Many people are understandably concerned about the risk to themselves and their children posed by a small number of dangerous men who are not mentally ill but have severe lifelong antisocial personality disorders. The government is intending to introduce legislative proposals for powers to detain such people in secure institutions of some kind for as long as is necesary for the protection of the public. This report, by an expert committee of the Royal College of Psychiatrists, describes contemporary classifications of personality disorders and the rating scales and structured interviews available for the diagnosis and assessment of personality disorders, particularly in forensic settings. It also discusses knowledge of the prevalence of personality disorders, both in the general population and in prison and special hospital populations. It looks at life long courses of childhood conduct disorder and risk factors for and protective factors against delinquency.
The final section of the report discusses the various therapies that have been employed in an attempt to enable personality disordered people to change their established ways of thinking, reacting and behaving, and to become less of a nuisance to others. It concludes that although a number of psychotherapeutic and behavioural regimes have shown encouraging results none has yet been adequately assessed, in the UK or elsewhere, and that there is an urgent need for properly designed clinical trials. This report should be of particular interest to a wide range of people professionally concerned with personality disordered offenders, including lawyers, criminologists, social workers, probation officers, prison governors, psychologists, psychiatric nurses and psychiatrists themselves.