Search results for ‘Subject term:"personality disorders"’ Sort:
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Changing legal characteristics of dangerous and severe personality disorder (DSPD) patients and prisoners
- Authors:
- TREBILCOCK Julie, WEAVER Tim
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 23(2), April 2012, pp.237-243.
- Publisher:
- Taylor and Francis
This paper investigated the legal status of 172 dangerous and severe personality disorder (DSPD) patients and prisoners with respect to indeterminate sentences. Dangerous and severe personality disorder prisoners were more likely to have been serving indeterminate sentences, while patients admitted to hospital units were more likely to have been given determinate sentences. At admission, the majority of prisoners were in advance of their tariff expiry or parole eligibility dates, while the majority of patients had passed them. Patients previously serving a determinate prison sentence were close to their non-parole date (NPD), the date they expected to be released from prison, with 40% of pre-NPD patients found to have less than two weeks to serve. At follow-up 85% of patients originally serving a determinate sentence had passed their NPD. The findings suggest that a proportion of patients were ‘preventively detained’ within the DSPD hospital units.
Self harm in a dangerous and severely personality disordered population
- Author:
- MANNION Aisling
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 20(2), April 2009, pp.322-331.
- Publisher:
- Taylor and Francis
This article reports on a total of 309 incidents of self-harm recorded between October 2004 and September 2007, for a group of male patients deemed to be dangerous and severely personality disordered (DSPD), within the Peaks Unit at Rampton high security hospital. The first part of this paper describes self-harm within this group of patients, to see whether, as well as posing danger to the public, these patients also pose a risk of harm to themselves. Second, the paper investigated the antecedents of the self-harm incidents recorded. Finally, statistical analyses were conducted to assess the relationships between self-harm and patient/environmental characteristics. No significant differences were found between those who self-harmed and those that did not, although some differences were found within the self-harming group. Implications for future research and treatment are discussed.
Personality disorder, temperament, and childhood adversity: findings from a cohort of prisoners in England and Wales
- Authors:
- ROBERTS Amanda, et al
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 19(4), December 2008, pp.460-483.
- Publisher:
- Taylor and Francis
This study examines associations between personality disorder, childhood temperament, adverse childhood experiences, and victimisation. The Prisoner Cohort Study was carried out as part of the dangerous and severe personality disorder (DSPD) service development programme commissioned by the Home Office. The study comprised 1396 male offenders interviewed with the Structured Clinical Interview (SCID II) to diagnose personality disorders in addition to reveal self-reported experiences of childhood victimisation and disadvantage. Independent and joint relationships were examined between reported temperament and adverse childhood experiences and Axis II disorders measured at interview. Prisoners with personality disorder reported adverse childhood experiences and victimisation more frequently than those with no personality disorder. Different childhood experiences were interrelated with specific personality disorder categories. Associations between temperamental features and specific personality disorders were increased by the addition of adverse childhood experiences (joint effects). A difficult temperament and childhood adversity increase the likelihood of personality disorder in prisoners and may be risk factors to target for future early intervention.
What is the link between personality disorder and dangerousness? A critique of 'dangerous and severe personality disorder'
- Author:
- HOWARD Rick
- Journal article citation:
- British Journal of Forensic Practice, 8(4), December 2006, pp.19-23.
- Publisher:
- Emerald
This article review the medico-legal background to the development of the pilot programme for treatment and assessment of dangerous individuals with severe personality disorder. It raises the question: is personality disorder related to dangerousness, and (if so) what mediates the relationship? It then reviews recent findings suggestion that patients deemed to be dangerous and severely personality disorders are characterised by a combination of antisocial and borderline traits, and as such are a source of distress both to themselves and to others. It is recommended that the current criteria for 'dangerous and severe personality disorder' be dispensed with.
Serious violence by people with mental illness: national clinical survey
- Authors:
- FLYNN Sandra, et al
- Journal article citation:
- Journal of Interpersonal Violence, 29(8), 2014, pp.1438-1458.
- Publisher:
- Sage
This study estimates the prevalence of mental disorder in offenders convicted of serious violence, examines their social and clinical characteristics, and compares them with patients convicted of homicide. The study examined a national clinical survey of all people convicted of serious violence in England and Wales in 2004. Mental disorder was measured by contact with mental health services within 12 months of the offence. Of the 5,966 serious violent offenders, 293 (5%) had been in recent contact with mental health services. Personality disorder (63, 22%) and schizophrenia (55, 19%) were the most common diagnoses. Most had previous convictions for violence (168, 61%). Seventy-two (25%) patients were at high risk of violence and 34 (49%) were not subject to the Care Programme Approach. Compared with serious violence offenders, homicide offenders were more likely to have been patients. The study concludes that patients were responsible for a small proportion of serious violent offences; however, high-risk patients require closer supervision, and regular inquiry about changing delusional beliefs, thoughts of violence, and weapon carriage. (Edited publisher abstract)
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.
Service user experiences of a community forensic personality disorder service: a qualitative survey
- Authors:
- JACOBS Barbara, et al
- Journal article citation:
- British Journal of Forensic Practice, 12(4), November 2010, pp.47-56.
- Publisher:
- Emerald
In mental health services today, the management of risk posed by violent and sexual offenders who have a personality disorder is a high priority. A vital aspect of service delivery is to maintain client engagement with the care team in order to promote positive change. Service-user involvement in evaluations have been shown to increase involvement and ownership of services and thereby increasing engagement. This study presents the findings from a service user evaluation of a pilot project known as the Forensic Intensive Psychological Treatment Service (FIPTS). Participants included 12 male service user participants aged 30 to 64 years. Findings highlighted the importance of a good therapeutic relationship and good communication with the care team, how therapy work offered insight and understanding into behaviour, encouraging service users to make positive changes, and how returning to work gave hope, independence and confidence. Service users generally felt supported and able to approach the team with any concerns of escalating risk.
Violent forensic psychiatric inpatients and violent detainees in the Netherlands
- Authors:
- HORNSVELD Ruud H. J., et al
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 19(3), September 2008, pp.407-419.
- Publisher:
- Taylor and Francis
A group of 136 violent inpatients detained under hospital order and a group of 100 violent detainees with a prison sentence of at least four years were compared as regards individual criminogenic factors such as personality traits and problem behaviours. The inpatients appeared to score higher than detainees on antisocial lifestyle, neuroticism, and disposition to anger. No significant differences were found on other measures. Inpatients were all classified as having an antisocial personality disorder, but there were indications that this was also the case for a considerable percentage of the detainees. It seems advisable that the psychiatric and psychological criteria used in the decision to detain an offender under hospital order should be specified further.
Compulsory treatment of dangerous offenders with severe personality disorders: a comparison of the English DSPD and Dutch TBS systems
- Authors:
- de BOER Judith, WHYTE Sean, MADEN Tony
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 19(2), June 2008, pp.148-163.
- Publisher:
- Taylor and Francis
British society has come to see itself as at risk from violent and antisocial behaviour from people with mental disorders. One manifestation of this is the DSPD programme for offenders with severe personality disorders, inspired by the Dutch TBS system. The TBS legislation was introduced to combat the frequent reoffending of “psychopaths”. The number of TBS hospital beds has increased rapidly, from 400 in 1975 to more than 1,600 in 2006. This is mainly due to the growing confidence of Dutch courts that the order protects the public and minimises recidivism. Five-year recidivism rates among discharged TBS patients have fallen from 52% in 1974 to 17% in 1998. The authors describe the main differences between the two systems in terms of philosophy, treatment programmes, outcomes and costs. They argue the DSPD programme has deviated substantially from the TBS model in ways that may prevent it being as effective. They argue it has not properly implemented the patient responsibility, the rehabilitation focus, or the clear care pathways of the Dutch system.
Risk, dangerousness and the DSPD unit
- Author:
- SEDDON Toby
- Journal article citation:
- Prison Service Journal, 177, May 2008, pp.27-31.
- Publisher:
- Her Majesty's Prison Service of England and Wales
The author examines the terms of 'risk' and 'dangerousness' in the context of the two prison-based dangerous people with severe personality disorders (DSPD) units in Whitemoor and Frankland.