Wiley: Criminal Behaviour and Mental Health: Table of Contents

Judicial Review, Legal Safeguards and the Rights of Persons With Severe Mental Illness: Reflections on Taiwan's Revised Mental Health Act

Fang‐Chi Shih, Lien‐Chung Wei — Sun, 31 May 2026 22:30:49 -0700

Criminal Behaviour and Mental Health, EarlyView.

Comparison of Impulsivity, Alexithymia and Facial Emotion Recognition in Schizophrenia Patients With and Without Criminal Records

Mon, 18 May 2026 11:40:58 -0700

ABSTRACT

Introduction

Criminal behaviour by people with schizophrenia has been attributed variously to direct effects of the illness, an interplay between clinical features and social circumstances or neither. A difficulty in the interpretation of the relevance of the illness may lie in the focus on the more clearly psychotic features and the relative neglect of emotional dysregulation or deficits in social cognition. We, therefore, aimed to examine whether psychological and social cognitive factors—such as alexithymia, impulsivity, aggression and facial emotion recognition—differ between individuals with schizophrenia who have a criminal history and those who do not.

Method

Forty-seven patients with schizophrenia and a criminal record were recruited from consecutive admissions to a specialist forensic mental health inpatient unit and 73 patients with schizophrenia but no criminal record were recruited from a general psychiatry unit in the same hospital. All participants, aged 18–65 years, completed a battery of assessments, including the facial emotion recognition test, the Toronto Alexithymia Scale, the Barratt Impulsiveness Scale and the Buss–Perry Aggression Questionnaire, between October 2023 and June 2025.

Results

The offender-patients showed significantly higher average motor impulsivity scores, significantly higher alexithymia scores—particularly externally oriented thinking—and significantly higher anger scores, but significantly superior performance in facial emotion recognition tests, specifically identifying shame, fear, surprise and happiness more accurately than the noncriminal group. Clinically, individuals with a criminal history had a significantly later onset of disorder (30.78 vs. 23.42 years), shorter disorder duration (8.85 vs. 12.36 years) and fewer psychotic episodes (2.48 vs. 3.21) and were more prone to self-harm. The offender-patients appeared to have been less treatment-adherent; specifically, they were less likely to have sustained treatment with depot antipsychotic medication. These findings remained significant in regression analyses, with offending as the dependent variable and these other characteristics as independent variables.

Conclusion

This study adds evidence on links between criminal behaviour and schizophrenia other than, or over and above, positive psychotic symptoms. Emotional dysregulation, substance use and poor treatment adherence were problematic, but facial emotion recognition was not. Thus, forensic risk assessments should include tests of emotion dysregulation to inform clinical interventions. Attention is also needed to improve treatment engagement and substance use management. Future research is needed to better understand the apparent disconnection between intact emotion recognition and criminal behaviour in this population.

Depression, Anxiety and Criminal Behaviour Between Ages 32 and 48: A Propensity Score Matching Analysis From the Cambridge Study in Delinquent Development

Kim Reising, Maria M. Ttofi — Wed, 06 May 2026 11:24:19 -0700

ABSTRACT

Background

Depression, anxiety and criminal behaviour are often correlated, but the direction and nature of these associations remain contested.

Aims

To investigate the temporal relationships between depression and/or anxiety and criminal behaviour at age 32 and depression and/or anxiety and criminal behaviour at age 48.

Methods

Using prospective, longitudinal data from the Cambridge Study in Delinquent Development, we applied propensity score matching to estimate the associations between (a) depression and/or anxiety at age 32 and criminal convictions at age 48 and (b) criminal convictions at age 32 and mental health problems at age 48. Propensity score matching (PSM) was used to adjust for a wide range of childhood and adolescent risk factors for offending or illness.

Results

Overall, a significant association between depression and anxiety and much later offending was evident, but after allowing for childhood adversities by propensity score matching, these relationships disappeared, suggesting that they are best explained by the common antecedent of childhood adversities. There was no relationship between any offending up to age 32 and depression or anxiety measured at age 48.

Conclusions

Although our findings were limited by the very large time gap between measures of mental health and offending, it is clear that depression and anxiety may be important in the pathway to crime, but that this association is largely accounted for by shared early-life risk factors. Our findings also, however, caution against assuming any direct relationship between these symptoms and crime, regardless of direction. Recognising early developmental vulnerabilities and intervening appropriately may be the most effective way of preventing later ill health and criminal behaviour.

Adverse Childhood Experiences and Their Relationship With Psychological Disorders and Violent Criminal Behaviour Within a Forensic Psychiatric Cohort

Manon van Beeck, M. Vere van Koppen, Janna Verbruggen, Joke M. Harte — Sun, 03 May 2026 20:25:49 -0700

ABSTRACT

Background

Adverse childhood experiences (ACEs) are traumatic events occurring before the age of 18 that may undermine a child's sense of safety, stability and attachment. ACEs can have lifelong consequences, including an elevated risk of developing psychological disorders and an increased likelihood of engaging in delinquent or violent behaviour later in life. Clinical practice suggests that many forensic psychiatric patients have a history of ACEs, but scientific research on ACEs within this population remains limited.

Aim

To study the prevalence of ACEs before the age of 18 within a large Dutch forensic psychiatric prison cohort and the relationship between repeated ACEs and psychopathology or violent criminal behaviour.

Methods

Data collected from 3421 adults (91% men) who had been admitted to one of the four penitentiary psychiatric centres (PPCs) in the Netherlands were used to examine the prevalence of ACEs and their association with different clusters of psychological disorders or violent criminal behaviour.

Results

Over half of the men (1,633, 53%) and nearly two thirds of the women (198, 62%) had experienced repeated ACEs. The men with repeated ACEs had greater odds of having a neurobiological developmental disorder, having committed a violent offence and developing a substance use or addiction disorder, a personality disorder and/or a trauma- or stress-related disorder. The women with repeated ACEs had greater odds of developing a personality disorder.

Conclusions

Our findings underscore the importance of incorporating assessment of trauma histories and trauma-informed service for forensic psychiatric offenders. We also add evidence for the potential for early intervention, given that repeated ACEs were associated with certain mental disorders and with violent offending, in particular for men.

Evaluating the Effectiveness of Empathy Training for Women in Prison in Iran: An Exploratory Trial of an Empathy Training Group for Its Impact on Aggression, Moral Disengagement and Moral Identity

Alireza Azimpour, Fatemeh Ebrahimi, Habib Hadianfard — Wed, 29 Apr 2026 01:31:25 -0700

ABSTRACT

Background

Empathy deficits are linked to antisocial behaviour and low prosocial abilities. Improving capacity for empathy may help reduce aggression and support positive social engagement.

Aims

To evaluate the impact of empathy training among women in prison in Iran.

Methods

Thirty female prisoners from Kermanshah Prison, Iran, volunteered to take part and were assigned to two groups. Fifteen participants received empathy training, whereas 15 served as a control group and only completed assessments. The intervention was of eight group sessions (45–60 min each). Standardised questionnaires were administered pre- and post-intervention to assess empathy, aggression, moral identity, moral disengagement and social desirability. Gain scores for social desirability were treated as covariates in a multivariate analysis of covariance (MANCOVA).

Results

MANCOVA did not reveal statistically significant effects of empathy training. However, individual ANOVA analyses showed a significant increase in moral disengagement among the intervention group, suggesting unintended consequences.

Conclusions

This study adds to existing literature by highlighting both the challenges and risks of implementing empathy training in a prison context. Whereas results do not confirm effectiveness, at least partly because of sample size limitations, they confirm that such intervention can be implemented and evaluated safely in prison. They also show the importance of monitoring and interpreting apparent side effects. They pave the way towards larger samples and exploration of intensive interventions to foster psychological change among people in prison.

Loneliness, Meaning in Life and Distress Among Incarcerated Men: The Moderating Role of Search for Meaning

Dominik Borawski, Daria Matynia, Dominik Moskal, Bartosz Pyrz — Sun, 19 Apr 2026 23:55:47 -0700

ABSTRACT

Background

Incarceration often disrupts an individual's sense of purpose and connectedness, contributing to loneliness and psychological distress. Identifying psychological resources that might buffer these effects is especially relevant in correctional settings. One such resource, emphasised in Viktor Frankl's existential theory, is search for meaning—a motivation to pursue existential purpose.

Aims

To investigate whether search for meaning moderates associations between loneliness and (a) presence of meaning and (b) psychological distress. We also explored whether presence of meaning mediates the link between loneliness and distress and whether any such indirect association varies by levels of search for meaning.

Methods

A total of 114 male prisoners aged 18–65 years (mean 37.25, SD = 9.52) were recruited from two correctional facilities encompassing closed and semi-open units. Participants completed the revised UCLA Loneliness Scale, the Perceived Stress Scale and both subscales of the Meaning in Life Questionnaire (MLQ).

Results

Higher loneliness scores were associated with lower presence of meaning and higher distress. Presence of meaning mediated the relationship between loneliness and distress. Search for meaning moderated the link between loneliness and presence of meaning: The association was weaker at higher levels of search.

Conclusions

Identification of presence of meaning as a key mechanism relating loneliness and distress among these incarcerated men extends research on meaning in life to a setting where management of loneliness and distress may be key to safety and underscores the potential relevance of meaning-centred interventions in prison settings.

Primary Psychoses Among Sentenced Prisoners in Finland

Petra Laivonen, Taina Laajasalo, Mika Rautanen — Thu, 16 Apr 2026 10:38:28 -0700

ABSTRACT

Background

Recent studies suggest an increased prevalence of primary psychotic disorders among sentenced prisoners in Finland. Exploring the extent and correlates of lifetime primary psychoses through high-quality data is crucial for early identification and effective interventions within correctional settings.

Aims

To establish the current lifetime prevalence and comorbidities of primary psychotic disorders among sentenced prisoners in Finland and to explore associations between these and sex, solitary confinement, forensic mental health examination, index offence and total days imprisoned.

Methods

Data were derived from a subsample (n = 295) of the Health and Wellbeing of Prisoners 2023 (Wattu IV) study (n = 529). Assessments included Structured Clinical Interview for the US Diagnostic and Statistical Manual for Mental Disorders (DSM-IV; SCID I and II). Details of offending to date and imprisonment history from official records and self-reported solitary confinement were included in the database. Logistic regression analysis was used to examine associations between lifetime primary psychotic disorders and variables significantly related in binary analyses.

Results

Twenty-four (8%) participants had a lifetime primary psychotic disorder, according to SCID-based data. A further 100 (34%) had a lifetime substance-induced psychotic disorder. The odds of primary psychotic disorder were over five times (OR 5.22) higher among women than men. For more detailed analyses, prisoners with a drug-related psychosis could not be separated from prisoners without psychosis. The odds of disciplinary solitary confinement were over three times (OR 3.36) higher among those with lifetime primary psychosis than among all other sentenced prisoners and over four and a half times (OR 4.61) higher among those requesting it. Neither index offence nor total lifetime days imprisoned had any relationship with primary psychosis.

Conclusions

This study updates the understanding of lifetime primary psychotic disorders and their correlates in Finnish prisons, descriptively suggesting a likely rise in their prevalence from 6% in 2017 to 8% in 2023, a 33% increase. The finding that twice as many female as male prisoners have primary psychosis aligns with previous research. The higher use of solitary confinement among sentenced prisoners with lifetime primary psychosis than among other sentenced prisoners, including those with substance-related psychosis, is new and troubling. As only one third of these prisoners with primary psychosis had had a court-ordered forensic mental health examination to determine the need for psychiatric treatment and, specifically, compulsory treatment instead of a prison sentence, our findings suggest an urgent case for re-examining pathways into healthcare for prisoners both during pretrial detention and after sentencing.

Social‐Therapeutic Custodial Treatment of Individuals Who Committed Sexual Offences: A Comprehensive Controlled and Multicentred Evaluation

Friedrich Lösel, Eva Link, Lena C. Carl — Thu, 09 Apr 2026 03:03:42 -0700

ABSTRACT

Background

In-prison treatment of persons who committed sexual offences often showed nonsignificant, small or sometimes even negative effects, particularly in sexual recidivism. Various reasons for this situation seem to be relatively short and standardised group-based programmes, isolated implementations and insufficient attention to context factors and needs for replication.

Aims

This study contains a controlled evaluation of males who had committed serious sexual offences and received treatment in German social-therapeutic prison units (STUs) versus a control group from regular prisons without treatment. STUs offer a broad range of treatment (including CBT) and rehabilitation measures during about 2 years of incarceration.

Methods

Valid recidivism data were available for 1245 individuals, of which 710 were treated (TG) and 535 were not treated (CG). In addition to the individuals from STUs, there was also a subsample that received individual or group treatment in normal prisons. The mean follow-up period after release was 9.3 years. As there were expectable differences between treated and untreated persons, a comprehensive propensity score matching (PSM) of relevant variables was applied that led to balanced equivalence of TGs and CGs. In addition to various criteria of recidivism (e.g., general, sexual, violent), we developed a harm index of seriousness. Offender characteristics were assessed by the regular documentation form of the Criminological Service in Bavaria that also contained the Static-99 risk measure. For the assessment of therapeutic context factors, prisoners and staff filled in the EssenCES on the institutional climate in the STUs.

Results

There were significant treatment effects on general recidivism (TG = 35.9% vs. CG = 41.4%) and nonsignificant tendencies on sexual recidivism (6.0% vs. 8.0%) and other outcomes. In contrast to general recidivism, sexual recidivism did not occur later after release. There were more promising results in a more recent cohort than in a previous cohort, and the sexual harm of treated persons decreased post-treatment (as compared to pretreatment). Men who had committed rape of adult victims showed more violent and less sexual recidivism than individuals who had victimised children. The seven STUs differed substantially in recidivism and dropout rates. These differences were related to the risk level of the inmates, but prison climate was also associated with outcome differences. On average, there were both similarities and differences in the climate ratings by inmates and staff. Most individuals from the STUs got a legal order for relapse prevention in community treatment centres after release. However, this did not lead to a booster effect, whereas persons who were not treated in custody benefitted from therapeutic aftercare.

Conclusions

The results of a comprehensive social-therapeutic treatment of prison inmates who had been sentenced for sexual offences showed multifaceted patterns of results. Offender variables played an important role in the outcomes. Individuals who had victimised children were particularly assigned to STUs, and persons with a not generally assessed paraphilic disorder may be relevant for less promising results in sexual recidivism. There were also hints that the intensive treatment in STUs may not be superior to therapeutic interventions in regular prisons. Based on our findings, differentiated selections of groups, treatment contexts and outcome measures are suggested for further development of successful treatment strategies in custody.

Medical Management of Problematic Sexual Arousal for People With a Sexual Conviction in England and Wales: Challenges, Learning and Progress

Thu, 09 Apr 2026 03:03:42 -0700

ABSTRACT

Background

In England and Wales, the primary treatments for individuals convicted of sexual offences are psychological. However, medication to manage problematic sexual arousal (MMPSA) is gaining importance as an alternative. This article reviews the current evidence surrounding the MMPSA approach.

Aim

This paper synthesises challenges encountered, advancements achieved and learnings accumulated over 16 years of the MMPSA treatment pathway from 2009 to 2025 in England and Wales.

Methods

Drawing on a programme of mixed-methods research, including cohort studies, case studies, qualitative interviews with patients and professionals and implementation evaluations, this paper seeks to bring together key findings to present a consolidated picture of the research on the MMPSA pathway to date. The focus is on synthesising findings and identifying implications for service delivery.

Results

Evaluations of treatment outcomes showed promising results regarding the effectiveness of the MMPSA service. Qualitative analyses and case studies provided insightful details regarding patient and staff concerns that may hinder the efficiency and reach of the treatment pathway. Research with community clinicians highlighted issues regarding the ‘off-label’ use of medication for this purpose.

Conclusions

The MMPSA treatment service is available in a limited number of prisons in England and Wales. Supported by promising service evaluations and existing literature, a larger population could benefit from MMPSA treatment. Furthermore, the MMPSA service would benefit from improvements to create smoother transitions for individuals leaving prison and entering the community, and it should ideally be expanded to ensure that those in the community can also access the MMPSA service.

Rapport Features Moderate Treatment Readiness of Incarcerated Male Sex Offenders After Forensic Risk and Needs Assessment Interviews

Boon Siang Kwek, Rebecca P. Ang, Olivia Choy — Thu, 09 Apr 2026 03:03:42 -0700

ABSTRACT

Background

Forensic risk and needs assessment interviews are commonly conducted for incarcerated sex offenders to inform treatment planning. Despite strong evidence showing the positive influence of rapport-based investigative interviews on sex offenders' cooperation, disclosure and confession, the impact of rapport-based interviews on treatment readiness has yet to be examined.

Aims

As rapport features are mostly addressed in offender treatment and less in pre-treatment assessments, this study aimed to examine the influence of perceived rapport features and personal factors on treatment readiness of incarcerated sex offenders after forensic risk and needs assessment interviews. We hypothesised that sex offenders' perceived rapport levels of the interviewers and personal factors significantly moderate positive change in their treatment readiness after the interviews.

Methods

Incarcerated male sex offenders (n = 80) participated in interviews conducted by trained correctional professionals (n = 33). Treatment readiness ratings (pre- and post-interview) and rapport features ratings (post-interview) were collected from the sex offenders using pen and paper questionnaires. Personal data of interviewers and sex offenders were obtained from prison records and case files.

Results

All ratings of rapport features (expertise, trust/respect, connected flow, cultural similarity, and attentiveness) and sex offending risk level (moderate and high) significantly moderated the change in treatment readiness of sex offenders after the interview.

Conclusion

Rapport formed during forensic risk and needs assessment interviews can positively influence the treatment readiness of moderate and high risk sex offenders. Results suggest that correctional agencies may implement policies and training to apply rapport-based interviewing techniques during forensic risk and needs assessment interviews to increase the likelihood of sex offenders starting and engaging in treatment.

The Association Between Previous Suicide Attempts and Risk Level According to the Static‐99R in Men Who Have Sexually Offended

Jordyn Monaghan, Krystal Lowe, Michael C. Seto, Marc W. Patry, Skye Stephens — Thu, 09 Apr 2026 03:03:42 -0700

ABSTRACT

Background

Suicide is a leading cause of death within correctional institutions, with men convicted of sexual offences over-represented among those who have attempted suicide. Despite an increased risk for suicidality, limited research has examined how past suicide attempts are associated with sexual offending and specific risk domains on assessment tools.

Aim

In consideration of shared risk factors for suicidality and sexual offending, the present study examined the association between previous suicide attempts and sexual offending, particularly in terms of risk domains.

Methods

The study sample comprised 369 men who underwent a comprehensive psychosexual assessment at a large sexual behaviour clinic between 1995 and 2006. Suicide attempt history was coded from clinical files and the association with Static-99R scores, recidivism, sexual interest in children, antisocial traits and diagnosis, and demographic variables was examined.

Results

Of our participants, 12.5% self-reported having previously attempted suicide. Although there was no significant association between Static-99R scores and previous suicide attempts, the magnitude of the effect was the same as previous research. Previous suicide attempts were significantly associated with an individual's age, prior non-sexual violence, and four or more previous sentencing dates.

Conclusion

Given the limited research in this area, the findings are important for increasing the understanding of suicide risk among people who have sexually offended. Study results suggest the need for an increasing understanding of suicide risk and more targeted suicide assessment and management strategies for those with sexual convictions.

Current International Research on the Assessment and Treatment of Individuals Who Committed Sexual Offences

Friedrich Lösel, Georgia Zara — Thu, 09 Apr 2026 03:03:42 -0700

Criminal Behaviour and Mental Health, Volume 36, Issue 2, Page 49-52, April 2026.

Issue Information

Thu, 09 Apr 2026 03:03:42 -0700

Criminal Behaviour and Mental Health, Volume 36, Issue 2, April 2026.

The Sexual Recidivism Rates of Women Are Still Low: An Updated Meta‐Analysis

R. Karl Hanson, Franca Cortoni, Jeffrey Sandler — Thu, 09 Apr 2026 03:03:42 -0700

ABSTRACT

Background

Compared to men, women are less likely to sexual offend. Previous reviews found low rates of sexual recidivism among women. The last published meta-analysis was based on studies from before 2010.

Aims

Conduct an updated meta-analysis of the sexual recidivism rates of women returned to the community. We expected the rates to be low and to decline the longer they remained sexual offence free in the community.

Methods

Fourteen studies met selection criteria. Their publication/presentation dates ranged from 1998 to 2023. Results were presented as raw proportions as well as meta-analytic averages.

Results

Of the 4208 women, 3.1% (131) were known to have sexually reoffended. The rate was 2.4% during the first 5 years (64/2642, k = 8) and 1.1% between years 5 and 10 (6/535, k = 2). There was large and significant variability across studies (prediction intervals: < 0.001%–11%). The rates of violent recidivism (7.8%) and general (any) recidivism (30.1%) were substantially higher than the rate of sexual recidivism.

Conclusions

This review confirms previous findings that the sexual recidivism rate of women is very low. Their risk is so low that it is unlikely to be reduced by sexual crime specific treatment or public protection measures (e.g., registration and notification). Instead, gender-responsive interventions should focus on the women's risk for general criminal recidivism and strive to promote successful reintegration.

Suicide in Prisons and Other Custodial Settings in Bangladesh: Key Challenges for Prevention

Anisur Rahman Khan, Rasel Hussain — Thu, 05 Mar 2026 00:14:47 -0800

Criminal Behaviour and Mental Health, EarlyView.