and that a far more expedient longterm strategy is to mitigate risk. Further, inclusion of protective factors (items that may mitigate or buffer risk, as well as others that are important for improving treatment response), is intended to promote a dynamic and holistic approach to facilitating positive development, healthy transitions into adulthood, and prosocial lives. By shifting the focus to risk mitigation through treatment we are hoping to influence not just practice but the policy driving practice” (p. 164).

“The TNPS and its guiding principles are not an attempt to devalue assessment of risk, and we are not recommending abandoning risk assessment. Risk is a sensitive barometer for what must be targeted in treatment. However, lessons learned from the past is that risk assessment with juveniles, when treated as an endpoint, is fraught with problems, both substantive (methodological) and practical (management). What we recommend is that risk take its place embedded in the matrix of an idiographic assessment that focuses, as a midpoint, on mitigation through treatment and other interventions that foster health rather than as an end goal of prediction” (p. 164).

“Although the data from our pilot sites will hopefully shed light on our basic assumptions about the efficacy and merits of the TNPS, these assumptions must continue to be examined empirically well after the pilot phase. We should emphasize, however, that the TNPS alone can never mitigate risk, and its assistance with guidance, treatment, and management can be no better than the fidelity with which it is used. The potential implications described below refer to how, if implemented with fidelity, the TNPS might inform decision-making and impact juveniles, their parents and caregivers, child welfare system case workers, law enforcement, probation officers, juvenile court judges and attorneys, teachers and school administrators, clinicians/treatment providers, public policy advocates, and researchers” (p. 164-165).

Other Interesting Tidbits for Researchers and Clinicians

“We have sought to develop and test a different model for addressing the needs of juveniles with sex offenses. This model has three overarching goals: (a) reverse the prevailing standard of practice that understands risk prediction as the quintessential purpose of assessment, (b) reintroduce treatment as the principal objective of sound management, and, in so doing, (c) potentially reduce the large number of false positive decisions (i.e., classifying low risk youth as presenting a high risk), that pose a financial burden on society and may further cripple already troubled youth” (p. 165).

“Our proposal is not novel. Over two decades ago, Chaffin and Bonner (1998) penned their oft-cited Editor’s introduction: “Don’t Shoot, We’re Your Children:” Have we gone too far in our response to adolescent sexual abusers and children with sexual behavior problems? Ten years later Chaffin (2008) wrote his reprise focusing on the continued disconnect between policy-based misperceptions of high risk, homogeneity, and intransigence (the belief that sexually offending behaviors in juveniles are ‘tenacious and difficult to change and require not just specialized intervention but lots of it . . . delivered over a long period of time . . . and should involve more intensive, restrictive, and expensive elements’ [pp. 118–119]). As Chaffin pointed out in 2008, there was no scientific support for those beliefs, a finding that continues to be true today” (p. 165).

“In the decade since Chaffin’s (2008) article, there has been a wealth of empirical literature documenting: (a) heterogeneity among juveniles with sex offenses, (b) low sexual recidivism base rates, implying a low risk of new sex offenses, (c) marked developmental immaturity, indicating that change is inevitable as a mere function of growth, and (d) amenability to short-term treatment; indeed there is evidence that high intensity treatment for low-risk youth may actually increase the likelihood of reoffending. Thus, the TNPS is not an experiment with a new risk assessment scale for JSOs, but rather a structural attempt – and an opportunity – to align policy and practice with scientific evidence. Any steps, even preliminary ones, that lay groundwork for empirically informed policies, management strategies, and treatment methods that reduce a youth’s contact with the juvenile justice or child welfare system will be beneficial for everyone—our juvenile clients, their families and communities, and our society: (p. 165-166).

Join the Discussion

As always, please join the discussion below if you have thoughts or comments to add!

Authored by Amanda Beltrani

Amanda Beltrani is a current doctoral student at Fairleigh Dickinson University. Her professional interests include forensic assessments, professional decision making, and cognitive biases.

Impact of report framing on juvenile probation officers’ decision making

Findings from this study caution against using negatively framed language in court reports, given its detrimental impacts on JPOs’ perceptions of youths’ compliance and their recommendations to sanction youth and revoke probation. This is the bottom line of a recently published article in Law and Human Behavior. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | Law and Human Behavior | 2019, Vol. 43, No. 2, 193-204

Impact of Community-Based Provider Reports on Juvenile Probation Officers’ Recommendations: Effects of Positive and Negative Framing on Decision Making

Author

Elizabeth Gale-Bentz, Naomi E. S. Goldstein, Lindsey M. Cole, and Kelley Durham, Drexel University (L3)

Abstract

This study examined whether varying the presentation of information about a youth’s compliance with probation requirements in community provider reports influenced juvenile probation officers’ (JPOs) perceptions and court recommendations. This study used an experimental design to explore the impact of report framing (positive, neutral, negative) and youth risk level (low, high) on JPOs’ decision making. Pennsylvania-based JPOs (N = 209) participated in an anonymous, online study. Participants read one of six community provider reports about a hypothetical probationer and answered five questions about impressions of the youth and their recommendations to the court. JPOs who read negatively framed information rated compliance and effort significantly lower than those who read positively or neutrally framed information. JPOs who read negatively framed information reported lower likelihood of recommending positive court responses and greater likelihood of recommending negative court responses, particularly when considering probation revocation for youth identified as high risk. JPOs rated compliance significantly higher for youth identified as low risk than for youth identified as high risk. Mediation analyses revealed that JPOs’ perceptions of youth significantly mediated the pathway between report framing and court recommendations, but did not mediate the pathway from youth risk level to JPOs’ recommendations. Findings suggest that JPOs differentially interpret identical behaviors depending on the framing of information. Given that negatively framed information evoked significantly more unfavorable impressions and punitive recommendations, practitioners should consider how youths’ progress on probation is communicated among court personnel, particularly as ongoing juvenile probation reform efforts seek to promote consistent treatment across youth.

Keywords

juvenile probation officers, framing, decision making

Summary of the Research

“Probation is the most commonly ordered sanction for youth adjudicated delinquent in the juvenile justice system, and juvenile probation officers (JPOs) are tasked with monitoring youths’ progress toward probation completion, with a particular focus on compliance with court ordered conditions. Official responses to noncompliance are at the discretion of the presiding judge and can have serious consequences for youth, including probation revocation and placement in correctional facilities. In fact, more than half of youth in one large sample failed to comply with at least one condition of probation, and nearly half of youth in the sample were sent to residential placements following revocation of probation. Judges’ decisions regarding youths’ status on probation are largely informed by information provided by JPOs, and, thus, the ways in which JPOs perceive youths’ (mis)behavior and convey that information to the court is an important area of research for further study. This study examined whether the framing of information about youths’ behavior in community provider reports affected JPOs’ perceptions of youth and the recommendations they would make to the court—taking into account the youth’s identified risk for recidivism level” (p. 193-194).

“Ongoing juvenile justice reform efforts emphasize the negative impacts of confinement on youth, and research demonstrates that many youth under community supervision who do not follow their court-ordered requirements are at risk for placement in secure facilities. JPOs’ reports and recommendations provide important information to inform and guide judges’ rulings and, therefore, can substantially impact youth outcomes. As a result, it is necessary to gain insight into what influences JPOs’ decision-making processes. The current study sought to build upon extant research by examining whether the framing of information community providers convey to JPOs about youths’ compliance with probation requirements affects JPOs’ perceptions of youth and recommendations to the court” (p. 195).

“The differential effects of youths’ behavioral framing on JPOs’ impressions and recommendations align with prior research on factors influencing the ways in which JPOs assign labels to youth and how these factors impact their decision making. To that end, findings from these studies, as well as others, emphasize the power of language in shaping JPOs’ decision making, identifying the ways in which differences in descriptions of youths’ behaviors impact outcomes. The current study adds to this body of literature by revealing another factor that influences JPOs’ decision-making processes: JPOs’ perceptions of how hard youth are trying to comply with their probation requirements. More specifically, JPOs’ impressions of youths’ effort to comply, which were shaped by the ways in which their probation-related behaviors were framed, guided JPOs’ recommendations to the court. Further, the large effect sizes observed for the main effects of report framing indicate that the way information was presented strongly influenced JPOs’ decision making, particularly with respect to their perceptions of the youth’s compliance and the youth’s effort to fulfill probation conditions. Notably, negative framing drove the majority of the large effect sizes observed across the five outcome variables, again suggesting the powerful impact of negative portrayals of youth on JPOs’ decision making. In contrast, for all but the ultimate outcome of likelihood of recommending probation revocation and placement, which was a moderate effect size, youth risk level exerted less of an impact on JPOs’ decision making than did report framing, as indicated by the small effect sizes for main effects and interaction terms. Together, these findings suggest that the framing of information about youths’ probation-related behaviors generates substantial implications for JPOs’ decision making—not only about their perceptions of youth, but also about their recommendations to incentivize or sanction youth—particularly when information is negatively framed” (p. 200-201).

Translating Research into Practice

“The subjectivity of the interpretation of young people’s behaviors has broader juvenile justice system policy and practice implications. As juvenile probation departments across the country begin to develop and implement structured, developmentally informed systems of supervision that are intended to foster equity across youth care must be given to the ways in which youths’ compliant and noncompliant probation-related behaviors are defined, described, and communicated among juvenile justice personnel. Although these structured systems aim to promote consistency in responding to young people’s behaviors, findings from the current study suggest that this task may be more difficult in practice than in theory. We see that differences in language choices— such as describing a physical interaction as a fight versus a scuffle—and emphasized behaviors—such as focusing on what the youth has done versus what the youth has not done—can affect the ways in which JPOs think about and respond to their supervisees’ progress on probation. Differences in JPOs’ perceptions of youth and recommendations to the court were produced in a brief, one-paragraph community provider report with limited information about a hypothetical youth. The negative impact of longer, more detailed reports and interactions over a period of months on JPOs’ decision making about their supervisees could have longterm impacts; the longer and more intensive juveniles’ probation supervision, the more opportunities to identify misbehavior and sanction youth to confinement in a secure facility—a consequence with long-term outcomes academically, vocationally, emotionally, and with respect to recidivism” (p. 201).

“In addition to the ways court personnel communicate about young people’s behavior, it is important to consider the ways in which young people themselves may internalize descriptions of behaviors. The phenomenon of the self-fulfilling prophecy has been observed in many environments, such as educational settings, where children’s academic performance often matches teachers’ expectations, particularly for minority youth and youth from economically disadvantaged communities and home settings, where parents’ beliefs about their children’s substance use impact outcomes. Although the impact of expectations on youths’ achievement has not been examined in a probation context, these findings suggest that when community providers, JPOs, and judges communicate to youth that they are not putting forward effort and failing to comply with their probation requirements, it is possible that youth may adopt these negative attributions and act accordingly. However, positive expectations held by adults can combat negative expectations of youth held by other adults. Community providers and JPOs, then, have an important role in providing positive messages to court involved youth about their abilities to succeed, particularly around descriptions of compliance and effort. Expectations communicated by JPOs and judges of young people’s capacities to successfully fulfill probation requirements have the potential to shape youths’ behaviors for the better. If court personnel seek to promote positive outcomes for youth, framing behaviors in ways that acknowledge effort and recognize success, they may better position youth to successfully complete probation” (p. 201).

Other Interesting Tidbits for Researchers and Clinicians

“Findings from the current study lay the foundation for several areas of future research. Findings from this study should be replicated in other jurisdictions across the country, as well as with other court personnel, such as district attorneys and judges. Broadening the data in these ways may provide direction for policy and practice changes. For example, if consistent findings are produced by probation departments across the nation, standardized report formats might be adopted to promote the provision of fair and proportionate responses to the behavior of young people on probation. Recommendations for such standardized formats might include presenting quantitative information neutrally and objectively (e.g., stating that the youth has attended 10 out of 15 sessions) to provide court personnel with information regarding what the youth has accomplished, in addition to what was required of the youth. Additionally, consideration might be given to the use of qualitative descriptors when describing youths’ behaviors, as these qualitative descriptors can portray identical behaviors in markedly different lights. To that end, standardized language may help to reduce inconsistencies and disproportionality across youth” (p. 202).

“Finally, future research should further explore the extent to which youths’ risk levels impact JPOs’ impressions of youth and their recommendations to the court. Findings from the current study suggest that risk level influenced JPOs’ decision making, particularly when considering probation revocation—JPOs were more likely to recommend probation revocation for youth identified as high risk when receiving negatively framed reports of their behavior. Although this discrepancy may reflect bias—JPOs may be inclined to jump to negative conclusions and recommendations about youth labeled high risk—it may also reflect appropriate use of risk labels. If youth on probation are identified as high risk to the community, it may be appropriate to have a lower behavioral threshold for revoking probation. With movement toward use of risk assessment tools in juvenile probation decision making across the country, better understanding the role of identified risk level in JPOs’ impressions and recommendations could improve case management and youth outcomes. Knowing the harmful effects of placement on youths’ well-being, understanding factors that put justice-involved youth at greater risk for negative outcomes is a meaningful line of inquiry with important policy and practice implications” (p. 202).

Join the Discussion

As always, please join the discussion below if you have thoughts or comments to add!

Authored by Amanda Beltrani

Amanda Beltrani is a current doctoral student at Fairleigh Dickinson University. Her professional interests include forensic assessments, professional decision making, and cognitive biases.

The Dark Triad of Sex: Psychopathy, Deviant Sexual Interests, and Gender

The present study examined associations between psychopathic traits and deviant sexual interests across gender in a community sample. The results reflect that there was a stronger association between the antisocial facet of psychopathy and deviant sexual interests in women, compared to men. Furthermore, the associations between the interpersonal facet of psychopathy and voyeuristic interests and between the lifestyle facet of psychopathy and sadistic interests were stronger in men. These findings suggest that, in the realm of deviant sexual interests, psychopathic traits may manifest differently in men and women. This is the bottom line of a recently published article in the International Journal of Forensic Mental Health. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | International Journal of Forensic Mental Health | 2018, Vol. 17, No. 3, 256-271

Psychopathic Traits and Deviant Sexual interests: The Moderating Role of Gender

Authors

Rob van Bommel, Department of Developmental Psychology, Tillburg University, Tillburg, The Netherlands
Kasia Uzieblo, Department of Applied Psychology, Thomas More University College, Antwerp, Belgium; Department of Experimental-Clinical & Health Psychology, Ghent University, Ghent, Belgium
Stefan Bogaerts, Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands; Kijvelanden-Fivoor, Poortugaal, The Netherlands
Carlo Garofalo, Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands

Abstract

The present study examined associations between psychopathic traits and deviant sexual interests across gender in a large community sample (N = 429, 24% men). Correlation analyses supported the positive link between psychopathic traits and deviant sexual interests. Regression analyses indicated that the unique variance in the antisocial facet of psychopathy predicted all six deviant sexual interests. The interpersonal facet predicted voyeuristic and exhibitionistic interests, whereas the affective facet predicted pedophilic interests. Moderation analyses revealed that gender moderated most of the relations between the antisocial facet of psychopathy and deviant sexual interests, such that those positive associations were stronger among women. On the contrary, the associations between the interpersonal facet and voyeuristic interests, as well as between the lifestyle facet and sadistic interests, were stronger among men. Findings appear to suggest that deviant sexual interests represent a domain in which the manifestation of psychopathic traits may differ across gender. These findings emphasize the relevance of psychopathic traits for the understanding and risk assessment of sexual deviance, while suggesting the need for gender-sensitive considerations.

Keywords

Psychopathy, sexual deviance, sexual fantasies, gender differences, paraphilia

Summary of the Research

“While sexual offenders generally report more deviant sexual interests than non-offenders…deviant sexual interests are also frequent in community samples…Psychopathy is a personality disorder characterized by a pervasive pattern of interpersonal, affective, and behavioral dysfunctions…Many studies on psychopathy have been conducted among detainees and forensic psychiatric patients, due to the relatively higher prevalence of psychopathic traits in such populations. Although the prevalence of clinically significant levels of psychopathy in the general population is relatively small, there is substantial evidence that psychopathy is best conceptualized as a dimensional construct and that individual differences in psychopathic traits are also present in the general population…” (p.256-257).

“In general, the associations between psychopathic traits and a variety of externalizing behavior (e.g., aggression, substance abuse, and impulsivity) seem quite similar for men and women…However, prior studies have also highlighted meaningful gender differences in the associations between psychopathy and specific forms of aggression, with women being more likely to use relational (or social) aggression, and men being more prone to use physical aggression…In the realm of externalizing behavior, psychopathy is also associated with deviant sexual behavior…although the association between psychopathy and deviant sexuality has been relatively understudied so far and also has produced mixed findings…In an attempt to advance research in this area, we examined associations between psychopathy facets and deviant sexual interests in a community sample, as well as the possible moderating effect of gender in these relations” (p.257-260).

“Overall, the present study extends prior findings that have mostly been focused on the more violent declensions of sexual deviance. Consistent with other recent studies…we showed that psychopathic traits are related to a broad range of sexual interests, in keeping with earlier research showing that offenders with psychopathic traits exhibited a more diverse profile of deviant sexual behavior compared to non-psychopathic offenders…Further, the present study provided novel findings on gender differences in the association between psychopathic traits and deviant sexual interests. Taken together, the main pattern appeared to show that associations between the antisocial facet of psychopathy and deviant sexual interests were significantly stronger among women, compared to men…suggesting that psychopathic traits may be related to greater interests about deviant sexual behavior among women, compared to men” (p.267).

“First, only in women, pedophilic, exhibitionistic, and rape sexual interests were related to the antisocial facet of personality. This may suggest that these deviant sexual interests particularly characterize the nomological network of psychopathy among women. Second, the association between the antisocial facet and sadistic interests was stronger among women, whereas the lifestyle facet of psychopathy was related to sadistic interests among men only. While largely exploratory in nature, these results appear to indicate that different mechanisms may explain sadistic interests across gender, calling for further investigation…Finally, voyeuristic interests were related to the antisocial facet of psychopathy among women only, but the relation between voyeuristic interests and the interpersonal facet of psychopathy was significant only among men” (p.267).

Translating Research into Practice

“…That is, future studies are needed to examine whether engaging in deviant sexual interests contributes to the development of psychopathic traits, whether psychopathic traits facilitate and increase the frequency and variety of deviant sexual interests, or whether a reciprocal relationship occurs over time. Nevertheless, our findings are consistent with [prior researchers’] claim that practitioners involved in treatment or risk assessment should take into account that psychopathic traits may be associated with a tendency to endorse deviant sexual interests that might remain unnoticed unless accurately scrutinized…” (p.267).

“These findings can inform forensic research by indicating that individuals with psychopathic traits may be more likely to nurture interest about deviant sexual behavior, which can in turn increase the risk for deviant sexual behavior…Further, these findings can inform future studies on deviant sexual interests across gender, showing that different personality traits might be related to sexual interests in men and women” (p.268).

Other Interesting Tidbits for Researchers and Clinicians

“The present study…appears to suggest that women report to experience deviant sexual interests more often, and especially about sadistic, pedophilic, exhibitionistic, and rape-like contents. If replicated, these partly unexpected results would warrant further investigation on the mechanisms explaining gender differences in the endorsement of these deviant sexual interests. For instance, studies that emphasize culture and sexual socialization across gender could greatly advance existing knowledge” (p.265).

“…In summary, far from being a mere reflection of overt criminal behavior, the antisocial facet of psychopathy seemed related to interest in deviant sexuality that involves both a deviant activity and a deviant target, with stronger relationships with those deviant sexual interests that are both deviant and aggressive in nature (i.e., sadistic, pedophilic, and rape interests)…The interpersonal facet of psychopathy predicted voyeuristic and exhibitionistic interests, suggesting that these interests may not only be related to antisocial tendencies, but also to aspects such as grandiosity and interpersonal manipulation…Finally, pedophilic interest was associated with the affective facet of psychopathy, possibly indicating that this specific form of deviant sexual interests may not only be related to antisocial tendencies, but also to more pronounced disturbances in emotional functioning, involving callousness and a lack of empathy” (p.266).

Join the Discussion

As always, please join the discussion below if you have thoughts or comments to add!

Authored by Amber Lin

Amber Lin was a volunteer in Dr. Zapf’s research lab at John Jay College of Criminal Justice. She graduated from New York University in 2013 with a B.A. (honors) and is a third year Masters student at Fairleigh Dickinson University. Her research interests include forensic assessment, competency to stand trial, and the refinement of instruments used to assess the psychological states of criminal defendants.

The virtue of similarity: Overcoming resistance in intelligence interviews through cooperative mindset

Creating a relationship with a subject that is based on similarities with the interviewer, rather than on dissimilarities with the target, can overcome barriers to cooperation that stem from affiliation concerns. This is the bottom line of a recently published article in Psychology, Public Policy, and Law. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | Psychology, Public Policy, and Law | 2019, Vol. 25, No. 2, 107–115

Enhancing cooperation and disclosure by manipulating affiliation and developing rapport in investigative interviews

Authors

Laure Brimbal, Iowa State University
Rachel E. Dianiska, Iowa State University
Jessica K. Swanner, Iowa State University
Christian A. Meissner, Iowa State University

Abstract

We sought to identify motivations to resist cooperation in intelligence interviews and develop techniques to overcome this resistance. One source of resistance can arise because of concerns for affiliations (e.g., “I do not want to inform on my friends/family/fellow countryman”). We investigated two avenues of rapport building—approach and avoidance—designed to overcome this concern. In a modified cheating paradigm, our participants (N = 116) became affiliated with a confederate who they then witnessed cheating. Participants were interviewed about the event in a 2 (approach: present vs. absent) X 2 (avoid: present vs. absent) design. The interviewer used either an approach technique that aligned them with the interviewer (portrayed as a morally good person) or an avoid technique that moved them away from the culprit (portrayed as nefarious), neither, or both. The approach technique increased rapport between the interviewer and participant. However, the avoid technique decreased the amount information elicited. When submitted to a mediation model, the approach technique had a positive indirect effect on information yield via perceived rapport and cooperation, while this was not the case for the avoid technique. An exploratory moderator analysis revealed that sympathy for the confederate moderated the effect of the avoid technique on information disclosed, where the more sympathy a participant felt for the confederate, the less information he or she provided. Implications for interviewing are discussed.

Keywords

investigative interviewing, rapport, cooperation, affiliation, resistance

Summary of the Research

“There is growing consensus among practitioners and researchers that a rapport-based approach to interviewing is more reliable and productive than a confrontational, accusatorial approach. […] The current study adds to [the] literature by offering the first assessment of how reshaping a resistant source’s affiliations might influence perceived rapport between the source and an interviewer, as well as the extent to which such perceived rapport is likely to increase both the likelihood of cooperation and the provision of actionable information.” (p. 107)

“Interviewers have […] defined rapport as a working relationship in which there is willful communication by the subject, trust between the interviewer and source, and mutual respect. When interviewers are asked about their current practices, they report using rapport and relationship-building tactics, and they perceive these methods as effective in eliciting cooperation and investigative information. […] From the subject’s perspective, rapport-based techniques are also judged as best practice. […] Finally, when observing actual interrogations, the use of rapport and relationship-building techniques has been associated with higher levels of cooperation, information disclosure, and admissions, whereas the use of conversational rapport elements drawn from motivational interviewing (e.g., showing empathy, allowing autonomy, providing a nonjudgmental context) has been associated with both the elicitation of critical information and the reduction of counterinterrogation strategies (e.g., suspect remaining silent, claiming lack of memory).” (p. 108)

“While there is considerable consensus that rapport is important for interviews and interrogations, only a handful of studies have, to date, experimentally manipulated rapport-based tactics in interviews involving reluctant interview subjects (modeling the interrogation context). […] In the [previous] studies, the primary outcome of interest was whether or not a participant confessed; however, given the current impetus toward information-gathering approaches, the effect of rapport on information yield has become of principal interest. […] In the current study, we build on manipulations of rapport that seek to evoke positive emotional responses and/or pleasant feelings toward the interviewer. We sought to increase rapport via the relationship between interviewer and subject and focused our efforts on modifying a subject’s sense of affiliation within the interview.” (p. 108)

“While people generally feel connected to others who are a part of the same social groups as they are (e.g., gender, nationality, sports team), research suggests that affiliation can be artificially created and exert a similar influence over behavior. […] In the interviewing literature, rapport tactics are often focused on relationship building with the subject. This is important because people are more likely to protect sensitive information that is obtained from those they are affiliated with and to disclose sensitive information to other individuals by whom they feel accepted. […] If the interviewer is able to successfully influence an individual’s perceptions of his or her affiliations (by strengthening an affiliation between the interviewer and the individual or by distancing the individual’s affiliation with others involved), this could increase rapport between the interviewer and the individual and affect the individual’s resistance to disclosing critical information.” (pp. 108–109)

“The current study focuses on the motivational factor and explores tactics by which a reluctant subject might be led to cooperate and disclose important information. Specifically, we posited that perceived rapport with the interrogator could be influenced by increasing the interviewer’s affiliation with the subject by highlighting similarities between the two and/or by decreasing the subject’s affiliation with a confederate (with whom he or she had engaged in an activity and witnessed cheating) by highlighting dissimilarities between the two. We predicted that these tactics would influence subjects’ perceptions of rapport with the interviewer and that perceived rapport would affect subjects’ decision to cooperate with the interviewer, leading to increased information disclosure.” (p. 109)

Participants included 116 undergraduate students who volunteered to participate in a study described as a test of general knowledge. The participants competed the study with a confederate.

“Before they began going through the items, to bolster the minimal group manipulation by inciting sympathy for the confederate, she introduced herself and asked the participant several questions (e.g., “What class are you doing this study for?”). She then described the difficult semester she had had (i.e., heavy work schedule, declining grades, and family problems). After this initial disclosure, the confederate apologized for burdening the participant with her troubles, and they then began the getting-to-know-you session.” (p. 110)

“Once they completed all getting-to-know-you questions, the participant and confederate collaborated on a general knowledge task (a series of 30 questions). […] Once the experimenter left the room, the confederate engaged in three instances of cheating. […] Once the general knowledge task was complete, the experimenter informed the pair that their answers would be reviewed and scored, and provided them with another filler questionnaire. Following a 2-min delay, the experimenter rushed into the room stating that there was a problem with the study and that he or she needed the confederate to come with him or her. The experimenter told the participant to wait because another experimenter would talk to him or her about the problem.” (p. 110)

“The interviewer then entered the room and informed the participant that his or her responses were almost all correct, despite the fact that most people only get approximately 60% of the questions right. The participant was told that this was a major problem and that the professor in charge might consider this a case of academic dishonesty.” (p. 110)

“In the control condition, the interviewer began questioning the participant directly by asking whether the participant had cheated, followed by an open-ended request for information […] In all other conditions, to seamlessly set up the specific manipulation(s), the interviewer attempted to build rapport with the participant by engaging in small talk (e.g., asking about major, interests, semester progress) immediately after introducing themselves.” (p. 110)

“In the approach condition, the interviewer highlighted similarities between themselves and the participant, stating that like the interviewer, the participant seemed like an honest and sincere person who prided themselves on being accountable for his or her actions. The interviewer then indicated that he or she viewed the participant as similar to themselves. […] In the avoid condition, the interviewer stated that the participant seemed like an honest and sincere person who prided themselves on being accountable for his or her actions as well. However, instead of likening themselves to the participant, the interviewer highlighted that these characteristics were in stark contrast with someone who would violate policy […] The approach + avoid condition combined both the approach and avoid manipulations; thus, the mention of the participant being an honest and sincere person was first likened to the interviewer’s actions and then repeated and contrasted with the confederate’s previous behavior.” (p. 110)

“Contrary to our predictions, only the approach technique—which involved attempts at increasing affiliation between the interviewer and the source—led to increased feelings of rapport for the interviewer. Further, only the approach technique indirectly facilitated cooperation via rapport, which in turn facilitated the elicitation of key admissions. In contrast, the avoid technique—which involved attempts at decreasing affiliation between the source and the target—led to fewer admissions of critical information.” (p. 112)

“Given that the avoid technique did not independently increase rapport between the participant and the interviewer, this limits the potential benefits of trying to break down the relationship between a subject and a target. Post hoc analyses suggested that the effectiveness of the avoid technique may have been influenced by participants’ perceptions of the confederate, such that those who felt more sympathy for the confederate were less likely to disclose information when the technique was used, providing insight into why the avoid technique did not function as predicted. These findings demonstrate the potential utility of creating a bond between the interviewer and source, while illustrating the danger of trying to undermine the relationship they have with a target.” (p. 112)

“Importantly, this was the first experimental study to explicitly test the link between rapport, cooperation, and information yield. The experimental nature of this study allowed us to separate participants’ perceptions of the interviewer, their decision to cooperate, and the objective amount of verifiable details they provided.” (p. 112)

Translating Research into Practice

“Although further research is necessary to provide a more detailed account of the process, the current findings suggest that interviewers’ time may be best served by seeking to increase affiliation between the subject and themselves, rather than attempting to diminish an existing affiliation between the source and the target— especially if the subject has a strong sympathetic connection with the target.” (p. 113)

“The present experiment also demonstrated the importance of successful rapport building for creating a cooperative mind-set. In the approach condition, perceptions of rapport facilitated a decision to cooperate with the interviewer and increased the amount of information provided. Hence, it is possible that rapport needs to be successfully built and linked with cooperation in order to yield information. Indeed, in the control condition, there was a significant indirect effect of rapport on information yield through cooperation.” (pp. 113–114)

“However, perceived rapport on its own was not sufficient to yield more information in our avoid condition: Interviewers were not able to build rapport with their subjects, and rapport was not tied to cooperation and did not increase information yield. Thus, it is possible that the avoid manipulation created reactance that made rapport more difficult to build and broke down the link between rapport and cooperation. This highlights the importance of fostering a cooperative mind-set through rapport in order to obtain a productive interview outcome. Finally, detailing this link is important because it clearly establishes the role of rapport within an investigative information-gathering interviewing framework. Whereas good questions increase information yield and accuracy of memory, rapport can help overcome resistance—a main concern for intelligence interviewers and law enforcement interrogators.” (p. 114)

“The present research demonstrated that rapport may be built strategically with particular barriers to cooperation in mind. Specifically, interviewers may listen for opportunities to utilize approach techniques in order to enhance rapport. If an individual mentions anything about themselves, then the interviewer may leverage that information to either increase similarity or find common ground (approach technique). Finally, these findings provide support for the idea that an interviewer should shy away from addressing a source’s connection with a target. Indeed, if an individual feels strongly connected to another target, then the interviewer should be mindful of that connection and not attempt to diminish the relationship. In conclusion, creating a relationship with a subject can be useful to overcome barriers to cooperation derived from concerns of affiliation, and importantly, interviewers should strive to develop a cooperative mind-set with their rapport-building attempts.” (p. 114)

Other Interesting Tidbits for Researchers and Clinicians

“Several limitations were present in the current study. First, the number of participants we had to exclude from analyses limits our findings. Several technical difficulties during data collection resulted in the loss of data. Further, as is typical when using the current paradigm, additional participants were lost due to suspicion of our procedures. […] Second, although we made efforts to ensure psychological realism for our participants, the current study is still a laboratory experiment, using interview scripts, which limits its applicability in the field and the recommendations we can provide practitioners based upon our findings.” (p. 113)

“Third, we designed a situation in which we held constant that the interviewer was not initially affiliated with the participant (as we assume this is most often the case at the outset of an interview) and created a relationship between the source and the target (again assuming that this represents the most likely scenario). While more typical than not, this may not always represent a given interview situation, and therein the current findings are limited to the context created in the present study.” (p. 113)

“Finally, our measurement of rapport was based on the interviewees’ perceptions of the interviewer. This was done to increase measurement validity and focus on the psychological mechanisms that lead to interviewees’ perceptions of rapport and their decision to cooperate with the interviewer. Thus, we chose to focus on the interviewees’ perspective of the interviewer rather than either a subjective impression of the interviewee by the interviewer or a more objective coding of the behavior of the interviewee during the interview.” (p. 113)

Join the Discussion

As always, please join the discussion below if you have thoughts or comments to add!

Authored by Kseniya Katsman

Kseniya Katsman is a Master’s student in Forensic Psychology program at John Jay College of Criminal Justice. Her interests include forensic application of dialectical behavior therapy, cultural competence in forensic assessment, and risk assessment, specifically suicide risk. She plans to continue her education and pursue a doctoral degree in clinical psychology.

Fairness, objectivity, and probability: Perceptions of defendant’s future risk of violence by jurors

When testifying regarding violence risk assessment, the experts are advised to present the information in multiple data formats, including comprehensive risk management plan in conjunction with objective estimates of future behavior, to avoid overestimation of risk by the jurors. This is the bottom line of a recently published article in Psychology, Public Policy, and Law. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | Psychology, Public Policy, and Law | 2019, Vol. 25, No. 2, 92–106

Communicating violence risk during testimony: Do different formats lead to different perceptions among jurors?

Authors

Ashley B. Batastini, University of Southern Mississippi
Michael J. Vitacco, Augusta University
Lauren C. Coaker, University of Southern Mississippi
Michael E. Lester, University of Southern Mississippi

Abstract

The legal system often charges forensic clinicians with the task of assisting the court in making decisions about a defendant’s risk for violence. The extent to which these evaluations are useful depends, in part, on how the results are communicated to and understood by the trier of fact. Using a sample of 155 participants who previously served as a criminal trial juror, this study examined the effects of various risk communication formats on participants’ perceptions of a hypothetical defendant’s risk level, including his likelihood of reoffense and risk category, as well as sentencing and release decisions. Results consistently showed that when risk data was not anchored by an absolute recidivism estimate, predictions of future violence were highest. That is, when risk was stated only as an ordinal category (medium risk) or only in terms of needed interventions, participants severely overestimated the defendant’s likelihood of violence. In the context of numerical data, the use of elaborative strategies (i.e., base rate examples and visual aids) did not impact risk perceptions. However, no between-groups differences were found across participants’ decisions regarding sentencing and community release. Overall, participants tended to adhere to the expert’s opinion when judging risk. Implications for best practices and future research are discussed, including the need for experts to simplify information during testimony and for risk researchers to work toward a better understanding of which strategies impact layperson perceptions of risk testimony and under what conditions.

Keywords

violence risk assessment, risk communication, actuarial, structured professional judgment, expert testimony

Summary of the Research

“Violence risk assessments are often relied on in contentious trials dealing with issues of life and liberty. […] The use of violence risk assessments in court has almost become routine; however, their usefulness depends in large part on how well the results are communicated by the expert and understood by the trier of fact (e.g., trial judges, jurors, and parole boards). Although violence risk assessments have become commonplace, the road to their acceptability was not linear or easy, and best practices for communicating their results to laypersons have not been clearly established within the field.” (p. 92)

“Barefoot v. Estelle (1983) is a United States Supreme Court case at the center of violence risk assessment, as it allowed for expert testimony on violence risk, not because mental health professionals are particularly good at making such decisions, but simply because if jurors with no specialized training are required to make decisions regarding dangerousness, so too can mental health professionals. […] Conversely, the argument against the use of opinions based on clinical judgment alone in the context of violence risk assessment was grounded in inaccurate predictions that led nonviolent individuals to be classified as likely violent. […] The field of psychology has made concerted efforts to move away from relying on clinical judgment exclusively when making predictions about future violence.” (p. 93)

“In the last 25 years, substantial progress has been made in the development of risk assessment instruments designed to predict violence risk. Specifically, assessments based on actuarial and structured professional judgment (SPJ) approaches predominate the prediction of violence risk in both clinical and forensic settings.” (p. 93)

“The most widely accepted methods of communicating risk findings include: (a) numerical estimates, (b) rank-ordered categories or “bins,” and/or (c) risk needs/management. Actuarial (or statistical) prediction methods mechanically quantify empirically determined factors, often through meta-analysis, that are highly correlated with some criterion behavior like violence recidivism. Factors predictive of violence can be static (e.g., victim type, perpetrator’s gender and age, and relation to victim) or dynamic (e.g., criminal associates, unproductive leisure time, and poor problem-solving skills) in nature. An examinees’ numerical score on these assessments is then compared with offenders with similar scores in the normed sample. Actuarial scales yield numerical probability estimates that may or may not be accompanied by a categorical interpretation, whereby an offender is described as falling into one of several risk bins (e.g., low, medium, and high).” (p. 93)

“Actuarial measures provide several ways of communicating numerical data derived from the calculation of risk factors, including comparative recidivism estimates, percentile ranks, or risk ratios Categorical estimates are also reported with SPJ tools like the HCR-20, which are based on the presence (or absence) of empirically relevant risk factors, but do not yield a numerical estimate. Recommendations for risk management—interventions that target dynamic risk factors and are intended to reduce future risk—are also commonly included when reporting both actuarial and SPJ tools, though SPJ tools typically offer a more structured approach to identifying management strategies than actuarial tools.” (p. 93)

“Some evidence suggests that the format in which data is presented makes a difference in cases involving the prediction of general an d sexual violence. […] As risk assessment tools become more advanced and complex, forensic clinicians may experience greater difficulty conveying their message in a manner that is easily understood by laypersons. Yet, the ability for jurors and judges to fully comprehend, appreciate, and incorporate expert testimony, including the science behind risk assessment tools, into their decisions is crucial for producing an outcome that is fair and impartial.” (p. 93)

“Because of their complexity, laypersons appear to have difficulty interpreting numerical prediction formats such as likelihood ratios, frequencies, or percentages (absolute recidivism rates) that often accompany violence risk testimony when an expert relied on actuarial scales for the basis of an expert’s opinion. […] Because of the challenges associated with probabilistic methods (perhaps especially absolute recidivism estimates), use of categorical bins seems to be the most preferred among both forensic clinicians and triers of fact. A primary reason cited by evaluators for their tendency to avoid probabilistic estimates was a belief that research did not support the predictive validity of specific numbers, and that describing predictions of violence with such apparent precision may mislead the triers of fact.” (p. 94)

“Still, some have argued that the use of categorical rankings alone generates more arbitrary and, thus, potentially inaccurate, conclusions about risk if not anchored numerically. […] While some mixed evidence exists regarding the usefulness of categorical communication formats, research generally supports the accuracy of numerical data in predicting future risk with a reasonable degree of scientific certainty. But, the reluctance of clinicians to use it, and the difficulty of properly explaining the underlying science of actuarial prediction models to laypersons poses a dilemma: how can violence risk evaluators communicate accurate predictions of risk in a way that is most optimally understood by the people who need to hear it?” (p. 94)

“In an effort to better understand the nuances of risk communication and the strategies that may help, the present study has two primary aims: (a) to investigate potential differences in legal decision-making across common modes of risk communication (including combined methods), and (b) further explore the use of additive strategies such as base rate examples and visual aids to enhance understanding of numerical data. In this study, we focus on numerical risk presented as an absolute probability of reoffending. This study is not about the accuracy of risk assessment tools; it is about the consequences of different expert communication methods on the perceptions of a largely layperson audience.” (p. 95)

“Participants in this study were at least 18 years old, spoke fluent English, self-reported previous experience serving as a juror on at least one criminal court case, and responded correctly to several validity questions assessing attentiveness. […] The final sample included a total of 64 male (41%) and 91 female (58.3%) respondents (N = 155). Participants varied in age from 23 to 79 (M = 51.0, SD = 16.2) with an average of 14.7 (SD = 2.4) years of education. Over 85% identified as White (n = 134; 86.5%); African American (n = 7; 4.5%), Asian American (n = 6; 3.8%), Pacific Islander (n = 1; 0.6%), and Other (n = 7; 4.5%) populations were also represented. Unfortunately, the underrepresentation of minorities in this sample is similar to that of actual juries.” (p. 95)

“[Participants] were randomly assigned to one of six study conditions varying according to the type of risk information that was provided: 1. Risk management (Management); 2. Numerical without base rate elaboration (Numerical); 3. Numerical with base rate elaboration (NumericalBR); 4. Categorical risk (Categorical); 5. Hybrid without base rate elaboration (Categorical + Numerical+ Management; Hybrid); 6. Hybrid with base rate elaboration (Categorical + Numerical + Management + Base Rate; HybridBR). Regardless of assigned condition, participants were then instructed to listen to a recorded excerpt of a violence risk evaluation written by a licensed psychologist with more than 15 years of experience in the field of forensic mental health. A typed version of the excerpt was also included. […] Following the defendant’s background information, participants were instructed to listen to the expert’s testimony and were again provided a transcript to follow along. Testimony was based on results from the Violence Risk Appraisal Guide. […] Following the introduction to the VRAG, participants heard [defendant’s] risk assessment results respective to the condition they were assigned. ” (p. 96)

“In considering decision-making, several findings from this study are especially pertinent. A consistent pattern emerged showing that risk management (or action-oriented) information and a categorical representation of risk presented in isolation (without absolute recidivism risk) was related to higher ratings of risk. This finding held when respondents were asked to report their estimates for violence within 7- and 10-years and to rank risk as a category. Furthermore, management and categorical formats led to higher ratings of risk even when crime types were considered separately across general and sexually violent behavior.” (p. 101)

“Of interest to the authors, however, risk communication format did not appear to impact participants’ ratings of risk when they were asked to predict the defendant’s likelihood of violence outside the expert’s specified time constraints. From this result, it could be inferred that, even in the context of numerical presentations, jurors will significantly overestimate a defendant’s risk if the task is to predict violence over an indefinite period of time—or perhaps any period of time that does not correspond to the timeframes used by the expert in testimony. In other words, without expert guidance, jurors seemed lost on how to determine risk and erred on the side of caution.” (p. 102)

“Results of the present study failed to support any real benefit of using a bar chart and a medical-based example in the context of absolute recidivism risk. To be clear—all three conditions included a very basic discussion about the risk of violent reoffending for the general population, so we nonetheless maintain that at least a mention of the base rate for violent offending is required. Yet, that seems simple enough, as jurors generated congruent ratings of risk regardless of the added strategies.” (p. 102)

“When considering some additional descriptive data and secondary analyses, the results from the current study indicate a general concordance between expert testimony and juror perceptions of risk. In other words, jurors tended to act in accordance with the information provided by the expert. […] Attitudes toward the offender, the seriousness of the offense, or inattention could impact the extent to which jurors adhere to expert testimony. Despite this, clear evidence of base rate neglect was not found. In addition to largely sticking with the expert’s predictions about the likelihood of future violence, participants also generally adhered to the instructed VRAG parameters.” (p. 102)

“While others have begun exploring best practices in violence risk communication, none to our knowledge have compared the most common risk communication formats while also testing several elaborative strategies to improve juror understanding of risk. […] our results suggest that (a) management and categorical formats, absent of any actuarial data, tend to produce higher estimates of risk, (b) using visual aids to contextualize base rates appears unnecessary for understanding actuarial data, and (c) in an overall general sense, laypersons follow expert testimony regarding estimates of risk but other factors (e.g., crime severity) may have a greater influence on their legal decisions.” (p. 104)

“The one message that remains clear is the need to continue investigating various risk communication techniques across multiple settings with multiple types of defendants, crimes, and triers of fact. Given the myriad of factors that could complicate the decision-making process, it may be impractical to strive for a set of guidelines that guarantee forensic clinicians’ messages will be adequately heard by laypersons; however, it seems well within reason to work as a field toward a clearer understanding of what helps and under what circumstances.” (p. 104)

Translating Research into Practice

“Findings from the present study suggest that risk management data, when presented in isolation, leads to more severe overestimations of risk. Yet, the presentation of risk management recommendations is frequently of value to the court who are often concerned that appropriate safeguards are in place to prevent violence and reduce the likelihood of recidivism.” (p. 103)

“More important, results of this study showed that risk management data was not associated with overestimates of risk when combined with numerical and categorical data. […] Risk estimates presented in conjunction with management recommendations based on R-N-R [Risk-Need-Responsivity] would be important to share with triers of fact before making determinations regarding initial placement or release. To ensure triers of fact receive the most useful and accurate information, clinicians are advised to testify about risk using multiple data formats; that is, including a comprehensive risk management plan in conjunction with more objective estimates of future behavior.” (p. 103)

“A more challenging aspect of expert testimony stems from results suggesting that laypersons generally adhere to the testimony provided by the expert but may still make decisions based on other information or biases that override the actuarial information provided by the expert. […] We suggest that experts explicitly provide information to the court or retaining party (to allow for such testimony to take place) regarding how the index offense contributed to their overall judgment of violence risk. The goal of risk assessment testimony should be to provide clear and accurate information to fully inform the decision-making process.” (p. 103)

“Finally, findings from this study are also relevant for consultants and attorneys when preparing cases. […] Attorneys and consultants who prepare clinicians for court can ensure clinicians gather and evaluate information that will enable the trier of fact to accurately understand the individual’s risk and any strategies available to reduce this risk. A concern borne from these data is that risk results could intentionally be used to misrepresent risk and bias the trier of fact. […] Even for those whose job it is to represent one side of the courtroom or the other, we believe there is a moral obligation to present risk data in a way that is both understandable and comprehensive enough to assist the court in rendering a just decision.” (p. 103)

Other Interesting Tidbits for Researchers and Clinicians

“Despite the strengths of this study, there are several limitations that warrant consideration. First, the sample was predominantly European American with an African American defendant. While secondary analyses suggested that participants’ race did not significantly impact the observed outcomes, this analysis was weakened by the creation of a dichotomous variable. […] Second, the high-stakes nature of the crime may have led to some of the null effects observed regarding sentencing and comfort with release. It is important to consider how jurors may perceive violence risk in other contexts and various criminal behaviors. […] Third, the risk assessment information presented in the current study may not generalize to actual courtroom testimony. Several procedural factors (e.g., jury deliberation, opposing expert findings) were not incorporated using this experimental design. Likewise, jurors were only exposed to an audio recording of the expert’s testimony.” (pp. 103–104)

“Fourth, future studies should consider altering how risk data is presented and how population base rates are phrased, as well as the types of graphical or illustrative examples used to aid understanding. […] Finally, while using a sample of former jurors from criminal trials was purposeful to better understand layperson perceptions in a courtroom setting, judges are perhaps more often the receivers of risk data in making decisions about sentencing or commitment. […] It is […] important to continue exploring differences among judges and other decision-makers (e.g., parole/probation boards, hospital administrators) who are routinely presented with the results of violence risk assessments.” (p. 104)

Join the Discussion

As always, please join the discussion below if you have thoughts or comments to add!

Authored by Kseniya Katsman

Kseniya Katsman is a Master’s student in Forensic Psychology program at John Jay College of Criminal Justice. Her interests include forensic application of dialectical behavior therapy, cultural competence in forensic assessment, and risk assessment, specifically suicide risk. She plans to continue her education and pursue a doctoral degree in clinical psychology.

A Subpopulation Within a Subpopulation: Working with Women in Forensic Settings

Women’s pathways into and experiences in forensic settings differ from men’s, as they frequently share histories characterized by complex trauma and attachment disturbances. Thus, effective engagement with women requires gender-sensitive techniques, both in assessment and treatment. Some of the challenges that evaluators may face when working with this population include suspiciousness of authority figures and the indirect expression of distress through behavioral disturbances. This article discusses effective techniques for establishing rapport with and eliciting trust and cooperation from women in forensic settings. This is the bottom line of a recently published article in The International Journal of Forensic Mental Health. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | International Journal of Forensic Mental Health | 2019, Vol. 18, No. 1, 21-34

Engaging Women in Forensic Clinical Interviews: The Impact of Gender

Authors

Anna Motz, Oxford Health NHS Foundation Trust, Family Assessment and Safeguarding Service, Oxford, UK

Abstract

Women’s pathways into forensic settings differ from men’s. In particular, women in forensic settings, whether in prison, hospital, or the community frequently share histories of multiple trauma and attachment disturbances, often leading to profound difficulties in relating to others, despite a wish to do so. Consequently, effective engagement with such women requires gender-sensitive techniques, both in assessment and treatment. They are likely to view authority figures with suspicion and to be wary of engaging in a clinical interview whether for risk assessment, evaluation for a court report or another psychological issue, including treatment viability. They may have told their stories countless times before, and yet feel that they have never been heard, or seen. Communication is often indirect, rather than verbal, as the women may express their distress through behavioral disturbance including severe self-harm, aggression, and verbal assaults. This can challenge and confuse practitioners, and may also disguise a wish for care and emotional contact. This article explores the question of how to elicit trust and cooperation within the clinical interview and identify effective techniques for establishing therapeutic rapport. It focuses both on the experience of the clinicians, including their countertransference feelings, and the experience of the women being interviewed.

Keywords

Countertransference, Communication, Engagement, Gender-Sensitive, Trauma

Summary of the Research

“It is clear that the assessment and treatment of women, both in the criminal justice and the forensic mental health systems, has all too often been either gender-blind or gender-biased, and that this has created services in which women’s traumatic histories, risk profiles, and psychological needs can be overlooked…In addition, the perception of female dangerousness may be heightened by the vilification of women who commit violent crimes, as these offenses are unusual – most crimes committed by women are nonviolent…Alongside the development of gender-sensitive assessment measures…it is important to attend to particular process issues in the effective clinical interviewing of females within forensic settings” (p.21-22).

“Alongside higher rates of personality disorder compared to the general population, the women in forensic settings frequently share histories of multiple trauma and attachment disturbances, creating profound difficulties in relating to others, despite a wish to do so. The rates of adverse childhood experiences are high in this population…As the women seen within these settings have often had multiple experiences of betrayal and misunderstanding by those in authority, starting with their parents, or carers, they are likely to be wary of engaging in a clinical interview…The women’s feelings toward early carers can be transferred onto interviewing clinicians, with powerful results; sensitive interviewers can anticipate and modify this…When interviewing women in these settings it will be important to address those areas that link directly to their offending and which distinguish them most significantly from male offenders, particularly their histories of trauma, mental health, and substance misuse” (p.22-23).

Translating Research into Practice

“It will be essential to be clear that the remit of the interview is not to offer therapeutic intervention oneself, but that it would be possible to direct her to a therapist thereafter, so that any details she wants to keep confidential should not be disclosed. Although she may hear this and understand it rationally, it is inevitable that the interview will generate a degree of emotional engagement with you, and transference feelings, so it is essential to proceed with sensitivity and care. While this is not therapy per se, the disclosure of intimate details to a female interviewer eliciting trust will invite some transference and it is crucial that [the client] not be left feeling exposed and unprotected, so you will need to keep her defenses intact. This means checking how she is feeling at regular points in the interview, reminding her of the limits of your role, and that you will be considering with her whether future work of a therapeutic interview is indicated, and if she wants to engage” (p.30).

“It is ethically and professionally essential to inform the woman at the outset that there are strict limits on confidentiality in the interview, as its purpose is to prepare a report for the Court, or to advise the multidisciplinary team about therapeutic and risk considerations. If she has not been made aware of the limits of confidentiality and the report or its findings are subsequently shared, she may, understandably, feel betrayed, and angry. She should always be asked if she gives consent to be evaluated, and, where possible, written indication of consent obtained” (p.32).

“…While asking questions and inviting discussion, you should also observe non-verbal behavior closely. Any points of heightened arousal or disturbance in the interview itself, including tears, expressions of anger, or attempts to leave the room can be seen as cues to slow down the interview process, pause, and then return to explore what happened just at the point where the arousal level increased. This may be the woman’s unconscious attempt to stop the interview, but if you are skilled and aware of this, you can see it as a useful piece of data, and explore it…When interviewing women with whom one has a strong identification, for example, someone close to one’s own age, or with a similar background, it is essential to maintain a professional stance, use supervision to consider the possibility of enactments and ensure appropriate boundaries are maintained” (p.32).

“There may be some sensitive cultural issues with some BAME (Black, Asian, Minority Ethnic) women, including their fear of being viewed primarily through the lens of race and seen as ‘other’ dangerous, and alien. Some BAME women with previous experience of harsh treatment by those in authority may expect that this will recur in the interview and this can impact on engagement. It is particularly important for the interviewer to bear this in mind, and to allow time and space for therapeutic rapport to develop. If the interviewer is from a BAME background they may face prejudice from women they assess…and feel under attack. This can lead to powerful countertransference reactions and requires close supervision and self-reflection. When assessing a BAME woman for risk, care should be taken to reflect on one’s own, sometimes unconscious, prejudices, and assumptions” (p.32).

“Interviewing women who have committed sexual crimes will create particular challenges for practitioners; beware of…your own excitement as you ask for details that may not be necessary…It will help engagement if you bear in mind that victim and perpetrator often coexist in the same woman. As there is far less research available generally on female sex offenders than males, a rich clinical interview is essential to enable comprehensive formulation and risk assessment of a female perpetrator” (p.33).

“While women within forensic mental health settings present particular challenges for clinicians, with persistence, patience, and sensitivity, these can often be overcome…It is essential that the interviewer manages their intense countertransference responses to the women, bearing the coexistence of victim and perpetrator in mind to resist being drawn into either a punitive role or an overly sympathetic one…the interviewer has the difficult task of remaining still, thoughtful and empathic ‘in the eye of the storm’ to glean sensitive and rich information about the woman, and determine appropriate pathways for her within forensic mental health and criminal justice systems” (p.33).

Other Interesting Tidbits for Researchers and Clinicians

“…While it [effective clinical interviewing] is a means to achieving important clinical information it is also an important encounter in itself, and can offer the woman a valuable experience of containment. One must be mindful, however, that such an encounter, if helpful, can also awaken needs for further contact in a woman who is starved for such containment and understanding. A responsible practitioner should keep in mind that assessment might reveal the client’s receptivity and need for therapeutic work, and also alert her, and those around her, to the possibility that she might feel stirred up after the interview ends. Communication is often indirect, rather than verbal as the women may express their distress through behavioral disturbance including severe self-harm, aggression, and verbal assaults that challenges and confuses workers, disguising a wish for care and emotional contact” (p.23).

“It may be helpful for you to identify the specific way that the experience appears to have impacted on her and to reflect this back to her verbally at the end of the assessment rather than leaving her to read it in your report. A clear summary, delivered in person, can leave her with a sense of having been heard and understood…Offering her with a formulation of sorts can be helpful in containment, but should not be offered prematurely as this may interfere with how she presents herself in the situation, and could be seen as leading her in a particular direction” (p.30).

Join the Discussion

As always, please join the discussion below if you have thoughts or comments to add!

 

Authored by Amber Lin

Amber Lin was a volunteer in Dr. Zapf’s research lab at John Jay College of Criminal Justice. She graduated from New York University in 2013 with a B.A. (honors) and is a second year Masters student at Fairleigh Dickinson University. Her research interests include forensic assessment, competency to stand trial, and the refinement of instruments used to assess the psychological states of criminal defendants.

Helping or hurting: A review of the impact and effectiveness of mental health courts

Mental health courts continue to be the most important interventions for people with mental illness who come in contact with the criminal justice system – however, more precise and well-defined research is needed to understand the overall impact and effectiveness of these interventions. This is the bottom line of a recently published article in Psychology, Public Policy, and Law. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | Psychology, Public Policy, and Law | 2019, Vol. 25, No. 2, 73–91

Bridging mental health and criminal justice systems: A systematic review of the impact of mental health courts on individuals and communities

Authors

Kelli Canada, University of Missouri
Stacey Barrenger, New York University
Bradley Ray, Indiana University Purdue University at Indianapolis

Abstract

Existing reviews of mental health courts summarize the effectiveness of these programs without consideration of the component parts of the mental health court and who the court serves. This systematic review addresses this gap by using specific criteria for what constitutes a mental health court and presents results based on the charge type for the target population. Only experimental or quasi-experimental research designs are included in this review. Studies included involved mental health courts containing essential elements and included measures of recidivism or other mental health and quality of life-related outcomes. Twenty-nine articles were reviewed. Research on mental health courts primarily originated in the Unites States, covering 14 states. Findings are synthesized by whether the courts served people with felony, misdemeanor, or combination charges. These findings inform the need for national or international standards or clear guidelines for what components or elements define a mental health court. State-level policy is also needed to encourage the systematic collection of data on mental health courts to inform who mental health courts work for in specific communities. These data can also be used to inform local mental health court policy decisions.

Keywords

systematic review, mental health courts, essential elements

Summary of the Research

“People with mental illnesses are overrepresented in the criminal justice system. Interaction with the criminal justice system puts people at risk for exacerbation of mental and physical health symptoms. Once arrested and incarcerated, persons with mental illnesses are more likely to be unable to post bail and wait longer for adjudication of cases; and, once convicted, they are more likely to serve their entire sentence rather than qualifying for early release. In an attempt to ameliorate these disparities associated with incarceration, municipalities have focused efforts on diverting individuals away from jail or prison through the use of alternative to incarceration programs. While these diversion programs can take many forms, one of the most utilized is the mental health court (MHC).” (p. 73)

“MHCs are collaborative efforts between criminal justice, mental health, and substance use treatment systems. They are one part of an overall strategy to reduce the incarceration of persons with mental illnesses. MHCs differ from traditional courts in that they include a specialized docket for people with mental illnesses, voluntary diversion into the court, engagement in treatment as a condition of participation with the use of rewards and sanctions to facilitate compliance, and regular status hearings. […] In 2007, the Bureau of Justice Assistance (BJA), in collaboration with various stakeholders, recommended 10 essential elements of MHCs that include up-front collaborative planning and administration of courts, defining the target population, timely identification of participants and linkage to services, clear terms of participation with informed choice, adequate treatment supports and services that are grounded in evidence, the composition and functioning of the court team, monitoring and confidentiality, and sustainability (Thompson et al., 2007).” (p. 73)

“While some research shows reduced recidivism and a better connection to mental health services for MHC participants, at least one study shows an increase in criminal justice involvement related to increased monitoring. Research using quasi-experimental designs show participants in MHC, on average, recidivate less than they did before MHC and in comparison with matched samples.” (pp. 73–74)

“To date, however, existing reviews conflate varying MHC models as one single model. […] This is problematic because burgeoning evidence suggests the impact of MHC participation may vary by factors like charge status (i.e., misdemeanor or felony) and psychiatric diagnosis. Further, MHCs are not required to include the 10 essential elements to be called an MHC. Surveys of MHCs show great variability in what jurisdictions identify as an MHC. This is especially problematic in reviews that aim to formulate conclusions about the effectiveness of MHCs.” (p. 74)

“To further develop the knowledge base about the effectiveness of MHCs, it is important to compare similar MHCs to one another to discern the population of people best served by MHCs, a current deficit in the literature. This project addresses the current limitations in the review literature by conducting a comparative systematic review of MHCs as defined by Thompson and colleagues (2007), where findings are synthesized by charge type.” (p. 74)

The research questions was: “Is diversion to MHC effective in reducing recidivism, improving mental health, and increasing access to mental health services for adults with mental illnesses?” (p. 74)

The systematic review included studies about adults with mental illnesses who came into contact with the criminal justice system who underwent an intervention defined as an MHC according to Thompson and colleagues’ (2007) criteria (target population of people with mental illness, informed voluntary participation, provision of treatment and services, integration of criminal justice and mental health staff, ongoing and consistent monitoring).

The included comparisons in the research included randomized control trial compared with normal court processing with pre- and postmeasurement, randomized control trial compared with normal court processing with postmeasurement only, comparing MHC participants to a matched sample (e.g., a group of people eligible for MHC in a county without an MHC), comparing MHC participants to a matched sample of people who were eligible for the MHC but did not participate, nonrandomized comparison of MHC to normal court processing, and within group comparison of pre- and post-MHC participation.

The outcomes included criminal recidivism, as shown by new arrests, number of days to recidivism, and violations to probation, and mental health, as defined by symptom severity and quality of life, psychosocial factors, substance use, and access to and use of treatment and services. The present review included research involving MHCs outside of the United States.

“Over half of the articles identified conducted research on MHCs involving people with misdemeanor and felony charges. Within this body of work, results are generally promising for graduates of MHCs but for people who do not complete MHC, recidivism remains high. Research on felony only MHCs account for only a small portion of existing MHC studies. It is important to increase the research on these programs to further disentangle emergent research that MHCs may have a disparate impact on people by charge type. Across all studies in this systematic review, recidivism was the primary outcome on interest with fewer studies assessing within or between group treatment use or mental health differences.” (p. 86)

“Complex interventions like MHCs are typically lumped together in research and treated as a single program or intervention. When the component parts of those programs and interventions are the same, data can be synthesized; however, when component parts vary across programs, it complicates the ability to compare across programs and to summarize findings. Further, when a program may actually work differentially for different subpopulations, it is important to attend to those subpopulations to ascertain who benefits from MHC and under what specific conditions.” (p. 87)

“When looking across subgroups, MHC graduates consistently fare better compared with noncompleters in misdemeanor only or mixed felony/misdemeanor MHCs. […] It is unclear from studies in this review why MHC noncompleters fail and if MHC is the most effective way to engage this subpopulation.” (pp. 87–88)

“Findings from this review also highlights the need for additional, rigorous research on MHCs, especially felony MHCs. According to the Council of State Governments (2019), there are over 300 MHCs in the United States. This review identified four studies of felony MHCs, and across all charge types, only 14 states were represented. Many other MHCs exist in the United States and across the world; research and evaluation is needed to better understand the impact of these programs.” (p. 88)

“MHCs continue to be one of the more prominent interventions for diverting people with mental illnesses from serving time in prison. Despite the wide-spread implementation, important research is needed to determine who is best served by MHCs. This review is just one step in this process. Synthesizing outcome data by charge type helped to illuminate the need for further outcome research on felony MHCs and to highlight the mixed findings in misdemeanor only MHCs. The difficulty in randomizing MHC participants and the lack of a cohesive MHC model has presented broad methodological challenges to the study of these programs. Currently, the essential elements outlined by the BJA offer the best guidance of what critical and necessary elements of the MHC model might be. As such, accurate and consistent reporting on these essential elements, as well as rigorous quasi-experimental research designs, are crucial to understand the overall impact and effectiveness of MHCs in accomplishing the primary goals of reduced recidivism and improved mental health outcomes. Above all, people with mental illness and treatment needs are best served in the community. Continuing to hone criminal justice practice and policy to divert this population successfully is critical to the welfare of people and communities and there should be an attempt to develop a range of programs across the criminal justice systems that vary in intensity.” (p. 89)

Translating Research into Practice

“MHCs are examples of complex interventions. Although BJA and stakeholders identified 10 essential elements that define MHCs, additional exploration is needed from practitioners, researchers, and participants to identify the benefits and limitations to creating more structure around what constitutes an MHC. To this end, research is needed to examine and explore the utility of the essential elements and whether they individually or collectively contribute to participant outcomes. […] To assist in this process, authors should note whether MHCs under study include the essential elements, and if not, identify what elements are missing in addition to providing rich details regarding MHC policies on selection and admissions, services offered, and if guilty pleas are required, to name a few.” (p. 88)

“Since their inception, MHCs have been taking on more serious offenses, as many courts now accept felony defendants. The findings from this study suggest that this may be a positive trend, as MHC defendants with a felony are at no greater risk of recidivism, but also that felony MHCs experience the greatest success in outcomes. These results also echo the suggestion that MHCs might avoid accepting low-level misdemeanor offenders. In terms of the Risk-Need-Responsivity (RNR) principles, which suggest offenders should be matched to an intervention based on their recidivism risk level, it is important to consider that MHCs are generally an intervention that entails a high level of supervision over a long period of time. Thus, defendants with minor offenses under MHC supervision might not only be a potential waste of resources, but might also lead to iatrogenic effects whereby outcomes are worsened.” (p. 88)

“Moreover, offense type is only one of many ways that researchers might consider contextualizing the extant literature on MHCs to examine differences and future research should explore other court factors within this literature. Once the core components and mechanisms that collectively define an MHC and best practices are identified and known to be effective at keeping individuals out of jails and prisons, national standards to guide MHC development and sustainability can be established. Likewise, through dissemination and implementation science, researchers can also aim to develop instruments or checklists that measure key components of the MHC to better assess fidelity to the model and develop effective practices. MHC administrations can use data to make policy and programmatic decisions, which is especially important when resources are scarce. While local conditions and context should be taken into account when developing MHCs, municipalities should also have some confidence around which elements are essential and which ones can be changed to take into account local resources.” (p. 88)

“Further exploration is needed regarding who benefits from MHC participation. […] State-level policies should include requirements for MHCs to collect data on the impact of the program, including data on index charge, demographics, completion status, and at minimum, 12 months of rearrest data. […] Using data to drive both policy and programming decisions will help counties make informed and evidence-based decisions on what they need to reduce the contact people with mental illnesses have with the criminal justice system.” (pp. 88–89)

“State-level data can also inform the costs and benefits to establishing or expanding MHCs. The resources available across communities varies, and because MHCs rely heavily on community mental health services, knowing who benefits most from MHCs and what cost MHC participation has on various systems is needed to determine if more people could be served by MHCs and if MHC policies require modification to ensure the program is working in the way it was intended. […] Requiring MHCs to collect and report on basic demographic and recidivism data would allow for routine cost-benefit analyses.” (p. 89)

“Finally, it is well established that randomization to MHC is a methodological challenge. Conducting applied research on programs in the criminal justice system can be especially difficult. However, caution is needed when interpreting findings from research with comparison groups. Some of the strategies used in the MHC research in this review are inherently flawed. When groups are systematically different from the start, comparing outcomes lacks significant meaning. Studies utilizing comparison groups involving people who were eligible for MHC but were not referred or selected or who opted out, jeopardize internal validity because of selection bias. Despite efforts to use post hoc strategies to match or control, it is possible that groups differ in a more meaningful way than demographics, clinical variable, or criminal histories. Despite these challenges and uncertainties, it is well known that people with mental illnesses fare far worse when sentenced to prison. Diversion from prison is not only healthier to the individual but also their family members and community.” (p. 89)

Other Interesting Tidbits for Researchers and Clinicians

“Identifying whether an MHC included the essential elements was imperfect; as such, it is possible that MHCs including the essential elements were unfairly omitted from this review and likewise that authors stated a court adhered to these elements without fully knowing. However, authors did their due diligence in determining appropriate inclusion. […] In addition, using the essential elements to define the bounds of an MHC may have created too narrow a pool of MHC studies. Like any systematic review, this study was also limited in the types of outcomes examined in the extant literature. To this end, many of the studies focused on recidivism with fewer looking at mental health outcomes. There was inconsistency in how these outcomes were measured, making data synthesis for these mental health outcomes more challenging. Finally, emergent research on variation in outcomes by charge type was used to guide this review. It is possible that other key elements like requiring a guilty plea are just as important to consider when synthesizing findings.” (p. 89)

Join the Discussion

As always, please join the discussion below if you have thoughts or comments to add!

 

Authored by Kseniya Katsman

Kseniya Katsman is a Master’s student in Forensic Psychology program at John Jay College of Criminal Justice. Her interests include forensic application of dialectical behavior therapy, cultural competence in forensic assessment, and risk assessment, specifically suicide risk. She plans to continue her education and pursue a doctoral degree in clinical psychology.

Concerns regarding the potential negative effects of the psychopathy “label” on punishment outcomes may not be deserved

Significant effects on punishment outcomes may be attributable to the general impact of any mental disorder diagnosis, rather than psychopathy specifically. This is the bottom line of a recently published article in Law and Human Behavior. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | Law and Human Behavior | 2019, Vol. 43, No. 1, 9-25

The Psychopathic “Label” and Effects on Punishment Outcomes: A Meta-Analysis

Authors

Colleen M. Berryessa, Rutgers University
Barclay Wohlstetter, Bucknell University (L3)

Abstract

The current study, using a meta-analytic approach and moderation analysis, examines 22 studies reporting how psychopathic “labeling” influences perceptions on 3 punishment outcomes (dangerousness, treatment amenability, and legal sentence/sanction) for 2 types of experimental studies utilizing vignettes: (a) studies in which a defendant with a psychopathic “label” is compared to a defendant with no mental health diagnosis (psychopathic label vs. no label) and (b) studies in which a defendant with a psychopathic “label” is compared to a defendant with a different psychiatric diagnosis (psychopathic label vs. other psychiatric label). Results show statistically significant or marginally significant (p < .10) summary effect sizes, albeit of different strengths, for the three punishment outcomes studied (legal sentence/sanction: d = 0.17; dangerousness: d = 0.58; and treatment amenability: d= 0.30) for studies comparing a psychopathic label versus no label. Conversely, all summary effects sizes for the three punishment outcomes in studies comparing a psychopathic label versus other psychiatric label were both weak and nonsignificant (legal sentence/sanction: d _ 0.09; dangerousness: d _ 0.14; and treatment amenability: d = 0.02). This suggests a significant general labeling effect, but not a specific labeling effect, for psychopathy in these studies. Further, these results suggest that the lay public, but not those in the criminal justice system, may subscribe to both general and specific labeling effects for psychopathy when it comes to punishment. This has potential implications for jury sentencing in both capital and, in select states, noncapital cases.

Keywords

psychopathy, label, meta-analysis, stigma, punishment

Summary of the Research

“The current study, using a meta-analytic approach, examines how psychopathic ‘labeling’ effects influence the perceptions of punishment in three areas: dangerousness, treatment amenability, and legal sentence/sanction. For each of these outcomes, studies involving two different scenarios were examined: (a) a defendant with a psychopathic ‘label’ compared to a defendant with no mental health diagnosis, which are studies said to represent a general labeling effect (psychopathic label vs. no label) and (b) a defendant with a psychopathic ‘label’ versus a defendant with a different psychiatric diagnosis, which are studies said to represent a specific labeling effect (psychopathic label vs. other psychiatric label).” (p. 12).

“Results show two statistically significant summary effect sizes, albeit of different strengths, for two of the punishment outcomes studied (legal sentence/sanction and dangerousness) for studies comparing an offender with a psychopathic label versus an offender with no label… Across studies, the psychopathic label did lead to significantly more support for punitive legal sanctions and reduced views regarding an offender’s potential for treatment, compared to an unlabeled offender; this not only supports literature that the psychopathic label may prompt more aggravated punishments based on stigma, but also that the psychopathic label may perpetuate views on lack of treatability. However, these effect sizes were weak; this may suggest that concerns related to how the stigma associated with psychopathy may lead to unjustly punitive outcomes for offenders, particularly related to less options for treatment, are substantiated as the label could significantly influence views, but may ultimately not result in extensive effects to perceptions of legal sanctions and treatment amenability of labeled offenders” (p. 19).

“The effect size for treatment amenability in studies comparing an offender with a psychopathic label versus an offender with no label, however, did have some interesting moderators. Particularly, the fact that an offender was a juvenile in the vignette moderated the relationship between the psychopathic label and potential for treatment amenability, while the effect was not significant for when the offender was an adult. Thus, although the effect size was moderately small, juvenile offenders with the psychopathic label were viewed as significantly less treatable, while the same views for adult offenders with a psychopathic label were not statistically different from an offender without a label. This is interesting, as there are many long-standing concerns about the negative effects of applying the psychopathy construct to youth… [L]abeling juvenile offenders with psychopathy, as well as callous and unemotional traits, may potentially prevent access to treatment opportunities that could have a tangible effect on curbing recidivism and antisocial behavior”(p. 19).

“However, sample type also moderated results related to treatability; the effect size for clinicians was both significant and moderately strong, compared to criminal justice actors, lay public and students, and students which were nonsignificant (except for lay public). Thus, clinicians more strongly viewed offenders with a psychopathic label as less amenable to treatment, compared to the other sample types. As clinicians would likely be the sample type with the most experience regarding whether or not individuals with psychopathy would be able to be successfully treated, this result suggests that the stereotype that persons with psychopathy are not amenable to rehabilitation may be warranted. It is also possible that this finding may represent clinician bias, or potentially, the fact that there still is little research on the treatment of psychopathy. Regardless, as psychopathy is an accepted clinical construct, this could potentially cause problems particularly for juvenile offenders with the psychopathic label and getting access to treatment” (p. 19).

“The effect size for dangerousness in studies comparing an offender with a psychopathic label versus an offender with no label was moderately strong. This result appears to be intuitive, as it would be unlikely that an individual with a psychopathic label would be viewed as less dangerous in comparison to someone without any label, given the stigma around psychopathy and dangerousness” (p. 20).

“Finally, the type of labeling effect moderated results for dangerousness; all but two studies either used a labeling effect (13 effect sizes) or both a labeling and criterion effect together (21 effect sizes). Interestingly, the label effect alone was significant but resulted in a small effect, whereas the use of both label and criterion effects resulted in an effect size over five times as large as the labeling effect alone. Previous literature has discussed that it is unclear whether the results of these studies reflect a labeling effect or a criterion effect. These results suggest that the combination of both label and criterion effects substantially influences outcomes related to dangerousness in studies comparing an offender with a psychopathic label versus an offender with no label; as use of the label alone produced only a small effect and much weaker than when the label and criterion effects were presented together, these data appear to show how impactful including the characteristics of psychopathy, along with the label, may be on perceptions of dangerousness” (p. 20).

“Conversely, summary effects sizes for the three punishment outcomes in studies comparing an offender with a psychopathic label versus an offender with another psychiatric label were both weak and nonsignificant. The effect sizes for legal sentence/sanction and treatment amenability were close to zero” (p. 20).

“The diagnostic label also moderated the results for the legal sentence/sanction outcome; principally, only the effect size for psychotic disorder was significant, and those for conduct disorder, antisocial personality disorders, and paraphilic disorder were all essentially zero. This suggests, at least related to the rendering of a legal sentence/sanction, that an offender with a psychopathic label is not viewed as significantly different from an offender labeled with conduct disorder, antisocial personality disorders, or paraphilic disorder. Conduct disorder, antisocial personality disorders, and paraphilic disorder all have been traditionally associated with negative stigmata, such as dangerousness, lack of treatability, and punitive judgments similar to psychopathy. Psychosis, on the other hand, has been associated with reduced perceptions of responsibility and punitiveness due to beliefs that diagnosed individuals are less culpable for their behavior because they may have ‘broken from reality’ when offending. This might help to explain why participants appeared to render more punitive legal sentences/sanctions toward an offender with a psychopathic label compared to being labeled with psychotic disorder” (p. 20).

“The effect size for dangerousness in studies comparing an offender with a psychopathic label versus an offender with another psychiatric label was moderated by age of the offender in the vignette, psychiatric label used in the vignette, the type of labeling effect used for psychopathy, and how a study included the psychopathic label” (p. 20-21).

“Most perplexing however, related to other psychiatric labels used in the vignette, was that the only significant effect was for antisocial personality disorders; this means that offenders with psychopathic labels were viewed as significantly more dangerous than offenders with antisocial personality disorders, but not more significantly dangerous than offenders with conduct disorder or psychotic disorder. This appears to indicate that psychopathy is not viewed alone and apart from at least some other mental disorders (at least psychotic disorder and conduct disorder) as more indicative of dangerousness” (p. 21).

“Finally, type of labeling effect moderated results; unlike the effect size for dangerousness in studies comparing an offender with a psychopathic label versus an offender with no label, whether the label effect alone was used in the study was significant, whereas when both label and criterion effects were used, the effect size was nonsignificant and close to zero. As discussed below, this may suggest that certain types of labeling are only effective for certain types of studies involving punishment outcomes and the use of the psychopathic label” (p. 21).

Translating Research into Practice

“These results appear to suggest that significant effects on punishment outcomes may be attributable to the general impact of any mental disorder diagnosis, rather than psychopathy specifically. This indicates that concerns about the potential negative effects of the psychopathy label on punishment outcomes may not be deserved for the psychopathy labeling particularly, but mental health diagnoses generally. However, although this is an interesting finding, it is important to point out that in real-life contexts in the courtroom, whether the bias is due to the psychopathic label or another label both still may produce negative outcomes on punishment. Therefore, regarding the ecological validity of this result, this finding does not necessarily affect whether or not negative views toward punishment occurs in cases involving psychopathic labeling but may elucidate why such negative views are elicited” (p. 21).

“Second, although sample or participant type did moderate several effect sizes, the summary effect sizes for criminal justice actors were not significant except for dangerousness in studies comparing an offender with a psychopathic label versus an offender with no label, which was also significant for most sample types studied. This is interesting, as there have been fears that psychopathic labeling and stigma may result in unjustly punitive outcomes in other practices in criminal justice related to punishment, such as probation and sexually violent predator hearings. Psychopathy assessments have been increasingly used within the criminal justice system to inform decisions in court apart from sentencing, particularly by judges and probation officers. These results suggest that the psychopathic label may not affect the perceptions of criminal justice actors regarding punishment as negatively as previously thought, and therefore in practice, it is possible that such labeling may not result in unjustly punitive outcomes for offenders due to the psychopathic label in criminal justice contexts related to punishment. However, recent research has found that the influence of psychopathy on judicial ‘restrictiveness’ in juvenile contexts may function through the perceived dangerousness of the offender. Therefore, although labeling might not indeed affect the perceptions of criminal justice actors as negatively as previously though, the fact that the dangerousness summary effect size for criminal justice actors was significant might have implications for the rendering of legal sanctions” (p. 21).

“Third, the summary effect sizes for the lay public were significant across all punishment outcomes, even for those of which did not have significant summary effect sizes. The one exception was dangerousness in studies comparing an offender with a psychopathic label versus an offender with no label. Although it is unclear on why this exception exists, the fact that the effect sizes for the lay public subgroups were almost entirely significant, even for the outcomes that did not have significant summary effect sizes, suggests that the lay public does indeed subscribe to both general and specific labeling effects for psychopathy when it comes to punishment. This has potential implications for jury sentencing in both capital and, in select states, noncapital cases; as previous literature has cautioned that misconceptions and stigma against psychopathy related to dangerousness, lack of treatment amenability, and violence, may prompt jurors to have a perverted view on what psychopathy actually is and whether it represents an aggravating factor for punishment, this meta-analysis suggests that such concerns on the potential punitiveness of jurors due to the psychopathic label may be justified, and that the potential prejudicial impact of such evidence on psychopathy might indeed potentially outweigh its probative value” (p. 21-22).

“Finally, this meta-analysis may suggest that certain types of labeling effects are only effective for affecting perceptions of punishment outcomes in particular types of studies on psychopathy. Particularly, for dangerousness in studies using a design comparing an offender with a psychopathic label versus an offender with no label, a psychopathic label appeared to have a substantial effect on increasing perceptions of dangerousness only when paired with the characteristics or symptoms of psychopathy (label and criterion effects used together). Conversely, in studies using a design that compares an offender with a psychopathic label versus an offender with another psychiatric label, the impact of the psychopathic label appeared to only have a substantial effect in this area when the label effect alone was used. This suggests that in these psychopathy studies, the general labeling effect related to dangerousness may have the most impact when label and criterion effects are both used, whereas the specific labeling effect related to dangerousness has the most impact when a labeling effect is used alone. Particularly related to the specific labeling effect, this finding could be related to the fact that many personality disorders in the DSM, including antisocial personality disorder and conduct disorder, have similar diagnostic features to psychopathy, and thus, when both label and criterion effects are used, participants may recognize the similarities between disorders’ features and be less likely to view the disorders as significantly different as it relates to dangerousness. However, when only the label effect is used, people might be making judgments based upon the stigma associated with psychopathy—as psychopathy is representative of the cold blooded evil serial killers on TV and in movies—rather than its clinical features, and, therefore, view a labeled offender as significantly more dangerous than offenders with the other disorders” (p. 22).

Other Interesting Tidbits for Researchers and Clinicians

“[A]lthough we attempted to find unpublished studies by contacting researchers in the field who may have knowledge of unpublished literature and the fail-safe N analyses for significant effect sizes were robust and did not indicate publication bias, it is always possible that we may have missed studies that could have been included in this metaanalysis which may have affected results. Further, the number of studies that could be included in this analysis, and therefore k values used in the calculation of the effect sizes, was low. However, this could not be avoided, as this meta-analysis covers the known labeling psychopathy studies. Given the far ranging and conflicting results of these existing studies, a meta-analysis on these existing studies is beneficial regardless of the study number. In the same vein, one of the effect sizes for psychopathic label versus other psychiatric label (treatment amenability) did not contain at least 10 studies, which Higgins and Altman (2008) argue is the minimum number of studies, in most circumstances, needed in order to conduct moderation analysis. Therefore, although not found to be significant, the results of moderation analysis for treatment amenability should be taken with a grain of salt and might be skewed by the number of studies. As previously mentioned, this could not be avoided based on the number of existing studies, and although a limitation, this moderation analysis is still beneficial” (p. 22).

“Overall, [results] suggests a significant general labeling effect, but not a specific labeling effect, for psychopathy in these studies, and these results suggest that the lay public, but not those in the criminal justice system, may subscribe to both general and specific labeling effects for psychopathy when it comes to punishment and certain types of labeling effects are only influential for certain punishment outcomes, such as label and criterion effects on views of dangerousness. Future meta-analyses should regularly reevaluate the literature on these issues to examine if lay and criminal justice perceptions of psychopathy and punishment change moving forward” (p. 22).

Join the Discussion

As always, please join the discussion below if you have thoughts or comments to add!

Authored by Amanda Beltrani

Amanda Beltrani is a current doctoral student at Fairleigh Dickinson University. Her professional interests include forensic assessments, professional decision making, and cognitive biases.

The first fully randomized field experiment of police interrogations, investigates the impact of video recording

Informing suspects that interrogations are being recorded does not inhibit suspects or alter case dispositions. This is the bottom line of a recently published article in Law and Human Behavior. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | Law and Human Behavior | 2019, Vol. 43, No. 1, 45-55

Does Video Recording Inhibit Crime Suspects? Evidence From a Fully Randomized Field Experiment

Authors

Saul M. Kassin, John Jay College of Criminal Justice of the City University of New York
Melissa B. Russano, Roger Williams University
Aria D. Amrom and Johanna Hellgren, John Jay College of Criminal Justice of the City University of New York
Jeff Kukucka, Towson University
Victoria Z. Lawson, Institute for State and Local Governance of the City University of New York

Abstract

In partnership with a small city police department, we randomly informed or did not inform 122 crime suspects that their interrogations were being video-recorded. Coding of all sessions indicated that camera-informed suspects spoke as often and as much as did those who were not informed; they were as likely to waive Miranda at the outset and later; they were as likely to make admissions and confessions, not just denials; and they were perceived no differently by detectives on a range of dimensions. Looking at distal outcomes, we observed no differences in ultimate case dispositions. In terms of policy and practice, results did not support the hypothesis that recording—even when transparent, as required in 2-party consent states—inhibits suspects or alters case dispositions. At least for now, this conclusion is empirically limited to situations in which cameras are concealed and to interrogations that do not involve juveniles, homicides, or drug crimes, which we a priori excluded from our sample.

Keywords

police interviews, interrogations, confessions

Summary of the Research

“In recent years, numerous wrongful conviction cases in which false confessions were a contributing factor and research on the causes and consequences of false confessions have inspired calls for reform. Some proposals seek ways to protect vulnerable suspects such as juveniles and people with intellectual or emotional impairments; others call for the reform of police interrogation practices, banning the use of certain confrontational tactics in favor of investigative interviewing. Perhaps the most significant proposed safeguard is to require the electronic recording of interrogations—the entire process, not just the confession. As stated in a American Psychology-Law Society white paper: ‘Without equivocation, our most essential recommendation is to lift the veil of secrecy from the interrogation process in favor of the principle of transparency’” (p. 46).

“At present, 25 states and the District of Columbia require the full recording of custodial interrogations; 25 states do not. This split betrays a history of debate regarding what constitutes good policy and practice. On the one hand, various professional organizations have favored mandatory recording and surveys of individual law enforcement investigators have yielded supportive results. For example, Sullivan, Vail, and Anderson (2008) interviewed police from hundreds of departments that recorded custodial interrogations and found that they cited numerous benefits of recording (e.g., it allows detectives to attend to the suspect without concurrent note-taking; it allows them to review the sessions for any incriminating comments initially unnoticed; it reduces the need for detectives to defend their interrogation practices in court). Yet others have opposed recording either on pragmatic grounds (e.g., citing the scope of such a requirement; financial costs; the evidentiary consequences of a failure to comply; and issues of consent, especially in two-party consent states) or out of concern for how recording will alter the behavior of both police and suspects during interrogation and the subsequent decision-making of judges and juries” (p. 46)

“To test the hypothesis that recording will alter a suspect’s behavior and decision-making, we observed real suspects caught up in real investigations. With cooperation from a small city police department in the U.S. Northeast, a unique opportunity presented itself. Consistent with statewide practice, this department records all suspect interrogations involving capital felony cases (i.e., those in which the suspect faces the possibility of life in prison; as a matter of departmental practice, many but not all other suspect interviews are also recorded). Operating within a one-party consent state, this department has the option by law to inform or not inform suspects of this practice. This combination—a police department that records, can do so without a suspect’s consent, and was interested in partnering on the present study—enabled the first fully randomized field experiment of police interrogations” (p. 46).

“With a total of 122 suspects brought into custody for questioning, we randomly assigned some but not others to be informed that their session was to be recorded by a concealed camera. We sought to guard against experimenter bias, a form of reactivity in which experimenters’ expectations can unwittingly influence the behavior of the participants with whom they interact. Hence, our experimental protocol called for the lead detective to be blinded regarding condition” (p. 47).

“All recordings were then made available for transcription and coding, allowing us to compare the two groups on a number of objective behaviors—including the frequency with which suspects gazed in the direction of the camera (a behavioral measure of self-consciousness) as well as indicators of possible inhibition such as the number of suspects who invoked and/or waived their Miranda rights, the average total duration of interrogation, the length—in time and word count—of suspects’ responses to questions, the frequency with which suspects made full or partial admissions and confessions, and the nature and level of detail in their statements. After each session, the lead detective rated the suspect on a number of relevant dimensions (i.e., forthcoming, cooperative, truthful, inhibited, anxious, talkative, relaxed, and self-conscious). After all data were collected, we tracked case dispositions for both groups” (p. 47).

“Results in general did not support the claim that recording would have inhibitory effects. To begin with, suspects exhibited little awareness or concern about the presence of a camera. Not a single suspect refused or expressed a reluctance to proceed because of being recorded. This simplest of results is important in light of the contrasting fact that 22 of 25 mandatory recording statutes across the United States contain a recording exception in the event that a suspect refuses to speak if recorded. Nor did we observe significant differences in other extraneous behaviors, such as whether suspects talked to themselves when left alone or cried during their interrogation. From a historical perspective, the finding that no suspects refused to proceed on camera resembles early experiences with the videotaping of confessions” (p. 52).

“Consistent with the actual behavior of suspects, detectives’ perceptions of their suspects were also not influenced by the camera condition. After each session, the primary detective rated the suspect on a brief questionnaire. On average, they saw the suspects as generally talkative, cooperative, and forthcoming, even while anxious; as moderately truthful and relaxed; and as not particularly inhibited. No condition differences were obtained on any of these measures. On the most direct question of all concerning the effect of the camera, detectives did not rate suspects in either group as seeming self-conscious about the possibility of being recorded. At 1.80 on a 10-point scale, this rating was the lowest of all ratings in both conditions” (p. 53).

“Turning from proximal to distal outcomes, we tracked case dispositions 14 months after all data were collected. In what is arguably the most important data point, we found no differences in the extent to which the cases of camera-informed and -uninformed suspects were resolved—and of those that were resolved, no differences in the extent to which suspects were convicted” (p. 53).

Translating Research into Practice

“At present, 25 states in the United States mandate the recording of interrogations, at least for serious crimes. Among those that do, 22 contain exceptions in the event that a suspect refuses to speak if recorded. Some of these states have one-party consent laws that enable police to record interrogations covertly. Others are two party states that require the suspect’s knowledge and consent (some make exceptions for custodial police interrogations). Among states that do not have a recording requirement, a concern often expressed is that the real or imagined presence of a camera will unduly inhibit suspects, causing them to “clam up,” become tense, and refuse to speak, thereby obstructing law enforcement efforts to investigate crimes” (p. 54).

“It is interesting that the same argument was made by early opponents of Miranda v. Arizona (1966). President Nixon at that time commented that Miranda constituted a victory for the forces of crime. Yet after 50 years, especially in light of high waiver rates, most researchers have concluded that these fears have proved unfounded— that, if anything, Miranda has functioned as a ‘safe harbor’ for police” (p. 54).

“Regarding the recording of interrogations, Sullivan and colleagues interviewed investigators in police and sheriff’s departments and found that these fears seemed unfounded in their own experience. By observing and coding the behavior, decision-making, and case dispositions of suspects who were randomly informed or not informed, the present study supports these prior self-report results. In terms of policy and practice, these results should allay fears in two-party consent states that are reluctant to mandate recording and offer guidance to one-party states that can inform or not at their discretion” (p. 54).

Other Interesting Tidbits for Researchers and Clinicians

“Although no significant differences were found on admissions of guilt or confessions, it is worth noting that—in response to a hypothesis suggested by detectives—subsequent coding and analyses indicated that although few suspects openly expressed a reluctance to implicate someone else during their interrogations, camera-informed suspects were somewhat less likely to actually incriminate another person. It is important to caution that this tendency was not significant. Still, we think this hypothesis deserves additional testing, perhaps in a larger sample that contains more homicide investigations and drug crimes, which may involve gang-related activities that invite the possibility of implicating others” (p. 53).

Join the Discussion

As always, please join the discussion below if you have thoughts or comments to add!

Authored by Amanda Beltrani

Amanda Beltrani is a current doctoral student at Fairleigh Dickinson University. Her professional interests include forensic assessments, professional decision making, and cognitive biases.

A Case of Misdiagnosis? Gang Members’ Mental and Emotional Health Needs

A meta-analysis of available literature on gang members’ mental health and emotions reveals that gang members may be at increased risk of suffering from mental illnesses and negative emotions. However, there remains a limited understanding of how gang members’ self-conscious emotions may relate to persistent offending and violence. Gang members may benefit from more clinically tailored interventions that support their mental and emotional health. This is the bottom line of a recently published article in The International Journal of Forensic Mental Health. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | The International Journal of Forensic Mental Health| 2018, Vol. 17, No. 3, 223-246

Gang membership, Mental Illness, and Negative Emotionality: A Systematic Review of the Literature

Authors

Sarah Osman, Centre for Research and Education in Forensic Psychology, Keynes College, University of Kent, Kent, Canterbury, UK
Jane Wood, Centre for Research and Education in Forensic Psychology, Keynes College, University of Kent, Kent, Canterbury, UK

Abstract

Gang-related violence poses detrimental consequences worldwide. Gang members suffer a range of adverse experiences, often as victims who then transition to adolescence and early adulthood as offenders. Such experiences may negatively affect their mental health. Yet, the relationship between gang membership and mental illness is, to date, not well understood. This systematic review synthesized the literature on gang members’ mental health and emotions.
A two-part search strategy of electronic and hand searches, dated from: January
1980–January 2017, was conducted. A total of n = 306 peer papers were included in a preliminary scoping review, of which n = 23 met the inclusion criteria and study outcomes. Narrative synthesis revealed how gang members may be at increased risk of suffering from mental illnesses and negative emotions, such as anger and rumination. Yet, synthesis showed that understanding remains limited regarding gang members’ experiences of self-conscious emotions and how such emotions might link to persistent offending patterns and violence. The results suggest gang members may benefit from clinically tailored interventions to support their mental and emotional health. Clinical and research implications are discussed to inform future empirical, intervention, and prevention work with gang members and individuals at risk of gang involvement.

Keywords

Emotions, gangs, mental illness, psychological, violence

Summary of the Research

“To date, gang membership has received scholarly attention, both theoretically and empirically, from an array of disciplines…In this breadth of literature, researchers have frequently examined how proclivity for gang involvement may be heightened by risk factors spanning five core domains: community, family, individual, peer, and school…examining links between gang membership and mental illness could deepen our understanding of gangs and as such, is a nexus, which warrants further investigation…The aim of this review is to synthesize current literature on gang members’ mental health and their emotions. Consideration of how mental illness and emotions link to gang involvement before, during, and/or following gang membership may have significant implications for theory development, empirical directions, and prevention and intervention programs that seek to reduce gang membership” (p. 223-224).

“Findings from [prior researchers] show that gang involvement relates to a range of problems such as antisocial personality disorder (ASPD), anxiety, conduct disorders, posttraumatic stress disorder (PTSD), paranoia, and psychosis…gang members, compared to violent and non-violent men suffer from higher levels of, and seek more professional help for, mental health difficulties such as anxiety, psychosis, and substance abuse” (p.225).

“…Narrative synthesis reveals gaps in the literature and methodological issues that preclude conclusions regarding the casual mechanisms between variables…Nonetheless, our findings suggest that gang members are a vulnerable sub-group of offenders who have a range of mental health and potentially, emotional needs. This review also included female gang members yet they appeared in only a handful of studies. For instance, despite the lack of clarity regarding the causal mechanism between gang membership and mental health, the findings by Kerig et al. (2016) revealed how PTSD symptoms among gang members was associated with the perpetration of violent crimes, but only female gang members had levels of symptoms relevant to the criteria for post-traumatic stress diagnosis. This suggests that gender differences may have significant implications for gang research and interventions, especially given the current reported increase in female gang participation…” (p.233).

Translating Research into Practice

“The measures for diagnosing mental health in studies also employed differential measures which were designed for varying populations (e.g., measures for clinical vs. community samples). This has clinical implications since some gang members may, dependent on the assessment used, be wrongly, or not, diagnosed. Inaccurately identifying the mental health needs of gang members, who may have a range of unmet needs, may contribute further to maladaptive behavior and contribute to the onset and/or persistence of mental illness…Any diagnosis with this population should be approached with caution given that most gang members reside in urban neighborhoods characterized by significant socio-economic deprivation, where delinquency and gang membership may be used as a means of coping…gang members’ elevated fear of victimization, anxiety, and reported increased service use suggests that their needs are several. Thus, future research should learn from existing studies and engage in multi-agency work including systematic practice between the criminal justice system and mental health services to develop appropriate mental health screening tools specific to gang members” (p.233).

“Indeed, the extent to which current interventions in the CJS [criminal justice system], such as gang exit programs include targeting the emotional and mental health needs of gang-affiliated individuals and members is unclear…with trauma-related interventions for gang members only introduced in recent years…It is also imperative that emotions are given more attention in the gang literature. The examination of gang members’ emotional experience has important implications for their treatment, in addition to, prevention work among vulnerable individuals at risk of gang involvement. For instance, we do not know how emotional experiences, such as guilt and shame, vary according to differential involvement and status within a gang. We also do not know if gang affiliates become increasingly prone to experiencing guilt due to their fleeting, as opposed to fixed, involvement with gang-related criminality…Thus, there are significant clinical, research, and policy implications invested in conducting research related to the mental and emotional health of gang members…Nonetheless, methodological issues such as the measurement of mental health and study designs must be addressed if gang research is to influence clinical and policy settings and benefit individuals and communities” (p.234).

Other Interesting Tidbits for Researchers and Clinicians

“Furthermore, affiliate gang members (who have loose association to the gang) have been found to be as at risk of mental illness are core gang members (committed to the gang…)…this seems to suggest that as gang membership deepens, so too do mental health problems. Comparisons between gang and non-gang prisoners also shows that gang members suffer higher levels of anxiety, paranoia, and PTSD – and that each relates strongly to exposure to high levels of violence before incarceration…Although research suggests that gang membership generally attracts discontented adolescent males…it also shows increasing levels of female gang involvement…Given the relationship between gang membership and violent offending, and the association between offending and the increased risk of violent victimization…both males and females can suffer violence due to gang connections. Moreover, due to the consistent evidence regarding the relationship between how childhood and/or adolescent exposure to violence, particularly when coupled with community violence exposure, is related to mental illness…investigating the relationship between gang involvement and mental illness in male and female gang members seems crucial for effective tackling of gang membership” (p.225).

Join the Discussion

As always, please join the discussion below if you have thoughts or comments to add!

Authored by Amber Lin

Amber Lin was a volunteer in Dr. Zapf’s research lab at John Jay College of Criminal Justice. She graduated from New York University in 2013 with a B.A. (honors) and is a third year Masters student at Fairleigh Dickinson University. Her research interests include forensic assessment, competency to stand trial, and the refinement of instruments used to assess the psychological states of criminal defendants.