A non-randomised controlled trial of the R&R2MHP cognitive skills program in high risk male offenders with severe mental illness

BMC Psychiatry

Susan Young¹  Gareth Hopkin¹  Amie Doidge¹  Derek Perkins¹  Gisli H Gudjonsson²  Vivienne C-Y Yip¹ 

[1] Broadmoor Hospital, Crowthorne, UK;Department of Psychology, PO77, King's College London, Henry Wellcome Building, De Crespigny Park, London SE5 8AF, UK

关键词: Cognitive skills;    Rehabilitation;    Reasoning &;    Treatment outcome;    Mentally disordered offenders;   

Others  :  1123927
DOI  :  10.1186/1471-244X-13-267

 received in 2013-02-08, accepted in 2013-10-10,  发布年份 2013

【 摘 要 】

Background

The growing popularity of offending behavior programs has led to the interest of whether such programs are effective with mentally disordered offenders. This study aimed to evaluate the effectiveness of the Reasoning and Rehabilitation program adapted for offenders with severe mental illness (R&R2 MHP).

Methods

A sample of 59 adult high risk males detained in a high secure hospital completed questionnaires at baseline and post treatment to assess violent attitudes, anger, coping processes and social problem-solving. An informant measure of social and psychological functioning, including disruptive behavior, was completed by staff at the same time. The data of 30 patients who participated in the group condition were compared using intention to treat analysis with 29 controls who received treatment as usual.

Results

80% of group participants completed the program. In contrast to controls, significant medium-large treatment effects were found at outcome on self-reported measures of violent attitudes, social problem-solving and coping processes. Improvements were endorsed by informant ratings of disruptive behavior, social and psychological functioning.

Conclusions

The R&R2MHP had a comparatively low dropout rate and was effective in a sample of high risk mentally disordered offenders requiring detention in high security. Future research should use a randomized controlled design.

Trial registration

Current Controlled Trials ACTRN12613000216718.

【 授权许可】

   
2013 Yip et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Hodgins S: Mental disorder, intellectual deficiency, and crime: evidence from a birth cohort. Arch Gen Psychiatry 1992, 49:476-483.
• [2]Wallace C, Mullen PE, Burgess P: Criminal offending in schizophrenia over a 25-year period marked by deinstitutionalization and increasing prevalence of co-morbid substance use disorders. Am J Psychiatr 2004, 161:716-727.
• [3]Brennan A, Mednick SA, Hodgins S: Major mental disorders and criminal violence in a Danish birth cohort. Arch Gen Psychiatry 2000, 5:494-500.
• [4]Fazel S, Danesh J: Serious mental disorder in 23 000 prisoners: a systematic review of 62 surveys. Lancet 2002, 359:545-550.
• [5]Swanson JW, Swartz MS, Van Dorn RA, Elbogen EB, Wagner HR, Rosenheck RA, Stroup TS, McEvoy JP, Lieberman JA: A national study of violent behavior in persons with schizophrenia. Arch Gen Psychiatry 2006, 63:490-496.
• [6]Hodgins S, Alderton J, Cree A, Aboud A, Mak T: Aggressive behavior, victimisation and crime among severely mentally ill patients requiring hospitalisation. Br J Psychiatry 2007, 191:343-350.
• [7]Walsh E, Buchanan A, Fahy T: Violence and schizophrenia: examining the evidence. Br J Psychiatry 2002, 180:490-495.
• [8]Swanson JW, Borum R, Swartz M, Hiday V: Violent behavior preceding hospitalisation among persons with severe mental illness. Law Hum Behav 1999, 23:185-204.
• [9]Rutherford M, Duggan S: Forensic mental health services: facts and figures on current provision. 2007. [The Sainsbury centre for mental health, forensic fact-file] http://www.centreformentalhealth.org.uk/pdfs/scmh_forensic_factfile_2007.pdf webcite
• [10]Bonta J, Law M, Hanson K: The prediction of criminal and violent recidivism among mentally disordered offenders: a meta-analysis. Psychol Bull 1998, 123:123-142.
• [11]Gray NS, Snowden RJ, MacCulloch S, Phillips H, Taylor J, MacCulloch MJ: Relative efficacy of criminological, clinical, and personality measures of future risk of offending in mentally disordered offenders: a comparative study of HCR-20, PCL:SV, and OGRS. J Consult Clin Psychology 2004, 72:523-530.
• [12]Kroner DG, Mills JF, Morgan RD: Underreporting of crime-related content and the prediction of criminal recidivism among violent offenders. Psychol Serv 2007, 4:85-95.
• [13]Morgan RD, Fisher WH, Duan N, Mandracchia JT, Murray D: Prevalence of criminal thinking among state prison inmates with serious mental illness. Law Hum Behav 2010, 34:324-336.
• [14]D’Zurilla TJ, Nezu AM, Maydeu-Olivares A: A Social Problem-Solving Inventory-Revised (SPSI-R) . North Tonawanda: NY: Technical Manual. Multi-Health Systems; 2002.
• [15]Biggam FH, Power KG: Social problem-solving skills and psychological distress among incarcerated young offenders: the issue of bullying and victimization. Cogn Ther Res 1999, 23:307-326.
• [16]Ingram JC, Dixon DN, Glover JA: Problem solving as a function of race and incarceration. J Soc Psychol 1983, 120:83-90.
• [17]McMurran M, Egan V, Richardson C, Ahmadim S: Social problem-solving in mentally disordered offenders: a brief report. Crim Behav Ment Health 1999, 9:315-322.
• [18]Gendreau P, Goggin C, Smith P: Is the PCL-R really the “unparalleled” measure of offender risk? a lesson in knowledge cumulation. Crim Justice Behav 2002, 29:397-426.
• [19]Gendreau P, Little T, Goggin C: A meta-analysis of the predictors of adult offender recidivism: what works! Criminology 1996, 34:575-608.
• [20]Simourd DJ, Olver ME: The future of criminal attitudes research and practice. Crim Justice Behav 2002, 29:427-446.
• [21]Barriga AQ, Gibbs JC, Potter GB, Liau AK: How I think (HIT) questionnaire manual. Champaign: Research Press; 2001.
• [22]Best D, Day E, Campbell A, Flynn PM, Simpson DD: Relationship between drug treatment engagement and criminal thinking style among drug-using offenders. Eur Addict Res 2009, 15:71-77.
• [23]Brezina T: Anger, attitudes, and aggressive behavior: exploring the affective and cognitive foundations of angry aggression. J Contemp Crim Justice 2010, 26:186-203.
• [24]Howells K: Anger and its links to violent offending. Psychiatry Psychol Law 2004, 11:189-196.
• [25]Zamble E, Porporino F: Coping, imprisonment, and rehabilitation: some data and their implications. Crim Justice Behav 1990, 17:53-70.
• [26]Taylor PJ, Leese M, Williams D, Butwell M, Daly R, Larkin E: Mental disorder and violence: a special (high security) hospital study. Br J Psychiatry 1998, 172:218-226.
• [27]Thomas S, Leese M, Dolan M, Harty M, Shaw J, Middleton H, Carlisle J, Davies L, Thornicroft G, Appleby L: The individual needs of patients in high secure psychiatric hospitals in England. J Forensic Psychiatry Psychol 2004, 15:222-243.
• [28]Martinson R: What works? questions and answers about prison reform. Public Interest 1974, 35:22-54.
• [29]McGuire J: What works: reducing reoffending: guidelines from research and practice. Wiley series in offender rehabilitation. Oxford: John Wiley & Sons; 1995.
• [30]Blud L, Travers R, Nugent F, Thorton D: Accreditation of offending behaviour programmes in HM prison service: ‘what Works’ in practice. Leg Criminol Psychol 2003, 8:69-81.
• [31]Clark DA: Theory manual for enhanced thinking skills: prepared for the joint prison accreditation panel. London: Home Office; 2000.
• [32]Ross RR, Fabiano EA, Ewles CD: Reasoning and rehabilitation. Int J Offender Ther Comp Criminol 1988, 32:29-35.
• [33]Landenberger NA, Lipsey MW: The positive effects of cognitive-behavioral programs for offenders: a meta-analysis of factors associated with effective treatment. J Exp Criminol 2005, 1:451-476.
• [34]Tong LS, Farrington DP: How effective is the “reasoning and rehabilitation” program in reducing reoffending? a meta-analysis of evaluations in four countries. Psychol Crime and Law 2006, 12:3-24.
• [35]Cullen AE, Soria C, Clarke AY, Dean K, Fahy T: Factors predicting dropout from the reasoning and rehabilitation program with mentally disordered offenders. Crim Justice Behav 2011, 38:217-230.
• [36]McMurran M, Theodosi E: Is treatment non-completion associated with increased reconviction over no treatment. Psychol Crime Law 2007, 13:333-343.
• [37]Wormith JS, Olver ME: Offender treatment attrition and its relationship with risk, responsivity, and recidivism. Crim Justice Behav 2002, 29:447-471.
• [38]Hollin CR, McGuire J, Hounsome JC, Hatcher RM, Bilby CAL, Palmer EJ: Cognitive skills behavior programs for offenders in the community: a reconviction analysis. Crim Justice Behav 2008, 35:269-283.
• [39]Andrews DA, Bonta J: Rehabilitating Criminal Justice Policy and Practice. Psychol Publ Pol Law 2010, 16:39-55.
• [40]Young SJ, Ross RR: R&R2 for youths and adults with mental health problems: a prosocial competence training program. Ottawa: Cognitive Centre of Canada; 2007.
• [41]Hollin CR, Palmer E: Cognitive skills program for offenders. Psychol Crime Law 2009, 15:147-164.
• [42]McGurk SR, Twamley EW, Sitzer DI, McHugo GJ, Mueser KT: A meta-analysis of cognitive remediation in schizophrenia. Am J Psychiatry 2007, 164:1791-1802.
• [43]Rees-Jones A, Gudjonsson G, Young S: A multi-site controlled trial of a cognitive skills program for mentally disordered offenders. BMC Psychiatry 2012, 12:1-11. BioMed Central Full Text
• [44]Young S, Chick K, Gudjonsson G: A preliminary evaluation of reasoning and rehabilitation 2 in mentally disordered offenders (R&R2M) across two secure forensic settings in the United Kingdom. J Forensic Psychiatry Psychol 2010, 21:336-349.
• [45]Young S, Hopkin G, Perkins D, Farr C, Doidge A, Gudjonsson GH: A controlled trial of a cognitive skills program for personality disordered offenders. J Atten Disord 17:598-607.
• [46]Cullen AE, Clarke AY, Kuipers E, Hodgins S, Dean K, Fahy T: A multi-site randomized controlled trial of a cognitive skills program for male mentally disordered offenders: social-cognitive outcomes. Psychol Med 2012, 42:557-569.
• [47]Haddock G, McCarron J, Tarrier N, Faragher EB: Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS). Psychol Med 1999, 29:879-889.
• [48]Spitzer RL, Williams JBW, Gibbon M, First MB: Structured clinician interview for DSM-III-R axis II disorders (SCID-II). Washington: American Psychiatric Press; 1990.
• [49]Walker JS: The maudsley violence questionnaire: initial validation and reliability. Personal Individ Differ 2005, 38:187-201.
• [50]Novaco RW: The novaco anger scale and provocation inventory. Los Angeles: Western Psychological Services; 2003.
• [51]Novaco RW, Taylor JL: Assessment of anger and aggression in offenders with developmental disabilities. Psychol Assess 2004, 16:42-50.
• [52]Mills JF, Kroner DG, Forth AE: Novaco anger scale: reliability and validity within an adult criminal sample. Assessment 1998, 5:327-248.
• [53]Monahan J, Steadman H, Silver E, Appelbaum P, Robbins P, Mulvey E, Banks S: Rethinking risk assessment: the MacArthur study of mental disorder and violence. New York: Oxford University Press; 2001.
• [54]Jones JP, Thomas-Peter BA, Trout A: Normative data for the novaco anger scale from a non-clinical sample and implications for clinical use. Br J Clin Psychol 1999, 38:417-424.
• [55]Lazarus R, Folkman S: Stress, appraisal and coping. New York: Springer; 1984.
• [56]Folkman S, Lazarus RS: If it changes it must be a process: study of emotion and coping during three stages of a college examination. J Pers Soc Psychol 1985, 48:150-170.
• [57]D’Zurilla TJ, Nezu AM, Maydeu-Olivares A: A social problem-solving InventoryRevised (SPSI-R): technical manual. Multi-Health Systems: North Tonawanda; 2002.
• [58]Young S, Gudjonsson G, Ball S, Lam J: Attention deficit hyperactivity disorder in personality disordered offenders and the association with disruptive behavioural problems. J Forensic Psychiatry Psychol 2003, 14:491-505.
• [59]Prince M, Stewart R, Ford T, Hotopf M: Practical psychiatric epidemiology. Oxford: Oxford Medical Publications; 2003.
• [60]Clarke AY, Cullen AE, Walwyn R, Fahy T: A quasi-experimental pilot study of the reasoning and rehabilitation program with mentally disordered offenders. J Forensic Psychiatry Psychol 2010, 21:490-500.
• [61]Nijman HL, Muris P, Merckelbach HG, Palmsteir T, Wistedt B, Vos AM, Rixtel AV, Allertz W: The staff observation aggression scale- revised (SOAS-R). Aggress Behav 1999, 25:197-209.
• [62]McMurran M, Huband N, Duggan C: A comparison of treatment completers and non-completers of an in-patient treatment program for male personality-disordered offenders. Psychol Psychother Theory Res Pract 2008, 81:193-198.
• [63]Laithwaite HM, Gumley A, Benn A, Scott E, Downey K, Black K, McEwen S: Self esteem and psychosis: a pilot study investigating the effectiveness of a self-esteem program on the self-esteem and positive symptomatology of mentally disordered offenders. Behav Cogn Psychother 2007, 35:569-577.
• [64]Mak AS: Psychosocial control characteristics of delinquents and nondelinquents. Crim Justice Behav 1991, 18:297-303.
• [65]Eysenck SB, McGurk BJ: Impulsiveness and venturesomeness in a detention centre population. Psychol Rep 1980, 47:1299-1306.
• [66]Gudjonsson G, Young S: The role and scope of forensic clinical psychology in secure unit provision: a proposed service model for psychological therapies. J Forensic Psychiatry Psychol 2007, 18:534-556.
• [67]Emilsson B, Gudjonsson G, Sigurdsson JF, Baldursson G, Einarsson E, Olafsdottir H, Young S: Cognitive behavior therapy in medication-treated adults with ADHD and persistent symptoms: a randomized controlled trial. BMC Psychiatry 2011, 11:1-10. BioMed Central Full Text