Todd Hogue

Risk Assessment in Offenders With Intellectual Disability: A Comparison Across Three Levels of Security

In mainstream offender samples, several risk assessments have been evaluated for predictive validity. This study extends this work to male offenders with intellectual disabilities. Participants from high-, medium-, and low-security settings, as well as community settings, were compared on a range of risk assessments. The Violence Risk Appraisal Guide, HCR-20—Historical Scale, the Risk Matrix 2000-C (combined risk), and the Emotional Problems Scales—Internalising discriminated between groups, with participants from high security having higher scores than those in medium security, who had higher scores than those in the community. The Violence Risk Appraisal Guide, all HCR-20 scales, the Short Dynamic Risk Scale, and the Emotional Problems Scales (Internalising and Externalising) showed significant areas under the curve for the prediction of violence. The Static-99 showed a significant area under the curve for the prediction of sexual incidents. The discussion reviews the value of these various scales to intellectual disability services.

Two studies on the prevalence and validity of personality disorder in three forensic intellectual disability samples

Abstract There is an extensive research literature on the association between personality disorder, antisocial personality disorder, and risk of future violent and sexual offences. Several studies have found an elevated prevalence of personality disorder diagnoses amongst those individuals with severe mental illness and criminal populations. While there has been some work on the prevalence of personality disorder among intellectual disability populations, it has been criticised as being unreliable and inconsistent. The present authors have taken account of these criticisms and recommendations in this comparison of 164 offenders with intellectual disability across three settings – community, medium/low secure, and high secure. In Study 1, DSM-IV diagnoses were made on the basis of four information sources: file review, interview with clinician, observations by care staff, and the Structured Assessment of Personality Interview. Across the samples, total prevalence of PD was 39.3%. The most common diagnosis was antisocial personality disorder. There was a higher rate of diagnosis in the high security setting, with no significant differences between the other two settings. There was no diagnosis of dependent PD, indicating that assessors were not overly influenced by the developmental disability itself. In Study 2 it was found that increase in severity of PD (as indicated by PCL-R scores and/or the number of PD diagnoses) showed a strong lawful relationship with instruments predicting future violence (VRAG, RM 2000/V) and a weaker relationship with instruments predicting future sexual offences (Static-99, RM 2000/S). The results indicate the utility of PD classification in this client group and that a number of individuals with PD classification are being managed successfully in community settings. These findings have considerable implications for staffing, both in terms of which individuals can be treated by these services and staff training.

Predictive validity of the PCL-R for offenders with intellectual disability in a high security hospital: treatment progress

Abstract Background Among mainstream offenders, the severe personality disorder of psychopathy has considerable importance as a construct. The disorder has long been associated with failure to make treatment progress. Previous work has identified that psychopathy as a disorder occurs in samples of offenders with intellectual disability (ID), and suggests that the Psychopathy Checklist – Revised (PCL‐R: Hare, 1991, 2003) as a measure of the disorder has adequate reliability and validity (Morrissey et al., 2005). The present study aimed to compare the predictive power of the PCL‐R in relation to treatment progress with a more general assessment of violence risk, the HCR‐20 (Webster, Douglas, Eaves, & Hart, 1997). Method A sample of 73 residents in a high security intellectual disability service, who had previously been assessed using the PCL‐R and the HCR‐20, were followed up at 2 years post‐assessment, and their outcome determined in terms of two distinct dichotomous variables reflecting definite positive treatment progress and definite negative treatment progress respectively. Results In line with predictions, the PCL‐R Total score and Factor 1 score (Interpersonal and Affective aspects of psychopathy) and the HCR‐20 Total score were significantly inversely associated with a positive move from high to medium security hospital conditions within 2 years of assessment. However against prediction, the PCL‐R Total score had incremental validity over the HCR‐20. The PCL‐R Total and Factor 1, but not the HCR‐20 Total score, were also significantly associated with negative treatment progress in terms of a move to more restricted treatment conditions. Conclusion Psychopathy, and in particular its interpersonal and affective manifestations, is a construct which appears to be associated with indirect measures of treatment progress in this high security ID group. However, caution should be applied in the use of a construct with potentially negative connotations in an already devalued population.

The influence of remorse, intent and attitudes toward sex offenders on judgments of a rapist

Abstract In clinical settings, sexual offenders-are encouraged to express remorse for their offending and acknowledge the extent to which they have acted intentionally. This study used a sample of 50 professionals, who regularly work with the victims and/or perpetrators of sexual offenses. A 2 × 2 design asked participants to make judgments on a short rape scenario varied on level of offender intent (spontaneous or planned) and offender remorse (remorseful or unremorseful). When acting with intent, the rapist was sentenced more punatively and rated as more to blame, more responsible, and more deserving of punish-ment. Ratings of the offender were strongly related to sentencing choice. Attitudes Towards Sex offenders were related to sentencing choice and were more predictive of sentencing type than the experimental manipulations. The results are discussed in terms of their implications for the management of sexual offenders within the criminal justice system.

First-stage evaluation of a treatment programme for personality disordered offenders

Abstract 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 finegrained 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 ...

Training multi-disciplinary teams to work with sex offenders: Effects on staff attitudes

Abstract A recent British Prison Service initiative has focused on providing sex offender programmes facilitated by multi-disciplinary teams of staff. A three week long training programme was designed to provide staff with the necessary knowledge, skills and experience to facilitate these structured treatment groups. Following the training, staff indicated they were more confident in their ability to provide treatment and showed a greater belief that treatment could be successful. In addition, they showed significantly more positive attitudes towards sexual offenders and to offenders in general. However, participants did not indicate undue concern about working in a sensitive treatment area. This pattern continued at six month follow-up, indicating that the training changed attitudes as expected, and that the training was seen by participants as adequately preparing them to undertake provision of a structured sex offender treatment programme in a secure setting.

Applicability, Reliability and Validity of the Psychopathy Checklist-Revised in Offenders with Intellectual Disabilities: Some Initial Findings

As a part of a larger study, the Psychopathy Checklist-Revised (PCL-R) was used to assess psychopathy in 203 individuals from three UK National Health Service settings for offenders with intellectual disabilities (ID): a high security hospital, a medium and low security hospital and a community based service. The PCL-R was rated from file review combined with a clinician interview. Internal consistency and inter-rater reliability were acceptable, and broadly comparable to that reported for other offender populations. The instrument was also associated in largely expected ways with level of security, and with measures of antisocial personality disorder, risk, and current behavioural functioning, providing some preliminary indications of convergent validity. However, further empirical investigation is required before the PCL-R can be used with confidence to make clinical and risk-based decisions in this population.

The Peaks: A clinical service for those with dangerous and severe personality disorder

Abstract Recent political initiatives have increased the focus on providing clinical services for personality disordered individuals. Increased attention on those identified as having dangerous and severe personality disorder (DSPD) has led to the piloting of specialist services to trial new assessments and interventions for the DSPD group in both health and prison settings. This article outlines the development and provision of clinical services for those within The Peaks, the DSPD pilot service within Rampton Hospital. The Peaks, the first new-build health-based unit, aims to provide a comprehensive service specifically focused on addressing the full range of clinical and criminogenic needs of those within the DSPD group. The philosophical underpinnings of the unit and the practical components of the service provided are described.

The Emotional Representation of Sexual Crime in the National British Press

The relationships between the media, public attitudes, and crime are complex, with evidence suggesting that public interaction with these press reports influencing wider social and political attitudes. Here, 543 articles from 8 of the 10 most-read British national newspapers were examined in terms of their representativeness of crime rates, and their linguistic properties. Results include a 9:1 representation of sexual crime, a 2.5:1 representation of violent crime, and a 1:4 representation of acquisitive crime within press articles compared with official statistics. Rating the linguistic content indicates that sexual crime articles comprised angrier and more emotionally negative tones than stories on all other groups. Tabloid and broadsheet differences were found in headlines, but not in the main bodies of the articles. Cognitive–experiential self-theory is offered as just one social psychological framework for understanding the role of emotion in sexual crime reporting.

The use of psychiatric and psychological evidence in the assessment of terrorist offenders

The present paper focuses on the prediction of violent recidivism among individuals convicted of politically motivated violence – terrorism. We argue that the assumptions of general violence prediction models, used in risk assessment procedures with other offenders, do not necessarily apply to terrorist offenders. Subsequently we discuss the assumption of general expertise in mental health professionals in such cases. Furthermore, we describe the role of professionals in this field, their expertise, and the use of psychological and psychiatric evidence. We are particularly concerned about the use of psychometric testing. Finally we make some recommendations about the approach to be used and the expertise required in assessing risk in politically motivated offenders.