PMID- 34408675 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20210820 IS - 1664-0640 (Print) IS - 1664-0640 (Electronic) IS - 1664-0640 (Linking) VI - 12 DP - 2021 TI - Effectiveness of an Individual Cognitive-Behavioral Intervention for Serious, Young Male Violent Offenders: Randomized Controlled Study With Twenty-Four-Month Follow-Up. PG - 670957 LID - 10.3389/fpsyt.2021.670957 [doi] LID - 670957 AB - Background: Psychological recidivism-reducing interventions with serious, young violent offenders in residential care have unsatisfactory effects. We tested if a complementary individual cognitive behavioral therapy (iCBT) intervention focusing problem-solving, cognitive self-control, and relapse prevention reduces criminal recidivism beyond usual institutional care encompassing interventions such as social skills training and prosocial modeling (treatment-as-usual; TAU). Method: We consecutively approached 115 eligible serious, male violent crime offenders in five residential treatment homes run by the Swedish National Board of Institutional Care. Eighty-one (70%) 16 to 21-year-old youth at medium-high violent recidivism risk were included and randomized to an individualized 15 to 20-session CBT intervention plus TAU (n = 38) or to TAU-only (n = 43), 4-6 months before release to the community. Participants were assessed pre- and post-treatment, at 12 months (self-reported aggressive behavior, reconvictions) and 24 months (reconvictions) after release. Intent-to-treat analyses were applied. Results: The violent reconviction rate was slightly higher for iCBT+TAU vs. TAU-only youth at 12 months (34 vs. 23%, d = 0.30, 95% CI: -0.24 to 0.84) and 24 months following release (50 vs. 40%, d = 0.23, 95% CI: -0.25 to 0.72), but neither of these differences were significant. Cox regression modeling also suggested non-significantly, negligibly to slightly more violent, and any criminal recidivism in iCBT+TAU vs. TAU-only youth during the entire follow-up. Further, we found no significant between-group differences in conduct problems, aggression, and antisocial cognitions, although both iCBT+TAU and TAU-only participants reported small to large within-group reductions across outcome measures at post-treatment. Finally, the 12-month follow-up suggested marginally more DSM-5 Conduct Disorder (CD) symptoms of "aggression to people and animals" in iCBT+TAU vs. TAU-only youth (d = 0.10, 95% CI: -0.40 to 0.60) although this difference was not significant. Conclusion: We found no additive effect of individual CBT beyond group-based TAU in residential psychological treatment for serious, young male violent offenders. Limited sample size and substantial treatment dropout reduced the robustness of intent-to-treat effect estimates. We discuss the possible impact of treatment dose and integrity, participant retention, and TAU quality. CI - Copyright (c) 2021 Larden, Hogstrom and Langstrom. FAU - Larden, Martin AU - Larden M AD - Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. AD - Swedish Prison and Probation Service, Norrkoping, Sweden. FAU - Hogstrom, Jens AU - Hogstrom J AD - Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. AD - Stockholm Health Care Services, Stockholm, Sweden. FAU - Langstrom, Niklas AU - Langstrom N AD - Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. AD - Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. AD - National Board of Health and Welfare, Stockholm, Sweden. LA - eng PT - Journal Article DEP - 20210802 PL - Switzerland TA - Front Psychiatry JT - Frontiers in psychiatry JID - 101545006 PMC - PMC8365084 OTO - NOTNLM OT - aggression OT - cognitive behavioral therapy OT - randomized controlled (clinical) trial OT - reoffending OT - residential treatment OT - treatment outcome OT - violent crime OT - young offenders COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. ML designed the CBT intervention, but has not made economic or other gains from royalties, training, or consulting regarding the model. EDAT- 2021/08/20 06:00 MHDA- 2021/08/20 06:01 PMCR- 2021/08/02 CRDT- 2021/08/19 06:39 PHST- 2021/02/22 00:00 [received] PHST- 2021/06/30 00:00 [accepted] PHST- 2021/08/19 06:39 [entrez] PHST- 2021/08/20 06:00 [pubmed] PHST- 2021/08/20 06:01 [medline] PHST- 2021/08/02 00:00 [pmc-release] AID - 10.3389/fpsyt.2021.670957 [doi] PST - epublish SO - Front Psychiatry. 2021 Aug 2;12:670957. doi: 10.3389/fpsyt.2021.670957. eCollection 2021.