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Carr, Alan
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Carr, Alan
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Carr, Alan
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- 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.
167 - 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)
; ; ; 41 - 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.
101 - 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.1015 - PublicationSupporting parents of adolescent perpetrators of CSAThe importance of parental involvement in the treatment of their adolescent CSA perpetrators cannot be underestimated. One of the defining differences between the fields of adult and adolescent sexual offending is the fact that adolescents are still in a formative stage of development. Parents can still exercise a major influence in re-engaging children back on a normative developmental pathway and reducing future risk to a minimum. It is also important to include parents of adolescent CSA perpetrators in treatment programmes because it is well documented in Irish and international studies that some have significant problems.
372 - 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.
123 - PublicationChild maltreatment and adult psychopathology in an Irish context(Elsevier, 2015-07)
; ; ; ; ; ; One-hundred-ninety-nine adult mental health service users were interviewed with a protocol that included the Childhood Trauma Questionnaire, the Structured Clinical Interviews for Axis I and II DSM-IV disorders, the Global Assessment of Functioning scale, the SCORE family assessment measure, the Camberwell Assessment of Need Short Appraisal Schedule, and the Readiness for Psychotherapy Index. Compared to a U.S. normative sample, Irish clinical cases had higher levels of maltreatment. Cases with comorbid axis I and II disorders reported more child maltreatment than those with axis I disorders only. There was no association between types of CM and types of psychopathology. Current family adjustment and service needs (but not global functioning and motivation for psychotherapy) were correlated with a CM history. It was concluded that child maltreatment may contribute to the development of adult psychopathology, and higher levels of trauma are associated with co-morbid personality disorder, greater service needs and poorer family adjustment. A history of child maltreatment should routinely be determined when assessing adult mental health service users, especially those with personality disorders and where appropriate evidence-based psychotherapy which addresses childhood trauma should be offered.477Scopus© Citations 5 - PublicationFamily and marital profiles of couples in which one partner has depression or anxietyTwenty-nine couples in which one partner was depressed, 21 couples in which one partner had an anxiety disorder, and 26 nondistressed control couples were compared on measures of (1) quality of life, stress, and social support; (2) family functioning; (3) marital functioning; and (4) relationship attributions. The depressed group had significant difficulties in all four domains. In contrast, the control group showed minimal difficulties. The profile of the anxious group occupied an intermediate position between those of the other two groups, with some difficulties in all four domains, although these were less severe and pervasive than those of the depressed group..
498Scopus© Citations 17 - PublicationA Controlled Evaluation of Mindfulness-Based Cognitive Therapy for Patients with Coronary Heart Disease and DepressionThis study evaluated the effectiveness of an eight-session mindfulness-based cognitive therapy (MBCT) group intervention programme for treating depression in coronary heart disease (CHD) patients. Thirty-two depressed CHD patients were assigned to an MBCT treatment group, and a demographically and clinically similar group of 30 cases were assigned to a waiting list control group. Participants were evaluated at baseline, 8 weeks, and 6-month follow-up with the Hospital Anxiety and Depression Scale (HADS), Brief Symptom Inventory (BSI), Profile of Mood States (POMS), Psychosocial Adjustment to Illness Scale (PAIS) and the Mindful Attention Awareness Scale (MAAS). After each session, MBCT participants completed the post-session Questionnaire on helpful aspects of therapy and after the programme, completed the Client Satisfaction Questionnaire. At follow-up, 71 % of the MBCT group was clinically recovered from depression compared with 50 % of the control group. The MBCT group showed significantly greater improvement than the control group on all measures with effect sizes at follow-up of d = 0.43–1.0. Increases in mindfulness on the MAAS correlated significantly with improvements on the HADS, BSI, POMS and PAIS. Key helpful aspects of therapy identified by MBCT participants included learning meditation, obtaining group support and developing optimism. There was a high level of satisfaction with the MBCT programme. These results indicate that a randomized controlled trial of MBCT for depressed CHD patients is now warranted.
856Scopus© Citations 22 - 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 group567Scopus© Citations 10