Background. The literature on Theory of Mind (ToM) in antisocial samples is limited despite evidence that the neural substrates of theory of mind task involve the same circuits implicated in the pathogenesis of antisocial behaviour.Method. Eighty-nine male DSM-IV Antisocial Personality Disordered subjects (ASPDs) and 20 controls (matched for age and IQ) completed a battery of ToM tasks. The ASPD group was categorized into psychopathic and non-psychopathic groups based on a cut-off score of 18 on the Psychopathy Checklist : Screening Version.Results. There were no significant group (control v. psychopath v. non-psychopathic ASPD) differences on basic tests of ToM but both psychopathic and non-psychopathic ASPDs performed worse on subtle tests of mentalizing ability (faux pas tasks). ASPDs can detect and understand faux pas, but show an indifference to the impact of faux pas. On the face/eye task non-psychopathic ASPDs showed impairments in the recognition of basic emotions compared with controls and psychopathic ASPDs. For complex emotions, no significant group differences were detected largely due to task difficulty.Conclusions. The deficits in mentalizing ability in ASPD are subtle. For the majority of criminals with ASPD and psychopathy ToM abilities are relatively intact and may have an adaptive function in maintaining a criminal lifestyle. Our findings suggest the key deficits appear to relate more to their lack of concern about the impact on potential victims than the inability to take a victim perspective. The findings tentatively also suggest that ASPDs with neurotic features may be more impaired in mentalizing ability than their low anxious psychopathic counterparts.

Care and treatment in forensic mental health wards can present with challenges when loss of hope and freedom, and aggression are present, which can then influence ward atmosphere and feelings of safety. Safewards is a model designed to address a range of conflict (e.g., aggression and self-harm) and containment (e.g., use of restrictive interventions) events and may provide a suitable approach to delivery of care in a forensic setting, while also addressing aggression, restrictive interventions, and ward atmosphere. The aim of this study was to evaluate the introduction of Safewards to a forensic mental health ward to determine suitability, and to explore if changes to conflict, containment, and ward atmosphere occurred. A mixed methods approach was used involving the collection of incident data related to conflict and containment, an assessment of the degree to which interventions were implemented, and an assessment of the social climate before and after implementation. Results suggested that there were fewer conflict events after Safewards was introduced; however, there did not appear to be any changes in the already low use of restrictive interventions. The Safewards interventions were implemented to a high degree of fidelity, and there was indication of an increase in a positive perception of ward atmosphere, supported by themes of positive change, enhanced safety, and respectful relationships. Safewards may assist in contributing to an improvement in the perception of ward atmosphere. To enhance implementation in a forensic mental health setting, there may be a need to consider additional elements to Safewards, pertinent to this setting.

Background. There is a limited literature examining face affect recognition in offenders. In line with the Integrated Emotion Systems (IES) model, existing studies suggest a psychopathy-related deficit in sad/fear recognition. However, many of these studies have small samples, and few include a healthy control group in order to examine the contribution of criminality.Method. We compared the performance of male criminals with dissocial (antisocial) personality disorder (PD group) and healthy male IQ-matched controls, on a morphed face affect-processing task and examined the relationship between psychopathy (assessed using the Psychopathy Checklist : Screening Version, PCL : SV), score and performance on this task in the PD sample.Results. The PD group had a specific deficit in the recognition of sad facial affect that was present even at 100% expression intensity. This deficit could not be attributed to impulsive responding as the PD group generally had longer mean reaction times than healthy controls. Within the PD group, those with high scores on the PCL : SV were less accurate than low scorers at classifying sad facial affect. There was also a significant negative correlation between total psychopathy score and sad affect recognition accuracy. There were no specific relationships between affect recognition and the subcomponents of psychopathy.Conclusions. The findings suggest that criminality/antisocial personality may be associated with a deficit in the recognition of aversive cues in others, and that this deficit is more severe in psychopathic offenders. The findings lend further support to the IES model.