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The dangerous and severe personality disorder experiment--review of empirical research
Birgit Völlm1, Nagaraj Konappa
1Section of Forensic Mental Health, Division of Psychiatry, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham,UK. birgit.vollm@nottingham.ac.uk
Background:
A pilot programme for the treatment of individuals with dangerous and severe personality disorder (DSPD) was established in the UK in 2001. A substantial investment had been made into research and evaluation of the initiative, but it is not clear what the outcomes of this research have been.
Aim:
This study aimed to review empirical research on the DSPD programme.
Method:
We conducted a systematic literature review by using electronic searches of the databases MEDLINE, PsycINFO and EMBASE, complemented by hand searches of key journals and websites.
Results:
We identified a total of 29 empirical research papers and three comprehensive research reports. Most studies were concerned with describing the DSPD population and confirmed that the projects targeted high-risk personality disordered offenders. Qualitative research identified a number of concerns regarding stigma, restrictiveness of the environment and indeterminate detention. Organisational enquiries recognised inefficiencies in assessment and treatment delivery. No high-quality trials were carried out of specific treatments or service environments.
Conclusions/Implications For Practice:
The key question--what treatments are effective for high-risk personality disordered offenders--remains unanswered. More time would be needed to fully assess the impact of this programme, and similar future initiatives should allow longer observation periods.
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