The effects of a mindfulness-based procedure, called Meditation on the Soles of the Feet, were evaluated as a cognitive-behavioral intervention for physical aggression in 6 offenders with mild intellectual disabilities. They were taught a simple meditation technique that required them to shift their attention and awareness from the precursors of aggression to the soles of their feet, a neutral point on their body. Results showed that physical and verbal aggression decreased substantially, no Stat medication or physical restraint was required, and there were no staff or peer injuries. Benefit-cost analysis of lost days of work and cost of medical and rehabilitation because of injury caused by these individuals in both the 12 months prior to and following mindfulness-based training showed a 95.7% reduction in costs. This study suggests that this procedure may be a clinically effective and cost-effective method of enabling adult offenders with intellectual disabilities to control their aggression.

Clinical and Benefit—Cost Outcomes of Teaching a Mindfulness-Based Procedure to Adult Offenders With Intellectual Disabilities

Psychopathy has emerged as one of the constructs most predictive of violence risk in the forensic field. The Psychopathy Checklist-Revised (PCL-R) has previously been found to have acceptable reliability and validity in a sample of offenders with intellectual disability, but its predictive validity in this group has yet to be established. This prospective study examined the relative ability of the PCL-R and two other instruments, the Historical Clinical Risk-20 (HCR-20) and the Emotional Problem Scales' Behaviour Ratings Scale, to predict officially recorded institutional aggression. A sample of 60 offenders with intellectual disability in a high security forensic psychiatric setting was followed up for a period of 12 months. The PCL-R 20-item total, the PCL-R 13-item total, and PCL-R Factor 1 and Factor 2 scores did not significantly predict any type of aggressive behaviour. In contrast, the two more clinically based measures significantly predicted both interpersonal physical and verbal/propert...

Predictive validity of the PCL-R in offenders with intellectual disability in a high secure hospital setting: Institutional aggression

Purpose of reviewThe aim of this article is to review reports of aggressive challenging behaviour in individuals with intellectual disability from September 2006 to March 2008.Recent findingsStudies continued to demonstrate the prevalence and significance of aggressive challenging behaviour in perso

Aggressive challenging behaviour and intellectual disability.

This document is intended as a review of legal and psychiatric factors to offer practical guidance in the performance of forensic evaluations. It is a guideline developed through the participation of forensic psychiatrists who routinely conduct a variety of forensic assessments and who have

http://jaapl.org/content/jaapl/43/2_Supplement/S3.full.pdf

AAPL Practice Guideline for the Forensic Assessment

As a part of a larger study, the Psychopathy Checklist-Revised (PCL-R) was used to assess psychopathy in 203 individuals from three UK National Health Service settings for offenders with intellectual disabilities (ID): a high security hospital, a medium and low security hospital and a community based service. The PCL-R was rated from file review combined with a clinician interview. Internal consistency and inter-rater reliability were acceptable, and broadly comparable to that reported for other offender populations. The instrument was also associated in largely expected ways with level of security, and with measures of antisocial personality disorder, risk, and current behavioural functioning, providing some preliminary indications of convergent validity. However, further empirical investigation is required before the PCL-R can be used with confidence to make clinical and risk-based decisions in this population.

Applicability, Reliability and Validity of the Psychopathy Checklist-Revised in Offenders with Intellectual Disabilities: Some Initial Findings

Background. Despite an increasing knowledge base concerning the assessment of emotional and behavioural problems in people with intellectual disabilities (ID), relatively little research has examined such problems in offenders with ID. Methods The study assessed 172 male offenders with ID in three service settings (high, medium-low security and community) using the Behaviour Rating Scale of the Emotional Problem Scales (EPS), with the aim of assessing differences in Externalizing and Internalizing Behaviour Problems. Results Normative information is presented on the Behaviour Rating Scale of the EPS across three levels of forensic ID care. It was found that offenders in higher secure care scored higher on sub-scales reflecting physical aggression than those in lower secure care. However, there was no difference in terms of other Externalizing Behaviour Problems, such as verbal aggression, non-compliance or hyperactivity. In addition, those offenders in higher secure care scored significantly higher on all Internalizing Behaviour Problems sub-scales, including anxiety, depression and low self-esteem. Conclusions Implications for research and clinical pratice are discussed, including the utility of the EPS as a measure of clinical need and treatment outcome

S. Johnston

Papers

Emotional and behavioural problems in offenders with intellectual disability: comparative data from three forensic services.