Consistent and transparent? personality disorder diagnosis, the sentencing of offenders with mental health difficulties, and the relevance of stigma and psychiatric diagnosis.

Young, Samantha (2022) Consistent and transparent? personality disorder diagnosis, the sentencing of offenders with mental health difficulties, and the relevance of stigma and psychiatric diagnosis. Doctoral thesis, University of East Anglia.

Preview

PDF Download (3MB) | Preview

Abstract

Aims: This portfolio aims to aid the understanding of psychiatric diagnosis, mental illness stigma and the sentencing of offenders with mental health difficulties (OMHDs).

Method: The thesis portfolio contains two main papers; a systematic review and meta-analysis which reviews the interrater reliability (IRR) of the novel Alternative Model of Personality Disorder (AMPD; DSM-5) and an empirical online project investigating whether psychiatric diagnosis, stigmatic attitudes and guidance laid down in R v Vowles can predict sentencing outcomes for OMHDs.

Results: Fifteen studies were included in the review. Meta-analysis provided tentative support for Criterion A of the AMPD and its domains with pooled ICCs above acceptability levels for the DSM and previous estimates for the current diagnostic framework. Subgroup analysis suggests IRR could be improved by using a structured clinical interview designed for the AMPD. Variation in IRR was found across domains. However, heterogeneity was high across all analyses and results should be interpreted with caution. Few studies were found examining the IRR of Criterion B and overall PD diagnosis; however initial studies show mixed results. In the empirical project, only one Vowles Criteria, “the extent to which the offender requires punishment” was a significant predictor in the model. However, the overall model was not significant, therefore results should be interpreted with caution. The remaining Vowles Criteria, stigmatic attitudes and psychiatric diagnosis were not found to be significant predictors of sentencing outcome.

Conclusions: Overall the portfolio demonstrates tentative support for IRR of Criterion A of the AMPD. Further research is recommended for Criterion B and overall PD diagnosis alongside more ecologically valid methods using structured clinical interviews. Only one Vowles criteria was found to be a significant predictor of sentencing outcome, however limitations of the study were identified and discussed. Replication with a judicial population and a further focus on expert witness testimony is advised.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	16 Nov 2022 11:53
Last Modified:	16 Nov 2022 11:53
URI:	https://ueaeprints.uea.ac.uk/id/eprint/89882
DOI:

Downloads

Actions (login required)

View Item