A descriptive evaluation of patients and prisoners assessed for dangerous and severe personality disorder

• Published in: The journal of forensic psychiatry & psychology Vol. 21; no. 2; pp. 264 - 282
• Main Authors: Kirkpatrick, Tim, Draycott, Simon, Freestone, Mark, Cooper, Sylvia, Twiselton, Karen, Watson, Neil, Evans, Jacquie, Hawes, Val, Jones, Lawrence, Moore, Claire, Andrews, Kathryn, Maden, Tony
• Format: Journal Article
• Language: English
• Published: Colchester Routledge 01.04.2010; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Adult and adolescent clinical studies; Anatomical correlates of behavior; Behavioral psychophysiology; Biological and medical sciences; Clinical psychology; Forensic psychiatry; Fundamental and applied biological sciences. Psychology; high-security hospital; Maximum security institutions; Medical sciences; Mental health; Mental hospitals; Mental illness; Mental institutions; Offending; personality disorder; Personality disorders; prison; Prisoners; Prisons; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psychopathology; Psychopathology. Psychiatry; Psychopathy; Risk assessment; risk assessments; Risk factors; Human; risk assessments; Prisoner; psychopathy; Carceral environment; Hospital environment; Personality disorder; Behavioral disorder; high-security hospital; Psychopathia; Risk factor; Safety; Social behavior disorder; prison
• ISSN: 1478-9949; 1478-9957
• DOI: 10.1080/14789940903388978

The Dangerous and Severe Personality Disorder (DSPD) programme was introduced to assess, manage and treat severely personality disordered individuals who present a high risk of serious offending. We describe the clinical and risk characteristics of the first 241 patients admitted to the high-security DSPD service for assessment. Eighty-four percent of patients were regarded as meeting the DSPD criteria. Clinically, the DSPD patients demonstrated high levels of psychopathy, with 78% scoring 25 or more on the Psychopathy Checklist. The most commonly diagnosed personality disorders were antisocial, borderline and paranoid. The risk assessments indicated the DSPD patients exhibited a broad range of risk factors for future offending, suggesting that these patients had extensive treatment needs. The DSPD service had been relatively successful in retaining patients, with 82% of those admitted to treatment remaining within the high-security DSPD service. The clinical mix of the patients may have implications for treatment outcome, and future challenges for the service are highlighted.