Erik Søndenaa

The Prevalence and Nature of Intellectual Disability in Norwegian Prisons.

BACKGROUND The objective of the study was to calculate the prevalence of inmates with intellectual disabilities (ID), and identify historical, medical and criminological characteristics of a certain impact. METHODS A random sample of 143 inmates from a Norwegian prison cross sectional sample was studied. The Hayes Ability Screening Index (HASI) was validated with the Wechsler Abbreviated Scale of Intelligence (WASI). RESULTS The prevalence of inmates with ID, IQ < 70, was 10.8%. Some essential characteristics of inmates with ID were more frequent medication for mental disorders, a higher number of imprisonments, less drug abuse and less education than the other inmates. The results indicated that the HASI is a valid tool for screening of ID for the Norwegian inmates. CONCLUSIONS The prevalence of ID in Norwegian inmates is significant, measured by WASI and HASI. Identification, rehabilitation and care, concerning an intellectual handicap, are mostly absent in the Norwegian criminal justice system.

Forensic issues in intellectual disability

Purpose of review The present paper reviews some of the most significant findings in the field of forensic issues related to intellectual disability over the last 2 years. Recent findings Recent publications have explored the prevalence and assessment of intellectual disabilities in the criminal justice system, as well as individual characteristics of intellectual disabled offenders. Service by the criminal justice system and treatment of intellectual disabled offenders have also been explored. New insights into violence and sexual offences have been achieved, however identification and evidence-based treatment of intellectual disabled offenders are not widely explored issues. Summary Progress in treatment studies, studies of the function of the criminal justice system and risk assessments have resulted in improvements in these aspects during recent years. The wide range of services involved in successful initiatives has been addressed, but some crucial aspects still receive too little attention. Differences between countries and cultures have not been emphasized, and the progress that has been achieved seems to be confined to countries with a clear policy and organized services for offenders with intellectual disabilities.

Prevalence of intellectual disabilities in Norway: Domestic variance

Based on national registers, the prevalence of intellectual disability (ID) in Norway is estimated to be 0.44 per 100 inhabitants. This study aimed to examine geographic and urban-rural differences in the prevalence of ID in Norway. Methods A survey based on the national register. Financial transfers intended to provide equal services to people with ID are based on these reports. Results A higher prevalence was found in the North region of Norway. A negative correlation between the population density and the prevalence of ID was also found. Conclusion There was considerable geographic and urban-rural differences in the prevalence of ID, which may be attributable to not only the large diversity of services, but also some other factors. The results were discussed with respect to the deinstitutionalisation progress, resource-intensive services and costs. Differences also reflect some problems in diagnosing ID in people having mild ID.

Violence and Sexual Offending Behavior in People with Autism Spectrum Disorder who have Undergone a Psychiatric Forensic Examination

The increased awareness of Autism Spectrum Disorders (ASD) over the last few decades as well as the potential association between ASD and offending behaviors has spurred a need for increased research in this area. In order to explore any possible relationship between ASD and violent or sexual crime the present study examines all forensic examination reports over a 10-yr. period in Norway where the charged persons were diagnosed with ASD and charged with either a violent (N = 21) or a sexual (N = 12) offense. Differences between these two groups regarding previous contact with child welfare and confessions to the offense were found. There was also a tendency toward more severe mental health problems and less intellectual problems among the violent offenders than the sexual offenders.

Validation of the Norwegian version of Hayes Ability Screening Index for mental retardation.

The Hayes Ability Screening Index was developed primarily to provide a short, effective screening test to indicate possible mental retardation amongst persons who come in contact with the criminal justice system. This study examined the validity of a Norwegian version in a sample of 73 subjects. 45 were male and 28 were female (M = 33.3 yr, SD=12.5; range = 17 to 60 years) consecutively selected from patients referred for neuropsychological examination. The Wechsler Adult Intelligence Scale (WAIS-III) was the criterion of validity. The correlation of .81 between scores on the WAIS-III and the Hayes Index was significant. At a stated cut-off score of 85, the sensitivity was 100% and specificity 57%. A suggested alternative cut-off score of 81 obtained a sensitivity of 95% and specificity of 72%. These results indicate that the Hayes Ability Screening Index is a useful, valid, and time-saving tool for screening of mental retardation for the Norwegian population.

Validation and adaptation of the Norwegian version of Hayes Ability Screening Index for intellectual difficulties in a psychiatric sample

Background: Intellectual disabilities (ID) among psychiatric patients have traditionally been neglected. A lack of convenient instruments and competency in ID may have worsened the conditions and treatment availability for these patients. Aims: Validation and adaptation of a screening instrument for ID (Hayes Ability Screening Index; HASI) in a psychiatric hospital setting. Methods: This is a cross-sectional study of 50 psychiatric patients in two Norwegian psychiatric hospitals comparing results of the HASI with the Wechsler Abbreviated Scale of Intelligence (WASI). Results: The HASI correlated well with the standard IQ test used (r= 0.67, P< 0.001). At a stated cut-off score of 85, the HASI had a sensitivity of 100% and specificity of 34%. Conclusions: The HASI is a valid and time-saving screening instrument for ID among psychiatric patients. The prescribed cut-off score, however, resulted in a large number of false positives.

The usefulness of assessing suggestibility and compliance in prisoners with unidentified intellectual disabilities

This present study explored the relationship of interrogative suggestibility (n = 133) and compliance (n = 118) to intellectual functioning among prison inmates. The Norwegian versions of the Gudjonsson Suggestibility Scale (GSS) and the Gudjonsson Compliance Scale (GCS) were used. The results supported previous findings of a negative correlation between the Gudjonsson scales and IQ, and the scales were found useful throughout the IQ range. The impact of a memory artifact was discussed in the light of recent studies and criticism of the scales.

A qualitative study of how people with severe mental illness experience living in sheltered housing with a private fully equipped apartment

BackgroundThere are a number of supported housing options for people with severe mental illness (SMI), but limited knowledge about residents’ experiences. The aim of this study was to explore how people with SMI experienced sheltered housing consisting of both a private fully equipped apartment and a shared accommodation room for socializing.MethodsFourteen people with SMI living in sheltered housing apartments participated in a qualitative study with semi-structured face to face individual or group interviews.ResultsResidents’ access to the service providers in the sheltered housing, who were seen as both “ordinary people” and skilled to observe symptom changes at an early stage, were major factors for the perception of security. In addition, residents highlighted the possibility of living in a fully equipped apartment, and having access to a shared accommodation room to connect with other residents. Having a fully equipped apartment including their own equipment such as a washing machine was said to help reduce conflicts. Short tenancy agreements made some informants feel insecure. It was also essential to have meaningful daily activities outside the residence to avoid re-hospitalization.ConclusionsThe positive experience was connected to having a fully private equipped apartment including shared accommodation room. The service providers should be aware of the dilemma with in-house support, to make residents feel secure versus increased dependency on service providers.

Exploring the role of communication skills among natives and immigrants on their misconduct behaviour in prisons

As Norwegian society becomes increasingly multicultural and linguistically diverse and prison services continue to see larger numbers of immigrants, our knowledge about the interplay between communication and language and behavioural problems needs to be improved and addressed. The study focuses on language and communication problems associated with misconduct behaviour among immigrant and Norwegian prisoners. A cross-sectional study of immigrant and Norwegian inmates took part in six prisons in Norway, with a total of 250 inmates, where 88(35%) were immigrants and 162(65%) were Norwegian. There was a statistically significant difference between the two groups: manslaughter/murder (p=.045) and assault/robbery (p=.008) and crime against property (p=.004). Norwegian inmates presented three times more risk of misconduct behaviour than immigrant inmates. Those who had communication problems less then once a month presented higher risk of misconduct behaviour than those who had communication problems more often. Those who have communication problems quite often seem to adapt to the situation: they adjust to it and are, in a way, able to put up with the situation. Those who have communication problems more rarely, on the other hand, seem to react with more built-up internal anger and, consequently, with more severe aggression.

Resilience and Professional Quality of Life in Staff Working with People with Intellectual Disabilities and Offending Behavior in Community Based and Institutional Settings.

Staff in forensic services for people with intellectual disabilities (ID) are expected to deal with a wide range of emotional challenges when providing care. The potential impact of this demanding work has not been systematically explored previously. This article explores the professional quality of life (QoL) and the resilience (hardiness) of the staff in this setting. The Professional QoL questionnaire and the Disposional Resilience Scale were completed by staff (n=85, 80% response rate) in the Norwegian forensic service for ID offenders. Responses from staff working in institutional settings were compared to those from staff in local community services. Staff in the local community services had higher resilience scores compared to the staff in the institutional setting, (t=2.19; P<0.05). However in the other QoL and resilience domains there were no differences between the staff in the two settings. The greater sense of resilient control among community staff may be a function of both the number of service users they work with and the institutional demands they face. Even though these participants worked with relatively high risk clients, they did not report significantly impaired quality of life compared to other occupations.