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Prediction of treatment outcomes for personality disordered offenders

Sarah-Jane Archibald (based at Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Kings College London, London, UK)
Colin Campbell (based at Forensic Intensive Psychological Treatment Service, South London and Maudsley NHS Trust, London, UK and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Kings College London, London, UK)
Derval Ambrose (based at Forensic Intensive Psychological Treatment Service, South London and Maudsley NHS Trust, London, UK)

The Journal of Forensic Practice

ISSN: 2050-8794

Article publication date: 4 November 2014

Abstract

Purpose

Evidence has shown associations between personality disorder (PD) and poor treatment outcomes. The purpose of this paper is to: first, establish which risk assessment method (i.e. structured professional judgement or actuarial) is most reliable for predicting treatment outcomes for individuals with PD. Second, determine whether individuals identified as high risk are more likely to have poorer treatment outcomes. Third, determine if engagement in treatment helps to reduce risk assessment scores.

Design/methodology/approach

In total, 50 patients were recruited from a medium secure forensic PD service. Their risk was assessed using one structured professional judgement instrument (the HCR-20) and one actuarial instrument (the RM2000). The study used a retrospective cohort design.

Findings

Overall, the HCR-20 was a better predictor of treatment outcome than the RM2000. Personality-disordered offenders with high HCR-20 scores are at an increased risk of adverse treatment outcomes.

Research limitations/implications

This investigation used a small, non-randomised sample of male patients with PD at one South East England medium secure unit. The data were over-represented by white British males. Future research should compare PD offenders with non-PD offenders to investigate what factors best predict poorer treatment outcomes.

Originality/value

The findings indicate that structured professional judgement approaches are more effective predictors of risk than actuarial measures for assessing patients with PD. This study therefore adds value to forensic services and to the risk assessment debate.

Keywords

Acknowledgements

The authors would like to thank Dr Alexis Cullen and Mr Symon Wandiembe for their assistance with statistical analyses. Many thanks are extended to Mr Philip Norman, Ms Chloe Charteris, Ms Qian Zhang, Ms Belinda Coulston and Dr Matt Bruce for their support throughout the study.

Citation

Archibald, S.-J., Campbell, C. and Ambrose, D. (2014), "Prediction of treatment outcomes for personality disordered offenders", The Journal of Forensic Practice, Vol. 16 No. 4, pp. 281-294. https://doi.org/10.1108/JFP-05-2013-0037

Publisher

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Emerald Group Publishing Limited

Copyright © 2014, Emerald Group Publishing Limited