Association of Demographic Factors and Comorbid Diagnoses with Crime Typein an Arrest Cohort with Schizophrenia and/or Related Psychosis

The implications of the interface between the criminal justice system and individuals with schizophrenia persist despite decades of research on criminalization and risk of arrest. Research exploring the broader construct of criminality has predominantly focused on individuals with severe mental illness as a collective. This study diverges from others by examining diagnoses comorbid with schizophrenia and related psychoses and their relationships with risk of arrest across a spectrum of criminal categories ranging in severity

The criminalization hypothesis: The relationship between deinstitutionalization and the increased prevalence of individuals with mental illness in correctional systems

There are one tenth the number of psychiatric beds today as there were 50 years ago, while the population of the United States has nearly doubled. A combination of socio-cultural and political forces led to deinstitutionalization, creating an exodus of individuals with mental illness from state hospitals into society. Although the number of incarcerated individuals quadrupled between 1980 and 2000, there were no national statistics on the prevalence of mental illness within correctional systems until 1999. Despite great speculation for the criminalization hypothesis, backed up by fragmented research with less than ideal methodology, evidence suggests a relationship between deinstitutionalization and an increased prevalence of individuals with mental illness in correctional systems. This relationship appears most conclusive among homeless individuals with mental illness. Research lags in quantifying the influence of various factors on criminalizing individuals who, in earlier times, would otherwise have received psychiatric treatment in a hospital. Regardless of the political factors and social climate influencing the criminalization hypothesis, it appears jails and prisons have become the most enduring asylums

Treatment of Borderline Personality Disorder with Dialectical Behavior Therapy: An outcome study

This qualitative archival outcome study was designed to assess the effectiveness of intensive outpatient Dialectical Behavior Therapy (DBT) for 36 female clients diagnosed with Borderline Personality Disorder. Clients received 2.75 hours of group DBT per day, three days per week, for at least one year. Decreased frequency of self-injurious behavior (SIB), psychiatric hospital admissions, and prevalence of subjects attempting suicide defined effectiveness in this study. Decreases in the frequency of SIB, psychiatric hospital admissions, and prevalence of subjects attempting suicide were hypothesized when comparing the first and last six months of therapy. The application of intensive outpatient DBT produced statistically significant moderate and large effect-size reductions in the frequency of SIB and psychiatric hospitalizations respectively. The prevalence of subjects attempting suicide was not found statistically significant. This study supports the application of intensive outpatient DBT for treating clients diagnosed with Borderline Personality Disorder as an effective treatment to reduce SIB and psychiatric hospitalization

Arrest Types and Co-occurring Disorders in Persons with Schizophrenia or Related Psychoses

This study examined the patterns of criminal arrest and co-occurring psychiatric disorders among individuals with schizophrenia or related psychosis that were receiving public mental health services and had an arrest history. Within a 10-year period, 65% of subjects were arrested for crimes against public order, 50% for serious violent crimes, and 45% for property crimes. The presence of any co-occurring disorder increased the risk of arrest for all offense categories. For nearly all offense types, antisocial personality disorder and substance use disorders conferred the greatest increase in risk for arrest. Among anxiety disorders, post-traumatic stress disorder was associated with a greater risk of arrest for serious violent crimes but not other offense types. Criminal risk assessments and clinical management in this population should focus on co-occurring antisocial personality disorder and substance use disorders in addition to other clinical and non-clinical factors