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Poster: Suicide and Self-Harm Behaviors in a Psychiatric Sex Offender Sample

April 2012:

Little empirical research exists describing the rates and characteristics of suicide, suicide attempts, and self-harm behaviors among sexual offenders. Earlier research has demonstrated that sexual offenders often present with significant rates of mood and personality disorders, which are frequently correlates or important precursors of suicidal or self-harm behaviors. Given the rising prevalence of specialized treatment programs, residential facilities, and correctional or civil commitment units devoted to the care and treatment of sexual offenders, gaining an understanding of their suicide and self-harm behaviors should be a priority for treatment providers and administrators alike. Further, it is often assumed that legislative and policy changes targeting sex offenders, as well as negative public sentiment toward them, will have a negative impact on their outcome and well-being, which may in turn increase the prevalence of suicide and self-harm behaviors. Research describing the suicide and self-harm risk of this population may help us better understand these outcomes.

In the current study, 1190 psychiatric inpatients in a forensic state hospital are examined to evaluate the following research questions:
1) What are the rates of suicide and self-harm behaviors in an inpatient sample of sexual offenders?

2) Do these rates significantly differ from those of demographically- and psychiatrically-similar non-sex-offending inpatients?

3) What diagnostic variables, if any, may mediate important differences in the suicidality of these groups?
Preliminary analysis of 25% of the sample indicates that while rates of suicidality for the two groups are similar at 28-29%, those with sexual offenses engage in significantly higher rates of self-harm behaviors (21% vs. 31%).

With regards to important diagnostic variables, those with sexual offenses demonstrate significantly lower rates of serious psychotic psychopathology but significantly higher rates of impulse control disorders, Borderline Personality Disorder, and intellectual and developmental disabilities. Diagnoses which appear to mediate the likelihood and severity of suicidal behaviors for both groups include mood and anxiety disorders, personality pathology, and symptoms suggestive of impulse control deficits. It is anticipated that these results will be replicated with the larger sample, with perhaps additional findings of differences between the two groups.

We will present important differences and similarities between these groups, as well as potential explanations for these findings and implications for treatment, assessment, and risk management. Establishing that sex offenders in this psychiatric sample have higher rates of Borderline Personality Disorder and self-harm behaviors than their non-sex-offending counterparts, for example, has implications for treatment recommendations (e.g., Dialectical Behavior Therapy) and needed monitoring and safety precautions to ensure client well-being. Understanding the overall prevalence of suicidality in this group can also aid supervisory agents and treatment providers in assessing not only these offenders’ risk to others but also to themselves as they make transitions into the community, where they may receive fewer direct supports and will likely experience greater isolation and social pressure. Future directions for this research will also be discussed.

..Source.. by Jill D. Stinson, Ph.D., Fulton State Hospital --and-- Valerie Gonsalves, Ph.D., MLS, Fulton State Hospital (note: Within the Fulton State Hospital there is The Biggs Forensic Center [Civil Commitment unit] and a separate Sex Offender Treatment Program)

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