Extrait

Background and study aims Personality disorder is the name given to describe the persistent problems that some people have in managing their feelings, and managing their feelings in relation to other people. Up to 3% of the general population and up to 63% of offenders suffer from Antisocial Personality Disorder (ASPD). Someone with ASPD may not care about the feeling or rights of other people. Typical features include aggressiveness, failure to follow rules and not respecting the law. Its more severe consequences commonly include violent criminal behaviour with direct emotional and physical injury to victims. ASPD poses a significant health and financial burden both for individuals who have it, and for wider society. People with ASPD are more likely to suffer from additional health problems and are significantly more likely to die at a younger age than people without the disorder. Despite its high prevalence and harmful consequences, there is almost no evidence about which treatments are more effective for ASPD. One possible reason that an effective treatment has not yet been found is that most treatments that have been tested are not specifically designed for ASPD. We aim to test a treatment that has been specifically adapted for ASPD, from a model of treatment known as Mentalization Based Treatment (MBT). MBT is a psychological treatment that focuses on understanding of our own and others’ thoughts, feelings, wishes, dreams and desires. MBT has been shown to be effective in patients with another type of personality disorder called Borderline Personality Disorder (BPD). It has also been shown to be effective in patients who have both BPD and ASPD, and has now been specially adapted for people who suffer from just ASPD. Despite its promise, the question of whether MBT is effective for ASPD has not yet been investigated. The aim of the initial study is to investigate whether MBT can reduce aggressive acts and antisocial behaviour of offenders with ASPD, and whether it does so more effectively and cost-effectively than the usual services offered to offenders on probation. Following this, a full study will be conducted across thirteen sites, which aims to find out the benefits of MBT on a larger scale. Who can participate? We are looking for males aged over 21 who are currently on probation or community sentence, have a diagnosis of ASPD and do not want to offend anymore. What does the study involve? In both the initial study and the full-scale study, participants are randomly allocated to receive MBT or standard probation as usual (PAU) for 12 months. The MBT involves receiving a monthly 1-hour individual mentalization-based therapy session and a weekly group mentalization-based therapy for 75 minutes. The results of the two groups are compared by asking participants how often they are violent, and look at police records to see if the participant has re-offended. Other possible differences between the two groups such as impact of the treatment on quality of life and social functioning are also examined. Participants are asked these questions every 3 months throughout the year that they receive their treatment (either MBT or PAU), and for 24 months after they have completed treatment. This data is collected by members of the research team through questionnaires and interviews. All the this data is then analysed in order to find out whether the expected benefit of MBT is achieved and whether the treatment would be a more cost-effective option to be used across the country. What are the possible benefits and risks of participating? This is the first ever large scale research study of MBT for offenders with ASPD in the community and will provide evidence to inform treatment decisions for this population. The main benefits of the treatment are an expected reduction in aggressive behaviour and therefore a reduction in arrests and offences. All participants will receive help and support during this process. There are no identifiable risks for anyone who wishes to take part in the research. Where is the study run from? The pilot study takes place in three probation services in the UK and the full study takes place in 13 services around the UK. When is the study starting and how long is it expected to run for? From June 2014 to December 2020 Who is funding the study? 1. The Michael J Samuel Charitable Trust (UK) 2. National Institute for Health Research (UK) Who is the main contact? 1. Ms Elizabeth Simes 2. Dr Stephen Butler

Critère d'inclusion

• Antisocial Personality Disorder

Liens

• isrctn
• ictrp