Forensic psychiatry embodies a highly heterogeneous population differing widely in terms of diagnoses, crimes committed, and risk factors. All of these are vitally important for treatment indications and should be accounted for in research. However, there is limited empirical knowledge of patient profiles. This study constructed patient profiles on the basis of the three domains mentioned above. Participants were found guilty of having committed crimes due to psychiatric disorders and were admitted to Forensic Psychiatric Center (FPC) 2landen or FPC De Kijvelanden in the Netherlands. Retrospective data were retrieved from patient files. Diagnoses were assessed according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria and risk factors according to the Historical Clinical Future–30 (HKT-30) instrument. Latent class analysis was conducted to define typologies; external variables were included for validation. Four different classes or “patient risk profiles,” with varying psychopathologies, risk factors, and crimes, were identified. Results were consistent with previous studies, and external validation with the Psychopathy Checklist–Revised (PCL-R) two-factor model and the four facets of the PCL-R agreed with results found. Results display specific risk factors for specific psychopathology/offense combinations.
AllanM.GraceR. C.RutherfordB.HudsonS. M. (2007). Psychometric assessment of dynamic risk factors for child molesters. Sexual Abuse: A Journal of Research and Treatment, 19, 347-367. doi:10.1007/s11194-007-9052-5
2.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
3.
AndrewsD. A.BontaJ. (2010). The psychology of criminal conduct (5th ed.). New Providence, NJ: Matthew Bender.
4.
AndrewsD. A.GuzzoL.RaynorP.RoweR. C.RettingerL. J.BrewsA.WormithJ. S. (2012). Are the major risk/need factors predictive of both female and male reoffending? A test with the eight domains of the Level of Service/Case Management Inventory. International Journal of Offender Therapy and Comparative Criminology, 56, 113-133. doi:10.1177/0306624X10395716
5.
BeekmanA. T. F.Van OsJ.Van MarleH. J. C.Van HartenP. N. (2012). Stagering en profilering van psychiatrische stoornissen [Staging and profiling of psychiatric disorders]. Tijdschrift voor Psychiatrie, 54, 915-920.
6.
BelliH.UralC. (2012). The association between schizophrenia and violent or homicidal behavior: The prevention and treatment of violent behavior in these patients. West Indian Medical Journal, 61, 538-543.
7.
BoS.Abu-AkelA.KongerslevM.HaahrU. H.SimonsenE. (2011). Risk factors for violence among patients with schizophrenia. Clinical Psychology Review, 31, 711-726. doi:10.1016/j/cpr.2011.03.002
8.
BogaertsS.PolakM.SpreenM.ZwetsA. (2012). High and low aggressive narcissism and anti-social lifestyle in relationship to impulsivity, hostility, and empathy in a group of forensic patients in the Netherlands. Journal of Forensic Psychology Practice, 12, 147-162. doi:10.1080/15228932.2012.650144
9.
BogaertsS.SpreenM. (2011). Persoonlijkheidspathologie, slachtofferschap vóór het 18e levensjaar, huiselijk geweld en delict informatie in een klinische groep terbeschikkinggestelden [Personality pathology, victimization before the age of 18, domestic violence and crime information in a clinical group of inpatients]. Den Haag, The Netherlands: Onderzoek in opdracht van het Ministerie van Justitie en Veiligheid, WODC.
10.
BogaertsS.SpreenM.HorváthZ.PolakM. S.Cima-KnijffM. J. (2013). Career criminality, childhood experiences and adult personality among forensic patients in the Netherlands. In HelfgottJ. B. (Ed.), Criminal psychology (pp. 381-402). Westport, CT: Praeger.
11.
BogaertsS.VanheuleS.DeClercqF. (2005). Recalled parental bonding, adult attachment style, and personality disorders in child molesters: A comparative study. The Journal of Forensic Psychiatry & Psychology, 16, 445-458.
12.
BogaertsS.VervaekeG.GoethalsJ. (2004). A comparison of relational attitude and personality disorders in the explanation of child molestation. Sexual Abuse: A Journal of Research and Treatment, 16, 37-47.
13.
BontaJ.AndrewsD. A. (2007). Risk-need-responsivity model for offender assessment and treatment (User Report No. 2007-06). Ottawa, Ontario: Public Safety Canada.
14.
BontaJ.LawM.HansonK. (1998). The prediction of criminal and violent recidivism among mentally disordered offenders: A meta-analysis. Psychological Bulletin, 123, 123-142.
15.
BoutronN.BonnetK.MakT. (1996). Drug abuse: A significant variable in schizophrenia research. Biological Psychiatry, 39, 1053-1054. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8780842
16.
BuschmanJ.BogaertsS.FoulgerS.WilcoxD.SosnowskiD.CushmanB. (2010). Sexual history disclosure polygraph examinations with cybercrime offences: A first Dutch explorative study. International Journal of Offender Therapy and Comparative Criminology, 54, 395-411. doi:10.1177/0306624X09334942
17.
CernkovichS.GiordanoP. (2001). Stability and change in antisocial behavior: The transition from adolescence to early adulthood. Criminology, 39, 371-410. doi:10.1111/j.1745-9125.2001.tb00927.x
18.
CoidJ.HickeyN.KahtanN.ZhangT.YangM. (2007). Patients discharged from medium secure forensic psychiatry services: Reconvictions and risk factors. British Journal of Psychiatry, 190, 223-229.
19.
CraigL. A.BrowneK. D.BeechA.StringerI. (2006). Differences in personality and risk characteristics in sex, violent and general offenders. Criminal Behaviour and Mental Health, 16, 183-194. doi:10.1002/cbm.618
20.
CursonD. A.DukeP. J.HarveyC. A.PantelisC.BarnesT. R. (1999). Four behavioural syndromes of schizophrenia: A replication in a second inner-London epidemiological sample. Schizophrenia Research, 37, 165-176. doi:10.1016/S0920-9964(98)00151-0
21.
DavisonS.JancaA. (2012). Personality disorder and criminal behaviour: What is the nature of the relationship?Current Opinion in Psychiatry, 25, 39-45. doi:10.1097/YCO.0b013e32834d18f0
22.
Dell’OssoL.PiniS. (2012). What did we learn from research on comorbidity in psychiatry? Advantages and limitations in the forthcoming DSM-V era. Clinical Practice & Epidemiology in Mental Health, 8, 180-184. doi:10.2174/1745017901208010180
23.
De VogelV.De RuiterC.BoumanY. (2007). Meting van protectieve factoren en het belang ervan voor behandeling in de forensische setting [Measurement of protective factors and the importance within treatment in the forensic setting]. Tijdschrift voor Psychotherapie, 33, 102-119. doi:10.1007/BF03062262
24.
De VriesK.SpreenM. (2012). De HKT-30 als instrument voor beslismomenten binnen een tbs-behandeling [Can the clinical items of the risk assessment instrument HKT-30 predict to what extent forensic patients will break agreements during the resocialisation phase of treatment?]. Tijdschrift voor Psychiatrie, 54, 429-438. Retrieved from http://www.tijdschriftvoorpsychiatrie.nl/issues/453/articles/9380
25.
FirestoneP.BradfordJ. M.GreenbergD. M.SerranG. A. (2000). The relationship of deviant sexual arousal and psychopathy in incest offenders, extrafamilial child molesters, and rapists. Journal of the American Academy of Psychiatry and the Law, 28, 303-308.
26.
FridellM.HesseM.JaegerM. M.KühlhornE. (2008). Antisocial personality disorder as a predictor of criminal behaviour in a longitudinal study of a cohort of abusers of several classes of drugs: Relation to type of substance and type of crime. Addictive Behaviors, 33, 799-811. doi:10.1016/j.addbeh.2008.01.001
27.
FullamR.DolanM. (2006). The criminal and personality profile of patients with schizophrenia and comorbid psychopathic traits. Personality and Individual Differences, 40, 1591-1602. doi:10.1016/j.paid.2006.01.003
28.
HallR. C.HallR. C. (2007). A profile of pedophilia: Definition, characteristics of offenders, recidivism, treatment outcomes, and forensic issues. Mayo Clinic Proceedings, 82, 457-471. doi:10.4065/82.4.457
29.
HannemS. (2013). Experiences in reconciling risk management and restorative justice: How Circles of Support and Accountability work restoratively in the risk society. International Journal of Offender Therapy and Comparative Criminology, 57, 269-288. doi:10.1177/0306624X11432538
30.
HansonR. K.HarrisA. J. R. (2000). Where should we intervene? Dynamic predictors of sexual offense recidivism. Criminal Justice and Behavior, 27, 6-35. doi:10.1177/0093854800027001002
31.
HaqqiS. (2010). Substance abuse in Schizophrenia—A short report. Procedia—Social and Behavioral Sciences, 5, 2239-2241. doi:10.1016/j.sbspro.2010.07.442
32.
HareR. D. (1991). The Psychopathy Checklist–Revised. Toronto, Ontario, Canada: Multi-Health Systems.
33.
HareR. D.HarpurT. J.HakstianA. R.ForthA. E.HartS. D.NewmanJ. P. (1990). The revised Psychopathy Checklist: Reliability and factor structure. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2, 338-341. doi:10.1037/1040-3590.2.3.338
34.
HareR. D.NeumannC. S. (2005). Structural models of psychopathy. Current Psychiatry Reports, 7, 57-64. doi:10.1007/s11920-005-0026-3
35.
HarteJ.BreukinkM. (2010). Objectiviteit of schijnzekerheid? Kwaliteit, mogelijkheden en beperkingen van instrumenten voor risicotaxatie [Objectivity or false security? Quality and possibilities of risk assessment tools]. Tijdschrift voor criminologie, 52, 52-72. Retrieved from http://hdl.handle.net/1871/21902
36.
HildebrandM.De RuiterC. (2012). Psychopathic traits and change on indicators of dynamic risk factors during inpatient forensic psychiatric treatment. International Journal of Law and Psychiatry, 35, 276-288. doi:10.1016/j.ijlp.2012.04.001
37.
HildebrandM.HesperB. L.SpreenM.NijmanH. L. I. (2005). De waarde van gestructureerde risicotaxatie en van de diagnose psychopathie. Een onderzoek naar de betrouwbaarheid en predictieve validiteit [The value of structured risk assessment and the diagnosis of psychopathy. A study for reliability and predictive validity]. Utrecht, The Netherlands: Expertise Centrum Forensische Psychiatrie.
38.
HöingM. A.BogaertsS.VogelvangB. (2013). Circles of support and accountability: How and why they work for sex offenders. Journal of Forensic Psychology Practice, 13, 267-295. doi:10.1080/15228932.2013.808526
39.
KawakamiC.OhnishiM.SugiyamaT.SomekiF.NakamuraK.TsujiiM. (2012). The risk factors for criminal behaviour in high-functioning autism spectrum disorders (HFASDs): A comparison of childhood adversities between individuals with HFASDs who exhibit criminal behaviour and those with HFASD and no criminal histories. Research in Autism Spectrum Disorders, 6, 949-957. doi:10.1016/j.rasd.2011.12.005
40.
LaubJ. H.SampsonR. J.SweetenG. A. (2006). Assessing Sampson and Laub’s life-course theory of crime. In CullenF. T.WrightJ. P.BlevinsK. R. (Eds.), Taking stock: The status of criminological theory—Advances in criminological theory (Vol. 15, pp. 313-334). New Brunswick, NJ: Transaction.
41.
LeeJ. K. P.JacksonH. J.PattinsonP.WardT. (2002). Developmental risk factors for sexual offending. Child Abuse & Neglect, 26, 73-92. doi:10.1016/S0145-2134(01)00304-0
42.
LeisticoA.-M. R.SalekinR. T.DeCosterJ.RogersR. (2008). A large-scale meta-analysis relating the Hare measures of psychopathy to antisocial conduct. Law and Human Behavior, 32, 28-45. doi:10.1007/s10979-007-9096-6
43.
LockmullerM.BeechA.FischerD. (2008). Sexual offender with mental health problems: Epidemiology, assessment and treatment. In SoothillK.RogersP.DolanM. (Eds.), Handbook of forensic mental health (pp. 446-479). Cullompton, UK: William.
44.
MouridsenS. E. (2012). Current status of research on autism spectrum disorders and offending. Research in Autism Spectrum Disorders, 6, 79-86. doi:10.1016/j.rasd.2011.09.003
45.
MulderE.VermuntJ.BrandE.BullensR.van MarleH. (2012). Recidivism in subgroups of serious juvenile offenders: Different profiles, different risks?Criminal Behaviour and Mental Health, 22, 122-135. doi:10.1002/cbm.1819
46.
MurphyD. (2010). Understanding offenders with autism-spectrum disorders: What can forensic services do? Commentary on . . . Asperger syndrome and criminal behavior. Advances in Psychiatric Treatment, 16, 44-46. doi:10.1192/apt.bp.109.006775
47.
NanayakkaraV.O’DriscollC.AllnuttS. (2012). HCR-20 risk profiles of patients referred to forensic mental health services in New South Wales. Psychiatry, Psychology and Law, 19, 711-719. doi:10.1080/13218719.2011.615819
48.
NeutzeJ.GrundmannD.SchernerG.BeierK. M. (2012). Undetected and detected child sexual abuse and child pornography offenders. International Journal of Law and Psychiatry, 35, 168-175.
49.
O’DriscollC.LarneyS.IndigD.BassonJ. (2012). The impact of personality disorders, substance use and other mental illness on re-offending. The Journal of Forensic Psychiatry & Psychology, 23, 382-391. doi:10.1080/14789949.2012.686623
50.
PalermoG. B. (2009). Editorial: Delinquency: Risks and protective factors. International Journal of Offender Therapy and Comparative Criminology, 53, 247-248. doi:10.1177/0306624X09335886
51.
PetersonJ. L.SkeemJ. L.HartE.VidalS.KeithF. (2010). Analyzing offense patterns as a function of mental illness to test the criminalization hypothesis. Psychiatric Services, 61, 1217-1222. doi:10.1176/appi.ps.61.12.1217
52.
RennieC. E.DolanM. C. (2010). The significance of protective factors in the assessment of risk. Criminal Behaviour and Mental Health, 20, 8-22. doi:10.1002/cbm.750
53.
ScoonesC. D.WillisG. M.GraceR. C. (2012). Beyond static and dynamic risk factors: The incremental validity of release planning for predicting sex offender recidivism. Journal of Interpersonal Violence, 27, 222-238. doi:10.1177/0886260511416472
54.
SkeemJ. L.PoythressN.EdensJ. F.LilienfeldS. O.CaleE. M. (2003). Psychopathic personality or personalities? Exploring potential variants of psychopathy and their implications for risk assessment. Aggression and Violent Behavior, 8, 513-546. doi:10.1016/S1359-1789(02)00098-8
55.
SpreenM.BrandE.Ter HorstP.BogaertsS. (2014). Handleiding en Methodologische Verantwoording HKT-R, Historisch, Klinische en Toekomstige–Revisie [Manual and methodological justification HKT-R historical, clinical and future–Revised]. Groningen, The Netherlands: Dr. van Mesdag kliniek.
56.
SpreenM.Ter HorstP. R. M.BogaertsS.LammersS. M. M.HochstenbachJ.Soe-AgnieS. E.ReubsaetR. J. (2009). Risicotaxatie aan de hand van de HCR-20 en de HKT-30: Een vergelijking tussen beide instrumenten [Risk assessment with the HCR-20 and the HKT-30: A comparison between both instruments]. In OeiT. I.GroenhuijsenM. S. (Eds.), Forensische psychiatrie en haar grensgebieden: Actualiteit, geschiedenis en toekomst [Forensic psychiatry and het boundaries: Actuality, history and future] (pp. 459-476). Alphen aan den Rijn, The Netherlands: Kluwer.
57.
TrullT. J.SherK. J.Minks-BrownC.DurbinJ.BurrR. (2000). Borderline personality disorder and substance use disorders: A review and integration. Clinical Psychology Review, 20, 235-253. doi:10.1016/S0272-7358(99)00028-8
58.
TyrerP.JohnsonT. (1996). Establishing the severity of personality disorder. American Journal of Psychiatry, 153, 1593-1597. doi:10.1176/ajp.153.12.1593
59.
Van der VeekenF. C. A.BogaertsS.LucieerJ. (2012). Routine outcome monitoring in forensic psychiatry: FPC2landen and FPC de Kijvelanden. In OeiT. I.GroenhuijsenM. S. (Eds.), Progression in forensic psychiatry (pp. 355-375). Alphen aan den Rijn, The Netherlands: Kluwer.
60.
Van MarleH. J. C. (2012). De stagering met profielen in de forensisch psychiatrische delictanalyse [Staging with profiles in offence analysis: Diagnostic steps in forensic psychiatry]. Tijdschrift voor Psychiatrie, 54, 973-978.
61.
Van NieuwenhuizenC. H.BogaertsS.De RuijterE. A. W.BongersI. L.CoppensM.MeijersR. A. A. C. (2011). TBS-behandeling geprofileerd; een gestructureerde casussenanalyse [Profiling TBS-treatment: A structured cases analysis]. Wetenschappelijk Onderzoek- en Documentatiecentrum (WODC) Ministerie van Veiligheid en Justitie. Retrieved from https://www.wodc.nl/onderzoeksdatabase/voorstudie-onderzoek-tbs.aspx?cp=44&cs=6779
62.
VermuntJ. K. (2004). Toepassingen van latente klassenanalyse in sociaal wetenschappelijk onderzoek. Sociale Wetenschappen, 47(1), 2-14. Retrieved from http://members.home.nl/jeroenvermunt/sw2004.pdf
63.
VermuntJ. K.MagidsonJ. (2005a). LG 4.0 user’s guide. Basic and advanced. Belmont, MA: Statistical Innovations.
64.
VermuntJ. K.MagidsonJ. (2005b). Technical guide for Latent Gold 4.0: Basic and advanced. Belmont, MA: Statistical Innovations.
65.
WardT.GannonT. A. (2006). Rehabilitation, etiology, and self-regulation: The comprehensive good lives model of treatment for sexual offenders. Aggression and Violent Behavior, 11, 77-94. doi:10.1016/l/avb.2005.06.001
66.
WebsterC. D.DouglasK. S.EavesD.HartS. D. (1997). HCR-20: Assessing the Risk for Violence (Version 2). Vancouver, British Columbia, Canada: Simon Fraser University, Mental Health, Law and Policy Institute.
67.
Werkgroep Risicotaxatie Forensische Psychiatrie [Taskforce Risk Assessment Forensic Psychiatry]. (2002). Handleiding HKT-30 versie 2. Risicotaxatie in de forensische psychiatrie. Den Haag, The Netherlands: Ministerie van Justitie, Dienst Justitiële Inrichtingen.
68.
WoessnerG. (2010). Classifying sexual offenders: An empirical model for generating type-specific approaches to intervention. International Journal of Offender Therapy and Comparative Criminology, 54, 327-345. doi:10.1177/0306624X08331213
69.
WongS.GordonA. (2006). The validity and reliability of the violence risk scale: A treatment friendly violence risk assessment tool. Psychology Public Policy Law, 12, 279-309. doi:10.1037/1076-8971.12.3.279
70.
YiendJ.FreestoneM.Vazauqes-MontesM.HollandJ.BurnsT. (2013). The clinical profile of high-risk mentally disordered offenders. Social Psychiatry and Psychiatric Epidemiology, 48, 1169-1176. doi:10.1007/s00127-013-0696-9
71.
ZadehM. D.DamavandiA. J. (2010). The incidence of personality disorders among substance dependents and non-addicted psychiatric clients. Procedia—Social and Behavioral Sciences, 5, 781-784. doi:10.1016/j.sbspro.2010.07.184
72.
ZitmanF. G. (2012). Stagering, profilering en routine outcome monitoring [Staging, profiling and routine outcome monitoring]. Tijdschrift voor Psychiatrie, 54, 979-984.
