Which of the following is true with regard to VRAG?
C. VRAG is an actuarial risk tool that incorporates 12 items which are scored on the basis of a weighting procedure developed from the original study of Canadian prisoners. The variable with the heaviest weighting is the PCL-R psychopathy score, which is incorporated as a subscale. It does not use HCR-20 as a subscale. The factors positively associated with increased risk of recidivism are psychopathy score, history of elementary school difficulties, diagnosis of a personality disorder, young age, separation from parents prior to age 16, failure on prior conditional release, history of non-violent offenses, never been married, and history of alcohol abuse. A diagnosis of schizophrenia is considered to reduce the overall risk of recidivism.
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Which of the following is true with regard to the association between learning disability and offending?
E. Significantly below average intellectual ability is an independent predictor of future offending, irrespective of a diagnosis of learning disability (LD). Individuals with mild LD show a higher rate of offending than age- and sex-matched individuals without LD. No correlation has been found between the severity of intellectual disadvantage and the seriousness of the offense committed. In fact, individuals with more severe or profound learning disability rarely commit serious offenses. Studies in the UK have shown a rate of 2–5% for recorded offenses among the learning-disabled population. The degree of disability does not correlate with rate of offending. The most common offenses by the learning-disabled group are property offenses. Many risk factors that operate in the general population for risk of violence operate in the learning-disabled population, e.g. being young and male, a history of family offending, being unemployed, drug use, psychosocial disadvantage, etc.
The proportion of male remand prisoners in England and Wales with at least one personality disorder is:
E. Almost 80% of male remand prisoners in England and Wales were found to have at least one personality disorder, with antisocial personality disorder being most prevalent. From the Office of National Statistics data (1997) the prevalence of any personality disorder was 78% for male remand prisoners, 64% for male sentenced prisoners and 50% for female prisoners (both sentenced and remand).
Antisocial personality disorder had the highest prevalence of any category of personality disorder (63% of male remand prisoners, 49% of male sentenced prisoners, and 31% of female prisoners) followed by paranoid personality disorder in men (29% of male remand prisoners, 20% of male sentenced, and 16% of female prisoners) and borderline personality disorder in women (20% of female prisoners). Compare these rates with a weighted prevalence for any personality disorder of 4.4% among people aged 16–74 years in households in England, Scotland and Wales.
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The McNaughton rules are often discussed when a defence of insanity is used.
Which of the following is NOT a factor that can be used for the insanity defence under the McNaughton rules?
D. The McNaughton rules refer to a set of guidelines for the insanity defence that was used in England until the 1960s. According to these rules one can plead the defence of insanity only if ‘at the time of committing the act, the accused was labouring under such a defect of reason from disease of the mind, as not to know the nature and quality of the act he was doing, or if he did know it then he did not know he was doing what was wrong’. Those who merely lack the capacity to control a criminal action could still be deemed punishable. Hence, a defect of moral judgement or failure to exercise existing capability to make the right decision cannot be brought up as an insanity defence under the McNaughton rules.
Which of the following statements is true with regard to the relationship between antisocial personality disorder and psychopathy?
E. The constructs of psychopathy and antisocial or dissocial personality are often referred to interchangeably, but in reality these are quite different concepts. Approximately 3–5% of people in the general population would meet the criteria for antisocial personality. But less than 1% will meet the criteria for psychopathy (i.e. a high score (30/40) on the PCL-R). Similarly, although only 15% of male prisoners have scores that fall in the psychopathy range on the PCL-R, nearly 80% of them will satisfy the criteria for antisocial personality disorder. In other words, although most patients (81%) diagnosed as psychopaths by the PCL-R criteria met the criteria for a diagnosis of antisocial personality disorder, only a minority (nearly 35–40%) of those with antisocial personality receive a diagnosis of PCL-R psychopathy. The correlation between antisocial personality disorder and PCL-R scores was much higher for behavioural (social deviance: r = 0.65) factor of psychopathy than affective (interpersonal: r = 0.39) factor. Psychopaths are less impulsively aggressive than those with antisocial personality disorder, but are more likely to engage in antisocial behaviour of an instrumental nature. Those with psychopathy commit higher rates of serious violence and have strikingly high rates of recidivism than those with antisocial personality disorder but who are not psychopathic.
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