Forensics Reseach

Question 1

What are the potential barriers to conducting research in UK forensic/prison settings?

Answer 1

1. Difficulty recruiting b.c. of low turnover of the study population
2. Extra regulatory steps required= take time
3. Security measures everywhere (restricted items, long time if you want to interview prisoners)

Question 2

What are potential ethical issues in conducting research in UK forensic/prison settings?

Ethical principles proposed over time that are in place now

Answer 2

Principles of medical ethics (Beauchamp & Childress 1979):

Autonomy – i.e. allowing participants to make their own decisions
Beneficence – i.e. seeking to do good
Non-maleficence – i.e. doing no harm
Justice – i.e. acting fairly and equitably

Nuremberg Code (1947):

• Research should seek societal good & minimise harm
• Researchers should be competent
• Participation must be voluntary

Declaration of Helsinki (1964):
Added independent ‘Institutional Review Boards (IRBs) or Research Ethics Committees (RECs)
UK: NHS (Health Research Authority / IRAS) or University ethics committees

Question 3

What are the practical issues of the present barriers and ethical issues for the study design?

Answer 3

• Long time for approval
• Interventions are trickier to apply
• Tricky to do longitudional resaerch
• Cross-sectional / case-control designs more common designs

Question 4

Case-study of forensic research in prison

Answer 4

The SHAPE (Self-harm and the prison environment)
Rationale: Noted increase of self-harm in prisons. A lot of literature on the risks of self-harm in individual ppl -> research gap in risk factors in prison
Aim: Answer the RQs and the longitudinal study to measure the effects of identified factors over time. 
RQ1: What are the main characteristics of the prison environment contributing to self-harm behaviour amongst men in prison, from the perspective of patients and staff? -> Qualitative, interviews and focus groups

RQs2: How frequent is self-harm in the study population? What are the estimated effect sizes of various prison-environment factors on self-harm? Is a prospective cohort study feasible in this study population/setting? -> Pilot, quantitative, prospective cohort

Question 5

Potential issues with ethics

Answer 5

3 types of vulnerability which can undermineautonomy (being able to make decisions) (Roberts & Roberts):

1. Intrinsic (e.g.intelligence, mental illness)
2. Extrinsic (situational factors e.g. imprisonment)
3. Relational (e.g. doctor-patient)

Question 6

Cross-sectional study design

Answer 6

A type of observational research that analyzes data of variables collected at one given point in time across a sample population or a pre-defined subset.

Question 7

Case-control study designs

Answer 7

Observational design where people who have developed a disease/ studied condition are identified and their past exposure to suspected aetiological factors is compared with that of controls or referents who do not have the disease/condition.

• > Good in prison b.c. you are not encouraging behaviour e.g. self-harm
• > Limitation: reasons for developing the ‘thing’ are not for sure casual, low predictive value, are not longitudinal

Question 8

An exemplary cross-sectional study in prison

Answer 8

Völlm and Dolan, 2009
Rationale: Psychiatric morbidity and suicide rates in prisoners are high. The detection of mental illness and its associated risks in prison are low
Aim: To estimate psychiatric symptomatology, needs and self-harming behaviour among UK female prisoners and to identify differences between individuals with and without a history of self-harm.

Methods: Cross-sectional study on over 600 female inmates. Self-harm and needs were self-reported in the questionnaire.
Findings: 45.9% had a history of self-harm. An average of 8.5 needs was identified with more than half of those needs classified as unmet.
> Confirmed high prevalence of psychiatric symptomatology and self-harm in female UK prisoners
> Individuals at risk of self-harming behaviour may be identified using screening questionnaires.

Question 9

An exemplary case-control study in prison

Answer 9

Grella et al., 2013
Aim: Studies if there are differential relationships among trauma exposure, familial risk and protective factors, substance abuse, and (PTSD) among incarcerated and non-incarcerated women
Methods: 100 incarcerated women and 100 from the general population.
Findings: Incarcerated women had a significantly higher risk of trauma exposure as compared with controls.
When the group was controlled, exposure to sexual or physical trauma significantly increased the odds of PTSD, as did substance use in response to traumatic distress
> The findings suggest that incarcerated women are at high risk for PTSD given their high rates of trauma exposure and apparent lack of appropriate coping mechanisms supporting trauma-specific interventions.