The assessment and meaning of the legal classification of offenders in a Special Hospital using observer ratings of interpersonal style

Disturbed interpersonal functioning is believed to be a cornerstone of pers onality disorder. We sought to determine differences in interpersonal funct ioning between patients detained under the Mental Health Act classification s of psychopathic disorder and mental illness. An observer-rated scale of i nterpersonal behaviour (CIRCLE) was administered to a mixed gender, Rampton Hospital sample of 92 patients classified as having psychopathic disorder and 92 matched patients classed as suffering from mental illness. Three-qua rters of the initial sample (136 patients) were successfully assessed. Sati sfactory inter-rater reliability was achieved (intra-class correlation coef ficients between 0.72 and 0.55), although some potential for rater bias was identified. We found statistically significant differences between the two groups for four of the eight octants of the interpersonal circle and the t wo groups were typically represented in opposing halves of the interpersona l circle. The significant differences in interpersonal functioning between the two groups suggest that the current legal categorization has some valid ity. Our results are generally in accordance with findings from previous wo rk in another English Special Hospital and may be generalizable to other si milar settings. The CIRCLE may provide a simple tool to assist in the asses sment and management of the personality disordered in secure hospitals.