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The impact on staff of working with personality disordered offenders: A systematic review

Mikton, Chris; Timmer, Antje; Freestone, Mark C.; Wilson, Kim; Jones, Rose; Mikton, Christopher; Milsom, Sophia; Sonigra, Ketan; Taylor, Celia; Campbell, Colin

The impact on staff of working with personality disordered offenders: A systematic review Thumbnail


Antje Timmer

Mark C. Freestone

Kim Wilson

Rose Jones

Sophia Milsom

Ketan Sonigra

Celia Taylor

Colin Campbell


© 2015 Freestone et al. Background: Personality disordered offenders (PDOs) are generally considered difficult to manage and to have a negative impact on staff working with them. Aims: This study aimed to provide an overview of studies examining the impact on staff of working with PDOs, identify impact areas associated with working with PDOs, identify gaps in existing research,and direct future research efforts. Methods: The authors conducted a systematic review of the English-language literature from 1964-2014 across 20 databases in the medical and social sciences. Results: 27 papers were included in the review. Studies identified negative impacts upon staff including: negative attitudes, burnout, stress, negative counter-transferential experiences; two studies found positive impacts of job excitement and satisfaction, and the evidence related to perceived risk of violence from PDOs was equivocal. Studies demonstrated considerable heterogeneity and meta-analysis was not possible. The overall level of identified evidence was low: 23 studies (85%) were descriptive only, and only one adequately powered cohort study was found. Conclusions: The review identified a significant amount of descriptive literature, but only one cohort study and no trials or previous systematic reviews of literatures. Clinicians and managers working with PDOs should be aware of the potential impacts identified, but there is an urgent need for further research focusing on the robust evaluation of interventions to minimise harm to staff working with offenders who suffer from personality disorder Copyright:


Mikton, C., Timmer, A., Freestone, M. C., Wilson, K., Jones, R., Mikton, C., …Campbell, C. (2015). The impact on staff of working with personality disordered offenders: A systematic review. PLoS ONE, 10(8), e0136378.

Journal Article Type Article
Acceptance Date Mar 18, 2015
Publication Date Aug 25, 2015
Deposit Date Sep 16, 2016
Publicly Available Date Sep 16, 2016
Journal PLoS ONE
Electronic ISSN 1932-6203
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 10
Issue 8
Pages e0136378
Keywords psychological stress, database searching, forensics, nurses, personality disorders, prisons, mental health and psychiatry, systematic reviews
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