Investigation of the relationship between cognitive impairment and treatment responsivity in mentally disordered offenders
Overend, Carol Olive
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Background There appears to be clear evidence of cognitive impairment in schizophrenia which is wide ranging and relatively stable throughout the illness. Both cognitive impairment and treatment response have been argued to be highly relevant in risk assessment and management of offenders. However, there does not appear to be any research in this area on mentally disordered offenders. It is on this basis that this study attempts to determine the impact of cognitive impairment on treatment responsivity in mentally disordered offenders. Method A cohort quantitative research design was used and the data were obtained via the administration of neuropsychological assessments and self-report measures. Neuropsychological data on attention, executive functioning, memory and IQ were matched with treatment gain scores for 114 male mentally disordered offenders. The participants were further matched according to the group treatments they had participated in resulting in five different groups. Results Univariate and bivariate analyses were used to explore the relationship between cognitive predictor variables and treatment gain scores. Variables that were significantly associated with treatment gain scores were further investigated using multiple regression analyses. Results indicated that for each group, cognitive variables such as attention and memory were significantly predictive of treatment gain scores. Conclusion The results indicate the need to consider cognitive impairment constructs such as attention, executive functioning, memory and IQ when determining appropriate interventions for mentally disorders offenders. Doing so may improve treatment responsivity and have a consequent impact on risk management and recidivism. The research limitations are discussed in relation to the methodology used, and clinical implications and directions for future research are explored.