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. 2021 Sep 16:12:737846.
doi: 10.3389/fpsyt.2021.737846. eCollection 2021.

The Long-Term Changes in Dynamic Risk and Protective Factors Over Time in a Nationwide Sample of Dutch Forensic Psychiatric Patients

Marija Janković  1   2 , Geert van Boxtel  3 , Erik Masthoff  2 , Elien De Caluwé  1 , Stefan Bogaerts  1   2
Affiliations

The Long-Term Changes in Dynamic Risk and Protective Factors Over Time in a Nationwide Sample of Dutch Forensic Psychiatric Patients

Marija Janković et al. Front Psychiatry. .

Abstract

The long-term changes of dynamic risk and protective factors have rarely been studied in forensic psychiatric patients. We utilized a latent growth curve analysis to investigate trajectories of risk and protective factors over time in all 722 male forensic psychiatric patients who were unconditionally released between 2004 and 2014 from any of 12 Dutch forensic psychiatric centers (FPCs). The study covered the period from juridical observation until unconditional release. Moreover, we investigated whether these trajectories differ between patients depending on their psychiatric diagnosis namely substance use disorders (SUD), psychotic disorders, and cluster B personality disorders (PDs). In addition, we also investigated whether SUD may influence changes in risk and protective factors in a group of psychotic and cluster B PDs patients, respectively. Overall, findings suggest that all changes in dynamic risk and protective factors could be depicted by two phases of patients' stay in the FPCs. Specifically, most changes on dynamic risk and protective factors occurred at the beginning of treatment, that is, from the time of juridical assessment up to the time of unguided leave. Moreover, the moment of unguided leave could be considered the 'turning point' in the treatment of offenders. We also found that SUD and psychotic patients changed the most in the first phase of their stay, while cluster B PDs patients changed the most in the second phase. However, SUD did not modify changes in risk and protective factors in psychotic and cluster B PDs patients. These findings may help improve offender treatment and crime prevention strategies.

Keywords: cluster B personality disorders; forensic psychiatric patients; latent growth curve analysis; protective factors; psychotic disorders; risk factors; substance use disorder.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Changes over time in the clinical scale and the risk and two protective subscales. T1, Judicial psychiatric assessment; T2, Admission to the clinic; T3, Unguided leave; T4, Conditional leave; T5, Unconditional leave.
Figure 2
Figure 2
Changes over time in the protective skills subscale for patients with and without SUD. SUD, Substance use disorders; T1, Judicial psychiatric assessment; T2, Admission to the clinic; T3, Unguided leave; T4, Conditional leave; T5, Unconditional leave.
Figure 3
Figure 3
Changes over time in the clinical scale for patients with and without psychotic disorders. T1, Judicial psychiatric assessment; T2, Admission to the clinic; T3, Unguided leave; T4, Conditional leave; T5, Unconditional leave.
Figure 4
Figure 4
Changes over time in the risk subscale for patients with and without psychotic disorders. T1, Judicial psychiatric assessment; T2, Admission to the clinic; T3, Unguided leave; T4, Conditional leave; T5, Unconditional leave.
Figure 5
Figure 5
Changes over time in the protective skills subscale for patients with and without psychotic disorders. T1, Judicial psychiatric assessment; T2, Admission to the clinic; T3, Unguided leave; T4, Conditional leave; T5, Unconditional leave.
Figure 6
Figure 6
Changes over time in the risk subscale for patients with and without cluster B diagnosis. T1, Judicial psychiatric assessment; T2, Admission to the clinic; T3, Unguided leave; T4, Conditional leave; T5, Unconditional leave.
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