ABSTRACT

The neuropsychological assessment of individuals with a mental disorder and deemed to be a ‘grave and immediate’ risk of harm to others admitted to one UK high-secure psychiatric care (HSPC) hospital makes an important contribution to the formulation of their difficulties and treatment needs. Included within the assessments is the DEX S questionnaire, assessing the subjective experience of any executive dysfunction (ED). An examination of 205 DEX S profiles suggests ED is common, particularly among younger individuals and with no difference between those who self-report a history of head injuries. Whilst a non-clinical non-forensic classification system suggested 43.9% of individuals fall into a ‘high deficit’ category and 24.4% fall into a ‘moderate deficit’ category, a HSPC classification system suggests higher thresholds, with 22.4% and 33.2% falling in ‘high deficit’ and ‘moderate deficit’ categories, respectively. Frequently endorsed items are associated with difficulties understanding others unless things are kept simple and straightforward, acting without thinking, expressing emotions, feeling restless, and problems sitting still for any length of time and being easily distracted. Results are discussed in terms of increasing awareness of ED among those involved in the care of mentally disordered offenders, cognitive remediation and the potential for a forensic psychiatric version of the DEX.

摘要

对患有精神障碍的患者进行神经心理学评估，并认为对英国一家高安全精神病护理 (HSPC) 医院收治的其他人有“严重且直接”的伤害风险，对确定他们的困难和治疗需求做出了重要贡献。评估中包括 DEX S 问卷，用于评估任何执行功能障碍 (ED) 的主观体验。对 205 个 DEX S 档案的检查表明 ED 很常见，尤其是在年轻人中，并且与那些自我报告头部受伤史的人没有差异。非临床非法医分类系统表明 43.9% 的人属于“高赤字”类别，24.4% 属于“中度赤字”类别，而 HSPC 分类系统则建议更高的阈值，分别为 22.4% 和 33。“高赤字”和“中度赤字”类别分别下降 2%。经常被认可的项目与理解他人的困难有关，除非事情保持简单明了、不假思索地行动、表达情感、感到不安、久坐不动和容易分心。研究结果从提高参与精神障碍罪犯护理人员对 ED 的认识、认知矫正以及法医精神病学版 DEX 的潜力等方面进行了讨论。以及久坐不动和容易分心的问题。研究结果从提高参与精神障碍罪犯护理人员对 ED 的认识、认知矫正以及法医精神病学版 DEX 的潜力等方面进行了讨论。以及久坐不动和容易分心的问题。研究结果从提高参与精神障碍罪犯护理人员对 ED 的认识、认知矫正以及法医精神病学版 DEX 的潜力等方面进行了讨论。