Ch.9,10,13,14

Cycle of Violence

1. Tension Building Stage

Abuser escalates in whatever form of abuse he has been using: possessive smothering, verbal harangues, physical brutality

Victim is in survival mode, caters to his every whim, desperately trying to avoid the inevitable

Jealous is huge during this stage

Cycle of Violence

2. Acute Battering or “Explosive” Stage

Abuser continues to punch and kick harder and faster to the point of exhaustion

The release of energy lowers tension levels, and the abuser becomes addicted to this form of release

Victim’s response is to protect self in any way possible

Cycle of Violence

3. Contrition/Remorse Stage

Alienated victim – attempts to get her back

Victim agrees to stay or return, hopeful

Tactics of Abusive Men

control partner through

intimdiation

emotional abuse

isolate parnter

minimize or blame victim for abuse

use children

male privilege

Econmic abuse/control

use coercion/threats

all strategies are designed to undermine and control partner so that partner will not abandon abuser

Characteristics of the Abusive Personality

Borderline Personality Disorder (BPD)

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning in early adulthood and present in a variety of contexts, as indicated by five (or more of the following):

Afraid of abondoament

born out of the history of pain

Borderline Personality Disorder (BPD)

Frantic efforts to avoid abandonment

Unstable and intense relationships

Identity disturbance

Impulsivity

Recurrent suicidal/self-mutilating behavior

Affective instability

Emptiness

Inappropriate, intense anger

Paranoid ideation or dissociative symptoms

BPD/BPO & IPV

Theoretical connection exists between BPD/BPO and IPV.

Gunderson (1984):

1) Involvement in intense and unstable relationships in which the significant other is undermined and manipulated

2) Intolerance of being alone combined with increasing abandonment anxiety

3) Intense anger, demandingness, and impulsivity, often linked to substance abuse or promiscuity

the person needs someone to claim as home

The Abusive Personality (APB)

A syndrome of affective, behavioral, and phenomenological traits that predispose men to assault their wives.

Dutton et al. (1996; 1998)

Administered battery of measures to assaultive males and controls

Abusive males scored higher on:

BPO symptoms, chronic anger, trauma symptoms, fearful attachment, childhood abuse.

symptoms are broader than BPD

1. Borderline Personality Organization

Abusive males evidenced comparable scores to males dx as borderline.

2. Chronic Anger

Abusive males scored high on anger/hostility, a strong predictor of abuse.

3. Childhood Trauma

Abusive males scored high on trauma measures and similar personality profiles as PTSD victims

4. Guilt/Shaming Experiences

Public scolding, random punishment, generic criticism.

Shame thought to drive Contrition Phase

5. Fearful Attachment

Abusive males most likely to have insecure relationship attachment

Preoccupied and Fearful

In Summary: The Abusive Personality is…

A repertoire of borderline traits, intense anger, trauma symptoms, and a fearful attachment style characterized by devaluation of self and other. These traits make for an insecure and unstable person who is at risk for inflicting serious physical and psychological harm on their spouse.

A Typology of Abusive Men

Types of IPV Perpetrators

Family Only Aggressors

Low levels of anger, depression, jealousy. Least likely to be violent outside home.

Generalized Aggressors

Most likely to be violent outside home. Violence most likely associated with alcohol use and severe. settle arguements through violence and are highest on psychopathic.

Emotionally Volatile

Highest levels of depression, anger, and jealousy. Most psychologically abusive and least satisfied in relationships. High antisocial and BPD.

Explanations for IPV by Abusive Men

Disengagement of internal standards (Bandura, 1991)

Cognitive distortions used to justify abuse

Redefining the behavior

Moral justification

Palliative comparisons (did hit them but didn’t break bones)

Euphemistic labelling ( we fight, i got carried away)

Displacement of responsibility

Externalizing responsibility

Diffusion of responsibility

taking the blame off the abuser and putting it on something/someone else

spreading accountability thin

Distort the consequences

Minimization

Ignoring

making something smaller than it actually is

Blame the victim

Blaming the victim

Dehumanization

“this person deserves it” “ she had it coming”

have a scheme for these types of relationships. Treatment involes attacking the distortions

Etiology of IPV

Sociological-Feminist Theories

SA reflects an underlying system of patriarchal values that support male dominance and female subordination.

its a mans home and whatever happens stays in the home

thinks their partners are property

Social and Structural Theories

Alienating conditions within society create frustration and stress and thus, increase potential for acting out violently.

society is to blame

Social Learning Theories

Children are exposed to domestically assaultive behavior and this behavior is role modeled and later reperpetrated.

learned behaviour, they learn to be violent from watching it happen

Integrative Social-Learning Attachment Model

Violence and abuse in the family models assaultive behavior and contributed to the formation of the abusive personality.

IPV Risk Assessment

Assessing Risk For IPV

Same considerations apply as for sexual violence risk assessment, general violence risk assessment, and general recidivism risk assessment

Including the use of structured tools: These are developed the same way as tools for sexual, violent, and general recidivism assessment i.e., from collections of risk markers linked to IPV Correlates of Intimate Partner Violence

relationship might end when spouse goes to jail

central eight applies

Hanson et al. (1997) (N= 997)

Conduct disorder

Prior convictions

Hostility (BDHI)

Attitudes

Alcohol abuse (Central eight)

Drug abuse (central eight)

BDI

Poor self-concept

Violence family of origin

Poor relationship adjustment

Arguments initiated

Worried about other men

Propensity for Abusiveness Scale (Dutton, 1995)

29-item self-report inventory designed to appraise risk for spousal violence.

Scores reflect severity of traits of ABP.

basically a lot of problems associated with violent personality

Three factors:

Recalled negative parental treatment

Affective lability

Trauma symptoms

Abusive males (59.2) vs. controls (44.7)

Correctly classified 82% males into high and low abusiveness.

Based on Dutton’s theory; PAS not frequently used…

Spousal Assault Risk Assessment (SARA)

(Kropp, Hart, Webster, & Eaves, 1995)

The original structured professional judgment (SPJ) tool

Developed by the same group as the HCR-20

20 items developed through theory and research linked to IPV

Items rated 0, 1, 2

Criminal History (general)

Past assault of family members

Past assault strangers/acquaintances

Past violation cond. Release

Psychosocial Adjustment: Recent… (Central Eight Variables)

Relationship problems

Employment problems

Victim/witness family violence

Substance abuse

Suicidal/homicidal ideation

Psychotic/manic symptoms

Personality disorder (anger, impulsivity)

Spousal Assault History (History of inimate partner violence and dynamic factors)

Past physical assault

Past sexual assault/sexual jealousy

Past weapon use/death threats

Recent escalation in violence

Past violation “no contact” order

Denial/minimization of spousal assault

Spousal assault attitudes

Alleged (Current) Offense

Severe and/or sexual assault

Weapon use/credible death threats

Violation of “no contact” order

SARA Research

(Kropp & Hart, 2000)

SARA ratings analyzed on six samples of adult male offenders (N = 2,681).

SARA ratings:

Positively correlated with the VRAG, PCL:SV, and SIR

102 men followed up on release (50% recidivism)

AUC = .60

SARA Research

(Helmus & Bourgon, 2011)

Meta-analysis of 9 IPV risk tools, focusing on the SARA

k = 8 studies, n = 2,174

AUC = .63 for IPV recidivism

A SARA V3 has just been released in the past year. Psychometric research is forthcoming.

Ontario Domestic Assault Risk Assessment (ODARA)

(Hilton, Harris, Rice, Lang, Cormier, & Lines, 2004)

Developed by the VRAG folks at Penetang!

Actuarial IPV risk measure

Designed to be rated by frontline responders to domestic incidents (e.g., police)

13-binary items (rated 0-1)

Possible scores range from 0-13

Anything above 7 is high risk

most items are static in nature

ODARA Research

Inaugural study (Hilton et al., 2004)

589 domestically violent offenders identified from police records

Followed up nearly 5 years post release

29.7% of men reoffended with a ne IPV offense

Rated on large collection of variables from archival records used to create ODARA

ODARA total score AUC = .77

DVRAG

The ODARA was expanded by Hilton et al. (2008) by adding the PCL-R as a 14th item …called the DVRAG

Domestic Violence Risk Appraisal Guide

Rated on 346 men

AUC = .70

(ODARA AUC = .65 by contrast)

Which IPV Tool Works Best?

Meta analysis by Hanson, Helmus and Bourgon (2007), updated by Helmus & Bourgon (2011), and subsequently by van der Put et al. (2019) examined predictive accuracy of IPV risk tools for IPV recidivism.

Which IPV Tool Works Best?

As with the sexual violence and general violence risk assessment literature, they all pretty well predict comparably

Broadly moderate predictive accuracy

DA and DVSI do a bit worse

Also have overlapping but slightly different purposes

The Duluth Model

Domestic Abuse Intervention Project (DAIP; 1980):

Intensive, 6-month group

Cognitive-behavioral approach

Pro-feminist psychoeducational material

Learn about the specific nature of their abuse and the impact it has on significant others

Learn more egalitarian ways of conducting themselves in intimate relationships

Key assumption: violence is instrumental - used to control others!

The Duluth Model

Five Objectives:

Facilitate appreciation that behavior is a means of controlling others

Increase understanding of causes of violence

Increase motivation to change

Accept responsibility

Explore non-controlling and non-violent ways of relating

How are these objectives achieved?

The Duluth Model

Structure:

Weekly goal - check-in

Video vignettes - depicting controlling/abusive behavior; a woman’s perspective

Personal disclosures

Control log - facilitates analysis of 6 key elements of an abusive act and alternatives to that act

Role Plays - to teach/reinforce non-controlling behavior

Strategies/skills training for non-violence

In last phase of treatment, participants develop a behavior cycle and relapse prevention plan based on history of abusive behavior

Crime Cycle: Identify pattern of abuse and the specific events, thoughts. and feelings that trigger it

Relapse Prevention Plan: Develop plan involving internal and external coping strategies with which to intervene prior to becoming abusive

The Duluth Model In sum,

Ultimate goal of this model is to replace the abusive tactics commonly used by spousal assaulters with the non-controlling, non-violent tactics that couples frequently used in egalitarian relationships.

Goal is achieved through analyzing specific abusive behavior, examining behavior as tactics of control, exploring and practicing non-controlling and non-violent behavior.

Cognitive Behavioral Approaches

Violence as a learned phenomenon that can be unlearned

Violence occurs because it is functional for the user (i.e., has been reinforced)

Reducing bodily tension

Gaining victim compliance

Ending an uncomfortable situation

Generate feelings f power and control

CBT identifies pros and cons of violence

Involves skills training to develop alternatives to violence

Problem solving

Communication/assertiveness skills

Anger management

Time outs

Perception checks

Address attitudes and values toward women and use of violence with women

Treatment Outcome

Addresses question as to whether IPV programs can reduce IPV recidivism

Single treatment outcome studies

Babcock, Green, & Robie (2004)

Meta- Analysis of DV Interventions

Meta analysis of IPV/DV treatment outcome studies in reducing recidivism

K = 22 studies, 36 ES computed

Deluth (k = 19) and CBT (k= 11) most common txts

Rates of IPV recidivism?

21% based on police reports

35% based on partner reports

Meta-analysis of Treatment Outcome on

Police Reported IPV Recidivism

(Adapted from Babcock et al., 2004)

Meta-analysis of Treatment Outcome on

Partner Reported IPV Recidivism

(Adapted from Babcock et al., 2004)

Outcome Research Conclusions

Conclusions from Babcock et al. (2004)

Overall small effect size (d = .18 or 9% recidivism reduction) for treatment in reducing IPV recidivism

No clear evidence for relative superiority of one program over another, but most evidence for Deluth and CBT

Both generated small effects

IPV Treatment Attrition

Men referred to IV treatment have big problem with drop out (aka attrition)

Highest rates of attrition compared to all offender programs (Olver, Stockdale, & Wormith, 2011)

IPV Treatment Attrition

(Olver, Stockdale, & Wormith, 2011)

IPV Treatment Attrition

Men who fail to complete IPV programs have significantly higher rates of IPV recidivism, violent recidivism, and general recidivism (Olver, Stockdale, & Wormith, 2011)

Backgrounder on Mental Illness

Schizophrenia and other psychotic illnesses

Hallucinations

Delusions (faulty reality)

Disorganized behavior/thinking

Negative symptoms

Bipolar Disorder

Alternating episodes of mania and depression

Unipolar Mood Disorders

Major depressive episodes, persistent depressive disorder

Myths, Misconceptions, and the Media

The mentally ill have long been stigmatized as prone to violent behavior as seen in literature, the media, folklore, and common sense.

Shakespeare, Taming of the Shrew, Henry the Sixth

17% of American prime-time dramas contained a character who was mentally ill (Gerbner et al., 1981).

73% of mentally ill characters are portrayed as violent (vs. 40% of “normals”).

23% of mentally ill characters were shown to be homicidal (vs. 10% of “normals”).

The Case of Johnnie Baxstrom

In 1966, Johnnie Baxstrom challenged a ruling to civilly commit him on the grounds that he posed a risk for future violence since he had a mental disorder.

The case of Baxstrom set a precedent which sparked the release of 976 institutionalized mentally ill patients.

Over a 2-year follow-up, 20% of the “Baxstrom patients” were rearrested, 11% were reconvicted, and only 2% committed a violent offense

Relationship between Crime and Mental Disorder

Monahan (1993): two paradigms for investigating the relationship between violence and mental disorder (can also be applied to general criminality):

Crime among the disordered

Disorder among the criminally active

Violence and Crime Among the Disordered

Several studies have examined the base rates of violence and general criminality in psychiatric populations compared to non-psychiatric controls.

Hodgins (1993): Swedish Metropolitan Project

Examined base rates of violence and general crime in a sample of 15,117 persons born in Stockholm, 1953.

Residents followed up for 30 years.

Hodgins et al. (1996)

Similar methodology as above, only with Danish sample

358,180 persons born b/w 1944 and 1947

Base Rates of Violence and Crime:

Swedish and Danish Census Data

Violence and Crime Among the Disordered

Epidemiological Catchment Area (ECA) Study (Swanson et al., 1990; Swanson, 1994)

Sample of 10,059 respondents from geographically diverse locations.

DSM-III-R diagnoses made using Diagnostic Interview Schedule (DIS).

Violent incidents in the current and previous year recorded.

55.5% of violent respondents met criteria for a DSM disorder.

19.6% of non-violent respondents had a DSM disorder.

Estimated Probabilities of Violence for Different Psychiatric Diagnoses

Mental Disorder Among the Violent or Criminally Active

Alternative paradigm

Examining base rates of mental disorder in violent or incarcerated populations (i.e., prison inmates)

Mental Illness in Canadian Corrections

Mental Disorder, Recidivism, and Crime

Rezansoff, Moniruzzaman, Gress, and Somers (2013)

BC Corrections

31,014 provincial offenders followed up 3 years post release

39% no diagnosis

21% nonsubstance related mental disorder (NSMD)

10% substance use disorder (SUD)

23% dual diagnos

SUD + mental disorder

7% Unknown

Mental Disorder, Recidivism, and Crime

Several studies have found certain diagnoses to be associated with a greater number of criminogenic needs = higher risk (Skeem et al., 2014; Kingston et al., 2015, 2016)

PD, SUD, and DD largest number of positive associations with criminogenic need

These studies have also found particularly high prevalence of PD and SUD

Any PD: ≈ 50-75%

ASPD: > 50%

SUD: ≈ 50-75%

Conclusions on Association between Mental Disorder and Crime/Violence

Base rates of crime/violence are consistently higher among mentally disordered populations.

Base rates of crime/violence are particularly high amongst substance abusers.

Males are consistently higher risk(i.e., have higher base rates of crime/violence).

Major mental disorder has higher prevalence among offender samples than the general public.

PDs (especially ASPD) and SUDs particularly common in offender populations.

Relationship between Crime and Mental Disorder

Violence and Psychosis

Psychosis as a possible cause of violence

Psychosis serves a focusing role by providing a clear motivation for violence (Link & Stueve, 1994)

Threat Control Override

Principle of “rationality within irrationality”

Psychosis destabilizes decisions and behavior

Leads to disorganized/impulsive violence and crime

Psychosis serves a disinhibiting role in violence

Negative symptoms block inhibitions to act violently

Violence and Psychosis

Douglas, Guy, and Hart (2009)

Meta analysis of 204 studies examining association between psychosis and violence

Psychosis associated with a 49% to 68% increase in the odds of violence

Finding held up across gender and country

Several moderators (i.e., lots of variability) among studies

Effects were largest in:

Community settings (350% increase or 3.5X odds of violence)

MUCH smaller effect in correctional settings (27% increase)

Patients with schizophrenia diagnoses

Positive symptoms

Psychotic patients were compared to non-mentally disordered, non-offenders

No significant effect when compared against other antisocial individuals

Relationship between Crime and Mental Disorder

Risk factors for recidivism among mental health correctional populations

Psychopathological Theory

Mental disorder symptomatology would constitute the strongest predictors of recidivism (e.g., depression, anxiety, delusions)

General Personality Cognitive Social Learning (GPCSL)

General criminogenic needs and other variables transcend different correctional populations, and tend to be the strongest predictors of recidivism (e.g., criminal attitudes, peers)

Predictors of Recidivism in mental health correctional populations

Bonta, Blais, and Wilson (2014)

Meta analysis of predictors of violent and general criminal recidivism among mental health correctional samples specifically

(Update on Bonta, Law, & Hanson, 1998)

126 studies on 96 unique samples and 23,900 offenders

Douglas et al. (2009) examined studies of mentally ill patients across a range of samples and settings; not just offenders

In correctional settings, psychosis associated with a 27% increase in the odds of violence, much smaller than civil psychiatric (69% increase) or community settings (350% increase)

Predictors of Recidivism in mental health correctional populations

The Central Eight predict recidivism in mental health correctional samples

NSMD, and psychosis specifically, are weaker predictors in offender samples

PD, ASPD, and psychopathy are predictive

They embody collections of criminogenic needs or directly represent criminogenic needs (e.g., antisocial personality pattern)

Severe mental disorder

Likely has modest criminogenic relevance

May interact with other criminogenic predictors

Is an important responsivity consideration

Relationship between Crime and Mental Disorder

Treatment of Mental Health Correctional Populations

Absence of controlled treatment studies specifically targeting mental health correctional populations

Most programs are no different than those provided for non-offending psychiatric patients

Medication

Inpatient treatment

Two Promising Developments:

Recognition that treatment of mental health correctional pops should attend to the general offender rehabilitation literature

Importance of providing treatment/support post hospitalization/release is being given more attention E.g., Bow Unit, RPC

Treatment of Mental Health Correctional Populations

Mental Illness as a Need and Responsivity Issue:

As a need issue

Certain mental illnesses and mental illness symptoms are criminogenic

Treated through medication, therapy, and community supports (e.g., employment, housing, family psychoeducation)

Don’t know anything about their diagnose

As a responsivity issue

Mental health symptoms can undermine engagement in treatment if left untreated

E.g., cognitive and attentional deficits of active psychotic symptoms, interpersonal problems with staff and patients

Treatment of Mental Health Correctional Populations

So the RNR principles should apply at least in theory

…Remarkably little research has actually examined this

Treatment of Mental Health Correctional Populations: General Conclusions

A modest, yet consistent and significant relationship exists between crime/violence and mental illness.

Prevalence rates of crime/violence appear to be highest in the most severe mental disorders.

Risk for crime/violence is greatest when mental disorders are comorbid with substance abuse.

In the absence of a criminal history and other criminogenic markers, mental disorders are likely poor predictors of violence and other types of crime.

Risk factors derived from a general personality cognitive social learning model are the strongest predictors of violence and general criminality

Dearth of controlled treatment studies

Some famous (or infamous) examples:

The “Ken and Barbie Killers” (Ontario ~ early to mid 1990s)

Paul Bernardo (“Scarborough Rapist”) and;

Karla Homolka

Testified as a witness against her husband

Received a 12 year sentence (plea agreement)

For the deaths of two teenage school girls

As well as the rape and death of her own sister!

Killed and Murder two 13 year old girls

Would entice the girls and would watch paul commit these crimes

Her PCL score has been released (24)

Case remains controversial

E.g., dubbed the “deal with the devil” - videotapes surfaced post

E.g., romantic relationship with lawyer

E.g., release and community reintegration in Quebec (2016)

Some famous (or infamous) examples:

The Reena Virk Case (British Columbia ~ late 90s to mid 2000)

Virk was swarmed, beaten, drowned by teenagers including:

Kelly Ellard

15-years old at the time of the offense

Raised to adult court

Convicted of 2nd Degree Murder

Sentenced to Life

Case controversy

E.g., 3 trials: guilty; appeal with subsequent mistrial; guilty

E.g., denied day parole as continues to “minimize” crime

Pregnant in custody (2016)

Some famous (or infamous) examples:

Serena Nicotine (Saskatchewan)

At age 12 drowned a 3-year old in a hotel pool

Brutally murdered a 58-year old group home operator in North Battleford with another teenage girl (1997)

Stabbed 15 times with a kitchen knife and beaten with a cast iron pan

Has since been involved in several hostage takings while in custody

Tortured correctional officer with lit cigarettes and broken scissors, pulled through it from being offered McDonald’s

Has FASD, has problems with attention and impuslivity

And recently in the news...

Do these women share any common features ? How do they compare to men in the criminal justice system ?

Public attention is periodically drawn to sensational cases

Lots of girls has higher levels of violence

Only more recently have female offenders become more “empirically visible”

True or False?

More men commit crime than women

Statistical snapshot

In 2014/2015, Canadian women accounted for 15% of overall correctional admissions to provincial/territorial correctional services.

They accounted for a higher proportion of community admissions (20%) than custody admissions (13%)

Women made up a small share of admissions to both remand and sentenced custody in the provinces and territories - 13% and 11% respectively and 7% federally.

In 2014/2015, just over three-quarters of Canadian youth admitted into correctional services were male (77%); 23% were female.

The findings were about the same for both custody and community supervision.

True or False?

Women are more likely to commit offenses involving property or drugs as opposed to violent offenses(true)

Canada’s only female dangerous offender or DO:

Renee Acoby

Once they go into jail for one offence they usually get more conventions which leads to more jail time

Got DO due to her violence

True or False?

Violence perpetrated by girls and women has increased in recent years (complex answer)

Violence and aggression by women

While the rate of charges for violent crimes may fluctuate and/or increase, this may be because

the numbers of women committing violent offenses is proportionally so small (CSC, 2013)

While rates of “simple” assault may fluctuate/increase, rates of serious violent offenses has remained stable

Societal changes?

E.g., decreased reluctance to charge and prosecute women

Definitional changes?

E.g., relational aggression (Crick and colleagues)

A few seminal Canadian studies...

Simourd & Andrews (1994)

Examined 60 studies that produced 464 correlations between risk factors and delinquency (grouped into 8 risk factors)

The rank order of the predictive strength of the risk factors for males and females was identical.

Likewise the magnitude of the correlations were comparable for each risk factor.

Conclusion: Risk factors that are important for male delinquency are also important for females.. delinquency.

Risk factors for women and girls

A few seminal Canadian studies...

Rettinger (1999)

441 provincially sentenced female offenders

LSI/LSI-OR + survey data

Gender-specific variables (e.g., abuse hx., self-harm hx.) did not discriminate recidivists from non-recidivists for general recidivism. Exception: problematic childhood.

Self-injury behavior predicted violent recidivism.

Conclusion: Support for the use of the LSI to determine risk and need for incarcerated and community-sentenced women.

The more problematic the childhood more likely to recommit

If there are common risk factors can we use the same assessment tools for male and female correctional populations ?

The short answer – it depends who you ask!

“...the assessment of psychopathy is not valid for women offenders. As a result, the use of instruments designed to assess psychopathy are not sanctioned.”CSC MEMORANDUM (2000)

Can general neutral be used to assess recidivism

But what does the research say?

A “homegrown” example (Stockdale, Olver, & Wong, 2010):

2 main camps...

Gender neutral risk assessment

Gender Informed risk assessment

2 main camps (cont’d)

Gender neutral

Risk assessment instruments developed on samples composed predominantly of male cases and based on gender neutral theories of crime apply to women and girls

E.g., the LSI family of tools

The same risk factors applies across gender groups

Gender informed

Proponents argue that gendered pathways to crime impact the validity of risk assessment instruments and gender neutral tools are missing key female specific risk-need factors

Certain risk factors that apply to both genders may be more relevant to females

Female-specific risk-need tools developed from “the ground up” for women and girls are required

E.g., the Women’s Risk Need Assessment or WRNA (Van Voorhis and colleagues)

There are gender pathways to crime

Are missing specfiic risk need factors

The extreme viewpoints are wrong

Both camps are wrong in their own ways

Research shows that there are more gender pathways

But what are female specific factors?

Potential female specific risk/need factors identified in the research literature include:

financial stress

Internalizing mental health symptoms (depression and anxiety)

self injurious behavior ( cutting, burning and other self harm injury, non-sucidical self-injury)

victimization histories

relationship dysfunction

family factors

parental stress

child custody issues

housing safety

poor self efficacy

Gender is fluid and complex

Example: NSSI and female offenders

Klonsky and Muehlenkamp (2007) refer to non-suicidal self-injury (NSSI) as deliberate bodily disfigurement or harm without suicidal intent and for non-socially sanctioned reasons. E.g., head banging, cutting, burning

Women in custody are more likely than males to engage in NSSI (e.g., Blanchette & Brown, 2006) and to do so more than one time

Barrett, Allenby, and Taylor (2010)

CSC survey; N=178 female offenders

43.6% reported engaging in self-harming behaviors

Women incarcerated for violence more likely to engage in self-harm

Coping with emotional pain from being in jail

Self-harming is a factor of BPD

BPD they don’t feel real and cutting is away of grounding themselves

But what does the research say?

Another “homegrown” example:

Stewart (2011)

Women must have been in jail for 2+ years

Rated four risk assessment instruments (the LSI-R, the LS/CMI, the VRS, and the SIR) on N=101federal female offenders and examined relationships with several outcome measures (e.g., general and violent recidivism)

Also explored the incremental predictive validity of several gender informed variables (e.g., history of abuse, economic concerns, childcare concerns, self-harm/suicidality) looked at these variables to predict recidivism

4 risk assessment instruments performed well (AUCs from .650 to .842) (medium to large effect)

Few of the gender-informed outcomes correlated with outcome except for childhood emotional abuse which was related to violent recidivism (.687)

This combined with substance abuse appeared the most promising composite gender-informed predictor(s)

Looks at conventional risk assessment

Gender as Risk-Need or Responsivity ?

Class discussion

Increase in trauma approaches treatment, it will validate their trauama and will work in their recidivism

Prison for Women (P4W)

P4W (cont’d)

Maximum security environment for women regardless of security level

Women were geographically separated from local support systems

Inadequate conditions, no gender or culturally informed programs

CSC established a Task Force on Federally Sentenced Women in 1989

Published report entitled “Creating Choices” in 1990

Recommended closure of P4W

Creation of smaller, regional facilities, and an Aboriginal Healing Lodge

Between 1995 and 2004 5 new regional facilities and 1 lodge (in SK) were opened across Canada

Women were stripped searched by the male staff in a degrading way

P4W (cont’d)

The Honourable Louise Arbor

Commission of Inquiry into Certain Events at the Prison for Women” (1996)

Lengthy segregation

Male emergency response team; role in strip searches

Violent confrontations

Ruled that many of the women’s concerns were valid

On May 8, 2000 the last inmate was transferred out of P4W

Moving on...

Since the 1990s CSC has developed gender-informed programs, the most recent programs

include:

Engagement Programs*

Moderate Intensity Programs*

High Intensity Programs*

Self-Management Programs*

Women’s Modular Intervention

Women’s Sex Offender Program

Social Integration Program for Women

Parenting Skills Training Program

* Indigenous specific program available

Moving on, but how far ?

The Ashley Smith case

Ontario Coroner’s Inquest into the death of Ashley Smith, a young woman under suicide watch at Grand Valley Institution for Women

Strangled herself with a strip of cloth while guards watched via video monitor for 45 min (October 2007)

Coroner’s jury returned a verdict of homicide (December 2013)

Advanced 104 recommendations to the Coroner

Suggested ways in which CSC could better serve female inmates including those with mental health concerns

Indefinite solitary confinement should be banned

Mental health needs of female offenders

According to CSC estimates, 62% of incoming women required further mental health evaluation (post initial screening)

High rates of lifetime substance dependence

Those with substance dependence also exhibited symptoms of another lifetime psychiatric disorder (Derksen et al., 2013)

High rates of concurrent disorders

Do programs for women and girls work?

Some promising results

However, more rigorous evaluations of new programs are needed...

Results from meta-analysis Dowden & Andrews (1999)

Reviewed 26 treatment programs for female offenders

Programs adhering to risk and/or need principles reduced criminal recidivism by 19 to 26%

Programs adhering to the general responsivity principle reduced recidivism by 25 to 27 %

The prgtams have 60% of responsitvity

Gobeil, Blanchette, & Stewart (2016)

22 000 women offenders (37 studies)

Odds of community success were 22 to 35 % higher for women who participated in correctional interventions

Gender informed and gender neutral program produced similar effects...

So, where does this leave us ?

Thoughts, take home messages, and question

Justice Impacted Indigenous Persons:

Too Risky to Use, or Too Risky Not to? Lessons Learned from Over 30 Years of Research on Forensic Risk Assessment with Indigenous Persons

The Context and the Controversy

• Indigenous persons are vastly overrepresented in Canadian Corrections

– Minority groups are actually overrepresented in correctional settings all over the world

• Represent 4% of the national population

– …25.2% of the federal offender population in 2018-2019 (28.8% of custody pop)

• Up from 18.9% in 2010-2011 (Corrections and Conditional Release Statistical Overview 2020)

The Context and the Controversy

Salient Social/Contextual/Historical Issues (see R v. Gladue, 1999; Truth and Reconciliation Commission, 2015)

• Elder Gerry Oleman’s 5 Rs

– Colonial past; residential school abuse

– Cultural erosion (religion)

– Over-policing (RCMP)

– Racism and discrimination within justice system and broader societal level

– Social plight/destitute communities (reservations)

The Context and the Controversy

Indigenous peoples (Perrault, 2011; Public Safety Canada, 2014; Scrim, 2010)

• More likely to be victims of abuse and trauma

• More likely to be victims of violent crime

• Social plight (e.g., poverty, unemployment, education, racism, addictions)

• Medical/health concerns

The Context and the Controversy

Indigenous persons in correctional contexts (Bonta, Rugge, & Dauverge, 2003; Olver, 2016; Rugge, 2006; Stewart & Wilton, 2019)

• Tend to score higher on conventional risk tools

• More likely to be classified as high risk

• Have higher rates of recidivism

The Context and the Controversy

• Ewert v. Canada (2015)

• Impugned tools

– Psychopathy Checklist-Revised (PCL-R)

– Violence Risk Appraisal Guide (VRAG)

– Sex Offender Risk Appraisal Guide (SORAG)

– Static-99/99R

– Violence Risk Scale-Sexual Offense version (VRS-SO)

The Context and the Controversy

• Plaintiff/Defense expert (S.D. Hart)

– Impugned tools biased against Indigenous persons and their use had resulted in harm to Ewert

• Arguments raised about rigid and culturally insensitive use of actuarial tools along with insufficient psychometric research in form or quality

• Crown’s expert (M.E. Rice)

– Tools are equivalent across racial/cultural groups given the heterogeneity of construction and validation samples that are heavily represented by Indigenous persons

The Context and the Controversy

Core psychometric issues

• Structural invariance

– Are the constructs measured by a test organized the same way from one group to another?

• E.g., Does the PCL-R 4-factor model hold up between ancestral groups?

• Predictive Invariance

– Does the instrument predict equivalently between two different groups?

• E.g., Does the PCL-R/Static-99R/etc. have good predictive accuracy for both Indigenous and non-Indigenous persons?

Structural Invariance: Multigroup CFA

Predictive Invariance: Recidivism Prediction Metrics

• Effect size metrics (cont’d)

– E.g., Group M score = 22, SD = 8

• d = .50  8 x .50 = 4 pts diff between violent recidivist and nonrecidivist

– (e.g., recidivist M = 24, non-recidivist M = 20)

• What happened?

Decision Chronology

The Context and the Controversy

• Some of the main issues that arose out of Ewert V. Canada (2015)

– The number of replications were too few and far between

– The samples were small-ish and the studies were underpowered

– Need for larger, representative samples

• Created an impetus to combine samples into a large aggregate to test foundational propositions drawing Indigenous non-Indigenous comparisons for impugned tools

• Some of my observations from Ewert v. Canada (2015)

– Extreme stances adopted by opposing side; missing/omitted works.

– Perpetuation of false narratives that certain tools performed poorly and were de facto culturally biased (e.g., SIR scale)

– Languaging of psychometric differences (even minute) in test properties as “cultural” differences

– Conflating ethnoracial heritage and culture

– A tendency to ignore or dismiss prior research findings that had merit; and to overlook the nuances.

– Assumption from Plaintiff – absence of evidence of validity/reliability was presumed evidence for absence of validity/reliability

Further Developments in Risk Assessment with Indigenous Persons

• CSC in the process of evaluating and updating Offender Intake Assessment (OIA) process for federally sentenced Indigenous men and women

• Began in 2021 as an updated literature review commissioned by CSC from an advisory subgroup to inform the process, structured as a systematic review and a series of targeted meta-analyses.

• Submitted for publication June 2021, accepted October 2023

Results from Meta-Analysis

Meta-Method

Olver, Stockdale, Helmus, Woods, Termeer, & Prince (2024)

• K = 91 studies, 88 documents

– 57 refereed journal articles

– 17 government reports

– 11 graduate theses/dissertation

– 4 unpublished data/ms under review

– 2 conference presentation

• Spanned 22 instruments and 15 risk factor predictor domains

– Indigenous, N = 59,693; non-Indigenous/White, N = 237,729

Meta-Method

• Primary unit of effect size for aggregation purposes

– Standardized mean difference Cohen’s d

• Difference between recidivists and nonrecidivists on risk scores reported in standard deviation units

• d = .20 small, .50 medium, .80 large

• AUC equivalents (Rice & Harris, 2005) = .56 small, .64 medium, .71 large

– Why d?

• Less impacted by fluctuations in base rates

• Most readily converted from other metrics (e.g., rpb) using applicable formulae including base rate info

• Readily computed from M and SD of recidivists and nonrecidivists

• Readily translated to AUC

• Easily interpreted

Meta-Method

• Reported fixed and random effects

– FE most stable with small K (i.e., < 30), but influenced by very large samples

• Orwin’s fail safe N computed to determine # studies with no effect (d = 0.00) required to reduce d < .20 (i.e., small effect)

• ES magnitudes directly compared (Q statistic) for Indigenous and non-Indigenous/White subgroups

Forensic Assessment Measures Included in Meta-Analysis

• Indigenous samples scored higher on average by more than ½ SD across measures

• Group differences tended to be larger on certain general-risk need tools, general violence risk measures, and those that heavily weighted general criminal history.

• Smaller differences on PCL measures and youth variants of some tools.

• Nonsignificant differences on measures of risk change.

• All measures significantly predicted their targeted recidivism outcomes (general, violent, sexual, IPV) across ethnoracial groups

• Most effect sizes tended to be medium in magnitude

– (i.e., d = .50-.79, AUC = .64-.70)

– Frequently in same class/magnitude of prediction effect sizes and/or differences in ES not significantly different

• ES diff significant in 16/45 (35.6%) direct comparisons of d/AUC between groups

• LS measures the largest volume of empirical support

– d/t large K and n, many ES diffs significant b/w groups

• SPIn/YASI largest effects

• SFA and DFIA-R had weakest effects

• More frequent ES disparities and evidence of potential bias for static tools

• Smaller disparities in prediction effects for youth variants of tools (e.g., YLS/CMI; VRS-YV; SAVRY; PCL: YV)

• PCL measures (R and YV) remarkable continuity between groups and across outcomes

• VRS/SO change measures associated with decreased recidivism across groups

– VRS change < general and violent recidivism

– VRS-SO change < sexual recidivism

Some Conclusions and

Future Directions

Conclusions

• Static tools must be supplemented with dynamic tools; to not do so is committing an act of social injustice

– Greatest potential for ethnoracial bias in static tools

• Conduct reassessments of risk using dynamic measures

– Guide service delivery, track and measure changes in risk

• Assess protective factors

• Further research needed on cultural specific risk factors

– Cultural engagement/connectedness

Samples and Subgroups

• Generalizing from a large sample can be problematic for any and all constituent subgroups

– Results of meta-analysis of ES for VRS-SO, PCL-R, and VRS generated substantively same findings as performing analyses on a large single combined sample

• To be human is to be diverse

– Cultural/racial/ethnic diversity abounds; cautions of generalizability apply to all groups

The Threshold of Scientific Acceptability and the Meaning of Differences

• Absence of evidence is not evidence for absence

• What is the threshold for acceptable psychometric properties?

– Do the properties have to be identical or do they need to be robust across samples and settings?

– E.g., Medium effect sizes for risk classification, identifying treatment needs, evaluating change, and making release decisions

Harming when Intending to Help

• Not having the option of using a particular brand of tools (e.g., actuarial, SPJ, etc.) for their designated purpose may possibly disadvantage evaluators, decision making bodies, or correctional clients?

– E.g., Dynamic tools to track and quantify change, inform conditional release, community supervision, residential placements, reductions in security, ETAs/UTAs, release planning etc., etc.

– Case conceptualization training can assist in integration of multiple and even disparate findings

Placing the use of Actuarial Tools into Context

• All assessment as SPJ; or “actuarially informed”

– SPJ vs. actuarial as an artificial dichotomy

• The structure of a test does not constrain its use

• Case conceptualization training can assist in integration of multiple and even disparate findings

• An assessment instrument is not an assessment

The Misuse of Psychological Instruments

• All tools have the potential for misuse, particularly with vulnerable or marginalized populations

– E.g., use of static tools only could perpetuate adverse consequences for justice involved Indigenous persons

• The potential for misuse should not be the sole basis for governing decisions about whether to employ a given test

– Underscores the necessity of training and professional discretion

– Use of dynamic tools and integrating multiple measures with evidence of less bias

Indigenous Correctional Treatment Approaches

• Indigenous persons for several years now in CSC have access to traditional spiritual practices, Indigenous literacy classes, sweat lodge ceremonies, drumming circles, etc.

• Many of these programs are offered with Indigenous healing lodges

• 10 operated at the federal level 7 additional ones exist across Canada in provincial jurisdictions.

• Integration of CBT-based approaches with traditional Indigenous-specific approaches to healing

• Includes strengthening a reconnection to Indigenous cultural heritage

• Two models reviewed here:

• Indigenous healing lodges

• Integrated Indigenous correctional programs

Indigenous Healing Lodges

• Largely minimum security facilities that provide correctional services to Indigenous clients in a manner that respects Indigenous cultures. These services are often provided in traditional

• Environments designed specifically for Indigenous persons.

• Culturally appropriate services and programs (including Elder services) incorporating Indigenous values, traditions and beliefs.

• Goal to address factors that led to incarceration and prepare for community reintegration.

• Needs addressed through teachings and ceremonies, contact with Elders, and interaction with nature.

• Example of “Two eyed seeing”

o Integration of traditional holistic healing approaches with Western treatment approaches for the benefit of all

• Often experience spiritual growth due to reconnecting with Indigenous ways of knowing and being (e.g., sweat lodge, pipe, and Sundance ceremonies), engage in the process of recovery

Integrated Indigenous Correctional Treatment Approaches

• Integration of mainstream corrections treatment with Indigenous cultural rituals, beliefs, and practices within a correctional setting

• Indigenous men and women have option of completing core programming or Indigenous specific stream; may result in transfer to an Indigenous healing lodge

• Common threads of participation in cultural activities, service delivery by Indigenous staff, and support from family and community.

• Examples include Pathways, Indigenous Integrated Correctional Program Model, In Search of Your Warrior, and Tupiq

Integrated Indigenous Correctional Treatment Approaches

1. Pathways Initiative

o Elder-driven program that enables the Indigenous person to follow healing as a way of life.

o Completely immersive 24-7 adheres to the Medicine Wheel as a teaching tool (i.e., physical, spiritual, emotional, and intellectual components that create the whole (healed) person)

2. Indigenous Integrated Correctional Program Model (IICPM; previously Aboriginal ICPM, or AIPCM)

o RNR merged with Indigenous-specific program considerations

o minimum 50% Elder involvement, meets other cultural/spiritual needs

o Purpose to reconnect with Indigenous identity, promote healing, increase prosocial skills, decrease criminogenic needs

o High (108–117 sessions) and moderate (62–70 sessions) intensity IICPM streams

o Primarily group with some individual sessions and a weekly ceremony.

o Multi-target (i.e., targeting Central 8) or sexual offense specific (i.e., general and sexual-offense-specific criminogenic needs).

3. In Search of Your Warrior (ISYW)

o No longer in operation, but was a high intensity Indigenous specific violence reduction program that integrated Indigenous teachings and cultural practices with mainstream RNR interventions

4. Tupiq

o Inuit specific sexual offense treatment program, integrating Inuit cultural practices and beliefs with sexual offense specific treatment targets and intervention approaches

Effectiveness of Indigenous Correctional Treatment Approaches

• Positive self-reports of increasing comfort and engagement with Inidgenous staff and that culturally based programs enabled them to trust people more, stay out of trouble better, and deal more positively with their problems

• Outcome evaluations of Indigenous healing lodges have been highly variable from no effect to a positive treatment effect (i.e., reduced recidivism)

• Promising results for ISYW (Trevathan et al., 2005) and Tupiq (Stewart et al., 2015)

o Decreased violent and general recidivism

• AICPM/IICPM vs. standard ICPM vs. no intervention (Baffoe et al., 2019)

o Indigenous ICPM and standard ICPM better than no services

o No difference between Indigenous and standard variants in returns to custody for Indigenous persons