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Biomedical subjects

J W Coid

Publications and source records attributed to J W Coid.

10 recordsLinked to original sources
PubMed2001

The Federal Administrative Maximum Penitentiary, Florence, Colorado.

Policies for the control of dangerous and disruptive prisoners in European penal institutions depend upon social regimes managed by prison staff. These contrast with certain US regimes where there is increasing use of the incapacitation approach. This paper describes an incapacitation regime developed in the US Federal Administrative Maximum Penitentiary (ADX), Florence, Colorado which is complemented by an architectural design minimizing contact between prisoners and staff. This is reported to have been highly effective in controlling violent and predatory behaviour, escapes, drug-taking, and the influence of members of criminal gangs and notorious prisoners transferred to the ADX. Despite a shift of policy from therapeutic intervention towards deterrence of problem behaviour in prisons in some European countries, such as the UK, it is unlikely that such a regime would be acceptable in Europe.

Adult↗
PubMed1999

Aetiological risk factors for personality disorders.

BACKGROUND: Elucidation of aetiological processes leading to development of Axis II disorders is important in category validation and could lead to new treatments. AIMS: To establish aetiological associations between Axis II disorders and specific risk factors. METHOD: Male and female subjects (n = 260) in maximum security hospitals and prisons were interviewed to determine DSM-III Axis II and lifetime Axis I diagnoses. Aetiological risk factors were obtained at interview and from case files. Independent statistical associations were established by logistic regression. RESULTS: Axis II categories were divided into four groups: (a) disorders of character development, secondary to an adverse early environment: antisocial, self-defeating and paranoid; (b) disorders of temperament, secondary to constitutional aetiology: avoidant, dependent, schizoid and schizotypal; (c) a 'mixed' disorder of constitutional and environmental aetiology: borderline; and (d) aetiological associations not established: narcissistic, histrionic, compulsive and passive-aggressive. CONCLUSIONS: The study validates several Axis II categories but challenges the inclusion of others within Axis II of DSM-IV, in particular schizoid, schizotypal, avoidant and borderline personality disorders. The findings have implications for future treatment interventions.

Adult↗
PubMed1999

Empirical clusters of DSM-III personality disorders in violent offenders.

Violent male offenders in a maximum security hospital and special units in prisons (N = 164) were interviewed with the Structured Clinical Interview for DSM-III Axis II disorders (SCID-II). Cluster analysis of the personality disorder criteria sets identified six diagnostic patterns: (1) antisocial-narcissistic; (2) paranoid-antisocial; (3) borderline-antisocial-passive-aggressive; (4) borderline; (5) compulsive-borderline; and (6) schizoid. Offenders in the first three groups had more extensive criminal careers, and most were identified as psychopaths by the Psychopathy Checklist-Revised (PCL-R). These Groups also had more frequent lifetime histories of substance abuse. A history of affective and anxiety disorders was more common in Groups 3 and 5, and almost two thirds of Group 2 had a history of psychotic disorder. The results emphasize that dangerous offenders are heterogeneous in personality pathology. They also suggest that personality disorder among violent offenders is more commonly represented by recurring patterns of covarying traits than by single categorical entities proposed in the DSM classification.

Adult↗
PubMed1993

Quality of life for patients detained in hospital.

The quality of life of detained patients has not received adequate attention despite the responsibilities placed on hospital staff and the special problems faced by these patients. Legal principles to ensure quality of life have not been formalised, and the acceptable standards that a patient can expect have not been tested in the UK courts. Contemporary models of ensuring quality are being imposed with increasing pressure on health care professionals, but high-quality management has sometimes lagged behind. This has led to a poor quality of life for certain patients. It is important for future research to overcome difficulties in developing objective measurements and set the appropriate standards of quality of life that detained patients should expect. This would provide a basis against which both appropriate standards of care and the necessary resource allocation could be measured.

Hospitalization↗
PubMed1993

An affective syndrome in psychopaths with borderline personality disorder?

A preliminary study of the repetitive mood swings of 72 female psychopaths with a DSM-III diagnosis of borderline personality disorder demonstrated considerable complexity and specificity in what has been previously considered a criterion of personality disorder. A principal-components analysis of the symptom profile for these affective disturbances revealed four factors (anxiety, anger, depression, and tension) which showed individual patterns of association with additional lifetime diagnoses of major mental illness and other personality disorders. The women also had multiple mood-related behavioural disorders, enacted with a feeling of compulsion, which appeared to relieve the original affective symptoms. It is hypothesised that these women could have a distinct affective syndrome that has not previously been described in the literature.

Adult↗
PubMed1988

Mentally abnormal prisoners on remand: I--Rejected or accepted by the NHS?

Increasing numbers of mentally abnormal offenders are sentenced to prison. The decision to treat or imprison them is influenced by the attitudes of consultant psychiatrists and their staff. The process whereby those decisions were made and the willingness of consultants to offer treatment were investigated. A retrospective survey of all (362) mentally abnormal men remanded to Winchester prison for psychiatric reports over the five years 1979-83 showed that one in five were rejected for treatment by the NHS consultant psychiatrist responsible for their care. Those with mental handicaps, organic brain damage, or a chronic psychotic illness rendering them unable to cope independently in the community were the most likely to be rejected. They posed the least threat to the community in terms of their criminal behaviour yet were more likely to be sentenced to imprisonment. Such subjects were commonly described by consultants as too disturbed or potentially dangerous to be admitted to hospital or as criminals and unsuitable for treatment. Consultants in mental hospitals were most likely and those in district general hospitals and academic units least likely to accept prisoners. The fact that many mentally ill and mentally handicapped patients can receive adequate care and treatment only on reception into prison raises serious questions about the adequacy of current management policies and the range of facilities provided by regional health authorities.

Adult↗
PubMed1988

Mentally abnormal prisoners on remand: II--Comparison of services provided by Oxford and Wessex regions.

Most regional health authorities have or plan to have secure units for treating mentally abnormal offenders. A retrospective study was carried out to compare the effectiveness of the health care services for men remanded to Winchester prison from Oxford and Wessex regions over the five years 1979-83. Thirty seven (30%) of 124 prisoners from Oxford region were rejected for treatment compared with 36 (16%) of the 220 men from Wessex region. Men from Oxford region were significantly more likely to be recommended for admission to a special hospital than those from Wessex (13/124 (10%) v 9/220 (4%), respectively) and significantly less likely to be recommended for admission to a hospital in the catchment area (35/124 (28%) v 94/220 (43%)). Men on remand from Oxford region were significantly more often perceived as being disruptive or aggressive by hospital staff and more likely to be labelled as having psychopathic or personality disorders. These differences may have reflected different attitudes towards mentally abnormal offenders and the allowances in the services available in the two regions; in particular, Oxford region did not have a secure unit or a forensic psychiatrist. If mentally ill prisoners do not receive the treatment that they need they run the risk of being criminalised. Most such men are best treated in general psychiatric units; only a few require secure conditions and staff with specialised psychiatric skills.

Community Mental Health Services↗