This study will assess the construct validity of Rotter’s Locus of control measure by relating it to the Gudjonnson Blame Attribution Inventory; in mentally disordered offending men in a medium secure setting.
The findings of this study would help the authors in a future follow up study to understand if locus of control plays a role in why some mentally ill patients engage in offending behaviours
Amongst various theories that have been put forth to explain offending behaviours social cognition theories have been of some interest. These theories include attribution and amongst them: fundamental attribution and control theories.
Fundamental Attribution theories have been developed further by Gudjonsson and the Blame Attribution Inventory and the revised version came to be researched amongst offenders both with and without mental illness.
Locus of Control theory has received similar research interest although less used in mentally unwell offenders. Recently more sophisticated attempts to postulate the combined effect and interaction between biological and psycho-social interactions as causal explanations rather than one or the other have been made (Moffit 2005; Taylor & Kim-Cohen 2007).
Similarly the construct of Locus of Control has been presented as having a neurobiological basis overlapping with widely accepted theories of personality. It is now postulated that a biochemical basis might be present to this trait (neuro-anatomical and psycho-physiological in its association with dorso-lateral, ventral prefrontal cortex and anterior cingulated cortex and the subcortical-cortical dopamine pathways. Declerck et al 2006)
Locus of Control refers to the extent to which individuals believe that they can control events that affect them. Individuals with a high internal locus of control believe that events result primarily from their own behavior and actions. Those with a high external locus of control believe that powerful others, fate, or chance primarily determine events. Those with a high internal locus of control have better control of their behaviour and tend to exhibit more socially acceptable behaviors than externals and are more likely to attempt to influence other people; they are more likely to assume that their efforts will be successful. They are more active in seeking information and knowledge concerning their situation than do externals. The propensity to engage in political behavior is stronger for individuals who have a high internal locus of control than for those who have a high external locus of control.
The Revised Gudjonsson Blame Attribution Inventory (GBAI; Gudjonsson & Singh, 1989) is a 42- item questionnaire determining attribution of blame for criminal offences. The GBAI consists of three independent factors: ‘external attribution’ which measures the extent to which the cause of the offence is blamed on external factors, ‘mental-element attribution’ which looks at how much blame responsibility is associated with mental illness or poor self-control and ‘guilt feeling attribution’ which measures feelings of regret or remorse concerning the offence.
The Gudjonsson Blame Attribution inventory revised has been researched well in those who actually offend; with or without mental illness. For example, external attribution of blame was found to be positively correlated with psychoticism, hostility, and external locus of control (Gudjonsson and Singh 1989).
In a similar setting drawn from a different sample the results were replicated with external blame attribution being associated with psychoticism and hostility. Data also reported on criminality, addiction and direction of hostility subscales which indicate that these personality characteristics are associated with external blame attribution (Shine 1997).
Gudjonsson (1990) reported that Cognitive distortions were found to be highly significantly correlated with external attribution of blame concerning the crime committed.
References and further reading may be available for this article. To view references and further reading you must purchase this article.
Amongst the large population of mentally unwell only a small proportion of them go on to offend. Exploring blame attribution helps us to understand criminogenic constructs in those who offend but cannot be used to understand why many mentally ill people don’t offend. The GBAI can only be completed by those who have offended.
Because of the above, Locus of Control which is, in our opinion a related and helpful alternative way of understanding offending behaviour could, if found to be measuring a similar construct as the GBAI, be used to help study why some mentally unwell offend. If Locus of control is found to have relevance it could then help clinicians focus on this wider personality construct. This could potentially impact on health behaviours such as adherence to medications, engagement with treatments, use of alcohol and illicit drugs.
Background and Theoretical Framework.
Offending behaviours in mentally disordered individuals has attracted attention from all quarters alike: society, media, clinicians and academics. It is a behaviour which has multiple correlates and poses significant challenges in terms of conducting methodologically sound research.
On balance it is now accepted despite initial debate (Gunn 1977 and Monahan and Steadman 1983 stating there was no association) that mental disorder, personality disorder and substance misuse have significant over representation in the offending population (Swanson 1990; Hodgins et al 1996; Steadman 1998; Singleton et al 1998; Monahan et al 2001).
However, the question of why a small but significant proportion of mentally unwell go on to offend remains.
If one considers that this group of people (mentally unwell who offend) might have been victimized themselves and might be easier targets to be processed by the criminal justice the understanding of behaviours of concern among these already stigmatized group of patients becomes muddier.
Overall, however, psychiatric patients who are violent have rates of repeated aggression, somewhere between general population and a criminal cohort (Bonta J et al 1998).
DATA FROM MENTAL ILLNESS and CRIMINOLOGY.
Psychiatric patients who are violent are not a homogenous group, and their violence reflects various biological, psychodynamic, and social factors. Most researchers and clinicians agree that a combination of factors play a role in violence and aggression, although there are differing opinions regarding the importance of some of the individual factors (Marie et al 2008).
Here is a summary: Substance use disorders have been proven to vastly increase the risk of a violent incident. Patients with alcohol or drug use problems had more arrests over their lifetime than patients with schizophrenia, personality disorders, or affective disorders (Holcomb and Ahr P 1998). It has been also reported that patients with concomitant mental illness and substance abuse were 73 percent more likely to be aggressive than were nonsubstance abusers, with or without mental illness. Furthermore, patients with a primary diagnosis of substance use disorders and personality disorders were 240 percent more likely to commit violent acts than mentally ill patients without substance abuse issues. (Steadman HJ et al 1998)
Intoxication or withdrawal from various substances of abuse, including alcohol, sedatives, cocaine, amphetamines, and opiates, can promote violent behaviors, with or without co-morbid mental illness (Lindquist et al 1989). Swanson and colleagues as part of the Epidemiological Catchment Area Study (1990) noted that substance abuse was by far the most prevalent diagnosis among survey responders reporting past violent acts. Substance abuse was present in 42 percent of violent responders and in only five percent of nonviolent responders.
Psychiatric disorders associated with violence are wide-ranging, and can include psychotic disorders, affective disorders, Cluster B personality disorders, conduct and oppositional defiant disorders, delirium and dementia, dissociative and posttraumatic stress disorders, intermittent explosive disorder, sexual sadism, and premenstrual dysphoric disorder (Petit J 2005).
Studying recently discharged patients indicated that the one-year prevalence rates for violent incidents was 18 percent for major mental illness without co-occurring substance abuse, 31 percent for major mental illness with co-morbid substance abuse, and 43 percent for personality-disordered patients with co-morbid substance abuse. The rate for mentally ill patients who didn’t abuse substances was roughly equal to that of patients who are not mentally ill and who did not abuse substance. (Steadman 1998)
In a long-term study of schizophrenic patients, substance abuse increased conviction rates for violent crimes 16-fold among the schizophrenic group, and 30 percent of male subjects with both schizophrenia and substance abuse had been convicted of a violent crime (Wallace et al 2004.)
The Epidemiologic Catchment Area Study found that the rate of violence among those with a mental illness was twice that of those without a mental illness, but violence was not more prevalent in persons with schizophrenia than among those with other disorders. The study noted that 92 percent of schizophrenic patients were not violent by their own report. The rate of violence increased linearly with the number of diagnoses, and they concluded that major mental illness was one risk factor for violence, among many others.
Approximately 20 percent of violent psychotic patients are motivated directly by their delusions or hallucinations (Taylor 1985). The authors showed that increases in the number and intensity of such delusions were associated with increases in violent behavior (Link et al 1998). Other studies, however, have found this to be less significant when controlling for factors such as substance abuse and non-adherence with treatment (Appelbaum et al 2000).
So overall the theories explaining the relationship between mental illness and associated conditions and offending has improved our understanding but is far from definite. Studies from criminology suggest that the below factors could contribute to the understanding of violence.
Biological factors. There has been some evidence gathered for a genetic predisposition in general (Klassen et al 1988). Violence is likely a polygenetic phenomenon, with many genes acting in a coordinated fashion to produce an aggressive phenotype (Cadoret et al 1997)
Neurotransmitters. Researchers have focused on neurotransmitter involvement in a pathological model of aggression, directed by studies of suicidal patients and trials using different psychotropic medications in the treatment of violent patients. Investigators have determined that a low concentration of 5-hydroxyindoleacetic acid (5-HIAA), a metabolite of serotonin, in cerebrospinal fluid (CSF) is associated with an increased propensity for aggressive acts in psychiatric patients (van Praag et al 1990). It is also reported that there is an inverse correlation between 5-HIAA concentrations and a lifetime history of aggression, expressly in personality-disordered patients (Brown et al 1982). Mesolimbic dopamine pathways are reported to be affecting responses to the environment have a role in promoting aggression. They suggest that increasing dopamine in these pathways enhances irritability and subsequent aggression (Depue et al 1986)
Neuroimaging. Prior to 2005, all 10 studies that investigated changes on single-photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging in violent individuals found deficits in either prefrontal or frontal functioning, suggesting problems in executive functions and interpreting environmental stimuli as threatening or safe (Bufkin et al 2005 ). PET scanning in 41 subjects indicted for homicide found significantly lower levels of glucose metabolism in the prefrontal cortex and corpus callosum, as compared to matched controls, also suggesting that the ventral prefrontal cortex plays an important role in the control of impulsive urges, including aggression.
Individual psychosocial factors. Psychodynamic theory proposes that aggression is a reaction to the blocking of libidinal impulses. It further asserts that aggression can result from the projection of self-destructive impulses, or death instinct, onto external objects (Blue et al 1995) Impulsive aggression may be a direct response to the individual’s perception of deprivation or punishment, and is often coupled with feelings of frustration, fear, injustice, and anger (Oquendo et al 2000). Negative parental home and personality traits: low anxiety, high impulsivity, hostility and external locus of control have been found to be associated with criminal behaviours irrespective of class differences (Buikhuisen 1984).
Social learning theory proposes that violent behavior is a product of past experiences, which involved predisposing environmental conditions and reinforcing rewards. More recently the debate between the biological (nature) and psycho-social (nurture) theories seem to be taking a new turn. Some progress has been made in the bringing together the complex overlap between biology and environment (Moffit 2005; Taylor & Kim-Cohen 2007) and there are theories that now suggest that the two must be considered in conjunction and how they interact to provide causal pathways.
Amongst such theories that are linking the biological elements with psycho-social elements, one of them is the growing sophistication in the understanding of the locus of control as a personality construct. Declerck et al 2006 postulate a biochemical basis to this trait (neuro-anatomical and psycho-physiological in its association with dorso-lateral, ventral prefrontal cortex and anterior cingulated cortex and the sub cortical-cortical dopamine pathways). Therefore this construct fits in with the new trends in aetiological research, which use a nature and nurture model rather than one or the other.
With this interest in Locus of control theory, we shall present briefly the history of
social learning theories, control theories in particular and why based on what has been said above, we want to study them further.
Gottfredson and Hirschi (A General Theory of Crime: 1990) suggest arguments for individual control. They state that the object of offending is to maximize pleasure and thus self-control is necessary for law abiding behaviour. This they suggest comes from monitoring children’s behaviours, recognizing and punishing deviant behaviours concluding that self control is learned and is shaped by socialization. They add that opportunity is another critical element to offending working in conjunction with self control.
Why do offenders consider committing crime?
Is there something distinctive about their thinking patterns which facilitate the suspension of social controls?
The area of Social Cognition offers various theories which can be used to try to explain the thinking that goes on in the mind of the criminal. Social Cognition, as defined by Banyard & Grayson’s glossary to Introducing Psychological Research, is “The way we think about and interpret social information and social experience.” So this section looks at the way the criminal thinks about his (or, less commonly, her) crimes and how they experience the consequences of those crimes. Amongst them, Attribution theory looks generally at how individuals make sense of others’ and their own behaviour. There are a number of biases at work in the attribution process, which are found generally in the everyday social cognition of the general population, and do not make offenders any different.
Attribution theory (Heider 1944) is a theory designed to explain how people perceive, infer or ascribe causes to their own and other people’s behaviour. People tend to attribute another person’s behaviour to internal/dispositional causes rather than external/situational causes, if the behaviour is different from the norm. However if the behaviour seems similar to others in the same situation but uncharacteristic of that person’s past behaviour, then we are likely to attribute it to external causes.
Beck, whose CBT based treatments are the mainstay for treatment in terms of offence related work, asserts that aggressive individuals develop a cognitive framework containing basic flaws in perceptions of social interactions, so that the individual sees others as responsible for all of his or her problems (Beck A 1999). This alludes to what offenders explain away/attribute their behaviours to.
Fundamental Attribution Error theory.
One way in which criminal social cognition may be affected is through the Fundamental Attribution Error. Nisbett et al (1973) researched the way that people make attributions (that is, the way they offer explanations for behaviours) and concluded that most people attribute the other person’s behaviour (that is, the ‘actor’) to their disposition (or character) but their own behaviour to the situation. In other words, if s/he helps a blind person it’s because they are a nice person; if I do it it’s because I have time. If s/he doesn’t help, it’s because they’re not nice people; if I don’t help it’s because I don’t have time. Whilst Nisbett did no specific research on the criminal mind his theory can be extended to how criminals can excuse their behaviour using the FAE.
Continuing the research into attribution, Gudjonsson (1984) developed the Blame Attribution Inventory, revising it in 1989. The Revised Gudjonsson Blame Attribution Inventory (GBAI; Gudjonsson & Singh, 1989) is a 42- item questionnaire determining attribution of blame for criminal offences. The GBAI isolates three types of attribution from their research with offenders: ‘external’ attribution by blaming society or the victim for the crime, ‘mental element’ attribution involving the blame being placed on mental illness, poor self-control or distorted perception, and ‘guilt-feeling’ attribution, where the offender had feelings of remorse.
The Revised Gudjonsson Blame Attribution inventory has been applied to understand offending behaviours in mentally unwell patients since its revision in 1989. This measure has been well studied in mentally unwell offenders. In a sample of 65 men in a medium secure setting, external attributions were positively correlated with neuroticism scores (Simone Fox et al 2003).
Attribution theory & Locus of Control (Rotter, 1966)
The main idea in Julian Rotter’s Social Learning Theory is that personality represents an interaction of the individual with his or her environment.
Locus of control has been one of the most widely studied personality traits, appearing as a key word in some 13,428 articles cited in Psychinfo alone since 1887 (Judge et al 2002). It has also been a frequently researched construct in mainstream offenders. In a sample of sex offenders receiving treatment (Fisher et al 1998) it was reported that having an internal locus of control prior to treatment was an important predictor of treatment success. Offenders were found to have a higher external locus of control than that found in the non-offending population (Gudjonsson and Sigurdsson 2007) .
Although less frequently applied to mentally unwell offenders it has been tested as a plausible hypothesis in treatment outcomes for sex offenders (Fisher, D et al 1999) and in drug users (Dekel, Benbenishty and Amram, 2004). It has been suggested as a reliable indicator of treatment amenability in young offenders (Page and Scalora, 2004) and internal locus of control to be positively correlated in convicted offenders with learning disability (Wendy and Legget 2007).
Much of current cognitive-behavioural treatment has its roots in Rotter’s social learning theory, although these debts often go unacknowledged. Rotter like other social cognitivists conceives of psychological problems as maladaptive behaviour brought about by faulty or inadequate learning experiences. He asserts that the symptoms of pathology, like all behaviour, are learned.
A number of studies have shown that offenders tend to see their behaviour as under external control that is they explain their behaviour as being controlled by influences beyond their personal control (Beck & Ollendick 1976; Kumchy & Sayer 1980).
However, some other studies have failed to show any difference in locus of control between offender and non-offender samples (Groh & Goldenberg 1976).
The varied findings are probably due to two unfounded assumptions:
locus of control is a unitary concept (which led to the development of the model along other dimensions: Hannah Levenson, Wallston et al)
Offenders form a homogeneous population.
There is an overlap between the constructs measured by the two scales as demonstrated in the summary of their theoretical underpinnings above. This we feel justifies the exploration of the empirical relationship between the two scales.
In keeping with the evidence for social cognitive factors that contribute to offending and the developing neuro-biological underpinnings to the aspect of perceived control, an important construct in social cognitive theories, we attempt to unearth an empirical association between this construct and the well applied and well researched scale of attribution inventory revised (GBAI) in mentally disordered offenders.
Such an association if found, will then allow us to measure Locus of Control by Rotter’s scale to seek to understand why many who suffer from mental illness don’t offend but only a small minority do. Gudjonsson’s revised blame inventory would not be suitable to undertake this comparison because it measures attitudes after offending has taken place.
Design- This is an observational survey with no interventions. This will involve comparing and assessing the validity of one measure with another.
Participants – 48 patients who are mentally disordered (but not actively psychotic and who can consent to filling out the questionnaires) will be recruited from a medium secure setting. Patients who have a diagnoses of Schizophrenia and Personality disorders (either or and) and with or without drug misuse. The diagnosis is that recorded in the cases using ICD-10 or DSM IV criteria. Patients with florid and active symptoms of mental illness will not be asked to fill out the questionnaires. Only those who can give valid informed consent (benchmarked against if they can consent to medications/ not requiring a second opinion doctor to authorise treatment) will be requested to fill the questionnaires.
All cases/ participants will be between 18-65 years old and male. Men only will be recruited to the study as it is likely that there will be gender differences in this construct and there will be insufficient females to recruit for the study on our hospital.
The medium secure setting from which participants will be recruited has 65 beds. It is expected that recruitment will take approximately 8-10 weeks. If recruitment is unexpectedly slow and problems arise a further recruitment site will be sought.
Eligible patients will be approached and the study will be explained to them. They will be given a participant information sheet and time to consider if they wish to enter the study. After at least 24 hours researchers will ask patients if they want to consent to enter the study and obtain informed consent. The patients will be given the questionnaires and be asked to complete them.
The permission of the Responsible Clinician for each patient will be sought before patients are approached. The study investigators are all doctors who are working in the teams responsible for the care of the patients and will directly oversee the filling in of the administered questionnaires.
A data extraction sheet will be developed to document demographic and other pertinent variables, which have been recorded in the case notes. Socio-economic status will be recorded based on the social worker’s assessment in the initial CPA, from the information regarding such as if these patients/cases are in receipt of state benefits and/or their employment status at the time of the offence. In addition the following two measures will be completed by the participants.
GBAI AND LOCUS OF CONTROL MEASURES.
The Revised Gudjonsson Blame Attribution Inventory (GBAI; Gudjonsson & Singh, 1989) is a 42- item questionnaire determining attribution of blame for criminal offences. The GBAI consists of three independent factors: ‘external attribution’ which measures the extent to which the cause of the offence is blamed on external factors, ‘mental-element attribution’ which looks at how much blame responsibility is associated with mental illness or poor self-control and ‘guilt feeling attribution’ which measures feelings of regret or remorse concerning the offence. The 42 questions are grouped into three subsets and are true-false questions.
Locus of Control Scale (Rotter 1966) is a 29 scale true-false measure, which measures Locus of Control, where the construct refers to the extent to which individuals believe that they can control events that affect them. Externals believe that outcomes are beyond their control whereas internals believe they can influence outcomes. Higher scores on the scale indicate a more external locus of control.
Statistical Analysis and sample size.
The Multitrait-Multimethod Matrix (hereafter labeled MTMM) is an approach to assessing the construct validity of a set of measures in a study. It was developed in 1959 by Campbell and Fiske (Campbell and Fiske1959) in part as an attempt to provide a practical methodology that researchers could actually use (as opposed to the nomological network idea which was theoretically useful but did not include a methodology). Along with the MTMM, Campbell and Fiske introduced two new types of validity — convergent and discriminant — as subcategories of construct validity. Convergent validity is the degree to which concepts that should be related theoretically are interrelated in reality. Discriminant validity is the degree to which concepts that should not be related theoretically are, in fact, not interrelated in reality.
Correlations coefficients will be used to summarise the relationship between the two measures of interest. The precision of the correlation coefficients will be assessed using 95% confidence intervals. Convergent validity will be assessed by correlating the Locus of Control Scale with the ‘External Attribution’ subscale of the GBAI. A high positive correlation would be expected if the two measures are assessing a similar construct. A lower or potentially a negative correlation would be expected between the Locus of Control Scale and the other two subscales of the GBAI. If this is the case and the other two subscales are less or not significantly associated with the Locus of Control this would indicate discriminant validity.
To be able to detect a medium correlation between variables, 0.4, with 80% power at a 5% significance level 48 participants are required.
Only necessary data such as the diagnoses and other demographic variables will be collected from the notes. The data so collected will be anonymised and used appropriately
The Data Protection Act (1998) will be followed. All research data will remain on NHS premises and stored in the same manner as medical records. Patient identifiable information will only be held on NHS computers with the same protection as other NHS patient information. The Principle Investigator (and local investigators) will act as custodian of the data.
The patients will be advised of the purpose of the study as being facilitative to test out and assess the scales. Management of the patients will not be influenced by the results of the questionnaires and the results will be disseminated locally to the RCs.
Any distress that might occur whilst filling out the questionnaire will be overseen by a senior nurse or ward doctor and assistance or appropriate intervention will be offered. Although we do not foresee distress while filling the forms, any distress will be carefully managed as appropriate.
Justification and use of results.
We choose the Rotter’s scale and the Gudjonsson’s Blame Attribution Inventory because of their widespread use in measurement of psychological constructs related to mentally unwell offenders, as explained above.
Understanding offending behaviours is not only in the interest of the clinician and researcher but also in the interest of society. Limited understanding does no favours to stigmatization of the minority of those mentally unwell who offend. We hope that this study will contribute to understanding offending behaviour in mentally unwell patients.
The results obtained from this study (adhering to the rules of data protection) will be disseminated locally and at appropriate forums where further discussion and critiquing of this work can be made and research can be advanced.
It is hoped that the immediate beneficiaries would be the academicians attempting to understand these behaviours, but hope that the usefulness would extend to policy makers, patients, carers and society in general.
Appelbaum PS, Robbins PC, Monahan J. Violence and delusions: data from the MacArthur violence risk assessment study. Am J Psychiatry 2000;157: 566-572.
Ackerman, P. L., & Heggestad, E. D. Intelligence, personality, and interests: evidence for overlapping traits. Psychological Bulletin, (1997). 121, 219-245.
Beck A. Prisoners of Hate: The Cognitive Basis of Anger, Hostility and Violence. New York: Harper Collins, 1999
Beck, S. J. and Ollendick, T. H. Personal space, sex of experimenter, and locus of control in normal and delinquent adolescents. Psychological Reports, (1976) 38, 383-387.
Blue H, Griffith E. Sociocultural and therapeutic perspectives on violence. Psych Clin N Am. 1995;18:571-587.
Bonta J, Law M, and Hanson K. The Prediction of criminal and violent recidivism among mentally disordered offenders: Meta analysis. Psychological Bulletin. 1998; 123:123-142
Bufkin JL and Luttrell VR. Neuroimaging studies of aggressive and violent behavior: current findings and implications for criminology and criminal justice. Trauma Violence Abuse. 2005;6(2):176-191.
Buikhuisen, W, E.H.M Bonetkoe, C. V. D. Plas- Korenhoff and S. Van Buuren, Characteristics of Criminals: The Privileged Offender: International Journal of Law and Psychiatry, Vol. 7 pp. 301-313, 1984
Cadoret RJ, Leve LD, Devor E. Genetics of aggressive and violent behavior. Psych Clin N Am. 1997;20: 301-322.
Campbell, D. and Fiske, D. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. 56, 2, 81-105
Declerck CH, Boone C, De Brabander B. On feeling in control: a biological theory for individual differences in control perception. Brain Cognition. 2006 Nov; 62(2):143-76.
Dekel R, Benbenishty R, Amram Y: Therapeutic communities for drug addicts: prediction of long-term outcomes. Addictive Behaviors 2004, 29:1833-1837.
DeNeve, K. M., & Cooper, H. (1998). The happy personality: a meta-analysis of 137 personality traits and subjective well-being. Psychological Bulletin, 124, 197-229.
Depue R, Spoont M. Conceptualizing a serotonin trait: a behavioral dimension of constraint. Ann NY Acad Sci. 1986; 487:47-