Over the last ten years, there has been greater interest in the diagnosis of personality disorder (PD) in people with intellectual and developmental disabilities (IDD)…
Over the last ten years, there has been greater interest in the diagnosis of personality disorder (PD) in people with intellectual and developmental disabilities (IDD). One important characteristic of a diagnostic system is that it should have validity as a contribution to utility. PD has been found to have a predictive relationship with violence and the purpose of this paper is to review two methods for the diagnosis of PD in offenders with IDD in order to evaluate the utility of the diagnoses.
In total, 212 offenders with ID were recruited from three settings – maximum-security, medium/low security and community services. Diagnoses of PD in the case files were compared with a structured system of diagnosis based on DSM-IV traits.
There were significant differences between the two systems with a significantly higher frequency of PD diagnosis in the community forensic setting in the structured assessment system. There was no relationship between the case files diagnosis of PD and future violence but there was a significant predictive relationship between the structured diagnosis of PD and future violence with an AUC=0.62.
As with all such studies, the research is limited by the quality of the case files available to the researchers.
Only the structured assessment of PD had utility for the prediction of violence. Reasons for the differences between the systems are discussed and suggestions made on how a diagnosis of PD can be structured for the busy clinician.
The accurate diagnosis of PD has important implications since the PD is a crucial addition to any violence risk evaluation.
This study is the first of its kind to review the way in which clinicians assess PD.
This study was carried out as part of a larger study commissioned by the UK Department of Health to investigate the service pathways for offenders with learning…
This study was carried out as part of a larger study commissioned by the UK Department of Health to investigate the service pathways for offenders with learning disabilities (LD). The study covered three health regions in the UK and included 477 people with LD referred to services because of antisocial or offending behaviour during a 12‐month period. Data were collected concerning demographic, individual, offending behaviour and service characteristics. The findings of the study are broadly consistent with contemporary research concerning this population, particularly in relation to the nature and frequency of offending, history of offending, psychopathology, age and gender distribution. However, very few of those referred had any form of structured care plan, despite having significant offending histories, and this may have compromised early identification of their needs and communication between the health, social and other services involved.
Several studies have related diagnostic information and adversity in childhood to criminal careers and risk of recidivism. Notably, ADHD and conduct disorder in childhood…
Several studies have related diagnostic information and adversity in childhood to criminal careers and risk of recidivism. Notably, ADHD and conduct disorder in childhood, schizophrenia, sexual abuse and physical abuse have been associated with offences in adulthood. This study investigates these variables in relation to large cohorts of offenders with learning disabilities. A case note review was undertaken for 126 individuals referred but not accepted into forensic learning disability services and 197 individuals accepted for such services. Results are reported on diagnostic information and experience of adversity in childhood. ADHD/conduct disorder featured prominently in both groups. Autistic spectrum disorders were not particularly over‐represented. For adversity in childhood, general socioeconomic deprivation featured prominently in both groups. This also increased significantly for those accepted into services. Sexual abuse and non‐accidental injury were featured at around 13‐20% for both groups. These results are broadly consistent with the mainstream literature on offending, ADHD/conduct disorder and general deprivation featuring significantly in all groups and rising for those accepted into offender services. It is important to deal with these aspects during assessment and to provide appropriate psychotherapeutic services for these individuals.
Provides a comparison of the press coverage of the introduction of IVF in different contexts, giving a vantage point for examining the variability and the…
Provides a comparison of the press coverage of the introduction of IVF in different contexts, giving a vantage point for examining the variability and the context‐dependence of the issue. Sheds some light on the cultural‐political‐social problems that the new technology entails. Contrasts the differences between Canada and Israel, showing that both countries endorse modern technology in the field of medidine: in both countries, IVF was imported about the same time and both used the US and Britain as a frame of reference and model rather than local developments. Shows the cultural differences of how each culture embraced the new technology.
The Forensic Mental Health Services Managed Care Network is described, including the School of Forensic Mental Health. The purpose of this paper is to outline background…
The Forensic Mental Health Services Managed Care Network is described, including the School of Forensic Mental Health. The purpose of this paper is to outline background, it details successes and challenges, focuses on links to clinical practice for Learning Disabilities (LD) service development, describes education and training, multi-disciplinary and multi-agency working and quality improvement. Findings from a small scale brief educational study undertaken in the high-secure service are included as an example of good practice.
Specific features relating to LD are highlighted. Comparisons are made with other managed clinical and managed care networks.
The Forensic Network has evolved over time. It has played a crucial role in shaping Scotland’s approach to Forensic Mental Health and LD. Central to its success is active involvement of key stakeholders, a multi-agency approach and collaborative working practice. Future plans include formal evaluation of impact.
This paper offers an interesting perspective from a forensic mental health managed care network; the existing literature is limited.