The Role of Neuropsychological Functioning Between Forensic and Community Mental Health Patients
ProQuest, 2008 - 55 ページ
Although mental disorders have been viewed as a heightened risk for violent offences that occur in the community, it is important to note that the majority of individuals with a mental disorder do not commit violent crimes. This study examined what distinguishes between mentally disordered individuals who do and do no commit violent offenses, which resulted in the involvement of the forensic justice system opposed to the civil mental health care system. 23 mental health inpatient forensic participants who had been found Not Criminal Responsible (NCR) for a past offense and 22 community mental health inpatients were recruited on a voluntary basis. Participants were classified based on current residency---Forensic inpatient housing (n=23) and inpatient community hospital (n=22) as well as current diagnoses---Bipolar Mood Disorder (n=14), Schizophrenic (n=18) Psychotic Disorder (n=4), Delusional (n=3), Schizoaffective (n=2), Major Depression (n=1), not reported (n=3). Participants completed a battery of neuropsychological tests that included the Iowa Gambling Task (IGT), as a measure of ventromedial prefrontal cortex, and the Integrated Visual and Auditory---Continuous Performance Test (IVA), as a measure of orbitofrontal prefrontal cortex. Participants also received the National Adult Reading Test (NART) as a measure of intellectual ability. Within this study it was noted that the sample size was too small and due to the small sample size, power for detecting significant difference was extremely low. Therefore, scores for the individuals who were involved within the forensic mental health setting were not significantly lower (therefore, seen as not performing poorly) on the neuropsychological measures when compared to the individuals within the community mental health setting. The forensic mental health participants were not found to be impaired on the IGT (a measure of impulsive decision making) relative to the community mental health participants. There were also no significant differences between the community and forensic individuals for instant gratification as measured by the WA. These findings did not support the idea that deficits in inhibition may be a result of ventromedial prefrontal impairment and not mental disorders alone. However, this may not be the case of being untrue, rather only related to the low sample size and difficulty detecting differences between groups. More research would be needed to inquire if individuals involved in the forensic system may have more difficulty with inhibition; therefore, responding to their personal wants before thinking about and acknowledging possible future consequences. The negative behaviour may be a result of biological impairments and would warrant continued evaluation. Ultimately, the findings from this study can contribute with further research and assist with identifying treatments that can target possible risk factors.
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