Personality disorder & serious further offending

Offender characteristics are considered important in the prediction of future risk of re-offending and response to treatment. The psychiatric classification of offenders can therefore be an important variable influencing decision making. Although the relationship between personality disorder and offending is established in the literature, the relationship is complex. Recidivism of any type, particularly serious further offending that is violent or sexual in nature, has far reaching implications on the victims, the perpetrator, the criminal justice system and wider society. The identification and management of individuals with personality disorder is a priority for both mental health professionals and the criminal justice system. The overall aim of this thesis is to examine the relationship between personality disorder and further offending in adult forensic populations (prison and probation). Chapter one presents a general introduction to the topic. Chapter two presents a literature review following a systematic approach and poses the question: Is personality disorder associated with recidivism? The findings are generally supportive of the view that some personality disorders are associated with a greater likelihood of recidivism. The limited good quality research available indicates the need for further research. Chapter three presents a critique of a screening tool for personality disorder, the Standardised Assessment of Personality: Abbreviated Scale (SAPAS). It highlights that despite some shortcomings, the SAPAS is a simple, brief and useful first-stage screening tool for personality disorder that possesses adequate psychometric properties. It is proposed that a combined screening approach, using the SAPAS and Offender Assessment System Personality Disorder (OASys PD) screen, is necessary to improve the detection of antisocial cases, particularly in forensic populations. In Chapter four an exploratory cohort study examines personality disorder in a UK sample of offenders, that have committed a further serious sexual or violent offence, whilst under the active supervision of the London Probation Trust. The study investigated the prevalence and type of personality disorders using the SAPAS and OASys PD screen. Comparisons were made between serious further offence (SFO) offenders with and without personality disorder, and within the SFO group by type of SFO (violent or sexual). The SAPAS and OASys PD screen were also explored in relation to their ability to predict group membership (SFO vs. non-SFO). The study identified that personality disorder prevalence was higher in SFO offenders, particularly antisocial traits, and that the OASys PD and OASys risk of harm (RoH) classification are significant variables for predicting group membership. The study has added to the knowledge base and understanding of SFO offenders and has implications for the practice of Offender Managers/Supervisors in UK prisons and probation units. The findings support the efficacy of the screening approach used in the Offender Personality Disorder Pathway (DOH/NOMS, 2012), London Pathways Project. A single case study is presented in Chapter five which evaluates the utility of psychological therapy with a man on Licence, presenting with traits of antisocial personality disorder. The difficulties associated with working with this client group are considered. In Chapter six a discussion of the work presented concludes the thesis. Overall, the thesis identifies some interesting findings in relation to the prevalence of personality disorder in SFO offenders and the utility of some key tools used in the assessment of offenders in probation/prison, and how these could be used in relation to risk management. Chapter 5, the single case study, has been removed and is only accessible in the printed version.