• Abstraction ability and impairment: The barrow hospital sorting test in clinical psychological testing

      Tong, John E. (1955)
      "The current paper describes the use of a modified scoring system for the Sorting test, and the application of the test to a group of psychotic and non-psychotic subjects. The relative difficulty of the subtests is examined, and the relationship of the test scores and diagnostic signs to those of the Wechsler Vocabulary and Similarities Tests, the Raven Matrices test and Rorschach test features, is also described. The effect of age and sex is discussed, and it is shown that the main differential sign (patterning) may be related to Rorschach diagnostic signs. Certain practical issues concerning the use of the test are also touched upon, e.g. its use with severely disturbed patients and those of low intelligence, the possibility of modifications and the question of the test providing information not gained from other tests or clinical examination." (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Validation of a short form WISC with clinic children

      McKerracher, David W.; Watson, R. A. (1968)
      Summary. One‐hundred‐and‐twenty‐seven children tested at a child guidance clinic were given a full scale WISC in the course of their examination. Prorated IQs were calculated from four of the ten sub‐tests (Arithmetic, Vocabulary, Picture Arrangement and Block Design). These prorated IQs correlated + 0·96 with full scale IQ and gave accurate indications of level of performance on the full scale. This shortened version is least suited for young children and children in the IQ range 70–89. 1968 The British Psychological Society
    • Developing risk assessment scales in forensic psychiatric care

      Robinson, David K. (1996)
      This article offers preliminary details about a current research programme, which seeks inter alia to develop and validate nursing assessments of potential dangerousness. The authors feel that there is a need to communicate these initial ideas while approaches are new and developing, rather than in 2 or 3 years' time when the research may be expected to yield substantive results.
    • Advancing observational quality methods for the measurement of forensic psychiatric care

      Robinson, David K. (1996)
      Discusses some of the current problems associated with observational quality measurement. Uses Lerninger's conceptual theory-generating model as the basis of discussion. Puts forward a qualitative approach which breaks away from the traditional methods.
    • The Behavioural Status Index: Therapeutic assessment of risk, insight, communication and social skills

      Robinson, David K. (1999)
      An overview is given of the Behavioural Status Index (BSI), a developing classification instrument offering practical approaches to assessment and therapy surrounding social 'risk'. The approach hypothesizes that social 'risk' presented by a patient tends to correlate inversely with his/her degree of personal insight and capacity to perform well in key communicative and social skills, though no causal claims are made. Evidence exists to suggest that personal insight and communicative and social skills deserve serious consideration in a therapeutic approach to violent and dangerous behaviours. 'Risky' behaviours, as operationalized in the 'risk' subscale of the BSI, insight into the self and its activities, and communicative and social skills, may provide three critical foci for treatment planning in high security psychiatric care. A hypothetical linked factorial structure is proposed.
    • 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.
    • Risk assessment and suicide prevention in primary care

      Milton, John; Ferguson, Brian G. (1999)
      General practitioners (GPs) are assumed to occupy an important position in the prevention of suicide through the introduction of risk assessment techniques commonly used in psychiatric practice. Despite this theoretical role for primary care services, it remains unclear how frequently GPs implement risk assessment in patients who may be vulnerable to suicide. To address this, a retrospective survey of probable suicides was conducted within a primary care setting utilizing a questionnaire of GPs who had experienced a patient suicide and was augmented by hospital and coroners' records. 85% of questionnaires were returned and 61 deaths were adjudged as suicides during the year long census period. 75% of suicides were male and 54% were aged under 35.28% were in contact with psychiatric services prior to death, although 60% had some diagnosis of mental disorder. GPs had little knowledge of a patient's life circumstances in up to half of cases. Recording of risk assessment occurred in 38% of subjects, was positively associated with prior psychiatric contact (p = 0.001) but negatively associated with presence of physical illness (p = 0.004), older patient age (p = 0.04), and GPs length in practice (p = 0.05). One GP felt their suicide case was preventable. The low rate of risk assessment and limited knowledge of patient lifestyle point to the need for active engagement of GPs in future suicide prevention strategies and should influence the content of training programs in primary care.
    • CORE: Clinical Outcomes in Routine Evaluation

      Evans, Chris (2000)
      Can different therapists, motivated by different theories and working in different settings, find a single measure - a 'core' - for monitoring their work? This paper introduces the Clinical Outcomes in Routine Evaluation (CORE) outcome measure, its philosophy, practice and utility. The measure is brief and acceptable to clients and therapists. It covers well being, problems/symptoms, life functioning and risk to self and others. It is easy to score by hand and is computer scannable. It measures individual differences on entry into therapy and change. Analyses of over 2,000 responses show good reliability and convergent validity against longer and less general measures; small gender effects; large clinical/non-clinical differences and good sensitivity to change. Referential clinical and non-clinical distributions and reliability enable calculation of clinically significant and reliable change criteria. Two short forms are available for frequent use within therapy and a centrally supported system will scan questionnaires and provide standardised reports and raw data.
    • 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.
    • Service profiling and outcomes benchmarking using the CORE-OM: Toward practice-based evidence in the psychological therapies

      Evans, Chris (2001)
      To complement the evidence-based practice paradigm, the authors argued for a core outcome measure to provide practice-based evidence for the psychological therapies. Utility requires instruments that are acceptable scientifically, as well as to service users, and a coordinated implementation of the measure at a national level. The development of the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) is summarized. Data are presented across 39 secondary-care services (n = 2,710) and within an intensively evaluated single service (n = 1,455). Results suggest that the CORE-OM is a valid and reliable measure for multiple settings and is acceptable to users and clinicians as well as policy makers. Baseline data levels of patient presenting problem severity, including risk, are reported in addition to outcome benchmarks that use the concept of reliable and clinically significant change. Basic quality improvement in outcomes for a single service is considered.
    • Sensational interests and sensation seeking in mentally disordered offenders

      Egan, Vincent; Charlesworth, Philip (2001)
      Examined the differences in sensational interests and sensation-seeking (SS) between patients detained under the Mental Health Act (1983) classifications of psychopathic disorder (PD) and mental illness (MI), the degree to which sensational interests related to sensation-seeking, and the relationship between these factors and self-reported personality disorders. The Sensational Interests Questionnaire (SIQ), Zuckerman's Sensation-Seeking Scale (SSS), the Standard Progressive Matrices (SPM) and the MCMI-II were given to 42 psychiatric patients (32 MI, 10 PD). There were no significant differences between the MI and PD groups for scores on the SIQ or the SSS. The SIQ was not related to scores on the SPM. As predicted, the SIQ's subscales of militarism and the violent-occult were significantly and positively associated with sensation-seeking, especially the SSS subscales of Disinhibition and Thrill and Adventure Seeking. Sensation-seeking mediated the relationship between sensational interests and measures of personality disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Towards a standardised brief outcome measure: Psychometric properties and utility of the CORE-OM

      Evans, Chris (2002)
      Background: An acceptable, standardised outcome measure to assess efficacy and effectiveness is needed across multiple disciplines offering psychological therapies. Aims: To present psychometric data on reliability, validity and sensitivity to change for the CORE-OM (Clinical Outcomes in Routine Evaluation - Outcome Measure). Method: A 34-item self-report instrument was developed, with domains of subjective well-being, symptoms, function and risk. Analysis includes internal reliability, test-retest reliability, socio-demographic differences, exploratory principal-component analysis, correlations with other instruments, differences between clinical and non-clinical samples and assessment of change within a clinical group. Results: Internal and test-retest reliability were good (0.75-0.95), as was convergent validity with seven other instruments, with large differences between clinical and non-clinical samples and good sensitivity to change. Conclusions: The CORE-OM is a reliable and valid instrument with good sensitivity to change. It is acceptable in a wide range of practice settings.
    • Using needs assessments to understand continuing disability in patients with enduring mental illness. Implications for considerations of service development

      Hopkins, Nigel (2002)
      Particular strengths of the MRC Needs for Care Assessment Schedule have been used to investigate the treatment status of patients with persistent psychiatric disability in ways that other needs assessment tools are unable to. One hundred and seventy-nine such patients from three settings; a private sector psychiatric hospital, two public sector day hospitals situated in the same town, and a high security hospital, were found to have a high level of need. Although there were differences between settings, overall these needs were well met in all three. The high level of persistent disability found amongst these patients could not be attributed to failure on the part of those treating them to use the best available methods, or to failures to comply or engage with treatment on the patient's part. In some two thirds of instances persistent disability was best explained by the fact that even the most suitable available treatments have to be considered only partially effective.
    • Risk assessment in offenders with intellectual disability: The evidence base

      Johnston, Susan J. (2002)
      A review of the current literature on risk assessment and management in offenders with intellectual disability (ID) revealed little direct evidence for the specific population. Theoretical models and non-ID populations have been abstracted and adapted, but not validated, for those with ID. The varying conceptual frameworks of risk, and its assessment and management, must be considered in context. Difficulties remain with the consideration of offences versus offence-like behaviour, offender versus those with similar needs, and indeed, what is regarded as 'intellectual disability'. Mainstream forensic assessment has moved towards a more dynamic appreciation of risk and risk management, as opposed to risk elimination. This development is more in line with the normalization principles of 'risk-taking' in ID. Consideration is given to future research and development priorities.;
    • The properties of self-report research measures: Beyond psychometrics

      Evans, Chris (2002)
      Self-report measures pertinent for personality disorder are widely used and many are available. Their relative merits are usually assessed on nomothetic psychometrics and acceptability to users is neglected. We report reactions of lay, patient and professional groups to the Personality Diagnostic Questionnaire (PDQ-IV); Millon Clinical Multiaxial Inventory (MCMI-III); the Borderline Syndrome Index (BSI); Rosenberg's Self-Esteem Scale (RSE) and the Social Functioning Questionnaire (SFQ). These were sent to 148 professionals, ex-patients and lay people for comment. Thirty-six per cent were returned. Pattern-coding by three raters revealed problematic themes across all measures, including inappropriate length, vague items and language, cultural assumptions and slang, state-bias and response-set. Measures can be depressing and upsetting for some participants (both patients and non-patients), hence administration of measures should be sensitive. Treatment may make people more self-aware, which may compromise validity for outcome research. This evaluation raises issues and concerns, which are missed in traditional psychometric evaluation.
    • The use of the PCL-R in forensic populations with learning disability

      Morrissey, Catrin (2003)
      Although the PCL-R is used widely for assessing forensic populations in general, there has been no published research on the reliability and validity of such assessments with offenders with a learning disability. The problems with applying the PCL-R with this population are discussed. The results of a pilot study analysing data collected for clinical purposes on a high-security hospital LD admission ward are described, and recommendations for further development and research are made.
    • An overview: DSPD programme concepts and progress

      Hogue, Todd E. (2003)
      The article focuses on the progress made toward developing services for individuals identified with Dangerous and Severe Personality disorder (DSPD). The article defines the DSPD programme, the structure of the programme and progress made in key areas of work, research and development, assessment and treatment. The background to the programme lies in the limited availability of specialist services for this group. Current mental health legislation can only be used to detain this group if they are considered 'treatable', yet professionals often disagree whether this is possible and this has often resulted in people with these characteristics being excluded from services. Despite the risk that they pose and the problems they face, too often they are not given access to interventions that might protect the public and help them achieve safe and successful re-integration into the community. The Government's proposals for the DSPD Programme are intended both to ensure that the public is protected from some of the most dangerous people in society and provide high quality services to improve their health outcomes and reduce risk. The DSPD Programme has now moved on from the initial work to launch the programme, to its main and longer-term implementation phase. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Substance use disorders in patients admitted to a medium secure unit: A comparison of three assessment measures

      Bloye, Darran (2003)
      The presence of co-morbid substance use disorders among individuals suffering from a severe mental illness has an adverse effect on risk-related behaviour and prognostic indicators. Using a multi-assessment approach, the study examined the prevalence and risk consequences of substance use disorders in the population of a medium secure unit, by comparing the assessments of professionals and the participants' self-reports. A sample of 58 inpatients was assessed using the severity of dependence scale (SDS), clinician rating scales (CRS), and a case-note questionnaire. For each assessment tool, a majority of the sample recorded a history of substance use disorder and risk-relevant substance use. The morbidity related to individual substances varied and there was support for the self-medication hypothesis of secondary substance misuse. Subjects identified by professionals as having problematic substance use appeared to have disproportionately avoided participation in the study, whereas the professionals did not differ significantly in their diagnosis of rates of substance use disorder. A multi-assessment approach enables a more comprehensive assessment of substance use disorders within a forensic population and this study further highlights the importance of developing therapeutic strategies for dual diagnosis patients.
    • Using the psychological inventory of criminal thinking styles with English prisoners

      Palmer, Emma J. (2003)
      Purpose. This study considers the use of the Psychological Inventory of Criminal Thinking Styles (PICTS) within an English prison population. Method. The reliability and validity of the PICTS scales were investigated, and scores compared with data from an American prison population. Results. The results suggested that the PICTS was functioning in a similar way in both populations, although the English population's scores were higher. The calculation of test-retest change scores over the duration of 6-12-month sentences allowed the sensitivity of PICTS scales to change over time to be analysed, an aspect of the PICTS functioning that had not previously been examined. This analysis over time suggested that even when the effect of age was controlled for, changes were occurring over the duration of the sentence. Conclusion. The potential of the PICTS as a measure of change, as well as assessment, is discussed.