Learning
Disability Spring One Day Meeting 30/03/2012
Faculty
of Health
Department of Psychological Sciences
Norwich Medical School
Moral Reasoning Theory and Criminal Offending by People with Intellectual
Disabilities
Peter Langdon
Broadland Clinic
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Collaborators
•
Professor Glynis H Murphy (Tizard Centre, University of Kent)
•
Dr Isabel CH Clare (University of Cambridge)
•
Dr Emma Palmer (University of Leicester)
•
Dr Tom Steverson (University of East Anglia)
•
Dr Jo Rees (University of East Anglia)
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Background
•
Meta-analytic studies demonstrate a strong association between moral
reasoning and criminal offending. (e.g. d=0.76; Stams et al., 2006). There
is also a literature linking intelligence and offending behaviour (Farrington,
1996; Moffitt, 1993, Moffit et al., 1981).
•
Developmental progression within moral reasoning is fuelled by social role
taking opportunities, and is dependent upon cognitive ability.
•
Gibbs (2010) argues that a ‘developmental delay in moral judgment’,
coupled with distorted cognitions and social skills deficits are common
amongst offenders. He argues that moral reasoning relates to schema
development, which in turn leads to distorted cognition in offenders, which
supports the occurrence of offending behaviour.
Broadland Clinic
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Gibbs’ Sociomoral Stage Theory (Gibbs, 2010)
Level 1: Immature
Stage 1: Centrations
Moral justifications are based upon unilateral authority and rule based, or related to punitive consequences of
the violation of rules. Physical size and power.
Stage 2: Pragmatic Exchanges
Moral justifications based upon an understanding that has arisen from social interaction with others. For
example, decisions to help others may be justified because that person may help you in the future.
Justifications remain superficial. “Do for others if they did or will do for you”. Still egocentric.
Level 2: Mature
Stage 3: Mutualities
Moral justifications are characterised by further decentration, and are based upon a prosocial understanding of
emotional states (e.g. empathy), care, trust and good conduct..
Stage 4: Systems
Further maturity is indexed by the development of an understanding of the complex social structures in which we
live. Justifications are also based upon constructs such as rights, values and character within society.
Other justifications may be based upon social justice and responsibility or conscience.
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
• What do we already know (Langdon et al., 2010a)?
• The moral reasoning of children and adults with ID lags behind that
of age-matched peers.
• This difference tends to disappear if people with ID are matched to
people (usually younger children) of similar “mental age”.
•
A single longitudinal study (Stephens and colleagues, 1974)
demonstrated that the development of moral reasoning amongst
children with ID is similar to children without ID, although it lags.
• One study (Sigman et al., 1983) demonstrated a relationship
between moral reasoning and behavioural difficulties amongst
adolescents with borderline ID on an inpatient ward.
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
What did we do?
•
Undertook three studies to investigate moral development and its
relationship to offending behaviour by men with mild intellectual disabilities.
•
Study 1: What is the more appropriate method for measuring the moral
reasoning abilities of people with intellectual disabilities?
•
Study 2: How do offenders with intellectual disabilities score on a measure
of moral reasoning?
•
Study 3: Can we improve the moral reasoning of offenders with intellectual
disabilities using a clinical intervention?
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Study 1
Aims
1. To examine the psychometric properties of a production and recognition
measure of moral reasoning with a group of men with and without
intellectual disabilities.
2. To compare the moral reasoning abilities of men with and without
intellectual disabilities.
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Participants
•
Men with Intellectual Disabilities
•
•
32 men recruited from the community (M age=45.88, SD=15.01; M Full Scale
IQ=59.35, SD=6.16)
Men without Intellectual Disabilities
•
28 men recruited from the community (M age=40.64, SD=10.41; M Full Scale
IQ=102.29, SD=8.05)
There were no significant differences between the groups in terms of age
(t(57)=1.48, p=0.14; BCa 95% CI= -1.79 to 11.78)
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Measures
All participants completed:
1. WAIS-III
2. Test of Adolescent and Adult Language Forth Edition (TOAL-4)
3. Sociomoral Reflection Measure-Short Form: comprises eleven questions, and
generally takes about twenty minutes to administer. The questions relate to the
following seven constructs, (a) Contract (questions one to three), (b) Truth (question
four), (c) Affiliation (questions five and six), (d) Life (questions seven and eight), (e)
Property (question nine), (f) Law (question ten), and (g) Legal Justice (question
eleven).
4. The Moral Theme Inventory: primarily developed for use with children, but has
also been used with populations of adults. Respondents are asked to consider four
moral stories which have a moral message, and these are presented by playing a
digital audio file to each participant. After this, respondents are asked to engage in a
series of tasks to assess their moral reasoning.
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Results
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Results
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Results
Figure 1. Adjusted means (SEM) across the Sociomoral Reflection Measure-Short Form controlling for Full
Scale Intelligence Quotient or Spoken Langauage Ability
400
Moral Reasoning Score
350
300
250
200
ID (Covariate FIQ)
150
No ID (Covariate FIQ)
100
ID (Covariate Spoken Language)
50
No ID (Covariate Spoken Language)
0
Contract
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Truth
Affiliation
Life
Property
Sociomoral Reflection Measure Short Form
Law
Legal
Justice
Total Score
Faculty of Health
Department
of Psychological Sciences
Study 2
Aims
1. First, we examined the moral reasoning abilities of offenders with and
without intellectual disabilities and compared these abilities to those of nonoffenders with and without intellectual disabilities.
2. Based on the theoretical relationships among moral reasoning, distorted
cognitions, and empathy (Gibbs, 2003, 2010; Hoffman,2000), we examined
whether the relationship between empathy and distorted cognitions would
be mediated by moral reasoning.
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Participants
N=80 men were recruited spread across four groups.
IDs-Group: men with IDs and no known history of arrests, cautions or
convictions (M IQ=58.8, SD=5.87; M Age=45.35; SD=16.57)
IDs-Offender Group: men with IDs and a documented history of criminal
offending (M IQ=62.9, SD=5.22; M Age=33.60, SD=7.54)
Comparison-Group: men without IDs with no known history of arrests, cautions
or convictions (M IQ=103.25, SD=5.77; M Age=38.70; SD=12.99).
Comparison-Offender Group: men without IDs with a documented history of
criminal offending (M IQ=89.50, SD=11.12; M Age=38.80; SD=15.20).
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Measures
All participants completed:
1. WAIS-III
2. Sociomoral Reflection Measure-Short Form (Moral Reasoning)
3. Modifed Bryant Empathy Index
4. The How I Think Questionnaire (Cognitive Distortions)
5. Offence Data – this was assigned a severity score and ranked according to
Soothill and Dittrich (2001).
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Results
400
Figure 1: Means and Adjusted Means (Controlling for Spoken Language or Intelligence) for
Total Sociomoral Reflection Measure-Short Form Score by Group.
SRM-SF Total Score
350
300
250
No Covariates
200
Covariate: Spoken Language (Adjusted
Means)
Covariate: Full Scale IQ (Adjusted Means)
150
100
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Figure 1: Adjusted means (SEM) on the Sociomoral Reflection Measure-Short Form
Results
controlling for Full Scale IQ by Group.
400
SRM-F Score
350
300
250
200
150
IDs Group (Covariate IQ)
IDs-Offender (Covariate IQ)
100
Comparison-Offender Group (Covariate IQ)
50
Comparison Group (Covariate IQ)
0
Contract
Truth
Affiliation
Life
Property
Sociomoral Reflection Measure - Short Form
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Law
Legal Justice
Faculty of Health
Department
of Psychological Sciences
Results
Moral Reasoning
b
a
Empathy
Cognitive Distortions
c’
Unstandardised
a
b
c
c’
Indirect Effect
Indirect Effect
(Bootstrap)
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SE
t
B
6.698
2.137
3.13
-0.004
0.001
-3.55
-0.056
0.024
-2.29
-0.027
0.024
-1.12
B
SE
z
-0.029
0.012
-2.37
Lower BCa 95% CI
Upper BCa 95% CI
-0.0601
-0.0092
p
0.0024
0.0007
0.0249
0.2649
p
0.0177
Faculty of Health
Department
of Psychological Sciences
Study 3
Aims & Method
1. To evaluate an adapted Equipping Youth to Help One Another (EQUIP)
programme using a single case series design.
Seven men with intellectual or other developmental disabilities and a history
of illegal behaviour leading to criminal convictions took part in an EQUIP
treatment programme over 12 weeks.
Participants completed pre- and post-treatment measures of moral
reasoning, problem solving ability, cognitive distortions, and anger. We
hypothesised that treatment would lead to an increase in moral reasoning
and problem solving abilities, and a decrease in distorted cognitions and
anger.
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Participants
•
•
•
•
•
•
•
Participant 1 was 34 years old, with a Full Scale IQ of 77. He was diagnosed with Asperger
Syndrome after pleading guilty to manslaughter. He had previous convictions for violent offences.
Participant 2 was 28 years old, with a Full Scale IQ of 88. He was diagnosed with Asperger
Syndrome after being convicted of arson. He had previous convictions for theft.
Participant 3 was 21 years old, with a Full Scale IQ of 65. He had a diagnosis of mild intellectual
disability and had been convicted of sexual offences involving a child under the age of 13 years.
He had previous convictions for theft and sexual offending.
Participant 4 was 25 years old, with had a Full Scale IQ of 111. He was a man with a diagnosis of
Asperger Syndrome who had pleaded guilty to arson.
Participant 5 was 30 years old, with had a Full Scale IQ of 65. He had a diagnosis of mild
intellectual disability and depression. His had pleaded guilty to arson and had previous convictions
for assault.
Participant 6 was 23 years old, with a Full Scale IQ of 69. He had a mild intellectual disability and
had been convicted of sexual offences involving children under the age of 13. He had previous
convictions for theft and assault.
Participant 7 was 36 years of age, with a Full Scale IQ of 77 and a diagnosis of Asperger
Syndrome. He had pleaded guilty to manslaughter and had previous convictions relating to
firearms.
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Measures
Sociomoral Reflection Measure – Short Form (SRM-SF)
How I Think Questionnaire (HIT)
Problem Solving Task (PST)
Anger Inventory for “Mentally Retarded” Persons (AI-MRP)
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
EQUIP
EQUIP is a manualised treatment programme that was adapted and delivered
over 12 weeks.
The treatment is a multicomponent programme comprising two types of
treatment sessions a) Mutual Help Meetings, and b) Equipment Meetings.
Mutual Help: These meetings provide a forum for participants to discuss their
difficulties within a framework that allows for an appropriate resolution.
Participants are encouraged to report their problems and thinking errors that
have occurred since the last meeting and one individual is chosen
collaboratively by the group to discuss their problems in greater depth. The
group is provided with a list of 12 potential problems that they may have or
develop, which is used as a reference to aid participant understanding of
their difficulties.
Broadland Clinic
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EQUIP
Example Potential Problems
“AGGRAVATES OTHERS” PROBLEM
You threaten and hassle other people
You bully other people
You tease other people
You try to “get back” at other people
Broadland Clinic
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EQUIP
Example Potential Problems
“TRICKS OTHERS” PROBLEM
You get others to do bad things for you
You get others to do your “dirty work”
You manipulate others
You pretend you had nothing to do with it when others get caught
and you blame the other person
Broadland Clinic
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Department
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EQUIP
Example Potential Problems
“DRUG AND ALCOHOL” PROBLEM
You abuse alcohol and drugs
You are afraid to face life without using drugs or alcohol
You think that drug and alcohol abuse are not bad
You blame the drugs or alcohol when you do something wrong
Broadland Clinic
Faculty of Health
Department
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EQUIP
Thinking
the Worst
Being
Self
Centred
“I can do what I want!”
“No one can tell me
what to do!”
“I just want to have a good
time, what’s so bad about
that?!”
“I didn’t really hurt him or
her anyway!”
Minimising and
Mislabelling
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“Why bother? It never
works out for me!”
“I never do anything
right!”
“I got mixed up with
the wrong crowd!”
“He was asking for
it!”
Blaming
Others
Faculty of Health
Department
of Psychological Sciences
EQUIP
Equipment Meetings: These are “active treatment” meetings comprising
three different types of sessions: a) anger management and thinking
error correction (there are four categories of thinking errors), b)
social skills training, and c) social decision making. There are 30
sessions spread equally across three domains.
The treatment programme was delivered over 12 weeks with four one
hour sessions taking place each week.
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
EQUIP
Social Decision Making (Moral Development)
“Leon has been in a secure unit for a while and then he tried to escape. As a result, all of his leave
was cancelled and he was moved to a different unit. It took Leon one year to earn the trust of the
staff again. He now thinks it is stupid to try to escape. However, Bob, who is also in the secure
unit, tells Leon that he is planning to escape that night. “I’ve got it all figured out,” Bob says. “I’ll
hit the staff on the head and take their keys.” Bob asks Leon to come along. Leon tries to talk
Bob out of it, but Bob won’t listen.
Should Leon tell the staff about Bob’s plan to escape?
What if Bob is a pretty violent kind of buy, and Leon thinks that Bob might seriously injure or maybe
even kill the staff member? Then what should Leon do?
What is the staff member is mean and everyone hates him? Then what should Leon do?
Is it right to ever tell on someone?
Let’s change the situation! Let’s say that member of staff happens to be Leon’s uncle. Then what
should Leon do?
Let’s change the situation! Let’s say that Bob is Leon’s brother. What should Leon do?
Which is most important? Not telling on your friend/not letting people get hurt/ minding your own
business
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
Sociomoral Reflection Measure- Short Form
Contract (M)
Truth
Affliation (M)
Life (M)
Property
Law
Legal Justice
Total Score
How I Think Questionnaire
Anomalous Responding
Self-Centred
Blaming Others
Minimising Mislabelling
Asssuming the Worst
Opposition-Defiance
Physical Aggression
Lying
Stealing
Overt Scale
Covert Scale
Total Score
Problem Solving Task
Problem Identification
Generation of Solutions
Solution Selection
Evlauation of Solutions
Total Score
Anger Inventory for Mental Retarded Persons
Score
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Pre-treatment
M (SD)
Post-treatment
M (SD)
283.43 (27.25)
250.00 (28.89)
264.29 (43.96)
253.57 (56.70)
216.67 (40.83)
207.14 (93.22)
228.57 (26.73)
252.86 (26.73)
309.52 (37.09)
300.00 (64.55)
296.43 (50.89)
303.57* (22.49)
285.71* (55.64)
314.29* (55.64)
307.14* (67.26)
300.00** (33.32)
3.29 (0.82)
2.10 (0.84)
2.61 (1.50)
2.00 (0.83)
2.09 (0.84)
2.39 (0.95)
2.30 (1.60)
2.64 (0.81)
1.64 (0.72)
2.34 (1.24)
2.14 (0.69)
2.22 (0.93)
3.12 (1.22)
1.43* (0.55)
1.54 (0.61)
1.38* (0.57)
1.55* (0.57)
1.63* (0.64)
1.34* (0.56)
1.57** (0.66)
1.40 (0.58)
1.49 *(0.56)
1.49 *(0.56)
1.48 *(0.55)
3.86 (0.41)
2.17 (0.85)
3.00 (0.35)
4.29 (0.78)
16.64 (2.09)
4.20 (0.38)
2.23 (0.39)
3.31* (0.25)
4.23 (0.82)
17.46 (1.60)
78.00 (17.18)
72.29 (14.55)
*p<0.05
**p<0.001
***p<0.0001
Faculty of Health
Department
of Psychological Sciences
Conclusions
The findings indicated that moral reasoning and ability to choose
solutions that were more likely to overcome relevant obstacles and
results in a minimum of negative consequences increased.
There was a reduction in distorted cognitions.
Anger and overall problem solving ability did not change.
EQUIP appears to be a promising treatment for offenders with
intellectual and developmental disabilities. However, this is a small
study and little can be said about causality. A much larger RCT is
needed and getting underway.
Broadland Clinic
Faculty of Health
Department
of Psychological Sciences
References
•
•
•
•
•
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Langdon, P. E., Clare, I. C. H., & Murphy, G. H. (2010a). Developing an understanding of the
literature relating to the moral development of people with intellectual disabilities. Developmental
Review, 30, 273-293.
Langdon, P. E., Clare, I. C. H., & Murphy, G. H. (2010b). Measuring social desirability amongst
men with intellectual disabilities: The psychometric properties of the Self- and Other-Deception
Questionnaire-Intellectual Disabilities. Research in Developmental Disabilities, 31, 1601-1608.
Langdon, P. E., Clare, I. C. H., & Murphy, G. H. (2011). Moral reasoning theory and illegal
behaviour by adults with intellectual disabilities. Psychology, Crime & Law, 17, 101 - 115.
Langdon, P. E., Murphy, G. H., Clare, I. C. H., & Palmer, E. J. (2010). The psychometric properties
of the Socio-Moral Reflection Measure – Short Form and the Moral Theme Inventory for men with
and without intellectual disabilities. Research in Developmental Disabilities, 31, 1204-1215.
Langdon, P. E., Murphy, G. H., Clare, I. C. H., Palmer, E. J., & Rees, J. (In Press). An evaluation
of the EQUIP treatment programme with men who have intellectual or other developmental
disabilities Journal of Applied Research in Intellectual Disabilities.
Langdon, P. E., Murphy, G. H., Clare, I. C. H., Steverson, T., & Palmer, E. J. (2011). Relationships
among moral reasoning, empathy and distorted cognitions amongst men with intellectual
disabilities and a history of criminal offending. American Journal on Intellectual and
Developmental Disabilities, 116, 438-456.
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