Cornelia Rada

Background and Objectives: Cross-country differences in chronic kidney disease (CKD) burden across Europe, as estimated by the Global Burden of Disease (GBD) study, are often interpreted as reflecting unequal diagnosis, yet this interpretation has rarely been examined against other data sources. This study examined associations between economic, social and environmental determinants and CKD prevalence and mortality across 29 European Union and European Economic Area countries, assessed convergence between 1990 and 2023, and compared GBD estimates with vital registration data. Materials and Methods: Age-standardized CKD prevalence, mortality and disability-adjusted life years were obtained from GBD 2023. Cross-sectional regression (2023; heteroskedasticity-consistent standard errors; n = 27), k-means cluster analysis, and sigma- and beta-convergence analyses were performed. GBD mortality was compared with Eurostat death rates for diseases of the kidney and ureter (ICD-10 N00–N29, 2011–2023). GBD input sources for CKD prevalence were reviewed for Estonia, Latvia, Lithuania and Austria. Results: No structural determinant was robustly associated with CKD prevalence or mortality, and outcomes did not differ significantly across the three-cluster typology (Kruskal–Wallis, p = 0.17–0.75). Mortality dispersion declined between the mid-1990s and the mid-2000s and stagnated thereafter. Prevalence dispersion increased marginally until the mid-2000s, with no significant trend from 2008 onward. Rank agreement between GBD and Eurostat mortality was moderate (ρ = 0.38 in 2023, down from 0.61 in 2017) and improved when diabetes deaths were added (ρ = 0.66). Estonia showed the largest discrepancy. Prevalence estimates for all four reviewed countries relied mainly on kidney replacement therapy registries, and no population-based source was identified for Latvia or Lithuania. Conclusions: The structural determinants examined did not explain cross-country differences in GBD-estimated CKD burden, and no consistent regional pattern emerged. Part of this variation is compatible with differences in cause-of-death coding and sparse local input data. GBD-derived estimates alone are therefore insufficient to infer diagnostic inequality between countries, and direct indicators of screening and detection are needed.

Psychopathy is a multidimensional construct consistently associated with antisocial and violent behavior; however, its affective–interpersonal and behavioral components may contribute differently to distinct forms of violent offending. The present study investigated variations in psychopathy dimensions according to the type of violent offense and age, as well as the predictive role of agreeableness and conscientiousness in a sample of incarcerated individuals convicted of violent crimes. The sample comprised 500 incarcerated individuals from six Romanian prisons (M age = 38.49 years, SD = 10.39), assessed using the Self-Report Psychopathy Scale–III (SRP-III), the Levenson Self-Report Psychopathy Scale (LSRP), and the Agreeableness and Conscientiousness dimensions of the Big Five personality model. Data were analyzed using analyses of variance (ANOVA), Pearson correlation analyses, and hierarchical linear regression. The results revealed significant differences in psychopathy levels according to the type of violent offense (SRP-III: F(2, 484) = 12.13, p < 0.001, η² = 0.048), with higher psychopathy scores observed among individuals convicted of physical violence offenses. Psychopathy decreased significantly with age, particularly in its behavioral dimension. Agreeableness and conscientiousness emerged as significant negative predictors of psychopathy (β = −0.179, p < 0.001, and β = −0.175, p = 0.001, respectively), accounting for an additional 10% of the explained variance. These findings support a dimensional conceptualization of psychopathy and highlight the role of personality traits in the psychological profile of violent offenders. The results have important implications for violence risk assessment and the development of individualized intervention strategies within correctional settings, although the modest proportion of variance explained (13%) and the predominantly small effect sizes observed indicate that these findings should be considered preliminary rather than a basis for standalone clinical decision-making.

This study examined how affective distress, self-esteem, and personality traits are related among detained young adults, and how these factors connect to rehabilitation-relevant risk factors. The sample included 455 participants (18–25 years, M = 21.31, SD = 2.32; 97.8% male), recruited from educational, detention and prison centers. CP5F, RSES, and PDA were used, and analyses included Mann–Whitney tests, linear regression, and mediation models. The results showed that placement history predicted higher levels of Depression and Total Distress, as well as lower self-esteem, while access to intimate visits was associated with lower levels of Sadness and Total Distress. The diagnosis of chronic/psychiatric illness, suicide attempts, and trauma in the family of origin were associated with higher levels of distress, while diagnosis, suicide attempts, and a history of recidivism were also associated with lower self-esteem. In the regression model, Depression was negatively associated with self-esteem, whereas Concern showed a positive association (R² = 0.18). In the parallel mediation model, the Dysfunctional Score was negatively associated with self-esteem both directly and indirectly, through Extraversion, Conscientiousness and Emotional Stability; Autonomy showed no mediating effect and the indirect effect of Agreeableness, significant in the individual model, became non-significant when tested alongside the other mediators. The total indirect effect and the direct effect were both significant in the parallel mediation model. The conclusions highlight the central role of affective distress in lowering self-esteem and support the need for early psychological screening and detention interventions aimed at reducing distress and strengthening emotional stability.

Criminal behavior has been explained through multiple theoretical frameworks developed independently, including general personality models (FPI, Big Five, HEXACO), maladaptive configurations (Dark Triad/Tetrad, psychopathy), and criminogenic cognitions. However, integrated analysis of this literature suggests the existence of a multilevel architecture of antisocial vulnerability rather than entirely distinct, non-communicating mechanisms. This narrative integrative review synthesizes empirical evidence regarding these frameworks in incarcerated populations, drawing predominantly on literature indexed in Web of Science and Scopus, supplemented by Google Scholar and snowballing searches, as detailed in the Methods section. The analysis identifies a convergent dispositional core—characterized by elevated aggression, emotional excitability, and psychological strain, alongside reduced conscientiousness, agreeableness, honesty–humility, and social integration—that may exert its influence on behavior partly through dynamic mechanisms such as self-efficacy and self-control, together with the more proximal influence of criminogenic cognitions, expressed differentially through maladaptive personality configurations. The persistent heterogeneity of offender profiles and conceptual convergences across models support this same multilevel structure. The findings propose a three-level integrative conceptual model that explicitly links these previously fragmented studies, with implications for directing correctional interventions toward dynamic mechanisms rather than solely toward stable personality traits.

Background/Objectives: Substance use disorders are common in the prison population and are associated with relapse and criminal recidivism, yet qualitative evidence on recovery capital and family support within Eastern European penitentiary systems remains limited. This study explored how incarcerated men with a history of substance use perceive initiation, withdrawal, recovery, and the role of family support as a recovery capital resource. Methods: A qualitative descriptive study was conducted in a Romanian penitentiary with 50 definitively sentenced men with self-reported substance use history, selected through purposive sampling. Data were collected through semi-structured interviews, without audio recording due to institutional security regulations, and reconstructed in detailed written notes validated through member checking, then analyzed using inductive thematic analysis via consensus-based double coding (initially coded by the first researcher and reviewed by a second researcher, with discrepancies resolved through discussion), until thematic saturation was reached. Results: Six themes were identified: initiation of use influenced by peer groups, socioeconomic vulnerability, and criminogenic environments; effects initially perceived as beneficial, followed by progressive deterioration; severe withdrawal and denial of dependence; cognitive mechanisms sustaining use, including externalization of responsibility; the dual role of the family as both a risk and a protective factor; and a recovery process marked by ambivalence toward abstinence, in which family support, employment, and prosocial relationships were central. Abstinence during incarceration was frequently perceived as maintained under institutional constraint rather than as internally motivated recovery. Conclusions: In this single-prison sample, recovery extended beyond abstinence, suggesting the need to strengthen personal, social, and family recovery capital. The findings, which require confirmation in larger samples, support exploring integrated prison–community continuum-of-care interventions centered on addiction treatment, family involvement, and post-release support.

Psychopathy is a multidimensional construct consistently associated with antisocial and violent behavior; however, its affective-interpersonal and behavioral components may contribute differently to distinct forms of violent offending. The present study investigated variations in psychopathy dimensions according to the type of violent offense and age, as well as the predictive role of agreeableness and conscientiousness in a sample of incarcerated individuals convicted of violent crimes. The sample comprised 500 incarcerated individuals from six Romanian prisons (M age = 38.49 years, SD = 10.39), assessed using the Self-Report Psychopathy Scale–III (SRP-III), the Levenson Self-Report Psychopathy Scale (LSRP), and the Agreeableness and Conscientiousness dimensions of the Big Five personality model. Data were analyzed using analyses of variance (ANOVA), Pearson correlation analyses, and hierarchical linear regression. The results revealed significant differences in psychopathy levels according to the type of violent offense (SRP-III: F(2, 484) = 12.13, p < .001, η² = .048), with higher psychopathy scores observed among individuals convicted of physical violence offenses. Psychopathy decreased significantly with age, particularly in its behavioral dimension. Agreeableness and conscientiousness emerged as significant negative predictors of psychopathy (β = −.179, p < .001, and β = −.175, p = .001, respectively), accounting for an additional 10% of the explained variance. These findings support a dimensional conceptualization of psychopathy and highlight the role of personality traits in the psychological profile of violent offenders. The results have important implications for violence risk assessment and the development of individualized intervention strategies within correctional settings, although the modest proportion of variance explained (13%) and the predominantly small effect sizes observed indicate that these findings should be considered preliminary rather than a basis for standalone clinical decision-making.

Background/Objectives: Substance use disorders are common in the prison population and are associated with relapse and criminal recidivism, yet qualitative evidence on recovery capital and family support within Eastern European penitentiary systems remains limited. This study explored how incarcerated men with a history of substance use perceive initiation, withdrawal, recovery, and the role of family support as a recovery capital resource. Methods: A qualitative descriptive study was conducted in a Romanian penitentiary with 50 definitively sentenced men with self-reported substance use history, selected through purposive sampling. Data were collected through semi-structured interviews and analyzed using inductive thematic analysis, with independent coding by two researchers, until thematic saturation was reached. Results: Six themes were identified: initiation of use influenced by peer groups, socioeconomic vulnerability, and criminogenic environments; effects initially perceived as beneficial, followed by progressive deterioration; severe withdrawal and frequent denial of dependence; cognitive mechanisms sustaining use, including externalization of responsibility; the dual role of the family as both risk and protective factor; and a recovery process marked by ambivalence toward abstinence, in which family support, employment, and prosocial relationships were central. Abstinence during incarceration was frequently perceived as externally imposed rather than as authentic recovery. Conclusions: In this single-prison sample, recovery extended beyond abstinence, suggesting the need to strengthen personal, social, and family recovery capital. The findings, which require confirmation in larger samples, support exploring integrated prison–community continuum-of-care interventions centered on addiction treatment, family involvement, and post-release support.

Criminal behavior has been explained through multiple theoretical frameworks developed independently, including general personality models (FPI, Big Five, HEXACO), maladaptive configurations (Dark Triad/Tetrad, psychopathy), and criminogenic cognitions. However, integrated analysis of this literature suggests the existence of a common psychological architecture rather than distinct mechanisms. This narrative integrative review synthesizes empirical evidence regarding these frameworks in incarcerated populations, drawing predominantly on literature indexed in Web of Science and Scopus. The analysis identifies a convergent dispositional core—characterized by elevated aggression, emotional excitability, and psychological strain, alongside reduced conscientiousness, agreeableness, honesty-humility, and social integration—that largely influences behavior through mediating dynamic mechanisms such as self-efficacy, self-control, and criminogenic cognitions, expressed differentially through maladaptive personality configurations. The persistent heterogeneity of offender profiles and conceptual convergences across models support this same unitary structure. The findings propose a three-level integrative conceptual model that explicitly links these previously fragmented literatures, with implications for directing correctional interventions toward dynamic mechanisms rather than solely toward stable personality traits.

(1) Background. Substance use disorders are frequently associated with difficulties in emotion regulation and the use of ineffective coping strategies. (2) Methods. A total of 201 participants undergoing specialized treatment for substance use disorders in Romania completed the Difficulties in Emotion Regulation Scale (DERS) and the Strategic Approach to Coping Scale (SACS). Statistical analyses included independent samples t-tests, Pearson correlations, path analysis, and linear regression. (3) Results. Participants with more severe substance use (history of hospitalization, detoxification treatment, and polysubstance use) exhibited significantly higher levels of emotion regulation difficulties. The latent factor DIFFICULTY was predicted by two correlated SACS predictors: Assertive Action (AA) and Antisocial Action (AS). Substance type differentially influenced DERS dimensions. The strongest correlation with the total DERS score was observed for antisocial action. (4) Conclusions. Emotion regulation and coping optimization are key targets in the treatment of substance use disorders, reflecting persistent difficulties in effectively managing emotions despite cognitive awareness. Social support may function as both an adaptive and maladaptive mechanism in this clinical context.

1)Background. Substance use disorders are frequently associated with difficulties in emotion regulation and the use of ineffective coping strategies. 2)Methods. A total of 201 participants undergoing specialized treatment for substance use disorders in Romania completed the Difficulties in Emotion Regulation Scale (DERS) and the Strategic Approach to Coping Scale (SACS). Statistical analyses included independent samples t-tests, Pearson correlations, path analysis, and linear regression. 3)Results. Participants with more severe substance use (history of hospitalization, detoxification treatment, and polysubstance use) exhibited significantly higher levels of emotion regulation difficulties. The Impulse dimension was a significant predictor of antisocial (β = .52) and aggressive coping strategies (β = .46). Assertive action and seeking social support were associated with lower DERS scores. Substance type differentially influenced DERS dimensions. The strongest correlation with the total DERS score was observed for seeking social support. 4)Conclusions. Emotion regulation and coping optimization are key targets in the treatment of substance use disorders, reflecting persistent difficulties in effectively managing emotions despite cognitive awareness. Social support may function as both an adaptive and maladaptive mechanism in this clinical context.