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Actuarial risk assessment (Static-99 and Static-99-R) scores were obtained for 399 Australian adult sexual offenders who were subsequently released from prison and followed up with searches of police arrest records (mean follow-up period = 29 months; range = 15-53 months). Indigenous offenders (n = 67; 16.8%) scored significantly higher on both the Static-99 (M = 4.04 vs. 2.89, p < .001) and Static-99-R (M = 3.72 vs. 2.22, p < .001), were more than twice as likely to be arrested for sexual offenses (9.0% vs. 4.1%, ns), and were significantly more likely to be arrested for nonsexual violent (28.4% vs. 1.9%, p < .001), any violent (including sexual; 37% vs. 5.9%, p < .001), and any offenses (58.2% vs. 21.6%, p < .001). For the combined groups, predictive accuracy of both instruments was comparable to results reported elsewhere. Predictive accuracy of the Static-99 was similar for indigenous and nonindigenous offenders. The Static-99-R was only marginally predictive of any violent recidivism (AUC = .65, 95% CI = [.52, .79]), and did not predict sexual (AUC = .61, 95% CI = [.45, .77]) or nonsexual violent recidivism (AUC = .65, 95% CI = [.48, .78]), for indigenous offenders. Higher risk scores, indigenous race, and unsupervised release all contributed unique variance to any violent recidivism. Results suggest that the Static-99 may be appropriate for assessing Australian indigenous sexual offenders, but more research is needed to test the validity of the Static-99-R for this population. We conclude that practitioners should consider the potential effects of racial differences and postrelease factors, as well as static risk factors, in their assessments.

Confidential self-report data obtained on 107 adult male child sexual abusers were analyzed to test theoretical propositions concerning the role of attachment problems in the onset of sexual offending. Offenders' parent-child attachment relationships were most frequently characterized by affectionless control, reflecting low parental care and high overprotection and control. Offenders reported significantly less secure attachment with their fathers than with their mothers. Overall, weak continuity from childhood attachment to trait (general) adult attachment was found, with insecure attachment more stable than secure attachment. Childhood attachment problems, particularly with fathers, were more clearly reflected in state adult attachment (i.e., in the month preceding sexual offending onset) than in trait adult attachment. Offenders who were in an adult intimate relationship prior to their onset sexual offense reported significant state increases in attachment avoidance, and their onset offenses were more likely to involve a female familial victim. Offenders who were not in a relationship prior to offending onset were younger, and their onset sexual offenses occurred in much more diverse circumstances. These findings provide tentative evidence that directly and indirectly implicates offenders' attachment problems specifically in the onset of their sexual abuse behavior. Implications for developmental prevention and early intervention, situational prevention, and offender treatment are discussed.

Objective: To examine the relationship between committing homicide, the presence of schizophrenia, substance misuse and past criminality., Method: The study employed a data linkage design, using contacts recorded on two statewide databases, one of which recorded public mental health services contacts and the second of which recorded contacts with the police. The estimated rates of schizophrenia disorders, substance abuse and criminal convictions found among a population of 435 homicide offenders were contrasted with estimated rates in two composite comparison samples., Results: Of the 435 offenders, 38 (8.7%) had been diagnosed with a schizophrenia disorder, which was RR 13.11 (95% CI 9.14-18.80) times more likely than a comparison sample. Rates of known substance abuse between homicide offenders with and without schizophrenia and community-dwelling residents with schizophrenia did not differ significantly. However, these rates were higher than those found in the general community. A similar pattern emerged for comparisons regarding offending histories between these same groups., Conclusion: The association between homicidal violence and having a schizophrenia disorder cannot be explained away simply on the basis of either comorbid substance abuse or prior criminal offending., (© 2011 John Wiley & Sons A/S.)

Objectives: This study investigated the proposition that the 'State-trait anger expression inventory' (2nd ed.; STAXI-2) is susceptible to impression management (IM) and Self-Deceptive Enhancement (SDE) in clinical forensic populations. It was hypothesized that individuals engaging in IM would report significantly lower levels of trait anger, external expression of anger, and internal expression of anger on the STAXI-2. Those reporting above average SDE were predicted to claim higher levels of anger control., Design: A between-groups design was used, comparing STAXI-2 scores of individuals who reported high levels of IM and SDE to those who did not., Method: One-hundred and fifty-nine male patients of a community forensic mental health service, referred for assessment of stalking behaviours, completed the STAXI-2 and Paulhus Deception Scales (PDS). Individuals engaging in high levels of IM and SDE were compared to low scorers in regard to STAXI-2 scales using Mann-Whitney U tests., Results: Individuals engaging in IM had significantly lower levels of reported trait anger, outward expression of anger, and inward expression of anger, and higher levels of anger control. Similar results were found with the SDE scale, although the magnitude of the effect was smaller and not apparent on all subscales., Conclusions: The STAXI-2 was vulnerable to social desirability response bias in this sample of forensic clients. Where the STAXI-2 is used as a basis for treatment recommendations and decisions, it should be administered and interpreted in conjunction with a recognized measure of such bias to improve validity.

Objective: The aim of this paper was to consider some of the recent literature that has raised questions about the prevalence of, and problems with, post-traumatic stress disorder (PTSD) in the forensic context and whether it is a failure by experts to consider adequately Criterion A (1), which leads them into error and results in a skewed picture of the prevalence of PTSD in litigation., Method: The nature of the stressor criterion for PTSD from DSM-III to DSM-IV-TR, and recent literature relating to problems with the manner in which that stressor criterion is applied in forensic contexts, are considered., Results: It becomes clear that, notwithstanding that the class of persons who can suffer PTSD after a particularly traumatic event has widened since it was included in the DSM-III, the nature of the stressor required before a diagnosis of PTSD can be made has remained fairly constant., Conclusions: Whether it is because PTSD is commonly associated with receiving a benefit (e.g. through post-war disability benefits, victims of crime compensation or because of a desire to use it as an ideological weapon), PTSD has become a ubiquitous presence in the forensic context, notwithstanding objective (i.e. non-forensic) clinical studies which refer to its rarity. It is clear now that PTSD symptoms can be readily simulated when the simulator is seeking a benefit. It is also becoming clear that some psychiatrists are not being as rigorous in the forensic context as they might be in a clinical context. Thus, with discussion now underway regarding DSM-V, it may be timely to reconsider the utility of PTSD as a clinical condition.

Background: Despite the increased prevalence of psychiatric disorder amongst offenders with an intellectual disability (ID), there is very little known about the characteristics and needs of those with dual disability., Method: A study of admissions to a new community forensic dual disability clinic during the first 10 months of its operation., Results: Typically, the offenders are male, are older than other offenders, exhibit long-standing and continuing serious behavioural disturbance (independent of their psychiatric diagnosis or level of involvement with the criminal justice system) and require supported or custodial accommodation, despite only mild or borderline levels of ID. Although only one-third have a diagnosable major nonparaphilic psychiatric disorder, three-quarters have had prior or current contact with psychiatric services and two-thirds suffer chronic medical illness., Conclusions: These offenders suffer psychosocial disadvantages far more extensive than those implied by the "psychiatric" or "disability" label. The multiple services provided to this group have been ad hoc, poorly co-ordinated and sometimes dangerously inappropriate. A service provision model is required which must be integrative and consistent. We suggest the use of multiskilled key workers, who maintain close contact with individual clients. Their role will be to implement management plans from the various specialist agencies who become involved with this group and provide long-term follow-up of their recommendations.

Objective: Western Australia has one of the highest published rates of the use of compulsory treatment orders in the English-speaking world. Differences in patient characteristics, legislation and service setting may explain variations in the reported efficacy of compulsory community treatment. Our objective is to investigate predictors of Community Treatment Orders (CTO) placement in the first year of implementation in Western Australia and see if there were any differences in the type of patients placed on these orders compared to other studies., Method: A population-based record linkage study of Mental Health and Offender Databases comparing 265 patients on CTOs with a consecutive control group (CCG) of equal number matched on date of discharge from inpatient care or CTO placement., Results: Previous health service use, after-care placement, mental disorder history including schizophrenic history, a positive forensic history of violence to others as well as patient's marital status were the significant predictors of CTO placement., Conclusions: Studies of compulsory community treatment appear to be of similar populations. In spite of the comparatively high rate of use, psychiatrists in Western Australia do not appear to be applying community treatment orders to different types of patient compared to elsewhere. We need further research to establish the relative contribution of patient characteristics, legislation and service setting toward the use and outcome of compulsory community treatment.

Despite a growing awareness of the unique needs of psychiatric patients with co-occurring substance abuse and dependence disorders (i.e. dual diagnosis), there is a dearth of research investigating the prevalence of dual diagnosis in forensic psychiatric populations. Similarly, little work has been done to determine the implications of dual diagnosis for forensic psychiatric patients. Patients at the Thomas Embling Hospital in Victoria, Australia, were assessed to determine the prevalence of substance abuse disorders and mental illnesses within this population. Results reveal that the majority of patients (approximately 74%) have a lifetime substance abuse or dependence disorder. Information was collected concerning patients' criminal histories and the Level of Service Inventory, Revised, was completed for each patient who participated. Results suggest that patients with both major mental illnesses and substance abuse disorders have more extensive criminal histories and demonstrate a higher level of risks and needs when compared with patients with major mental illness alone. The implications for the development and delivery of effective forensic mental health services that address both co-occurring disorders are also discussed., (Copyright 2004 John Wiley & Sons, Ltd.)

Evaluations of programs for sex offenders report mixed results, are costly, and require validation. This study examines recidivism following a sexual offender treatment program in an Australian male offender population over an average at-risk period of 5 years and 1 month in the community. The group format, cognitive-behavioral program was offered to a subgroup of adult male prisoners. Subsequent reoffense types and rates for program completers, dropouts, and controls were compared. No statistically significant recidivism reduction was observed following participation in this sexual offender treatment program, whereas recidivism appears to be related to a history of violent or sexual offenses. The initial promise of sexual offender treatment programs must be further examined by individual and meta-analytic studies. Limited follow-up, missing data, and fidelity of the program may have contributed to the null result. Monitoring treatment programs to ensure inclusion of proven interventions may enhance future program effectiveness.