Emotional and behavioural problems in offenders with intellectual disability: comparative data from three forensic services.

The team used the EPS Behaviour Rating Scale in three UK forensic services. They compared emotional and behavioural scores across low, medium and high security wards. All participants had intellectual disability and a court or hospital order.

The survey looked at physical aggression, verbal aggression, non-compliance, hyperactivity and internalising problems like anxiety or low mood.

Offenders in higher-security wards scored higher on physical aggression. They also scored higher on every internalising domain, such as worry or sadness.

Verbal aggression, non-compliance and hyperactivity did not differ by security level. The pattern held after controlling for age and gender.

Myrbakk et al. (2008) used the same EPS scale and showed that high scores link to hidden psychiatric disorders, not just stricter locks. This extends the 2007 finding: security level is a proxy for clinical need.

Tenneij et al. (2009) studied forensic inpatients and found that antisocial, mood and psychotic symptoms predict severe aggression. Their data explain why higher-security units in Emerson et al. (2007) house more physically aggressive clients.

Fine et al. (2005) looked at urban children and saw more antisocial behaviour in mild-ID boys from poor areas. At first glance this clashes with the adult forensic pattern, but age and poverty explain the gap. Once you control for those, both studies agree that environment shapes risk.

Use the EPS scale at intake. A high physical-aggression or internalising score tells you the client needs both tighter structure and a psychiatric review. Share the numbers with the psychiatrist and the ward manager so treatment plans match real risk, not just the building’s postcode.