Mediation of the risk of serious police or legal trouble in adults with a mental disorder.
Adults with mental disorders more frequently report getting into serious trouble with the police and the law than do adults with no mental health diagnosis. The mechanisms underlying this statistical association remain unclear.
The study used data from a US population survey to examine whether the previously recognized association between psychiatric diagnosis and getting into serious police or legal trouble is mediated by impaired psychosocial function or psychiatric symptoms. The predictor variable was psychiatric diagnosis. The mediator variables were two forms of psychosocial function, social and role-emotional, and the presence of recent symptoms. The outcome variable was police or legal trouble.
When known risk factors are included as covariates, the association between mental disorder and serious police or legal trouble over the past year is maintained and is significantly mediated (p < 0.05) both by social and role-emotional function (social, excess relative risk [ERR] 1.42 [95% CI: 0.96, 1.88]; role-emotional, ERR 1.45 [95% CI: 0.98, 1.91]) and by recent symptoms(ERR 1.63 [95% CI: 1.13, 2.13]). The contribution of mediation varies by diagnosis.
Previous research suggested that it is unusual for psychiatric symptoms to lead directly to violence. These results suggest that symptoms and signs of mental disorder nevertheless contribute indirectly to violence and other adverse outcomes. The identification of these mediators may, in turn, suggest new approaches to reducing the risk of those outcomes. Future research should further examine and describe the mechanisms that underlie these and other forms of mediation.
The study used data from a US population survey to examine whether the previously recognized association between psychiatric diagnosis and getting into serious police or legal trouble is mediated by impaired psychosocial function or psychiatric symptoms. The predictor variable was psychiatric diagnosis. The mediator variables were two forms of psychosocial function, social and role-emotional, and the presence of recent symptoms. The outcome variable was police or legal trouble.
When known risk factors are included as covariates, the association between mental disorder and serious police or legal trouble over the past year is maintained and is significantly mediated (p < 0.05) both by social and role-emotional function (social, excess relative risk [ERR] 1.42 [95% CI: 0.96, 1.88]; role-emotional, ERR 1.45 [95% CI: 0.98, 1.91]) and by recent symptoms(ERR 1.63 [95% CI: 1.13, 2.13]). The contribution of mediation varies by diagnosis.
Previous research suggested that it is unusual for psychiatric symptoms to lead directly to violence. These results suggest that symptoms and signs of mental disorder nevertheless contribute indirectly to violence and other adverse outcomes. The identification of these mediators may, in turn, suggest new approaches to reducing the risk of those outcomes. Future research should further examine and describe the mechanisms that underlie these and other forms of mediation.
Authors
Buchanan Buchanan, Stefanovics Stefanovics, Wu Wu, McMahon McMahon, Gueorguieva Gueorguieva
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