Investigating changes in anger and aggression in offenders with high levels of psychopathic traits attending the Chromis violence reduction programme

Offenders With Personality Disorder Who Fail to Progress: A Case-Control Study Using Partial Least Squares Structural Equation Modeling Path Analysis

BACKGROUND

Offenders with personality disorder can be challenging to engage and retain in treatment. The UK Offender Personality Disorder (OPD) pathway aims to proactively and responsively identify and engage offenders with personality disorder. However, a subpopulation of offenders on the pathway have been found to not be accepted into any OPD service and therefore fail to progress.

OBJECTIVE

This study aims to identify and describe offenders on the OPD pathway who fail to progress and to understand the causal drivers by which individuals fail to progress in the pathway.

METHODS

A sample of 50 offenders on the OPD pathway who had been refused from at least two OPD services (nonprogression group) were compared to 100 offenders accepted into OPD services (control group). Partial least squares structural equation modeling was used to model the causal factors involved in not being accepted into OPD services.

RESULTS

The path coefficients in the structural model showed that the most influential factor in nonprogression was attitude toward treatment (β=.41; P<.001; f2=0.25) alongside those with psychopathology (β=.41; P<.001; f2=0.25), specifically, psychopathy, psychosis, and co-occurring personality disorder.

CONCLUSIONS

The findings of the study provide a basis of how to work with this population in the future to increase the likelihood of acceptance into OPD services.

Does "Enhanced Support" for Offenders Effectively Reduce Custodial Violence and Disruption? An Evaluation of the Enhanced Support Service Pilot

This study aimed to examine the effectiveness of The Enhanced Support Service (ESS) pilot in reducing custodial violence and disruption, and the associated costs, by observing the behavioural change of the 35 service users who participated in ESS intervention within its first 22 months of operation. Frequencies of recorded incidents of aggressive behaviours, self-harming behaviours, noncompliance, and positive behaviours were counted from routine administrative systems using a coding structure developed in previous studies. The count data were analysed using nonparametric tests and Poisson regression models to derive an Incident Rate Ratio (IRR). Findings suggest the ESS is associated with a reduction in aggressive behaviours and noncompliance, with medium to large effect sizes ( r = .31-.53); however, it was not associated with a reduction in deliberate self-harm or increased positive behaviours. The Poisson models revealed that levels of pre-intervention behaviour, intervention length, intervention completion, and service location had varying effects on postintervention behaviour, with those who completed intervention demonstrating more favourable outcomes. The ESS service model was associated with a reduction in behaviour that challenges, which has implications for the reduction in associated social, economic, and political costs-as well as the commissioning of interventions and future research in this area.

Hostile Attribution Bias as a Mediator of the Relationships of Psychopathy and Narcissism With Aggression

Hostile attribution bias (HAB), the tendency to perceive hostility in ambiguous situations, has been linked to aggressive outcomes, such as reactive aggression. HAB has been connected to personality types involving hostile beliefs and reactive aggression, including narcissism and psychopathy. Specifically, secondary psychopathy is associated with HAB and reactive aggression. Despite research and theory connecting these constructs, few studies have examined if HAB mediates the relationships among psychopathy, narcissism, and aggression. The current study explores this possible mediation in an urban college sample. Narcissism was associated with aggression but not hostile aggression or HAB. Reactive aggression and HAB were both associated with psychopathy, but there were no mediation relationships. The associations with aggression may be, therefore, due to underlying traits of secondary psychopathy rather than the hostile attributions to which the traits contribute; consequently, treatments focused on reducing aggressive responses by correcting interpretations of social situations may not be successful.

Implementing evidence-based psychological substance misuse interventions in a high secure prison based personality disorder treatment service

Purpose

This paper aims to describe: the need for substance misuse treatment with high risk, personality disordered prisoners, and the implementation of two evidence-based psychological interventions aimed at addressing substance misuse within a high secure, personality disorder treatment unit and potential future evaluation options.

Design/methodology/approach

In addition to the literature base evidencing the need for substance misuse treatment with this population, the Iceberg and ‘InsideOut’ interventions are presented. These interventions adopt a risk reduction and health intervention approach respectively. This includes explanations of how they came to be implemented within a prison based personality disorder treatment service and potential ways to evaluate these services.

Findings

Evidence-based psychological interventions can be implemented for this population whilst being responsive to changing government priorities for substance misuse treatment. The organisation’s research strategy includes an intention to evaluate these interventions in order to inform future delivery.

Practical implications

The high levels of co-morbidity between personality disorder and substance misuse disorders in the high security prison estate highlights the need for substance related treatment for this population. Given the responsivity issues relevant to personality disordered offenders, the format of delivery of evidence-based psychological interventions has to be considered.

Originality/value

This paper discusses the application of evidence-based psychological interventions for substance use within a high secure, personality disordered population which has developed as a result of ministerial changes within the treatment of both substance misuse and personality disorder.

The Westgate Service and Related Referral, Assessment, and Treatment Processes

The formerly named "Dangerous and Severe Personality Disorder" (DSPD) units are no longer standalone services within the criminal justice system in England and Wales. These sites now provide personality disorder treatment services in the high-security prison estate as part of the new national Offender Personality Disorder (OPD) Pathway Strategy. The OPD Pathway intends to take responsibility for the assessment, treatment, and management of offenders who are likely to have a personality disorder and who present a high risk of re-offending (men and women) and serious harm to others (men). Further PD treatment and progression services are being commissioned in lower security prisons and in the community as part of the new PD Strategy. While the suitability criteria for the two male high-security PD treatment sites are the same, the individual units have their own assessment and treatment methods. This article aims to communicate the referral, assessment, and treatment methods employed within the prison-based Westgate Personality Disorder Treatment Service, HMP Frankland.