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1 – 10 of 20Marlene Kelbrick and Jane Radley
People with Asperger syndrome are at increased risk of co‐morbid mental health problems. The core features underlying autism are likely to play an important role in offending…
Abstract
Purpose
People with Asperger syndrome are at increased risk of co‐morbid mental health problems. The core features underlying autism are likely to play an important role in offending behaviour amongst this population. Forensic rehabilitation includes a multidisciplinary approach and combination of therapeutic interventions. However there is limited evidence in the literature of what constitutes effective treatment within this setting, and how the process of rehabilitation is experienced by patients. The purpose of this paper is to describe a case of Asperger syndrome with co‐morbid psychosis and offending behaviour and the process of forensic rehabilitation.
Design/methodology/approach
The authors briefly review the literature related to Asperger syndrome, offending in this population and co‐morbidity. The authors then describe and reflect on a case of a young man with Asperger syndrome, sexual offending and the process of forensic rehabilitation, and offer an insight from the patient's perspective.
Findings
Co‐morbid mental illness, when detected early, can be successfully managed with limited additional disability. The process of forensic rehabilitation includes a multidisciplinary approach. Therapeutic interventions specifically aimed at addressing core features of autism, risk and offence‐related factors are effective in promoting recovery amongst those with autism and offending behaviour.
Originality/value
The paper highlights how core features of autism can lead to offending behaviour, the importance of early recognition and treatment of co‐morbidity, and the process of forensic rehabilitation and recovery. Also included are quotes from the patient's perspective on what it is like to have Asperger syndrome, and what has been the key learning from the rehabilitation process.
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Camilla Haw, Jane Radley and Louise Cooke
The purpose of this paper is to describe the characteristics of adult male autistic spectrum disorder (ASD) patients admitted to low secure services and to compare them with…
Abstract
Purpose
The purpose of this paper is to describe the characteristics of adult male autistic spectrum disorder (ASD) patients admitted to low secure services and to compare them with non‐ASD patients.
Design/methodology/approach
Case‐control study of admissions to two ASD units and one non‐ASD unit at a tertiary referral centre. Subjects were compared on demographic, personal, clinical and offending behaviour variables.
Findings
In total, 51 ASD and 43 controls were studied. Median age at diagnosis of ASD was 21 years (range 6‐56). The ASD group were younger (median age 27 vs 33 years) and more likely to be single than controls. Their age at first contact with psychiatric services was lower and proportionally more were admitted from prison and courts. Almost three‐quarters had psychiatric comorbidity, most commonly schizophrenia, but unlike controls, personality disorder and drug and alcohol disorders were uncommon. Lifetime sexually inappropriate behaviour and physical violence were less common, as was non‐compliance with medication. However, 78 per cent had a lifetime history of physical violence and a third had a conviction for GBH or homicide. Offending behaviour was sometimes atypical in nature and some had convictions for unusual offences such as harassment and stalking.
Research limitations/implications
The age difference between cases and controls is likely to have confounded the results. Findings cannot be generalised to the NHS.
Originality/value
This group of ASD patients in low security differed in several important respects from their non‐ASD counterparts, which highlights their differing treatment needs, strengths and weaknesses.
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Jane Radley and Zakia Shaherbano
People with autistic spectrum disorders (ASD) may offend as a result of social skills deficits, co‐morbid mental health problems, abuse of drugs and alcohol, or because of their…
Abstract
Purpose
People with autistic spectrum disorders (ASD) may offend as a result of social skills deficits, co‐morbid mental health problems, abuse of drugs and alcohol, or because of their special interests. The purpose of this paper is to illustrate these issues by describing a patient in whom all of these factors contributed to fire‐setting behaviour.
Design/methodology/approach
This paper briefly summarises the literature in relation to ASD and offending, then describes the case of a young man with Asperger syndrome who set a fire in his home.
Findings
The paper concludes that late diagnosis and the consequent lack of intervention may increase the risk of offending. Adults with ASD who offend can benefit from treatment in specialist secure units and the prognosis following such treatment may be good.
Originality/value
The paper highlights the risk of offending in people with ASD, the factors which may contribute to offending, and possible approaches to treatment.
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Leanne Jane Staniford, Duncan Radley, Paul Gately, Jamie Blackshaw, Lisa Thompson and Vickie Coulton
The purpose of this study is to explore public health employees' experiences of participating in a commercial weight management programme supported by their employers over a…
Abstract
Purpose
The purpose of this study is to explore public health employees' experiences of participating in a commercial weight management programme supported by their employers over a 12-week period.
Design/methodology/approach
Semi-structured interviews were conducted with 28 employees who had participated in the programme (group-based or online).
Findings
The main motivators for enquiring about and attending the programme were: the offer to attend the programme free of charge, the opportunity to kick start their weight loss efforts, to take part in an academic research study and the opportunity for “shared experiences” with their colleagues.
Research limitations/implications
This study did not allow us to explore the reasons why some employees opted not to take up the opportunity for weight management support through their workplace. Further qualitative research with non-engagers would allow us to inquire about why employees might not engage with WM support and offer alternative strategies.
Practical implications
Employers should facilitate their employees' efforts to lead a healthier lifestyle in the long-term creating employer health and safety policies that actively encourage healthy living and weight management. Improving employee health can contribute to increasing productivity, reducing stress and absenteeism.
Originality/value
This paper presents a novel approach to facilitating employees' weight management. Employees perceived their employer-supported participation in a commercial weight management programme outside of their work setting as a positive experience that assisted their weight management efforts suggesting the acceptability and feasibility of this approach to addressing weight in the workplace.
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Kerry Ferguson and Carol Ireland
The objective of this study was to investigate attitudes towards individuals who commit different types of sex offence, with subsidiary aims of exploring the influence of…
Abstract
The objective of this study was to investigate attitudes towards individuals who commit different types of sex offence, with subsidiary aims of exploring the influence of respondent sex and the influence of personal experience of sexual abuse. The sample comprised 139 participants (49 students and 90 forensic staff). All were provided with a vignette depicting a specific type of sex offence, and asked to complete a scale assessing attitudes towards sex offenders (Hogue, 1993). Forensic staff were more likely than students to view sex offenders in positive terms, viewing them as individuals who could be rehabilitated. Participants who reported being victims of sexual abuse, or that someone close to them had been abused, viewed sex offenders less negatively than non‐victims. Men demonstrated less positive attitudes towards child incest and child indecent assault offenders than to stranger rapists. Women held more positive views towards sex offenders than men, and this was consistent across offence type.
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Indira Kjellstrand and Russ Vince
The purpose of this chapter is to explore the potential of photo-elicitation as a data generating method. Photo-elicitation is rarely used for data generation, despite the…
Abstract
The purpose of this chapter is to explore the potential of photo-elicitation as a data generating method. Photo-elicitation is rarely used for data generation, despite the considerable promise of this method. Our empirical investigation focused on people's emotions and experiences of dual systems in Kazakhstan, a country currently undergoing change from the old Soviet system to a new market economy. In addition to semistructured interviews, we use photographs in order to enhance emotional connection and recall. We use the imagery as a device to generate data, and more specifically, data on individual and social perspectives that are integral to particular experiences. We argue that photo-elicitation can bring out peoples' lived experiences of the social context being investigated. We explain why and how to use the method in practice.
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Ron Gray, Debra Bick and Yan-Shing Chang
The purpose of this paper is to describe the major factors affecting health during pregnancy, birth and the postnatal period and outline the evidence for interventions to improve…
Abstract
Purpose
The purpose of this paper is to describe the major factors affecting health during pregnancy, birth and the postnatal period and outline the evidence for interventions to improve outcomes in women and their children.
Design/methodology/approach
Selective review of the literature. A number of electronic bibliographic databases were searched, including the Cochrane Database of Systematic Reviews, PubMed and PsycINFO, for relevant studies published since 1990. Papers were restricted to those published in English which presented data from studies conducted in high-income countries, with priority given to systematic reviews, randomised controlled trials and other quantitative studies which present a higher level of evidence.
Findings
Many factors may affect maternal and infant health during and after pregnancy. Potentially modifiable factors with an evidence base to support intervention include improving diet, and the avoidance of smoking, alcohol and illicit drugs. Good clinical management of underlying illness is also important, along with attempts to engage women in improving health prior to conception and postnatally rather than once pregnancy is established.
Research limitations/implications
The evidence base for interventions on some potentially modifiable risk factors is incomplete. There is good evidence of benefit from some health behaviours such as smoking cessation and uptake of breastfeeding and accumulating evidence of the benefit of some models of maternity care.
Practical implications
Good maternal health during and after pregnancy plays a key role in giving the child a better start in life. Improved health behaviours are vital but often these are heavily dependent on social context and hence working to tackle social inequality and provide maternity care tailored to individual need is likely to be just as important as trying to directly alter behaviour.
Originality/value
Pregnancy and the postnatal period present an opportunity to improve maternal health and have a positive effect on future child health. Greater investment is required in this antenatal period of life.
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