Fabian Haut

Brief Report: The Sexual and Physical Abuse Histories of Offenders with Intellectual Disability.

BACKGROUND Some studies have found higher rates of childhood sexual abuse in sex offenders while others have failed to find such relationships. METHOD This study reviews the sexual and physical abuse histories of 156 male sex offenders with intellectual disability (ID), 126 non-sexual male offenders with ID and 27 female offenders with ID. RESULTS Sexual offenders reported a higher rate of sexual abuse in childhood than non-sexual male offenders (32.6% vs. 17.8%), while the opposite was true for non-accidental injury (16.0% vs. 32.5%). Female offenders reported the highest rates of sexual abuse in childhood (59.3%). CONCLUSIONS Some specificity of childhood abuse was evident in the male cohorts suggesting limited evidence of a developmental pathway to offending, while the women were a group highly vulnerable to all forms of abuse.

Internal consistency and factor structure of personality disorders in a forensic intellectual disability sample

Abstract Background The publication of the DSM‐III (American Psychiatric Association (APA), 1980) prompted a significant increase in interest and research on personality disorder (PD), and the concept has subsequently been incorporated into mental health legislation in the developed world. Despite this, such research on people with intellectual disability (ID) has been sporadic, with widely varying results. The present study addresses a number of criticisms directed at previous research. Method DSM‐IV (APA, 2000) diagnoses of PD were made on 164 participants with ID on the basis of four independent sources of classification. Results Reliability data for each PD was acceptable and alpha was .74 or above, with the exception of schizotypal PD (.63). Exploratory and confirmatory factor analyses were conducted, with the former revealing a 4‐factor solution accounting for 58.9% of the variance, and a 2‐factor solution accounting for 37.2% of the variance emerging for the latter. The factors were orthogonal, and we called the first factor “avoidant/rumination/inhibited” and the second factor “acting out”. Discussion We review these findings in relation to previous research on PD and alternative frameworks for the understanding of personality. We hypothesise consistencies between these findings and previous work on personality and ID. A number of drawbacks to the research are discussed, including a caution on the pejorative nature of a diagnosis of PD in an already devalued population.

An evaluation and 20-year follow-up of a community forensic intellectual disability service.

BACKGROUND Since the middle of the 20th century, there have been several heterogeneous studies of recidivism by offenders with intellectual disabilities (ID) who have been in specialist mental health services after an index offence. Although some were long term, as befits a chronically needy group, laws and services have changed in that time. It may no longer be appropriate to rely on findings from the 1960s and 1970s. AIMS To compare mental health presentations and recidivism between male sex offenders, men convicted of other offences and female offenders from a 1986-2008 cohort of offenders referred to specialist forensic ID services in Scotland. METHOD A 20-year follow-up of an assessment and treatment service for 309 offenders with ID (156 sex offenders, 126 non sexual male offenders and 27 women) was conducted. RESULTS Sex offenders were more likely to be referred from the courts and had lower anger levels. Women were more likely to be diagnosed with mental illness. There was a split between groups with sex offenders committing few nonsexual offences and the other groups showing few sexual offences. During the study period, 16% of sexual offenders, 43% of male nonsexual offenders and 23% of women committed at least one further offence. Following assessment and treatment there was a 90-95% reduction in offending incidents. CONCLUSIONS Although recidivism rates are disappointing, harm reduction data suggests that assessment and treatment for offenders with ID can be highly successful in terms of public safety.

The sexual and physical abuse histories of offenders with intellectual disability

BACKGROUND Some studies have found higher rates of childhood sexual abuse in sex offenders while others have failed to find such relationships. METHOD This study reviews the sexual and physical abuse histories of 156 male sex offenders with intellectual disability (ID), 126 non-sexual male offenders with ID and 27 female offenders with ID. RESULTS Sexual offenders reported a higher rate of sexual abuse in childhood than non-sexual male offenders (32.6% vs. 17.8%), while the opposite was true for non-accidental injury (16.0% vs. 32.5%). Female offenders reported the highest rates of sexual abuse in childhood (59.3%). CONCLUSIONS Some specificity of childhood abuse was evident in the male cohorts suggesting limited evidence of a developmental pathway to offending, while the women were a group highly vulnerable to all forms of abuse.

Referral patterns for offenders with intellectual disability: a 20-year study

Following deinstitutionalisation, people with intellectual disability living in the community have had access to ordinary, local services including criminal justice services. This study reports a 20-year review of 309 referrals to a community forensic intellectual disability service. There were significant increases across time periods in referrals from criminal justice services and significant decreases from community services. These results may reflect changes in society whereby the courts are becoming more comfortable with defendants with intellectual disability and services more willing to involve the police when there are incidents of offending behaviour.

Predictive validity of the dynamic risk assessment and management system in individuals with intellectual disability residing in the community

ABSTRACT Background. The Dynamic Risk Assessment and Management System (DRAMS) was created to measure dynamic risk in individuals with intellectual disabilities (ID). Steptoe, Lindsay, Murphy, and Young, (2008) examined the construct validity, reliability and predictive validity of the dynamic risk assessment and management system (DRAMS) in offenders with intellectual disability and found that the total DRAMS score and sections on mood, antisocial behaviour and intolerance/agreeableness predicted incidents with a medium effect size for offenders with ID residing in high secure settings.

DSM IV, DSM-5, and the Five-Factor Model: The Diagnosis of Personality Disorder With Intellectual and Developmental Disabilities

ABSTRACT In DSM-5 there has been a move to dimensional personality disorder (PD) diagnosis, incorporating personality theory in the form of the five-factor model (FFM). It proposes an alternative assessment system based on diagnostic indicators and the FFM, while retaining DSM-IV categorical criteria. Four individuals with intellectual disability are assessed for PD utilizing the Assessment of Global Personality Functioning Index (AGPF), the International Personality Disorder Examination (IPDE), and, in terms of the FFM, through an adapted version of the NEO-PI short form. PD ratings (self, staff, and observer) tended to converge for borderline, antisocial, and narcissistic PDs. NEO-PI ratings converged on Neuroticism, Extraversion, and Openness, with discrepancies on Agreeableness and Conscientiousness (staff rating lower). A structured DSM-5 system is easily usable but takes more time than a diagnostic interview.

The protective scale of the Armidilo-S: The importance of forensic and clinical outcomes

BACKGROUND The Armidilo has two scales-the risk scale and the protective scale. Research has been confined to the risk scale which appears to predict future incidents with medium to large effect sizes. There have been no publications on the use of the protective scale. METHODS The Armidilo was completed on four individuals with IDD who were either moving on from their placement or whose placement was in jeopardy because of new information or altered policies in the organization. The Armidilo was completed in the usual fashion. RESULTS Risk and protective results show that for each individual, recommendations could be made that ensured the best outcome. For two participants, restrictive placements were avoided because of the data on protective factors. CONCLSIONS The protective scale can be a powerful support for the clinicians case in offenders with IDD. The protective scale should be completed routinely for clinical evaluation.

Brief report: The sexual and physical abuse histories of offenders with intellectual disability: Child abuse in offenders with ID

BACKGROUND Some studies have found higher rates of childhood sexual abuse in sex offenders while others have failed to find such relationships. METHOD This study reviews the sexual and physical abuse histories of 156 male sex offenders with intellectual disability (ID), 126 non-sexual male offenders with ID and 27 female offenders with ID. RESULTS Sexual offenders reported a higher rate of sexual abuse in childhood than non-sexual male offenders (32.6% vs. 17.8%), while the opposite was true for non-accidental injury (16.0% vs. 32.5%). Female offenders reported the highest rates of sexual abuse in childhood (59.3%). CONCLUSIONS Some specificity of childhood abuse was evident in the male cohorts suggesting limited evidence of a developmental pathway to offending, while the women were a group highly vulnerable to all forms of abuse.