Mathlin Georgina, Freestone Mark, Taylor Celia, Shaw Jake
Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.
Alan Turing Institute, London, United Kingdom.
JMIRx Med. 2021 Oct 29;2(4):e27907. doi: 10.2196/27907.
Offenders with personality disorder can be challenging to engage and retain in treatment. The UK Offender Personality Disorder (OPD) pathway aims to proactively and responsively identify and engage offenders with personality disorder. However, a subpopulation of offenders on the pathway have been found to not be accepted into any OPD service and therefore fail to progress.
This study aims to identify and describe offenders on the OPD pathway who fail to progress and to understand the causal drivers by which individuals fail to progress in the pathway.
A sample of 50 offenders on the OPD pathway who had been refused from at least two OPD services (nonprogression group) were compared to 100 offenders accepted into OPD services (control group). Partial least squares structural equation modeling was used to model the causal factors involved in not being accepted into OPD services.
The path coefficients in the structural model showed that the most influential factor in nonprogression was attitude toward treatment (β=.41; P<.001; f=0.25) alongside those with psychopathology (β=.41; P<.001; f=0.25), specifically, psychopathy, psychosis, and co-occurring personality disorder.
The findings of the study provide a basis of how to work with this population in the future to increase the likelihood of acceptance into OPD services.
患有人格障碍的罪犯在参与和持续接受治疗方面可能具有挑战性。英国罪犯人格障碍（OPD）治疗途径旨在积极主动且灵活地识别并让患有人格障碍的罪犯参与治疗。然而，已发现该治疗途径中的一部分罪犯未被任何OPD服务机构接纳，因此无法取得进展。
本研究旨在识别和描述在OPD治疗途径中未能取得进展的罪犯，并了解个体在该途径中未能取得进展的因果驱动因素。
将50名在OPD治疗途径中被至少两家OPD服务机构拒绝的罪犯（无进展组）与100名被OPD服务机构接纳的罪犯（对照组）进行比较。采用偏最小二乘结构方程模型对未被OPD服务机构接纳所涉及的因果因素进行建模。
结构模型中的路径系数表明，无进展的最具影响力因素是对治疗的态度（β = 0.41；P <.001；f = 0.25）以及伴有精神病理学问题的因素（β = 0.41；P <.001；f = 0.25），具体而言，是精神病态、精神病和共病的人格障碍。
该研究结果为未来如何与这一群体合作以增加被OPD服务机构接纳的可能性提供了依据。
