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Title: Assessment and treatment of anger in offenders with developmental disability
Author: Taylor, John L.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2002
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Aggression is the primary reason for people with developmental disabilities to be admitted or re-admitted to institutions. It is also the main reason for this client group to be prescribed anti-psychotic and behaviour control drugs. Anger is a significant predictor and activator of aggressive behaviour. There is some limited evidence for the value of cognitive-behavioural treatments for anger problems with people with developmental disabilities. However, no controlled studies of anger treatment involving developmentally disabled offenders living in secure settings have been conducted to date. In an anger assessment study conducted within a specialist learning disability hospital, a detained in-patient group of 129 developmentally disabled men with offending histories were assessed on a range of anger and aggression measures in order to investigate the nature and scope of anger problems in this population. The reliability, concurrent and discriminant validity of several criterion measures of anger and aggression were investigated by examination of the intra- and inter-relationships of self and informant measures of anger, aggression and personality characteristics. Results from this hospital-wide assessment study show that on multiple selfreport and staff-rated measures, anger is an important clinical problem for this patient population, having significant links to patient background factors and assault behaviour in the hospital. It was demonstrated in this study that anger as a construct has validity and could be reliably assessed in a coherent manner among clients with intellectual impairments and forensic histories that might have confounded such assessment. In a treatment study conducted in the same setting, 40 detained patients with developmental disabilities and histories of offending were allocated to specially modified cognitive-behavioural anger treatment (AT group) or to routine care waiting-list control (RC group) conditions. Eighteen sessions of individual treatment were delivered over a period of 12 weeks. The AT and RC groups were assessed simultaneously at four time points: screen, pre- and post-treatment, and at 4-months follow-up (all before the RC group entered treatment). The effectiveness of the treatment was evaluated by analysing between group differences in linear trend on a range of self- and staff-rated outcome measures using repeated measures mixed design analyses of co-variance (ANCOVA). Compared to the RC condition, patients in the AT condition had significantly greater decreases in self-reported anger following intervention and at follow-up. This indication of therapeutic gain associated with the anger treatment also received some convergent support by staff ratings of patient behaviour post-treatment. It was also found that the anger treatment impacted positively on direct care-staffs' ability to cope with patients' anger problems. It is concluded that people with developmental disabilities and offending histories can benefit from intensive individual cognitive-behavioural anger treatment that also appears to have beneficial systemic' effects. Further research is required to examine the mechanisms for change, their sustainability and generalisability across a range of settings.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Psych.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available