Forensic psychiatric aspects of assessing the risk of recidivism among minors

Introduction

Forensic psychiatric examination of juvenile participants in criminal proceedings is one of the most complex types of expertise [1]. Mental disorders in minors differ in clinical dynamics, often occurring against the backdrop of puberty, and are more frequently accompanied by behavioral disturbances [2]. Clinical presentations commonly include consequences of psychoactive substance use [3], as well as emotional immaturity, which can lead to significant diagnostic difficulties and often necessitates inpatient forensic psychiatric evaluation (either homogeneous or comprehensive psycho-psychiatric/sexological-psycho-psychiatric examinations) for more in-depth assessment [4-6].

Notably, in recent years, inpatient comprehensive psycho-psychiatric (sexological-psycho-psychiatric) examinations have become the predominant and justified form of expertise within the adolescent population [7][8].

This interdisciplinary approach combines the expertise of forensic psychiatric examiners, sexologists, and clinical psychologists within a medical institution providing inpatient psychiatric care, producing expert conclusions that carry significant evidentiary weight for investigative authorities by diagnosing the clinical, psychosexual, and psychological characteristics of juvenile individuals [9].

Comprehensive forensic psychiatric examination of juveniles in contemporary conditions is not an isolated investigation but an integral part of a system embedded within the criminal process. It involves collaboration among specialists working within a single medical facility, as well as close cooperation with law enforcement agencies, constituting an interagency, multifaceted legal institution. This institution encompasses a continuum of actions by officials and state bodies conducting criminal proceedings alongside specialists in fields such as psychiatry, sexology, and clinical psychology [10]. Such a multidisciplinary approach ensures a more thorough assessment, rendering expert conclusions more substantiated and valuable to judicial and investigative bodies [11].

Furthermore, forensic psychiatric evaluation of minors involved in criminal proceedings constitutes an essential component of criminalistic expertise. Scientifically grounded expert conclusions provide investigative bodies with valuable insights into the personality of the juvenile, facilitating more effective investigation processes [12-14].

The methods employed in forensic psychiatric examination not only confirm the presence or absence of a mental disorder at the time of the offense, thereby determining criminal responsibility and assessing its severity and influence on the individual’s behavior, but also allow for evaluation of the disorder’s current state, accompanied by recommendations for compulsory medical measures. Importantly, these methods also predict the likelihood of recidivism [15][16].

Common grounds for ordering forensic psychiatric examination of juveniles in criminal proceedings include records of observation or treatment in psychiatric or narcological facilities, unusual behavior or statements, the severity or particular cruelty of the offense, and the absence of clear motives or goals for the unlawful act [17]. However, current forensic psychiatric practice does not include assessment of the risk of recidivism in juveniles during such examinations [18]. We argue that risk assessment for repeat offenses should constitute a vital aspect of inpatient forensic psychiatric examination of juveniles. This process aims to determine the probability that the juvenile person will commit similar unlawful acts in the future [19]. Such evaluation is critical for designing individualized rehabilitation and social reintegration programs for juveniles, as well as ensuring public safety [20].

During inpatient forensic psychiatric evaluation, specialists (particularly clinical psychologists) consider numerous factors influencing the likelihood of recidivism, with the juvenile’s psychological state being a key element [21]. Experts analyze various psychological characteristics, including personality traits, levels of aggression, the presence of mental disorders, and the history of traumatic experiences [22].

In addition, assessment of recidivism risk takes into account the juvenile’s social environment. Factors such as family background, education, and association with peers exhibiting antisocial behavior also impact the probability of future offenses.

To improve the accuracy of recidivism risk assessment, specialized methods and tools developed for this purpose are frequently employed. These instruments assist experts in systematizing and analyzing data collected during the examination, enabling more evidence-based conclusions regarding the likelihood of recidivism [23][24].

This study analyzes the principal modern methods capable of accurately determining the risk of repeat offenses among juvenile offenders.

Research Aim: to examine the main approaches to assessing the risk of recidivism among juvenile offenders.

Materials and Methods

A retrospective analysis was conducted using inpatient medical records and 42 expert forensic psychiatric reports concerning juveniles aged 15–18. These individuals underwent inpatient forensic psychiatric evaluations (including comprehensive psychological-psychiatric and sexological-psychological-psychiatric assessments) between 2019 and 2023 at the State Budgetary Healthcare Institution “Specialized Clinical Psychiatric Hospital No. 1” of the Ministry of Health of the Krasnodar Territory, as part of criminal investigations.

The study employed the structured method “Risk and Opportunities Assessment” (ROA) [25], a retrospective analysis of criminal case materials, and the Yudofsky Overt Aggression Scale – Clinical Version (OASCL) [26]. Data analysis was performed using Statistica 12.0 software (StatSoft Inc., USA). Given the use of absolute statistical values, neither parametric nor non-parametric statistical tests were applied.

Results

The study revealed that the majority of offenses committed by juveniles fell under the category of property crimes (52.4%), including Articles 158, 158.1, 159, 161, and 163 of the Criminal Code of the Russian Federation. Crimes against the person accounted for 47.6% of all cases and included offenses against life and health (Articles 105, 109, 111, 115, and 119 of the Criminal Code), as well as crimes against sexual integrity and freedom (Article 132).

In terms of diagnostic categories, the largest share was represented by organic mental disorders, registered in 32.5% of cases. An analysis of the structure of these disorders provides insight into the psychological profile and potential behavioral challenges among the juveniles studied. The spectrum of organic disorders included: organic personality disorder (F07) – 23.1%; mild cognitive disorder (F06.7) – 30.7%; organic emotionally labile (asthenic) disorder (F06.6) – 38.5%; organic delusional (schizophrenia-like) disorder (F06.2) – 7.7%.

Understanding these patterns may aid in developing more effective rehabilitation and prevention strategies for juveniles with similar conditions, as well as in more accurately assessing the risk of recidivism in this population.

Intellectual disability (F70) also represented a significant proportion – 30.1% of the cases. These conditions can severely impact an individual’s ability to behave appropriately and interpret social cues, potentially increasing the likelihood of conflict and unlawful behavior.

Conduct disorders, both socialized and unsocialized, accounted for 15% of the total. These are typically associated with behavioral and social adaptation difficulties, which may also heighten the risk of involvement in criminal activity.

Schizophrenia spectrum disorders (F2) were identified in 12.5% of the juveniles. These conditions are important to consider when analyzing causes of antisocial behavior, as they may impair rational thinking, emotional regulation, and behavioral control.

Notably, 7.4% of the adolescents were found not to have any psychiatric disorders based on the results of their inpatient forensic psychiatric evaluation.

Analyzing and understanding mental disorders among juveniles is crucial for developing effective prevention measures and providing adequate care and support for this vulnerable population.

According to the legal criterion of criminal responsibility, the vast majority of adolescents (61%) were deemed sane with respect to their socially dangerous acts; 21% were classified as partially sane, and 18% were found legally insane. Among the 12% of adolescents who underwent a comprehensive inpatient forensic sexological-psychological-psychiatric evaluation, no cases of pedophilia (F65.4) or other paraphilic disorders were identified.

The study revealed a high risk of recidivism among a substantial proportion of juveniles (64%), as determined using the ROA method, retrospective analysis of criminal case materials, and the OASCL. The OASCL assigns risk levels based on the total score, with four gradations: very high risk, high risk, moderate risk, and low risk. In this study, 14% of the adolescents were assessed as having a moderate risk, and 22% were identified as being at very high risk, posing a serious concern for public safety.

Of particular interest is the finding that the highest risk of recidivism was observed among adolescents with intellectual disability (17.5%), highlighting the need for an individualized approach to rehabilitation and ongoing monitoring of this subgroup.

Discussion

As shown by the literature review, studies assessing the risk of criminal recidivism among minors within the framework of forensic psychiatric evaluation have not been conducted to date.

Given the growing need for effective methodological tools that predict recidivism risk in juveniles, the findings of this study highlight the relevance of further developing and refining recidivism risk assessment methods in the context of forensic psychiatric evaluations. This is essential for designing individualized rehabilitation and reintegration strategies for adolescents, and it also enables the identification of potential risks and the implementation of timely preventative measures, contributing to the creation of a safe and healthy environment for youth development.

Notably, the overall assessment of recidivism risk levels using the above-mentioned methods did not correlate with expert determinations of sanity/insanity or with the recommended compulsory medical measures for the individuals under evaluation.

Conclusion

In the context of juvenile delinquency, evaluation of recidivism risk is a key factor influencing both the adolescent’s future and the strategy of their rehabilitation. In this regard, forensic psychiatric evaluation becomes not merely a procedural formality but a vital instrument for in-depth personality analysis and for identifying the root causes of deviant behavior. It allows experts to uncover the major drivers of social maladaptation in adolescents, to determine the extent of their legal responsibility, and to contribute meaningfully to the development of personalized rehabilitation and reintegration programs. Such efforts are crucial for preventing further offenses among minors and for ensuring their successful reintegration into society.

The methods used to assess the risk of criminal recidivism among juveniles must be comprehensive, incorporating not only psychopathological assessment but also psychological, social, and criminological analysis. Only such an integrated approach can effectively prevent offenses among adolescents and support their long-term rehabilitation.