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Article
Publication date: 1 June 2008

Carol Ireland

This paper will discuss the potential impact of a range of cognitive impairments when working with sex offenders who present with them. It will begin by outlining the…

Abstract

This paper will discuss the potential impact of a range of cognitive impairments when working with sex offenders who present with them. It will begin by outlining the nature of cognitive impairment and the research examining the extent of such difficulties in sex offenders. It will then explore the impact of such impairments when engaging a sex offender in treatment, including the role that cognitive impairment might play in the function of their offence. Finally, some methods by which to manage and compensate for cognitive impairments will be presented. While the focus of this paper is on sex offenders, the issues presented in this paper are not exclusive to this group and may be applied to offenders in general.

Details

The British Journal of Forensic Practice, vol. 10 no. 2
Type: Research Article
ISSN: 1463-6646

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Article
Publication date: 14 March 2016

Jacqueline Bloomfield, Damith Woods and Jason Ludington

The purpose of this paper is to review and provide information on the small but growing body of literature that demonstrates that some people with Parkinson’s disease (PD…

Abstract

Purpose

The purpose of this paper is to review and provide information on the small but growing body of literature that demonstrates that some people with Parkinson’s disease (PD) are unaware of the memory impairment, and this has clinical implications for how family members care for their loved one, and how clinical staff and others may interact with them on a day-to-day perspective.

Design/methodology/approach

The approach takes the form of a general review.

Findings

People with PD experience a variety of cognitive impairment including deficits in memory and higher level executive processes. Impairment in these areas can occur early in the disease course and result in adverse consequences including distractibility, trouble recalling information, and problems remembering to execute planned actions like adhering to medication regimes. The literature also suggests heterogeneity in both the memory performance of people with PD and in the definition of awareness used to investigate this phenomenon.

Practical implications

Strategies for remembering may be of practical importance for people with PD, and/or caregivers should be introduced and educated to the nature of memory impairment in PD, as well as its likely course and natural progression in a non-threatening way before they are later instructed on “tips” for maximising daily functioning as more severe cognitive deficits begin to appear.

Originality/value

This paper adds to the small body of literature that investigates patients’ awareness of memory impairment in PD and advocates for ongoing research within the area.

Details

Working with Older People, vol. 20 no. 1
Type: Research Article
ISSN: 1366-3666

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Article
Publication date: 7 August 2019

Sophie Moore, Rebecca Wotus, Alyson Norman, Mark Holloway and Jackie Dean

Brain Injury Case Managers (BICMs) work closely with individuals with Acquired Brain Injury (ABI), assessing needs, structuring rehabilitation interventions and providing…

Abstract

Purpose

Brain Injury Case Managers (BICMs) work closely with individuals with Acquired Brain Injury (ABI), assessing needs, structuring rehabilitation interventions and providing support, and have significant experience of clients with impairments to decision making. The purpose of this paper is to explore the application of the Mental Capacity Act (MCA) and its guidance when applied to ABI survivors. This research aimed to: first, highlight potential conflicts or tensions that application of the MCA might pose, and second, identify approaches to mitigate the problems of the MCA and capacity assessments with ABI survivors. It is hoped that this will support improvements in the services offered.

Design/methodology/approach

Using a mixed method approach, 93 BICMs responded to an online questionnaire about decision making following ABI. Of these, 12 BICMs agreed to take part in a follow-up semi-structured telephone interview.

Findings

The data revealed four main themes: disagreements with other professionals, hidden disabilities, vulnerability in the community and implementation of the MCA and capacity assessments.

Practical implications

The findings highlight the need for changes to the way mental capacity assessments are conducted and the need for training for professionals in the hidden effects of ABI.

Originality/value

Limited research exists on potential limitations of the application of the MCA for individuals with an ABI. This paper provides much needed research on the difficulties surrounding mental capacity and ABI.

Details

The Journal of Adult Protection, vol. 21 no. 4
Type: Research Article
ISSN: 1466-8203

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Article
Publication date: 1 December 2007

Ekkehart Staufenberg

This paper is based on seminar, workshop and lecture materials presented at national and international conferences, and follows an invitation to cover this topic as part…

Abstract

This paper is based on seminar, workshop and lecture materials presented at national and international conferences, and follows an invitation to cover this topic as part of a one‐day conference on mental health issues in autism spectrum disorders (Staufenberg, 2005; 2007). The paper will seek to a) outline a review of the current evidence base and clinical approaches to the appraisal of risk behaviour or aggressive conduct in general and forensic psychiatric practice, before b) reviewing the current issues in the clinical risk appraisal in individuals with complex neurodevelopmental syndromes of the high functioning autism spectrum, and in particular Asperger's syndrome.References based on clinical and structured instrument‐based risk appraisal will also introduce the pertinence of assessing personality traits in individuals with Asperger's syndrome, with specific reference to forensic neuropsychiatry‐based expertise and case vignettes. A discussion of potential research directions and collaborations will conclude this introductory guide to the emerging field of forensic developmental neuropsychiatry.

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Article
Publication date: 10 April 2017

Michael Preston-Shoot

The purpose of this paper is twofold: first, to update the core data set of self-neglect serious case reviews (SCRs) and safeguarding adult reviews (SARs), and…

Abstract

Purpose

The purpose of this paper is twofold: first, to update the core data set of self-neglect serious case reviews (SCRs) and safeguarding adult reviews (SARs), and accompanying thematic analysis; second, to respond to the critique in the Wood Report of SCRs commissioned by Local Safeguarding Children Boards (LSCBs) by exploring the degree to which the reviews scrutinised here can transform and improve the quality of adult safeguarding practice.

Design/methodology/approach

Further published reviews are added to the core data set from the websites of Safeguarding Adults Boards (SABs) and from contacts with SAB independent chairs and business managers. Thematic analysis is updated using the four domains employed previously. The findings are then further used to respond to the critique in the Wood Report of SCRs commissioned by LSCBs, with implications discussed for Safeguarding Adult Boards.

Findings

Thematic analysis within and recommendations from reviews have tended to focus on the micro context, namely, what takes place between individual practitioners, their teams and adults who self-neglect. This level of analysis enables an understanding of local geography. However, there are other wider systems that impact on and influence this work. If review findings and recommendations are to fully answer the question “why”, systemic analysis should appreciate the influence of national geography. Review findings and recommendations may also be used to contest the critique of reviews, namely, that they fail to engage practitioners, are insufficiently systemic and of variable quality, and generate repetitive findings from which lessons are not learned.

Research limitations/implications

There is still no national database of reviews commissioned by SABs so the data set reported here might be incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. This makes learning for service improvement challenging. Reading the reviews reported here against the strands in the critique of SCRs enables conclusions to be reached about their potential to transform adult safeguarding policy and practice.

Practical implications

Answering the question “why” is a significant challenge for SARs. Different approaches have been recommended, some rooted in systems theory. The critique of SCRs challenges those now engaged in SARs to reflect on how transformational change can be achieved to improve the quality of adult safeguarding policy and practice.

Originality/value

The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice. The paper also contributes new perspectives to the process of conducting SARs by using the analysis of themes and recommendations within this data set to evaluate the critique that reviews are insufficiently systemic, fail to engage those involved in reviewed cases and in their repetitive conclusions demonstrate that lessons are not being learned.

Details

The Journal of Adult Protection, vol. 19 no. 2
Type: Research Article
ISSN: 1466-8203

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Article
Publication date: 26 October 2020

Sandra Verhülsdonk, Ann-Kristin Folkerts, Barbara Höft, Tillmann Supprian, Josef Kessler and Elke Kalbe

The purpose of this study is to collect the first empirical data on the cognitive state of elderly prisoners in Germany and to examine associations between cognitive…

Abstract

Purpose

The purpose of this study is to collect the first empirical data on the cognitive state of elderly prisoners in Germany and to examine associations between cognitive function and sociodemographic, clinical and incarceration characteristics.

Design/methodology/approach

All prisoners aged 60 years and older of five prisons in North Rhine-Westphalia, Germany, were asked to participate. The cognitive screening instruments mini-mental state examination (MMSE) and the DemTect were used to assess global cognition. Executive functions were tested with the trail making test and the frontal-assessment-battery. The Patient Health Questionnaire (PHQ-9) was used to assess participants’ affective state.

Findings

The sample of this study consisted of 58 prisoners with a mean age of 65.52 years (standard deviation = 6.03); 82.8% are male. Using the MMSE with age- and education-corrected z-scores, 36.9% of the prisoners showed marginal or impaired global cognition scores. Using the DemTect, 41.4% of the prisoners were classified as being cognitively impaired. Up to 40% of the prisoners showed deficits in executive functioning and around 60% of the prisoners showed depressive symptoms. The correlation analysis revealed significant associations between cognitive scores and age (rho = –0.335, p = 0.014), education (rho = 0.309, p = 0.020), sentence duration (rho = 0.409, p = 0.007) and duration of current incarceration (rho = 0.302, p = 0.043). The DemTect total score was significantly associated with the PHQ-9 (rho = –0.335, p = 0.016).

Practical implications

A large group of the prisoners showed a higher prevalence of cognitive dysfunction than that observed in same-age people who are not incarcerated. Taken together, there is an urgent need for an adequate management of older cognitively impaired prisoners including routine cognitive testing and guidelines-oriented treatment of cognitive symptoms.

Originality/value

This study has several strengths. To the best of the authors’ knowledge, this is the first study examining the cognitive and affective state in a German prison population. The authors considered female and male prisoners, as well as different prison settings, representing a realistic prison sample. The authors used several neuropsychological instruments to get a more detailed insight into the older prisoners’ cognitive status while trying to consider the economy of time and possible attention deficits to prevent dropouts during testing.

Details

International Journal of Prisoner Health, vol. 17 no. 2
Type: Research Article
ISSN: 1744-9200

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Article
Publication date: 4 November 2014

Mark Holloway

The purpose of this paper is to examine the research into prevalence of acquired brain injury in non-ABI specialist services, the impact of the invisible aspects of…

Abstract

Purpose

The purpose of this paper is to examine the research into prevalence of acquired brain injury in non-ABI specialist services, the impact of the invisible aspects of executive impairment and loss of insight upon functioning and to question how this is assessed and managed by generalist services.

Design/methodology/approach

A literature search was undertaken to identify where people with an ABI may come in to contact with services that are not specifically designed to meet their needs.

Findings

ABI is prevalent amongst users of a variety of community, inpatient and criminal justice services. The common albeit invisible consequences of ABI complicate assessment, service use and or treatment particularly in the context of a lack of under pinning knowledge and experience amongst the staff in non-specialist ABI services. As a consequence risks to children and adults are increased, opportunities for rehabilitation and growth are lost and human potential squandered. Addressing the first stage in this process, developing knowledge of the consequences of ABI and how to assess need, is a pre-requisite for change.

Practical implications

An absence of basic underlying knowledge of the consequences of ABI impacts upon assessment and so limits the effectiveness of services. A consequence of this is manifest in the over-representation of people with an ABI to be found in non-specialist settings.

Originality/value

–Little research is undertaken from a social and community perspective into the impact of ABI over the longer term for those who have no contact with specialist services and yet, quite clearly by their use of other services, have unidentified, unrecognised and un-responded to needs.

Details

Social Care and Neurodisability, vol. 5 no. 4
Type: Research Article
ISSN: 2042-0919

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Article
Publication date: 21 November 2016

Rahul Rao

The assessment of cognitive impairment in community services for older people remains under-explored. The paper aims to discuss this issue.

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Abstract

Purpose

The assessment of cognitive impairment in community services for older people remains under-explored. The paper aims to discuss this issue.

Design/methodology/approach

Cognitive impairment was examined in 25 people aged 65 and over with alcohol use disorders, on the caseload of community mental health services over a six-month period. All subjects assessed using Addenbrooke’s Cognitive Assessment (ACE-III).

Findings

In total, 76 per cent of the group scored below the cut-off point for likely dementia but only 45 per cent of people scored below the cut-off point for tests of language, compared with 68-84 per cent people in other domains.

Research limitations/implications

This finding has implications for the detection of alcohol-related brain cognitive impairment in clinical settings.

Practical implications

Standardised cognitive testing is common within mental health services for older people, but may also have utility within addiction services.

Social implications

The early detection of alcohol-related cognitive impairment can improve social outcomes in both drinking behaviour and the social consequences of alcohol-related dementia.

Originality/value

This may be the first published study of cognitive impairment in patients under a mental team for older people with alcohol use disorders and offers some unique findings within this sampling frame.

Details

Advances in Dual Diagnosis, vol. 9 no. 4
Type: Research Article
ISSN: 1757-0972

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Abstract

Details

The Broad Autism Phenotype
Type: Book
ISBN: 978-1-78441-657-7

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Article
Publication date: 28 June 2021

Nicolle Robertson, Adam Qureshi and Rebecca L. Monk

This study aims to represent a first attempt to examine in a non-clinical population the interplay between social engagement, executive function (EF) and theory of mind…

Abstract

Purpose

This study aims to represent a first attempt to examine in a non-clinical population the interplay between social engagement, executive function (EF) and theory of mind (ToM) within a social motivation theory framework.

Design/methodology/approach

A total of 170 participants (135 female; mean age = 19.01 and standard deviation = 1.27) completed measures of ToM (Faux Pas task), autistic traits (Autism Spectrum Quotient), social engagement (reward dependence subscale of the Temperament and Character Inventory), sociability and EF (both subscales of the Adult Temperament Questionnaire).

Findings

Path analyses found that EF, sociability and social engagement were negatively associated with autistic traits both directly and indirectly. Results indicate that EF may impact sociability and social engagement and their interaction may relate to the degree of autistic traits shown in a typical sample. However, ToM (as measured by the Faux Pas test) was not related to any of the other variables.

Originality/value

Sociability, social engagement and effortful control deficits may be linked to higher levels of autistic traits. These factors appear to form a hierarchy of factors underpinning autism spectrum disorder, with EF contributing to all aspects, followed by sociability and social engagement at a higher level. Future research examining in clinical populations the utility of a more integrated model of social motivation that incorporates EF appears warranted.

Details

Advances in Autism, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-3868

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