The objective of this review is to summarise the recent state of research on intake criteria for ... more The objective of this review is to summarise the recent state of research on intake criteria for forensic psychiatry in Germany. Therefore, a systematic literature review was conducted on the legal basis of paragraph 64 of the German Penal Code for forensic psychiatry. Although the patients were very heterogeneous, relatively robust indicators were identified that may yield an unsuccessful therapy outcome. A younger age, previous delinquency, absence of an educational and vocational qualification, and personality disorders are the most robust indicators adversely affecting therapy in German forensic psychiatric institutions.
Für Straftäter konnte wiederholt eine hohe Prävalenz belastender Lebenserfahrungen aufgezeigt wer... more Für Straftäter konnte wiederholt eine hohe Prävalenz belastender Lebenserfahrungen aufgezeigt werden. Nur wenige Untersuchungen gingen bisher der Frage nach, ob und in welchen Fällen das eigene Delikt für Straftäter ein traumatisches Ereignis darstellen kann. Die Behandlungsakten von 82 männlichen Gewalt- und Sexualstraftätern, die im Kanton Zürich in deliktorientierter Behandlung waren, wurden ausgewertet. 35 der Therapieklienten erklärten sich für eine persönliche Untersuchung bereit. Acht der 35 Gewalt- und Sexualstraftäter benannten ihr Delikt als belastendstes Erlebnis. Nur bei einem der acht Straftäter konnte die Diagnose einer PTBS gestellt werden. Deliktorientierte forensisch-psychologische Behandlungsprogramme setzen die Auseinandersetzungsfähigkeit mit dem Delikt voraus. Bei Straftätern, die durch das eigene Delikt belastet oder traumatisiert wurden, ist von einem Vermeidungsverhalten auszugehen, das die Bearbeitung des Deliktverhaltens deutlich erschwert und somit den Erfolg von aufwändigen deliktorientierten Behandlungsprogrammen gefährdet.
Schweizer Archiv für Neurologie und Psychiatrie, 2011
Background: Predictors for successful inpatient alcohol rehabilitation have been studied in the l... more Background: Predictors for successful inpatient alcohol rehabilitation have been studied in the last few years mainly in the German-speaking geographical area. The objective of this study was to identify indicators for the outcome of ambulatory alcohol rehabilitation. Method: The study included a sample of patients (N = 1065) treated between 2004 and 2007 at the Forel Hospital, an institution specialised in the treatment of alcohol dependence. The differences between three groups of patients were studied: patients who abandoned the treatment prematurely, and patients who terminated the treatment with and without improvement. Results: Multinomial regression analyses showed that the group of premature abandoners differed with respect to age, level of education and employment status. Furthermore, the group terminating with improvement were more likely to be employed and less likely to have been diagnosed with a personality disorder. Discussion: While the sample population in this study did not require 24-hour care due to the relatively low psychiatric and somatic comorbidity level, its degree of alcoholism nevertheless required ambulatory care. In spite of the sample specificity, a number of predictors for unsuccessful treatment could be identified. It was possible to identify indicators for a positive treatment outcome. The course of treatment is influenced by social rather than psychiatric factors. The treatment outcome is, however, influenced by comorbid personality disorders.
The penal code in Switzerland is strongly oriented toward the prevention of crime. Hence, most ca... more The penal code in Switzerland is strongly oriented toward the prevention of crime. Hence, most cases involving severe acts of violence trigger a psychiatric evaluation that includes a risk assessment. The threshold for court-ordered treatment is low and follows a rather pragmatic approach: On the basis of a psychiatric expert opinion, the court can order a specifi c therapeutic or confinement measure. Treatment can be ordered regardless of criminal responsibility. The court’s decision depends upon the determined risk for reoffending and whether there are treatment strategies available to reduce this risk. In most cases, the courts order outpatient treatment that can follow a period of treatment during incarceration, during a suspended sentence or period of probation, or even while awaiting sentencing.
Background: In the aftermath of the Tsunami disaster in 2004, an online psychological self-assess... more Background: In the aftermath of the Tsunami disaster in 2004, an online psychological self-assessment (ONSET) was developed and made available by the University of Zurich in order to provide an online screening instrument for Tsunami victims to test if they were traumatized and in need of mental health care. The objective of the study was to report the lessons learnt that were made using an Internet-based, self-screening instrument after a large-scale disaster and to discuss its outreach and usefulness. Methods: Users of the online self-assessment decided after finishing the procedure whether their dataset could be used for quality control and scientific evaluation Their answers were stored anonymously only if they consented (which was the case in 88% of the sample), stratified analyses according to level of exposure were conducted. Results: A total of 2,914 adult users gave their consent for analysis of the screenings. Almost three quarter of the sample filled out the ONSET questionnaire within the first four weeks. Fortyone percent of the users reported direct exposure to the Tsunami disaster. Users who were injured by the Tsunami and users who reported dead or injured family members showed the highest degree of PTSD symptoms. Conclusion: ONSET was used by a large number of subjects who thought to be affected by the catastrophe in order to help them decide if they needed to see a mental health professional. Furthermore, men more frequently accessed the instrument than women, indicating that Internet-based testing facilitates reaching out to a different group of people than “ordinary” public mental health strategies.
Forensische Psychiatrie und Psychotherapie Werkstattschriften, 2010
Das Level of Service Inventory-Revised (LSI-R) wurde 2001 von Andrews & Bonta entwickelt. Viele M... more Das Level of Service Inventory-Revised (LSI-R) wurde 2001 von Andrews & Bonta entwickelt. Viele Merkmale des LSI-R haben einen dynamischen Charakter, was die Anwendung des LSI-R in der praktischen Arbeit mit Straftätern attraktiv macht. Die meisten Validierungsstudien zum LSI-R untersuchten einen kurzen Untersuchungszeitraum und konzentrierten sich auf nicht gewalttätige Straftäter. Ziel vorliegender Arbeit war es die prädiktive Validität erstmals an einer Stichprobe von entlassenen Gewalt- und Sexualstraftätern zu untersuchen. Die Stichprobe setzte sich aus 107 Gewalt- und Sexualstraftätern zusammen. Bei der Untersuchung der prädiktiven Validität wurde zwischen einem Beobachtungszeitraum von einem und sieben Jahren unterschieden. Die prädiktive Validität des LSI-R für allgemeine Rückfälligkeit war sowohl für einen Beobachtungszeitraum von einem Jahr (AUC=0.67) als auch einen von sieben Jahren (AUC=0.78) zufriedenstellend. Hingegen war die prädiktive Validität für gewalttätige Rückfälle mangelhaft (AUC=0.51 für Rückfälle innerhalb von einem Jahr, AUC=0.65 innerhalb von sieben Jahren). Die Ergebnisse weisen darauf hin, dass das LSI-R auch bei Gewalt und Sexualstraftätern ein valides Instrument darstellt, um das Risiko erneuter Straffälligkeit zu schätzen.
Schweizer Archiv Für Neurologie und Psychiatrie, 2010
Background: The HCR-20 is a risk assessment instrument developed in Canada
whose validity has bee... more Background: The HCR-20 is a risk assessment instrument developed in Canada whose validity has been shown in several studies of patients in forensic settings. However, only a few studies on unselected samples exist, and they show varying results. The aim of the present study was to conduct a first time validation of the HCR-20 on an unselected sample of offenders released from prison in Switzerland. Method: The HCR-20 and the PCL-R were scored for 107 released sex and violent offenders. Legal probation was examined using excerpts from the criminal records drawn after a follow-up period of 7 years. ROC analyses were computed to examine the predictive validity of the sum scores of the two instruments. Results: The HCR-20 was significantly associated with recidivism and showed an AUC = 0.76 for general recidivism and an AUC = 0.70 for sex or violent recidivism. The difference in predictive validity of the HCR-20 and the PCL-R was not significant and the two instruments correlated with r = 0.69. Discussion: It was also possible to replicate findings of other studies on the predictive validity of the HCR-20 in Switzerland. However, in the present study the HCR-20 was of no additional explanatory value compared to the PCL-R.
In North America, the use of actuarial instruments is considered to be state of the art in the as... more In North America, the use of actuarial instruments is considered to be state of the art in the assessment of offender recidivism risk. One of these instruments is the “Sex Offender Risk Appraisal Guide” (SORAG), which was developed specifically for the use in sex offender risk assessment. The present review investigates the current state of knowledge regarding the instrument’s validity specifically for its use in German-speaking countries. Overall the results speak for the instrument’s good discriminatory power. However, this is not true to the same degree for all types of sex offender populations. The discriminatory power is especially good in the subpopulation of child molesters. Part of the present review is a German translation of the instrument authorised by the developers of the SORAG.
Background: In past years, the female offender population has grown, leading to an increased inte... more Background: In past years, the female offender population has grown, leading to an increased interest in the characteristics of female offenders. The aim of this study was to assess the prevalence of female violent offending in a Swiss offender population and to compare possible socio-demographic and offense-related gender differences. Methods: Descriptive and bivariate logistic regression analyses were performed for a representative sample of N = 203 violent offenders convicted in Zurich, Switzerland. Results: 7.9% (N = 16) of the sample were female. Significant gender differences were found: Female offenders were more likely to be married, less educated, to have suffered from adverse childhood experiences and to be in poor mental health. Female violent offending was less heterogeneous than male violent offending, in fact there were only three types of violent offenses females were convicted for in our sample: One third were convicted of murder, one third for arson and only one woman was convicted of a sex offense. Conclusions: The results of our study point toward a gender-specific theory of female offending, as well as toward the importance of developing models for explaining female criminal behavior, which need to be implemented in treatment plans and intervention strategies regarding female offenders.
Schweizer Archiv für Neurologie und Psychiatrie, 2009
Introduction: Various international validation studies have found a satisfactory to very good pre... more Introduction: Various international validation studies have found a satisfactory to very good predictive validity for the Static-99, with AUC-values between .70 and .80. It is argued by the authors of this study that due to the static nature of the items assessed in the instrument it is primarily suited for first time psychiatric assessments and less for continuous assessment of offenders’ risk dispositions. So far no validation studies of the Static-99 were made on samples of first time psychiatrically assessed offenders in Switzerland. Method: The Static-99 scores of sixty-three sex offenders in Switzerland were assessed by using data from their psychiatric assessments. At no point of the study was there personal contact with the offenders. Recidivism was operationalized as reconviction assessed from penal records. Any reconvictions as well as reconvictions due to sexual and violent offenses were coded and analyzed separately. The follow-up-period was between 7–32 years. Results: The Static-99 risk categories showed satisfactory predictive validity for reconvictions due to any offense (AUC =. 64) and good predictive validity for reconvictions due to violent offenses (AUC =. 81). They were however, unable to predict sexual recidivism in our population. Discussion: The Static-99 is a valid instrument to predict recidivism also in Swiss offender populations. In this sample of psychiatrically assessed sex offenders the Static-99 was however not able to predict sexual recidivism contrary not only to other international studies but also to a study on Swiss sex and violent offenders administered by the Zurich office of penal corrections. This finding suggests that risk assessment instruments are only valid for specific offender populations and that they can not be applied to other offender groups without further evaluation.
Beim Vergleich verschiedener Studien über Gewalt im Strafvollzug ist zu
berücksichtigen, dass sic... more Beim Vergleich verschiedener Studien über Gewalt im Strafvollzug ist zu berücksichtigen, dass sich Vollzugsinstitutionen stark voneinander unterscheiden. Studien aus der Schweiz ergaben, dass etwa jeder vierte Insasse mindestens einmal während der Haft mit Gewalt auffällt. Dabei haben die Gewalthandlungen unterschiedliche Erscheinungsformen. Die spezifische Charakterisierung der Gewalt nach Art, Ziel, Auswirkung und Auslöser ist darum wichtig. Bestehende Instrumente zur Kriminalprognose eignen sich nicht zur Schätzung des Risikos gewalttätiger Handlungen im Strafvollzug, weshalb die Entwicklung spezifischer Modelle für diese Fragestellung notwendig ist. In internationale Studien wurden diverse Risikomerkmale identifiziert. Auf Schweizer Verhältnisse lassen sich diese jedoch aufgrund der erwähnten Institutionsunterschiede nur teilweise übertragen.
Objective: Most instruments used for assessing the recidivism risk of an offender with a violent ... more Objective: Most instruments used for assessing the recidivism risk of an offender with a violent or sex offense have been developed and validated in North America. Methods: The aim of this study is to discuss the state of validation for the Violence Risk Appraisal Guide (VRAG) – an instrument for assessing the recidivism risk of violent offenders. A systematic literature research forms the basis for the processing of the literature. In a second section, a scientific translation of the instrument to German, including the scoring rules, is presented. Results: Normally, while examining the validity of the VRAG, there is a focus on the discriminatory power (displayed using the so-called Area Under the Curve [AUC]). These examinations showed a satisfactory to good discriminatory power (AUC: 0.70 – 0.86). A standardization of this instrument for populations in Europe respectively the German-speaking area has not yet taken place. Only few studies have verified whether North American standard values are also valid for Europe. The few studies on this subject question the generalizability of these standard values to other countries. Conclusions: The VRAG can be considered a valid measure for the assessment of recidivism risk in Germany and in Switzerland, although so far, standardization has been dispensed with. The application of the VRAG can provide indications for the evaluation of recidivism risk and be integrated into an individual case-oriented assessment.
International Journal of Mental Health Systems, 2009
Background: In Switzerland, a total of 1'000 patients a year are treated for alcohol-dependence i... more Background: In Switzerland, a total of 1'000 patients a year are treated for alcohol-dependence in specialized institutions. Though the current literature suggests favoring outpatient treatment, whether outpatient or inpatient treatment is more efficient cannot be answered generally. For Germany, "AWMF"-treatment guidelines were formulated in order to treat patients with substance use disorders in the appropriate treatment settings. The aim of the present study was to test the hypothesis that the majority of patients treated in the largest specialized institution for alcohol abuse treatment in Switzerland were treated in the appropriate setting. Methods: All completed treatments conducted in the Forel-Hospital – the largest clinic of its kind in Switzerland – between the 1st of January 2004 and the 20th of December 2006 were included in the investigation (n = 915). Patient and treatment characteristics were gathered using the information from the PSYREC and act-info questionnaire. The AWMF criteria were operationalized on the basis of the questionnaire. Results: Applying the AWMF criteria resulted in the emergence of three groups: 73.7% of the study sample could clearly be assigned to the inpatient treatment group, and for 7.5% there was evidence supporting the allocation to an outpatient treatment setting. In 18.8% of the cases, however, the AWMF criteria did not allow an assignment to either of the treatment settings. Of the total sample, 18.5% of all patients apparently did not profit from the inpatient treatment setting, whereas for the vast majority (81.5%), a therapeutic progress was documented. In those patients who, according to the AWMF guidelines, did not need an inpatient setting, a larger proportion improved than in the group of the patients who needed an inpatient treatment in a specialized hospital. Furthermore, the logistic regression analyses revealed that the less severe the clinical state of a patient upon admittance, the higher the odds of improvement during the hospital stay. Conclusion: The results serve as evidence that for at least three out of four patients treated in the investigated specialized institution, an inpatient treatment was appropriate. The principal reason for the necessity of an inpatient treatment setting was that this hospital population showed severe psychiatric, somatic or social irregularities. Only a very limited number of patients hospitalized in a specialized institution for the treatment of alcohol-related disorders can be treated in an outpatient setting.
Background: There is an ongoing debate on whether consumers of child pornography pose a risk for ... more Background: There is an ongoing debate on whether consumers of child pornography pose a risk for hands-on sex offenses. Up until now, there have been very few studies which have analyzed the association between the consumption of child pornography and the subsequent perpetration of hands-on sex offenses. The aim of this study was to examine the recidivism rates for hands-on and hands-off sex offenses in a sample of child pornography users using a 6 year follow-up design. Methods: The current study population consisted of 231 men, who were subsequently charged with consumption of illegal pornographic material after being detected by a special operation against Internet child pornography, conducted by the Swiss police in 2002. Criminal history, as well as recidivism, was assessed using the criminal records from 2008. Results: 4.8% (n = 11) of the study sample had a prior conviction for a sexual and/or violent offense, 1% (n = 2) for a hands-on sex offense, involving child sexual abuse, 3.3% (n = 8) for a handsoff sex offense and one for a nonsexual violent offense. When applying a broad definition of recidivism, which included ongoing investigations, charges and convictions, 3% (n = 7) of the study sample recidivated with a violent and/or sex offense, 3.9% (n = 9) with a hands-off sex offense and 0.8% (n = 2) with a hands-on sex offense. Conclusion: Consuming child pornography alone is not a risk factor for committing hands-on sex offenses – at least not for those subjects who had never committed a hands-on sex offense. The majority of the investigated consumers had no previous convictions for hands-on sex offenses. For those offenders, the prognosis for hands-on sex offenses, as well as for recidivism with child pornography, is favorable.
Journal of Offender Therapy and Comparative Criminology, 2009
The Static-99 is a widely used actuarial risk assessment instrument. Various international valida... more The Static-99 is a widely used actuarial risk assessment instrument. Various international validation studies have found satisfactory to good predictive validity for the Static-99, with the area under the curve (AUC) between 59% and 95%. This study is the first evaluation of the predictive accuracy of the Static-99 among sex offenders in Switzerland. The Static-99 scores of 69 violent/sex offenders in Switzerland were assessed using data from their psychiatric assessments. Recidivism was operationalized as reconviction assessed from penal records. The Static-99 risk levels were predictive for recidivism (AUC = .758) among our population. The results are discussed on the basis of the literature.
Background: Research conducted with forensic psychiatric patients found moderate correlations bet... more Background: Research conducted with forensic psychiatric patients found moderate correlations between violence in institutions and psychopathy. It is unclear though, whether the PCL-R is an accurate instrument for predicting aggressive behavior in prisons. Results seem to indicate that the instrument is better suited for predicting verbal rather than physical aggression of prison inmates. Methods: PCL-R scores were assessed for a sample of 113 imprisoned sex and violent offenders in Switzerland. Logistic regression analyses were used to estimate physical and verbal aggression as a function of the PCL-R sum score. Additionally, stratified analyses were conducted for Factor 1 and 2. Infractions were analyzed as to their motives and consequences. Results: The mean score of the PCL-R was 12 points. Neither the relationship between physical aggression and the sum score of the PCL-R, nor the relationship between physical aggression and either of the two factors of the PCL-R were significant. Both the sum score and Factor 1 predicted the occurrence of verbal aggression (AUC = 0.70 and 0.69), while Factor 2 did not. Conclusion: Possible explanations are discussed for the weak relationship between PCL-R scores and physically aggressive behavior during imprisonment. Some authors have discussed whether the low base rate of violent infractions can be considered an explanation for the non-significant relation between PCL-R-score and violence. The base rate in this study, however, with 27%, was not low. It is proposed that the distinction between reactive and instrumental motives of institutional violence must be considered when examining the usefulness of the PCL-R in predicting in-prison physical aggressive behavior.
Risk assessment instruments have been the subject of a number of validation studies which have ma... more Risk assessment instruments have been the subject of a number of validation studies which have mainly examined the psychometric properties known primarily from psychological test development (objectivity, reliability and validity). Hardly any attention was paid to the fact that validation of forensic risk assessment instruments is confronted with a whole row of methodical challenges. Risk assessments include a quantitative and a qualitative component in that they state the probability (quantitative) of a particular offense (qualitative) to occur. To disregard the probabilistic nature of risk calculations leads to methodically faulty assumptions on the predictive validity of an instrument and what represents a suitable statistical method to test it. For example, ROC analyses are considered to be state of the art in the validation of risk assessment instruments. This method does however not take into account the probabilistic nature of prognoses and its results can be interpreted only to a limited degree. ROC analyses for example disregard certain aspects of an instrument’s calibration which might lead in an instrument’s validation to high ROC values while demonstrating only low validity. Further shortcomings of validation studies are that they ignore changes of risk dispositions or that they don’t differentiate between offense specific risks (e. g. any recidivism vs. violent or sexual recidivism). The paper discusses and reviews different quality criteria of risk assessment instruments in view of methodological as well as practical issues. Many of these criteria have been ignored so far in the scientific discourse even though they are essential to the evaluation of the validity and the scope of indication of an instrument.
International Journal of Forensic Mental Health, 2008
Recent studies have found mixed results for the ability of the PCL:SV to predict in-prison violen... more Recent studies have found mixed results for the ability of the PCL:SV to predict in-prison violence. The purpose of this study was to evaluate the accuracy of the PCL:SV for predicting in-prison violence in Switzerland. Method: PCL:SV scores were assessed from a sample of 114 prisoners sentenced to at least 10 months in prison for sexual or violent offenses. Results: Significant effect sizes for verbal aggressive behavior were found for sexual offenders. No significant results were found in a sample of violent offenders. No significant results were found for physical violence in any subgroup. Discussion: The results suggest only a limited degree of accuracy for the PCL:SV in predicting intramural aggressive behavior for the sample used in this study.
Background: Despite the high prevalence rate of mental health problems among young prisoners, lit... more Background: Despite the high prevalence rate of mental health problems among young prisoners, little is known about the longitudinal course and covariates of their mental health symptoms during incarceration, especially the influence of the correctional climate. The current study aimed: (1) to examine changes in young prisoners’ mental health symptoms during incarceration, (2) to identify personal factors associated with their mental health symptoms and perceptions of the correctional climate, and (3) to test the incremental effect of perceptions of the correctional climate on mental health symptoms. Methods: Data were obtained from a sample of 75 youths (aged 17 to 22 years) detained in a Portuguese young offender prison. Data were gathered 1, 3, and 6 months after their admission in this facility. Socio-demographic, clinical and criminological variables were collected. Mental health symptoms and perceptions of the correctional climate were assessed through self-report assessment tools. Linear and logistic (multi-level) regressions and tests for differences between means were performed to analyze the data. Results: Overall, mental health symptoms marginally declined by the sixth month in prison. Prisoners with a history of mental health treatment were more likely to have increased symptoms. Higher levels of mental health symptoms were associated with a history of mental health treatment, remand status, and a lower educational level. Better perceptions of the correctional climate were associated with Black race and participation in prison activities. A negative perception of the correctional climate was the strongest covariate of young prisoners’ mental health symptoms and had incremental validity over that of personal variables. Conclusions: The results highlight that both characteristics of the prisoners and of the prison environment influence young prisoners’ mental health. Prison management can try to reduce young prisoners’ mental health problems by developing scientific procedures for their mental health assessment and creating a more beneficial correctional climate.
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Papers by Jérôme Endrass
mit dem Delikt voraus. Bei Straftätern, die durch das eigene Delikt belastet oder traumatisiert wurden, ist von einem Vermeidungsverhalten auszugehen, das
die Bearbeitung des Deliktverhaltens deutlich erschwert und somit den Erfolg von aufwändigen deliktorientierten Behandlungsprogrammen gefährdet.
setzte sich aus 107 Gewalt- und Sexualstraftätern zusammen. Bei der Untersuchung der prädiktiven Validität wurde zwischen einem Beobachtungszeitraum von einem und sieben Jahren unterschieden. Die prädiktive Validität des LSI-R für allgemeine Rückfälligkeit war sowohl für einen Beobachtungszeitraum von einem Jahr (AUC=0.67) als auch einen von sieben Jahren (AUC=0.78) zufriedenstellend. Hingegen war die prädiktive Validität für gewalttätige Rückfälle mangelhaft (AUC=0.51 für Rückfälle innerhalb von einem Jahr, AUC=0.65 innerhalb von sieben Jahren). Die Ergebnisse weisen darauf hin, dass das LSI-R auch bei Gewalt und Sexualstraftätern ein valides Instrument darstellt, um das Risiko erneuter Straffälligkeit zu schätzen.
whose validity has been shown in several studies of patients in forensic settings. However, only a few studies on unselected samples exist, and they show varying results. The aim of the present study was to conduct a first time validation of the HCR-20 on an unselected sample of offenders released from prison in Switzerland. Method: The HCR-20 and the PCL-R were scored for 107 released sex and violent offenders. Legal probation was examined using excerpts from the criminal records drawn after a follow-up period of 7 years. ROC analyses were computed to examine the predictive validity of the sum scores of the two instruments. Results: The HCR-20 was significantly associated with recidivism and showed an AUC = 0.76 for general recidivism and an AUC = 0.70 for sex or violent recidivism. The difference in predictive validity of the HCR-20 and the PCL-R was not significant and the two instruments correlated with r = 0.69. Discussion: It was also possible to replicate findings of other studies on the predictive validity of the HCR-20 in Switzerland. However, in the present study the HCR-20 was of no additional explanatory value compared to the PCL-R.
berücksichtigen, dass sich Vollzugsinstitutionen stark voneinander unterscheiden.
Studien aus der Schweiz ergaben, dass etwa jeder vierte Insasse mindestens einmal während der Haft mit Gewalt auffällt. Dabei haben die Gewalthandlungen unterschiedliche Erscheinungsformen. Die spezifische Charakterisierung der Gewalt nach Art, Ziel, Auswirkung und Auslöser ist darum wichtig. Bestehende Instrumente
zur Kriminalprognose eignen sich nicht zur Schätzung des Risikos gewalttätiger Handlungen im Strafvollzug, weshalb die Entwicklung spezifischer Modelle für diese Fragestellung notwendig ist. In internationale Studien wurden diverse Risikomerkmale identifiziert. Auf Schweizer Verhältnisse lassen sich diese jedoch
aufgrund der erwähnten Institutionsunterschiede nur teilweise übertragen.
Methods: The aim of this study is to discuss the state of validation for the Violence Risk Appraisal Guide (VRAG) – an instrument for assessing the recidivism risk of violent offenders. A systematic literature research forms the basis for the processing of the literature. In a second section, a scientific translation of the instrument to German, including the scoring rules, is presented. Results: Normally, while examining the validity of the VRAG, there is a focus on the discriminatory
power (displayed using the so-called Area Under the Curve [AUC]). These examinations showed a satisfactory to good discriminatory power (AUC: 0.70 – 0.86). A standardization of this instrument for populations in Europe respectively the German-speaking area has not yet taken place. Only few studies have verified whether North American standard values are also valid for Europe. The few studies on this subject question the generalizability of these standard values to other countries. Conclusions: The VRAG can be considered a valid measure for the assessment of recidivism risk in Germany and in Switzerland, although so far,
standardization has been dispensed with. The application of the VRAG can provide indications for the evaluation of recidivism risk and be integrated into an individual case-oriented assessment.
were formulated in order to treat patients with substance use disorders in the appropriate treatment settings. The aim of the present study was to test the hypothesis that the majority of patients treated in the largest specialized institution for alcohol abuse treatment in Switzerland were treated in the appropriate setting.
Methods: All completed treatments conducted in the Forel-Hospital – the largest clinic of its kind in Switzerland – between the 1st of January 2004 and the 20th of December 2006 were included in the investigation (n = 915). Patient and treatment characteristics were gathered using the information from the PSYREC and act-info
questionnaire. The AWMF criteria were operationalized on the basis of the questionnaire. Results: Applying the AWMF criteria resulted in the emergence of three groups: 73.7% of the study sample could clearly be assigned to the inpatient treatment group, and for 7.5% there was evidence supporting the allocation to an outpatient treatment setting. In 18.8% of the cases, however, the AWMF criteria did not allow an assignment to either of the treatment settings. Of the total sample, 18.5% of all patients apparently did not profit from the inpatient treatment setting, whereas for the vast majority (81.5%), a therapeutic progress was documented. In
those patients who, according to the AWMF guidelines, did not need an inpatient setting, a larger proportion improved than in the group of the patients who needed an inpatient treatment in a specialized hospital. Furthermore, the logistic regression analyses revealed that the less severe the clinical state of a patient upon admittance, the higher the odds of improvement during the hospital stay. Conclusion: The results serve as evidence that for at least three out of four patients treated in the investigated specialized institution, an inpatient treatment was appropriate. The principal reason for the necessity of an inpatient treatment setting was that this hospital population showed severe psychiatric, somatic or social
irregularities. Only a very limited number of patients hospitalized in a specialized institution for the treatment of alcohol-related disorders can be treated in an outpatient setting.
Methods: The current study population consisted of 231 men, who were subsequently charged with consumption of illegal pornographic material after being detected by a special operation against Internet child pornography, conducted by the Swiss police in 2002. Criminal history, as well as recidivism, was assessed using the criminal records from 2008. Results: 4.8% (n = 11) of the study sample had a prior conviction for a sexual and/or violent offense, 1% (n = 2) for a hands-on sex offense, involving child sexual abuse, 3.3% (n = 8) for a handsoff sex offense and one for a nonsexual violent offense. When applying a broad definition of recidivism, which included ongoing investigations, charges and convictions, 3% (n = 7) of the study sample recidivated with a violent and/or sex offense, 3.9% (n = 9) with a hands-off sex offense and 0.8% (n = 2) with a hands-on sex offense. Conclusion: Consuming child pornography alone is not a risk factor for committing hands-on sex
offenses – at least not for those subjects who had never committed a hands-on sex offense. The majority of the investigated consumers had no previous convictions for hands-on sex offenses. For those offenders, the prognosis for hands-on sex offenses, as well as for recidivism with child pornography, is favorable.
and its results can be interpreted only to a limited degree. ROC analyses for example disregard certain aspects of an instrument’s calibration which might lead in an instrument’s validation to high ROC values while demonstrating only low validity. Further shortcomings of validation studies are that they ignore changes of risk dispositions or that they don’t differentiate between offense specific risks (e. g. any recidivism vs. violent or sexual recidivism). The paper discusses and reviews different quality criteria of risk assessment instruments in view of methodological
as well as practical issues. Many of these criteria have been ignored so far in the scientific discourse even though they are essential to the evaluation of the validity and the scope of indication of an instrument.
offender prison. Data were gathered 1, 3, and 6 months after their admission in this facility. Socio-demographic, clinical and criminological variables were collected. Mental health symptoms and perceptions of the correctional climate were assessed through self-report assessment tools. Linear and logistic (multi-level) regressions and tests for differences between means were performed to analyze the data. Results: Overall, mental health symptoms marginally declined by the sixth month in prison. Prisoners with a history of mental health treatment were more likely to have increased symptoms. Higher levels of mental health symptoms were associated with a history of mental health treatment, remand status, and a lower educational level. Better perceptions of the correctional climate were associated with Black race and participation in prison activities. A negative perception of the correctional climate was the strongest covariate of young prisoners’ mental health symptoms and had incremental validity over that of personal variables. Conclusions: The results highlight that both characteristics of the prisoners and of the prison environment influence young prisoners’ mental health. Prison management can try to reduce young prisoners’ mental health problems by developing scientific procedures for their mental health assessment and creating a more beneficial
correctional climate.