Assessment and treatment of risk for harm to self or others in inmates. The experience at the Monza prison

Author/s Manuela Valsecchi, Marco Bani, Francesca Barile, Emanuele Truisi, Michele Monticelli, Gabriele Travagin, Federico Zorzi, Giorgio Rezzonico, Umberto Mazza
Publishing Year 2018 Issue 2018/3
Language Italian Pages 25 P. 307-331 File size 90 KB
DOI 10.3280/RIP2018-003002
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Main risk factors of self or to others injurious behaviors in prison settings, as describing by researches, could be divided in situational factors, related to the prison environment and importation factors, related to the socio-demographic status and clinical characteristics prior the imprisonment. Related to the specificity of prison setting, considering self or others injurious behaviors in prison settings as the outcome of composite combinations of multiple risk factors is more appropriate for orienting the clinical interventions. Considering guidelines a specific protocol actuated at the Monza Prison to assess and prevent risk for harm in prisoners. It has been applied since September 2012 and within 72 hours from the entrance in prison every prisoner has a clinical session with a psychologist where some screening tools are administered: i) Jail Screening Assessment Tool (JSAT), used to explore juridical situation, history of aggressive acts, psychosocial evaluation, drug assumption, presence of psychiatric disorder, suicide or self- -harm risk, presence of anxious and depressive symptomatology; ii)Barrat Impulsiviness Scale-11 (BIS-11), a rating scale to evaluate the impulsiveness; iii)Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM), a rating scale to evaluate the distress’ level. It could be used also to evaluate outcome of treatment. When the psychologist detect the risk by J-SAT and/or by BIS-11’s score above cut-off, it’s possible a psychiatric advice and the prisoner is included in a monitoring and treatment plan which is dependent on the development of the clinical conditions. In these prisoners, Millon Clinical Multiaxial Inventory-III (MCM-III) is also administered within 2 weeks from first clinical session, to investigate the structure and the functioning of personality.This protocol allows to investigate both situational and importation risk factors and how they interacting with each other and the psychologist could use these information for orienting the clinical interventions.

Keywords: Self or others injurious behaviors, inmates, importation factors, situational factors, clinical intervention.

  1. Accordini, M., Saita, E., Irtelli, F., Buratti & M., Savuto, G. (2017). Stories of change: the text analysis of handovers in an Italian Psychiatric residential care home. Journal of Psychiatric and mental Health Nursing, 24, 232-242.
  2. Baccaro, L. (2003). Carcere e salute. Padova: Sapere. Barker, E., Kolves, K., & De Leo, D. (2014). Management of Suicidal and Self-Harming Behaviors in Prisons: Systematic Literatre Review of Evidence-Based Activities. Archives of Suicide Research, 18, 227-240. DOI: 10.1080/13811118.2013.824830
  3. Barrat, E., Stanford, M. (1995). Impulsiveness. In C. Costello, Personality Characteristics of the Personality Disorder Client. New York: Wiley.
  4. Boergers, J., Spirito, A., & Donaldson, D. (1998). Reasons for adolescent suicide attempts: Associations with psychological functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 1287-1293. DOI: 10.1097/00004583-199812000-00012
  5. Brown, M., Comtois, K., & Linehan, M. (2002). Reasons for suicide attempts and nonsuicidal self-injury in women with borderline personality disorder. Journal of Abnormal Psychology, 111, 198-202. DOI: 10.1037/0021-843X.111.1.198
  6. Chandler, A. (2014). Narrating the self-injured body. Medical Humanities, 40, 111-116. DOI: 10.1136/MEDHUM-2013-010488
  7. Chapman, A. L., Gratz, K. L., & Brown, M. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44, 371-394. DOI: 10.1016/J.BRAT.2005.03.005
  8. Ciappi, S. (2011). JSAT Jail Screening Assessment Tool. Uno strumento di screening psicologico in mbito forense e penitenziario. Firenze: Giunti Organizzazioni Speciali.
  9. Cima, M., Merckelbach, H., Hollnack & S., Knauer, E. (2003). Characteristics of psychiatric prison inmates who claim amnesia. Personality and Individual Differences, 35, 373-380. DOI: 10.1016/S0191-8869(02)00199-X
  10. Connell, J., Barkham, M., Stiles, W., Twigg, E., Singleton, N., Evans, O., & Miles, J.N. (2007). Distribution of CORE-OM scores in general population, clinical cut-off points and comparison with the CIS-R. British Journal of Psychiatry, 190, 69-74. DOI: 10.1192/BJP.BP.105.017657
  11. Daigle, M. (2004). MMPI inmate profiles: suicide completers, suicide attempters, and non-suicidal controls. Behavioural Science and the Law, 22, 833-842. DOI: 10.1002/BSL.618
  12. Daniel, A.E., & Fleming, J. (2006). Suicide in a State Correctional System, 1992-2002: a Review. Journal of Correctional Health Care, 12, 24-35. DOI: 10.1177/1078345806287541
  13. De Luca, L., Saita, E., & Graffigna, G. (2017). Representations and feelings related to organizational change: A Grounded Theory study with Italian prison workers. Bollettino di Psicologia Applicata, 65, 14-23.
  14. Department of Health (2007). Best Practice in Managing Risk – Principles and evidence for best practice in the assessment and management of risk to self and others in mental health services. London: Department of Health.
  15. Dom, G., Hulstijn & W., Sabbe, B. (2006). Differences in impulsivity and sensation seeking between early- and late-onset alcoholics. Addict Behav, 31, 298-308.
  16. Dougherty, D., Mathias, C., Marsh, D., Papageorgiou, T., Swann, A., & Moeller, F. (2004). Laboratory Measured Behavioral Impulsivity Relates to Suicide Attempt History. Suicide and Life-Threatening Behavior, 34, 374-385. DOI: 10.1521/SULI.34.4.374.53738
  17. Ettinger, S. (1992). Transforming psychic pain. The meaning and function of self injury in womens lives. Northampton, MA: Thesis.
  18. Evans, C., Connell, J., Barkham, M., Margison, F., McGrath, G., Mellor-Clark, J., & Audin, K. (2002). Towards a standardized brief outcome measure: psychometric properties and utility of the CORE-OM. British Journal of Psychiatry, 180, 51-60.
  19. Fossati, A., Di Ceglie, A., Acquarini, E., & Barratt, E. S. (2001). Psychometric properties of an Italian version of the Barratt Impulsiveness Scale-11 (BIS-11) in non clinical subjects. Journal of Clinical Psychology, 57, 815-828.
  20. Gratz, K. (2003). Risk factors for and functions of deliberate self-harm: An empirical and conceptual review. Clinical Psychology: Science and Practice, 10, 192-205. DOI: 10.1093/CLIPSY.BPG022
  21. Herpertz, S., Sass, H., & Favazza, A. (1997). Impulsivity in self-mutilative behaviour: Psychometric and biological finding. Journal of Psychiatric Research, 31, 451-465. DOI: 10.1016/S0022-3956(97)00004-6
  22. Holm, A., & Severinsson, E. (2010). Desire to survive emotional pain related to self-harm: A Norwegian hermeutic study. Nursing and Health sciences, 12, 52-57.
  23. Janis, I., & Nock, M. (2009). Are self-injurers impulsive? Results from two behavioral laboratory studies. Psychiatry Res, 169, 261-267. DOI: 10.1016/J.PSYCHRES.2008.06.041
  24. Jollant, F., Bellivier, F., Leboyer, M., Astruc, B., Torres, S., Verdier, R., Castelnau, D., Malafosse, A., & Courtet, P. (2005). Impaired decision making in suicide attempters. American Journal of Psychiatry, 162, 304-310. DOI: 10.1176/APPI.AJP.162.2.304
  25. Klonsky, E., & Glenn, C. (2009). Assessing the functions of non-suicidal self-injury: Psychometric properties of the Inventory of Statements About Self-injury (ISAS). Journal of Psychopathology and Behavioral Assessment, 31, 215-219. DOI: 10.1007/S10862-008-9107-Z
  26. Konrad, N., Daigle, M. S., Daniel, A. E., Dear, G. E., Frottier, P., Hayes, L. M., Kerkhof, A., Konrad, N., Liebling, A., & Sarchiapone, M. (2007). Preventing suicide in prisons, part I: Recommendations from the International Association for Suicide Prevention Task Force on Suicide in Prison. Crisis, 28, 113-121. DOI: 10.1027/0227-5910.28.3.113.
  27. Leach, C., Lucock, M., Barkham, M., Noble, R., Clarke, L., & Iveson, S. (2005). Assessing risk and emotional disturbance using the CORE-OM and HoNOS outcome measures at the interface between primary and secondary mental healthcare. Psychiatric Bulletin, 29, 419-422. DOI: 10.1192/PB.29.11.419
  28. Lohner, J., & Konrad, N. (2007). Risk factors for self-injurious behaviour in custody: Problems of definition and prediction. International Journal of Prisoner Health, 3, 135-161. DOI: 10.1080/17449200701321654
  29. Lüscher, M. (1978). Il test dei colori. Roma: Astrolabio.
  30. Martins, S., Tavares, H., Silva Lobo, D., Galetti, A., & Gentil, V. (2004). Pathological gambling, gender, and risk-taking behaviors. Addictive Behaviors, 29, 1231-1235. DOI: 10.1016/J.ADDBEH.2004.03.023
  31. Millon, T. (1995). Disorder of personality: DSM-IV and beyond. New York: Wiley.
  32. Millon, T. (1997). Millon Clinical Multiaxial Inventory-III manual (2 ed.). Minneapolis: National Computer System.
  33. Moeller, F., Barratt, E., Dougherty, D., Schmitz, J., & Swann, A. (2001). Psychiatric aspects of impulsivity. American Journal of Psychiatry, 158, 1783-1793. DOI: 10.1176/APPI.AJP.158.11.1783
  34. National Institute for Health and Clinical Excellence (2011). Self-harm (longer term management). Retrieved 28 dicembre 2011, from National Institute for Health and Clinical Excellence. --
  35. Naud, H., & Daigle, M. (2013). How to improve testing when trying to predict inmate suicidal behavior. International Journal of Law and Psychiatry, 36, 390-398. DOI: 10.1016/J.IJLP.2013.06.010
  36. Osuch, E., Ford, K., Wrath, A., & Bartha, R. (2014). Functional MRI of pain application in youth who engaged in repetitive non-suicidal self-injury vs. psychiatric controls. Psychiatry Res., 223, 104-112. DOI: 10.1016/J.PSCYCHRESNS.2014.05.003
  37. Palmieri, G., Evans, C., Hansen, V., Brancaleoni, G., Ferrari, S., Porcelli, P., Reitano, F., & Rigatelli, M. (2009). Validation of the Italian version of the clinical outcomes in routine evaluation outcome measure (CORE-OM). Clinical Psychology and Psychoterapy, 16, 444-449. DOI: 10.1002/CPP.646
  38. Perry, T., Barkham & M., Evans, C. (2013). The CORE-OM and CORE-OM (SV) in secure settings: a template analysis of the experiences of male patients and their staff. The Journal of Forensic Practice, 15, 32-43. DOI: 10.1108/14636641311299068
  39. Rodham, K., Hawton, K., & Evans, E. (2004). Reasons for deliberate self-harm: Comparison of self-poisoners and self-cutters in a community sample of adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 80-87. DOI: 10.1097/01.CHI.0000096627.64367.74
  40. Saita, E., Acquati, C., Fenaroli, V., Zuliani, C., & Bonanno, G. A. (2017). A confirmatory factor analysis of the Perceived Ability to Cope with Trauma (PACT) scale. Testing, Psychometrics, Methodology in Applied Psychology, 24, 255-268.
  41. Shearer, S. (1994). Phenomenology of self injury amongst inpatient women with BPD. Journal of Nervous and Mental Disease, 182, 524-526.
  42. Simeon, D., Stanley, B., Frances, A., Mann, J., Winchel, R., & Stanley, M. (1992). Selfmutilation in personality disorders: Psychological and biological correlates. American Journal of Psychiatry, 149, 221-226. DOI: 10.1176/AJP.149.2.221
  43. Tiet, Q., Ilgen, M., Byrnes, H., & Moos, R. (2006). Suicide Attempts Among Substance Use Disorder Patients: An Initial Step Toward a Decision Tree for Suicide Management. Alcoholism: Clinical and Experimental Research, 30, 998-1005. DOI: 10.1111/J.1530-0277.2006.00114.X
  44. Turati, S., Sorge, A., & Saita, E. (2018). La valutazione del rischio suicidario nei detenuti stranieri attraverso l’uso di un test proiettivo. Una ricerca sui detenuti del carcere di vigevano. Ricerche di Psicologia, 3, 333-351.
  45. Weinstein, K., Crocker, A., Reyes Ayllon, A., & Caron, J. (2015). Impulsivity in an Epidemiological Catchment Area Sample of the General Population: A confirmatory Factor Analysis of the Barratt Impulsiveness Scale (Version 11a). International Journal of Forensic Mental Health, 14, 120-131. DOI: 10.1080/14999013.2015.1033111
  46. Wichmann, C., Serin, R., & Motiuk, L. (2000). Predicting suicide attempts among male offenders in federal penitentiaries. Ottawa: Correctional Service of Canada.
  47. Zennaro, A., Ferracuti, S., Lang, M., & Sanavio, E. (2008). L’adattamento italiano del MCMI-III. Firenze: Organizzazioni Speciali.
  48. Zorzi, F., Cova, F., Mauri, S., Rubelli, P., Salerno, R., Truisi, E., Clerici, M., Rezzonico, G., & Mazza, U. (2012). Valutazione del rischio auto/etero lesivo in carcere. Monza (Protocollo in uso, allegato alle Linee Guida Regionali).

  • Stili di personalità e definizione dei percorsi di cura per pazienti detenuti attraverso l'inventario di Millon Emanuele Truisia, Marco Bani, Francesca Barile, Manuela Valsecchi, Federica Corbetta, Giorgio Rezzonico, Umberto Mazza, in RICERCHE DI PSICOLOGIA 3/2018 pp.353
    DOI: 10.3280/RIP2018-003004

Manuela Valsecchi, Marco Bani, Francesca Barile, Emanuele Truisi, Michele Monticelli, Gabriele Travagin, Federico Zorzi, Giorgio Rezzonico, Umberto Mazza, Valutazione e percorsi di trattamento del rischio autolesivo in carcere. L’esperienza nella Casa Circondariale di Monza in "RICERCHE DI PSICOLOGIA " 3/2018, pp 307-331, DOI: 10.3280/RIP2018-003002