Assessing personality disorder in learning disabled forensic populations: A rapid evidence assessment

Abstract

Purpose:The aim of this rapid evidence assessment (REA) is to evaluate the literature pertaining to the assessment of Personality Disorder (PD) within Learning Disabled (LD) forensic populations. This paper will provide practitioners with recommendations about the administration of PD assessment that can be applied to clinical practice.Design/methodology/approach:Following the refinement of the search terms and a thorough literature search (using databases such as PsychINFO, OVID, SCOPUS), 98 abstracts were read. Through multiple exclusion criteria, seven papers were included in the results section of this paper.Findings:The primary research papers included in this report demonstrated various degrees of interrater reliability, predictive validity and utility for several specific assessments designed to assess PD.Research limitations/implications:There is a paucity of research in this area. It was therefore difficult to obtain primary research about assessing PD within LD populations. Further to this, there was just one paper that compared different diagnostic systems against one another. Therefore, this REA is not considered to be a full evaluation of the entire PD/LD evidence base. As a research method, REA’s are more biased than compared to a systematic review. This is because REA’s conduct limited data extraction and limit the types of research papers that are included meaning the search is not as comprehensive. Finally, there was only one reviewer for this REA. This is a limitation as the appraisal and selection of the research for this paper was not blind.Social implications:There are ethical concerns relating to the pursuit of diagnosing PD within LD populations. It has been argued a diagnosis of PD is essentially adding another pejorative label to an already marginalised group. However, research indicates that a better understanding of an individual’s presentations will yield a more robust formulation and an individualised intervention plan. This will in turn, improve treatment outcomes and has the potential to benefit the quality of life for people with PD/LD.Originality/value:As stated above, there is a paucity of research in this area. Currently there are no LD specific PD psychometric assessments and adaptations to mainstream assessments causes the assessment itself to lose validity and reliability. There is a clear need for further research in this area and for the development of more LD specific tools within forensic psychology.