Exploring the Relationship between Criminal Thinking and Psychiatric Symptoms Among Justice-Involved Men with Serious Mental Illnesses

Background and Significance: The high levels of criminal thinking patterns found among people with serious mental illnesses (SMI) suggests that this treatment target may be particularly important for this population. The relationship between psychiatric symptomatology and criminal thinking, however, has yet to be explored. Consequently, this paper investigates the relationship between psychiatric symptomatology and criminal thinking within the context of pilot study of a new intervention.

Methods: This paper draws on data from the randomized control trial (RCT) phase of a small-scale efficacy trial of a novel intervention that addresses criminogenic risk factors among people with SMI incarcerated in prison. Criminal thinking was one of the primary treatment targets for this intervention. Data for the analyses presented here were collected through face-to-face interviews with participants at three-month follow up. The sample in this analysis (N=33) were all men in the treatment and control groups of the intervention. Criminal thinking was captured using the Measure of Criminal Attitudes and Associates (MCAA) and psychiatric symptomatology was measured using the Colorado Symptom Index (CSI). The MCAA includes four domains related to Attitudes Towards Violence, Sentiments of Entitlement, Antisocial Intent and Attitudes Towards Associates, where higher scores in each domain indicate endorsement of each area. The CSI provides an overall measure of psychiatric symptoms over the past 30 days with higher scores indicating more frequent psychiatric symptoms. Pearson correlations were used to assess the relationship between the variables within the at the three-month follow-up. Then ordinary least-squares regression was used to assess whether the relationship between psychiatric symptoms and criminal thinking subscales while controlling for treatment condition.

Results: The results of the analysis found a statistically significant relationship between psychiatric symptoms and two subscales of the MCAA. Specifically, the “attitudes toward violence” (r(33)=.47, p<.01) and “anti-social intent”(r(33)=.37, p<.05) subscales were significantly and positively correlated with psychiatric symptomatology. Results of the OLS regression indicated that psychiatric symptoms were significantly and positively associated with attitudes toward violence (b=.15, p<.01) and with antisocial intent (b=.11, p<.05) when treatment condition was held constant.

Conclusion and Implications: This is one of the first studies to examine the relationship between psychiatric symptomatology and criminal thinking. Findings show that in this sample, psychiatric symptoms are related to a key treatment target in criminogenic interventions. While preliminary in nature, this study adds to the growing literature regarding that mental health contributes to the overall criminogenic risk factors, highlighting the importance of interventions that specifically target these risk factors among this population as this effect was found regardless of whether participants were receiving services or not.