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Purpose This study aims to provide an overview and quality appraisal of the current scientific evidence concerning the prevalence and characteristics of mental and physical disorders among sentenced female prisoners. Design/methodology/approach A mixed-methods systematic literature review. Findings A total of 4 reviews and 39 single studies met the inclusion criteria for the review. Mental disorders were the main area of investigation in the majority of single studies, with substance abuse, particularly drug abuse, as the most consistently gender biased disorder, with higher prevalence among women than men in prison. The review identified a lack of updated systematic evidence on the presence of multi-morbidity. Originality/value This study provides an up-to-date overview and quality appraisal of the current scientific evidence concerning the prevalence and characteristics of mental and physical disorders among female prisoners.

Background and Hypothesis Violence is more prevalent in patients with psychotic disorders compared to the general population. Hence, adequate violence risk assessment is of high clinical importance. Impaired insight is suggested as a risk factor for violence in psychosis, but studies have yielded conflicting results. We hypothesized that impaired insight was associated with a history of severe violence in patients with psychotic disorders. Study Design Clinical insight was assessed both using the Birchwood Insight Scale (BIS) and the Positive and Negative Symptom Scale (PANSS) item G12 (lack of judgment and insight). The degree of impaired clinical insight was compared between psychosis patients with (N = 51) and without (N = 178) a history of severe violence. Multiple linear regression analyses were performed to investigate the effects of putative confounders. Study Results We found that a history of severe violence was significantly associated with lower insight in one of the three BIS components (the relabeling of symptoms) (P = .03, R2 = 0.02) and the PANSS item G12 (P = .03, R2 = 0.02) also after controlling for putative confounders. Conclusions The results suggest there is an association between impaired insight and severe violence in psychosis patients. We propose that examination of insight by validated instruments comprising different components may add useful information to clinical violence risk assessment in psychosis patients.

Several of the known risk factors for sexual violence concern a lack of capacity for engaging in mutually satisfying interpersonal relationships. Socio-cognitive deficits may be approached from a theory of mind (ToM) perspective, where lack of ability to attribute mental states to others is seen as the core feature. This study focuses on imprisoned men (n = 26) convicted of rape against an adult. A video-based measure of ToM (MASC) was applied, depicting social interaction in a dynamic real-life setting. The results showed that the rape-convicted men have a markedly inferior ability to infer the mental states of others. Clinical as well as theoretical implications of the findings are discussed.

The Static-99R has been recommended for use as a first global screen for sorting out sex-convicted persons who are in need of further risk assessment. This study investigated the Static-99R’s predictive validity based on a nonselected Norwegian sample ( n = 858) of persons released from prison after having served a sex crime sentence. After a mean observation period of 2,183 days, 3.4% ( n = 29) had recidivated to a new sex offense. A higher number of recidivists were found among those with higher Static-99R total scores. The predictive contribution from each of the ten Static-99R risk items was investigated using standard logistic regression, proportional hazard regression, and random forest classification algorithm. The overall results indicate that the Static-99R is relevant as a risk screen in a Norwegian context, providing similar results concerning predictive accuracy as previous studies.

BACKGROUND A large proportion of the prison population experiences substance use disorders (SUDs), which are associated with poor physical and mental health, social marginalization, and economic disadvantage. Despite the global situation characterized by the incarceration of large numbers of people with SUD and the health problems associated with SUD, people in prison are underrepresented in public health research. OBJECTIVE The overall objective of the PriSUD (Diagnosing and Treating Substance Use Disorders in Prison)-Nordic project is to develop new knowledge that will contribute to better mental and physical health, improved quality of life, and better life expectancies among people with SUD in prison. METHODS PriSUD-Nordic is based on a multidisciplinary mixed method approach, including the methodological perspectives of both quantitative and qualitative methods. The qualitative part includes ethnographic fieldwork and semistructured interviews. The quantitative part is a registry-based cohort study including national registry data from Norway, Denmark, and Sweden. The national prison cohorts will comprise approximately 500,000 individuals and include all people imprisoned in Norway, Sweden, and Demark during the period from 2000 to 2019. The project will investigate the prison population during three different time periods: before imprisonment, during imprisonment, and after release. RESULTS PriSUD-Nordic was funded by The Research Council of Norway in December 2019, and funding started in 2020. Data collection is ongoing and will be completed in the first quarter of 2022. Data will be analyzed in spring 2022 and the results will be disseminated in 2022-2023. The PriSUD-Nordic project has formal ethical approval related to all work packages. CONCLUSIONS PriSUD-Nordic will be the first research project to investigate the epidemiology and the lived experiences of people with SUD in the Nordic prison population. Successful research in this field will have the potential to identify significant areas of benefit and will have important implications for ongoing policy related to interventions for SUD in the prison population. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/35182

Homicide-suicide incidents make up a relatively small proportion of homicides overall, but occur more frequently in certain subtypes of homicide, such as men who kill their female partners. This study investigates aspects of intimate partner homicide-suicide (IPHS) by comparing it with intimate partner homicide (IPH). All IPHs in Norway from 1990 to 2012 ( N = 177) were included. Quantitative data were extracted from court documents. Qualitative data were collected by interviews with bereaved. Multivariate logistic regression analyses and systematic text condensation were conducted. Nearly one fourth of IPHs were identified as IPHS. Perpetrators of IPHS were less likely to have a previous criminal record, even having a history of disregard and violations of the law. Perpetrators of IPHS were mainly native-born citizens and were more educated than IPH perpetrators. The motive of IPHS was more often jealousy than a dispute, but the motive was most often recorded as “other” or “unknown.” IPHS was perceived as intentional, and the bereaved did not unambiguously support the interpretation that the IPHS had been triggered by stressful situations. The bereaved pointed to the loss of hope or loss of a future combined with an inability to cope with severe disappointments as an important risk factor. Within the framework of an interactional perspective, our findings indicate that IPHS shares more characteristics with IPH than it does with other categories of homicide and other violent deaths in general.

Even though women are far more likely to be killed by an intimate partner than by anyone else, Intimate Partner Homicide (IPH) is an infrequent occurrence, even in at-risk populations. However, the majority of IPHs do not occur without warning signs. Identifying valid risk factors for IPH is fundamental in order to mitigate the risk, and increase the potential to prevent IPH. Authors within the field of intimate partner violence and IPH have called for investigation of “the violence process”, examining the nature of the violent relationship, events and conditions preceding the intimate partner violence episode or an IPH, and motivations and outcomes of these fatal acts. This chapter describes recent research, the latest empirical evidence, and understanding concerning characteristics of and possible risk factors for intimate partner homicide including: (1) previous intimate partner violence, (2) sociodemographic, contextual, and clinical factors, (3) help-seeking prior to IPH, (4) substance use, (5) immigration, (6) IPH-suicide, and (7) differentiating female and male IPH perpetrators.

Individuals with psychotic disorders have an increased risk of committing acts of violence. Neurobiological support for the extent to which violence in psychosis is driven by psychotic symptoms and/or antisocial traits could have clinical and legal implications. Neuroimaging studies have reported white matter (WM) abnormalities in individuals with psychosis and in those with antisocial traits. However, it is unknown whether WM abnormalities in psychosis patients with a history of violence (violent-PSY) resemble those found in nonviolent psychosis patients (nonviolent PSY), violent nonpsychotic individuals (violent non-PSY), or both. Diffusion tensor imaging scans from 301 males including violent-PSY (n = 28), violent non-PSY (n = 20), nonviolent PSY (n = 58), and healthy controls (HC, n = 195) were analyzed with tract-based spatial statistics. Fractional anisotropy (FA), mean, axial and radial (RD) diffusivity were compared between groups. Psychopathic traits in the violent groups were measured with Psychopathy Checklist-revisited (PCL-R). Violent-PSY had globally lower FA and higher RD, compared with nonviolent PSY. Both psychosis groups and violent non-PSY group had widespread disruptions in WM compared with HC. There were no significant WM differences between violent-PSY and violent non-PSY. PCL-R scores did not differ between the violence groups and were associated with higher RD in corpus callosum. Here we demonstrate a widespread pattern of reduced WM integrity in violent-PSY compared with nonviolent PSY. The lack of significant WM and PCL-R differences between the violence groups, together with the positive association between PCL-R and WM deficits in violent-PSY and violent non-PSY may indicate shared neurobiological underpinnings of trait violence.

Intimate partner homicides (IPH) are fatal violent attacks perpetrated by intimate partners. Research has indicated that substance use can co-occur in IPH. This study investigates the role ...

Most of our knowledge about intimate partner homicide (IPH) is based on studies of men, as they outnumber women as perpetrators. From a total cohort of IPHs in Norway from 1990 to 2012 (N =...

The amygdala is involved in fear perception and aggression regulation, and smaller volumes have been associated with psychotic and non-psychotic violence. We explored the relationship between amygdala nuclei volumes in violent offenders with and without psychosis, and the association to psychopathy traits. 3T MRI scans (n=204, males, 18-66 years) were obtained from psychotic violent offenders (PSY-V, n=29), non-psychotic violent offenders (NPV, n=19), non-violent psychosis patients (PSY-NV, n=67), and healthy controls (HC, n=89). Total amygdala and 9 amygdala nuclei volumes were obtained with FreeSurfer. Psychopathy traits were measured with the Psychopathy Checklist-revised (PCL-R). Multivariate analyses explored diagnostic differences in amygdala nuclei volumes and associations to psychosis, violence, and psychopathy traits. PSY-V had a smaller basal nucleus, anterior amygdaloid area, and cortical amygdalar transition area (CATA), whereas PSY-NV had a smaller CATA than HC. Volumes in NPV did not differ from HC, and there were no associations between PCL-R total or factor scores and any of the nuclei or whole amygdala volumes. The lower volumes of amygdala nuclei involved in fear modulation, stress responses, and social interpretation may point towards some mechanisms of relevance to violence in psychosis, but the results warrant replication in larger subject samples.

This study investigated the dimensionality of the Perception of Sex Offenders scale among prison officer students in Norway, and whether the students’ perceptions of this group of prisoners changed during their theoretical education and 1-year practical training. The target sample comprised a full cohort of freshman prison officer students, and two waves of data collection were conducted. The response rate was 94 percent ( n = 188) at time 1 (T1) and 64 percent ( n = 112) at time 2 (T2). The originally reported three-dimensional structure of the Perception of Sex Offenders scale was replicated in our sample. Moreover, the results supported our hypothesis that prison officer students were likely to hold less punitive views about sentencing and punishment at the end (T2) than at the beginning (T1) of their education. However, their endorsement of risk did not change, while the tendency to adhere to stereotypical images of persons convicted of sex offenses increased.

Background Substance use is one of many risk factors for schizophrenia, and substance use is also associated with violent offending. This study compared a group of individuals suffering from schizophrenia with a history of violent offending (SCZ-V) to a group of schizophrenia patients without any history of violent offending (SCZ-NV). We investigated whether there is a difference between the SCZ-V and SCZ-NV groups when it comes to lifetime use, and debut age for use, of alcohol, cannabis, and amphetamines. Methods This study examined the overall lifetime substance-use and the debut age of use of alcohol, cannabis and amphetamine among a selected group of patients with schizophrenia and a history of violent offending (SCZ-V n=25) recruited from psychiatric security wards in South-Eastern Norway, compared to a matched group of schizophrenia patients without violent offending (SCZ-NV n=34). Participants completed interviews and questionnaires to confirm diagnoses and to map the history of substance use. Results While we found no significant difference in lifetime use of alcohol and cannabis between the groups (alcohol: SCZ-V: 88%, SCZ-NV: 97%, cannabis: SCZ-V: 76%, SCZ-NV: 71%), the SCZ-V group reported significantly more lifetime use of amphetamines compared to the SCZ-NV group (SCZ-V: 76% vs SCZ-NV: 18%, p Discussion The SCZ-V group reported significantly more lifetime use of amphetamine and a significantly lower debut age for use of alcohol, cannabis, and amphetamines than the SCZ-NV group. According to the Norwegian Institute of Public Health, the average lifetime uses of cannabis for the general Norwegian population between 16 and 64 years old is 20.6%, while the average for the population between 16 and 34 years old when it comes to ever have used amphetamines is 4.7%. The numbers for both the SCZ-V and the SCZ-NV groups were noticeably higher than the population averages. What separates the groups are the significantly lower debut age of drug use in the SCZ-V group, and especially the higher number of lifetime amphetamines use. The findings point towards an association between the early debut of use of alcohol, cannabis, and amphetamines, and later violent offending in patients suffering from schizophrenia.

The extent to which sexual offenders are a group separate from other types of offenders has been debated for many years and investigated from different perspectives. The present study investigated similarities and differences regarding socio-economic background, criminal history and recidivism involving new crimes between rape offenders and three other groups: other sexual offenders, non-sexual violent offenders and other offenders. Data came from Norwegian population registers containing information on all crimes investigated from 1992 to 2012. The sample consisted of all persons convicted in 2002 and 2003 (N = 36,951). Background characteristics and estimated recidivism risk was described using hazard models. Results indicated that men convicted of rape (n = 142) had lower levels of education and that a higher percentage of them were on social benefits compared to the other crime groups. A large majority (79%) of rape-convicted men had previous convictions. Rape offenders were considerably more ...

In this one-year prospective, naturalistic study in an acute psychiatric facility, we explored gender differences between 230 men and 284 women regarding the predictive validity of the Violence risk screening-10 (V-RISK-10). Hospital staff recorded violent incidents during hospital stays (range 1–176 days; median: 5.5 days) resulting in 50 men (22%) and 30 women (11%) being recorded for violence. The predictive validity was significant for both genders, with ROC-AUCs of .79 for males and .80 for females. Scoring at cut-off or beyond indicated a two-fold increased risk of becoming violent for men and a three-fold risk for women. A lower score indicated a five-fold decrease in risk for both genders. Estimates of explained variance for the prediction model were higher for men. Findings indicate gender differences for risk factors of violence and highlight the need of further research on this issue.

Stalking is a considerable health problem. In order to develop interventions for victims, more knowledge is needed concerning prevalence, stress and coping related to stalking as well as associated symptomatology in the victims. This is the first population-based study of stalking in Norway.To examine the prevalence of stalking in relation to gender and time, and the association with indicators of socio-demographic status and mental health.A cross-sectional case-control questionnaire design. The sample, 5000 Norwegians aged 20-59 years, was nationally representative according to gender, 10-year age groups and county of living. A total of 248 (5%) of the mailed envelops were returned due to wrong address, leaving 4752 individuals as possible respondents. Among them 1520 (32%) returned the questionnaire, but 98 of them had to be discarded due to lack of completion, giving a sample of 1422 valid questionnaires (30%).The total weighted lifetime prevalence of stalking was 8.1% (95% CI 6.6-9.4%), for females 11.8% (95% CI 10.2-13.5%) and for males 4.3% (95% CI 3.2-5.3%) [corrected]. The point prevalence of current stalking was 2.8% (95% CI 2.0-3.7%). The stalked individuals had a significantly poorer social situation and mental health than the controls. Few significant group differences were observed between males and females exposed to stalking.The prevalence of stalking was within the range observed by questionnaire studies in other cultures.

Intimate partner homicides (IPH) are fatal violent attacks perpetrated by intimate partners. Immigrants are overrepresented in the IPH statistics as both perpetrators and victims. If explanatory factors for this are not studied, immigrants may be stigmatized. The present study investigates whether IPHs committed by immigrant perpetrators have characteristics that differentiate them from IPHs committed by the native majority of IPH perpetrators. All IPHs in Norway from 1990 to 2012 (N = 177) were included. Quantitative data were extracted through structured investigation of court documents. Information concerning risk factors (previous intimate partner violence and sociodemographic, contextual and clinical factors) was drawn from three validated risk assessment instruments. Univariate analysis and multivariate logistic regression analyses were conducted. When adjusted for other group differences, very few differences remained in the multivariate models. IPHs perpetrated by immigrants differed from cases with native perpetrators on modus operandi and ascribed motives and resulted in longer sentences than IPHs with native perpetrators. This study indicates considerable similarities in IPHs perpetrated by immigrants and natives. Findings indicating that IPHs by immigrants were perceived differently in the justice system need further investigation. Keywords: intimate partner homicide, femicide, ethnicity, immigration, risk assessment, intimate partner violence

To explore possible risk factors for intimate partner homicide by combining structured risk assessment based on information available in court documents and individual risk assessment provided through interviews with the bereaved. Method: The aim of this study was to scrutinize intimate partner homicide (IPH) situations and interactions within a retrospective, mixed methods design. All IPHs in Norway that had received a final legal judgment from 1990 to 2012 (N = 177) were included. Quantitative data was extracted through structured investigation of the court documents. Risk factors were identified from three validated risk assessment instruments. Qualitative data were retrieved from interviews with a sample of bereaved (n = 12). Results: The IPH distribution was biased toward low socioeconomic status. Previous intimate partner violence (IPV) was identified in 7 out of 10 IPH incidents. Observed risk by the bereaved was infrequently communicated to health care, police, or support services. Individuals who did communicate risk found that professionals underestimated the reported risk and did not act on their warnings. Conclusions: The majority of IPHs did not occur without warning signs. To prevent IPH, structured risk assessments and knowledge of family and friends’ perceptions of risk is essential. Keywords: intimate partner homicide, risk assessment, intimate partner violence, domestic violence

Background: Women prisoners are known to suffer from an accumulation of factors known to increase the risk for several major health problems. This study examines the prevalence of adverse childhood experiences (ACE) and the relationship between such experiences and suicide attempts and drug use among incarcerated women in Norway. Methods: A total of 141 women inmates (75% of all eligible) were interviewed using a structured interview guide covering information on demographics and a range of ACE related to abuse and neglect, and household dysfunction. The main outcome variables were attempted suicide and adult drug abuse. Results: Emotional, physical and sexual abuse during childhood was experienced by 39%, 36% and 19%, respectively, and emotional and physical neglect by 31% and 33%, respectively. Looking at the full range of ACE, 17% reported having experienced none, while 34% reported having experienced more than five ACEs. After controlling for age, immigrant background and marital status, the number of ACEs significantly increased the risk of attempted suicide and current drug abuse. Conclusion: The associations observed between early life trauma and later health risk behaviour indicate the need for early prevention. The findings also emphasize the important role of prison health services in secondary prevention among women inmates.

Most structured sex-offender programs are based on a cognitive-behavioural model of behaviour change. Within this overarching theoretical paradigm, extensive use of cognitive distortions is seen as a central core symptom among sex offenders. However, the literature on cognitive distortions lacks a clear and consistent definition of the term. It is unclear whether cognitive distortions are consciously employed excuses or unconscious processes serving to protect the offender from feelings of guilt or shame. In this article, the dominant cognitive-behavioural interpretation of cognitive distortions is contrasted with two alternative interpretations. One is based on an attributional perspective and the notion of attributional biases. The other explanation is based on a narrative approach focusing on the action elements of cognitive distortions, that is, as something people do rather than something they have. Clinical implications of these alternative conceptualizations are discussed and illustrated throughout by a case example.

This article addresses the importance of offenders’ perceived chances of anticipated desistance. The aim is to investigate to what extent anticipated desistance is associated with (objective) welfare deficiencies, perceived social status and personal agency as measured by the concept of perceived self-efficacy. Secondly, potential differences between men and women in the prediction of future chances of avoiding crime are investigated. Data derive from a survey of a nationwide representative sample of Norwegian prison inmates (225 men and 35 women). The results indicated the presence of severe welfare deficiencies among both male and female inmates. Despite this, a large majority among both genders anticipated their chances of abstaining from crime in the future as good or very good. Practical as well as theoretical implications of these findings are discussed.

Background: One problem in studies of social inequality in health is that traditional socio-economic indicators are unsuitable for groups finding themselves on the outside of those societal arenas from which measures of education, income and occupation are generated. A measure of subjective social position has accordingly been proposed as an addition to the traditional objective socio-economic measures. The present study investigates this concepts’ usefulness as an addition to objective SES markers in a sample of prison inmates, known for their marginalized position in society as well as their poor health. Methods: Analyses are based on the male part ( n = 225) of a nationally representative sample of prison inmates in Norway. Outcome measures are self-rated health, long-standing illness or disability, mental health problems, perceived change in health status and drug use. Analyses of correlation as well as multivariate logistic regression analyses were performed. Results: Subjective social status was bivariately related to all of the health outcomes, except long-standing illness. Multivariate analyses indicated that subjective social status influenced the odds of experiencing mental health problems, but not any of the other health outcomes when controlling for the other independent variables. Conclusion: Subjective social status may add important information to our understanding of the relationship between social disadvantage and mental health in a marginalized social group such as prison inmates.

Prisons all over the western world are known to be inhabited by a biased sample of the population. More information is needed on how problems in diverse areas interact. The present study investigated how general welfare deficiencies, drug use and mental health problems were related in a representative prison population. Data stem from a level-of-living survey among a nationwide representative sample of Norwegian prison inmates. The sample was drawn randomly from the official register of prison inmates. Data were collected through structured personal interviews (computer assisted). Analyses presented in this paper are based on the male part of the sample (n=225). Only 24% of male prisoners were affected by neither drug use problems nor mental health problems. Investigating the relationship between variables indicated an increasing accumulation of childhood stressors and general welfare deficiencies with increasing drug use and mental health problems. As health problems are intertwined with more general social problems, health promotion among prison inmates is clearly a multidisciplinary task, requiring close collaboration between different service providers and systems of care.

In this paper, we investigate the differential contribution of accumulated welfare deficiencies, drug use, and self‐efficacy on inmates' current symptoms of mental health problems. Few studies so far have investigated inmates' mental health based on empirical data covering both social and psychological predictors. Our analyses are aimed at the following research questions: (a) what is the relationship between welfare deficiencies, drug use, and symptom reporting among prison inmates? (b) is this relationship influenced by inmates' perceived self‐efficacy? and (c) how might this information be used to inform the discussion of challenges in prisoner re‐entry? Findings are based on a national survey among prison inmates in Norway, focusing on living conditions generally, as well as mental distress, drug use, and self‐efficacy. The findings indicate serious accumulation of disadvantage, and more welfare deficiencies among drug users and those suffering from mental distress. When it comes to prediction of ment...

Purpose The study investigates the predictive value of body image, self-esteem and gender for adolescent dieting at ages 15, 18 and 21 and whether adolescents' self-esteem moderates the relationship between body image and dieting. Method Data stem from the Norwegian Longitudinal Health Behaviour Study (NLHB study): Adult by the Year 2000 (‘Voksen i ar 2000’). The NLHB study is a 10-year prospective cohort study based on self-completed questionnaires investigating health behaviour and lifestyle patterns among Norwegian adolescents. This paper presents data from Wave II (1992), Wave IV (1995) and Wave VI (1998), thus covering the ages 15, 18 and 21. Analyses are based on the 487 respondents participating at all three timepoints. Results At all ages included, 25% of the girls reported they had dieted several times over the past year, while the corresponding figure for boys was 5%. Among boys, self-esteem and body image contributed to the same extent in the prediction of dieting, while only body image proved a significant predictor among girls, increasing in importance over time. Interaction between self-esteem and body image was present among young boys (ages 15 and 18) only. Conclusions Self-esteem and body image play quite different roles in the prediction of dieting among girls and boys. The difference is not only related to strength of association between the variables, but, more importantly, to qualitatively different underlying processes. Copyright © 2004 John Wiley & Sons, Ltd and Eating Disorders Association.

Objective. This study examined utilization of psychological or emotional counseling by suicidal adolescents to answer questions about the extent to which health services can contribute to the prevention of adolescent suicide. Method. The study used data from Wave 1 of the National Longitudinal Study of Adolescent Health, which involved a household-based interview with a nationally representative sample of 15 483 adolescents from grades 7 to 12. Of these, 2482 adolescents were classified as suicidal, as indicated by an affirmative response to the question “During the past 12 months, did you ever seriously think about committing suicide?” For this group, the study asked the following questions: 1) What proportion receives psychological or emotional counseling? 2) What are the sources of this counseling? 3) What factors are associated with receipt of such counseling? Results. Less than one third (28%) of suicidal adolescents received psychological or emotional counseling. The most common sources of care were private doctors’ offices (37%) and schools (34%). Factors associated with receipt of counseling in the past 12 months included age, race, degree of suicidality, depression status, and having had a physical examination during the same period. Conclusions. Only one third of those who report suicidal ideation and behavior receive psychological or emotional counseling. Although not all of these young people may identify a need for counseling, this finding still suggests that many of those at risk of harming themselves do not receive professional help. However, on the positive side, those who do use counseling services tend to do so on the basis of their being in the greatest need, rather than their parents’ capacity to pay for services. Counseling services have an important role to play in suicide prevention, and a variety of sources of care need to be available. Although counseling services are vital, a range of other strategies is necessary to reduce the youth suicide rate.

The present study investigated the relationship bewteen social representations about smokers and smoking, and attitudes towards smoking restrictions. Data were collected by means of questionnaires among a sample of employees (n=4224)in the Norwegian Navy. Based on the results from first- and second-order principal components analyses, three dimensions of social representations were identified. The dimensions were labeled “negative representations”, “positive representations” and “social influence”. The three dimensions clearly differentiated between daliy, occasional and non-smokers. Further, structural equation modeling of the relation between social representations and attitudes towards smoking restrictions, indicated that social representations function as intermediating factors of the effect from smoking states upon attitudes towards smoking restrictions. The findings indicate the need to focus upon social psyshological processes taking place in the ineraction between groups of smokers and non-smokers, as understanding of such processes may be relevant in preventing the development of group conflict.

Using results from a large Norwegian follow-up study of former adolescent psychiatric in-patients we have traced the progression from mental disorders requiring hospitalisation in adolescence to registered criminal behaviour in adulthood, particularly highlighting gender differences. A nationwide representative sample of 1095 adolescent psychiatric inpatients (46% females) was followed up 15–33 years after admission to the National Centre for Child and Adolescent Psychiatry in Oslo, Norway. In adolescence 45% fulfilled the DSM-IV criteria for a disruptive behaviour disorder. At follow-up, 63% of the males and 39% of the females had a criminal record. Among females, psychoactive substance use disorder in adolescence seemed to be a sine qua non for later registered criminality, with intravenous drug use a potent risk factor for life-course-persistent criminality. The same strong association between drug use and criminality was not found in males. Factor analysis demonstrated that while the DSM-IV Conduct Disorder criteria structure was similar across genders, the prevalence of the various forms of expression was different in males and females. The differences between individuals with violent and non-violent crimes were more substantial in males than in females. There were marked gender differences in the criminal profiles observed, with the females' criminal career developing in a less serious manner than in males: females had later criminal debut, a lower number of acts on record, less diverse criminal behaviour, and an escalation in the severity of offences over time was less frequently encountered. However, secular trend analyses indicated that gender differences had diminished over the last several decades, with females “catching up” with their male counterparts. Overall, the results demonstrated important qualitative and quantitative gender differences in the criminal behaviour of former adolescent psychiatric in-patients. The results may be of use in prevention.

Aims: To explore possible systematic differences between prison inmates serving their first sentence and inmates having experienced previous incarcerations. It is hoped that a better knowledge of these issues will make us better equipped to meet the rehabilitation needs of our prisoners and decrease their risk of reoffending and reincarceration.Methods: In this cross-sectional study a randomly selected and nationally representative sample of 260 Norwegian prisoners, 100 serving their first sentence and 160 recidivists, was interviewed with special focus on childhood circumstances, education, work experience, and present social and economic situation. In addition their criminal records were collected from the National Crime Registry.Results: In males multivariate analyses identified a number of variables independently and significantly associated with being a repeat offender. The odds for reincarceration increased significantly if the person fulfilled any one of the following criteria: having experienced the incarceration of a family member during childhood ( OR = 3.6); having experienced childcare interventions during childhood ( OR = 3.2); current drug abuse ( OR = 2.6); current housing problems ( OR = 2.3). In females only one strong correlation emerged: if the person had current drug problems the odds for being a recidivist increased substantially ( OR = 10.9).Conclusions: While criminal reoffending and reincarceration seemed to be primarily associated with drug abuse in females, the childhood problems of male repeat offenders, compared with males serving their first sentence, indicate that these individuals' current multiple social and economic disadvantages were complex in origin and of long standing. Interventions aimed at preventing reoffending must take into account the gender differences demonstrated. Aiming at primary prevention, the negative effects associated with parental incarceration are crucial: how can one prevent the perpetuation of these problems from one generation to the next?

Background: In this paper, we investigate cross-sectional and prospective relationships between various socioeconomic indicators and different health behaviours among boys and girls at ages 13–21, and whether socioeconomic status (SES) is related to changes in health behaviour over time. Methods: The study is based on a 10-year, two-generation prospective cohort study of health and lifestyle factors among a sample of Norwegian adolescents and their parents. Data presented here were collected at the ages of 13 (baseline), 15, 18 and 21. Parental and adolescent reports of socioeconomic factors were assessed along with a number of health-enhancing and health-compromising behaviours, both as single behaviours and as part of health behaviour indices. Results: Relatively few significant relationships are observed between parental occupation and adolescents' reported health behaviour when the latter is analysed as single behaviours. A significant, but weak, social gradient in health-enhancing behaviour is observed when measuring health behaviour as composite indices rather than single forms of behaviour. This is apparent both when applying parental SES variables or adolescents' own educational aspirations as proxy measures of their socioeconomic status. Conclusion: Future investigations of the presence of a social gradient in adolescent health behaviour should focus on composite measures of health behaviour. Further research is needed on potential mediating mechanisms behind the SES–health behaviour relationships in youth.

Increased efforts are needed to promote adolescent health in all areas investigated in this study. Differences both in prevalence and socioeconomic patterning between Norway and the United States indicate that the major challenges differ between the two countries. The results also emphasize the need to undertake joint efforts to use measurements that make national data sets comparable across countries.