Open research questions in Psychopathy, Forensic Psychiatry, Sexual Offending

What the literature leaves open

• Although some studies have reported associations between specific crime types and clinical or family characteristics (Sertdemir et al, 2020; Lee et al,2015), these complexities suggest that further investigation is needed to better understand the relationship between psychiatric conditions and the type of crimes committed, particularly in the context of juvenile delinquency.

  An Investigation of Factors Associated with Types of Criminal Offenses in Juvenile Delinquents Evaluated at a High-Security Forensic Psychiatric Hospital · 2026 · DOI

• comprising minimal inpatient capacity, overcrowded prisons, and the absence of prison-based mental health services, highlight critical gaps in care and shed light on the urgent need for system-level development. toward Given the increasing demand for forensic psychiatric evaluations in Bangladesh, understanding physicians’ knowledge and attitudes is essential. Identifying gaps in training, awareness, and perception can help explain current challenges in medicolegal practice and service delivery.

  Knowledge, Attitudes and Perceived Barriers towards Forensic Psychiatry among Physicians in Bangladesh · 2026 · DOI

• There are several key factors highlighted by researchers to account for these challenges, including the complex, multi-tiered requirements of ethics committee reviews; inconsistencies in determinations across different ethics committees; a lack of support for research activities by correctional authorities; and limited research expertise among individuals involved in the review and approval processes for research (Charles et al.

  Guest editorial: The need for improved dual diagnosis research in criminalised populations · 2026 · DOI

• Strengths of the study include the large, naturalistic sample and routine, ‘real-world’ outcomes evaluated. Electronic health records, universally implemented in many settings, provide valuable opportunities for investigating novel research questions in data resources that are both large and granular. In mental health data science, this is being realised via the growing use of NLP applied to extract clinical entities of interest at scale from the extensive text data in the source records, exemplified by the algorithms for vic- timisation deployed in this analysis. Important covariates, such as medication use and symptom profiles, can also be derived in a similar way. Routine data resources should be seen as comple- mentary to traditional research approaches – providing substan- tially larger and more representative clinical samples than would be possible in a recruited cohort, but subject to challenges in the quality and availability of data achievable because health records are not set up for research objectives. Considering the sample, its definition and the timing of exposures were based on first contact with one catchment-based mental health service (SLaM). Although we believe that the majority of cases will thereby have been included at their first presentation, we do not have information on past mental healthcare contact and are not able to exclude those with earlier diagnoses from other providers migrating into the catchment and studied from a later point in their disorder. Also, no limitation was placed on the timing of the subsequent SMI diagnosis, bearing in mind diagnostic delays in routine practice; therefore, first presentations cannot all be assumed to reflect SMI emergence. It is important to consider that the NLP victimisation algorithm can ascertain this exposure only in patients who were willing to report any victimisation experience, and whose clinicians asked about this in the first place and recorded the experience in a way that could be ascertained. These patients may be different from those who had been exposed to victimisation but whose exposure was not ascertained and/or reported and/or recorded.33,34 Another current limitation of the NLP victimisation algorithm used in our analyses is that it does not attempt to characterise the timing of the victimisation experiences, thus conflating recent experiences (including those occurring during the 3-month ‘baseline’ assessment period) from more distant (e.g. childhood) exposures, as well as discrete and sustained exposures. Therefore, whereas it was possible to separate exposure and outcome ascer- tainment, it was not possible to disentangle the relative timings of exposures and covariates (hence the limitation of model 4 analyses described earlier), or to consider the effects of post-observation victimisation on clinical outcomes. Temporality is a feature that is being sought in ongoing development of the source algorithms. In addition, we did not attempt to consider the causative effects of violence perpetration or witnessing,35,36 and violence type/context was characterised only very broadly. We did not include other mental health disorders (e.g. depression and anxiety) as covariates, because these are common comorbidities in SMI and may not represent independent confounders. Outcome measurements had the advantages of being focused on clinically salient events, optimally ascertained in routine data sources, but will have been missed in patients who migrated out of the catchment, although we know of no reasons to suppose that exposure–outcome relationships would have influenced out-migration.

  An investigation of recorded physical, domestic and sexual victimisation as risk factors for adverse clinical outcomes in severe mental illness: longitudinal study · 2026 · DOI

• Although our large-scale national sample allows us to 57 NZJP, 55(1), 50-62 Correlates of Attitudes Towards People who have Sexually Offended into the personality insights provide generalisable correlates of attitudes towards people who have sexually offended, our study has several limitations. For one, crosssectional designs reflect a snapshot of attitudes at one specific time point and, thus, cannot speak to causal questions. As such, it is necessary to interpret our results with caution, and acknowledge that they do not represent causal relationships. Similarly, we only analysed data from one time point and cannot assess if attitudes change over time, nor whether they fluctuate in response to highprofile sex offences or policy changes. Nonetheless, we have identified important links that should be the focus of future research. incorporated Another common challenge when attempting to analyse the relationship between personality and political attitudes is that it can be difficult to isolate the effects of personality and political orientation. For example, personality research has been criticised due to the construct overlap between personality scales and conservatism. Indeed, political values were originally into personality measures. For example, Openness items like, “I believe that laws and social policies should change to reflect the needs of a changing world”, reflect political values (Hatemi & Verhulst, 2015). To address this concern, we used a previously-validated measure of the Big Six (i.e., the Mini-IPIP6; see Sibley et al., 2011) that does not include items that overlap with political views.

  Examining the Personality Correlates of Attitudes Towards People Who Have Sexually Offended and Related Policies · 2026 · DOI

• Bleidorn et al. (2019) assert that policymakers should attend to personality traits due to their combined stability and influence on people’s receptiveness to policy changes and interventions. Although traits are stable predictors of certain life outcomes and success, dynamic characteristics can be leveraged by interventions. In other words, personality can guide interventions by linking specific traits to desired outcomes. Understanding what preferences are more likely to align with punitive attitudes can help advocates for rehabilitation programmes garner support. Given that multiple traits correlated with attitudes towards sexual offending in our study, it may be useful to frame related policies in a targeted way that resonates with people’s dispositions. target those high Our results provide the foundations for future work on the framing of policies to appeal to different personality traits. More specifically, our results suggest interventions should in Conscientiousness, Extraversion and Neuroticism and tailor messages to address their fears and preferences. For example, penal populism and prevailing stereotypes about sexual offending means that discourse around rehabilitation should frame retributive justice as ineffective and unjust to victims. Presenting rehabilitative policies as a means of restoring order, rather than forgiving people who have caused harm, might increase support, particularly from individuals high in Conscientiousness. In this sense, framing rehabilitation as a way to protect the community rather than helping the transgressor may boost support for these policies. Understanding framing effects could inform how rehabilitation is discussed by professional services, presented in the media, and understood by government decision makers. Nevertheless, future research is needed to examine this possibility.

  Examining the Personality Correlates of Attitudes Towards People Who Have Sexually Offended and Related Policies · 2026 · DOI

• Despite the recognized need for cross-functional teamwork, research evaluating methods for such collaboration in crime investigations, especially in online CSA, is scarce.

  Co-Creation to Increase Cross-Functional Collaboration in Police Investigations of Online Child Sexual Abuse: A Qualitative Study Protocol · 2025 · DOI

• Because of the many differences between these studies and the settings studied, prevalence rates varied widely and no single percentage of diagnosis of PDs in OFMH settings can be given.

  A systematic review on the prevalence and assessment of persons with a diagnosis of personality disorders in outpatient forensic mental health services · 2025 · DOI

• Because previous research has generally neglected the role of the experiential system in working with sex offenders and cognitive-experiential theory has not been tested in the context of decisions of this nature, the purpose of this study was to examine significant predictors of the willingness of students in helping professions to work with sex offenders.

  ULOGA RACIONALNOG I ISKUSTVENOG SUSTAVA PRI DONOŠENJU ODLUKE STUDENATA O SPREMNOSTI ZA RAD S POČINITELJIMA SEKSUALNIH KAZNENIH DJELA · 2024 · DOI

• Further research is required to determine if seriously mentally ill Indigenous people who come into contact with the justice system are considered for the NCRMD defense similarly to non-Indigenous people and to explore why Indigenous individuals receive more restrictive dispositions, yet time to reoffending is similar.

  How Do Persons Found NCRMD and Identified as Indigenous Differ from Other Persons Found NCRMD: Profiles, Trajectories, and Outcomes · 2023 · DOI

• Available studies use varying methodological approaches and show mixed results, but incarcerated individuals are more likely to be impaired by emotional RRI.

  Emotional Rapid Response Impulsivity in Incarcerated Men and Non-Incarcerated Controls · 2022 · DOI

• To this end, the trajectories and outcomes were investigated in one understudied Canadian RB system on a sample of NCR individuals ( n = 109) and compared to other provincial practices.

  Trajectories and Outcomes of Those Not Criminally Responsible on Account of Mental Disorder through a Canadian Forensic System · 2022 · DOI

• Studies exploring advanced ToM showed mixed results overall, though the highest quality research appeared to indicate that offenders have impairments in advanced ToM which means that they may have difficulty understanding various mental states such as pretense, white lies, irony, double bluffs, and sarcasm.

  Theory of Mind in Offending: A Systematic Review · 2021 · DOI

• The study results indicate that while potential SSHOs share more in common with successful SSHOs than they do with single-victim nonsexual homicide offenders, and that there is an overlap between potential SSHOs and successful SSHOs, there is currently insufficient evidence to suggest that there are discreet transitions among categories.

  A heuristic study of the similarities and differences in offender characteristics across potential and successful serial sexual homicide offenders · 2021 · DOI

• This exploratory study aims to add to the previously sparse literature on the correlates of self-injury in inpatient forensic patients with schizophrenia spectrum disorders (SSD).

  Self-Harm Among Forensic Psychiatric Inpatients With Schizophrenia Spectrum Disorders: An Explorative Analysis · 2021 · DOI

• We identify areas needing further research, including the utility of the test in assessments of persons of color, investigations of the applicability of MMPI-3 results in various specific forensic assessments and rehabilitative applications, and further research on implications of the new English and Spanish-language norms.

  Using the MMPI-3 in Legal Settings · 2021 · DOI

• As these results are mixed and findings are not seemingly unique to sexual offenders, we suggest future sexual offender research may benefit from focusing on more financially feasible options, such as neuropsychological assessment approaches, to assess for and attend to offenders' criminogenic and rehabilitative/therapeutic needs in alignment with the risk-need-responsivity model.

  Neuroanatomical Differences Among Sexual Offenders: A Targeted Review with Limitations and Implications for Future Directions · 2020 · DOI

• And yet, despite the formative role which pre-trial procedures exert over the trajectory of proceedings, little is known about the experiences of people with ID during their initial interaction with law enforcement officers.

  Experiences of people with intellectual disabilities encountering law enforcement officials as the suspects of crime – A narrative systematic review · 2020 · DOI

• This notion has been supported among inpatient persons with mental illness (PMI) when examining antisocial cognitions; however, other key criminogenic risk factors (the Big Four and Central Eight risk factors) have not been examined among psychiatric inpatient PMI.

  A comparison of criminogenic risk factors and psychiatric symptomatology between psychiatric inpatients with and without criminal justice involvement. · 2020 · DOI

• Results from the survey suggest that, although evaluees request feedback a moderate amount of time, there is no consensus among mental health professionals regarding the ethical parameters surrounding feedback or how to respond to evaluees’ requests for feedback during FHMA.

  Feedback in Forensic Mental Health Assessment: A Preliminary Review of Ethics, Research, and Practice · 2019 · DOI

• The usefulness of the MCMI-III in the evaluation of sexual offenders seems limited to the detection of the presence or absence of general psychopathological symptoms.

  MCMI-III Profiles of Convicted Contact Sexual Offenders: A Cluster Analysis · 2019 · DOI

• The results highlight that despite frequent use of offense-specific group interventions for FPs in UK forensic mental health services, evaluation is lacking regarding both published evaluations and through routine clinical practice.

  What is the Evidence for Offense-Specific Group Treatment Programs for Forensic Patients? · 2019 · DOI

• The single-item predictive validity of the Short-Term Assessment of Risk and Treatability (START) has not been thoroughly investigated, although this has great clinical relevance for the selection of treatment targets.

  Single-item predictive validity of the Short-Term Assessment of Risk and Treatability (START) for violent behaviour in outpatient forensic psychiatry · 2019 · DOI

• Furthermore, it remains unclear whether the characteristic START additions of scoring strengths next to vulnerabilities and selecting key items, add incremental predictive validity.

  Single-item predictive validity of the Short-Term Assessment of Risk and Treatability (START) for violent behaviour in outpatient forensic psychiatry · 2019 · DOI

• Objective: Despite the growing research on the effectiveness of specialty courts, including drug treatment courts (DTCs) and veterans treatment courts (VTCs), little is known about the unique treatment needs of individuals with co-occurring mental health and substance use disorders (COD) who are commonly served by these courts.

  Comparing the treatment needs of participants with co-occurring mental health and substance use disorders in drug and veterans treatment courts · 2019 · DOI

Most-cited papers in Psychopathy, Forensic Psychiatry, Sexual Offending

• The Principles of Effective Correctional Treatment Also Apply To Sexual Offenders · Criminal Justice and Behavior · 2009 · 631 citations
• Mental Disorder, Intellectual Deficiency, and Crime · Archives of General Psychiatry · 1992 · 526 citations
• Psychosis as a risk factor for violence to others: A meta-analysis. · Psychological Bulletin · 2009 · 407 citations
• Psychopathy as a taxon: Evidence that psychopaths are a discrete class. · Journal of Consulting and Clinical Psychology · 1994 · 344 citations
• The Prediction of Violence in Adult Offenders · Criminal Justice and Behavior · 2009 · 288 citations
• When Criminal Coping is Likely: An Extension of General Strain Theory · Deviant Behavior · 2013 · 253 citations
• Personality Disorders, Violence, and Antisocial Behavior: A Systematic Review and Meta-Regression Analysis · Journal of Personality Disorders · 2012 · 216 citations
• Gender, Race, and DSM-III: A Study of the Objectivity of Psychiatric Diagnostic Behavior · Journal of Health and Social Behavior · 1988 · 200 citations
• Successful and unsuccessful psychopaths: A neurobiological model · Behavioral Sciences & the Law · 2010 · 197 citations
• Psychopathy and community violence among civil psychiatric patients: Results from the MacArthur Violence Risk Assessment Study. · Journal of Consulting and Clinical Psychology · 2001 · 189 citations

Most recent work

• A desistance practice framework to support police professionals working with people with sexual convictions · International journal of law, crime and justice · 2026
• The extent and consequences of continuity of care for prisoners with serious mental illness: A systematic review with a narrative synthesis · European Journal of Probation · 2026
• Psychological and legal criteria for criminal responsibility in the contemporary paradigm of forensic psychiatric assessment · Прикарпатський юридичний вісник · 2026
• Overburdened and understaffed: A national mixed-methods examination of Canadian forensic mental health and fitness to stand trial · International Journal of Law and Psychiatry · 2026
• Exploration of barriers to providing mental health care and factors supporting access to mental health care in Australian prisons · medRxiv · 2026
• Pseudologia fantastica: a systematic review of sociodemographic features and psychiatric comorbidities · Annals of Medicine & Surgery · 2026
• The first systematic review of treatment characteristics and recidivism outcomes for Indigenous people who have sexually offended · Psychiatry, Psychology and Law · 2026
• “I'm Going to Do Everything I Can to Keep You From Having to Interact With the Police”: Queer Therapists' Perceptions of Police · Journal of Marital and Family Therapy · 2026
• Determinants of antipsychotic prescription in women detainees admitted to an acute forensic psychiatric unit · Frontiers in Psychiatry · 2026
• Artificial Intelligence Centrality in Psychotic Delusions and Violence Risk in Forensic Psychiatry: Retrospective Observational Study of Judicial Decisions · Journal of Medical Internet Research · 2026

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