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Background: Young adults represent a third of the United Kingdom prison population and are at risk of poor health outcomes, including drug and alcohol misuse, self-harm and suicide. Court diversion interventions aim to reduce the negative consequences of criminal sanctions and address the root causes of offending. However, evidence of their effectiveness has not yet been established. The Gateway programme, issued as a conditional caution, aimed to improve the life chances of young adults committing low-level offences. Participants agreed not to reoffend during the 16-week caution and, following a needs assessment, received individual support from a Gateway navigator and attended two workshops encouraging analysis of own behaviour and its consequences. Objective: To evaluate the effectiveness and cost-effectiveness of Gateway in relation to health and well-being of participants compared to usual process (court summons or a different conditional caution). Design, setting and participants: Pragmatic, multisite, parallel-group, superiority randomised controlled trial with two 6-month internal pilots and a target sample size of 334. Randomisation between Gateway and usual process was on a 1 : 1 basis. Four Hampshire Constabulary sites recruited 18- to 24-year-old residents of Hampshire and Isle of Wight who were questioned for an eligible low-level offence. Semistructured interviews were also held with a sample of Gateway programme participants, staff and police study recruiters. Main outcome measures: Primary outcome was the Warwick-Edinburgh Mental Wellbeing Scale score at 12 months. Secondary outcomes included health status, alcohol and drug use, recidivism and resource use. Results: Recruitment commenced in October 2019 and the trial stopped in April 2021. A total of 191 participants were recruited, with 109 randomised to Gateway and 82 to usual process. Due to an initial overestimation of potentially eligible young people and low retention rates, recruitment targets were adjusted, and a range of mitigating measures introduced. Although recruitment broadly met study progression criteria [35/50 (70%) Pilot 1: 64/74 (86%) Pilot 2], retention was low throughout (overall: data collected at week 4 was 50%: at week 16 it was 50%: 1-year 37%). Low retention was multifactorial, with one of the main barriers being difficulties contacting participants. It was therefore not possible to complete the randomised controlled trial or the health economics analyses. Qualitative interviews held with 58 individuals yielded rare insights into the benefits and limitations of this type of intervention, as well as barriers and facilitators in relation to recruitment in this setting. Limitations: Despite close collaboration with the police to address recruitment and consent issues, expansion of the inclusion criteria and recruitment area and introducing other measures, the researchers were unable to collect sufficient data within an acceptable timeframe. Conclusions: The Gateway study was a unique endeavour to gather evidence for a potentially life-changing intervention for an underserved population. The experience gained indicates that randomised controlled trials of interventions, with a health-related outcome, are possible in this setting but point towards the need for conservative recruitment and retention estimates in this target population. Other study designs should be considered. The qualitative evaluation provided a range of valuable lessons for those seeking to design similar interventions or conduct research in similar settings. Study registration: This study is registered as ISRCTN11888938. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 16/122/20) and is published in full in Public Health Research; Vol. 12, No. 7. See the NIHR Funding and Awards website for further award information.

Young adults who commit low-level offences often have many health and social needs, making them vulnerable to physical and mental health problems. The Gateway programme was a conditional caution developed to address the underlying causes of low-level offending in young people aged 18­24 years and hence improve their life chances. In Gateway, a mentor assessed the young person's needs and supported them, signposting to healthcare, housing or other services as required. The young people also participated in two workshops, analysing the causes and consequences of their behaviour. To find out if Gateway improved health and reoffending rates, a group of those who received a Gateway conditional caution were compared with a group of those receiving a court summons or a different conditional caution. Of the 191 participants recruited to the study, 109 were randomised to Gateway and 82 to the usual process. However, the researchers had significant difficulties getting hold of the study participants on the phone and they were unable to collect enough information from them to be able to say whether Gateway worked. The researchers introduced various changes to overcome this, but in the end had to stop the study early. As part of the study, the researchers interviewed 28 Gateway programme participants, 17 Gateway project staff and 13 police officers and staff who had been recruiting into the study. From the interviews the study discovered the perceived benefits of Gateway, how programmes like this could be improved and which factors helped or got in the way of doing research in the police setting. The Gateway study aimed to provide evidence for a potentially life-changing intervention for vulnerable young adults. Although it proved impossible to complete the study, the lessons learnt from running it should help colleagues design similar programmes or plan research studies with similar populations or in similar settings.

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BACKGROUND: Childhood Maltreatment (CM) is linked to adverse outcomes, including Borderline Personality Disorder (BPD) and increased propensity for offending behaviors. However, research on the specific role that BPD plays between the two is limited and highly relevant given the high prevalence of CM in Australia. OBJECTIVE: The present study aimed to investigate (1) the relationship between CM and subsequent offending behaviors, (2) whether BPD mediates the relation between CM and offending behaviors, and (3) which type of CM (physical, sexual, emotional abuse, neglect, exposure to domestic violence, multitype maltreatment) predicts BPD. PARTICIPANTS: The sample comprised 106 self-identified Australian female survivors of interpersonal violent crimes. METHODS: Participants completed an online survey consisting of the Adverse Childhood Events Questionnaire, the McLean Screening Instrument for BPD, and a self-created questionnaire to measure offending behaviors. Regression, mediation analysis, and logistic regression were conducted. RESULTS: CM significantly predicted offending behaviors (path c, B = 1.39, p <. 001) with BPD partially mediating the relationship (path c', B = 1.04, 95 % CI [0.31, 1.77], p = .006; path a, B = 0.47, 95 % CI [0.12, 0.83], p = .009, path b, B = 0.34, 95 % CI [0.07, 0.61], p = .014). Emotional abuse and multitype exposure were identified as predictors of BPD symptom development (OR = 9.42, 95 % CI OR [2.58, 34.40]; OR = 3.81, 95 % CI OR [1.41; 10.28], respectively). CONCLUSION: These findings indicate the necessity of early interventions addressing CM, with a particular focus on emotional abuse and exposure to more than one type of maltreatment, to reduce the risk of developing BPD symptomatology and mitigate future offending behaviors.

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A growing body of research highlights the continuum between dark and bright personality traits impacting individual prosocial or antisocial tendencies. However, the interplay between personality dimensions and actual criminal behavior and its reoccurrence is not fully elucidated. We aimed to explore the cumulative predictive value of the bright and dark core of personality for criminal history in differentiating a general community sample (N = 282) from a large sample of inmates (N = 296), with (n = 129) or without (n = 167) criminal history while controlling for age, sex and impression management. Predictors of first-time offending were higher levels of Neuroticism, Openness, Dark Factor, Sadism, and Deceitfulness. Criminal recidivism was predicted by high Neuroticism and Deceitfulness. Finally, higher levels of Extraversion were negatively related to criminal behavior and history, highlighting a potential protective effect of displaying assertive and sociable tendencies. The findings highlight the relevance of considering the dark personality core complementary to the typical personality dimensions in the risk assessment, prediction, and reduction of criminal behavior.

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Medical-legal partnerships (MLPs) are well suited to address health-harming legal needs associated with the collateral consequences of mass incarceration in the United States, such as those that limit access to food, housing, employment, and family reunification postrelease. MLP innovations seek to expand the current model to address patients' criminal, as well as postrelease, civil legal needs by including community health workers and some patients as legal partners and creating coalitions to promote local and state policy change. Overall, this article explains how these MLP innovations can support rights of people returning to communities after incarceration and can be leveraged to mitigate criminal legal system involvement.

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BACKGROUND: The increase in online enticement has led to law enforcement agencies engaging in more proactive policing through undercover chat sting operations. OBJECTIVE: We aimed to identify the topics and communication strategies triggering suspicion in chats between law enforcement officers and offenders and why those topics do not result in suspicion in victim-offender conversations. METHODS: We conducted a thematic analysis identifying: (1) how LEOs trigger suspicion, (2) how offenders communicate suspicion, (3) how LEOs attempt recovery from suspicion, and (4) how these triggers were present but did not trigger suspicion in victim-offender chats. We examined 20 LEO-offender chats and 20 victim-offender chats from US ICAC task forces. RESULTS: We identified four themes that triggered suspicion: risk assessment by the LEO's persona, LEO avoidance measures, details related to the offense and evidence, and proof of identity of chat participants. Offender responses to triggers revealed three themes: discomfort navigating boundaries and uncertainty, risk identification, and risk mitigation. Themes for the LEO's responses to suspicion included: risk assessment for chatters, issues with technology, appeasement, and negative emotional reactions. Finally, juxtaposing triggers onto minor-offender chats yielded four themes: explicit boundary setting, victim risk assessment, deep relationship forming and disclosures, and technology issues. CONCLUSION: This study has implications for law enforcement agencies seeking to reduce suspicion and risk assessment by offenders during internet sting operations.

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BACKGROUND: Most research examining the consumption of online child sexual abuse material (CSAM) has focused on offenders' demographic and psychological characteristics. While such research may assist in the development of therapeutic interventions with known offenders, it has little to offer the development of interventions for the vast majority of offenders who are never caught. OBJECTIVE: To learn more about the offending strategies of CSAM offenders, in order to inform prevention efforts to deter, disrupt, and divert individuals from their pursuit of CSAM. PARTICIPANTS & SETTING: Seventy-five male CSAM offenders, who were living in the community and were voluntarily participating in a treatment programme. METHODS: Participants completed a detailed self-report questionnaire focussing on their pathways to offending and their online behaviour. RESULTS: Most participants reported that they did not initially seek out CSAM but that they first encountered it inadvertently or became curious after viewing legal pornography. Their involvement in CSAM subsequently progressed over time and their offending generally became more serious. The most notable feature of participants' online behaviour was the relative lack of sophisticated technical expertise. Opportunity and other situational factors emerged as mediators of offending frequency. Offending patterns were affected by participants' psychological states (e.g., depression, anger, stress), offline relationships and commitments (e.g., arguments with spouse, loss of job), and online experiences (e.g., blocked sites, viruses, warning messages). CONCLUSIONS: Findings suggest that many offenders are receptive to change and may be potentially diverted from their offending pathway.

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OBJECTIVE: We conducted three preregistered studies to examine whether victims of crime are more receptive to apologies in victim-offender mediation if they feel they know the "whole" truth about a crime. HYPOTHESES: We predicted that making salient the completeness (vs. incompleteness) of knowledge about a crime would lead victims to (a) have a greater sense of truth knowing and (b) view an apology more favorably. METHOD: Participants in Study 1 (N = 380; Mage = 41.2 years; 51% men; 78% White) and Study 2 (N = 550; Mage = 41.0 years; 65% women; 72% White) imagined being the victim of cybercrime. Participants in Study 3 (N = 670; Mage = 42.7 years; 52% men; 72% White) were real crime victims. Participants imagined taking part in victim-offender mediation during which the offender apologized, and then they evaluated the apology after answering questions that made salient what they either knew or did not know about the crime (complete knowledge salience vs. incomplete knowledge salience). Participants in Study 2 received additional information about the crime from either the offender or the police to test whether truth source acts as a moderator. RESULTS: Participants in the complete (vs. incomplete) knowledge salience condition reported greater truth knowing (Study 1 d = 1.40, Study 2 d = 1.26, Study 3 d = 0.58), readiness for an apology (Study 1 d = 0.25; Study 2 d = 0.23; Study 3 d = 0.09, nonsignificant), perceived completeness of an apology (Study 1 d = 0.26, Study 2 d = 0.31, Study 3 d = 0.19), and acceptance of an apology (Study 1 d = 0.22; Study 2 d = 0.21; Study 3 d = 0.10, nonsignificant). In Study 2, truth source moderated the effect only on apology acceptance (η2 = .009). Across the three studies, complete (vs. incomplete) knowledge salience was indirectly positively related to apology readiness, apology completeness, and apology acceptance (nonsignificant in Study 3), via truth knowing. CONCLUSIONS: Instances of victim-offender mediation should ensure that victims' need for truth is satisfied because this may increase the effectiveness of apologies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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To fully respond to the provisions of the Judicial Authority relating to the care of minors and/or young adults subjected to judicial measures and affected by mental suffering and/or substance abuse, also with a view to a possible provision of placement in a therapeutic community, the UOSD "Protection of the Health of Adults and Minors in the Penal Area" - ASL Salerno has ensured operations through the establishment of a dedicated multidisciplinary team, made up of a psychiatrist, psychologist and social worker, as required by DGRC 567/2018, or as the only interface with the Judicial Authority in reference to healthcare. This article aims to describe the birth of the EMM (Equipe Multidisciplinare Minori), and of the methods used to take care of minors and/or young adult offenders affected by mental suffering and/or substance abuse. The article examines a sample of 207 minors, relating to the years 2018-2022, to highlight the most critical areas.

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OBJECTIVE: The mainstream view in trait aggression research has regarded the structure as representing the latent cause of the cognitions, emotions, and behaviors that supposedly reflect its nature. Under network perspective, trait aggression is not a latent cause of its features but a dynamic system of interacting elements. The current study uses network theory to explain the structure of relationships between trait aggression features in juvenile offenders and their peers. METHODS: Network analysis was applied to investigate the dynamic system of trait aggression operationalized by the Buss-Perry Aggression Questionnaire in a sample of community youths (Mage = 17.46, N = 715) and juvenile offenders (Mage = 18.36, N = 834). RESULTS: The facet level networks showed that anger is a particularly effective mechanism for activating all other traits. In addition, anger was more strongly associated with physical aggression and the overall network strength was greater in juvenile delinquency networks than in their peers. The item level networks revealed that A4 and A6 exhibited the highest predictability and strength centrality in both samples. Also, the Bayesian network indicated that these two items were positioned at the highest level in the model. There are similarities and differences between juvenile delinquents and community adolescents in trait aggression. CONCLUSION: Trait aggression was primarily activated by difficulty controlling one's temper and feeling like a powder keg.

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INTRODUCTION: There is uncertainty about whether criminal legal involvement (CLI) impacts the effectiveness of medications for opioid use disorder (MOUD). We aimed to determine whether CLI modifies the association between buprenorphine-naloxone (BUP-NX) vs. extended-release naltrexone (XR-NTX) and MOUD treatment outcomes. METHODS: We conducted a secondary analysis of X:BOT, a 24-week multi-center randomized controlled trial comparing treatment outcomes between BUP-NX (n = 287) and XR-NTX (n = 283) in the general population. We used baseline Additional Severity-Index Lite responses to identify patients with recent CLI (n = 342), defined as active CLI and/or CLI in the past 30 days, and lifetime incarceration (n = 328). We explored recent CLI and lifetime incarceration as potential effect modifiers of BUP-NX vs. XR-NTX effectiveness on relapse, induction, and overdose. We conducted both intention-to-treat and per-protocol analyses for each outcome. RESULTS: In intention-to-treat analyses, recent CLI modified the effect of BUP-NX vs. XR-NTX on odds of successful induction (p = 0.03) and hazard of overdose (p = 0.04), but it did not modify the effect on hazard of relapse (p = 0.23). All participants experienced lower odds of successful induction with XR-NTX compared to BUP-NX, but the relative likelihood of successful induction with BUP-NX was lower than XR-NTX among individuals with recent CLI (OR: 0.25, 95 % CI: 0.13-0.47, p < 0.001) compared to those without recent CLI (OR: 0.04, 95 % CI: 0.01-0.19, p < 0.001). Participants with recent CLI experienced similar hazard of overdose with XR-NTX and BUP-NX (HR: 1.12, 95 % CI: 0.42-3.01, p = 0.82), whereas those without recent CLI experienced greater hazard of overdose with XR-NTX compared to BUP-NX (HR: 12.60, 95 % CI: 1.62-98.03, p = 0.02). In per-protocol analyses, recent CLI did not modify the effect of MOUD on hazard of overdose (p = 0.10) or relapse (p = 0.41). Lifetime incarceration did not modify any outcome. CONCLUSIONS: Compared to individuals without recent CLI, individuals with recent CLI experienced decreased relative effectiveness of BUP-NX compared to XR-NTX for induction and overdose outcomes. This highlights the importance of considering the impact of recent CLI on opioid use disorder treatment outcomes. Future research should explore the mechanisms through which recent CLI modifies MOUD effectiveness and aim to improve MOUD effectiveness for individuals with recent CLI.

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BACKGROUND: Effective classification of individuals who commit sexual offences is important for their assessment, treatment, and risk management. Victim age has often been used as a distinguishing factor between perpetrators. OBJECTIVE: This study aimed to analyse the distinctive psychopathological and criminological characteristics of contact sexual offenders with adult and minor victims. PARTICIPANTS AND SETTING: The study involved 97 adult males who were serving a prison sentence in Spain for at least one contact sexual offence against an adult or a minor. METHODS: Researchers gathered data on criminological variables concerning the offender, victim, and modus operandi from prison records and interviews. Participants completed the Millon Clinical Multiaxial Inventory-III (MCMI-III) in a second session, and between-group differences were analysed. RESULTS: Sex offenders with minor victims (SOMV) had significantly lower scores than sex offenders with adult victims (SOAV) on the Antisocial (r = -0.283, p = .005) and Sadistic (r = -0.209, p = .04) personality subscales, and on the Alcohol (r = -0.426, p < .001) and Drug dependence (r = -0.332, p = .001) syndrome subscales. SOAV were also more likely to use violence and/or intimidation, use a weapon, offend against female victims, offend against an intimate partner, commit their offences in public places, serve other ongoing prison sentences, and report a history of alcohol and substance abuse. SOMV were older and more likely to offend against family members. CONCLUSIONS: These results suggest that there are key differences between SOAV and SOMV that should be considered in tailored prevention programmes for each subgroup of offenders.

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BACKGROUND: The grooming process involves sexually explicit images or videos sent by the offender to the minor. Although offenders may try to conceal their identity, these sexts often include hand, knuckle, and nail bed imagery. OBJECTIVE: We present a novel biometric hand verification tool designed to identify online child sexual exploitation offenders from images or videos based on biometric/forensic features extracted from hand regions. The system can match and authenticate hand component imagery against a constrained custody suite reference of a known subject by employing advanced image processing and machine learning techniques. DATA: We conducted experiments on two hand datasets: Purdue University and Hong Kong. In particular, the Purdue dataset collected for this study allowed us to evaluate the system performance on various parameters, with specific emphasis on camera distance and orientation. METHODS: To explore the performance and reliability of the biometric verification models, we considered several parameters, including hand orientation, distance from the camera, single or multiple fingers, architecture of the models, and performance loss functions. RESULTS: Results showed the best performance for pictures sampled from the same database and with the same image capture conditions. CONCLUSION: The authors conclude the biometric hand verification tool offers a robust solution that will operationally impact law enforcement by allowing agencies to investigate and identify online child sexual exploitation offenders more effectively. We highlight the strength of the system and the current limitations.

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Psychosocial functioning represents a core treatment target of Schizophrenia Spectrum Disorders (SSD), and several clinical and cognitive factors contribute to its impairment. However, determinants of psychosocial functioning in people living with SSD that committed violent offences remain to be more thoroughly explored. This study aims to separately assess and compare predictors of psychosocial functioning in people with SSD that did and that did not commit violent offences considering several clinical, cognitive and violence-related parameters. Fifty inmates convicted for violent crimes in a forensic psychiatry setting diagnosed with SSD (OP group) and fifty participants matched for age, gender, education, and diagnosis (Non-OP group) were included in the study. A higher risk of violent relapse as measured by HCR-20 clinical subscale scores (p < 0.002) and greater global clinical severity as measured by CGI-S scores (p = 0.023) emerged as individual predictors of worse psychosocial functioning, as measured by PSP scores, in the OP group. Greater global clinical severity (p < 0.001), worse performance in the processing speed domain as measured by the BACS Symbol Coding (p = 0.002) and TMT-A tests (p = 0.016) and higher levels of non-planning impulsivity as measured by BIS-11 scores (p < 0.001) emerged as individual predictors of worse psychosocial functioning in the Non-OP group. These results confirm that clinical severity impacts psychosocial functioning in all individuals diagnosed with SSD and suggest that while cognitive impairment clearly represents a determinant of worse functional outcomes in most patients, the risk of violent relapse is a specific predictor of worse psychosocial functioning in people with SSD that committed criminal offences.

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BACKGROUND: Secure forensic hospital treatments are resource-intensive, aiming to rehabilitate offenders and enhance public safety. While these treatments consume significant portions of mental health budgets and show efficacy in some countries, their effectiveness in Czechia remains underexplored. Previous research has highlighted various factors influencing the likelihood of discharge from these institutions. Notably, the role of sociodemographic variables and the length of stay (LoS) in the context of forensic treatments has presented inconsistent findings across studies. METHODS: The study, part of the 'Deinstitutionalization project' in Czechia, collected data from all inpatient forensic care hospitals. A total of 793 patients (711 male, 79 female and 3 unknown) were included. Data collection spanned 6 months, with tools like HoNOS, HoNOS-Secure, MOAS, HCR-20V3 and AQoL-8D employed to assess various aspects of patient health, behaviour, risk and quality of life. RESULTS: The study revealed several determinants influencing patient discharge from forensic hospitals. Key assessment tools, such as HoNOS secure scores and the HCR-20 clinical subscale, showed that higher scores equated to lower chances of release. Furthermore, specific diagnoses like substance use disorder increased discharge odds, while a mental retardation diagnosis significantly reduced it. The type of index offense showed no influence on discharge decisions. CONCLUSION: Factors like reduced risk behaviours, absence of mental retardation diagnosis, social support and secure post-release housing plans played significant roles. The results underscored the importance of using standardized assessment tools over clinical judgement. A standout insight was the unique challenges faced by patients diagnosed with mental retardation, emphasizing a need for specialized care units or tailored programmes.

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The Criminal Sentiments Scale-Modified (CSS-M) has been widely used as a measure of criminal attitudes. This analysis examined CSS-M scores in a large sample of outpatients with serious mental illnesses and a criminal legal system history. We compared total and subscale scores in our sample to scores from two other previously published U.S. studies in which the CSS-M was used, and evaluated associations between total CSS-M score and nine variables (age, educational attainment, gender, race, marital status, employment status, diagnostic category, substance use disorder comorbidity, and adverse childhood experiences (ACE) score). Scores were higher than in two prior U.S. studies involving other types of samples. Independently significant predictors of higher CSS-M scores included being younger (P < .001), having a higher ACE score (P < .001), being male (P = 03), not identifying as White (P < 001), not having a psychotic disorder (P < 001), and having a comorbid substance use disorder (P = 002). Future research should test the hypothesis that these factors increase risk for arrest and that arrest events, and subsequent criminal legal system involvement, are characterized by negative experiences and perceptions of poor procedural justice, which in turn underpin the negative opinions referred to as "criminal sentiments" or criminal attitudes.

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INTRODUCTION: Treatment of individuals who have committed sexual offences with Testosterone-Lowering Medication (TLM) is a comparatively intrusive kind of intervention, which regularly takes place in coercive contexts. Thus, the question of efficacy, but also the question of who should be treated, when and for how long, are of great importance. METHODS: Recidivism rates of TLM-treated high-risk individuals (+TLM; n = 54) were compared with high-risk individuals treated with psychotherapy only in the same forensic outpatient clinic (-TLM; n = 79). RESULTS: Group differences suggested a higher initial risk of + TLM (e.g. higher ris-assessment, previous convictions). Despite the increased risk, after an average time at risk of six years, +TLM recidivated significantly less often and significantly later than - TLM (27.8% vs. 51.9%). Such an effect was also found for violent (1.9% vs. 15.2%), but not for sexual (5.6% vs. 10.1%) and serious recidivism (5.6% vs. 10.1%), which could be explained partly by the small number of cases. In the course of treatment, TLM proved to be a significant variable for a positive process, whereas a high risk-assessment score indicated a rather negative course. In total, n = 19 individuals had stopped their TLM treatment, of these 31.6% recidivated. CONCLUSION: The results support the efficacy of TLM, particularly in the group of high-risk offenders.

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BACKGROUND: Psychosocial rehabilitation in forensic psychiatric services requires sound measurement of patient and staff perceptions of psychosocial function. The recommended World Health Organisation Disability Assessment Schedule 2.0 (WHODAS), designed for this, has not been examined with offender patients. AIMS: To examine patient and staff WHODAS ratings of secure hospital inpatients with psychosis, any differences between them and explore associations with other clinical factors. METHODS: Seventy-three patients self-rated on the WHODAS after 3 months as inpatients. An occupational therapist interviewed the patient's primary nurse and care team at about the same time (staff ratings). Scores were calculated according to the WHODAS manual. WHODAS scores and interview-rated symptom severity, cognitive measures, daily antipsychotic dose and duration of care were compared. RESULTS: Patient ratings indicated less disability than staff ratings for total score and for the domains of understanding and communicating, getting along and life activities. Self-care and participation ratings were similar. Patients were more likely to rate themselves as disabled in getting around (mobility). Only one-fifth of patient- and staff- ratings (16, 22%) were similar, while for nearly a third of the patients (23, 32%) self-ratings were higher than staff ratings. More severe positive symptoms were associated with higher self-rated WHODAS disability after accounting for treatment duration, negative symptoms, cognitive score and antipsychotic dose. No variable accounted for the staff/patient differences in ratings. CONCLUSION: Our mean WHODAS score findings echoed those in other patient samples-of patient underestimation of disability, linked to severity of symptoms. In this study using the WHODAS for the first time in a forensic mental health secure inpatient service, however, we found that, by comparing individuals, half of the patients reported equivalent or greater disability than did staff. Future research should focus on elucidating from patients what contributes to their self-ratings. Understanding their thought processes in rating may enhance rehabilitation planning.

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Sexual homicide (SH) research has focused on those who commit these crimes and the crimes themselves. This leaves the victim, an equally crucial piece to the puzzle, left as a sort of afterthought, despite the valuable insight that victimology provides to the crime. For the current study, victim information related to their routine activities and lifestyles was taken from an international database containing 662 solved cases of SH. Nine victim variables were used in a latent class analysis to find hidden subgroups within the victim population. Three classes were identified-low-risk, homebody, and overt risk victims-which suggests that SH victimization varies depending on the victim lifestyles and routine activities. These groups were externally validated by examining their association with different phases of the crime commission process. Some sexual homicide offenders may be more drawn to a victim because they present as vulnerable and opportunistic, while others might be methodically targeted. The theoretical relevance of this typology, along with investigative and prevention strategies, is discussed.

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RATIONALE: Twenty-one Community Rehabilitation Companies were set up following the division of the National Probation Services during 'Transforming Rehabilitation' in England and Wales, under a 2013 Ministry of Justice initiative. Reunification commenced in 2018. A study completed prior to these changes suggested that probation officers had had little training in recognising attention-deficit hyperactivity disorder (ADHD) and may have been underestimating its prevalence among their clientele. Given the substantial changes in probation staffing and organisation since 2018, a new study seems warranted. AIMS: The aim of the study was to understand experiences of people under a community sentence who reported having ADHD and of probation staff working with them. METHODS: Using a qualitative research design, one-to-one semi-structured interviews were conducted with client facing probation staff recruited from one Community Rehabilitation Company. Service users undertaking a community sentence who had been diagnosed with or self-identified as having ADHD were then identified and recruited by these staff; those who consented were also interviewed. Transcripts were analysed using a thematic analytic approach. RESULTS: Thirteen probation staff and six male offenders under community sentences, agreed to participate and completed interviews. The overarching themes emerging from the two groups were similar, both reflecting on descriptions of ADHD; treatment of ADHD; experiences of having or working with ADHD in the wider community and in the criminal justice system specifically and visions of future support needs tied to the order. In addition, probation officers specifically raised the matter of payment by results. Both service users and probation staff identified gaps in knowledge, experience and services, but areas of good practice were also identified. CONCLUSION: The findings highlight the continuing under-acknowledgement of tailored clinical support for people serving a community sentence who have ADHD together with a lack of support and training about ADHD for probation staff. Return to the national organisation of probation services and recognition of need for a range of relevant skills offers a great opportunity for re-evaluating supervision and management of offenders under community sentences who have ADHD. These findings provide the basis for a template for developing knowledge and support provision for probation staff to recognise ADHD, or its likelihood, and their capacity to follow through with appropriately informed personalised supervision plans and access to specialist service advice and support.

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