title: Examining the effect of childhood trauma on psychological distress, risk of violence and engagement, in forensic mental health.
abstract: Previous research has found an association between childhood trauma and insecure attachment and psychological distress, risk of violence and engagement in therapy. The aim of this study was to investigate the relationships between these factors in a forensic population. Sixty-four participants from three secure psychiatric hospitals completed the Childhood Trauma Questionnaire (CTQ), the Relationship Scales Questionnaire (RSQ) and the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM). Overall scores from participants' Historical Clinical Risk Management Violence Risk Assessment Scheme, (HCR-20) were calculated. Staff evaluated participants' engagement in therapy via completion of the Service Engagement Scale (SES). This retrospective study found childhood trauma and insecure attachment significantly predicted psychological distress and risk of violence. No associations with engagement were found, but methodological reasons for this outcome were acknowledged. The importance of routinely assessing for a history of childhood trauma and insecure attachment was highlighted.
authors.affiliation: NHS Scotland, The State Hospital, Carstairs, Lanark ML11 8RP, UK. Electronic address: marlenemacinnes@nhs.net.
authors.forename: Marlene
authors.initials: M
authors.lastname: Macinnes
authors.affiliation: NHS Scotland, The State Hospital, Carstairs, Lanark ML11 8RP, UK.
authors.forename: Gary
authors.initials: G
authors.lastname: Macpherson
authors.affiliation: NHS Scotland, The State Hospital, Carstairs, Lanark ML11 8RP, UK.
authors.forename: Jessica
authors.initials: J
authors.lastname: Austin
authors.affiliation: School of Health in Social Science, The University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK.
authors.forename: Matthias
authors.initials: M
authors.lastname: Schwannauer
mesh_terms: D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology*; D000368:Aged; D057237:Criminals / Q000523:psychology*; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D000067073:Psychological Trauma / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000523:psychology*; D014754:Violence / Q000523:psychology*; D055815:Young Adult
keywords: Child abuse; Insecure attachment; Offending; Psychopathology