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Carr, Alan
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Carr, Alan
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Carr, Alan
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- PublicationA comparison of two CSA treatment programmesThe development of effective treatment programmes to ameliorate the sequelae of CSA is imperative. Ideally such programmes should address intrapsychic psychological difficulties through individually based child-focused interventions; peer-related interpersonal problems through group-based interventions; and difficulties within the family and wider social network through family therapy and systemic interventions. It would be expected that some programmes might be more effective than others for young people with particular constellations of difficulties and that programmes that combined two or more therapeutic modalities might be more effective than more narrowly focused programmes.
212 - PublicationThe Waterford mental health survey(University College Dublin. School of Psychology; Health Services Executive, 2015-02)
; ; ; The primary objective of the Waterford Mental Health Survey was to document the prevalence of co-morbid personality disorders in a sample of inpatients and outpatients attending the HSE mental health service in Waterford and outline the implications of this for service development. Between July 2011 and June 2014, 100 inpatients and 99 outpatients were evaluated with the Structured Clinical Interviews for DSM-IV axis I and II disorders, the Childhood Trauma Questionnaire, the Global Assessment of Functioning rating scale, the SCORE family assessment instrument, the Camberwell Assessment of Need Short Appraisal Schedule, and the Readiness for Psychotherapy Index. Participants were consenting, consecutive referrals who were not too unwell to engage with the study. The sample interviewed was probably slightly higher functioning than all cases attending the service. With regard to the primary objective of the study, we found that 98.4% of cases had DSM-IV axis I psychiatric disorders and 39.3% of these had comorbid axis II personality disorders. Between approximately a half and three-quarters of cases with personality disorders had comorbid anxiety, depressive or alcohol and substance use disorders. Compared to those without personality disorders, cases with personality disorders had experienced more child maltreatment; had poorer personal and family functioning and more severe presenting problems; and reported greater unmet service needs and motivation for psychotherapy. In terms of service development, approximately 2 out of 5 patients attending the public mental health services in Waterford require specialist psychological therapy for personality disorders which addresses low levels of personal and family functioning and past history ofchild maltreatment. Specialist psychological therapies include dialectical behaviour therapy (Linehan, 1993. 2014), schema therapy (Young et al., 2007), cognitive behaviour therapy (Beck et al., 2004) and brief psychodynamic psychotherapy such as mentalization-based treatment (Bateman & Fonagy, 2006; Clarkin et al., 2010). A review of psychology staffing levels is required to determine the number of psychologists required to provide this type of service in line with recommendations in the national mental health policy - Vision for Change (Department of Health & Children, 2006) - and the HPSI Psychology briefing paper for the HSE mental health division (Heads of Psychology Services Ireland, 2014). Intensive initial staff training and ongoing supervision are required for psychologists to provide these specialist evidence-based interventions.1147 - PublicationProfiles of adolescent perpetrators of CSAStudies of the psychological adjustment of adolescents who sexually abuse other youngsters have shown that they differ from normal control groups, and hold some features in common with clinical control groups with other psychological problems and incarcerated control groups convicted of non-sexual offences. For example, they show more behaviour problems than normal controls but not incarcerated controls; they have difficulties with making and maintaining friendships and establishing empathy with others; they have problems with impulse control, anger management and assertiveness; and they come from families characterized by a variety of problems. Despite the burgeoning international literature in this area, few studies have been conducted on Irish adolescent sexual abusers and non-adjudicated abusers.
206 - PublicationPerceptions of the criminal justice system and its association with well-being following a report of child sexual abuse(National Organisation for the Treatment of Abusers (NOTA Ireland), 2007)
; ; ; 130 - PublicationProfiles of parents of adolescent perpetrators of CSAThe present study aimed to expand our knowledge about the profiles of families of adolescent CSA perpetrators by comparing a group of parents of adolescent sexual offenders (PASO); a clinical control group (CC) of parents of non-offending adolescents attending a child and adolescent mental health service; and a normal control group (NC) of parents of non-offending adolescents in the community on a range of demographic, developmental, personal adjustment and family environment variables.
265 - PublicationProfiles of the parents of adolescent CSA perpetrators attending a voluntary outpatient treatment programme in IrelandA group of 22 parents of adolescent sexual offenders (PASO) was compared with a group of 19 normal controls (NC) and 10 clinical controls (CC) on demographic, developmental, personal adjustment and family environment variables. The assessment protocol included the General Health Questionnaire –12, the Culture-Free Self-Esteem Inventory, the Child Behaviour Checklist, the Family Assessment Device, the Parent Satisfaction Scale, and the Multidimensional Scale of Perceived Social Support. Compared with clinical and normal controls, more parents in the PASO group reported that they had been arrested orcharged for a criminal offence; had personally experienced child abuse; and more of their adolescents had experienced child abuse, with emotional abuse being the most common form of abuse for both parents and adolescents. Compared with clinical and normal controls, more adolescents of parents in the PASO group had witnessed parental drug or alcohol abuse and had been placed in care outside their home. While parents in the PASO group did not differ from clinical or normal controls in terms of personal adjustment, their adolescents had significantly more internalizing behaviour problems than normal controls, whereas adolescents of parents in the clinical control group had significantly more externalizing behaviour problems than normal controls. Compared with normal controls, parents in both the PASO and clinical control groups reported more difficulties with general family functioning, roles, affective responsiveness, affective involvement and behaviour control and lower levels of parental satisfaction. But the groups did not differ significantly in their levels of perceived social support.
734Scopus© Citations 16 - PublicationPsychological profiles of sexually abusive adolescents in IrelandObjective. This study aimed to profile the psychological and psychosocial characteristics of a group of Irish adolescents who had sexually abused other youngsters. Method. Levels of behaviour problems, personal adjustment, anger management and psychosocial adjustment were compared in 27 Irish adolescents with a history of sexual abusing another youngster (SA group); 20 clinical controls who had significant behavioural problems but no history of sexual offending (CC group); and 29 normal controls who were without significant psychological problems (NC group). Measures used included the Child Behaviour Checklist (CBCL); the Youth Self Report Form (YSR); selected scales from Beckett (1997) Adolescent Sex Offender Assessment Pack (ASOAP); and the Family Environment Scale (FES). Results. Compared with the CC group the SA group displayed fewer problems overall on the CBCL and the YSR. The SA group showed problems with self-esteem, emotional loneliness, and perspective taking similar to those of the CC group, but their impulsivity scores were similar to those of the NC group. The locus of control scores of the SA group fell between those of the CC and NC groups. The SA group showed an anger management profile which fell at an intermediate position between those of the NC and CC groups. The SA group showed problematic family functioning in the areas of expressiveness, behaviour control and social support similar to those of the CC group. Their difficulties with family cohesion were less severe than those of the CC group but worse than those of the NC group. Conclusions. Overall the psychological adjustment of adolescents with a history of sexual abusing others was more problematic that of normal controls but less problematic than that of youngsters who had significant behavioural problems but no history of sexual offending.
952Scopus© Citations 16 - PublicationProfiles of Irish survivors of institutional abuse with different adult attachment styles(Routledge (Taylor & Francis), 2009)
; ; ; ; ; ; ; ; Two hundred and forty seven survivors of institutional abuse in Ireland were classified with the Experiences in Close Relationships Inventory as having fearful (44%), preoccupied (13%), dismissive (27%) or secure (17%) adult attachment styles. The group with the secure adult attachment style had the most positive profile, while the most negative profile occurred for the fearful group in terms of DSM IV diagnoses and scores on the Trauma Symptom Inventory, the Global Assessment of Functioning Scale, the World Health Organization Quality of Life 100 scale, and the Kansas Marital Satisfaction Scale. The profile of the preoccupied group was more similar to that of the fearful group. The profile of the dismissive group was more similar to that of the secure group792Scopus© Citations 15 - PublicationChild sex abuse and the Irish criminal justice systemThe aims of this study were to develop scales to assess experiences of sexually abused children in the Irish criminal justice system (CJS); identify aspects of the CJS which children experience as negative; compare the perceptions of children, parents and professionals of sexually abused children's experiences of the CJS; and determine correlations between perceptions of children's CJS experiences and current psychological adjustment. Forty-three children, 101 parents, 32 mental health professionals, 27 police officers and 21 lawyers completed parallel versions of the Criminal Justice System Questionnaire (CJSQ) which assessed satisfaction with aspects of the CJS relevant to sexually abused children, specifically: Gardaà (police), medical examination, Director of Public Prosecutions, waiting for court, court professionals, court context and the CJS. Fifteen scales were developed by conducting principal component analyses. Children gave negative ratings on nine of these, and on seven children, parents and professionals differed in their perceptions of how children experienced the CJS with mental health professionals viewing the impact of the CJS as more problematic than parents and children. Scores of children and parents on CJSQ scales correlated with indices of current psychological adjustment. These results point to the importance of making the Irish CJS more child-friendly and for evaluating these reforms with the CJSQ. Copyright © 2011 John Wiley & Sons, Ltd.
577Scopus© Citations 9 - PublicationAttachment styles and psychological profiles of child sex offenders in IrelandWhen 29 child sex offenders, 30 violent offenders, 30 nonviolent offenders, and 30 community controls were compared, a secure adult attachment style was 4 times less common in the child sex offender group than in any of the other three groups. Ninety-three percent of sex offenders had an insecure adult attachment style. Compared with community controls, the child sex offender group reported significantly lower levels of maternal and paternal care and significantly higher levels of maternal and paternal overprotection during their childhood. Compared with all three comparison groups, the child sexual offenders reported significantly more emotional loneliness and a more external locus of control. With respect to anger management, the child sexual offenders’ profile more closely approximated those of nonviolent offenders and community controls than that of violent offenders.
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