Stokes, Anna Maria
(2018)
Exploring differences in substance use and attachment patterns amongst offending populations.
DForenPsy thesis, University of Nottingham.
Abstract
There appears to be a link between substance abuse and offending behaviour; however, other risk factors are likely to interact with this, and it is unclear how these factors relate to sexual offending. This thesis explored substance use and attachment patterns in sexual offenders compared to other offending and non-offending populations. It also considered the impact of these risk factors on treatment readiness, motivation to change, engagement and therapeutic alliance, and risk of future offending.
A systematic review examined the research literature on alcohol and drug abuse in male sexual offenders, and compared this to non-sexual offending and non-offending populations. Results into specific alcohol and drug use patterns were mixed; however, a lack of control groups made comparison with other offending groups difficult. A psychometric critique was undertaken on one of the most widely used, and most researched, screening tools to assess alcohol dependency and identify alcohol-related problems: the Michigan Alcoholism Screening Test (MAST; Selzer, 1971). Psychometric properties for the MAST, as well as its subsequent variations, were found to be generally satisfactory.
An empirical research study then examined substance use and attachment patterns in sexual offenders compared to other types of offenders and non-offenders, and investigated whether sexual offending could be better predicted by considering an association between substance use and attachment style. No differences were found in drug use or attachment, although alcohol abuse appeared to be an important risk factor for predicting non-sexual, non-violent offending. A case study evaluated the effectiveness of an intervention with a male psychiatric inpatient, whose risk of future violent behaviour appeared to be influenced by his mental health, continued poly-substance misuse, and underlying interpersonal difficulties linked to an insecure attachment style. This also considered the impact of these contributing risk factors on treatment readiness, motivation to change, and intervention engagement.
The findings from the thesis chapters were reviewed, and practical and clinical implications discussed. It was concluded that alcohol use and insecure attachment appear to be important risk factors in male offending behaviour in general, but are not specific to sexual offending. However, more research is needed to examine their specific role, as well as that of other contributing risk factors, in order to be of any practical utility in informing effective assessment and treatment of sexual and non-sexual offenders, as well as implementation of prevention strategies.
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