Attachment styles and violence in child molesters

Abstract

It has been suggested that sexual offenders lack the capacity to engage in or to maintain intimate relationships and that their attachment styles are insecure. The present study tested some of the implications of this theory with a group of incest offenders, nonfamilial child molesters, nonsex offenders, and nonoffenders recruited from the local community. Subjects completed a self-report questionnaire detailing their characteristic relationship style, and the level of violence employed by all sexual offenders was obtained from institutional files. Nonfamilial child molesters were five times more likely to report a fearful avoidant relationship style than a secure style compared to the community group. When they rated the degree to which they considered themselves to be fearful avoidant, the ratings of the nonfamilial child molesters were significantly higher than the ratings of community subjects and incest offenders. Incest offenders did not differ from community controls or from nonsex offender controls. Of the pooled group of child molesters, dismissively avoidant offenders employed higher levels of aggression in their offences than did secure or fearful avoidant offenders. These results are discussed in the light of current theory, and suggestions for future research and treatment initiatives are offered.     

The Interpersonal Style and Complementarity Between Crisis Negotiators and Forensic Inpatients

Previous negotiation research has explored the interaction and communication between crisis negotiators and perpetrators. A crisis negotiator attempts to resolve a critical incident through negotiation with an individual, or group of persons in crisis. The purpose of this study was to establish the interpersonal style of crisis negotiators and complementarity of the interpersonal interaction between them and forensic inpatients. Crisis negotiators, clinical workers and students (n = 90) used the Check List of Interpersonal Transactions-Revised (CLOIT-R) to identify interpersonal style, along with eight vignettes detailing interpersonal styles. Crisis negotiators were most likely to have a friendly interpersonal style compared to the other non-trained groups. Complementarity theory was not exclusively supported as submissive individuals did not show optimistic judgments in working with dominant forensic inpatients and vice versa. Exploratory analysis revealed that dominant crisis negotiators were optimistic in working with forensic inpatients with a dominant interpersonal style. This study provides insight into the area of interpersonal complementarity of crisis negotiators and forensic inpatients. Whilst further research is required, a potential new finding was established, with significant ‘similarity’ found when dominant crisis negotiators are asked to work with dominant forensic inpatients.     

How do psychiatric patients on prison healthcare centres differ from inpatients in secure psychiatric inpatient units?

Abstract

Mentally ill prisoners have consistently been highlighted as a group with complex needs. However, it is not clear what these needs are, how effective prison health services are in meeting the needs of this vulnerable group, and whether there would be any benefit to transferring them to psychiatric facilities. This study compared the characteristics and needs of mentally ill patients in prison healthcare centres (HCC prisoners) with patients in forensic medium secure psychiatric units (MSU inpatients) in the UK. HCC prisoners and MSU inpatients were in fact very similar. Where they did differ, though, was that MSU inpatients were significantly more likely to be of non-white ethnicity, diagnosed with psychotic or substance use disorders, and have recorded histories of drug misuse. HCC prisoners and MSU inpatients reported the same number of needs overall, according to the CANFOR-S (Camberwell Assessment of Need Forensic Short Version), but HCC prisoners reported significantly higher levels of unmet need. The need for transfer to alternative services was common in both groups, with bottlenecks evident at all levels. The high level of unmet need reported in the HCC prison sample is of particular clinical concern and highlights the need for improved assessment and treatment services in this setting.     

Attachment, Emotional Regulation, and the Function of Marital Violence: Differences Between Secure, Preoccupied, and Dismissing Violent and Nonviolent Husbands

The purpose of this study was to investigate behavioral differences among nonviolent, unhappily married husbands and violent husbands with different attachment classifications on the Adult Attachment Interview (AAI; Main and Goldwyn, 1994). Twenty-three Domestically Violent (DV) husbands and 13 maritally distressed but non-violent (DNV) husbands were interviewed using the AAI. Violent husbands (74%) were more likely than the distressed/nonviolent husbands (38%) to be classified into one of the insecure categories on the AAI. As predicted, during laboratory arguments with their wives, dismissing husbands were the most controlling and distancing, and preoccupied husbands the least distancing, during marital interactions. Secure husbands were significantly more defensive than the two insecure types. Sequential analyses of reports of violent arguments at home revealed different patterns among different types of batterers. For the preoccupied batterers only, wife withdrawal was a significant predictor of husband violence. For the dismissing batterer only, wife defensiveness was a significant precursor to husband violence. It is theorized that preoccupied batterers' violence and emotional abuse is related to expressive violence in response to abandonment fears; whereas dismissing batterers use instrumental violence to assert their authority and to control their wives. The overlap between this and other typologies of violent men is explored.Deceased     

Attachment and social bonding in maximum and minimum security prison inmates

Attitudes towards social attachment and bonding were evaluated in groups of maximum (N = 48) and minimum (N=46) security prison inmates and compared with the attitudes of a group of 49 noncriminal college students. Three primary styles of attachment were considered: avoidant, ambivalent/anxious, and secure. It was predicted that the maximum security condition, a group hypothesized to contain a large number of lifestyle criminals, would evidence more of an avoidant style of attachment compared to minimum security inmates or a group of coliege student controls. Consistent with this hypothesis, the maximum security inmates exhibited greater avoidance in their attitudes towards relationships than subjects in the other two conditions. The implications of these results are discussed.     

He Loves Me; He Loves Me Not: Attachment and Separation Resolution of Abused Women

Working within an attachment perspective, we examined women's success at emotional separation from abusive partners. The attachment patterns of 63 abused women were assessed shortly after having left their abusive relationships. Six months later, their perceptions, feelings, and behaviors regarding the separation were assessed, to determine an overall level of separation resolution. As expected, attachment patterns associated with a negative self model were overrepresented (88% of the sample had a predominant pattern of fearful or preoccupied attachment). Further, preoccupation was associated with shorter relationship length, more frequent previous separations from the abusive relationship, continuing emotional involvement with partners after separation, and more frequent sexual contact with partners. These findings suggest that preoccupation may be a risk factor in successful separation resolution from abusive relationships.     

Attachment and social bonding in maximum and minimum security prison inmates

Attitudes towards social attachment and bonding were evaluated in groups of maximum (N=48) and bonding were evaluated in groups of maximum (N=46) security prison inmates and compared with the attitudes of a group of 49 noncriminal college students. Three primary styles of attachment were considered: avoidant, ambivalent/anxious, and secure. It was predicted that the maximum security condition, a group hypothesized to contain a large number of lifestyle criminals, would evidence more of an avoidant style of attachment compared to minimum security inmates or a group of college student controls. Consistent with this hypothesis, the maximum security inmates exhibited greater avoidance in their attitudes towards relationships than subjects in the other two conditions. The implications of these results are discussed.     

Psychological distress and severity of personality disorder symptomatology in prisoners convicted of violent and sexual offences

Abstract

Background: There have been recent proposals in England and Wales to develop services aimed at reducing the risk to the public posed by offenders with so-called “severe personality disorder”. The emphasis of the proposals is on risk. However, prisoners with personality disorder may have psychiatric treatment needs other than those purely relating to public protection. The aim of the study was to examine the association between severity of self reported personality disorder pathology and psychological distress in serious offenders.

Method: All male prisoners in two prisons, convicted of violent or sexual offences, were sent the Personality Diagnostic Questionnaire 4+(PDQ?4+) and the Symptom Checklist 90-R (SCL-90-R).

Results: High levels of self reported personality pathology were associated with high levels of psychological distress.

Conclusions: Offenders with the most severe self reported personality disorder pathology experience distress that may be clinically significant. Services for offenders with personality disorder will need to address their associated psychiatric symptoms.     

Measuring criminal thinking styles: The construct validity and utility of the PICTS in a Dutch prison sample

Purpose. Criminal thinking and thinking styles are important areas in the assessment and treatment of offenders. The Psychological Inventory of Criminal Thinking Styles (PICTS: Walters, 2005) is designed to assess such criminal thinking styles. In the current study, the associations between criminal thinking styles on the one hand, and criminal histories, personality traits, and mental disorders of Dutch prisoners on the other, were explored. The aim is to test the reliability and construct validity of the PICTS in a population of male Dutch detainees. Methods. A sample of 191 randomly selected male prisoners of a large Dutch correctional institution were assessed by means of the PICTS, NEO‐PI‐R, and the MINI psychiatric interview. Prison inmates with very severe psychiatric symptoms and severe disruptive behaviours were excluded. Results. The psychometric qualities of the PICTS were found to be fair‐to‐good. The construct validity of the PICTS was supported by various convergent results with the criminal antecedents of the offenders, as well as with the scores on the scales measuring personality traits and psychiatric disorders. Conclusions. The associations between criminal thinking styles on the one hand and personality traits, antisocial personality disorder, and mental disorders on the other were rather strong. The current results suggest that the PICTS may be a valid and useful tool for assessing criminal thinking styles.     

Personality Traits are Related to Intimate Partner Violence Among Securely Attached Individuals

The general assumption has been that male batterers from clinical samples were mostly insecurely attached as compared to non-batterers. Recently, a large group was found (39.4 % of batterers in a clinical sample) whose main attachment style was secure. No previous studies have examined specifically the securely attached batterer. The aim of the present study was to test whether antisocial personality disorder (ASPD) and narcissistic personality disorder (NPD), but not borderline personality disorder (BPD), traits may be related to battering among securely attached individuals. Twenty-seven securely attached batterers, 45 insecurely attached batterers, 40 securely attached controls, and 22 insecurely attached controls who lived in the Netherlands, filled in self-report measures of personality disorder traits (i.e., antisocial, narcissism, borderline) and attachment (i.e., avoidant and anxious). Results showed that ASPD traits explained 19 % of the variance of battering in securely attached individuals. NPD and BPD traits are related to battering among securely attached individuals when NPD and BPD traits were entered alone in the equation.     

Finding a voice – the feasibility and impact of setting up a community choir in a forensic secure setting

This study reports on the feasibility and impact of running a choir for forensic psychiatric inpatients, staff and members of the local community, within the confines of a medium secure psychiatric unit. The choir ran between October and December 2013. Eight weekly workshops and a final concert performance were evaluated through participant observation and focus groups held with the participants. Between 12 and 16 male and female patients attended each workshop and the final concert. All participating patients had received a diagnosis of schizophrenia, schizo-affective disorder or personality disorder, all had committed serious violent or sexual offences and all were legally detained and receiving treatment in a forensic medium or low secure ward, under the Mental Health Act (England and Wales). Considerable benefits were reported by patients, as well as by the participating community choir members and staff. Primary benefits reported by patients included the following: improved happiness and well-being; increased confidence and self-esteem; greater emotional connectedness and reduced sense of stigma. Participating staff also reported increased feelings of well-being and happiness, greater tolerance and more positive perceptions of the functioning and capabilities of forensic psychiatric patients. The longer term benefits of music participation on the mental health and social functioning of forensic psychiatric patients require further investigation.     

Severe personality disorder,treatment engagement and the Legal Aid,Sentencing and Punishment of Offenders Act 2012: what you need to know

Empirical research has demonstrated a link between legal coercion and treatment engagement following conviction among those with severe personality disorder. Legal coercive pressures were often applied by the Indeterminate Sentence for Public Protection (IPP), until it was replaced by the Extended Determinate Sentence by the Legal Aid, Sentencing and Punishment of Offenders Act 2012. In this paper, it is proposed that use of the new determinate sentence will lessen motivation for treatment engagement. One effect of treatment refusal may be greater reliance by the Secretary of State for Justice on his jurisdiction to transfer prisoners due for release to secure hospital transfers under the Mental Health Act 1983. Not only will this risk posturing undermine the principal aim of the Offender Personality Disorder Implementation Pathway to improve treatment engagement among the target group, it will also have negative implications for medical practitioners working in secure forensic hospitals. To demonstrate what is at stake, the paper briefly recapitulates empirical findings familiar to readers of the journal, before drawing on original unpublished data.     

Recent life events and subjective well-being of personality disordered forensic outpatients

PurposeThe majority of patients treated at forensic psychiatric outpatient facilities suffer from personality disorders, especially Cluster B disorders. Life events have been shown to influence subjective well-being, severity of psychopathology and delinquent behaviour of patients with different personality disorders. However, the influence of life events on subjective well-being of patients suffering from Cluster B personality disorders has rarely been studied. Following General Strain Theory and the dynamic equilibrium model, we hypothesised that negative life events would negatively influence subjective well-being, and that subjective well-being would change when an instability of life events occurs.MethodsFifty-six adult male forensic psychiatric outpatients were interviewed on their subjective well-being and filled out a self-report life event questionnaire, at three time-points, with an interval of three months. Life events were categorized along two dimensions: positive / negative and controllable / uncontrollable.ResultsPatients had a stable pattern of positive, negative controllable and uncontrollable life events. Positive controllable events did not have a stable pattern. Results indicated that only negative controllable events correlated negatively with subjective well-being. Furthermore, positive and positive controllable events correlated with a positive change in subjective well-being and uncontrollable events correlated negatively with this change.ConclusionsForensic psychiatric outpatients seem to experience a relatively stable ‘load’ of stressful life events, that does not influence change in subjective well-being. We did not find unequivocal support for General Strain Theory. In line with the dynamic equilibrium model, forensic outpatients seemed less used to positive controllable life events, which influenced positive change in subjective well-being. In outpatient forensic treatment, attempts to limit negative life events together with enhancing behaviour which results in positive events should be targeted. This might result in better lives for patients and in reduced criminal behaviour.     

Attachment styles and psychological profiles of child sex offenders in Ireland

When 29 child sex offenders, 30 violent offenders, 30 nonviolent offenders, and 30 community controls were compared, a secure adult attachment style was 4 times less common in the child sex offender group than in any of the other three groups. Ninety-three percent of sex offenders had an insecure adult attachment style. Compared with community controls, the child sex offender group reported significantly lower levels of maternal and paternal care and significantly higher levels of maternal and paternal overprotection during their childhood. Compared with all three comparison groups, the child sexual offenders reported significantly more emotional loneliness and a more external locus of control. With respect to anger management, the child sexual offenders' profile more closely approximated those of nonviolent offenders and community controls than that of violent offenders.     

Disordered personalities at work

Current categorical classification systems of personality disorders (PDs) remain widely used amid growing evidence that argues against the conceptualisation of PDs as independent, discrete entities. Adopting the dimensional perspective of Morey et al. (Journal of Personality Assessment, 49, 245–251, 1985), this study compared PD traits across forensic, psychiatric and “normal” senior business manager samples. There was particular interest in the relative representations of elements of PD closely associated with psychopathic PD because of research suggesting that some “psychopaths” operate within mainstream society, and links that have been made between elements of these so-called “successful” psychopaths, and characteristics associated with success in senior business management roles. The dimensional Minnesota Multiphasic Personality Inventory Scales for DSM III Personality Disorders (MMPI-PD) were shown to be internally consistent for the “normal” sample. Evidence for the qualitative equivalence of the four PD profiles emerged. The PD profile of the senior business manager sample was found to contain significant elements of PD, particularly those that have been referred to as the “emotional components” of psychopathic PD. The findings provide strong support for the continuous distribution of personality disordered traits.     

Using the National Diabetes Audit to improve the care of diabetes in secure hospital in-patient settings in the UK

To examine the ability of two forensic units, one high secure and one medium secure, to meet the NICE (National Institute for Health and Care Excellence) standards of care for diabetes. We applied the National Diabetes Audit programme, which uses as standards the NICE guidelines, to assess the quality of care provided for patients in two forensic units. Of the 500 patients, 200 in high secure and 300 in medium secure, 88 (17.6%) had type 2 diabetes. None had Type 1 diabetes. Of those with Type 2 diabetes, the care of 74 (84%) met all 8 NICE recommended standards. Glucose levels were lower in the medium/low secure unit compared to the higher security environment. Whilst achievement of process-based outcomes was higher than those reported nationally, achieving clinical outcomes was more challenging. High-quality diabetic care can be provided for patients in forensic units. Benchmarking physical health outcomes against national criteria in mental health inpatients is a potential method of improving outcomes.     

Relationship Religiosity,Adult Attachment Styles,and Courtship Violence Experienced by Females

This study assesses the association between adult attachment styles, religiosity, and courtship violence as experienced by females. The sample was composed of 299, 18 to 24-year-old females attending junior level Human Development and Family Studies courses at a midwestern state university. Statistical analyses evaluated interactional effects and mean-level differences for both victimization and perpetration of courtship violence. Additionally, structural equation models were generated. Results indicate significant relationships between adult attachment styles and religiosity on reports of victimization from intimate partners. In general, the results suggest that females with low religiosity and insecure attachment styles report experiencing more courtship violence than females reporting high religiosity and secure attachment styles. The analyses also provide support for a multidimensional conceptualization of religiosity. Indicators of `relationship' religiosity were more strongly linked to lower reports of courtship violence than personal and private relationship measures. The findings suggest that future studies evaluating the effects of religiosity on courtship violence should include measures of `relationship’ religiosity.     

Parental bonding and adult attachment styles in different types of stalker

Attachment theory is one of the earliest and most vigorously promoted explanations of the psychological processes that underlie stalking behavior. Insecure attachment has been proposed as impairing the management of relationships, thus increasing the propensity to stalk. The current study explored the parental bonding and adult attachment styles of 122 stalkers referred to a specialist forensic clinic. Stalkers were grouped according to two common classification methods: relationship and motivation. Compared to general community samples, stalkers were more likely to remember their parents as emotionally neglectful and have insecure adult attachment styles, with the degree of divergence varying according to stalker type and mode of classification. In offering support for the theoretical proposition that stalking evolves from pathological attachment, these findings highlight the need to consider attachment in the assessment and management of stalkers. Also emphasized is the importance of taking classification methods into account when interpreting and evaluating stalking research.     

Antecedents of abusive personality and abusive behavior in wife assaulters

One hundred and forty men referred for wife assault and 45 demographically matched controls were assessed for psychological variables associated with abusive personality (anger, cyclical (borderline) personality organization (BPO) and chronic experience of trauma symptoms) and abusive behaviors (both physical and emotional) as reported by their female partners. Predictor variables for these abuse measures included the EMBU which assesses recollections of parental warmth and rejection and the Conflict Tactics Scale which assesses physical abuse in the family of origin. A composite of BPO, anger, trauma symptoms and fearful attachment called Abusive Personality (ABP) correlated .42 with wives reports of emotionally abusive behaviors. ABP was positively and significantly correlated with recollections of negative parental treatment by the abuse perpetrator. A compositive of parental rejection and verbal and physical abuse by parents correlated .41 with ABP. A discriminant function of high and low ABP found that ABP was predicted by paternal rejection, physical abuse, and absence of maternal warmth. Physical abuse by either parent correlated significantly with all subscales and total scores on the ABP measure. When combined with data showing ABP to correlate significantly with frequency of use of violence by wife assaulters (Dutton, 1995b, Dutton and Starzomski, 1993), the current study suggests a personality syndrome of assaultive males that has antecedents in the early experiences of these men. The present data suggest that family of origin experiences may have effects beyond modeling of abusive behaviors. These effects include development of a specific personality form associated with abusiveness.     

The prevalence of mental disorders in a German sample of male incarcerated juvenile offenders

The current study investigated the prevalence of mental disorders among incarcerated juvenile offenders in Germany and sought to identify clinically relevant subgroups. In sum, 149 newly incarcerated male juvenile delinquents (M age = 19 years) were included. Diagnostic tools included the German version of the Structured Clinical Interview for DSM-IV and the Psychopathy Checklist-Screening Version. The most prevalent diagnoses in the sample included conduct disorders (81%), Cluster B personality disorders (up to 62%), and substance-related disorders (up to 60%). Moreover, psychopathic features were found among 21% of the participants. Cluster analysis distinguished three subgroups among this group of young offenders. The most problematic consisted of juveniles with multiple psychopathology, including antisocial traits, personality pathology, higher scores on the Psychopathy Checklist, as well as multiple substance abuse. Study outcomes are discussed in light of their implications for the development of effective treatment for juvenile offenders.