{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:00:33Z","timestamp":1792648833643,"version":"4.5.0"},"reference-count":69,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T00:00:00Z","timestamp":1631750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p>The long-term changes of dynamic risk and protective factors have rarely been studied in forensic psychiatric patients. We utilized a latent growth curve analysis to investigate trajectories of risk and protective factors over time in all 722 male forensic psychiatric patients who were unconditionally released between 2004 and 2014 from any of 12 Dutch forensic psychiatric centers (FPCs). The study covered the period from juridical observation until unconditional release. Moreover, we investigated whether these trajectories differ between patients depending on their psychiatric diagnosis namely substance use disorders (SUD), psychotic disorders, and cluster B personality disorders (PDs). In addition, we also investigated whether SUD may influence changes in risk and protective factors in a group of psychotic and cluster B PDs patients, respectively. Overall, findings suggest that all changes in dynamic risk and protective factors could be depicted by two phases of patients' stay in the FPCs. Specifically, most changes on dynamic risk and protective factors occurred at the beginning of treatment, that is, from the time of juridical assessment up to the time of unguided leave. Moreover, the moment of unguided leave could be considered the \u2018turning point\u2019 in the treatment of offenders. We also found that SUD and psychotic patients changed the most in the first phase of their stay, while cluster B PDs patients changed the most in the second phase. However, SUD did not modify changes in risk and protective factors in psychotic and cluster B PDs patients. These findings may help improve offender treatment and crime prevention strategies.<\/jats:p>","DOI":"10.3389\/fpsyt.2021.737846","type":"journal-article","created":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T00:52:45Z","timestamp":1631753565000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["The Long-Term Changes in Dynamic Risk and Protective Factors Over Time in a Nationwide Sample of Dutch Forensic Psychiatric Patients"],"prefix":"10.3389","volume":"12","author":[{"given":"Marija","family":"Jankovi\u0107","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert van","family":"Boxtel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Masthoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elien De","family":"Caluw\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Bogaerts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,9,16]]},"reference":[{"key":"B1","volume-title":"The Psychology of Criminal Conduct","author":"Andrews","year":"2010"},{"key":"B2","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1080\/13218719.2018.1506721","article-title":"Dynamic risk factors, protective factors and value-laden practices","volume":"26","author":"Heffernan","year":"2019","journal-title":"Psychiatry Psychol Law."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2259","DOI":"10.1177\/0306624X17717128","article-title":"Predictive validity of the HKT-R risk assessment tool: two and 5-year violent recidivism in a nationwide sample of Dutch Forensic Psychiatric patients","volume":"62","author":"Bogaerts","year":"2018","journal-title":"Int J Offender Ther Comp Criminol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1002\/cbm.754","article-title":"A classification of risk factors in serious juvenile offenders and the relation between patterns of risk factors and recidivism","volume":"20","author":"Mulder","year":"2010","journal-title":"Crim Behav Ment Health."},{"key":"B5","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.avb.2006.03.004","article-title":"The good lives model of offender rehabilitation: clinical implications","volume":"12","author":"Ward","year":"2007","journal-title":"Aggress Violent Behav."},{"key":"B6","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1037\/1076-8971.11.3.347","article-title":"Violence risk assessment: getting specific about being dynamic","volume":"11","author":"Douglas","year":"2005","journal-title":"Psychol Public Policy Law"},{"key":"B7","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1080\/1068316X.2015.1109091","article-title":"Understanding dynamic risk factors for violence","volume":"22","author":"Klepfisz","year":"2016","journal-title":"Psychol Crime Law."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1533","DOI":"10.1177\/0306624X20923256","article-title":"Longitudinal network structure and changes of clinical risk and protective factors in a nationwide sample of forensic psychiatric patients","volume":"64","author":"Bogaerts","year":"2020","journal-title":"Int J Offender Ther Comp Criminol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1080\/14999013.2014.906519","article-title":"Historical-clinical-risk management-20, version 3 (HCR-20 V3): development and overview","volume":"13","author":"Douglas","year":"2014","journal-title":"Int J Forensic Ment Health."},{"key":"B10","unstructured":"SpreenM BrandE Ter HorstP BogaertsS Handleiding en Methodologische Verantwoording HKT-R [Guidelines and Methodological Research of the HKT-R, Historical, 685 Clinical and Future \u2013 Revision]2014"},{"key":"B11","article-title":"Hostile attribution bias as a dynamic risk factor in civil psychiatric patients and criminal offenders: change over time and relationship to violence and recidivism","author":"Hendry","year":"2015"},{"key":"B12","doi-asserted-by":"publisher","first-page":"101448","DOI":"10.1016\/j.ijlp.2019.05.002","article-title":"Inpatient violence in forensic psychiatry: does change in dynamic risk indicators of the IFTE help predict short term inpatient violence?","volume":"66","author":"Schuringa","year":"2019","journal-title":"Int J Law Psychiatry."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1491","DOI":"10.1177\/0306624X20909219","article-title":"Trajectories of dynamic risk factors during forensic treatment: growth trajectory of clinical risk factors in a sample of Dutch forensic patients","volume":"64","author":"Van der Linde","year":"2020","journal-title":"Int J Offender Ther Comp Criminol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"110410","DOI":"10.1016\/j.paid.2020.110410","article-title":"Workplace violence, post-traumatic stress disorder symptoms, and personality","volume":"168","author":"Jankovic","year":"2021","journal-title":"Pers Individ Dif."},{"key":"B15","unstructured":"Dynamic risk: evaluation of the nature and predictive validity of change on the clinical and risk management scales of the HCR-20 violence risk assessment scheme DouglasKS StrandS BelfrageH Barcelona11th Conference of the International Association of Forensic Mental Health Services (IAFMHS)"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1369","DOI":"10.1177\/0306624X15619636","article-title":"Patient profiles in Dutch forensic psychiatry based on risk factors, pathology, and offense","volume":"61","author":"Van Der Veeken","year":"2017","journal-title":"Int J Offender Ther Comp Criminol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"3059","DOI":"10.3389\/fpsyg.2021.695354","article-title":"A latent class analysis of forensic psychiatric patients in relation to risk and protective factors","volume":"12","author":"Jankovic","year":"2021","journal-title":"Front Psychol."},{"key":"B18","first-page":"92","article-title":"Prevalence and treatment of personality disorders in Dutch Forensic Mental Health Services","volume":"35","author":"De Ruiter","year":"2007","journal-title":"J Am Acad Psychiatry Law."},{"key":"B19","doi-asserted-by":"publisher","first-page":"7","DOI":"10.4102\/sajpsychiatry.v21i3.708","article-title":"Forensic state patients at Sterkfontein Hospital: a 3-year follow-up study","volume":"21","author":"Marais","year":"2015","journal-title":"South Afr J Psychiatry."},{"key":"B20","doi-asserted-by":"publisher","first-page":"dar.13344","DOI":"10.1111\/dar.13344","article-title":"Genesis of change: substance use treatment for forensic patients with mental health concerns","author":"McFadden","year":"2021","journal-title":"Drug Alcohol Rev."},{"key":"B21","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1177\/0306624X20986537","article-title":"The complex associations between early childhood adversity, heart rate variability, cluster b personality disorders, and aggression","volume":"65","author":"Jankovic","year":"2021","journal-title":"Int J Offender Ther Comp Criminol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1080\/14789949.2012.686623","article-title":"The impact of personality disorders, substance use and other mental illness on re-offending","volume":"23","author":"O'Driscoll","year":"2012","journal-title":"J Forens Psychiatry Psychol."},{"key":"B23","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"2013"},{"key":"B24","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1001\/archgenpsychiatry.2008.537","article-title":"The intricate link between violence and mental disorder","volume":"66","author":"Elbogen","year":"2009","journal-title":"Arch Gen Psychiatry."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1177\/0306624X11420252","article-title":"Substance use disorders in forensic psychiatry","volume":"56","author":"Kraanen","year":"2012","journal-title":"Int J Offender Ther Comp Criminol."},{"key":"B26","volume-title":"Onttrekkingen tijdens verlof, ontvluchtingen en recidives tijdens de tbs-behandeling in de jaren 2000-2005 [Withdrawals During Leave, Escapes and Recidivism During TBS Treatment 2000-2005]","author":"Hildebrand","year":"2006"},{"key":"B27","first-page":"29","article-title":"The link between psychotic disorders and substance use","volume":"24","author":"Barkus","year":"2007","journal-title":"Psychiatr Times."},{"key":"B28","doi-asserted-by":"publisher","first-page":"517","DOI":"10.4103\/IJPSYM.IJPSYM_164_18","article-title":"Comorbidity of personality disorder among substance use disorder patients: a narrative review","volume":"40","author":"Parmar","year":"2018","journal-title":"Indian J Psychol Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1111\/j.1360-0443.1994.tb00954.x","article-title":"Variations in therapist effectiveness in the treatment of patients with substance use disorders: an empirical review","volume":"89","author":"Najavits","year":"1994","journal-title":"Addiction."},{"key":"B30","doi-asserted-by":"publisher","first-page":"e55942","DOI":"10.1371\/journal.pone.0055942","article-title":"Risk factors for violence in psychosis: systematic review and meta-regression analysis of 110 studies","volume":"8","author":"Witt","year":"2013","journal-title":"PLoS ONE."},{"key":"B31","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1016\/j.cpr.2011.03.002","article-title":"Risk factors for violence among patients with schizophrenia","volume":"31","author":"Bo","year":"2011","journal-title":"Clin Psychol Rev."},{"key":"B32","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1016\/S1359-1789(02)00098-8","article-title":"Psychopathic personality or personalities? Exploring potential variants of psychopathy and their implications for risk assessment","volume":"8","author":"Skeem","year":"2003","journal-title":"Aggress Violent Behav."},{"key":"B33","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.ijlp.2003.12.001","article-title":"Behavioral changes during forensic psychiatric (TBS) treatment in the Netherlands","volume":"27","author":"Nijman","year":"2004","journal-title":"Int J Law Psychiatry."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hsdr05110","article-title":"A mixed-methods study exploring the characteristics and needs of long-stay patients in high and medium secure settings in England: implications for service organisation","volume":"5","author":"V\u00f6llm","year":"2017","journal-title":"Heal Serv Deliv Res."},{"key":"B35","first-page":"21","article-title":"Schizophrenia and comorbid substance use disorder: effects of antipsychotics","volume":"66","author":"Green","year":"2005","journal-title":"J Clin Psychiatry."},{"key":"B36","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1176\/appi.ps.51.2.216","article-title":"Predicting medication noncompliance after hospital discharge among patients with Schizophrenia","volume":"51","author":"Olfson","year":"2000","journal-title":"Psychiatr Serv."},{"key":"B37","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1176\/ajp.155.2.226","article-title":"Violence and severe mental illness: The effects of substance abuse and nonadherence to medication","volume":"155","author":"Swartz","year":"1998","journal-title":"Am J Psychiatry."},{"key":"B38","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1080\/13218719.2018.1474816","article-title":"Disorder in the court: cluster B personality disorders in United States case law","volume":"25","author":"Young","year":"2018","journal-title":"Psychiatry Psychol Law."},{"key":"B39","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/S0272-7358(99)00052-5","article-title":"The \u201ca-b-c's\u201d of the cluster b's","volume":"21","author":"Kraus","year":"2001","journal-title":"Clin Psychol Rev."},{"key":"B40","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1093\/acprof:oso\/9780199917938.003.0008","article-title":"Lack of empathy and offending","volume-title":"The Future of Criminology","author":"Jolliffe","year":"2012"},{"key":"B41","doi-asserted-by":"crossref","DOI":"10.1515\/9781503621794","volume-title":"A General Theory of Crime","author":"Gottfredson","year":"1990"},{"key":"B42","doi-asserted-by":"publisher","first-page":"S473","DOI":"10.1016\/j.eurpsy.2017.01.547","article-title":"The relationship between personality disorders and substance abuse disorders","volume":"41","author":"Goretti","year":"2017","journal-title":"Eur Psychiatry."},{"key":"B43","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1521\/pedi.2011.25.5.586","article-title":"Impulsive phenomena, the impulsive character (der Triebhafte Charakter) and DSM personality disorders","volume":"25","author":"Perry","year":"2011","journal-title":"J Pers Disord."},{"key":"B44","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1108\/JFP-08-2020-0036","article-title":"Risk classes of patients diagnosed with substance use disorders in Dutch forensic psychiatric centers","volume":"23","author":"Schmitter","year":"2021","journal-title":"J Forensic Pract."},{"key":"B45","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1080\/14999013.2002.10471163","article-title":"The Dutch Entrustment Act (TBS): its principles and innovations","volume":"1","author":"Van Marle","year":"2002","journal-title":"Int J Forensic Ment Health."},{"key":"B46","volume-title":"Diagnostic and Statistical Manual of Mental Disorders IV-TR","year":"2000"},{"key":"B47","unstructured":"R: The R Project for Statistical Computing"},{"key":"B48","volume-title":"Structural Equation Modeling With AMOS: Basic Concepts, Applications, and Programming","author":"Byrne","year":"2010"},{"key":"B49","volume-title":"Multivariate Data Analysis: A Global Perspective","author":"Hair","year":"2010"},{"key":"B50","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1037\/0021-843X.112.4.545","article-title":"Missing data techniques for structural equation modeling","volume":"112","author":"Allison","year":"2003","journal-title":"J Abnorm Psychol."},{"key":"B51","doi-asserted-by":"publisher","first-page":"i02","DOI":"10.18637\/jss.v048.i02","article-title":"lavaan : an R package for structural equation modeling","volume":"48","author":"Rosseel","year":"2012","journal-title":"J Stat Softw."},{"key":"B52","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10705519909540118","article-title":"Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives","volume":"6","author":"Hu","year":"1999","journal-title":"Struct Equ Model A Multidiscip J."},{"key":"B53","volume-title":"Principles and Practice of Structural Equation Modeling","author":"Kline","year":"2015"},{"key":"B54","doi-asserted-by":"publisher","first-page":"593","DOI":"10.3758\/s13428-020-01420-5","article-title":"Piecewise latent growth models: beyond modeling linear-linear processes","volume":"53","author":"Harring","year":"2021","journal-title":"Behav Res Methods."},{"key":"B55","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1080\/10705510802154349","article-title":"Specifying piecewise latent trajectory models for longitudinal data","volume":"15","author":"Flora","year":"2008","journal-title":"Struct Eq Model A Multidiscip J."},{"key":"B56","volume-title":"Latent Curve Models: A Structural Equation Perspective","author":"Bollen","year":"2006"},{"key":"B57","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1037\/lhb0000089","article-title":"Changes in dynamic risk and protective factors for violence during inpatient forensic psychiatric treatment: predicting reductions in postdischarge community recidivism","volume":"39","author":"De Vries Robb\u00e9","year":"2015","journal-title":"Law Hum Behav."},{"key":"B58","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1002\/cbm.594","article-title":"Personality disorders in a Dutch forensic psychiatric sample: changes with treatment","volume":"14","author":"Greeven","year":"2004","journal-title":"Crim Behav Ment Health."},{"key":"B59","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1177\/0093854813503543","article-title":"Which criminogenic need changes are most important in promoting desistance from crime and substance use?","volume":"41","author":"Wooditch","year":"2014","journal-title":"Crim Justice Behav."},{"key":"B60","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.1016\/S0140-6736(11)61640-1","article-title":"The medium-secure project and criminal justice mental health","volume":"378","author":"Taylor","year":"2011","journal-title":"Lancet."},{"key":"B61","volume-title":"Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors","author":"Marlatt","year":"2005"},{"key":"B62","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1016\/j.cpr.2006.12.006","article-title":"Theory-based processes that promote the remission of substance use disorders","volume":"27","author":"Moos","year":"2007","journal-title":"Clin Psychol Rev."},{"key":"B63","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1080\/10884600903078944","article-title":"A multi-method evaluation of a substance misuse program in a medium secure forensic mental health unit","volume":"20","author":"Oddie","year":"2009","journal-title":"J Addict Nurs."},{"key":"B64","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1080\/14789940802263736","article-title":"An evaluation of group work as an intervention to reduce the impact of substance misuse for offender patients in a high security hospital","volume":"20","author":"Morris","year":"2009","journal-title":"J Forens Psychiatry Psychol."},{"key":"B65","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1108\/14636646200800009","article-title":"Getting out and staying out: does substance use treatment have an effect on outcome of mentally disordered offenders after discharge from medium secure service?","volume":"10","author":"Derry","year":"2008","journal-title":"Br J Forensic Pract."},{"key":"B66","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1080\/13218719.2016.1256017","article-title":"Biased symptom reporting and antisocial behaviour in forensic samples: a weak link","volume":"24","author":"Van Impelen","year":"2017","journal-title":"Psychiatry Psychol Law."},{"key":"B67","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.ijlp.2015.03.005","article-title":"Antisocial features and \u201cfaking bad\u201d: a critical note","volume":"41","author":"Niesten","year":"2015","journal-title":"Int J Law Psychiatry."},{"key":"B68","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1080\/0164212X.2010.518307","article-title":"Exploring social participation of people with cluster B personality disorders","volume":"26","author":"Larivi\u00e8re","year":"2010","journal-title":"Occup Ther Ment Health."},{"key":"B69","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1037\/lhb0000222","article-title":"PCL-R field validity in prison and hospital settings","volume":"41","author":"Jeandarme","year":"2017","journal-title":"Law Hum Behav."}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2021.737846\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T05:20:30Z","timestamp":1673241630000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2021.737846\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,16]]},"references-count":69,"alternative-id":["10.3389\/fpsyt.2021.737846"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2021.737846","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,16]]},"article-number":"737846"}}