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The study explored the relationship between self and informant reports of emotional problems in a forensic intellectual disability sample. The Emotional Problems Scales (EPS) (Prout & Strohmer, 1991), which comprises a Self Report Inventory (EPS‐SRI) and an informant Behaviour Rating Scale (EPS‐BRS), was routinely administered to 30 individuals with intellectual disability in a secure forensic setting, as part of a standard clinical assessment procedure. It was hypothesised that there would be a moderate relationship between corresponding scores on the EPS‐SRI and EPS‐BRS. However, there were no significant relationships between corresponding scales of the EPS‐SRI and EPS‐BRS, apart from the EPS‐SRI and EPS‐BRS scales measuring anxiety (r = .376, p<.05). The results continued to be non‐significant, even when positive impression management was controlled for. The findings suggest little relationship between self and informant ratings in a forensic intellectual disability sample, and therefore support the need to gather information from multiple sources when assessing such individuals.

There are few reliable psychometric measures of the psychopathology of offenders with intellectual disabilities (ID). However, previous research has indicated that the emotional problems scale (EPS) is useful in identifying a range of treatment needs and in predicting risk to self and others. The purpose of this paper is to compare the severity of the emotional and behavioural problems of a small sample of offenders with ID in medium and low secure services, as assessed by EPS. Additionally, the data are tentatively compared with those reported in previous research to precipitate discussion regarding the changes in clinical populations in secure care over time.

The study collected demographic and EPS data for patients with ID (n=25) on medium secure and a low secure wards. Data were collected as part of routine clinical practice, with EPS forms being completed by nursing and other multi-disciplinary staff.

It was found that there was no statistically significant difference in EPS scores between medium and low secure patients with ID. The authors also highlight differences between the current sample and the normative data collected by previous research.

The data regarding the psychopathology of medium and low secure patients with ID provide insight into the ever changing resourcing needs and risk profiles of this complex patient group. In addition, there is a dearth of empirical research that comments on the clinical differences observed over time in forensic populations. As the current data differ from pre-existing normative data, the potential shift in populations and also implications for the accuracy of clinical decision making based on the assessment are discussed.

Individuals with intellectual disability (ID) are known to experience increased emotional and behavioural concerns. The study aims to assess whether detained ID patients with a forensic history (IDPF) have increased difficulty managing their impulse control in comparison to detained ID patients without a forensic history (IDP). Using the externalising behaviour problems (EBP) subscale of the EPS, the study aims to compare the differences between the IDFP and IDP groups.

A total of 60 patients with ID detained under the Mental Health Act 1983 (Revised 2007) were assessed using the behaviour rating scale of the EPS. The outcome scores of the EBP were used to examine any observed differences between the scores of forensically involved patients [n = 34] and those without a forensic history [n = 26]. It was hypothesised that patients with a forensic history would display higher scoring on externalised behavioural problems (EBP) than patients without such a history.

Non-parametric testing revealed that there were no significant differences in EBP scoring between the two sample groups. These findings indicate that, for patients in the present study, no differences were detected in the presentation of these two distinct groups. In fact, with the exception of the verbal aggression subscale of the EBP, the other three subscales (physical aggression, non-compliance and hyperactivity) show that actually the IDP group displayed the higher ranked means in these subscales when compared with the forensically involved group.

These results indicate possible increased treatment needs within the IDP group and question whether offending history is necessarily a reliable predictor of ongoing hostility and behavioural concerns within similar inpatient services.

This study aims to evaluate the clinical effectiveness of the Mindfulness module of the “I Can Feel Good” programme, an adapted dialectical behaviour therapy (DBT) informed skills programme for a group of intellectually disabled offenders (IDOs).

The programme module was delivered to a group of five male IDOs detained under the Mental Health Act 1983 (Revised 2007) at an intellectual disability (ID) rehabilitation hospital based in the UK. The mindfulness module was 12 sessions in length, and it was evaluated using the emotional problems scale (EPS) and the cognitive and affective mindfulness scale-revised (CAMS-R) self-assessment and observational scale. These measures were administered pre- and post-module and used the staff report scales as a primary source of evaluation.

Non-parametric testing revealed that there was a reduction in scores post module on the externalising behaviour problem scale of the EPS and increased scores on the CAMS-R observational scale, which would indicate clinical improvement in the IDO’s behavioural presentation, although it was not statistically significant. The internalising behaviour problem scale showed increased signs of anxiety post module, this could be related to increased self-awareness. The CAMS-R self-reported measure indicated reduced mindfulness qualities following the module.

The results indicate that following the mindfulness module, there was a reduced level of challenging behaviour displayed by the patients with increased signs of emotional regulation. There was also an observed reduction in symptoms of depression and low self-esteem post module.

The purpose of this article is to evaluate the prevention programme EFFEKT‐E that was designed for preschool children of depressive mothers and contains an intervention for children and for mothers.

Research was carried out in mother‐child clinics in Germany. In total, 220 strained mothers, who were screened for elevated levels of depressive symptoms, were enrolled in the control and 186 in the training group. For evaluation, mothers rated emotional disturbance and social competence of the child as outcome measures before and after the training. Changes in parenting behaviour, perceived parental competence and parenting stress were also assessed.

An effect on emotional disturbance of the child emerged (d=0.52) in the training group. Perceived parental competence increased (d=0.72) and parental stress decreased (d=0.23) significantly under training. EFFEKT‐E has proven to be a valuable programme for preventing depression in offspring of mothers who feel depressed.

The article identifies the significance of focusing on parenting as a preventive intervention in the mechanisms of familial transmission of depression and evaluation of a family‐oriented programme for young children designed to achieve this.

Although school bullying is an important social problem, its long‐term relation to mental health and behavioural outcomes is rarely investigated. The purpose of this paper is to address the relation between bullying in childhood and behavioural and emotional problems in adolescence.

Bullying and victimization were assessed in a sample of 557 German children (mean age 9 years). Nearly five years later anxious, depressive, delinquent, aggressive and other outcomes were assessed via self‐ and mother‐reports. Data analyses contained bivariate correlations and hierarchical regressions in which family and individual risk factors (measured two years before bullying/victimization) were controlled.

It was found that there were mostly small, but highly significant correlations between bullying perpetration and later antisocial behaviour. Among girls, bullying also predicted later symptoms of anxiety, depression and social withdrawal. The same was the case for victimization. Victimized girls also showed more antisocial outcomes. When controlling for other risk factors, bullying perpetration remained as a predictor of externalizing problems, however, there were no significant relations between victimization and internalizing or externalizing outcomes.

This paper presents longitudinal data on a large sample from a country under‐represented in the English‐language literature on bullying, also its findings reveal that bullying perpetration is a highly significant predictor of later antisocial and delinquent outcomes in adolescence.

This paper describes an innovative, multi‐modular group therapy programme based on cognitive‐behavioural principles and psycho‐education. It introduces participants to strategies and skills to assist with deficits such as poor social skills, low self‐esteem, poor emotional regulation and problematic inter‐personal relationships. The manual‐based format of this programme enables members to be introduced to working in a group, and enables facilitators to obtain qualitative information about group members to promote existing skills in future treatment programmes. The core deficit areas targeted by the programme are not by any means exclusive to individuals in in‐patient forensic learning disability settings, so the programme can be useful for clients with learning disability and offending behaviours who are resident in the community.

Therapeutic Community (TC) approaches have not been applied to individuals with intellectual disability. This paper aims to present preliminary evaluation of a planned TC service intervention in a secure setting for men with mild intellectual disabilities and personality disorder over a period of 12 months.

The TC intervention group (n=11) was compared on repeated measures of violent incidents, seclusion hours, and informant and self‐report clinical outcome measures collected six months prior to, six and 12 months post the start of the intervention. The TC group was also compared with a pragmatic control group (n=10) receiving treatment as usual (TAU).

Clinical changes in the predicted direction were evident, with the TC group showing comparatively less pathology both over time and in relation to the comparison group. However, change was more likely for clinical scales measuring internalising problems, than for externalising problems. The mean number of violent incidents did not reduce over time. There was nevertheless a strong trend towards reduction in seclusion hours in the TC treatment group over time, with significant differences between groups also being observed at the six and 12 months stage.

The sample size is small. The literature suggests a minimum of 18 months in TC treatment, so this is an interim evaluation. The planned evaluation period is two years, although attrition may affect the numbers of participants in the study after this period.

TC treatment is consistent with the core principles of involvement and choice. The findings of this preliminary service evaluation are promising in terms of the TC approach being a potential mode of treatment suitable for a proportion of patients with learning disability in secure conditions.

TC approaches are innovative in forensic learning disability. No previous evaluations of TC based interventions have been published in this field, and this paper contributes to an evidence base.

Dialectical behaviour therapy (DBT) (Linehan, 1993) is a comprehensive psychological treatment that was first developed for suicidal individuals with a diagnosis of borderline personality disorder. The model has successfully been used to address violence and aggression in a forensic setting (Evershed et al, 2003). The National High Secure Learning Disability Service (NHSLDS) piloted an adapted DBT programme suitable for men with mild learning/intellectual disabilities in 2004, and the programme has been developed over a period of six years. This paper describes the rationale for development of the programme, how the programme has evolved, the major modifications to mainstream DBT that it incorporates, and the challenges that remain.

The “outcomes revolution” in healthcare has yet to impact strongly on secure intellectual disability (ID) services in the UK. The purpose of this paper is to review the service-level outcome studies that exist for this population, and to explore some of the challenges of conducting such research. It further describes some illustrative routine outcome data from the National High Secure Learning Disability Service.

Routinely collected outcome measures (length of stay; violent incidents; Emotional Problem Scale (EPS) Behaviour Rating Scale and EPS Self-Report Inventory) were analysed for two overlapping cohorts of patients resident in the high-secure service between 2008 and 2013.

The median length of stay of those discharged during the study period (n=27) was around 9.9 years (range one to 40 years). A significant proportion (25 per cent) of discharges resulted in an eventual return to high security. There did not appear to be a treatment effect over two to three years using staff-rated global clinical measures, but patient-rated clinical measures did reduce. Violent incidents also reduced significantly over a longer period of four years in treatment.

There are identified challenges to research design and outcome measurement which need to be addressed in any future cross-service studies.

There are relatively few published outcome studies from forensic ID services. None of the studies have used clinical measures of changes or patient-rated outcome measures.