Individuals with psychopathic traits detained in forensic settings are considered a difficult-to-treat population, but empirical support for this claim has not been systematically evaluated. This systematic review aimed to answer two research questions for both youth and adults detained in forensic settings: Are specialized (psycho)therapeutic interventions more effective than Treatment As Usual in (1) reducing psychopathic traits; and (2) reducing criminal recidivism in individuals with high psychopathic traits? Literature searches yielded five studies, involving 653 youth (four studies: two assessing the changeability of psychopathic traits; two assessing criminal recidivism) and 64 adults detained in forensic settings (one study assessing criminal recidivism). Regarding the changeability of psychopathic traits, one study showed a reduction of psychopathic traits for treatment participants in comparison with controls, while the other did not find differences between groups. Regarding criminal recidivism, studies with youth showed that criminal recidivism could be reduced after the delivery of psychotherapeutic interventions, while the study with adults found that treatment could reduce the severity of subsequent offenses, but not recidivism per se Although scarce and limited, these findings presented promising treatment outcomes, especially in youth, stressing the need to develop evidence-based interventions to this high-risk population. (PROSPERO-CRD42021240218).

中文翻译：

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对法医环境中拘留的具有精神病特征的青少年和成人的治疗：系统评价

在法医环境中拘留的具有精神病特征的个体被认为是难以治疗的人群，但这一说法的经验支持尚未得到系统评估。这项系统综述旨在回答法医环境中被拘留的青少年和成年人的两个研究问题：在以下方面，专门的（心理）治疗干预措施是否比常规治疗更有效：（1）减少精神病特征；(2) 减少具有高度精神病特征的个人的犯罪累犯？文献检索得出了五项研究，涉及 653 名青少年（四项研究：两项评估精神病特征的可变性；两项评估犯罪累犯）和 64 名被拘留在法医环境中的成年人（一项评估犯罪累犯的研究）。关于精神病特征的可变性，一项研究表明，与对照组相比，治疗参与者的精神病特征有所减少，而另一项研究则没有发现组间差异。关于犯罪累犯，对青少年的研究表明，在提供心理治疗干预后，犯罪累犯可以减少，而对成年人的研究发现，治疗可以减轻随后犯罪的严重程度，但不能减轻累犯本身。尽管这些研究结果很少且有限，但有希望的治疗结果，特别是在年轻人中，强调需要针对这一高危人群制定基于证据的干预措施。（PROSPERO-CRD42021240218）。