A look at HM Institution Cornton Vale: a sample of women prisoners

Dr. Jennifer PerrinDivision of Applied MedicineUniversity of Aberdeen

Overview of talk Introduction and aims Methods Childhood trauma Personality disorders Psychiatric symptoms Where can we go from here: an open

discussion?

Introduction Study was commissioned by the Scottish Prison

service. Aim: to examine the prevalence of childhood

trauma, personality disorders and psychiatric symptoms among the female prisoners at Cornton Vale.

Why? To better understand the mental health needs of

the prisoners. Knowledge gained could aid the day-to-day

management of the prisoners.

Methods Prisoners were asked to fill out a survey

containing questionnaires which are designed to examine childhood trauma, personality disorders and psychiatric symptoms.

In total 159 women volunteered to complete the survey. This group included both prisoners on

remand and those who have been convicted.

Childhood Trauma Childhood trauma questionnaire (CTQ)

was used. Self-report questionnaire where you are

asked to rate the truth of each statement from never true to very often true.

CTQ covers emotional, physical and sexual abuse as well as emotional and physical neglect.

Trauma in contextCompared with a community sample.

Compared with a prison sample.

Emotional abuse

CDQ- Take home message High rates of reported childhood trauma,

with 33% reporting a history of severe to extreme sexual abuse. 33% also reported a history of severe to

extreme emotional abuse. Much higher rates of trauma then a

community sample. In terms of emotional abuse this population

was more similar to a psychiatric populations then community samples.

Personality disorders Current DSM (4th edition) includes 10

different disorders. Personality Diagnostic Questionnaire

PDQ version 4 was used. 99 true/false questions that produce

scores for the 10 different diagnoses. Score of 50 or greater = increased

likelihood of a personality disorder. Eg. I get into a lot of fights (antisocial)

37% screened for both BPD and ASPD, while 17% screened for BPD alone and 14% ASPD alone.

What do you think of the paranoid result – artifact or real result?

Personality disorders in context

Comparison with clinical populations.

Comparison with other prison samples.

Personality Disorders take-home message. A high rate of prisoners scored as likely to

have a PD diagnosis with borderline and antisocial being the most prevalent.

Cornton Vale sample is more like a psychiatric inpatient sample in terms of PD prevalence and has higher levels of borderline and antisocial than two other prison samples.

These results should be taken with some caution as the PDQ-4 can overestimate.

Psychiatric Symptoms The symptom checklist-90 was used as a

general measure of psychiatric symptoms. Self-report questionnaire scored on a five-

point scale (0-4) assessing rate of symptom occurrence over the last 7 days.

Subscales include: somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism.

Mean score = Global Severity Index

Symptoms in context

Symptoms take home message High levels of symptomatology among

the Croton Vale sample. This population is more similar to a

psychiatric population than it is to a community one.

Overall results High level of childhood trauma amongst

the women. These levels resemble a psychiatric

population. More than half of the prisoners fulfilled

the criteria for BPD and ASPD (according to the PDQ-4.

SCL-90 indicated that 80% of the women were experiencing considerable distress.

Where can we go from here? Examine for relationships between

trauma, PD and offence related factors. Eg. Current offence, number of offences,

violence. Role of social factors in the above.

Eg. Education, SES, relationships. Potential targets for interventions.

Questions to discuss Would you have used the same measure

of personality disorder (PDQ-4)?

What do these results mean to you? (i.e. are you surprised by what was found)

What do you think the next step should be research-wise?

Acknowledgments Rachel Hooks Dr. Linda Treviling Governor and staff of Cornton Vale