Article

Clinical Syndromes, Personality Disorders, and Neurocognitive Differences in Male and Female Inmates

Department of Psychology, University of Colorado at Colorado Springs, USA.
Behavioral Sciences & the Law (Impact Factor: 0.96). 09/2011; 29(5):741-51. DOI: 10.1002/bsl.997
Source: PubMed

ABSTRACT

This study examined clinical syndromes, personality disorders, and neurocognitive problems in adult male (n = 523) and female inmates (n = 523) and a sample of unincarcerated adult women (n = 523). Inmates were administered the Coolidge Correctional Inventory (CCI), and the unincarcerated sample was given an identical test, the Coolidge Axis II Inventory. Although there were significant differences between the two inmate groups on a majority of the 32 CCI scales, only two scales achieved a medium effect size. The two inmate groups were found to be highly similar in a comparison of ranked personality disorder prevalence rates. Consistent with previous literature, male inmates had a significantly higher prevalence of antisocial personality disorder than female inmates (24% vs. 18%). Female inmates had double the prevalence of male inmates on the borderline and histrionic personality disorder scales. Female inmates also reported significantly more general neuropsychological dysfunction, specifically memory problems and neurosomatic symptoms, than male inmates. Female inmates also reported significantly higher levels of anxiety, depression, symptoms of schizophrenia, post-traumatic stress disorder, attention deficit hyperactivity disorder, and depersonalization than male inmates. Overall, the findings support previous research of high levels of psychological and neuropsychological problems in inmates, regardless of gender, and reinforces the need for comprehensive mental health screening of offender populations.

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Available from: Frederick L Coolidge, Jul 03, 2014
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    • "International studies suggest that BPD is common among prison inmates. Self-report measurements suggest prevalences ranging from 10% to 48% [16] [17] [18] [19] whereas studies using structured interviewing typically report lower and less variable rates of BPD. Hence, in a summary report from the UK Government statistical service [20], BPD prevalence was estimated to 14%. "
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    ABSTRACT: Introduction: Borderline personality disorder (BPD) is a severely disabling condition, associated with substantially increased risk of deliberate self-harm and, particularly in men, also with interpersonal violence and other criminal behavior. Although BPD might be common among prison inmates, little is known about prevalence and psychiatric comorbidity in probationers and parolees. Method: In 2013, a consecutive sample of 109 newly admitted adult male offenders on probation or parole in all three probation offices of Stockholm, Sweden, completed self-report screening questionnaires for BPD and other psychiatric morbidity. Participants scoring over BPD cut-off participated in a psychiatric diagnostic interview. Results: We ascertained a final DSM-5 BPD prevalence rate of 19.8% (95% CI: 12.3-27.3%). The most common current comorbid disorders among subjects with BPD were antisocial personality disorder (91%), major depressive disorder (82%), substance dependence (73%), attention deficit hyperactivity disorder (ADHD) (70%), and alcohol dependence (64%). Individuals diagnosed with BPD had significantly more current psychiatric comorbidity (M=6.2 disorders) than interviewed participants not fulfilling BPD criteria (M=3.6). Participants with BPD also reported substantially more symptoms of ADHD, anxiety and depression compared to all subjects without BPD. Conclusions: BPD affected one fifth of probationers and was related to serious mental ill-health known to affect recidivism risk. The findings suggest further study of possible benefits of improved identification and treatment of BPD in offender populations.
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    • "Existing research on the neuropsychology of incarcerated offenders has tended to rely on samples of men. The few studies of cognition among female offenders show that they too tend to have neuropsychological dysfunction (Coolidge et al., 2011) and that such dysfunction is associated with aggression (Daoust et al., 2006). Neuropsychological data in these studies were, however, obtained from self-reported function, which constitutes a major methodological limitation (see Dunning et al., 2004, for a review). "
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    ABSTRACT: Background There is considerable evidence that aspects of cognitive function, especially executive function, are associated with antisocial behaviour and violence, but most research to date has measured current cognition and previous criminal behaviour. Furthermore, this research has been conducted almost exclusively with male offenders.AimThe aim of this study is to examine relationships between a wide range of cognitive functions and behaviours among women in prison. Our hypotheses were that cognitive functioning would be associated with both more-or-less contemporaneously observed behaviour problems and self-rated adjustment to the environment.Method Forty-five drug-free imprisoned female offenders were individually assessed on a battery of cognitive measures. Prison staff rated their behaviour on the Prison Behaviour Rating Scale and the women rated their own sense of adjustment to the environment on the Prison Adjustment Questionnaire.ResultsStepwise hierarchical regressions indicated that attention was independently associated with behaviours reflecting tension, depression, isolation, fear, victimisation and worry, whereas processing speed was independently associated with behaviours reflecting lack of energy, mental slowness and lack of awareness of the surrounding environment and total Prison Adjustment Questionnaire score. There was no relationship between cognitive functioning and subjective perception of adjustment to prison.Conclusions and Implications for Practice and Future ResearchResults indicate that cognition contributes to some of the behavioural problems displayed by inmates in the prison context. Future studies should evaluate the role of programmes to improve cognitive processes in also improving prison behaviour and also test for continuities and discontinuities with post-release integrative success. Copyright © 2014 John Wiley & Sons, Ltd.
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    ABSTRACT: There are few published studies of attention-deficit/hyperactivity disorder (ADHD) in adult inmates, and even fewer studies that have considered ADHD in adult inmates by gender. The present study examined the prevalence of ADHD, its subtypes, and associated psychological and neuropsychological comorbidity as a function of gender in a sample of 3,962 inmates (3,439 men and 523 women; mean age = 33.6 years, range 17-73) who had completed the 250-item, self-report, Diagnostic and Statistical Manual of Mental Disorders, 4th edition (Text Revision) (DSM-IV-TR)-aligned Coolidge Correctional Inventory (CCI). The overall ADHD prevalence rate found was 10.5%, which is substantially higher than the rate among adults in the general population (2-5%). The female inmate ADHD prevalence rate (15.1%) was higher than the male inmate ADHD rate (9.8%), consistent with some previous studies. The most prevalent ADHD subtype for both genders was the hyperactive-impulsive subtype. The combined and inattentive ADHD subtypes had higher levels of comorbid psychopathology than the hyperactive-impulsive ADHD subtype. As the presence of ADHD and associated gender differentials may impact the success of rehabilitation and educative programs with inmates, the assessment of ADHD and comorbid psychopathology should be a priority in initial inmate screening and evaluation.
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