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The Clinical Utility of Personality Profiles of High-Risk Offenders in Rehabilitation

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The Clinical Utility of Personality Profiles of High-Risk Offenders in Rehabilitation The Clinical Utility of Personality Profiles of High-Risk Offenders in Rehabilitation by Morgan K. A. Sissons A thesis submitted to the Victoria University of Wellington in fulfilment of the requirements for the degree of Doctor of Philosophy Victoria University of Wellington 2013 2 Abstract Personality disorders are common among high-risk offenders. These disorders may have relevance for their risk of offending, and they are likely to present barriers to their engagement in rehabilitation programmes. Co-morbidity between personality disorders—and the high frequency of clinical disorders in general—in offender samples complicate research on personality disorder in offender rehabilitation. One approach to understanding this heterogeneity is to use cluster analysis (CA). CA is an empirical strategy which is used to identify subgroups (clusters) of individuals who have similar scores on the variables used in the analysis. It has been used to empirically identify different patterns of personality and clinical psychopathology among incarcerated offenders. Two profiles frequently emerge in cluster analytic research on offender psychopathology profiles: an antisocial/narcissistic profile and a high-psychopathology profile. However, previous research has not empirically examined whether the identification of these profiles has clinical relevance for offender rehabilitation; that is, whether the profiles are simply descriptive, or whether they can provide useful information for the management and rehabilitation of offenders. In the current research, I used data collected from high risk offenders entering prison- based rehabilitation programmes to investigate the clinical utility of psychopathology clusters. Using a self-report measure of personality and clinical psychopathology—the Millon Clinical Multiaxial Inventory III—I identified three clusters: a low-psychopathology cluster (26% of the sample), a high-psychopathology cluster (35% of the sample), and an antisocial/narcissistic cluster (39% of the sample). The high-psychopathology and antisocial/narcissistic clusters in particular resembled high risk clusters found in previous research. To determine whether the three clusters had clinical relevance, I investigated cluster differences in criminal risk, treatment responsivity, and self-report predictive validity. I found 3 evidence for cluster differences in criminal risk: men in the high-psychopathology and antisocial/narcissistic clusters had higher rates of criminal recidivism after release compared to men in the low-psychopathology cluster. However, I found that regardless of psychopathology, men in all three clusters made progress in treatment, and there was little evidence that clusters that reported more psychopathology were less engaged, or made less progress. In the final study I examined cluster differences in self-presentation style and the predictive validity of self-report. Results indicated that offenders who reported high levels of psychopathology had a more general tendency for negative self-presentation, and their self- report on risk-related measures was highly predictive of criminal recidivism. Combined, the results of this research show that cluster analysis of self-reported psychopathology can generate a parsimonious model of heterogeneity in offender samples. Importantly, the resulting clusters can also provide information for some of the most important tasks in offender management: assessment and treatment. The results suggest the highest risk offenders tend to report higher levels of psychopathology, and that offenders who report extensive psychopathology also have highly predictive risk-related self-report. Perhaps one of the most reassuring findings of the current research is that even offenders who report high levels of psychopathology appear to benefit from rehabilitation. 4 Acknowledgements There are many people I am indebted to for their support over the course this research. I would like to give special thanks to just a few of the many people who have helped me on this journey. To my supervisors Devon and Garth, for taking a chance on me. Devon, you have been so generous in sharing your time, energy, and experience over the past four years, and always with a great sense of humour. I have learnt so much under your guidance, and am still learning. You have a gift for converting even the most garbled of my ideas into something coherent, which I am especially grateful for. I couldn’t ask for a better primary supervisor. Garth, thank you for sharing your impressive statistical knowledge, providing me with feedback, and opening my eyes to the infinite opportunities afforded by the dataset. I am aware that we are only scratching the surface! I would like to give a huge thanks to the Department of Corrections for enabling me to undertake this research. I feel lucky to have been given permission to access such a rich database, and I am thankful for the numerous opportunities I have been given to present the findings of the research back to the department. I would especially like to thank Liz Ross, Glen Kilgour, Alex Skelton, and Tadhg Daly for providing me with the data I have used in this research. I would also like to thank the staff at Te Whare Manaakitanga and Psychological Services for their assistance. Thanks Victoria University for having me as a student for the last eight years (eight years!). It has been great to be surrounded by intelligent and inspiring students and staff, especially in the psychology department. The doctoral scholarship is also hugely appreciated. I was lucky enough to study alongside a group of seriously intelligent honours, masters, and PhD students in the criminal justice lab, as well as a great office mate. Thank you for 5 providing me with support, feedback on dozens of drafts, and most importantly tea and chocolate! To my parents Margaret and Richmond, thank you for teaching me how to think, for your constant encouragement, and for sitting through hours of presentations and wading through pages of thesis drafts. You were there when I needed it most, and I love you both to pieces. Thanks also to my wonderful brother and sister on the other side of the world, and to Merle and Tony for your care and support. To my lovely friends, especially Kate, Brett, James, and Jingan. Thank you for being tolerant when I needed to be a recluse, but taking me out dancing when I needed a distraction. Thanks also to my three wonderful new flatmates, who provided great conversation and delicious food when I was housebound. I am sure you will be glad to reclaim the tables from my many piles of notes! And finally, to my Craig. You have been a constant source of support, whether from home, some small town in the south island, or the Caribbean. I couldn’t have done this without you. I have been doing this research almost the entire time we have known each other, thank you for your tolerance while my Honours project morphed into a Master’s, and then a Doctorate. Not much longer now. 6 Table of Contents List of Tables…………………………………………………………………………….........8 List of Figures……………………………………………………….……………………......9 Chapter One: Introduction ................................................................................................... 11 Personality ............................................................................................................................ 14 The MCMI-III Scale............................................................................................................. 17 The Current Research ........................................................................................................... 24 Chapter Two: Offender Personality Profiles ...................................................................... 25 Offender Psychopathology Profiles ..................................................................................... 26 Number of Clusters and Criminal Risk ................................................................................ 33 The Current Research ........................................................................................................... 33 Method ................................................................................................................................. 34 Results .................................................................................................................................. 37 Discussion ............................................................................................................................ 51 Chapter Three: Personality and Criminal Risk.................................................................. 57 Relationship Between Offender Personality and Criminal Behaviour ................................. 59 Psychopathology Clusters and Criminal Risk ...................................................................... 61 The Current Research ........................................................................................................... 61 Method ................................................................................................................................. 62 Results .................................................................................................................................. 65 Discussion ............................................................................................................................ 75 Chapter Four: Personality and Treatment Response .......................................................
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