Paul Mooney - Academia.edu (original) (raw)
Papers by Paul Mooney
Journal of Sexual Aggression, Jul 1, 2008
Abstract Sexually abusive behaviour by personality disordered patients presents a serious threat ... more Abstract Sexually abusive behaviour by personality disordered patients presents a serious threat to the integrity of staffÁpatient relationships and the safety of other residents. The occurrence of such behaviour is also problematic for the offending patient, as it may impact on ...
Irish Journal of Psychological Medicine, Sep 1, 2004
Objective: Post-traumatic stress disorder (PTSD) is one of the most prevalent psychological disor... more Objective: Post-traumatic stress disorder (PTSD) is one of the most prevalent psychological disorders. Methods to alleviate its symptoms range from 'talking therapies' to pharmaceutical interventions. Our objective was to carry out a systematic review of the effectiveness of sertraline, an SSRI, as a treatment for PTSD. Method: Databases were searched to identify relevant research on sertraline as a treatment for PTSD. Results: Five randomised control trials were identified, along with seven open trials and case series studies. Conclusions: The review and meta-analysis supported the use of sertraline for PTSD though further research on subgroup differences (eg. gender) is required.
Psychiatry, Psychology and Law, Aug 1, 2010
In mainstream studies on offenders and on individuals with psychopathology, relationships have be... more In mainstream studies on offenders and on individuals with psychopathology, relationships have been found between personality characteristics, emotional problems and personality disorders. This study reviewed the relationships between the Emotional Problems Scale, ...
Advances in Mental Health and Intellectual Disabilities, May 3, 2016
The purpose of this paper is to present the development and evaluation of an original training pa... more The purpose of this paper is to present the development and evaluation of an original training package for staff members on an awareness of an adapted Dialectical behaviour Therapy programme, the 'I Can Feel Good' programme (Morrissey & Ingamells, 2014) designed for individuals with intellectual disabilities and problems managing emotions. The quality and effectiveness of the training was assessed and is reported in this paper. Design/methodology/approach The training was delivered for staff working with individuals with intellectual disabilities in a UK Medium Secure Psychiatric Hospital and was attended by nursing staff. The workshop consisted of six modules: 'Introduction to the programme', 'Mindfulness', 'Managing feelings', 'Coping in crisis', 'People skills' and 'Application and summary'. Level of self-reported knowledge, confidence and motivation regarding seven aspects of the training was measured by an evaluation questionnaire completed pre and post training. Findings The results of this study showed that following the training there was a significant increase in self-reported knowledge, confidence and motivation regarding the seven aspects of the training. When perceptions of staff behaviours are observed, although in the right direction, this change was found not to be significant. Originality/value This study highlights the potential for staff training to increase awareness of newly adapted therapeutic programmes for individuals with intellectual disabilities. The staff training may increase their ability and willingness to facilitate the running of such programmes and ability to support learning transfer in group members.
Journal of intellectual disabilities and offending behaviour, Mar 4, 2014
Purpose – The social climate of psychiatric institutions correlates with multiple outcomes relate... more Purpose – The social climate of psychiatric institutions correlates with multiple outcomes related to staff and patients. Research into social climate in Learning Disability services is limited. Staff and patients in Learning Disability services have documented both positive and negative experiences. No research has directly compared the social climate of Learning Disability and non-Learning Disability psychiatric services. The purpose of this paper is to understand how these compare. The study will also compare staff and patient views of social climate and the impact of security on social climate in Learning Disability services. Design/methodology/approach – A total of 64 patients and 73 staff, from Learning Disability and non-Learning Disability psychiatric hospitals completed the Essen Climate Evaluation Schema (EssenCES) measure of social climate. Findings – Patients in Learning Disability and non-Learning Disability services did not differ in their perceptions of social climate. Staff in non-Learning Disability services had a more positive perception of social climate than staff in Learning Disability services. Patients and staff did not differ in their views on climate. Security was negatively related to patients’ Experienced Safety. Originality/value – The findings suggest that staff perceive that the deficits associated with Learning Disabilities may limit patients’ therapeutic experience and relationships with their peers. Despite this, patients with Learning Disabilities feel supported by their peers, have positive views of the treatment process and feel as safe as non-Learning Disabled psychiatric patients.
Journal of Intellectual Disability Research, Oct 1, 2007
Despite an increasing knowledge base concerning the assessment of emotional and behavioural probl... more Despite an increasing knowledge base concerning the assessment of emotional and behavioural problems in people with intellectual disabilities (ID), relatively little research has examined such problems in offenders with ID. The study assessed 172 male offenders with ID in three service settings (high, medium-low security and community) using the Behaviour Rating Scale of the Emotional Problem Scales (EPS), with the aim of assessing differences in Externalizing and Internalizing Behaviour Problems. Normative information is presented on the Behaviour Rating Scale of the EPS across three levels of forensic ID care. It was found that offenders in higher secure care scored higher on sub-scales reflecting physical aggression than those in lower secure care. However, there was no difference in terms of other Externalizing Behaviour Problems, such as verbal aggression, non-compliance or hyperactivity. In addition, those offenders in higher secure care scored significantly higher on all Internalizing Behaviour Problems sub-scales, including anxiety, depression and low self-esteem. Implications for research and clinical practice are discussed, including the utility of the EPS as a measure of clinical need and treatment outcome.
Journal of forensic psychology research and practice, 2017
The effectiveness of an adapted-DBT (dialectical behavioral therapy) program upon adaptive emotio... more The effectiveness of an adapted-DBT (dialectical behavioral therapy) program upon adaptive emotion management is reviewed. This case study focuses upon a male forensic inpatient diagnosed with mild learning disabilities and emotionally unstable personality disorder who presented with behavioral difficulties including self-harm and aggression. Following development of a psychological formulation, informed by an initial psychological assessment process, the client was referred for the "I Can Feel Good" program (Ingamells & Morrissey, 2014), which is designed to reduce difficulties managing emotions and resulting problematic behaviors. This was in addition to supplementary individual sessions designed to support and reinforce skills developed within the group. The effectiveness of this intervention was assessed using a combination of approaches including a range of self-and staff-report psychometrics and observational data. Findings demonstrated an effect upon some secondary treatment targets (namely an increase in use of mindfulness techniques and adaptive coping strategies) but no overall reduction of the primary treatment target of emotional management or associated emotional and psychological problems. Reflection upon the initial formulation in light of findings is discussed. Methodological difficulties and issues of evaluation are reviewed. Future adaptation of the "I Can Feel Good" program is considered.
Journal of intellectual disabilities and offending behaviour, Mar 13, 2017
Purpose The purpose of this paper is to describe a feasibility study into the development and pil... more Purpose The purpose of this paper is to describe a feasibility study into the development and pilot of a psychoeducational group for people with intellectual disability and co-morbid mental disorder (including mental illness and personality disorder) within forensic settings. Design/methodology/approach “Mind Matters”, a psychoeducational programme for people with an intellectual disability and co-morbid mental disorders is a group based programme in a medium secure hospital, adapted and developed to be suitable for people with intellectual disability therapist multidisciplinary approach was key to its development. An open group on a 16-bedded ward for individuals with mild to moderate intellectual disability and co-morbid mental illness was delivered over a six-week period. Findings The group was positively received in pilot by participants and members of the clinical teams. Attendance and engagement of participants were key measures of the success of the programme. In addition to the apparent increased social skills and motivation to engage with future psychological intervention. Practical implications The authors believe that this approach benefitted both the group members and staff on ward, reinforcing strategies for maintaining positive mental health. It also stimulated engagement, discussion about mental disorders including mental illness, personality disorder and intellectual disabilities. Originality/value This paper shows how a psychoeducational approach to mental disorder and mental health in individuals with an intellectual disability is possible, beneficial and well received.
Journal of Intellectual Disability Research, Jun 1, 2009
International Journal of Forensic Mental Health, Oct 1, 2005
Psychopathy is a severe personality disorder characterised by a set of affective, interpersonal a... more Psychopathy is a severe personality disorder characterised by a set of affective, interpersonal and behavioral features, which include the selfish, callous and remorseless use of others, deficient affective experience, and an impulsive and irresponsible lifestyle, which may include ...
Journal of Forensic Psychology Research and Practice, 2020
This study adapts and validates a scale designed to measure Attitudes Toward Mentally Disordered ... more This study adapts and validates a scale designed to measure Attitudes Toward Mentally Disordered Offenders (ATMDO). It is thought that by monitoring and subsequently improving attitudes, negative potentially damaging milieus within criminal justice, forensic mental health, and society in general can be minimized. Participants (N = 364) were recruited via snowball technique and data collected using an online version of the ATMDO. Psychometric properties were assessed. Test-retest and convergent validity was assessed with additional samples A (N = 30) and B (N = 50) respectively. Utilizing a cross-sectional design, differences in ATMDO scores across occupational groups were compared. The ATMDO demonstrates robust internal structure, reliability, and validity. Although ATMDO scores did not differ significantly across occupational groups, some differences were seen at a factorial level. Regression analysis demonstrates the influence of both demographic and occupation-related variables in predicting ATMDO scores. The ATMDO is robust and has clinical utility for comparison of professional groups or institutions, and within recruitment procedures. A model is proposed for the effects of exposure (catalyst factor) and professional certification training (moderating factor).
Journal of Intellectual Disabilities and Offending Behaviour, 2016
Purpose There are few reliable psychometric measures of the psychopathology of offenders with int... more Purpose There are few reliable psychometric measures of the psychopathology of offenders with intellectual disabilities (ID). However, previous research has indicated that the emotional problems scale (EPS) is useful in identifying a range of treatment needs and in predicting risk to self and others. The purpose of this paper is to compare the severity of the emotional and behavioural problems of a small sample of offenders with ID in medium and low secure services, as assessed by EPS. Additionally, the data are tentatively compared with those reported in previous research to precipitate discussion regarding the changes in clinical populations in secure care over time. Design/methodology/approach The study collected demographic and EPS data for patients with ID (n=25) on medium secure and a low secure wards. Data were collected as part of routine clinical practice, with EPS forms being completed by nursing and other multi-disciplinary staff. Findings It was found that there was no s...
The Journal of Forensic Psychiatry & Psychology, 2015
Abstract Introduction: The use of seclusion as a means of managing the extreme behaviours forensi... more Abstract Introduction: The use of seclusion as a means of managing the extreme behaviours forensic patients in secure settings is a controversial yet often common practice, despite there being little evidence that seclusion as a practice has any significant therapeutic value for the patient. The aim of this study was to explore the use of seclusion and whether this differs as a function of gender and diagnosis across secure services. Method: This study collated data from 11 medium and low secure hospitals that admit male and female patients, with some services providing services for patients with intellectual disability (with or without co-morbid disorders), and others for patients with mental illness and/or personality disorder only. Results: Both gender and diagnosis were associated with differential seclusion rates. Seclusions were three times longer for patients in the non-ID compared to the ID service. Male seclusions (for any diagnosis) were around twice as long as those in female services. Female ID patients spent significantly less time in seclusion compared to other groups. Female ID was associated with two to three times the number of seclusion events per patient compared to other groups. No statistically significant association between the type of service and the reason for a patient being secluded. Conclusions: A range of organisational factors that determine the use and duration of seclusion are cited and merit further exploration. High rates of psychiatric co-morbidity and the complexity of patients admitted to services may also mediate risk and use of seclusion. The study supports the use of early intervention techniques and the adoption of positive behaviour support.
Psychiatry, Psychology and Law, 2010
In mainstream studies on offenders and on individuals with psychopathology, relationships have be... more In mainstream studies on offenders and on individuals with psychopathology, relationships have been found between personality characteristics, emotional problems and personality disorders. This study reviewed the relationships between the Emotional Problems Scale, ...
Journal of Intellectual Disability Research, 2007
Despite an increasing knowledge base concerning the assessment of emotional and behavioural probl... more Despite an increasing knowledge base concerning the assessment of emotional and behavioural problems in people with intellectual disabilities (ID), relatively little research has examined such problems in offenders with ID. The study assessed 172 male offenders with ID in three service settings (high, medium-low security and community) using the Behaviour Rating Scale of the Emotional Problem Scales (EPS), with the aim of assessing differences in Externalizing and Internalizing Behaviour Problems. Normative information is presented on the Behaviour Rating Scale of the EPS across three levels of forensic ID care. It was found that offenders in higher secure care scored higher on sub-scales reflecting physical aggression than those in lower secure care. However, there was no difference in terms of other Externalizing Behaviour Problems, such as verbal aggression, non-compliance or hyperactivity. In addition, those offenders in higher secure care scored significantly higher on all Internalizing Behaviour Problems sub-scales, including anxiety, depression and low self-esteem. Implications for research and clinical practice are discussed, including the utility of the EPS as a measure of clinical need and treatment outcome.
Journal of Intellectual Disability Research, 2002
A review of the current literature on risk assessment and management in offenders with intellectu... more A review of the current literature on risk assessment and management in offenders with intellectual disability (ID) revealed little direct evidence for the specific population. Theoretical models and non-ID populations have been abstracted and adapted, but not validated, for those with ID. The varying conceptual frameworks of risk, and its assessment and management, must be considered in context. Difficulties remain with the consideration of offences versus offence-like behaviour, offender versus those with similar needs, and indeed, what is regarded as 'intellectual disability'. Mainstream forensic assessment has moved towards a more dynamic appreciation of risk and risk management, as opposed to risk elimination. This development is more in line with the normalization principles of 'risk-taking' in ID. Consideration is given to future research and development priorities.
Journal of Intellectual & Developmental Disability, 2007
The publication of the DSM-III (American Psychiatric Association (APA), 1980) prompted a signific... more The publication of the DSM-III (American Psychiatric Association (APA), 1980) prompted a significant increase in interest and research on personality disorder (PD), and the concept has subsequently been incorporated into mental health legislation in the developed world. Despite this, such research on people with intellectual disability (ID) has been sporadic, with widely varying results. The present study addresses a number of criticisms directed at previous research. DSM-IV (APA, 2000) diagnoses of PD were made on 164 participants with ID on the basis of four independent sources of classification. Reliability data for each PD was acceptable and alpha was .74 or above, with the exception of schizotypal PD (.63). Exploratory and confirmatory factor analyses were conducted, with the former revealing a 4-factor solution accounting for 58.9% of the variance, and a 2-factor solution accounting for 37.2% of the variance emerging for the latter. The factors were orthogonal, and we called the first factor "avoidant/rumination/inhibited" and the second factor…
Journal of Intellectual & Developmental Disability, 2007
Among mainstream offenders, the severe personality disorder of psychopathy has considerable impor... more Among mainstream offenders, the severe personality disorder of psychopathy has considerable importance as a construct. The disorder has long been associated with failure to make treatment progress. Previous work has identified that psychopathy as a disorder occurs in samples of offenders with intellectual disability (ID), and suggests that the Psychopathy Checklist - Revised (PCL-R: Hare, 1991, 2003) as a measure of the disorder has adequate reliability and validity (Morrissey et al., 2005). The present study aimed to compare the predictive power of the PCL-R in relation to treatment progress with a more general assessment of violence risk, the HCR-20 (Webster, Douglas, Eaves, & Hart, 1997). A sample of 73 residents in a high security intellectual disability service, who had previously been assessed using the PCL-R and the HCR-20, were followed up at 2 years post-assessment, and their outcome determined in terms of two distinct dichotomous variables reflecting definite positive treatment progress and definite negative treatment progress respectively. In line with predictions, the PCL-R Total score and Factor 1 score (Interpersonal and Affective aspects of psychopathy) and the HCR-20 Total score were significantly inversely associated with a positive move from high to medium security hospital conditions within 2 years of assessment. However against prediction, the PCL-R Total score had incremental validity over the HCR-20. The PCL-R Total and Factor 1, but not the HCR-20 Total score, were also significantly associated with negative treatment progress in terms of a move to more restricted treatment conditions. Psychopathy, and in particular its interpersonal and affective manifestations, is a construct which appears to be associated with indirect measures of treatment progress in this high security ID group. However, caution should be applied in the use of a construct with potentially negative connotations in an already devalued population.
Journal of Forensic Psychiatry & Psychology, 2006
Abstract There is an extensive research literature on the association between personality disorde... more Abstract There is an extensive research literature on the association between personality disorder, antisocial personality disorder, and risk of future violent and sexual offences. Several studies have found an elevated prevalence of personality disorder diagnoses amongst ...
Criminal Behaviour and Mental Health, 2006
A number of authors have described, with disparate results, the prevalence of people with intelle... more A number of authors have described, with disparate results, the prevalence of people with intellectual disability and their characteristics, in a range of offender cohorts defined by service use. These have included high security, a range of criminal justice services and community services. There is a need for research comparing cohorts of offenders with intellectual disabilities across different settings. AIM AND HYPOTHESIS: To conduct such a comparison and test the hypothesis that severity of characteristics measured will be highest in highest levels of residential security. A clinical-record-based comparison a offenders with intellectual disability in high security (n = 73), medium/low security (n = 70), and a community service (n = 69). Groups were similar in age and tested IQ levels. Early psychiatric service contact had been more likely in the lower security groups. In line with the hypothesis, more complex presentations, in particular comorbid personality disorder, was more likely in the highest security group. Both fatal and non-fatal interpersonal violence convictions were significantly related to group, with more in the high security group sustaining a conviction both at the index offence and prior to that. Over 50% of all groups had at least one conviction for a sexual offence. A regression model accounting for 78% of the variance was made up largely of disposal variables (Mental Health Act status and probation) and indications of antisocial traits (criminal damage, lifetime conviction for murder and ICD-10 personality disorder classification). The authors show that context of sampling affects most relationships between intellectual disability (ID) and offending when the methods for measuring ID are held constant. The results also present several questions on the relationship between risk, services available in an area and referral to higher security.
Journal of Sexual Aggression, Jul 1, 2008
Abstract Sexually abusive behaviour by personality disordered patients presents a serious threat ... more Abstract Sexually abusive behaviour by personality disordered patients presents a serious threat to the integrity of staffÁpatient relationships and the safety of other residents. The occurrence of such behaviour is also problematic for the offending patient, as it may impact on ...
Irish Journal of Psychological Medicine, Sep 1, 2004
Objective: Post-traumatic stress disorder (PTSD) is one of the most prevalent psychological disor... more Objective: Post-traumatic stress disorder (PTSD) is one of the most prevalent psychological disorders. Methods to alleviate its symptoms range from 'talking therapies' to pharmaceutical interventions. Our objective was to carry out a systematic review of the effectiveness of sertraline, an SSRI, as a treatment for PTSD. Method: Databases were searched to identify relevant research on sertraline as a treatment for PTSD. Results: Five randomised control trials were identified, along with seven open trials and case series studies. Conclusions: The review and meta-analysis supported the use of sertraline for PTSD though further research on subgroup differences (eg. gender) is required.
Psychiatry, Psychology and Law, Aug 1, 2010
In mainstream studies on offenders and on individuals with psychopathology, relationships have be... more In mainstream studies on offenders and on individuals with psychopathology, relationships have been found between personality characteristics, emotional problems and personality disorders. This study reviewed the relationships between the Emotional Problems Scale, ...
Advances in Mental Health and Intellectual Disabilities, May 3, 2016
The purpose of this paper is to present the development and evaluation of an original training pa... more The purpose of this paper is to present the development and evaluation of an original training package for staff members on an awareness of an adapted Dialectical behaviour Therapy programme, the 'I Can Feel Good' programme (Morrissey & Ingamells, 2014) designed for individuals with intellectual disabilities and problems managing emotions. The quality and effectiveness of the training was assessed and is reported in this paper. Design/methodology/approach The training was delivered for staff working with individuals with intellectual disabilities in a UK Medium Secure Psychiatric Hospital and was attended by nursing staff. The workshop consisted of six modules: 'Introduction to the programme', 'Mindfulness', 'Managing feelings', 'Coping in crisis', 'People skills' and 'Application and summary'. Level of self-reported knowledge, confidence and motivation regarding seven aspects of the training was measured by an evaluation questionnaire completed pre and post training. Findings The results of this study showed that following the training there was a significant increase in self-reported knowledge, confidence and motivation regarding the seven aspects of the training. When perceptions of staff behaviours are observed, although in the right direction, this change was found not to be significant. Originality/value This study highlights the potential for staff training to increase awareness of newly adapted therapeutic programmes for individuals with intellectual disabilities. The staff training may increase their ability and willingness to facilitate the running of such programmes and ability to support learning transfer in group members.
Journal of intellectual disabilities and offending behaviour, Mar 4, 2014
Purpose – The social climate of psychiatric institutions correlates with multiple outcomes relate... more Purpose – The social climate of psychiatric institutions correlates with multiple outcomes related to staff and patients. Research into social climate in Learning Disability services is limited. Staff and patients in Learning Disability services have documented both positive and negative experiences. No research has directly compared the social climate of Learning Disability and non-Learning Disability psychiatric services. The purpose of this paper is to understand how these compare. The study will also compare staff and patient views of social climate and the impact of security on social climate in Learning Disability services. Design/methodology/approach – A total of 64 patients and 73 staff, from Learning Disability and non-Learning Disability psychiatric hospitals completed the Essen Climate Evaluation Schema (EssenCES) measure of social climate. Findings – Patients in Learning Disability and non-Learning Disability services did not differ in their perceptions of social climate. Staff in non-Learning Disability services had a more positive perception of social climate than staff in Learning Disability services. Patients and staff did not differ in their views on climate. Security was negatively related to patients’ Experienced Safety. Originality/value – The findings suggest that staff perceive that the deficits associated with Learning Disabilities may limit patients’ therapeutic experience and relationships with their peers. Despite this, patients with Learning Disabilities feel supported by their peers, have positive views of the treatment process and feel as safe as non-Learning Disabled psychiatric patients.
Journal of Intellectual Disability Research, Oct 1, 2007
Despite an increasing knowledge base concerning the assessment of emotional and behavioural probl... more Despite an increasing knowledge base concerning the assessment of emotional and behavioural problems in people with intellectual disabilities (ID), relatively little research has examined such problems in offenders with ID. The study assessed 172 male offenders with ID in three service settings (high, medium-low security and community) using the Behaviour Rating Scale of the Emotional Problem Scales (EPS), with the aim of assessing differences in Externalizing and Internalizing Behaviour Problems. Normative information is presented on the Behaviour Rating Scale of the EPS across three levels of forensic ID care. It was found that offenders in higher secure care scored higher on sub-scales reflecting physical aggression than those in lower secure care. However, there was no difference in terms of other Externalizing Behaviour Problems, such as verbal aggression, non-compliance or hyperactivity. In addition, those offenders in higher secure care scored significantly higher on all Internalizing Behaviour Problems sub-scales, including anxiety, depression and low self-esteem. Implications for research and clinical practice are discussed, including the utility of the EPS as a measure of clinical need and treatment outcome.
Journal of forensic psychology research and practice, 2017
The effectiveness of an adapted-DBT (dialectical behavioral therapy) program upon adaptive emotio... more The effectiveness of an adapted-DBT (dialectical behavioral therapy) program upon adaptive emotion management is reviewed. This case study focuses upon a male forensic inpatient diagnosed with mild learning disabilities and emotionally unstable personality disorder who presented with behavioral difficulties including self-harm and aggression. Following development of a psychological formulation, informed by an initial psychological assessment process, the client was referred for the "I Can Feel Good" program (Ingamells & Morrissey, 2014), which is designed to reduce difficulties managing emotions and resulting problematic behaviors. This was in addition to supplementary individual sessions designed to support and reinforce skills developed within the group. The effectiveness of this intervention was assessed using a combination of approaches including a range of self-and staff-report psychometrics and observational data. Findings demonstrated an effect upon some secondary treatment targets (namely an increase in use of mindfulness techniques and adaptive coping strategies) but no overall reduction of the primary treatment target of emotional management or associated emotional and psychological problems. Reflection upon the initial formulation in light of findings is discussed. Methodological difficulties and issues of evaluation are reviewed. Future adaptation of the "I Can Feel Good" program is considered.
Journal of intellectual disabilities and offending behaviour, Mar 13, 2017
Purpose The purpose of this paper is to describe a feasibility study into the development and pil... more Purpose The purpose of this paper is to describe a feasibility study into the development and pilot of a psychoeducational group for people with intellectual disability and co-morbid mental disorder (including mental illness and personality disorder) within forensic settings. Design/methodology/approach “Mind Matters”, a psychoeducational programme for people with an intellectual disability and co-morbid mental disorders is a group based programme in a medium secure hospital, adapted and developed to be suitable for people with intellectual disability therapist multidisciplinary approach was key to its development. An open group on a 16-bedded ward for individuals with mild to moderate intellectual disability and co-morbid mental illness was delivered over a six-week period. Findings The group was positively received in pilot by participants and members of the clinical teams. Attendance and engagement of participants were key measures of the success of the programme. In addition to the apparent increased social skills and motivation to engage with future psychological intervention. Practical implications The authors believe that this approach benefitted both the group members and staff on ward, reinforcing strategies for maintaining positive mental health. It also stimulated engagement, discussion about mental disorders including mental illness, personality disorder and intellectual disabilities. Originality/value This paper shows how a psychoeducational approach to mental disorder and mental health in individuals with an intellectual disability is possible, beneficial and well received.
Journal of Intellectual Disability Research, Jun 1, 2009
International Journal of Forensic Mental Health, Oct 1, 2005
Psychopathy is a severe personality disorder characterised by a set of affective, interpersonal a... more Psychopathy is a severe personality disorder characterised by a set of affective, interpersonal and behavioral features, which include the selfish, callous and remorseless use of others, deficient affective experience, and an impulsive and irresponsible lifestyle, which may include ...
Journal of Forensic Psychology Research and Practice, 2020
This study adapts and validates a scale designed to measure Attitudes Toward Mentally Disordered ... more This study adapts and validates a scale designed to measure Attitudes Toward Mentally Disordered Offenders (ATMDO). It is thought that by monitoring and subsequently improving attitudes, negative potentially damaging milieus within criminal justice, forensic mental health, and society in general can be minimized. Participants (N = 364) were recruited via snowball technique and data collected using an online version of the ATMDO. Psychometric properties were assessed. Test-retest and convergent validity was assessed with additional samples A (N = 30) and B (N = 50) respectively. Utilizing a cross-sectional design, differences in ATMDO scores across occupational groups were compared. The ATMDO demonstrates robust internal structure, reliability, and validity. Although ATMDO scores did not differ significantly across occupational groups, some differences were seen at a factorial level. Regression analysis demonstrates the influence of both demographic and occupation-related variables in predicting ATMDO scores. The ATMDO is robust and has clinical utility for comparison of professional groups or institutions, and within recruitment procedures. A model is proposed for the effects of exposure (catalyst factor) and professional certification training (moderating factor).
Journal of Intellectual Disabilities and Offending Behaviour, 2016
Purpose There are few reliable psychometric measures of the psychopathology of offenders with int... more Purpose There are few reliable psychometric measures of the psychopathology of offenders with intellectual disabilities (ID). However, previous research has indicated that the emotional problems scale (EPS) is useful in identifying a range of treatment needs and in predicting risk to self and others. The purpose of this paper is to compare the severity of the emotional and behavioural problems of a small sample of offenders with ID in medium and low secure services, as assessed by EPS. Additionally, the data are tentatively compared with those reported in previous research to precipitate discussion regarding the changes in clinical populations in secure care over time. Design/methodology/approach The study collected demographic and EPS data for patients with ID (n=25) on medium secure and a low secure wards. Data were collected as part of routine clinical practice, with EPS forms being completed by nursing and other multi-disciplinary staff. Findings It was found that there was no s...
The Journal of Forensic Psychiatry & Psychology, 2015
Abstract Introduction: The use of seclusion as a means of managing the extreme behaviours forensi... more Abstract Introduction: The use of seclusion as a means of managing the extreme behaviours forensic patients in secure settings is a controversial yet often common practice, despite there being little evidence that seclusion as a practice has any significant therapeutic value for the patient. The aim of this study was to explore the use of seclusion and whether this differs as a function of gender and diagnosis across secure services. Method: This study collated data from 11 medium and low secure hospitals that admit male and female patients, with some services providing services for patients with intellectual disability (with or without co-morbid disorders), and others for patients with mental illness and/or personality disorder only. Results: Both gender and diagnosis were associated with differential seclusion rates. Seclusions were three times longer for patients in the non-ID compared to the ID service. Male seclusions (for any diagnosis) were around twice as long as those in female services. Female ID patients spent significantly less time in seclusion compared to other groups. Female ID was associated with two to three times the number of seclusion events per patient compared to other groups. No statistically significant association between the type of service and the reason for a patient being secluded. Conclusions: A range of organisational factors that determine the use and duration of seclusion are cited and merit further exploration. High rates of psychiatric co-morbidity and the complexity of patients admitted to services may also mediate risk and use of seclusion. The study supports the use of early intervention techniques and the adoption of positive behaviour support.
Psychiatry, Psychology and Law, 2010
In mainstream studies on offenders and on individuals with psychopathology, relationships have be... more In mainstream studies on offenders and on individuals with psychopathology, relationships have been found between personality characteristics, emotional problems and personality disorders. This study reviewed the relationships between the Emotional Problems Scale, ...
Journal of Intellectual Disability Research, 2007
Despite an increasing knowledge base concerning the assessment of emotional and behavioural probl... more Despite an increasing knowledge base concerning the assessment of emotional and behavioural problems in people with intellectual disabilities (ID), relatively little research has examined such problems in offenders with ID. The study assessed 172 male offenders with ID in three service settings (high, medium-low security and community) using the Behaviour Rating Scale of the Emotional Problem Scales (EPS), with the aim of assessing differences in Externalizing and Internalizing Behaviour Problems. Normative information is presented on the Behaviour Rating Scale of the EPS across three levels of forensic ID care. It was found that offenders in higher secure care scored higher on sub-scales reflecting physical aggression than those in lower secure care. However, there was no difference in terms of other Externalizing Behaviour Problems, such as verbal aggression, non-compliance or hyperactivity. In addition, those offenders in higher secure care scored significantly higher on all Internalizing Behaviour Problems sub-scales, including anxiety, depression and low self-esteem. Implications for research and clinical practice are discussed, including the utility of the EPS as a measure of clinical need and treatment outcome.
Journal of Intellectual Disability Research, 2002
A review of the current literature on risk assessment and management in offenders with intellectu... more A review of the current literature on risk assessment and management in offenders with intellectual disability (ID) revealed little direct evidence for the specific population. Theoretical models and non-ID populations have been abstracted and adapted, but not validated, for those with ID. The varying conceptual frameworks of risk, and its assessment and management, must be considered in context. Difficulties remain with the consideration of offences versus offence-like behaviour, offender versus those with similar needs, and indeed, what is regarded as 'intellectual disability'. Mainstream forensic assessment has moved towards a more dynamic appreciation of risk and risk management, as opposed to risk elimination. This development is more in line with the normalization principles of 'risk-taking' in ID. Consideration is given to future research and development priorities.
Journal of Intellectual & Developmental Disability, 2007
The publication of the DSM-III (American Psychiatric Association (APA), 1980) prompted a signific... more The publication of the DSM-III (American Psychiatric Association (APA), 1980) prompted a significant increase in interest and research on personality disorder (PD), and the concept has subsequently been incorporated into mental health legislation in the developed world. Despite this, such research on people with intellectual disability (ID) has been sporadic, with widely varying results. The present study addresses a number of criticisms directed at previous research. DSM-IV (APA, 2000) diagnoses of PD were made on 164 participants with ID on the basis of four independent sources of classification. Reliability data for each PD was acceptable and alpha was .74 or above, with the exception of schizotypal PD (.63). Exploratory and confirmatory factor analyses were conducted, with the former revealing a 4-factor solution accounting for 58.9% of the variance, and a 2-factor solution accounting for 37.2% of the variance emerging for the latter. The factors were orthogonal, and we called the first factor "avoidant/rumination/inhibited" and the second factor…
Journal of Intellectual & Developmental Disability, 2007
Among mainstream offenders, the severe personality disorder of psychopathy has considerable impor... more Among mainstream offenders, the severe personality disorder of psychopathy has considerable importance as a construct. The disorder has long been associated with failure to make treatment progress. Previous work has identified that psychopathy as a disorder occurs in samples of offenders with intellectual disability (ID), and suggests that the Psychopathy Checklist - Revised (PCL-R: Hare, 1991, 2003) as a measure of the disorder has adequate reliability and validity (Morrissey et al., 2005). The present study aimed to compare the predictive power of the PCL-R in relation to treatment progress with a more general assessment of violence risk, the HCR-20 (Webster, Douglas, Eaves, & Hart, 1997). A sample of 73 residents in a high security intellectual disability service, who had previously been assessed using the PCL-R and the HCR-20, were followed up at 2 years post-assessment, and their outcome determined in terms of two distinct dichotomous variables reflecting definite positive treatment progress and definite negative treatment progress respectively. In line with predictions, the PCL-R Total score and Factor 1 score (Interpersonal and Affective aspects of psychopathy) and the HCR-20 Total score were significantly inversely associated with a positive move from high to medium security hospital conditions within 2 years of assessment. However against prediction, the PCL-R Total score had incremental validity over the HCR-20. The PCL-R Total and Factor 1, but not the HCR-20 Total score, were also significantly associated with negative treatment progress in terms of a move to more restricted treatment conditions. Psychopathy, and in particular its interpersonal and affective manifestations, is a construct which appears to be associated with indirect measures of treatment progress in this high security ID group. However, caution should be applied in the use of a construct with potentially negative connotations in an already devalued population.
Journal of Forensic Psychiatry & Psychology, 2006
Abstract There is an extensive research literature on the association between personality disorde... more Abstract There is an extensive research literature on the association between personality disorder, antisocial personality disorder, and risk of future violent and sexual offences. Several studies have found an elevated prevalence of personality disorder diagnoses amongst ...
Criminal Behaviour and Mental Health, 2006
A number of authors have described, with disparate results, the prevalence of people with intelle... more A number of authors have described, with disparate results, the prevalence of people with intellectual disability and their characteristics, in a range of offender cohorts defined by service use. These have included high security, a range of criminal justice services and community services. There is a need for research comparing cohorts of offenders with intellectual disabilities across different settings. AIM AND HYPOTHESIS: To conduct such a comparison and test the hypothesis that severity of characteristics measured will be highest in highest levels of residential security. A clinical-record-based comparison a offenders with intellectual disability in high security (n = 73), medium/low security (n = 70), and a community service (n = 69). Groups were similar in age and tested IQ levels. Early psychiatric service contact had been more likely in the lower security groups. In line with the hypothesis, more complex presentations, in particular comorbid personality disorder, was more likely in the highest security group. Both fatal and non-fatal interpersonal violence convictions were significantly related to group, with more in the high security group sustaining a conviction both at the index offence and prior to that. Over 50% of all groups had at least one conviction for a sexual offence. A regression model accounting for 78% of the variance was made up largely of disposal variables (Mental Health Act status and probation) and indications of antisocial traits (criminal damage, lifetime conviction for murder and ICD-10 personality disorder classification). The authors show that context of sampling affects most relationships between intellectual disability (ID) and offending when the methods for measuring ID are held constant. The results also present several questions on the relationship between risk, services available in an area and referral to higher security.