Attitudes towards personality disorders: Comparison between prison officers and psychiatric nurses

Objectives. This study investigates the effects of working with dangerous and severely personality disordered (DSPD) prisoners and patients on the attitudes, perceptions and beliefs of staff, which may be important therapeutic variables in the management and treatment of prisoners and patients. Method. The attitudes of prison officers working in a DSPD prison unit and psychiatric nurses working in high‐security psychiatric hospitals were compared using the Attitude to Personality Disorder Questionnaire (APDQ) and the Staff Attitude to Personality Disorder Interview (SAPDI). Results. Prison officers and nurses differed in their attitudes. Prison officers' attitudes were more positive than those of psychiatric nurses in all aspects of the APDQ. Prison officers indicated that they felt more liking for and interest in contact with personality disordered prisoners, less fear and helplessness, less anger, were more optimistic regarding treatment, and less frustrated. The SAPDI revealed that nurses expressed more concern about caring for and managing personality disordered patients, and felt more vulnerable and less accepting towards them. Prison officers conveyed more confidence in their own abilities and felt less vulnerable. Conclusion. Differences found in attitudes towards personality disordered prisoners/patients are discussed in terms of personal, environmental and experiential influences, and implications for DSPD services. Attitudes towards personality disordered prisoners/patients between nurses and officers differed. They are likely to be influenced by a combination of experience with personality disorder, organisational culture and personal characteristics.     

Resettle: a significant new step in an emerging pathway that manages risk and addresses need in high-risk personality disordered offenders on their release into the community

Abstract

This paper will describe an innovative UK service development, Resettle, which is designed to address the needs and risks of personality disordered offenders who are released into the community from prison and whose high risks of harm and re-offending are linked to their personality disorder (PD). All the cases worked with are subject to Multi-Agency Public Protection Arrangements (MAPPA). This non-residential, intensive community-based service is nationally funded jointly by the Department of Health and Ministry of Justice, originally as part of the Dangerous and Severe Personality Disorder (DSPD) programme for high-risk offenders. Resettle became operational in 2008. It is currently being independently evaluated via a randomised control trial that is due to complete in March 2013. Formal outcome data are, therefore, not yet available, however, the developing model of intervention based on experience and learning to date is described alongside the policy and service context for this area of work.     

The relationship among distributive and procedural justice and correctional life satisfaction, burnout, and turnover intent: An exploratory study

Distributive and procedural justice, two dimensions of organizational justice, have been found to be salient antecedents of many correctional staff attitudes, such as job stress, job satisfaction, and organizational commitment; however, little correctional research has examined their relationships with the life satisfaction, burnout, and turnover intent. Multivariate regression equations were estimated to determine the association of personal characteristics, distributive justice, and procedural justice with the life satisfaction, burnout, and turnover intent of correctional employees based on a survey of 160 staff at a private midwestern maximum security institution. Both distributive and procedural justice had a statistically significant inverse association with burnout and turnover intent, while procedural justice had a significant positive relationship with life satisfaction. Additionally, the results indicated that the association of procedural justice was larger than the association for distributive justice. Similar results were obtained using only responses from correctional officers.     

Dangerous and severe personality disorder: An investigation of the construct

Introduction of the construct “Dangerous and Severe Personality Disorder” (DSPD) by the UK Home Office and Department of Health has provoked strong debate and opposition. Its aims and that of proposed subsequent legislation was to enhance public protection by identifying and detaining a minority of persons with severe personality disorder who pose a high risk of serious sexual/violent offending. The most serious criticism was the ethical implication of allowing indefinite detention of people without criminal convictions. More recently, policy emphasis has shifted towards treatment. 1396 male prisoners serving sentences of 2+ years for sexual/violent offenses were prospectively interviewed (personality disorders, psychopathy, and risk) at a mean follow-up of 2 years. The prevalence of DSPD was 15%. Significantly more re-offended. Five DSPD offenders would need treatment to prevent one violent act. Based on an estimate of attributable risk, successful treatment of DSPD could reduce violent re-convictions among DSPD offenders by 71% and violent/sexual re-offenses in the prison population by 27%. DSPD criteria correctly identify high risk prisoners but primarily through risk-related demographic features. DSPD does not accurately identify serious sexual/violent re-offenders. The DSPD programme may reduce major violent re-offending if treatment interventions prove effective.     

Psychopathology and tattooing among prisoners

Tattooing has always been associated with criminals. Indeed, it is both an administrative and clinical problem in prisons. This article looks at the relationship between psychopathology and tattooing infractions within prison. Using a sample of 8,574 male inmates in the Colorado Department of Corrections, initial admission personality testing was compared to tattooing infractions within the next 2 years. Personality types more likely to engage in tattooing included Antisocial, Sadistic, Negativistic, and Borderline. Compulsive personality types engaged in relatively less tattooing. Clinical syndromes associated with more tattooing included Mania, Drug Abuse, Post-Traumatic Stress disorder, and Thought Disorder.     

The correctional staff burnout literature

Correctional staff job burnout is costly to all involved. As such, it has generated a growing body of research. This study reviewed 53 empirical studies of correctional staff burnout and two review articles published between 1981 and 2014. The majority of studies focused on staff working in a variety of institutional positions, fewer studies focused exclusively on the subgroup of correctional officers, and even fewer focused on a different subgroup. The majority of studies also involved staff at US government-run adult prisons. Most but not all studies utilized Maslach’s Burnout Inventory. Research on the antecedents of job burnout among correctional staff is more common than research on the possible consequences or outcomes of job burnout. Interestingly, despite the empirical emphasis on antecedents of burnout, there has been almost no research on effective interventions designed to deal with correctional staff burnout. Based on this narrative review, significant gaps remain in the research on correctional staff burnout.     

Rating the prison boss: Examining supervision among prison health care staff

Health care staff are instrumental in prisons given their roles in aiding security and the growing demand for medical services among prisoners. Unfortunately, little attention has been paid to this prison staff subpopulation. This study examined perceptions of supervision among 424 prison health care staff in the Federal Bureau of Prisons. Participants felt that prison supervisors were most effective in clarifying expectations and least effective in giving feedback for performance, involving staff in planning, and extending job autonomy. Using hierarchical linear models (HLM), some unique findings emerged. Efficacy in dealing with inmates was the strongest predictor variable: health care staff who felt more positive and effective with inmates had more favorable feelings toward supervision. Staff working in high- and medium-security prisons had more positive feelings toward supervision than those in minimum security, and younger staff had more favorable attitudes toward supervisors than older staff. The implications of these findings and directions for future research are discussed.     

Delivering effective therapeutic interventions for men with severe personality disorder within a high secure prison

Abstract

The Fens Unit is a government-initiated facility for male prisoners reaching criteria for Dangerous and Severe Personality Disorder (DSPD). Prisoners are assessed using a standardised process; those meeting criteria engage in a five-year treatment programme using a cognitive interpersonal model. Personality disorder is seen as a combination of coping strategies, developed in response to experience, which results in dysfunctions of thinking, feeling, behaviour and interpersonal relationships. These dysfunctions are linked to offending. Therefore, in order to reduce risk, multiphasic interventions – individual and group therapies – specifically target each dysfunction area, focusing on the developmental experiences that generated them. Each man's individual risk factors become treatment targets that are addressed in every aspect of the programme. All staff on the unit, clinical and operational, attempt to improve the quality of interpersonal relationships the prisoner has access to in order to create remedial experiences that are necessary to attain the capacity to develop socially adaptive cognitive, emotional and behavioural responses. This paper describes the treatment provided to these prisoners and the outcomes for the first cohort to have completed treatment (n=18). Results indicate that there is a reduction in violent behaviour, a higher than expected attendance at therapy, a decrease in actuarial risk measures and the majority of men are successfully managed in lower security after programme completion.     

Offender personality disorder pathway: the impact of case consultation and formulation with probation staff

The latest government policies for personality disordered offenders emphasise the importance of a formulation-based approach to rehabilitation and pathway planning. However, research into forensic case formulation is limited. This paper examines the impact of consultation and formulation, on probation staff working with personality disordered offenders. Staff rated their knowledge, confidence, motivation, and understanding (of offenders), and satisfaction with management plans at three stages: pre-consultation, post-consultation and after receiving a written formulation. The analyses revealed that ratings on all variables examined increased after attending a consultation meeting, with no additional increase in scores following receipt of the formulation letter. The findings provide evidence that consultation has a range of benefits for probation staff, and offer support for the current model of joint-agency working. Further research is needed to clarify the benefits of providing written formulations after consultations, and to explore what features of a formulation are most useful to probation staff.     

Job burnout among narcotics investigators: An exploratory study

In exploring the relationship between narcotics investigators and job burnout in the United States, a sample of 115 East San Francisco Bay police officers from five law enforcement departments was drawn. Three subgroups (current narcotics investigators, former narcotics investigators, and patrol officers) were used in the survey. The findings indicate that current narcotics investigators had significantly higher burnout scores than the comparison groups on most dimensions of burnout. Both former narcotics officers and patrol officers had similar burnout scores. Conclusions reached were that: (1) narcotics officers experienced a greater degree of job burnout while in the assignment; (2) this burnout was directly attributed to the working environments of the narcotics officers; and (3) burnout decreased once an officer left the assignment. Administrative and managerial implications for dealing with job burnout are discussed along with suggested techniques for dealing with, and minimizing, job burnout among narcotics officers. Future research issues are identified.     

A symptom level examination of the relationship between Cluster B personality disorders and patterns of criminality and violence in women

The psychometric properties and structure of the Cluster B Personality Disorder criteria (Antisocial, Borderline, Histrionic, and Narcissistic) are examined in a sample of 261 female inmates using a self-report screen followed by a full diagnostic interview. The results of the structural analyses in this sample demonstrated good internal consistency and convergence, but poor discriminant validity between disorders. An exploratory factor analysis found that the structure of these disorders was best accounted for by a four-factor solution that paralleled the Diagnostic and Statistical Manual (DSM-IV-TR; APA, 2000) classification scheme with some significant and notable exceptions. Using the factor scores generated from the factor analysis, the personality profiles of the women were compared with several behavioral indices, including instant offense, institutional infractions, and self-report violence and victimization within the prison. Of particular importance was the consistent relationship observed between narcissistic personality traits and threatening and violent behavior within the prison combined with the impulsive but less malignant presentation of antisocial personality traits among this sample of women. Results are discussed as they inform our understanding of the structural integrity of the four Cluster B diagnostic categories and the relationship of these personality disorders to different types of criminality and violence.     

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.     

Screening for mental disorder using the UK national offender assessment system

Probation officers have large caseloads with high levels of psychiatric morbidity but receive minimal training in recognising/managing mental health problems. In the UK, there is no national screening procedure for mental illness among offenders that is considered effective. This study’s aim was to develop a screening system for mental/personality disorders using the Offender Assessment System. Seven screens for mental disorder were developed using items from assessments on 574 prisoners: alcohol misuse, drug dependence, antisocial personality disorder, psychopathy, learning difficulties, psychosis and severe mood disturbance. Internal validation showed that the screens performed well across accuracy estimates. Prevalence of mental disorders identified with the screens in test and validation samples was similar. However, the psychopathy and severe mood disturbance screens may be more effective in screening for true negatives. The screens are an economical method for prioritising mental health needs of the UK prison and probation population using routinely collected data.     

Changing approaches to corrections

A new training program was developed for correctional officers and other new employees. The training was designed to focus on a positive philosophy toward rehabilitation rather than emphasizing techniques for managing inmates. Attitude questionnaires were developed to test attitudes on treatment and security. The questionnaire was administered before and after the training to determine changes in attitude. The trainees' attitudes were compared to those of college students who had completed an internship. There was a significant difference in the attitudes of employees before training and after training. There was also a significant difference in attitudes of interns and employees before training but not after the employees had been trained.     

Job Stress,Job Involvement,Job Satisfaction,and Organizational Commitment and Their Associations with Job Burnout Among Indian Police Officers: a Research Note

Job burnout can negatively impact individual officers, the organization that employs the burned out officers, citizens with whom these officers directly interact, and the community more broadly. The vast majority of the empirical research on burnout has been based on Western police officers. The present study extends our understanding of the associations that job stress, job involvement, job satisfaction, affective commitment, and continuance commitment have with the three dimensions of burnout (emotional exhaustion, depersonalization, and a reduced sense of accomplishment) among Indian police officers. Ordinary least square (OLS) regression analysis was used to examine survey data from 827 police officers in the Sonipat and Rohtak districts of the Indian state of Haryana using a systematic random sample. The findings indicate that job involvement and job satisfaction were associated with lower levels of all three dimensions of burnout. Job stress was associated with emotional and reduced accomplishment burnout. High affective commitment was associated with lower levels of a reduced sense of personal accomplishment, while continuance commitment was associated with higher levels of emotional and depersonalization burnout. The results suggest that job stress, job involvement, job satisfaction, affective commitment, and continuance commitment have effects on burnout among Indian officers, as has been found among Western officers. As such, police scholars and administrators should focus on reducing job stress and continuance commitment and increasing job involvement, job satisfaction, and affective commitment among officers.     

Games guards play: a self-report study of institutional deviance within the Texas Department of Criminal Justice

While most correctional officers adhere to the highest level of professionalism, some engage in institutional deviance during the course of their eight-hour shifts. In the present study, we administered 501 self-report questionnaires to correctional officers within the Texas Department of Criminal Justice. Respondents who reported that their supervisors were not supportive tended to admit to higher levels of institutional deviance than their peers, though peer support did not contribute to correctional officer deviance. Additionally, respondents who perceived their jobs to be less dangerous than other officers were more likely to have attitudes that were conducive to institutional deviance. Moreover, a perception of deviance among others also helped ‘normalize’ these acts in the prison setting and contributed to more favorable attitudes toward institutional deviance by correctional officers. Theory X and Theory Y is used to explain the lack of supervisory support that leads to institutional deviance among correctional officers. These findings have important policy implications toward reducing deviance among correctional officers, thereby making prison facilities safer and more secure.     

INDIVIDUAL AND ORGANIZATIONAL DETERMINANTS OF CORRECTIONAL OFFICER ATTITUDES TOWARD INMATES*

This paper analyzes the impact of individual attributes and organizational influences in the determination of correctional officers’attitudes toward inmates. Drawing on survey data from 179 line-level correctional officers, the analysis evaluates the expectations of prison reformers that more highly educated, female, and minority officers will hold more positive attitudes toward their inmate clientele. Contrary expectations drawn from the sociology of work literature suggest that the work-role socialization will overshadow the effect of individual attributes in the determination of officer attitudes. The analysis reveals that minority officers hold more positive orientations toward inmates, while education and gender exert no impact. In addition, organizational-level characteristics are also important in the prediction of officer views of inmates. These findings suggest that correctional reforms that focus primarily on changing the demographic composition of correctional officers are quite unlikely to ameliorate significantly the tension in today's prisons. It is necessary for both reformers and social scientists to develop more sophisticated analyses of the interplay between individual attributes and work organization characteristics and their joint effects on behavior in the prison setting.