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Fire setters who have an intellectual disability (ID) are often identified as posing a particular danger to the community although relatively little is known about their characteristics, treatment and support needs. The paper aims to discuss this issue.

This study describes the characteristics of 134 residents of low, medium and high security ID facilities in the UK who have either an index offence of arson, a violent index offence or a sexual index offence.

Index arson offenders who had an ID had multiple prior convictions, a history of violent offending and a high likelihood of having a comorbid mental disorder. There were many shared characteristics across the three groups.

The current study suggests that offenders who have ID who set fires have treatment needs that are similar to those of violent and sex offenders. It follows that fire setters who have an ID may also benefit from participating in more established offending behaviour treatment programs, such as cognitive behaviour therapy programs, developed for other types of offender.

This study is one of the few which has investigated the characteristics and treatment needs of persons who have an ID who set fires. In particular, it is one of the first to compare the characteristics and treatment needs for persons with ID who set fires, to those who have committed violent and sexual offences.

De‐institutionalisation and resettlement have had a significant impact on offenders with learning disabilities (LD) who are now more visible in the wider community than before. Perhaps because of the challenges presented by people who were previously contained in institutions, there has been a growth of interest in their characteristics, the services and clinical interventions required to support them.This narrative review presents and discusses recent developments concerning offenders with LD. It looks at the historical association between crime and low intelligence, and then examines the evidence concerning the prevalence of offending by people with LD and recidivism rates. Recent research concerning service pathways for this population is summarised and progress in the development of actuarial, dynamic and clinical assessments of the future risk of offending is outlined.The second half of the paper focuses on a review of the evidence for and recent developments in the treatment of offending behaviour (anger/aggression, sexual offending and fire‐setting), utilising broadly cognitive behaviourally‐based approaches. Finally, future directions for research and practice innovation are proposed.

Over the last ten years, there has been greater interest in the diagnosis of personality disorder (PD) in people with intellectual and developmental disabilities (IDD). One important characteristic of a diagnostic system is that it should have validity as a contribution to utility. PD has been found to have a predictive relationship with violence and the purpose of this paper is to review two methods for the diagnosis of PD in offenders with IDD in order to evaluate the utility of the diagnoses.

In total, 212 offenders with ID were recruited from three settings – maximum-security, medium/low security and community services. Diagnoses of PD in the case files were compared with a structured system of diagnosis based on DSM-IV traits.

There were significant differences between the two systems with a significantly higher frequency of PD diagnosis in the community forensic setting in the structured assessment system. There was no relationship between the case files diagnosis of PD and future violence but there was a significant predictive relationship between the structured diagnosis of PD and future violence with an AUC=0.62.

As with all such studies, the research is limited by the quality of the case files available to the researchers.

Only the structured assessment of PD had utility for the prediction of violence. Reasons for the differences between the systems are discussed and suggestions made on how a diagnosis of PD can be structured for the busy clinician.

The accurate diagnosis of PD has important implications since the PD is a crucial addition to any violence risk evaluation.

This study is the first of its kind to review the way in which clinicians assess PD.

This paper reviews several issues in relation to offenders with intellectual disabilities. Although some authors have indicated an increased prevalence of offenders amongst the population of individuals with intellectual disabilities, other carefully controlled studies using recognised IQ tests have found only slightly increased incidences. Studies conducted in forensic settings have reported results somewhat different to those conducted in clinical settings with respect to both prevalence and characteristics. It is noted that individuals with learning disabilities commit offences across the spectrum of criminal behaviours but there may be some over‐representation in sexual offences and arson. Issues of assessment and treatment are also addressed with comments being made on extensions of interventions into community settings. With the amount of research increasing over the last 10 years, we are becoming clearer about the relevant issues involved in designing studies, developing assessments and providing treatment to this client group.

This study was carried out as part of a larger study commissioned by the UK Department of Health to investigate the service pathways for offenders with learning disabilities (LD). The study covered three health regions in the UK and included 477 people with LD referred to services because of antisocial or offending behaviour during a 12‐month period. Data were collected concerning demographic, individual, offending behaviour and service characteristics. The findings of the study are broadly consistent with contemporary research concerning this population, particularly in relation to the nature and frequency of offending, history of offending, psychopathology, age and gender distribution. However, very few of those referred had any form of structured care plan, despite having significant offending histories, and this may have compromised early identification of their needs and communication between the health, social and other services involved.

Although studies suggest alcohol abuse is not the major problem among offenders and others with intellectual disabilities (ID), it is still a significant problem. There are also suggestions that alcohol may have a more serious effect on those with ID. The purpose of this paper is to describe a treatment for alcohol-related difficulties designed for people with ID.

A programme for alcohol-related problems is described and four case studies are presented to illustrate the sessions and review the way in which people with ID have responded to the methods. The cases have a mixture of alcohol-related problems including anger, anxiety, social withdrawal and depression. The alcohol programme is coordinated with a range of person centred interventions for specific difficulties.

All cases responded to the programme positively. Two cases showed reductions in anger, two reported reductions in anxiety and one reported reductions in depression. All cases increased their alcohol knowledge considerably.

The programme seems promising in its approach to alcohol-related difficulties. It is noted that alcohol education alone is likely to improve participants’ wellbeing in the absence of coordinated intervention for other relevant personal difficulties. A controlled treatment trial for effectiveness is clearly required.

The paper describes a programme for alcohol-related problems and may be the first such programme that has contained pilot evaluation.

Several studies have related diagnostic information and adversity in childhood to criminal careers and risk of recidivism. Notably, ADHD and conduct disorder in childhood, schizophrenia, sexual abuse and physical abuse have been associated with offences in adulthood. This study investigates these variables in relation to large cohorts of offenders with learning disabilities. A case note review was undertaken for 126 individuals referred but not accepted into forensic learning disability services and 197 individuals accepted for such services. Results are reported on diagnostic information and experience of adversity in childhood. ADHD/conduct disorder featured prominently in both groups. Autistic spectrum disorders were not particularly over‐represented. For adversity in childhood, general socioeconomic deprivation featured prominently in both groups. This also increased significantly for those accepted into services. Sexual abuse and non‐accidental injury were featured at around 13‐20% for both groups. These results are broadly consistent with the mainstream literature on offending, ADHD/conduct disorder and general deprivation featuring significantly in all groups and rising for those accepted into offender services. It is important to deal with these aspects during assessment and to provide appropriate psychotherapeutic services for these individuals.

This paper seeks to describe the introduction of a component designed to enhance empathy, to an established cognitive behavioural treatment program for sexual offenders with an intellectual disability.

The treatment group received an empathy component and was compared with a control group. Therapeutic efficacy was assessed pre‐ and post‐treatment and at follow‐up using the interpersonal reactivity index which assesses fantasy; perspective taking; empathic concern and personal distress experienced due to others' misfortune.

There were no significant differences between treatment and control groups at baseline. For the treatment group, significant differences were identified between pre, post and three‐month follow‐up assessments indicating an increased empathy at post‐treatment assessment, the treatment group had significantly improved over the controls.

Future research could compare empathy measures and investigate specifically the relationship between what is taught in empathy programs and what is measured by empathy assessments. Difficulties with the study are discussed.

The empathy component appears to enhance empathic responses.