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Altered memory and affective instability in prisoners assessed for dangerous and severe personality disorder
- Authors:
- KIRKPATRICK Tim, et al
- Journal article citation:
- British Journal of Psychiatry, 190(Supplement 49), May 2007, pp.s20-s26.
- Publisher:
- Cambridge University Press
Previous studies of borderline personality disorder report neuropsychological impairments in several domains, including memory. No studies have compared memory functioning in high-risk prisoners with borderline personality disorder with similar prisoners with other personality disorders. The aim was to explore mnemonic impairments in prisoners undergoing personality assessment as part of the dangerous and severe personality disorder initiative or detained in a medium secure facility. The authors investigated memory function in 18 prisoners with borderline personality disorder and 18 prisoners with other personality Disorders. Prisoners with borderline personality disorder exhibited a pattern of multi-modal impairments in the immediate and delayed recall of verbal and visual information, with some association with affective instability. These deficits were not associated with the severity of personality disturbance. These data suggest that memory deficits have some specificity in relation to the constituent traits of borderline personality disorder and indicate that neuropsychological assessment may be a source of useful adjunctive information for distinguishing between the cognitive and psychological difficulties of individual prisoners.
An idiographic examination of patient progress in the treatment of dangerous and severe personality disorder: a reliable change index approach
- Authors:
- DRAYCOTT Simon, KIRKPATRICK Tim, ASKARI Roxanna
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 23(1), February 2012, pp.108-124.
- Publisher:
- Taylor and Francis
The aim of the Broadmoor Dangerous and Severe Personality Disorder (DSPD) project is the assessment of the effectiveness of different treatment approaches with patients considered untreatable such as dangerous offenders with personality disorders. This paper presents outcomes for a small pilot sample of patients in the DSPD unit over their first two years of treatment. Participants included 29 offenders where had been resident in Broadmoor for at least 21 months. To assess the effectiveness of the treatment provided within the Broadmoor DSPD pilot unit in terms of risk reduction and clinical indicators of improvement, routine assessment data were collected for each patient on a six-monthly basis. Across the sample, for some there appeared to be a trend towards improved scores on one measure of violence risk, with few signs of deterioration. However, the largest group of patients showed no change on any measure. The authors concluded that this was an important negative outcome given the expense associated with the provision of treatment.
A descriptive evaluation of patients and prisoners assessed for dangerous and severe personality disorder
- Authors:
- KIRKPATRICK Tim, et al
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 21(2), April 2010, pp.264-282.
- Publisher:
- Taylor and Francis
The dangerous and severe personality disorder (DSPD) programme is a joint initiative involving the Ministry of Justice and Department of Health, aiming to assess, manage and treat individuals with severe personality disorder who present a high risk of sexual or violent offending. This article describes the clinical and risk characteristics of the first 241 male patients admitted to the high security DSPD service for assessment between 2000 and 2007, of which 203 patients (84.2%) were regarded as meeting the DSPD criteria. The analysis showed that the DSPD patients demonstrated high levels of psychopathy, and that the most commonly diagnosed personality disorders were antisocial, borderline and paranoid, and the risk assessments indicated that the DSPD patients exhibited a broad range of risk factors for future offending, suggesting that they had extensive treatment needs; of 184 patients admitted to treatment at the DSPD units, 82% remained in the treatment programme. The authors discuss the findings and their implications.