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Examining the relationship between neuropsychological functioning assessed during admission to a high secure psychiatric care hospital and vulnerability to long-term segregation

Ishbel McMichael (High Secure Research Hub, Broadmoor Hospital, Crowthorne, UK and School of Psychology, Cardiff University, Cardiff, UK)
Olivia Tiley (High Secure Research Hub, Broadmoor Hospital, Crowthorne, UK and School of Psychology, Cardiff University, Cardiff, UK)
Josephine Broyd (Research Department, Broadmoor Hospital, Crowthorne, UK)
David Murphy (Neuropsychology Department, Broadmoor Hospital, Crowthorne, UK)

The Journal of Forensic Practice

ISSN: 2050-8794

Article publication date: 21 December 2020

Issue publication date: 25 February 2021

131

Abstract

Purpose

This paper aims to examine the relationship between neuropsychological functioning as assessed following admission to a high secure psychiatric care (HSPC) hospital and subsequent time spent in long-term segregation (LTS). Evidence from forensic populations suggests neuropsychological functioning difficulties can increase vulnerability to interpersonal violence. However, the impact of this relationship on restrictive interventions used in these settings is poorly understood.

Design/methodology/approach

This study quantitatively examined the neuropsychological profiles of 80 male HSPC patients as assessed during routine admission assessments, comparing data against any subsequent LTS duration during a one-year period, and a non-LTS control (n = 27).

Findings

Analysis found individuals who were willing and able to complete a routine neuropsychological admissions assessment spent significantly less time in LTS than those unable to complete the assessment. Performance within a test of novel problem solving (Key Search Test) was significantly worse in the LTS group than controls. Performance within a visual memory task (Immediate Recall section of the Rey Complex Figure Test) significantly correlated with LTS duration. Additional findings suggest the absence of self-reported planning difficulties as measured by a Dysexecutive Questionnaire (DEX) negatively correlated with LTS duration, while self-reported restlessness was positively correlated with LTS.

Practical implications

This has implications for early assessment of LTS risk and potential use of cognitive interventions to reduce the use of restrictive practices.

Originality/value

The results suggest some aspects of neuropsychological performance as assessed during admission to a HSPC hospital appear to be related to subsequent time spent in LTS.

Keywords

Citation

McMichael, I., Tiley, O., Broyd, J. and Murphy, D. (2021), "Examining the relationship between neuropsychological functioning assessed during admission to a high secure psychiatric care hospital and vulnerability to long-term segregation", The Journal of Forensic Practice, Vol. 23 No. 1, pp. 13-25. https://doi.org/10.1108/JFP-08-2020-0038

Publisher

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Emerald Publishing Limited

Copyright © 2020, Emerald Publishing Limited

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