The evolution of risk assessments with sexual/violent offenders is discussed, along with the role of police officers employing Active Risk Management System (ARMS). An updated systematic review evaluating the effectiveness of risk tools for predicting sexual recidivism in adult male offenders revealed moderate predictive accuracy with only three of 25 tools demonstrating a large effect size (AUC > .714). Quantitative and qualitative analysis of the usefulness of ARMS was conducted. The global theme of 'risk reduction' was identified. Results suggested that police officers employing ARMS would like to see changes to the tool, though overall, it improved their confidence in assessing offenders. Quantitative data were collected from a regional police force \((N=434)\),revealing four components, namely, sexual risk, protective factors, hostile attitude and relationship status. Whilst the results have important practice implications for police officers managing offenders in the community, additional longitudinal research will be required with regard to the effectiveness of ARMS. As RM2000 is incorporated within ARMS, a critique is provided. Whilst this tool can be a helpful adjunct to assessment, it is important to combine results with structured professional judgement, protective factors and a thorough case formulation. A tailored approach to assessment and treatment is advocated.

This thesis is concerned with the treatment of heroin addiction between 1965 and 1987. It examines a series of conflicts between seemingly opposed forces: between the medical and the social, the specialist and the generalist, the public and the private provision of healthcare, and the short-term and the long-term prescription of drugs to addicts. The establishment of specialised Drug Dependence Units (DDUs) in 1968 demonstrated that addiction was seen as both a disease to be treated and a social problem to be controlled. It is argued that the effects of this dynamic duality can be observed in the subsequent response to heroin addiction. Tension existed between specialist consultant psychiatrists who treated addicts at hospital based DDUs and community based private and general practitioners involved in the treatment of addiction. This was the result of contrasting approaches to addiction and its treatment. Conflict between these groups was particularly evident in the General Medical Council’s (GMC) cases for serious professional misconduct in 1983 and again in 1986-1987 against Dr Ann Dally, a leading private practitioner involved in the treatment of addiction. These cases highlighted the continuing differences between medical and social approaches to addiction but also demonstrated how these elements were inseparable and equally crucial to the formulation of drug treatment policy in this period.

Two psychometric assessments, developed for use with mainstream offenders of normal intelligence, measuring impulsivity and locus of control respectively, were adapted for use with offenders with an intellectual disability (ID). The language and sentence structures used were simplified, and the content of questions was changed to provide contexts that were familiar to detained offenders with ID. Data generated from the responses of 47 male offenders with ID indicated that both tools demonstrated good levels of reliability, in terms of internal consistency, test re-test reliability and correlations with other tools measuring related concepts . Both instruments were found not to differentiate detained offenders with ID (n=47) from two control groups of non-offenders with ID (n=2x46). In addition, an examination of the utility of the impulsivity tool in predicting institutional aggression using receiver operator characteristics, was examined. Two risk assessments, the PCL-R (Hare, 2003) and the HCR-20 (Webster, Douglas, Eaves & Hart, 1997), were also included in this study. The results indicated that the impulsivity measure did not predict institutional aggression. However, the HCR-20 and its sub-scales and the PCL-R and its factors both provided moderate and strong predictive ability, particularly in relation to physical aggression.

The primary purpose of this study was to conduct a comparative investigation and systematic examination of the constraints confronting advocacy groups in the post-transitional states of Kenya and Zambia. The researcher also examined the effects of such constraints on the ability of advocacy groups to effectively contribute to the process of democratic consolidation. The constrained advocacy sub-sector of civil society in a supposedly democratic political setting is an intriguing paradox that is less studied and understood despite advocacy groups' critical role in the process of democratic consolidation. The study employed a domestic politico-institutional approach with a comparative and case-oriented, qualitative research design, primarily based on in-depth semi-structured interviews method of data collection. The study demonstrated that advocacy groups in the post-transitional states of Kenya and Zambia are finding it extremely difficult to adapt to the new political environment. The groups are confronting constraints from the uncertainty of the new political environment defined by advocacy groups' internal contradictions and weaknesses, the legacy of authoritarianism, the influence of politics, primordialism, and international donor control; all have combined in varying degrees to undermine the role of advocacy groups in the process of democratic consolidation. Deliberate state strategies have also led to the 'closing civic space' for advocacy groups coupled with popular disengagement due to the disillusionment of citizens with advocacy groups' performance in the process of democratic consolidation. Advocacy groups are therefore a microcosm of society rigid and not as adaptable as previously portrayed in the literature of civil society studies. The contribution of advocacy groups to the process of democratic consolidation is, therefore, ambiguous. The study also concludes that domestic actors and institutions are the primary determinants of the pace and direction of democratic consolidation, while the state remains the most significant actor in the process.

This thesis examines the assessment and treatment of violence in personality disordered offenders, with the view of identifying pertinent issues to be considered when appraising risk within clinical practice. Chapter 1 reviews the relevant literature and outlines the remaining thesis. A systematic review evaluating Dialectical Behaviour Therapy (DBT) with borderline personality disordered (BPD) inpatients can be found in Chapter 2. Despite highlighting a number of methodological limitations, the review indicates DBT as having positive therapeutic effects within secure settings. Chapter 3 examines the predictive validity of the Historical/Clinical/Risk Management- 20 (HCR-20; Webster, Douglas, Douglas Eaves & Hart, 1997) showing it to be a valid and reliable within forensic populations. However, the review indicates the need for additional research, making recommendations for such work. The empirical paper in Chapter 4 investigates the concept Dangerous and Severe Personality Disorder (DSPD). A DSPD sample is compared to a non DSPD personality disordered group from the same setting on a number of risk related variables. Analysis of hospital incident data and Historical Clinical Risk Management-20 (HCR-20) scores suggests DSPD patients are at a higher risk of imminent harm to themselves and others than the comparison group. These findings offer substantiation to the DSPD label and the accompanying therapeutic programme. An individualised approach to risk assessment and treatment of a Learning Disabled offender with Borderline Personality Disorder is presented in Chapter 5, serving to highlight the difficulties with management of personality disordered inpatients. Chapter 6 offers concluding comments, discussing further implications for clinical practice.

This thesis explores the function of denial for sexual offenders, examining the role of shame and guilt. Chapter One provides an overview of the literature on the assessment and treatment of sexual offenders, drawing links to findings relating to shame/guilt and denial. Chapter Two reports the first systematic review to specifically examine existing research on shame/guilt and denial in sexual offenders. It highlights the lack of strong research exploring this relationship, although provides tentative evidence that shame is positively correlated with denial, while guilt is negatively correlated with denial in sexual offenders. In Chapter Three the correlation between shame/guilt and denial in sexual offenders is directly assessed. The findings are mixed, with some limited support for the positive relationship between shame and denial, and the negative relationship between guilt and denial in this population being generated. Possible reasons for the seemingly conflicting results are discussed, along with applications of the findings to theory, research and practice. Chapter Four is a critique of one of the psychometrics used in Chapter Three, including the background to its development, evidence for (and against) its reliability and validity and potential applications in research and applied settings. The thesis concludes in Chapter Five with a discussion of the findings of all chapters in relation to the aims set at the outset. While limitations are acknowledged, the unique contribution that the thesis makes to our understanding of the function of denial in sexual offenders, specifically in relation to shame and guilt, is highlighted.

Research associated with prisons and schools tends to focus on the connection between educational failure and the onset of offending. This research takes a different perspective by exploring whether school prepares men for prison per se. This focus emerged from the researcher's professional practice as a prison teacher. She completed induction interviews with over 200 prisoners and information from those conversations appeared to indicate that there may be a direct relationship between inmates' school and prison experiences. Observations in prison further suggested prisoners may constitute a community of practice who share a habitus and cultural capitals. To examine these themes in more detail, life histories were collected from eleven former prisoners for this doctoral thesis. The life history data was explored through Bowles and Gintis’ Correspondence Principle (1988), Bourdieu’s Reproduction through Education (1990), and Lave and Wenger’s Community of Practice (1991). Findings indicate that the former prisoners experienced a unique schooling on the margins of the mainstream school population. Segregations and various exclusions featured heavily and educational content was low. Features of this schooling experience are shown to directly correspond with the experience of being imprisoned. The researcher therefore argues that their schooling did serve as a preparation for prison.

The research component of this thesis firstly consists of a literature review considering relationships between maternal feeding practices, non-organic feeding problems and eating disorders. Findings suggest that certain feeding practices are associated with feeding problems and the development of eating styles but evidence for links with eating disorders is inconclusive. A model is proposed to explain the relationship between feeding practices and eating difficulties. It is concluded that the feeding episode is a bidirectional process, with which the wider context must be considered. Further research into longitudinal relationships between feeding practices and eating disorder is recommended, before robust conclusions can be drawn. Secondly, an empirical paper describes a laboratory study of the interaction between eating psychopathology and distraction during eating. A model is proposed to explain the control of eating behaviour, using cognitive theory. Both distraction and eating psychopathology were found to be significant predictors of food intake but interactions were not. It is argued that these surprising results are due to the specific qualities of internal and external distractors as well as the threatening nature of the food offered. Further studies with higher power are recommended in order to explore distractor qualities and the role of eating psychopathologies further.

This research volume examines the psychological adjustment of those diagnosed with either Mild Cognitive Impairment (MCI) or dementia. The first paper is a systematic review of the evidence of the use of Cognitive Behavioural Therapy (CBT) with people with dementia or MCI. Studies identified through database searches were reviewed. It was concluded that, although there is very modest evidence for the use of CBT to address depression, anxiety and acceptance among those with mild dementia or MCI, it is not possible to draw confident conclusions due to the lack of methodologically robust randomised controlled trials and the heterogeneity of existing studies. The second paper is an empirical paper of an exploration of patients’ experiences of receiving a diagnosis of MCI. Seven recently diagnosed MCI patients were interviewed about their diagnostic disclosure experiences. The interviews were analysed using Interpretative Phenomenological Analysis (IPA). Four super-ordinate themes emerged. These were ‘The test’: working it out for myself, Journey and Brakes, What’s wrong with me? and Decline and Loss. The use of multiple disclosure sessions and of pre and post assessment counselling is recommended. The third paper is a public dissemination summary of both the systematic review and the empirical paper.

This thesis investigates offences of online sexual grooming and abuse of children via Internet technologies. The literature review of online child sexual exploitation (Chapter 1) demonstrated that there is a lack of research studying this phenomenon using real-world data. This is followed by four empirical chapters (Chapters 2-5). Chapter 2 reports on a study that examined offenders’ (n = 5) modus operandi as part of sexually exploitative interactions with victims through transcripts of chat logs. Interactions were of a highly sexual nature, in which offenders used a range of manipulative strategies to engage victims. In Chapter 3, a descriptive account of the offence processes of these interactions (n = 29) is provided. Offenders employed either an indirect or a direct approach, further reflected in the types of strategies they used. Two offenders (indirect) engaged in aspects of sexual grooming; the majority of interactions by the other three offenders (direct) lacked features thereof. Chapter 4 examined victims’ (n = 22) behaviour and responses to approaches by offenders within their interactions. Most victims appeared to engage therein out of curiosity and sexual exploration/experimentation, while other victims presented with vulnerability factors (e.g., personal/psychological problems, sexual abuse experiences) that may have made them more vulnerable to contact by offenders, leading to serious offences of sexual abuse. Finally, to gain a fuller understanding of offenders’ point of view, their lived experiences of sexual grooming offences were explored through qualitative interviews (Chapter 5). Offenders employed narratives of ‘being trapped in a lie’ and ‘repenting a moral error’, through which they described the meaning they attach to these experiences. The overall discussion (Chapter 6) considers the findings of the review and research, and concludes with a discussion of limitations, implications and areas for future research.