• Preliminary psychomotor stress studies with subnormal psychopathic subjects

      Tong, John E. (1960)
      IN a series of research studies concerned with stress reactivity in adult male patients of subnormal intelligence quotient (I.Q.) and of known delinquent or psychopathic history, it has been established that stability, and possibly prognosis, are related to behavioural and physiological measures of stress reactivity1,2. Stress reactivity has been regarded as a continuous single variable, and it seems that instability corresponds with very high or very low reactivity, and stability with moderate reactivity, findings which are similar to those of Lykken3, for primary and neurotic sociopaths, and the views of Eysenck4,5 and Franks6,7, concerning introversion-extraversion and conditionability. In general, physiological measures, such as the conditioning-rate of the galvanic skin response, correlate more highly with various social criteria than do behavioural measures. This is for three reasons: (a) the physiological techniques reduce extraneous stimulus and response factors to a minimum; (b) the techniques are applicable to subjects of quite low I.Q., for example, down to 60; (c) the responses usually indicate a required range of scores from unreactivity to high reactivity. © 1960 Nature Publishing Group.
    • The eysenck personality inventory in male and female subnormal psychopaths in a special security hospital

      McKerracher, David W.; Watson, R. A. (1968)
      The EPI was administered to a sample of 264 male and female subnormal psychopaths at a special security hospital. The males were not significantly different from the general population norms in Neuroticism and Extraversion. The females were significantly more neurotic than the males and the general population. Both sexes were higher than the normal range in the Lie scale, and male patients lied more than female patients about their behaviour. The majority of female patients described themselves as neurotic extraverts, as hypothesized by Eysenck (1964). No similar trend was observed in the males. Lying was found to be correlated with intelligence in both sexes, and with age in males. ‘Liars’ congregated mainly in the non‐neurotic introvert quadrant and ‘truth‐tellers’ in the neurotic extravert. The ‘absolute’ meaning of these personality categories was considered to be obscured by (a) misinterpretation of the wording in some items, and (b) motivational distortion due to the circumstances of obtaining test results from a criminal population interviewed for clinical rather than for research purposes. 1968 The British Psychological Society
    • Addiction to violence: A new model of psychopathy

      Hodge, John E. (1992)
      Our understanding of the Mental Health Act 1983 category of psychopathic disorder is not enhanced by describing it as a personality disorder. A new operational concept of psychopathic disorder would greatly assist in both diagnosis and treatment planning. This paper proposes that psychopathic disorder has its origins in post-traumatic stress disorder (PTSD) consequent on childhood sexual and physical abuse. Such abuse is common in the background histories of psychopaths. Recent research on PTSD in Vietnam veterans has suggested that it is often associated with an increase in aggression and violence. In some veterans violent behaviour can assume the characteristics of an addiction, while at the same time becoming indistinguishable from the behaviour of violent psychopaths. Conceptualising psychopaths as being addicted to violence as a consequence of a developmentally mediated PTSD leads to many new avenues of possible treatment.
    • Psychopathic disordered, mentally ill, and mentally handicapped sex offenders: A comparative study

      Briggs, David (1992)
      Although there currently exists a large amount of research on the characteristics and treatment of psychopathic disordered (PD) sex offenders, little if any empirical studies have addressed the mentally ill (MI) and mentally handicapped (MH) offender populations. A total of 106 PD, MI, and MH sex offender records from Rampton (Special) Hospital were reviewed for the study. Offender categories were compared by age of first documented sex offence, IQ at the time of admission, sex offence type, frequency of each offence type, history of violence during sex offences, age and gender of sex offence victims and number of victims for age and gender. Results revealed that 88 per cent of PD, 98 per cent of MI, and only 56 per cent of MH offenders' victims were female. Further analysis revealed that PD and MI offenders' victims were primarily female, with the largest proportion being pubescent and adult females. MH offender victims were primarily males and females under the age of 16. IQ correlated positively with history of violence during sexual assault and mean IQs were higher for ‘violent’ than ‘non-violent’ offenders in each offender category. A discussion of these and other significant findings, as well as implications for clinical treatment, is presented. © 1992, The British Academy of Forensic Sciences. All rights reserved.
    • New thoughts on psychopathy and addiction

      Hodge, John E. (1992)
      In this series we invite mental health researchers to describe briefly important concepts or research findings that have emerged during the last decade. The aim is to keep mental health workers informed of new findings and new developments which are likely to have practical implications. © 1992 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.
    • A training and development strategy for clinically based staff working with people diagnosed as having psychopathic disorders

      Hughes, Gareth; Tennant, Allison (1996)
      There is a growing consensus that cognitive/behavioural methods of treatment are the most effective techniques in reducing offender recidivism. Consequently, these may be the treatment of choice in working with offenders who are detained under the Mental Health Act 1983 with the classification of psychiatric disorder. An effective strategy for the training of nurses and other ward-based staff is seen as essential to the effective cognitive/behavioural treatment of patients with psychopathic disorder. This article describes the implementation of a flexible training approach. This approach is multifaceted and enables staff to be trained to different levels of proficiency.
    • First-stage evaluation of a treatment programme for personality disordered offenders

      Hughes, Gareth; Hogue, Todd E.; Champion, Helen (1997)
      A first-stage evaluation of a treatment programme for personality disordered offenders conducted in a high-security setting is reported. Drawing on the literature, the treatment programme was designed to modify a range of clinical targets. The marked lack of standardized measures made fine-grained evaluation impossible to achieve. A methodology was therefore employed that was based on global change over an amalgam of outcome measures. Analysis revealed significant clinical gains as assessed by the global change measure. Level of global change did not correlate significantly with age, IQ, time in institutions, or time at risk. However, scores on the Psychopathy Checklist Revised (PCL-R) showed a significant negative correlation with global change. Further, analysis showed that this negative relationship was due to scores on PCL-R factor 1 (interpersonal style) not factor 2 (unstable lifestyle). The findings with regard to PCL-R scores both are consistent with the literature and show the importance of considering the factor structure of that instrument. It is concluded that this preliminary study has shown that positive clinical gains can be made in secure settings with a traditionally difficult patient group.
    • 'Men talking' about dysfunctional masculinity: An innovative approach to working with aggressive, personality disordered offender-patients

      Tennant, Allison; Hughes, Gareth (1998)
      Traditional concepts of masculinity may have important links with aggressive and criminal behaviour. Furthermore when such concepts form part of men's core beliefs about themselves, they appear to be highly dysfunctional with respect to their willingness to engage in treatment. This paper outlines some of the problems arising from dysfunctional concepts of masculinity and describes a first attempt to implement a group programme designed to address these problems with mentally disordered offenders in a maximum security setting. We describe some of our experiences with a small pilot group of male personality disordered violent offenders who participated in an 18 session weekly group programme, and offer some tentative results. The results show some change of attitude, with increased levels of motivation and participation in the group process, and an increased willingness to participate in treatment designed to address specific offence related problem areas.
    • Substance misuse and violence: A comparison of special hospital inpatients diagnosed with either schizophrenia or personality disorder

      Corbett, Mark; Duggan, Conor; Larkin, Emmet P. (1998)
      There is increasing interest in the relationship between schizophrenia, substance misuse and serious violence. We compared the pattern of substance misuse in inpatients with schizophrenia convicted of serious offences with that of a matched group with personality disorder. We also compared those with and without a history of substance misuse in their use of drugs or alcohol at the time of their violent index offence. We matched 75 substance misusing patients with schizophrenia with a group of patients with personality disorder and compared the types of substances misused in both groups. We compared these two groups with a larger sample of inpatients without a history of substance misuse to determine the presence of substance misuse at the time of the index offence. No differences were found between the matched groups in their choice of drugs. Drug abusing male inpatients with a personality disorder were significantly more likely to have consumed alcohol at the time of the violent offence compared with the other groups. Although the reporting of substance misuse was unexpectedly low, our data (a) showed no evidence that patients with schizophrenia preferentially choose to misuse specific types of drugs compared with personality disordered patients and (b) that intoxication with alcohol at the time of the violent offence may be important in male patients with a personality disorder and a history of substance misuse.
    • The assessment and meaning of the legal classification of offenders in a Special Hospital using observer ratings of interpersonal style

      Collins, Mick; Larkin, Emmet P.; Duggan, Conor (1999)
      Disturbed interpersonal functioning is believed to be a cornerstone of personality disorder. We sought to determine differences in interpersonal functioning between patients detained under the Mental Health Act classifications of psychopathic disorder and mental illness. An observer-rated scale of interpersonal behaviour (CIRCLE) was administered to a mixed gender, Rampton Hospital sample of 92 patients classified as having psychopathic disorder and 92 matched patients classed as suffering from mental illness. Three-quarters of the initial sample (136 patients) were successfully assessed. Satisfactory inter-rater reliability was achieved (intra-class correlation coefficients between 0.72 and 0.55), although some potential for rater bias was identified. We found statistically significant differences between the two groups for four of the eight octants of the interpersonal circle and the two groups were typically represented in opposing halves of the interpersonal circle. The significant differences in interpersonal functioning between the two groups suggest that the current legal categorization has some validity. Our results are generally in accordance with findings from previous work in another English Special Hospital and may be generalizable to other similar settings. The CIRCLE may provide a simple tool to assist in the assessment and management of the personality disordered in secure hospitals.
    • Criminal cognitions and personality: What does the picts really measure?

      Egan, Vincent (2000)
      Introduction: The Psychological Inventory of Criminal Thinking Styles (PICTS) is a measure of the criminal cognitions and thinking styles that maintain offending. The scale comprises 8 a priori thinking styles and two validation scales, the validation scales having been found to be unreliable. Owing to the large amount of apparently shared variance in the original validation study, this data matrix needs re-analysis. Results from the PICTS were examined in relation to general measures of individual differences, in order to link the PICTS to the broader literature on the characteristics of offenders. Method: The original PICTS data-matrix was re-analysed using a more parsimonious method of analysis. The PICYS was also given to 54 detained, mentally disordered offenders along with the NEO-Five Factor Inventory, the Sensation-Seeking Scale (SSS), the Attention Deficit Scales for Adults (ADSA) and, as a measure of general intelligence, the Standard Progressive Matrices. Results; Principal components analysis suggested that the PICTS really comprised two factors: A lack of thoughtfulness (i.e. lack of attention to one's experience), and wilful hostility, with the first factor being most well defined. Intelligence was not associated with any factor of criminal thinking style. High scores on the ADSA and Disinhibition and Boredom Susceptibility subscales of the SSS were associated with much greater endorsement of criminal sentiments; high Neuroticism, low Extroversion, and low Agreeableness were slightly lower correlates. Discussion: The issues involved in criminogenic cognitions need clarification and to be linked to the broader literature on cognitive distortions and personality. Interventions targeted at dismantling impulsive destructive behaviour, whether it be thoughtlessness or wilful hostility, may be effected by increasing thinking skills, so breaking down the cognitions that maintain criminal behaviour.
    • Assessment of personality disorder for individuals with offending histories

      Hogue, Todd E. (2000)
      The problems of those who encounter penal and mental health systems, and sometimes challenge the boundaries of both, are typically extremely complex. Consequently, the assessment process is a critical tool in the successful management of the difficulties presented by this group. Such assessment suggests opportunities for intervention where previous strategies are no longer working usefully, or have become excessively punitive. This paper provides a brief outline of current assessment aims, a summary of some of the measures used to obtain information about interpersonal behaviour in clinical and other settings, and some observations on the study of personality change in such institutions. (PsycINFO Database Record (c) 2017 APA, all rights reserved) (Source: journal abstract)
    • The NEO-FFI: Emerging British norms and an item-level analysis suggest N, A and C are norms reliable than O and E

      Egan, Vincent (2000)
      The NEO Five Factor Inventory (NEO-FFI) was given to 1025 British subjects as part of three independent research studies. Data from these studies were pooled and subjected to item-level analyses. Using standard scoring criteria from the measure provisional British norms were produced which were broadly equivalent to those obtained in the USA. The individual subscales showed good internal consistency. However, the item-level principal components analysis using varimax and oblique rotation and confirmatory factor analysis revealed that only the Neuroticism, Agreeableness and Conscientiousness traits were coherently represented in the main factors derived by the analysis. Openness and Extraversion factors did not show such stability or consistency. It is argued that as a result of these difficulties, thoughtlessly embracing the NEO-FFI as a quick and efficient instrument for measuring the 'Big Five' personality traits is perhaps premature, as the instrument requires modification and improvement before it can truly be regarded as measuring five independent personality traits. (C) 2000 Elsevier Science Ltd. All rights reserved.
    • A postal survey of the assessment procedure for personality disorder in forensic settings

      Milton, John (2000)
      Aims and method: A survey of 50 in-patient forensic health care and prison services in England, Wales and Scotland was employed to evaluate: (a) how severe personality disorder is assessed; and (b) how assessments compare with recommendations concerning standardised assessment by the Working Group on Psychopathic Disorder (Reed, 1994). Results: Seventy per cent of services responded, of whom 40% formally assessed personality disorder. Fifty-four instruments were routinely employed. Assessments of personality structure and cognitive/emotional styles were more common than structured diagnostic instruments or ratings of interpersonal functioning. Of the assessment tools, 25.7% of services provided at least one suggested by Reed (1994). Clinical implications: A nationally agreed, focused repertoire of instruments should be encouraged within secure forensic settings offering assessments to individuals with severe personality disorder.
    • 'Stop & Think!': Social problem-solving therapy with personality-disordered offenders

      McMurran, Mary; Fyffe, Stephen; McCarthy, Lucy; Duggan, Conor; Latham, Andrew (2001)
      Background: In this paper, the authors describe 'Stop & Think!', a social problem-solving intervention implemented with personality-disordered males resident on a dedicated personality disorder unit (PDU) within Arnold Lodge, a secure forensic psychiatric unit in Leicester, UK, as part of an integrated, multidisciplinary treatment programme. The problem-solving approach consists of seven steps: (1) orientation, (2) problem definition, (3) goal setting, (4) generation of alternatives, (5) decision making, (6) action, and (7) evaluation. Efforts to integrate the 'Stop & Think!' problem-solving process with individual and other therapies are described. Results: Using the Social Problem-Solving Inventory-Revised with 14 PDU patients at three and nine months after the commencement of 'Stop & Think!', significant improvements were recorded on all scales and subscales apart from Positive Problem Orientation. Change was maintained at 15 months for eight patients, with no significant further improvement. Recommendations for developments in assessment and treatment are made.
    • Controlling angry aggression: A pilot group intervention with personality disordered offenders

      McMurran, Mary; Charlesworth, Philip; Duggan, Conor; McCarthy, Lucy (2001)
      Describes the progress of 4 male, legally-detained personality disordered offenders (aged 19-42 yrs) in a group treatment program for angry aggression. "Controlling angry aggression" is a 15-session, structured, cognitive-behavioral program that is part of a wider integrated, multidisciplinary treatment program run within a specialist personality disorder treatment unit. Psychometric tests showed that 3 of the 4 patients improved over the course of the treatment program. Behavior ratings of staff and patients concurred, allowing confidence in patients' self-report of anger. No change in behavior was evident over time for any patient, but initial low rates of aggression allowed little room for improvement. Self-monitored anger and aggression scores did vary markedly over time, and since behavior remained stable despite anger, this indicates that these patients can control their behavior. One patient did not improve, and reasons for this are examined, concluding with a reminder of the need for rigorous selection of patients for treatment programs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)