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BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is overrepresented in prison, making it imperative to identify a screening tool that can be quickly applied to efficiently detect the disorder. We explored the discrimination ability of a widely used ADHD screen, the Barkley Adult ADHD Rating Scale (BAARS-IV), against a clinical diagnostic interview. A brief version of the screen was then developed in order to simplify its use in the prison context, and maximize its diagnostic properties. METHOD: A cross-sectional study of 390 male prison inmates was performed in the UK, all participants were screened and interviewed via the Diagnostic Interview for ADHD in Adults 2.0 (DIVA-2). RESULTS: A total of 47 (12.1%) inmates screened positive for ADHD using the full BAARS-IV, and 96 (24.6%) were clinically diagnosed, for a sensitivity of 37.9 and a specificity of 96.3. Our models identified the six items that most predicted ADHD diagnosis, with adjusted odds ratios ranging from 2.66 to 4.58. Sensitivity, specificity and accuracy were 0.82, 0.84 and 0.84, respectively, for the developed brief scale, and 0.71, 0.85 and 0.81 for its validation. Weighted probability scores produced an area under the curve of 0.89 for development, and 0.82 for validation of the brief scale. CONCLUSIONS: The original BAARS-IV performed poorly at identifying prison inmates with ADHD. Our developed brief scale substantially improved diagnostic accuracy. The brief screening instrument has great potential to be used as an accurate and resource-effective tool to screen young people and adults for likely ADHD in the criminal justice system.

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There are very few, if any, valid and victim-specific situation empathy measures available at present for use with mentally disordered offenders. The aim of this study was to validate a modified version (VERA-2) of the Victim Empathy Response Assessment (VERA) tool which was developed earlier (Young et al., 2008) to enable victim-specific situation empathy measurement in offenders. A total of 55 mentally disordered in-patients residing in a maximum security hospital were assessed on VERA-2 as well as on measures of antisocial personality traits, global affective empathy, violent cognitions, and reported remorse for the index offence. The VERA-2 cognitive and affective empathy scales were negatively correlated with antisocial personality traits and violent cognitions, and positively related to remorse for the index offence. Global affective empathy was positively related to VERA-2 affective empathy. Participants with a history of sexual offending had significantly higher cognitive empathy than other offenders. Acceptance of violence and remorse for the index offence were the best predictors of both cognitive and affective empathy. The findings suggest that the VERA-2 is a valid instrument for measuring victim empathy among mentally disordered offenders, and may prove useful in the context of future risk assessment and outcomes in this population.

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OBJECTIVE: Violent behaviour has been associated with presence of certain mental disorders, most notably antisocial personality disorder (ASPD) and schizophrenia, childhood abuse, and multiple brain abnormalities. This study examined for the first time, to the authors' knowledge, the role of psychosocial deprivation (PSD), including childhood physical and sexual abuse, in structural brain volumes of violent individuals with ASPD or schizophrenia. METHODS: Fifty-six men (26 with ASPD or schizophrenia and a history of serious violence, 30 non-violent) underwent magnetic resonance imaging and were assessed on PSD. Stereological volumetric brain ratings were examined for group differences and their association with PSD ratings. PSD-brain associations were examined further using voxel-based-morphometry. RESULTS: The findings revealed: reduced thalamic volume in psychosocially-deprived violent individuals, relative to non-deprived violent individuals and healthy controls; negative association between thalamic volume and abuse ratings (physical and sexual) in violent individuals; and trend-level negative associations between PSD and hippocampal and prefrontal volumes in non-violent individuals. The voxel-based-morphometry analysis detected a negative association between PSD and localised grey matter volumes in the left inferior frontal region across all individuals, and additionally in the left middle frontal and precentral gyri in non-violent individuals. CONCLUSIONS: Violent mentally-disordered individuals with PSD, relative to those with no or minimal PSD, suffer from an additional brain deficit, i.e., reduced thalamic volume; this may affect sensory information processing, and have implications for management, of these individuals. PSD may have a stronger relationship with volumetric loss of stress-linked regions, namely the frontal cortex, in non-violent individuals.

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The aim of the study was to investigate predictors of offending among prisoners from official records after controlling for age at first conviction and antisocial personality disorder. The participants were 198 Scottish prisoners, who had completed Diagnostic Statistical Manual IV screens for child and adult attention-deficit hyperactivity disorder (ADHD) symptoms and the Millon Clinical Multiaxial Inventory III for Axis I and Axis II disorders. The ADHD symptomatic group had significantly higher rates of total, acquisitive and violent offending than other prisoners, as well as greater regular heroin use. Hierarchical multiple regressions, using child and adult symptoms as dimensions, showed that frequent use of heroin in the year prior to imprisonment was the single most powerful predictor of the extent of total offending, with ADHD symptoms also adding independently to the variance in offending. In contrast, for violent offending, ADHD symptoms were the strongest predictor followed by alcohol dependence. The findings demonstrate the importance of heroin use and ADHD symptoms in the persistence of offending. There is an urgent need to treat drug addiction and ADHD symptoms in order to reduce offending among the most persistent offenders. Recently, treatment programmes have been developed for adults with ADHD, heroin and crack cocaine addiction which can be applied to this population.

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BACKGROUND: Interrogative suggestibility and compliance are important psychological vulnerabilities during interrogation. The aim of the study was to investigate the relationship of suggestibility and compliance with childhood and current symptoms of attention deficit hyperactivity disorder (ADHD). Compliance has not been studied previously in relation to ADHD. A further aim was to investigate the relationship between ADHD and the reporting of having made a false confession to the police. METHOD: The participants were 90 male prisoners, all of whom had completed the Gudjonsson Suggestibility and Compliance Scales (GSS and GCS) within 10 days of admission to the prison. Childhood ADHD symptoms were screened by the Wender Utah Rating Scale (WURS) and current adult symptoms by the DSM-IV Checklist criteria for ADHD. RESULTS: Half of the prisoners (50%) were found on screening to meet criteria for ADHD in childhood and, of those, over half (60%) were either fully symptomatic or in partial remission of their symptoms. ADHD symptoms were found to be significantly associated with compliance, but not with suggestibility. The relationship with compliance was stronger (effect size) in relation to current than childhood symptoms. The ADHD symptomatic groups were significantly more likely to claim that they had made a false confession to the police in the past. CONCLUSIONS: The findings raise important questions about the potential vulnerability of adults with ADHD symptoms in terms of their ability to cope with interrogation.

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BACKGROUND: People with intellectual disabilities who have been victims or other witnesses of crime have had limited access to the criminal justice system, often on the basis of assumptions about their incapacity to be interviewed by the police and to give evidence in court. The aim of this study was to assess their capacity to be witnesses in court. METHODS: Forty-nine men and women with intellectual disabilities, all of whom were potential witnesses of ill-treatment, were assessed in order to provide advice, initially to the police, about their capacity to be interviewed for judicial purposes. The assessments included evaluations of each person's intellectual ability, memory, acquiescence, suggestibility, and their ability to explain concepts relating to the oath. RESULTS: Only 37 (76%) were able to complete the assessments. Most of those with a Full Scale IQ score of > or = 60 had a basic understanding of the oath, compared with only a third of those with IQ scores between 50 and 59, and none of those with IQ scores < 50. Nevertheless, some of the people who were unable to demonstrate an understanding of the oath did understand the words 'truth' and 'lie', especially when asked about these concepts in relation to concrete examples. CONCLUSIONS: While intellectual ability appears to be the best overall predictor of the capacity of people with intellectual disabilities to act as witnesses, confining witnesses to those who could explain the meaning of the oath would mean that a number of persons who might be interviewed by the police and subsequently appear in court could be excluded from the judicial process.

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OBJECTIVES: To investigate differences and similarities between violent offenders and two types of sex offenders, rapists and child molesters, in terms of their personality, the nature of the victim, the role of alcohol, and their confession to their crime. METHOD: Thirty-six adult sex offenders, 23 child molesters, and 32 violent offenders were compared on personality measures, their relationship with the victim, the presence of alcohol intoxication, their confession rate and retraction at trial, and the reasons they gave for having confessed to the police. RESULTS: Child molesters and adult sex offenders (rapists) were significantly more introverted than the violent offenders. The child molesters had higher social desirability scores than the other groups, they tended to assault relatives and friends, they were rarely intoxicated while committing the offense, and they had strong internal need to confess to the police. Rapists and violent offenders were more commonly intoxicated during the commission of the offense; the former tended to assault acquaintances, where violent offenders most commonly assaulted strangers. Exactly half of the rapists retracted their confession when the case went to trial; in contrast none of the other offenders retracted their confession. CONCLUSIONS: The results show that there are significant differences as well as similarities between the three groups of offenders, which have implications for assessment and treatment.

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We examined how well children with mental retardation were able to recall a live staged event one day later compared to CA- and MA-comparable peers. Children with mental retardation performed very well on many measures of eyewitness memory performance, reaching the level of the CA-comparable group for free recall, general questions, open-ended questions, and correctly leading questions. They were, however, more suggestible in response to closed misleading questions than were children in the CA-comparable group, although they were not more suggestible than those in the MA-comparable group. Some relationships were found between a standardized measure of suggestibility and performance on the eyewitness memory task, but most of these relationships were not the same within each of our study groups.

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BACKGROUND: The past decade has witnessed a recognition that unsafe criminal convictions may be occasioned by unreliable confessions. AIMS: To present a case which illustrates the dangers of using abreaction interview techniques in a legal context and demonstrate the relevance of the memory distrust syndrome to an unsafe confession to murder. METHOD: We under took a detailed assessment of a person appealing against his original murder conviction, 'the appellant', and a careful scrutiny of all the relevant papers in the case. RESULTS: The appellant served 25 years in prison before his conviction was quashed as 'unsafe' on the basis of fresh psychological and psychiatric evidence. CONCLUSIONS: Amnesia for an offence had been misdiagnosed, and the use of repeated abreaction interviews had further confused both the appellant and the original court. At the Appeal Court, the advice was that the man had experienced a form of source amnesia which resulted in an unreliable confession.

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The present study investigated the relationship between anxiety, as measured by the State-Trait Inventory (Spielberger, 1983) and interrogative suggestibility, as measured by the Gudjonsson Suggestibility Scale (GSS 2, Gudjonsson, 1987). One hundred and sixty-one suspects detained at two English police stations for questioning were assessed prior to being interviewed by the police. Unexpectedly, trait anxiety correlated more consistently with suggestibility than did state anxiety. The correlations were consistently higher among the Caucasian than the Afro-Caribbean subjects and the Afro-Caribbean subjects were significantly more suggestible than the Caucasian subjects even after their GSS 2 memory and IQ scores had been controlled for. The main practical implications of the findings are that interrogative suggestibility cannot be easily evaluated from the person's self-reported anxiety and the situation in which people are assessed may influence the relationship between these psychological variables.

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The Gudjonsson Suggestibility Scale (GSS) is widely used, particularly in the preparation of court reports, to derive information on the memory, suggestibility and confabulation of criminal suspects, victims and witnesses. The inter-rater reliability of all these measures was assessed by three raters, using the data of 101 subjects who were tested on the parallel form of the scale (GSS2). The intra-class correlation coefficients for all the memory and suggestibility measures were both very high (.951-.996) and highly significant (p < .001 for all measures), indicating a high level of inter-rater reliability. In contrast, whilst still highly significant (p < .001), the correlations for confabulation on immediate and delayed recall were much lower (.724 and .803, respectively). Guidelines are provided to refine the scoring of memory and suggestibility and to clarify the definition of confabulation.

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This study investigates the effects of alcohol, drug intoxication and withdrawal symptoms on the mental state of criminal suspects and the nature of their confession. A total of 359 sentenced prisoners were approached on admission and 96% agreed to participate in the study. They completed a specially designed Confession Questionnaire, which asked them questions about their reasons for confessing to the police, their attitude towards their confession, their mental state at the time of the confession and the extent to which they had been under the influence of alcohol and drug intoxication at the time of crime and police interview. The confession rate for the sample was very high (92%), with serious traffic violators having the highest confession rate (95%) and sex offenders the lowest (83%). The findings illustrate that the "perception of proof", "internal need to confess" and "external pressure" are the main reasons why suspects confess. However, subjects were identified who had experienced a typical "prisoner's dilemma" phenomenon during the police interview because of a co-defendant. Alcohol and drug intoxication was very commonly reported both at the time of the offence and the police interview, but these were related to the nature of their offence. Although intoxication and withdrawal symptoms did not appear to seriously impair their coping during the police interview it was consistently reported as having made them confused.

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In order to assess a criminal suspect's ability to make a reliable statement, performance on three measures--interrogative suggestibility, confabulation and acquiescence--may be used. This paper presents preliminary data on these measures for people with mild learning disabilities (Full Scale IQ [FSIQ]: 57-75). It was found that they were more suggestible than their average ability counterparts (FSIQ: 83-111) because they were much more susceptible to 'leading questions'. They also confabulated more and were more acquiescent. Overall, the data emphasized their potential vulnerability to giving erroneous testimony during interrogations.

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The main purpose of this study was to investigate the relationship between interrogative suggestibility and previous convictions among 108 defendants in criminal trials, using a path analysis technique. It was hypothesized that previous convictions, which may provide defendants with interrogative experiences, would correlate negatively with 'shift' as measured by the Gudjonsson Suggestibility Scale (Gudjonsson, 1984a), after intelligence and memory had been controlled for. The hypothesis was partially confirmed and the theoretical and practical implications of the findings are discussed.

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This study looks at the reasons offenders give for having confessed during police interrogation. A number of hypotheses were tested, following the work of Gudjonsson and Petursson (1991) on an Icelandic prison sample. The subjects were 80 offenders who were serving prison sentences in Northern Ireland for violence, sex or property offences. The subjects completed the Gudjonsson Confession Questionnaire. All of the hypotheses tested were supported, indicating that there are three primary factors associated with the reasons why criminals make confessions during interrogation. These factors are referred to as Internal Pressure, External Pressure and Proof. The factors were found to be associated with the type of offence committed and the attitude of the offender towards his confession.

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This study investigates some of the hypotheses generated by the Gudjonsson and Clark model of interrogative suggestibility. The subjects were 40 adolescent boys (11-16 years), who completed the Gudjonsson Suggestibility Scale and instruments measuring intellectual skills, memory, field-dependence, hostility, and attitudes towards persons in authority. Suggestibility correlated negatively with I.Q. and memory capacity, and positively with field-dependence.

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This paper reviews the psychological factors that make some individuals susceptible to making a false confession of having committed a criminal offence. A number of 'vulnerability factors' are highlighted and it is emphasized that these need to be interpreted within the context of all circumstances surrounding the case.

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This study examines the relationship between type of offence and the attributions offenders make about their criminal act. The subjects were 98 Icelandic criminals who had completed the Gudjónsson Blame Attribution Inventory. Significant differences in attribution were found between offender groups. Sex offenders and those who had committed acts of interpersonal violence reported most guilt about their offence and they attributed cause for their offence more to mental factors (eg, loss of self-control) than other types of offender. Violent offenders had the highest external attribution and sex offenders the lowest. The findings with regard to the three attributions are remarkably similar to those found previously for British offenders.

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