Isabel C. H. Clare

The relationship between confabulation and intellectual ability, memory, interrogative suggestibility and acquiescence

Abstract The purpose of this study was to investigate the relationship between confabulation and intellectual ability, memory, suggestibility and acquiescence. A total of 145 subjects completed the WAIS-R, the Gudjonsson Suggestibility Scale and a measure of acquiescence. Confabulation did not correlate significantly with intellectual ability, verbal memory recall, suggestibility or acquiescence. Importantly, it was found that the two separate components of confabulation—distortions and fabrications—did not correlate significantly with each other. It is recommended that, in future research, distortions and fabrications are scored and analysed separately. The findings have important implications for theories of memory.

High functioning autistic spectrum disorders, offending and other law-breaking: findings from a community sample

Abstract The prevalence and pattern of offending and other law-breaking among groups of men and women with High Functioning Autism/Asperger Syndrome (ASDs) living in the community has not, so far, been examined empirically. In this study, the illegal behaviours of a small sample (N = 25) of people with ASDs were investigated. Unexpectedly, both self-report and ‘official’ data indicated that the rate of law-breaking, including offending, was very low. Indeed, it was significantly (p<0.05) lower than that of a stringent non-ASD comparison group (N = 20). Despite similarities, however, there were some striking differences between the patterns of illegal behaviours in the two groups. The participants with a diagnosis of an ASD were significantly (p<0.01) less likely to report that they had engaged in illicit drug-taking; in contrast, they were significantly more likely (p<0.05) to report activities which could be categorised as ‘criminal damage’. Moreover, they tended to have a greater history of violent behaviours. The methodological limitations of this study, particularly the difficulties of recruiting an adequate community sample of people with ASDs, are discussed, together with the implications for the development of services for the small minority of men and women with this diagnosis who are involved in criminal offending and other law-breaking.

Police interviewing and psychological vulnerabilities: predicting the likelihood of a confession

This paper is concerned with examining the differences between people who confess and those who deny offences during a police interview. The main hypothesis under investigation is that psychologically vulnerable suspects are particularly likely to confess. This paper is also concerned with identifying variables that might be related to the confession process. One hundred and sixty suspects detained at two London police stations were assessed psychologically prior to being interviewed by the police. The results of this assessment, an analysis of the interview procedure and biographic details were subjected to a logistic regression analysis. There was no evidence to support our main hypothesis. However, suspects were more likely to confess if they reported having consumed an illicit (non-prescribed) drug in the previous 24-hour period, and less likely to confess when interviewed in the presence of a legal adviser or if they had experience of prison or custodial remand. In this study younger suspects were also more likely to confess.

Using the cognitive interview with adults with mild learning disabilities

Abstract Forty-seven adults with mild learning disabilities (mild intellectual disabilities) attending day-centres and thirty-eight adults from the general population viewed a videorecording of an accident. A day later the participants were interviewed using either a cognitive interview (CI) or a structured interview (SI, a control interview). Compared with their counterparts with learning disabilities, adults from the general population recalled more correct information and made fewer confabulations about persons and objects. Nevertheless, the type of interview had an impact. For both groups, the CI was more effective than the SI in enhancing recall although, for the ‘learning disabilities’ group, the CI also produced a disproportionate increase in the reporting of person confabulations. All the same, the accuracy ratios were similar across interview types (80% for the CI and 82% for the SI). It is suggested that the CI could be helpful in assisting people with learning disabilities to provide informatio...

A case-control study of offenders with high functioning autistic spectrum disorders

Abstract Although a number of case reports have suggested that some people with autistic spectrum disorders (ASDs) commit criminal offences, and that core cognitive characteristics may be associated with this vulnerability, the possibility has not been investigated. The exploratory study described in this paper examined whether the cognitive impairments of people with ASDs are associated with their vulnerability to offending. Groups of 21 adults with ASDs and a history of offending, 23 adults with ASDs and no history of offending, and a general population group of 23 people without ASDs were compared on established measures of those aspects of cognition known to be impaired in both people with ASDs and offenders: theory of mind, executive function, and emotion recognition. Compared with their non-offending peers, the ASD offenders showed a significantly greater impairment in recognition of emotional expressions of fear, but no difference in theory of mind, executive function, and recognition of facial expressions of sadness. It is proposed that a small group of people with ASDs may be co-morbid for autism and developmental disorders of antisocial behaviour, and that this might be related to their vulnerability to criminal offending.

A comparison of mental health legislation from diverse Commonwealth jurisdictions

Introduction In the regulation of involuntary treatment, a balance must be found between duties of care and protection and the right to self-determination. Despite its shared common roots, the mental health legislation of Commonwealth countries approaches this balance in different ways. When reform is planned, lessons can be learned from the experiences of other countries. Method Criteria for involuntary treatment used in a sample of 32 Commonwealth Mental Health Acts were compared using a framework developed from standards derived from the Universal Declaration of Human Rights. Reasons for non-compliance were considered and examples of good practice were noted. Changes in the criteria used over time and across areas with differing levels of economic development were analysed. Results 1. Widespread deviation from standards was demonstrated, suggesting that some current legislation may be inadequate for the protection of the human rights of people with mental disorders. 2. Current trends in Commonwealth mental health law reform include a move towards broad diagnostic criteria, use of capacity and treatability tests, treatment in the interests of health rather than safety, and regular reviews of treatment orders. Nevertheless, there are some striking exceptions. Discussion Explanations for deviation from the standards include differing value perspectives underpinning approaches to balancing conflicting principles, failure to keep pace with changing attitudes to mental disorder, and variations in the resources available for providing treatment and undertaking law reform. Current good practice provides examples of ways of dealing with some of these difficulties.

Decision-Making Difficulties Experienced by Adults With Autism Spectrum Conditions

Autobiographical and clinical accounts, as well as a limited neuropsychological research literature, suggest that, in some situations, men and women with autism spectrum conditions (ASCs) may have difficulty making decisions. Little is known, however, about how people with ASCs experience decision-making or how they might best be supported to make decisions for themselves. In this study, we compared the decision-making experiences of adults with and without ASCs (n=38 and n=40, respectively) using a novel questionnaire and the General Decision Making Style inventory (GDMS, Scott & Bruce, 1995). The participants with ASCs reported experiencing several problems in decision-making more frequently than the comparison group, and were more likely to report avoidance of decision-making, as measured using the GDMS. The findings highlight areas of potential future research and inform suggestions for supporting adults with ASCs during decision-making

Analysis of motivation in people with mild learning disabilities (mental handicap) who set fires

Abstract Ten people with mild learning disabilities (mild mental handicap) who had all set rues and had been admitted to a hospital facility for people with challenging behaviours were interviewed about their perceptions of events, feelings and cognitions prior to and after setting fins. They were also asked to rate their excitement/upset in a series of fire-related situations. Results showed that people could identify reliably the events, feelings and cognitions prior to fire-setting but were less reliable at identifying consequences. Most commonly, people had felt angry prior to setting fires but it was also common to feel not listened to, sad or depressed. Multiple factors were relevant for most people. Some people identified the excitement of the rue as relevant and these people gave the highest ratings on the fire-related situations schedule and scored higher than controls on this schedule. Implications for treatment are discussed.

Issues in the assessment and treatment of male sex offenders with mild learning disabilities

Abstract The psychological assessment and treatment of male sex offenders has been of increasing interest in recent years, and a substantial literature, primarily cognitive-behavioural in orientation, now exists. However, there is little information about the application of this literature to men with mild learning disabilities (previously known as mild ‘mental handicap’), who have impaired intellectual and social functioning and are at increased risk of additional difficulties. This paper uses the cognitive-behavioural approach as a framework for presenting preliminary guidance on the assessment and treatment of men with mild learning disabilities. It should be emphasized that, at present, almost nothing is known about the outcome of attempts to intervene in the sex offending of this population.

Constructing and Reconstructing ‘Best Interests’: An Interpretative Examination of Substitute Decision‐making under the Mental Capacity Act 2005

The Mental Capacity Act 2005 (MCA) authorises substitute decision‐making in England and Wales, in relation to ‘acts in connection with care or treatment’, for a person lacking the capacity to make an autonomous decision, if it is both necessary and in his or her ‘best interests’ to do so. The approach adopted by the MCA is consistent with the common law, but widens both the scope and procedures of a ‘best interests’ determination to allow for a general model of substitute decision‐making in everyday health and social care. However, by decontextualising substitute decision‐making, the MCAs procedures relating to ‘best interests’ may prove to be problematic in three ways: first, by failing to adequately resolve certain ethical dilemmas that pervade this area; second, by reducing applied substitute decision‐making to a series of compulsory generalised instructions; and, finally, by necessitating deliberation but offering little practical guidance to the process of determination. Whilst the codification of five statutory principles in the MCA is designed to foster the empowerment of vulnerable adults, the realisation of these procedural and conceptual problems may have a negative impact on the implementation of the Act.