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The purpose of this paper is to assess the effectiveness of a gender-specific group treatment programme for personality disordered (PD) women in a medium secure psychiatric setting.

In all, 56 consecutive admissions with a primary diagnosis of personality disorder (mostly borderline type) and co-morbidity were assessed according to their participation in, and benefit from, a core set of five manualised group treatments that focused on social and interpersonal deficits, instability of mood and problematic substance use. A single cohort pre-test post-test comparison design was used with evaluation based on global change over an amalgam of self-report group specific outcome measures.

In all, 70 per cent of patients attended three or more core groups, with attendance for each group ranging from 85 to 53 per cent. Between 65 and 77 per cent of patients showed a significant improvement on pre-group psychometrics. Patients who achieved a significant positive change in one group tended to do so in others. In all, 85 per cent of patients who completed two or more groups had overall positive direction of change scores. Those who benefited from treatment engaged more quickly, were more likely to have been admitted from hospital, to have previously engaged in therapy and to score lower on measures of impulsivity and personality pathology.

In a clinically representative study the absence of a control group limits the extent to which observed changes can be attributed to described interventions.

Findings reflect the importance of providing a broad clinical approach to changing cognitive behavioural functioning with PD patients in secure settings. They also highlight the need to improve ways of engaging patients at an earlier stage of hospital stay and of increasing the acceptability and uptake of relevant group treatments. Further evidence-informed service developments are needed to meet these challenges.

The study adds to a small literature on the clinical impact of a gender-specific group treatment programme for PD women in secure settings.

Self‐reported quality of life (QOL) was examined in a cohort of detained psychiatric in‐patients. Two patient groups, categorised as high and low on the Lehman Quality of Life Interview (QOLI) in terms of their ‘satisfaction with life in general’, were compared. A model of satisfaction with life derived from a logistic regression analysis contained three measures: (high) QOLI satisfaction rating for living situation, (low) suicidality and (high) motivation and energy. The practical implications of these findings are discussed in terms of assessment, symptom relief and environmental change.

Social cognition is a prominent feature of explanations of crime, particularly violent crime. This paper aims to report a study that compared several aspects of the social cognition of convicted violent and non‐violent offenders.

Measures of social cognition were administered to 156 offenders, classified as violent and non‐violent according to index offence.

Analysis showed few significant differences between the violent and non‐violent offenders, although differences in thinking styles and social problem solving strategies were evident between high‐risk and low‐risk violent offenders.

The differences between high‐risk and lower risk violent offenders suggests that not all violent offenders function at the same level and so more precision is required in classifying offenders.

The purpose of this paper is to describe the architectural design considerations and effects of moving patients from an adapted Victorian medium secure unit to a purpose built facility.

Patients and staff views of the old and new unit environments were compared in terms of homeliness, architectural features, ward atmosphere (WAS) and patient satisfaction.

The new unit was rated as more homely. The change of environment did not increase risk behaviours and was associated with a reduction in symptomatology.

Limitations of the study include the small‐sample size and choice of measure of WAS. More research is needed into the constituents of “planned” environments where the physical environment is the primary intervention.

These include the need for close collaboration among architects, clinicians and patients in order to maximise the therapeutic benefit of the built environment.

This paper contributes to a small literature that “bridges” architectural, psychiatric and environmental domains.

In the UK, the mental health treatment requirement (MHTR) order for offenders on probation has been underused. A MHTR service was established to assess the effectiveness of a partnership between a probation service, a link worker charity and an independent mental healthcare provider. Short-term structured cognitive behavioural interventions were delivered by psychology graduates with relevant work experience and training. Training for the judiciary on the MHTR and the new service led to a significant increase in the use of MHTR orders. The paper aims to discuss these issues.

A total of 56 (of 76 MHTR offenders) completed treatment in the first 12 months. A single cohort pre-post follow-up design was used to evaluate change in the following domains: mental health and wellbeing; coping skills; social adjustment; and criminal justice outcomes. Mental health treatment interventions were delivered under supervision by two psychology graduates who had relevant work experience and who were trained in short term, structured, cognitive behavioural (CBT) interventions.

Clinically significant changes were obtained on measures of anxiety and depression, and on measures of social problem solving, emotional regulation and self-efficacy. Ratings of work and social adjustment and pre-post ratings of dynamic criminogenic risk factors also improved. This new initiative has addressed the moral argument for equality of access to mental health services for offenders given a community order.

While the current initiative represents one of a number of models designed to increase the collaboration between the criminal justice and the mental health systems, this is the first within the UK to deliver a therapeutic response at the point of sentencing for offenders with mental health problems. The significant increase in the provision of MHTR community orders in the first year of the project has been associated with a decrease in the number of psychiatric reports requested that are time consuming and do not lead to a rapid treatment.

This study aims to explore whether female psychiatric homicide offenders form a distinct group when compared to women who have committed other types of serious violent offences.

A range of background and psychological characteristics for 13 homicide and 13 non‐homicide offenders, matched by date of birth, were compared. In addition, change in psychological and behavioural presentation after 12 months stay at a registered charity trust hospital in England was considered.

The findings indicate that the two groups were broadly similar, although the non‐homicide violent offenders had somewhat more troubled backgrounds. The two groups responded similarly to treatment, although the homicide offenders displayed significantly fewer aggressive risk behaviours whilst in care.

It is concluded that the two groups present with similar needs, with indications of greater treatment need for polynomial substance misuse for the non‐homicide group.

This is the first study to compare directly these two specific groups of violent female offenders, considering both static background variables, and behaviour whilst in security.

In this study we demonstrate how the Health of the Nation Outcomes Scales for secure and forensic service users (HoNOS‐secure) tracks risk and recovery in men with mental illness and men with learning disability in a secure care pathway. Total and individual HoNOS‐secure item ratings made by multi‐disciplinary teams across the course of a period of admission (mean 15 months) for 180 men were examined. There was significant positive change on the clinical and risk‐related scales of HoNOS‐secure for patients in the learning disability care pathway (N = 48) between initial and final ratings. In the mental health care pathway (N = 132 patients) an apparent lack of change masked a more complex picture, where initial decline in HoNOS‐secure ratings was succeeded by significant improvement. Results suggest that it is challenging to measure clinical and risk‐related medium‐term clinical outcomes objectively for these patients, particularly in relation to core issues of treatment of mental disorder, and reduction of both problem behaviour and risk to others. However, it is important that practitioners continue to strive to demonstrate the benefits of care and treatment through appropriate outcomes measures.

The purpose of this paper is to review the empirical literature informing the nature of the relationship between criminal behaviour and both Alexithymia and Asperger's syndrome (AS).

The relevant literature was identified through database searches and via citations in primary sources.

Alexithymia and AS are relatively similar constructs with some overlap in their defining characteristics including utilitarian thinking and deficiencies in empathy. Alexithymia is significantly more prevalent in offender populations than controls and, in particular, has a complex relationship with psychopathy. The research concerning AS has mainly focused on offense type and reasons for offending. In terms of offences, homicide rates were in keeping with general base rates, however, sexual offences were under-represented and arson was over-represented.

In terms of reasons for offending, criminal behaviour is best described as a consequence of the classical characteristics of AS. It is suggested that despite their similarities the relationship of the two disorders with criminal behaviour may well be different. This suggestion has implications for the design of services intended to reduce the risk of offending in these two groups.

The review draws together a diverse range of literature around a rather neglected topic in criminological psychology. It will be of value to researchers in suggesting where new knowledge is needed, particularly with regard to disentangling the risk factors for offending for the two conditions, and to practitioners within the criminal justice system in pointing towards areas for intervention to reduce risk.