OBJECTIVE: To determine prevalence estimates of exposure to trauma and 12-month rates of posttraumatic stress disorder (PTSD) among juvenile detainees by demographic subgroups (sex, race/ethnicity, and age). DESIGN: Epidemiologic study of juvenile detainees. Master's level clinical research interviewers administered the PTSD module of the Diagnostic Interview Schedule for Children, version IV (DISC-IV), to randomly selected detainees. SETTING: A large, temporary detention center for juveniles in Cook County, Illinois (which includes Chicago and surrounding suburbs). PARTICIPANTS: Randomly selected, stratified sample of 898 African American, non-Hispanic white, and Hispanic youth (532 males, 366 females, aged 10-18 years) arrested and newly detained. MAIN OUTCOME MEASURES: Diagnostic Interview Schedule for Children, version IV. RESULTS: Most participants (92.5%) had experienced I or more traumas (mean, 14.6 incidents; median, 6 incidents). Significantly more males (93.2%) than females (84.0%) reported at least I traumatic experience; 11.2% of the sample met criteria for PTSD in the past year. More than half of the participants with PTSD reported witnessing violence as the precipitating trauma. CONCLUSION: Trauma and PTSD seem to be more prevalent among juvenile detainees than in community samples. We recommend directions for research and discuss implications for mental health policy.

Actuarial models for violence risk assessment have proliferated in recent years. In this article, we describe an approach that integrates the predictions of many actuarial risk-assessment models, each of which may capture a different but important facet of the interactive relationship between the measured risk factors and violence. Using this multiple-models approach, we ultimately combined the results of five prediction models generated by the Iterative Classification Tree (ICT) methodology developed in the MacArthur Violence Risk Assessment Study. This combination of models produced results not only superior to those of any of its constituent models, but superior to any other actuarial violence risk-assessment procedure reported in the literature to date.

Literature on gender & child sexual abuse (CSA) has highlighted patterns of similarity & difference among survivors & the need for further research. This study relied on gender analysis of 128 women & 69 men, obtained through an examination of childhood hospital records, to further examine gender differences in mental health outcomes among abuse survivors & correlates of mental health outcomes including professional help seeking, family environment, & other trauma exposure. Overall, men & women were similar in the context % consequences of CSA. The role of the characteristics of CSA & contextual variables in explaining variance in mental health for 106 male victims & nonvictims was also examined. Among male participants, number of incidents of sexual abuse, injury at the hands of a caregiver, & exposure to other traumas significantly explained higher levels of an array of mental health symptoms. Implications for future research are discussed.

A 1992 study, The Dynamics of Recidivism, was cited by the Home Secretary of the Conservative government during the 1990s to support the political doctrine that 'prison works'. This claim drew on qualitative data from pre- and post-prison interviews of 130 male offenders to uphold a narrow rational choice perspective that emphasized the perceived 'costs' of imprisonment to the offender. A ten-year reconviction study was carried out as a follow-up to the 1992 study. The subsequent criminal careers of the majority of the sample contradict an assumption that imprisonment has a deterrent impact. In the light of these findings, and an analysis of the differential impacts of subjective and social factors in the experiences of these ex-prisoners, this article reviews the limitations of 'rational choice theory' as a basis for understanding recidivism and desistance from crime.

The authors examined distal predictors of perpetration and victimization of intimate partner violence (IPV) among 725 young adult men and women using prospective data. Earlier problem drinking and negative affect were common predictors of perpetration for both genders. Lower education predicted female perpetration; parental fighting predicted male perpetration. No common predictors of victimization were found for men and women. Lower education, problem drinking, and childhood parental beating predicted female victimization. None of the models explained a large amount of the variance in IPV. More longitudinal research is needed on gender differences in the explanations for and consequences of IPV.

Most of the models that currently describe processes related to mental illness stigma are based on individual-level psychological paradigms. In this article, using a sociological paradigm, we apply the concepts of structural discrimination to broaden our understanding of stigmatizing processes directed at people with mental illness. Structural, or institutional, discrimination includes the policies of private and governmental institutions that intentionally restrict the opportunities of people with mental illness. It also includes major institutions' policies that are not intended to discriminate but whose consequences nevertheless hinder the options of people with mental illness. After more fully defining intentional and unintentional forms of structural discrimination, we provide current examples of each. Then we discuss the implications of structural models for advancing our understanding of mental illness stigma, including the methodological challenges posed by this paradigm.

This study examined how two types of public education programs influenced how the public perceived persons with mental illness, their potential for violence, and the stigma of mental illness. A total of 161 participants were randomly assigned to one of three programs: one that aimed to combat stigma, one that highlighted the association between violence and psychiatric disorders, and a control group. Participants who completed the education-about-violence program were significantly more likely to report attitudes related to fear and dangerousness, to endorse services that coerced persons into treatment and treated them in segregated areas, to avoid persons with mental illness in social situations, and to be reluctant to help persons with mental illness.

This study tests a social psychological model (Skitka & Tetlock, 1992). Journal of Experimental Social Psychology, 28, 491-522; [1993]. Journal of Personality & Social Psychology, 65, 1205-1223 stating that policy maker decisions regarding the allocation of resources to mental health services are influenced by their attitudes towards people with mental illness and treatment efficacy. Fifty four individuals participated in a larger study of education about mental health stigma. Participants completed various measures of resource allocation preferences for mandated treatment and rehabilitation services, attributions about people with mental illness, and factors that influence allocation preferences including perceived treatment efficacy. Results showed significant attitudinal correlates with resource allocation preferences for mandated treatment, but no correlates to rehabilitation services. In particular, people who pity people with mental illness as well as those that endorse coercive and segregated treatments, were more likely to rate resource allocation to mandated care as important. Perceived treatment efficacy was also positively associated with resource allocation preferences for mandated treatment. A separate behavioral measure that involved donating money to NAMI was found to be inversely associated with blaming people for their mental illness and not being willing to help them. Implications of these findings on strategies that seek to increase resources for mental health programs are discussed.

Arrest rates among the population of youth who have been served in child mental health systems are known to be high during adolescence and young adulthood, but individual longitudinal patterns have not been examined. The present study used developmental trajectory modeling, a contemporary method used widely in criminology, to examine clusters of individual criminal justice involvement patterns at ages 8 through 25, from database records of 13 individuals in public adolescent mental health services. Three groups of particular concern emerged: one with increasingly high offense rates and two with moderate to high violent offense rates that did not desist. Offense patterns in these groups indicate that early intervention should occur before age 15. Some risk factors were identified. Peak offending for most groups occurred between ages 18 and 20. Implications of these findings for mental health services during the transition to adulthood are offered. Studies that have followed youth with serious emotional disturbance (SED) from child.

From a very small base of empirical studies in the 1940s and 1950s, the literature on how and why people stop offending has grown rapidly in the last two decades (see Laub and Sampson (2001) for a comprehensive review). Only recently, however, have researchers started to forge links between studies of desistance from crime and 'What Works' in offender management policy (see especially, Maruna and Immarigeon 2004). This 'coming together' of research into why people stop offending and the (re-)emergence of concerns with effective practice is, like many partnerships, partly the result of good timing, partly the result of fortune, and not without its tensions and struggles. The purpose of this introductory essay, and indeed of this special issue, is to explore these tensions in greater depth than has been possible in previous work.

BACKGROUND: Epidemiological research examining health consequences of alcohol consumption generally relies on average volume consumed, yet examinations of drinking patterns show different dimensions of use associated with different health outcomes. Gender differences in metabolism and body composition may lead to gender-specific consequences of drinking frequency, quantity consumed per occasion, average amount consumed, and drinking pattern. Inconsistent results suggest gender differences are not well understood. METHODS: Participants were 3069 male and 2600 female health maintenance organization survey respondents. Gender differences in relationships between alcohol consumption and health were examined using analyses of covariance adjusting for age alone and for age, ethnicity, marital status, body water index, and smoking. Past-year alcohol consumption (frequency, quantity per occasion, average drinks per month, and drinking pattern) and health measures (Short Form-36 general health, physical functioning, mental health subscales) were examined. RESULTS: Gender x drinking frequency and drinking quantity interactions were significant in age-adjusted and fully adjusted models of general health and physical functioning. Gender interactions for drinking pattern were significant in the age-adjusted model and marginally significant in the fully adjusted model. No gender x drinking measure interactions were found for mental health. Fully adjusted models attenuated but did not eliminate gender differences for health and magnified relationships for functioning, the latter after adjusting for body water. For both genders, light to moderate consumption and more frequent drinking were associated with better health and functioning; relationships were stronger among women than men. CONCLUSIONS: Gender x drinking measure interactions in health outcomes suggest analyses should include such interactions except, possibly, for mental health. Adjusting for potential confounders can attenuate (general health) or magnify (physical functioning) gender differences. Functional status appears a sensitive measure for evaluating gender differences in alcohol's health effects, adjusting for body water. Women's health may benefit proportionally more from moderate drinking than men's.

This study examined gender differences in treatment outcomes and outcomes predictors among 155 men and 81 women attending a gender-sensitive substance abuse treatment program. Bivariate analyses indicated women improved more than men in social/family and daily functioning domains, but differences disappeared after controlling for baseline characteristics. Multivariate models predicting treatment outcomes revealed that, across Addiction Severity Index domains, outcomes for men were predicted primarily by mental health and medical conditions, severity of the substance abuse problem, and treatment completion. For women, in addition to treatment completion, outcomes were more likely to be predicted by social, socio-demographic, and life-history characteristics. For abstinence outcomes, women who completed treatment were 9 times as likely to be abstinent at 7-month follow-up as other women; men who completed were 3 times more likely to be abstinent than other men. Women with more severe psychiatric status and those who felt their life was out of control were less likely to be abstinent, as were men who lived alone. Clinicians targeting such factors differentially for men and women may enhance the effectiveness of treatment.

Enraged by sex crimes against young children committed by convicted sex offenders the public has demanded that government do whatever is necessary to prevent sexual recidivism. Victims' groups mobilized public opinion and politicians rapidly responded. Since about 1990, policymakers in the United States have adopted two distinct strategies to prevent convicted sex offenders from committing more sex crimes. One strategy emphasizes long-term confinement either in the prison system or in the mental health system. The other strategy relies on information compilation and dissemination. Both strategies assume that sex offenders are more dangerous than other criminals and are likely to reoffend during their entire lives. They also require public officials to predict whether a convicted sex offender will commit another sex crime if released into the community. These strategies present public officials with rather stark choices: confining sex offenders for a very long time or simply releasing them with minimal supervision into the community. This Article explores why it is so difficult to predict when sexual offenders will commit another sex crime. It then proposes the use of sex offender reentry courts to control sex offenders in the community, using a risk-management approach that will protect the community effectively at reasonable cost and also create incentives for sex offenders to seek rehabilitation. Sex offender courts, which are based on principles of Therapeutic Jurisprudence, can provide more intensive community supervision for a much larger group of sex offenders, while at the same time motivating them to change their attitudes and behavior.

OBJECTIVE: The inability to blind research participants to their experimental conditions is the Achilles' heel of mental health services research. When one experimental condition receives more disappointed participants, or more satisfied participants, research findings can be biased in spite of random assignment. The authors explored the potential for research participants' preference for one experimental program over another to compromise the generalizability and validity of randomized controlled service evaluations as well as cross-study comparisons. METHOD: Three Cox regression analyses measured the impact of applicants' service assignment preference on research project enrollment, engagement in assigned services, and a service-related outcome, competitive employment. RESULTS: A stated service preference, referral by an agency with a low level of continuity in outpatient care, and willingness to switch from current services were significant positive predictors of research enrollment. Match to service assignment preference was a significant positive predictor of service engagement, and mismatch to assignment preference was a significant negative predictor of both service engagement and employment outcome. CONCLUSIONS: Referral source type and service assignment preference should be routinely measured and statistically controlled for in all studies of mental health service effectiveness to provide a sound empirical base for evidence-based practice.

The widespread belief that illicit drugs are closely associated with crime has contributed to America's "War on Drugs" and attendant increases in arrests, convictions, and prison populations. However, the links between alcohol and crime have received less attention from policy makers and the public despite consistent evidence that alcohol is more likely than other drugs to be associated with violence. This study explores the relationship between alcohol and cocaine use and crime from 1989-1998, based on findings from the Drug Use Forecasting/Arrestee Drug and Alcohol Monitoring Program and the Uniform Crime Reports Program. We examine correlations among cocaine use, alcohol use, property crime, and violent crime at the city level to determine if there is a consistent pattern across cities over time. The analyses show a wide variation across cities in the links between both alcohol and cocaine use and violent and property crime rates over the 10-year period. However, the association between the annual rates of alcohol use and violent crime is stronger than that of alcohol use and property crime. These associations for alcohol remain in multivariate analyses, including statistical controls for temporal autocorrelation, SES, and heroin use. Cocaine use, in contrast, is not closely associated with either property or violent crime rates in the multivariate analyses. The findings suggest that to reduce violent crime rates, policy makers need to focus on addressing the contribution of alcohol. Furthermore, given the variation found across sites, efforts to reduce the drug/alcohol-crime links need to be tailored to local patterns and problems.

Research on offender verbalizations traditionally focuses on the degree to which offenders accept responsibility or blame for their mistakes. This small study expands this cognitive perspective in criminology by incorporating basic findings from the psychological literature on attributions. Additionally, offender attributions or neutralizations are framed within a life course perspective. It was found that active offenders and desisting ex-offenders differ in terms of explanatory style. Compared to desisting ex-offenders, active offenders tend to interpret negative events in their lives as being the product of internal, stable, and global forces. On the other hand, active offenders were more likely to believe that the good events in their lives were the product of external, unstable and specific causes. These other dimensions of offender cognitions may be useful in understanding the psychological aspects of desistance from crime.

The topic of desistance from crime has been the subject of considerable research (much of it largely descriptive) but has not received the same amount of theoretical attention. This theoretical re-evaluation of the desistance literature is broken down into four sections. In the first section, we seek a new definitional understanding of what desistance is and how to conceive of it for theoretical purposes. In the second, we very briefly review the major competing paradigms in current desistance theory. Third, we develop Farrall and Bowling's (1999) structuration-based critique of this literature, arguing that greater attention needs to be paid to the interaction between agency and structure in understanding desistance. Finally, we conclude by offering the beginnings of our own theoretical account of the desistance process centering around the notions of self-determination and prosocial labeling.

The study of desistance from crime has come of age in recent years, and there are now several, competing theories to account for the ability of long-term offenders to abstain from criminal behavior. Most prominently, recent explanations have borrowed elements from informal social control theory, differential association theory and cognitive psychology. In the following, we argue that labeling theory may be a neglected factor in understanding the desistance process. Drawing on interview data collected as part of a study of an offender reintegration program, we illustrate how the idea of the "looking-glass self-concept" is a useful metaphor in understanding the process of rehabilitation or recovery in treatment programs.

The notion of 'desistance' (or 'going straight') is becoming a more prominent one in criminological discourse, and the Liverpool Desistance Study (LDS) aimed to provide a deeper understanding of this process from the perspective of the individuals taking this life path. However, the LDS was not intended to address how the research might be applied in practice. This article therefore briefly outlines the research and discusses some of the policy implications, in order to open a debate with practitioners and others about the way that the research might be relevant to everyday practice with people who offend. The papers that follow this article were written in response to the challenge of applying the findings of the LDS in probation practice.

In The Culture of Control Garland describes the 'policy predicament' of late modern society as involving the normality of high crime rates and the acknowledged limitations of the criminal justice system. This combination has triggered a contradictory range of policy responses that Garland describes as adaptive and non-adaptive, with the non-adaptive responses characterized as 'denial' and 'acting out'. Garland's invocation of these Freudian constructs invites a more fully developed psychoanalytic reading of the contemporary landscape of penal policy. Drawing on the writings of Jung and Freud as well as more recent psychoanalytic interpretations of punishment and punitiveness, we aim in this paper to put the Culture of Control 'on the couch'. That is, we try to draw out some of the psychoanalytic themes that Garland so tantalizingly dangles before us, and begin to flesh out the implications of a full-fledged psychoanalytic interpretation of Garland's argument.

The Opiate Medication Initiative for Rural Oregon Residents trained physicians and counselors in Central and Southwestern Oregon to use buprenorphine and develop service models that supported patient participation in drug abuse counseling. The Change Book from Addiction Technology Transfer Centers was used to structure the change process. Fifty-one individuals (17 physicians, 4 pharmacists, 2 nurse practitioners, and 28 drug abuse counselors and administrators) from seven counties completed the training and contributed to the development of community treatment protocols. A pre-post measure of attitudes and beliefs toward the use of buprenorphine suggested significant improvements in attitude after training, especially among counselors. Eight months after training, 10 of 17 physicians trained had received waivers to use buprenorphine and 29 patients were in treatment with six of the physicians. The Change Book facilitated development of county change teams and structured the planning efforts. The initiative also demonstrated the potential to concurrently train physicians, pharmacists, and counselors on the use of buprenorphine.

OBJECTIVE: To estimate the 6-month prevalence of multiple substance use disorders (SUDs) among juvenile detainees by demographic subgroups (sex, race/ethnicity, age). METHOD: Participants were a randomly selected sample of 1,829 African American, non-Hispanic white, and Hispanic detainees (1,172 males, 657 females, aged 10 to 18). Patterns and prevalence of DSM-III-R multiple SUDs were assessed using the Diagnostic Interview Schedule for Children Version 2.3. The authors used two-tailed F and t tests with an a of .05 to examine combinations of SUDs by sex, race/ethnicity, and age. RESULTS: Nearly half of the detainees had one or more SUDs; more than 21% had two or more SUDs. The most prevalent combination of SUDs was alcohol and marijuana use disorders (17.25% females, 19.42% males). Among detainees with any SUD, almost half had multiple SUDs. Among detainees with alcohol use disorder, more than 80% also had one or more drug use disorders. Among detainees with a drug use disorder, approximately 50% also had an alcohol use disorder. CONCLUSIONS: Among detained youths with any SUD, multiple SUDs are the rule, not the exception. Substance abuse treatments need to target detainees with multiple SUDs who, upon release, return to communities where services are often unavailable. Clinicians can help ensure continuity of care by working with juvenile courts and detention centers.

OBJECTIVE: Racial and ethnic disparities in the criminal justice system have been widely reported, as have racial and ethnic disparities in diagnoses and certain aspects of clinical management. This study examined the association between race and ethnicity and dispositions for pre-trial defendants who were referred for forensic mental health evaluations. METHODS: Available data were reviewed for all defendants in Massachusetts who were referred to a Massachusetts court clinic from 1994 to 2001 for a screening evaluation of their competence to stand trial, their criminal responsibility, or both. Logistic regression models were developed to assess the relationship between defendants' race and ethnicity and the likelihood that they would be referred for inpatient evaluation and the likelihood that they would be evaluated within a strict-security facility. Race or ethnicity of the pretrial defendants was identified by clinicians. RESULTS: Blacks, but not Hispanics, were significantly more likely than whites to be referred for an inpatient evaluation after an outpatient forensic screening evaluation. Among male defendants, both Hispanics and blacks were more likely than whites to be referred for an inpatient evaluation in a strict-security facility, regardless of diagnoses and the level of severity of the criminal charges. CONCLUSIONS: Racial and ethnic disparities in disposition decisions exist within the forensic mental health system. These disparities, however, likely reflect numerous clinician and nonclinician variables.

To understand the work experiences of men who sexually offend against children, the authors conducted a qualitative study on a sample of 8 outpatients in mandated treatment. The results, based on both interview and quantitative data, highlighted the reciprocal influence of work and sexual offending and ways in which the offense affected participants' psychosocial and career stability. Participants who were rated as making the most favorable progress by their therapists ranked work as less salient than home and family, leisure, and community service, although they were relatively satisfied with their current jobs. Work was more salient than other life roles, but less satisfying for participants who were making less progress in treatment. Participants reported a loss of job security and career status, as well as restricted opportunities for vocational change and advancement.

Drawing on Agnew's (1992) general strain theory, this study seeks to determine whether depressed mood and anger mediate the effects of family conflict on delinquency. Drawing on earlier research, survey data were gathered from 7,758 ninth and tenth graders, aged 14 to 16, in Iceland. Structural equation modeling showed that exposure to arguments and fights at home are positively related to both depressed mood and anger. A positive association emerged between anger and delinquent behavior, whereas depressed mood had no effect on delinquency.

Why do youth in structurally disadvantaged neighborhoods experience lower levels of informal social control? To answer this question, we examined multilevel data from the Project on Human Development in Chicago Neighborhoods. Using hierarchical regression, we found that (1) neighborhood attachment & satisfaction with police contributed significantly to neighborhood levels of informal social control; (2) neighborhood attachment & satisfaction with police mediated a substantial portion of the association between informal social control & neighborhood levels of concentrated disadvantage & immigrant concentration.

This study provides an elaborated view of the types of high-risk patients identified by the multiple Iterative Classification Tree (ICT; Banks et al., in press). In particular, because clinicians must assess and treat patients before they are involved in violence, the investigation focuses on identifying subtypes of high-risk patients rather than violent patients in order to determine whether there are meaningful subtypes of patients at high risk for violence. Data were obtained from interviews with 165 patients identified as at risk by the multiple ICT in the MacArthur Risk Assessment Study (Monahan et al., 2001). Overall, these high-risk patients are best classified into 1 of 3 groups: (a) alpha patients (48%), who generally are depressed and abuse drugs heavily, but manifest multiple core traits of psychopathy and have extensive histories or arrest, including those for property crimes; (b) beta patients (38%), who typically are dysphoric, dependent on alcohol and other drugs, and sensitive to personal problems; and (c) delta patients (14%), who typically are delusional, have less drug and alcohol involvement, often experience command hallucinations, and have histories of intensive treatment. These 3 groups are largely consistent with hypothesized subtypes. Moreover, they were identified by applying multiple methods of cluster analyses, integrating the most stable results to develop a consensus cluster solution, and validating that solution on external variables. In short, the groups make theoretical sense, have some sound empirical grounding, and have implications for future research and treatment development efforts. For example, the demonstration that these 3 groups appear to exist provides direction for the next set of advances in risk management and intervention with particularly high-risk patients. Specifically, it provides a framework for systematically investigating the differential effects of particular types of interventions with these patients. Risk assessment and management requires this richer, more differentiated view of high-risk patients to achieve its potential.

OBJECTIVE: A significant portion of police work involves contact with persons who have mental illness. This study examined how knowledge that a person has a mental illness influences police officers' perceptions, attitudes, and responses. METHODS: A total of 382 police officers who were taking a variety of in-service training courses were randomly assigned one of eight hypothetical vignettes describing a person in need of assistance, a victim, a witness, or a suspect who either was labeled as having schizophrenia or for whom no information about mental was provided. These officers completed measures that evaluated their perceptions and attitudes about the person described in the vignette. RESULTS: A 4 x 2 multivariate analysis of variance (vignette role by label) examining main and interaction effects on all subscales of the Attribution Questionnaire (AQ) indicated significant main effects for schizophrenia label, vignette role, and the interaction between the two. Subsequent univariate analyses of variance indicated significant main effects for role on all seven subscales of the AQ and for label on all but the anger and credibility subscales. Significant role-by-label interaction effects were found for the responsibility, pity, and credibility subscales. CONCLUSION: Police officers viewed persons with schizophrenia as being less responsible for their situation, more worthy of help, and more dangerous than persons for whom no mental illness information was provided.

With the movement of persons with mental illness out of hospitals and into the community, the frequency of contact between police officers and such persons, in crisis or otherwise, has increased significantly. How police respond in these situations has important consequences for the subject, police officers, and the community. Officers (n = 554) from police departments in a major metropolitan area participated in a vignette experiment that examined how information that a subject has a mental illness influences the way police officers respond in several types of situations. Results indicate that officers are less likely to take action based on information provided by victims and witnesses with mental illness. No differences were found in response to suspects with or without a mental illness. The effects of officer characteristics and perceptions of the subject on responses to the vignettes were also examined. Findings suggest several directions for training and future research.

The field test of The Science of Mental Illness curriculum supplement for middle school (grades 6-8) children provided an opportunity to assess knowledge and attitudes about mental illness in more than 1,500 middle school students throughout the United States and to evaluate the impact of an educational intervention on stigma-related attitudes. Two primary questions were examined: (1) what are the baseline knowledge and attitudes about mental illness in this sample of middle school students, and (2) does participation in a curriculum about the science of mental illness increase knowledge and improve attitudes about mental illness? Consistent with findings from other studies, results indicate that students had some understanding of mental illness as a problem of the brain with biological and psychosocial causes; however, they lacked knowledge about treatment and overall were "not sure" about many aspects of mental illness. The students did not strongly endorse negative attitudes about mental illness at baseline. The curriculum produced significant improvements in both knowledge and attitudes at posttest and was most effective in improving attitudes among those with more negative baseline attitudes. These findings suggest that a brief educational program can be an effective intervention to increase knowledge and improve attitudes about mental illness.

This study explored the longitudinal associations of alcohol and marijuana use and violence over ages 11-20 in the youngest sample of males from the Pittsburgh Youth Study. The authors examined trends in alcohol and marijuana use and violence, how they covaried both concurrently and over time, and whether frequent substance use predicted violence and vice versa in multivariate models controlling for common risk factors. The analyses focused on frequent alcohol or marijuana users, those who scored in the highest 25% of frequency. Throughout adolescence, substance use was more prevalent than violence. Most substance users did not engage in violence, and the proportion of substance users who engaged in violence was smaller than the proportion of violent offenders who were also substance users.

The broad reach of therapeutic jurisprudence ('TJ'), which holds that legal rules and procedures often produce psychological and emotional impacts, some positive and some negative, is illustrated in the introduction to this issue. It brings together the various contributions from legal academics, lawyers, judges, criminologists, psychologists, and disability specialists and shows how they will be of interest to academics and practitioners alike.

BACKGROUND: Primary health care visits offer opportunities to identify and intervene with risky or harmful drinkers to reduce alcohol consumption. PURPOSE: To systematically review evidence for the efficacy of brief behavioral counseling interventions in primary care settings to reduce risky and harmful alcohol consumption. DATA SOURCES: Cochrane Database of Systematic Reviews, Database of Research Effectiveness (DARE), MEDLINE, Cochrane Controlled Clinical Trials, PsycINFO, HealthSTAR, CINAHL databases, bibliographies of reviews and included trials from 1994 through April 2002; update search through February 2003. STUDY SELECTION: An inclusive search strategy (alcohol* or drink*) identified English-language systematic reviews or trials of primary care interventions to reduce risky/harmful alcohol use. Twelve controlled trials with general adult patients met our quality and relevance inclusion criteria. DATA EXTRACTION: Investigators abstracted study design and setting, participant characteristics, screening and assessment procedures, intervention components, alcohol consumption and other outcomes, and quality-related study details. DATA SYNTHESIS: Six to 12 months after good-quality, brief, multicontact behavioral counseling interventions (those with up to 15 minutes of initial contact and at least 1 follow-up), participants reduced the average number of drinks per week by 13% to 34% more than controls did, and the proportion of participants drinking at moderate or safe levels was 10% to 19% greater compared with controls. One study reported maintenance of improved drinking patterns for 48 months. CONCLUSIONS: Behavioral counseling interventions for risky/harmful alcohol use among adult primary care patients could provide an effective component of a public health approach to reducing risky/harmful alcohol use. Future research should focus on implementation strategies to facilitate adoption of these practices into routine health care.

This paper focuses on the social capital of prisoners and the impact of criminal behavior and incarceration on its formation and mobilization. Emphasis is on the time-varying nature of four attributes of social capital: the strength of connections, the ability to mobilize them, the endowment of resources within these relationships, and their social context. The incarceration experience has the potential to alter the attributes of social capital in ways that reduce its ability to improve health and justice outcomes. To offset this effect, an investment strategy is recommended that could have a positive impact on the prisoner's social capital and prospects for successful reentry.

This paper profiles the behavioral health and criminal justice characteristics of the universe of male special inmates (N = 2,715) in New Jersey prisons. Mentally disordered inmates were found to vary significantly and systematically in their treatment needs and their risks to the community. The lack of homogeneity within the mentally disordered inmate population suggests the need to classify need-risk clusters within the offender group, develop programs that respond to particular need-risk clusters, and match types of mentally disordered offenders to these specialized programs. Recommended is a cafeteria-style approach to treatment planning that recognize the complexity of problem behaviors and the variation in the presentation of these problems.