Attention problems predict risk of violence and rehabilitative engagement in mentally disordered offenders

Ignazio Puzzo, Ottilie Louise Sedgwick, Rachel Kelly, Ben Greer, Veena Kumari, Gisli Gudjonsson, Susan Young

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
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Mentally disordered offenders (MDOs) endorse difficulties with attention, impulsivity and hyperactivity. Assessing these difficulties among MDOs may confer practical benefits for the management and provision of care for this population, by informing strategies to improve rehabilitative engagement and risk assessments for violence. However, there is a dearth of literature exploring these cognitive problems in MDOs in relation to outcome factors.
Forty-eight MDOs from a high security hospital completed the QbTest, which measures the domains of inattention, impulsivity and hyperactivity. Comprehensive file review of clinical and occupational/vocational rehabilitative engagement and Historical Clinical Risk Management-20 (HCR-20) were used as outcome measures of interest.
Participants displayed greater cognitive deficits in attention, impulsivity and hyperactivity compared to the general population. The domain of inattention and omission errors was related to occupational/vocational therapy engagement as well as a higher risk of present and future violence as measured by the HCR-20.
The findings suggest that QbTest is a helpful objective tool that could be incorporated into the assessment of MDOs. Specifically, inattention emerged as a strong predictor of patients’ risk of violence as well as patient’s vocational therapy engagement. Therefore, cognitive skills programs targeting attention problems should be introduced to improve outcomes for this population.
Original languageEnglish
Article number279
JournalFrontiers in Psychiatry
Issue numberMAY
Publication statusPublished - 7 May 2019


  • Attention
  • Hyperactivity
  • Impulsivity
  • Mentally disordered offenders
  • Risk of violence
  • Therapeutic engagement


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