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Personality disorders in offenders with intellectual disability: a comparison of clinical, forensic and outcome variables and implications for service provision
- Authors:
- ALEXANDER R. T., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 54(7), July 2010, pp.650-658.
- Publisher:
- Wiley
The aim of this study was to discover any differences between patients with and without a diagnosis of personality disorders, being treated in a secure inpatient service for offenders with intellectual disability (ID) in England. A total of 138 patients (109 men, approximate age on admission 30 years, 77 with a personality disorder) treated over a six year period were included. Women were more likely to be in the personality disorder group. Both groups had an equally high prevalence of abuse. Depressive disorders and substance abuse were more common in the personality disorder group, while epilepsy and autistic spectrum disorders were more common in the comparison group. The authors note that, rather than differences, what was more striking was the rate and range of the comorbidities across both groups. Although past histories of violence and institutional aggression were no different, compulsory detention under criminal sections and restriction orders were more common in the personality disorder group. There were no differences in treatment outcomes. It is concluded that although about half of patients detained in secure units for offenders with ID have a personality disorder, there were more similarities than differences between this group and the rest. Good treatment outcomes supported the case for specialised secure treatment units for people with ID, the case for more specialised ID–personality disorder units was less convincing.
Comorbidity of post traumatic stress disorder and paranoid schizophrenia: a comparison of offender and non-offender patients
- Author:
- SARKAR Jaydip
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), December 2005, pp.660-670.
- Publisher:
- Taylor and Francis
This study describes rates of trauma and posttraumatic stress disorder (PTSD) in forensic and non-forensic psychiatric patients, with a primary diagnosis of paranoid schizophrenia. Twenty-seven disordered offender patients (forensic) were compared with 28 non-offender (general) psychiatric inpatients. Ninety-three percent of the entire group reported previous trauma, with the forensic group reporting higher rates of physical and sexual abuse. The forensic patients had also experienced more multiple traumas then the general psychiatric patients, although the result was non-significant. There was no difference between the groups with regard to the age of the earliest trauma experienced. PTSD was common, with rates of 27% for current, and 40% lifetime diagnosis in the whole group. Forensic patients had higher rates of both current (33% v 21%) and lifetime (52% v 29%) PTSD. Very few patients had received a working diagnosis of PTSD, or were receiving trauma focussed psychological therapy. Possible reasons for high rates of trauma and PTSD, and implications for treatment are discussed.
Characteristics of male autistic spectrum patients in low security: are they different from non-autistic low secure patients?
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 4(1/2), 2013, pp.24-32.
- Publisher:
- Emerald
Purpose – The purpose of this paper is to describe the characteristics of adult male autistic spectrum disorder (ASD) patients admitted to low secure services and to compare them with non-ASD patients. Design/methodology/approach – Case-control study of admissions to two ASD units and one non-ASD unit at a tertiary referral centre. Subjects were compared on demographic, personal, clinical and offending behaviour variables. Findings – In total, 51 ASD and 43 controls were studied. Median age at diagnosis of ASD was 21 years (range 6-56). The ASD group were younger (median age 27 vs 33 years) and more likely to be single than controls. Their age at first contact with psychiatric services was lower and proportionally more were admitted from prison and courts. Almost three-quarters had psychiatric comorbidity, most commonly schizophrenia, but unlike controls, personality disorder and drug and alcohol disorders were uncommon. Lifetime sexually inappropriate behaviour and physical violence were less common, as was non-compliance with medication. However, 78 per cent had a lifetime history of physical violence and a third had a conviction for GBH or homicide. Offending behaviour was sometimes atypical in nature and some had convictions for unusual offences such as harassment and stalking. Research limitations/implications – The age difference between cases and controls is likely to have confounded the results. Findings cannot be generalised to the NHS. Originality/value – This group of ASD patients in low security differed in several important respects from their non-ASD counterparts, which highlights their differing treatment needs, strengths and weaknesses. (Publisher abstract)
Forensic issues in adolescents with developmental disabilities
- Authors:
- GRALTON Ernest, ed.
- Publisher:
- Jessica Kingsley
- Publication year:
- 2011
- Pagination:
- 287p.
- Place of publication:
- London
The book provides a comprehensive account of forensic issues in adolescents with a wide range of developmental disabilities, including autism spectrum disorders, acquired brain injury, developmental traumatology, and complex comorbidities. It examines the processes involved in working with this client group in forensic settings, and explores the ways in which their needs differ from those of other young people who engage in high risk behaviour or offending. The book covers assessment, intervention and treatment options for adolescents with developmental disabilities. It describes the obstacles, challenges and opportunities to consider when working with this population, and the role played by various professionals, including those working in forensic psychiatry and psychology, occupational therapy, physiotherapy, education, art psychotherapy and social work. The book also outlines the issues to consider when working in secure and community settings as well as the legal aspects of working with this client group, and the complex issues surrounding risk assessment. It is likely to be of interest to a wide range of professionals working with adolescents with developmental disabilities.