Malingering of cognitive symptoms.

Volume 1 is divided into 3 parts as follows: Part 1 (Review Paper) discusses the admissibility of psychometric evidence of cognitive malingering in UK criminal law courts. The paper opens with a historical account of psychologists as expert witnesses, highlighting significant advances relevant to malingering. This sets the context for a discussion about current developments in policy and specifically the creation of a UK standard for the admissibility of scientific evidence. The penultimate section outlines the statistical and methodological issues which challenge the development of empirical cognitive measures of malingering. The paper closes with a discussion of future directions for research and practice in presenting psychological evidence in court. Part 2 (Empirical Paper) reports on a study testing the utility of a battery of measures to identify simulating malingerers from healthy controls and psychiatric inpatients. The battery of measures were chosen for their different approaches to detecting malingerers. An additional qualitative interview was given to the simulating malingerers to investigate the strategies they used to fake the tests. The performance of the test battery was compared to a pre-existing screening tool for malingering. The results were discussed with reference to implications for research and practice. Part 3 (Critical Appraisal) reflects on the process of undertaking the research. It discusses the generalisability of the findings when using a simulating malingering design, the utility of measuring reaction time to detect malingering, difficulties in the recruitment of inpatients, the array of choices in selecting the test battery and the clinical applications of the research

Training probation officers in case formulation for personality disordered offenders

Background: The recent UK Strategy on Managing High Risk of Serious Harm Offenders with Severe Personality Disorder proposes a significant role for Offender Managers (OMs) completing case formulations on personality disordered (PD) offenders. However, there is very little evidence as to whether Offender Managers can be taught to carry out case formulation. Aim: The primary aims of this study were to devise and implement a training programme to teach Offender Managers to carry out case formulations, and assess their subsequent ability to do so. A secondary aim was to assess whether the training led to changes in OMs’ attitudes towards working with PD offenders. Method: A five day training programme was delivered to 20 Offender Managers, whose ability to carry out case formulation was assessed before and after the training using a 10 point quality checklist. Attitudes towards PD were also assessed before and after. Qualitative feedback relating to the training was used to provide further insight into the findings. Results: Offender Managers showed a significant improvement in their ability to carry out case formulation following training with 7 out of the 10 quality domains on the quality checklist rated as at least ‘satisfactory’ post-training. Qualitative feedback highlighted reasons for some of the shortfalls in two of the three areas that did not show improvement. Improvements were shown in attitudes towards working with PD offenders in two out of three domains. Conclusion: This study provides some evidence for Offender Managers’ ability to carry out case formulation following training, improvements in attitudes towards working with PD offenders and difficulties specific to this addition to their current role

Factors associated with progression in the London pathway project

Background: The London Pathways Partnership (LPP) Community Service is an approach to mainstreaming the identification of offenders with severe personality disorder to address their needs and reduce their risk. Aims: To evaluate the result of the full-scale implementation of the LPP and evaluate factors associated with an offender’s progression on the pathway. Method: The data collected as part of the LPP project and Offender Assessment System data were used to evaluate who was screened into the pathway and their progression on the pathway. Results: Over 3,400 offenders were screened into the pathway in the first 48 months of implementation but fewer were recorded as having progressed. It was not possible to determine whether this attrition reflected appropriate pathway action, inefficient service provision or weak recording procedures. Certain types of offenders were represented at progressive stages of the pathway. Those who had violent or sexual offences, had received custodial sentences, had more personality disorder indicators and were of higher risk were more likely to be found at progressive stages of the pathway. When probation areas began implementing the service was also found to be related to pathway movement. Also, those of Non-White ethnicity were no less likely than those of White ethnicity to be recommended or referred for services but were significantly less likely to start services. Conclusions: The LPP attempts to balance breadth (covering all offenders being convicted in London) with depth (developing a feasible pathway for all offenders identified with severe personality disorder) and has done so with some success. Implications: Future research should examine the continued rollout of the LPP service, and importantly the relationship between salient individual, risk and personality features, pathway inputs and measures of later reoffending

Evaluating the impact of the London Pathway Project

Background: The London Pathway Project (LPP) is an innovative whole-systems approach to addressing the needs of offenders who have severe personality disorder, with the goal of reducing their risk of harm. Previous research has evaluated the initial implementation of the LPP. Aims: This paper focused on evaluating the impact of the LPP on a number of criminogenic needs over time and its impact on the risk of reoffending and harm compared with a similar group who did not experience the pathway. Method Data for men who had been identified for the LPP were used to explore changes in key criminogenic needs an average of 11 months after commencing on the pathway. In addition, Offender Assessment System data was used to match men who had experienced the LPP for at least 12 months to a comparison group on key demographic and criminal history variables. Changes in validated risk assessment devices and changes in practitioners’ perception of risk were examined. Results: The LPP was associated with desirable within-individual change for most of the criminogenic needs explored. However, strong non-desirable changes in lifestyle and associates were also identified, but this was particularly the case for those sentenced to prison. When compared with a matched group, those identified for the pathway showed a significant reduction on an objective measure of risk of reoffending but were rated as having significantly increased risk of harm on the basis of practitioner’s perceptions. There was no evidence that greater progression along the pathway was associated with greater benefits. Conclusions: This is the first impact evaluation of the LPP, and the results were generally positive in terms of its relation to criminogenic needs and risks. Much more research that clearly links project inputs to actual behavioural outcomes, such as later reoffending, is needed

Mental health and Probation: a systematic review of the literature

A narrative systematic review was undertaken of the literature concerning the health of people on probation. In this paper, we provide an up-to-date summary of what is known about the most effective ways of providing mental healthcare for people on probation, and what is known about the relationship between different systems and processes of mental healthcare provision, and good mental health outcomes for this population. A total of 5125 papers were identified in the initial electronic searches but after careful double-blind review only four papers related to mental health that met our criteria, although a further 24 background papers and 13 items of grey literature were identified which are reported. None of the included studies was a randomized controlled trial although one was quasi-experimental. Two of the other papers described mental health disorders in approved premises and the other described the impact and learning from an Offender Personality Disorder project. We conclude that the literature is bereft of evidence on how to effectively provide mental healthcare for people on probation

Evaluation of the Enhanced Engagement and Relational Support Service (EERSS) within the Offender Personality Disorder (OPD) pathway

This was a mixed methods cross-sectional study evaluating OPD EERSS services in London. This included whether engagement with EERSS improved service participants? well-being and relationships with others, and reduced risk. Participants completed self-reported measures on working alliance, psychological distress, and well-being; and at different time points of service participation, were compared on outcomes including risk and attendance at statutory appointments. EERSS were compared to two control groups; the Intensive Intervention Risk Management Service (IIRMS) group, and a ?no-intervention? OPD screened-in group. A subsample of EERSS participants took part in qualitative interviews. Findings highlighted the positive impact of EERSS and IIRMS; in particular, that participants in those services improved their attendance at statutory probation appointments, compared to controls. There was a positive indication of improvement in well-being and risk. Qualitative findings identified aspects of the therapeutic alliance which improved well-being and engagement with probation. In conclusion, EERSS added value to the OPD pathway and may be deserving of wider rollout