Assessment and treatment of violent forensic psychiatric patients with a conduct or an antisocial personality disorder in the Netherlands

摘要

Because a Dutch treatment program for so-called terbeschikkinggestelden or violent forensic psychiatric inpatients was lacking, we took to developing an Aggression Control Therapy (ACT) in 2000, which was based on Goldstein, Glick, and Gibbs' Aggression Replacement Training (ART). The ACT program was subsequently also administered in adolescent and adult forensic psychiatric patients referred for obligatory treatment to an outpatient clinic owing to criminal acts of general violence. This thesis consists of a number of separate studies. First, a group of violent forensic psychiatric inpatients was compared to a group of violent prison inmates in order to gain insight into the determinants of verbally and physically aggressive behaviors of the patients. In order to complement existing assessment tools, two new instruments were developed to measure hostility and aggressive behavior on the ward. Following the development and implementation of our ACT program, the intervention was evaluated in a forensic psychiatric inpatient and a forensic psychiatric outpatient sample. Aggressive behaviors as observed in various violent forensic psychiatric subgroups were subsequently investigated to learn whether the content and procedure of the ACT needs to be modified to fit these specific groups. To conclude, we explored the aggressive behaviors and social competence in two related populations, i.e. in forensic psychiatric outpatients convicted of domestic violence or sexual assault