Pub Date : 1999-09-01DOI: 10.1080/09585189908403681
J. Fuller, J. Cowan
The changing fortunes of clinical approaches to risk assessment in the forensic and mental health fields are reviewed. A prospective study of medium-term clinical risk forecasting in a forensic setting is described, using receiver operating characteristics (ROC) to evaluate the judgements of the multi-disciplinary teams. The accuracy of consensus predictions of patient-related risks was found to be comparable with actuarially based studies over similar time-scales, although some low base-rate events eluded prediction. The study reasserts a role for clinical judgement in risk assessment, but recognizes that evaluation of risk assessment activity in care settings is methodologically confounded by subsequent risk management interventions. Studies of how clinicians proceed from the former process to the latter may prove a more fruitful direction for future research in forensic settings.
{"title":"Risk assessment in a multi-disciplinary forensic setting: Clinical judgement revisited","authors":"J. Fuller, J. Cowan","doi":"10.1080/09585189908403681","DOIUrl":"https://doi.org/10.1080/09585189908403681","url":null,"abstract":"The changing fortunes of clinical approaches to risk assessment in the forensic and mental health fields are reviewed. A prospective study of medium-term clinical risk forecasting in a forensic setting is described, using receiver operating characteristics (ROC) to evaluate the judgements of the multi-disciplinary teams. The accuracy of consensus predictions of patient-related risks was found to be comparable with actuarially based studies over similar time-scales, although some low base-rate events eluded prediction. The study reasserts a role for clinical judgement in risk assessment, but recognizes that evaluation of risk assessment activity in care settings is methodologically confounded by subsequent risk management interventions. Studies of how clinicians proceed from the former process to the latter may prove a more fruitful direction for future research in forensic settings.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"70 1","pages":"276-289"},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76480177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403684
S. Riordan
In an attempt to assess the overall frequency and impact of indecent exposure on women's lives and also to elicit women's fear of sexual crime in general, 72 women were questioned. Of the subjects, 35 (48.6%) had been the victim of indecent exposure, 13 (37.1%) of these on two or more occasions. The women agree that indecent exposers are dangerous and cause great distress. Furthermore, women perceive the offence to be trivialized by the police, and by men in general. Indecent exposure greatly impinges on women's spatial and social freedom and serves to reinforce their fears of sexual crime.
{"title":"Indecent exposure: The impact upon the victim's fear of sexual crime","authors":"S. Riordan","doi":"10.1080/09585189908403684","DOIUrl":"https://doi.org/10.1080/09585189908403684","url":null,"abstract":"In an attempt to assess the overall frequency and impact of indecent exposure on women's lives and also to elicit women's fear of sexual crime in general, 72 women were questioned. Of the subjects, 35 (48.6%) had been the victim of indecent exposure, 13 (37.1%) of these on two or more occasions. The women agree that indecent exposers are dangerous and cause great distress. Furthermore, women perceive the offence to be trivialized by the police, and by men in general. Indecent exposure greatly impinges on women's spatial and social freedom and serves to reinforce their fears of sexual crime.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"5 1","pages":"309-316"},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88819217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403690
L. Thomson
Abstract This paper reviews the recent literature in forensic psychiatry on clinical management. It examines the association between mental disorder and crime/violence, and considers specific conditions and problematic behaviours. Risk assessment and management techniques are reviewed, including those systems designed to maximize care and minimize risk.
{"title":"Clinical management in forensic psychiatry","authors":"L. Thomson","doi":"10.1080/09585189908403690","DOIUrl":"https://doi.org/10.1080/09585189908403690","url":null,"abstract":"Abstract This paper reviews the recent literature in forensic psychiatry on clinical management. It examines the association between mental disorder and crime/violence, and considers specific conditions and problematic behaviours. Risk assessment and management techniques are reviewed, including those systems designed to maximize care and minimize risk.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"19 1","pages":"367-390"},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85283770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403687
J. McKenna, J. Shaw, Kathleen Porceddu, A. Ganley, Katherine Skaife, S. Davenport
A sample of patients with schizophrenia detained in a high-security hospital, but thought no longer to require conditions of maximum security, was compared with patients in a high-dependency rehabilitation unit and a district rehabilitation service, by using several of the instruments from the TAPS studies (Team for Assessment of Psychiatric Services) and the REHAB scale. The high-dependency rehabilitation patients were found to be significantly more disabled than the maximum-security patients on a variety of parameters. Implications for service provision are discussed.
{"title":"‘Long-stay medium secure’ patients in Special Hospital","authors":"J. McKenna, J. Shaw, Kathleen Porceddu, A. Ganley, Katherine Skaife, S. Davenport","doi":"10.1080/09585189908403687","DOIUrl":"https://doi.org/10.1080/09585189908403687","url":null,"abstract":"A sample of patients with schizophrenia detained in a high-security hospital, but thought no longer to require conditions of maximum security, was compared with patients in a high-dependency rehabilitation unit and a district rehabilitation service, by using several of the instruments from the TAPS studies (Team for Assessment of Psychiatric Services) and the REHAB scale. The high-dependency rehabilitation patients were found to be significantly more disabled than the maximum-security patients on a variety of parameters. Implications for service provision are discussed.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"37 1","pages":"333-342"},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87597122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403689
K. Wheat
{"title":"Liability for failure to diagnose dyslexia","authors":"K. Wheat","doi":"10.1080/09585189908403689","DOIUrl":"https://doi.org/10.1080/09585189908403689","url":null,"abstract":"","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"20 1","pages":"355-365"},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82010408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-07-26DOI: 10.1080/09585189908403682
D. Reiss, D. Grubin, C. Meux
Abstract In England and Wales most patients with the legal classification of psychopathic disorder who are compulsorily detained in hospital receive treatment in one of the three high-security ‘Special Hospitals’. The aim of this study was to describe their psychopathology and examine its relationship with institutional performance. The sample consisted of 89 young male patients with this legal classification who had received treatment in Broadmoor Hospital. All subjects' hospital medical records were examined and the data used to calculate scores on Hare's Revised Psychopathy Checklist (PCL-R), to diagnose DSM-III-R personality disorders, and to quantify aspects of behaviour whilst in hospital. A score of 25 or above on the PCL-R was found to be associated with the diagnoses of borderline, antisocial and narcissistic personality disorder, lack of improvement in social functioning, continued need for seclusion or special care, and discharge to a resource in the community rather than to a hospital. The fin...
{"title":"Institutional performance of male ‘psychopaths’ in a high-security hospital","authors":"D. Reiss, D. Grubin, C. Meux","doi":"10.1080/09585189908403682","DOIUrl":"https://doi.org/10.1080/09585189908403682","url":null,"abstract":"Abstract In England and Wales most patients with the legal classification of psychopathic disorder who are compulsorily detained in hospital receive treatment in one of the three high-security ‘Special Hospitals’. The aim of this study was to describe their psychopathology and examine its relationship with institutional performance. The sample consisted of 89 young male patients with this legal classification who had received treatment in Broadmoor Hospital. All subjects' hospital medical records were examined and the data used to calculate scores on Hare's Revised Psychopathy Checklist (PCL-R), to diagnose DSM-III-R personality disorders, and to quantify aspects of behaviour whilst in hospital. A score of 25 or above on the PCL-R was found to be associated with the diagnoses of borderline, antisocial and narcissistic personality disorder, lack of improvement in social functioning, continued need for seclusion or special care, and discharge to a resource in the community rather than to a hospital. The fin...","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"28 10","pages":"290-299"},"PeriodicalIF":1.4,"publicationDate":"1999-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72598774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1080/09585189908402141
N. Morant, B. Dolan, D. Fainman, M. Hilton
Abstract This paper presents descriptive quantitative data on the first 12 months of operation of an innovative outreach service for people with severe personality disorders (SPD). Between November 1995 and November 1996, 156 patients were referred to the service for outpatient treatment, inpatient preparatory work, post-inpatient follow-up and advice on management. The psychological and psychiatric characteristics of these patients are described using a range of standardized self-report scales. Scores indicate high levels of personality disorders, especially borderline personality disorder and associated behavioural and social problems. The various clinical activities of the service are described. These include the provision of individual and group psychotherapies, referrals for specialist inpatient admission and the provision of specialist advice on management to local referrers. Evidence suggests that the service is successfully achieving its aims in providing a specialist community service for people ...
{"title":"An innovative outreach service for people with severe personality disorders: Patient characteristics and clinical activities","authors":"N. Morant, B. Dolan, D. Fainman, M. Hilton","doi":"10.1080/09585189908402141","DOIUrl":"https://doi.org/10.1080/09585189908402141","url":null,"abstract":"Abstract This paper presents descriptive quantitative data on the first 12 months of operation of an innovative outreach service for people with severe personality disorders (SPD). Between November 1995 and November 1996, 156 patients were referred to the service for outpatient treatment, inpatient preparatory work, post-inpatient follow-up and advice on management. The psychological and psychiatric characteristics of these patients are described using a range of standardized self-report scales. Scores indicate high levels of personality disorders, especially borderline personality disorder and associated behavioural and social problems. The various clinical activities of the service are described. These include the provision of individual and group psychotherapies, referrals for specialist inpatient admission and the provision of specialist advice on management to local referrers. Evidence suggests that the service is successfully achieving its aims in providing a specialist community service for people ...","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"2 1","pages":"84-97"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77826181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1080/09585189908402142
N. Gorsuch
Abstract Ten highly disturbed women on the psychiatric wing of HMP Holloway, who had experienced difficulty in obtaining beds in NHS secure facilities, were interviewed and completed the Millon Clinical Multiaxial Inventory II (MCMI-II). The results of the interviews and the MCMI-II, which both showed extreme ambivalence in the women's relationships, are discussed in terms of attachment theory. It is suggested that the ‘treatability’ criterion of the Mental Health Act is used to exclude from forensic psychiatric services women who are challenging to work with and who do not fit easily into a medical model. It is argued that ‘help’, as opposed to ‘treatment’, is a meaningful concept within the terms of the Act and that the gap in service provision through which these women fall could be filled by ‘attachment-minded’ services that have ‘help’ as their primary aim.
{"title":"Disturbed female offenders: helping the 'untreatable'","authors":"N. Gorsuch","doi":"10.1080/09585189908402142","DOIUrl":"https://doi.org/10.1080/09585189908402142","url":null,"abstract":"Abstract Ten highly disturbed women on the psychiatric wing of HMP Holloway, who had experienced difficulty in obtaining beds in NHS secure facilities, were interviewed and completed the Millon Clinical Multiaxial Inventory II (MCMI-II). The results of the interviews and the MCMI-II, which both showed extreme ambivalence in the women's relationships, are discussed in terms of attachment theory. It is suggested that the ‘treatability’ criterion of the Mental Health Act is used to exclude from forensic psychiatric services women who are challenging to work with and who do not fit easily into a medical model. It is argued that ‘help’, as opposed to ‘treatment’, is a meaningful concept within the terms of the Act and that the gap in service provision through which these women fall could be filled by ‘attachment-minded’ services that have ‘help’ as their primary aim.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"10 1","pages":"98-118"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85154070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1080/09585189908402136
M. McCartney, M. Collins, B. Park, E. Larkin, C. Duggan
Abstract 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 difference...
{"title":"The assessment and meaning of the legal classification of offenders in a special hospital using observer ratings of interpersonal style","authors":"M. McCartney, M. Collins, B. Park, E. Larkin, C. Duggan","doi":"10.1080/09585189908402136","DOIUrl":"https://doi.org/10.1080/09585189908402136","url":null,"abstract":"Abstract 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 difference...","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"124 1","pages":"17-33"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81580471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1080/09585189908402145
A. Mowbray
{"title":"Respect for the private lives of transsexuals","authors":"A. Mowbray","doi":"10.1080/09585189908402145","DOIUrl":"https://doi.org/10.1080/09585189908402145","url":null,"abstract":"","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"169 1","pages":"149-156"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72749132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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