The clinical profile and service needs of psychiatric inpatients with intellectual disabilities and forensic involvement

Intelligent Diagnosing of Intellectual Disabilities in Offenders: Food for Thought

“…Although probably most of the studies we have reviewed, did rely on full IQ testing, we observe a persistent lack of detailed assessment information to date. Returning to the aforementioned double special issue of Psychology, Crime & Law from 2011, it appears that none of seven empirical studies (Blacker, Beech, Wilcox, & Boer, 2011;Fitzgerald, Gray, Taylor, & Snowden, 2011;Holland & Perrson, 2011;Lindsay et al, 2011;Lunsky et al, 2011;Singh et al, 2011;Snoyman & Aicken, 2011) reported both full-scale IQs and a description of how exactly the level of adaptive functioning had been measured. Only a few provided some/more details on the circumstances of the IQ assessment.…”

“…The prevalence of offenders with ID in mental health settings appears to be substantially higher. Lunsky et al (2011) found a rate of 12.8% in in-patients with forensic involvement and 20.8% in psychiatric in-patients with ID in general. Obviously, because of the standard error of measurement there is always a chance of over-or underestimating an actual IQ score (American Psychiatric Association, 2000).…”

“…Given that intelligence is predictive for treatment attrition (Olver, Stockdale, & Wormith, 2011), that an ID diagnosis is related to relatively high recidivism rates (Barron, Hassiotis, & Banes, 2004;Holland & Persson, 2011), and that current treatment programs for ID offenders are often inadequate (Barron et al, 2004;Lunsky et al, 2011;but see, Lindsay, 2009), there can be little dispute that the development of proper treatment programs aimed at (or based on) the specific cognitive abilities of these offenders is of key importance. As Flanagan et al (2010) state, the CHC model is a useful tool to obtain insights into why certain intervention methods do not work, what interventions, compensatory strategies, and accommodations might be more effective, and what are the most promising means of delivering instruction and implementing intervention.…”

“…Several studies are reasonably austere in their descriptions of how IDs were specifically assessed (e.g., Gray, Fitzgerald, Taylor, Macculloch, & Snowden, 2007;Lindsay et al, 2008a;Lindsay, Whitefield, & Carson, 2007;Morrissey et al, 2010;Stupperich, Ihm, & Strack, 2009). Obviously, the lack of clarity regarding the exact circumstances of an ID diagnosis leaves some doubt as to the accuracy of the diagnosis in question (Lunsky et al, 2011). This might also influence the interpretation of the results in terms of reliability and validity.…”

“…No matter what perspective researchers take, it is usually the setting within its administrative framework that dictates the circumstances and further elaboration of the study design. In some studies, the diagnosis of ID has been made a priori by someone else without any influence of the researchers in question (e.g., trained facility staff in Lunsky et al, 2011). In others, the researchers had the possibility and responsibility to make the selection according to their own proposed standards (e.g., Søndenaa et al, 2008).…”