Screening and identification of fetal alcohol spectrum disorder in criminal legal settings: A realist review

IF 1.1 4区医学 Q3 CRIMINOLOGY & PENOLOGY

Criminal Behaviour and Mental Health Pub Date : 2024-04-25 DOI:10.1002/cbm.2336

Emma Jewell, Bianka Dunleavy, Martina Faitakis, Jessica W. Pun, Sarah Moss, Jacqueline Pei, Mansfield Mela, Katherine Flannigan, Melissa Tremblay, Kaitlyn McLachlan

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引用次数: 0

Abstract

Background

Screening for fetal alcohol spectrum disorder (FASD) has been identified as a promising approach to improve recognition, understanding and effective response to the unique needs of those with FASD in criminal legal settings. However, to date, there has been limited synthesis of relevant screening tools, indicators, or implementation considerations in this context.

Aims

The present review aimed to synthesise evidence and develop a conceptual framework for understanding how, when, why, for whom and by whom FASD screening tools, items and/or indicators and characteristics serve to accurately identify people with FASD in criminal legal contexts, with consideration of individual and system needs relevant to effective implementation and response.

Methods

A preregistered search was conducted using a modified realist review framework for both peer-reviewed articles and grey literature. Included sources were available in English, which focused on individuals with prenatal alcohol exposure and/or FASD with criminal legal involvement and offered new empirical evidence. Sources were reviewed using the Quality Control Tool for Screening Titles and Abstracts by Second Reviewer framework, extracted using a structured coding form and narratively synthesised.

Results

The search yielded 52 sources, 11 FASD screening tools designed for or applied in criminal legal settings and 38 potential FASD indicators or characteristics relevant to identifying people who may have FASD in criminal legal settings, organised into six conceptually related domains. There was limited evidence supporting the psychometric properties of screening tools across populations or settings, though growing evidence highlights the promise of some instruments. Although few studies characterised potential considerations to be made when implementing a screening tool or approach, both system and individual level needs related to recognising and effectively responding to FASD in criminal legal contexts were identified, and findings revealed strong support among legal and clinical professionals regarding the need for FASD screening in these settings.

Conclusions

Findings of this review can be used to inform the development, selection, implementation and evaluation of FASD screening tools in criminal legal settings and underscore a continued need for enhanced resources, policy and cross-sectoral response to better support the needs of people with FASD in the criminal legal contexts.

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在刑事法律环境中筛查和识别胎儿酒精谱系障碍：现实主义审查

背景对胎儿酒精谱系障碍（FASD）进行筛查已被认为是一种很有前途的方法，可以提高对刑事法律环境中 FASD 患者独特需求的识别、理解和有效应对。然而，迄今为止，对相关筛查工具、指标或在此背景下的实施考虑因素的综述十分有限。目的本综述旨在综合证据并制定一个概念框架，以了解FASD筛查工具、项目和/或指标及特征如何、何时、为何、针对谁以及由谁在刑事法律环境中准确识别FASD患者，同时考虑与有效实施和应对相关的个人和系统需求。方法采用修改后的现实主义审查框架，对同行评议文章和灰色文献进行了预先登记的搜索。所纳入的资料均为英文，重点关注产前酒精暴露和/或涉及刑事法律问题的 FASD 患者，并提供新的经验证据。第二审稿人使用筛选标题和摘要的质量控制工具框架对资料来源进行审查，使用结构化编码表进行提取，并进行叙述性综合。结果搜索结果包括52个资料来源、11个为刑事法律环境设计或应用的FASD筛查工具，以及38个潜在的FASD指标或特征，这些指标或特征与在刑事法律环境中识别可能患有FASD的人有关，并分为六个概念相关的领域。尽管有越来越多的证据表明一些筛查工具大有可为，但支持不同人群或不同环境下筛查工具心理测量特性的证据有限。尽管很少有研究描述了在实施筛查工具或方法时可能需要考虑的因素，但还是确定了在刑事法律环境中与识别和有效应对 FASD 相关的系统和个人层面的需求，研究结果显示，法律和临床专业人员强烈支持在这些环境中进行 FASD 筛查。结论本综述的结果可用于为刑事法律环境中FASD筛查工具的开发、选择、实施和评估提供信息，并强调需要继续加强资源、政策和跨部门响应，以更好地支持刑事法律环境中FASD患者的需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Criminal Behaviour and Mental Health Multiple-

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： Criminal Behaviour & Mental Health – CBMH – aims to publish original material on any aspect of the relationship between mental state and criminal behaviour. Thus, we are interested in mental mechanisms associated with offending, regardless of whether the individual concerned has a mental disorder or not. We are interested in factors that influence such relationships, and particularly welcome studies about pathways into and out of crime. These will include studies of normal and abnormal development, of mental disorder and how that may lead to offending for a subgroup of sufferers, together with information about factors which mediate such a relationship.