Thompson, Claire (2010)
Foren.Psy.D. thesis, University of Birmingham.
Restricted to Repository staff only until 01 July 2020.
This thesis examines the assessment and treatment of violence in personality disordered offenders, with the view of identifying pertinent issues to be considered when appraising risk within clinical practice. Chapter 1 reviews the relevant literature and outlines the remaining thesis. A systematic review evaluating Dialectical Behaviour Therapy (DBT) with borderline personality disordered (BPD) inpatients can be found in Chapter 2. Despite highlighting a number of methodological limitations, the review indicates DBT as having positive therapeutic effects within secure settings. Chapter 3 examines the predictive validity of the Historical/Clinical/Risk Management- 20 (HCR-20; Webster, Douglas, Douglas Eaves & Hart, 1997) showing it to be a valid and reliable within forensic populations. However, the review indicates the need for additional research, making recommendations for such work. The empirical paper in Chapter 4 investigates the concept Dangerous and Severe Personality Disorder (DSPD). A DSPD sample is compared to a non DSPD personality disordered group from the same setting on a number of risk related variables. Analysis of hospital incident data and Historical Clinical Risk Management-20 (HCR-20) scores suggests DSPD patients are at a higher risk of imminent harm to themselves and others than the comparison group. These findings offer substantiation to the DSPD label and the accompanying therapeutic programme. An individualised approach to risk assessment and treatment of a Learning Disabled offender with Borderline Personality Disorder is presented in Chapter 5, serving to highlight the difficulties with management of personality disordered inpatients. Chapter 6 offers concluding comments, discussing further implications for clinical practice.
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