Convergent, Discriminant and Predictive Validity of Two Instruments to Assess Recidivism Risk Among Released Individuals Who Have Sexually Offended: The SORAG and the VRAG-R

Recidivism risk assessment has played an essential role in the criminal justice system for many years. Various risk assessment tools have been developed and recalibrated over the years for the purpose. Two such instruments, the Violence Risk Appraisal Guide (VRAG) and the Sex Offender Risk Appraisal Guide (SORAG), were both revised before being combined into the VRAG-R. The aim of our study was to evaluate the convergent, discriminant and predictive validity of the SORAG and the VRAG-R in a cohort of 294 released individuals who have sexually offended in French Belgium. Results suggest that the tools have good convergent validity and the ability to discriminate the risk level of individuals who have sexually offended with victims younger than 14 years old, whether intra- or extra-familial, from that of others at higher risk for re-offending. Where predictive validity is concerned, the scores on both instruments predict nonviolent nonsexual recidivism with a large effect size, and general recidivism (any type of recidivism) and violent nonsexual recidivism with a medium effect size. Sexual recidivism is not predicted at a statistically significant level by either the SORAG or the VRAG-R. Violent recidivism (sexual and non-sexual combined) is moderately predicted by the SORAG and the VRAG. However, these predictive qualities vary by the age of the victim. Certain combinations of items can be good predictors. In this regard, the VRAG-R items “failure on conditional release” and “marital status” together constitute a predictive model for general recidivism and sexual recidivism. The addition of the item “age at index offense” improves this model for general recidivism.

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A Review on the Effectiveness of Canadian and American Mental Health Courts

Objective: This systematic review synthesizes mental health court (MHC) research across the United States and Canada. This study reviews and compares the operations and practices of MHCs across both countries, as well as their recidivism rates.

Methods: We gathered from existing literature to present common MHC practices used across the United States. However, in response to the lack of literature about Canadian day-to-day practices, we developed a questionnaire and contacted every Canadian MHC. In total, we contacted 36 Canadian MHCs, and 19 courts filled out a questionnaire. With respect to recidivism rates, we conducted a comprehensive literature search in February and March 2019 in PsycINFO, Google Scholar, Web of Science, and National Criminal Justice Reference Service Abstracts using the keywords mental health court, therapeutic justice, serious mental illness, mentally ill offenders, mental health diversion and problem-solving courts.

Results: Canadian and American MHCs have similar practices. However, American MHC’s have more robust screening measures and typically admit more participants with schizophrenia, bipolar disorder, and major depressive disorder into their programs compared to Canadian MHCs. MHC participants in both countries typically had lower recidivism rates compared to regular docket court participants.

Conclusions: MHC research should inform public policy. Additional research should move in the direction of discovering the predictors for why MHCs reduce recidivism.

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Anti-libidinal medication among sex offenders: A descriptive study from a specialized outpatient unit in Bordeaux (France)

Enhancements in the treatment of sexual of-fenders have been taking place for over four decades. The development of pharmacological therapy has helped to reduce the risk of re-offense and has demonstrated its utility in com-bination with psychotherapy. However further studies to demonstrate the efficacy of these therapies are required. We conducted a retrospective study in a unit, Erios, that provides care for sexual offenders (court ordered treatment or voluntary treatment). Among the 224 patients who were seen in the Erios unit over the past 15 years, we identified 23 patients who had received anti-libidinal treatment (ALM) at some point in their care. The results, obtained from 22 files, indicate that 16 patients presented no evidence of deviant fantasy or behavioral relapse under medication. This study also highlights the comorbidities and offers a perspective regarding the improvement in prescribing this type of pharmacological therapy.

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