The role of mentalising in the management of violence

Adshead, Gwen; Moore, Estelle; Humphrey, M.F.; Wilson, Claire; Tapp, James

doi:10.1192/apt.bp.110.008243

Cited by 28 publications

(18 citation statements)

References 60 publications

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“…Planning deficiencies increase the probability of violence by negatively affecting a person's ability to assess the possible consequences of his or her actions (Meijers et al, 2017). Impairments in ToM may lead to violence through misinterpretation of social cues (Adshead et al, 2013), underregulation of negative emotions (Fonagy and Luyten, 2009), blurring of self-other boundaries (Adshead et al, 2013) or lack of empathy (Hooker et al, 2008). There was no significant difference between violent and nonviolent patients in affective ToM, which is arguably more important for the last three than cognitive ToM.…”

Section: Discussionmentioning

confidence: 99%

“…Since EFs and ToM are essential for social adaptation, impairments in these cognitive functions are thought to underlie violent behavior. However, causal mechanisms likely differ by EF (Raine, 2008) and ToM type (Adshead et al, 2013). General population studies have repeatedly found that people who display violent behavior perform worse on neuropsychological tests of EFs (Ogilvie et al, 2011) and ToM (Hoaken et al, 2007; Nyline et al, 2018) than those who do not.…”

Section: Introductionmentioning

confidence: 99%

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Cognition and violent behavior in psychotic disorders: A nationwide case-control study

Lamsma

Cahn

Fazel

2020

Schizophrenia Research: Cognition

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BackgroundThe excess risk of violence in psychotic disorders may partly be explained by impairments in executive functions (EFs) and theory of mind (ToM). However, previous studies have been limited by composite measures of EFs and small samples of inpatients.MethodsData were collected for the research project Genetic Risk and Outcome of Psychosis (GROUP). Patients with psychotic disorders (N = 891) were recruited from various care settings in the Netherlands. The following neuropsychological tests were administered (targeted cognitive function in parentheses): (i) Continuous Performance Test-HQ (inhibition); (ii) Response Shifting Task (cognitive flexibility); (iii) Wechsler Adult Intelligence Scale, Third Edition (WAIS-III) Block Design subtest (fluid intelligence); (iv) Neuropsychological Assessment Battery (NAB) Mazes Test (planning); (v) Degraded Facial Affect Recognition Task (affective ToM); and (vi) Hinting Task (cognitive ToM). Lifetime violence was ascertained from medical records and patient interviews. We used analysis of covariance to compare the mean scores of violent and nonviolent patients on each test, adjusting for age and sex.ResultsViolent patients performed significantly worse than nonviolent patients on the WAIS-III Block Design subtest (F [1, 847] = 5.12, p = .024), NAB Mazes Test (F [1, 499] = 5.32, p = .022) and Hinting Task (F [1, 839] = 9.38, p = .002). For the other tests, the between-group differences were nonsignificant. Violent behavior explained no more than 1% of the variance in performance on each test.ConclusionImpairments in EFs and ToM are unlikely to provide useful targets for risk assessment and interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cognition and violent behavior in psychotic disorders: A nationwide case-control study

Lamsma

Cahn

Fazel

2020

Schizophrenia Research: Cognition

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“…Moreover, expectations that certain populations (e.g. those with personality disorder or prone to violence) will lack reflective function have not been consistently supported (Tolfree, 2012;Adshead, 2013). The conundrum of reflective function and whether certain groups lack it is somewhat redolent of the 'cognitive deficits' debate in the probation world.…”

Section: The Reflective Function and Mentalizationmentioning

confidence: 99%

A qualitative examination of attachment-based concepts in probation supervision

Ansbro

2019

Probation Journal

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Attachment theory is familiar to probation workers, with its broad messages that early care can leave a lasting legacy, and that patterns of relating can be repeated throughout the lifespan. Up close however, attachment theory is complex, and research findings sometimes vague or contested. This empirical research examined the use of four key attachment-based concepts in generic probation practice over a period of six months. The concept of the probation officer as a potential secure base was a useful one, as was the idea that service users' early attachment history could help to understand relationships and offending. Other concepts (the reflective function and attachment style) were less useful.

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“…Violent offenders may be divided into a highaffect, impulsive and hyperaroused group, and a low-affect, unemotional and psychopathic group (Meloy 2006;Adshead 2013). The first group are more likely to become violent in response to perceived threats to their sense of self.…”

Section: Violence and Mentalisationmentioning

confidence: 99%

Antisocial personality disorder: new directions

Yakeley¹,

Williams²

2014

Adv. psychiatr. treat

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SummaryAntisocial personality disorder is a complex condition carrying high rates of comorbidity and mortality for individuals as well as harmful consequences for their families and society. Despite the publication of National Institute for Health and Care Excellence (NICE) guidelines for the disorder, the evidence base and provision of effective treatments remain inadequate, and the belief that the condition is untreatable remains widespread among psychiatrists and other professionals. This article highlights current diagnostic controversies and summarises the evidence for conceptualising antisocial personality disorder as a disorder of attachment. Informed by this developmental perspective, we provide a framework for the management and treatment of adults with antisocial personality disorder, highlighting the importance of creating a safe setting and recommending adaptations of therapeutic technique to facilitate the engagement of this ‘treatment-rejecting’ patient population. We conclude with an outline of the current government policy on the treatment of high-risk offenders with personality disorder.LEARNING OBJECTIVESKnow the current diagnostic criteria and epidemiology of antisocial personality disorder.Evaluate the evidence that antisocial personality disorder can be conceptualised as a disorder of attachment, and use a developmental framework to inform treatment interventions.Gain an understanding of psychological approaches to antisocial personality disorder.

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The role of mentalising in the management of violence

Cited by 28 publications

References 60 publications

Cognition and violent behavior in psychotic disorders: A nationwide case-control study

Cognition and violent behavior in psychotic disorders: A nationwide case-control study

A qualitative examination of attachment-based concepts in probation supervision

Antisocial personality disorder: new directions

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