The prevalence of low self-esteem in an intellectually disabled forensic population.
Most forensic clients with ID already feel okay about themselves, so test first and treat what you find.
01Research in Context
What this study did
The team gave a self-esteem quiz to adults with intellectual disability who were in a secure forensic unit.
They used picture-based questions so reading level would not block answers.
Staff helped only when the person asked.
What they found
Most clients scored in the moderate or high self-esteem range.
Only a small slice showed very low self-worth.
The results broke the common belief that forensic clients with ID always feel bad about themselves.
How this fits with other research
Johnson et al. (1994) already showed that adults with mild-moderate ID can give steady self-reports on emotion scales. Johnson (2012) now adds that this holds true even in a locked forensic setting.
Fullana et al. (2007) found that low self-esteem predicts depression in community adults with ID. That link is still useful, but Johnson (2012) warns us not to assume every forensic client starts out low.
Vassos et al. (2023) reviewed nine mental-health tools and flagged only four as both reliable and valid for adults with ID. Practitioners should pick one of those four when they repeat the Johnson (2012) check in their own clinics.
Why it matters
Before you write "poor self-concept" in a forensic treatment plan, stop and measure. Use a picture scale or one of the four tools Vassos et al. (2023) endorse. If the score comes back moderate or high, shift your goals to skill building instead of self-esteem repair. This small step keeps treatment focused on real needs, not stereotypes.
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02At a glance
03Original abstract
BACKGROUND: This was a quantitative study to measure the prevalence low self-esteem in an intellectually disabled forensic population. The dependent variables used were the adapted six-item Rosenberg Self-Esteem Scale and the adapted Evaluative Beliefs Scale. It had a repeated measures design with independent variables including consideration of differences between the low and medium secure parts of the service, the influences of types of offences and the effects of disrupted childhood attachments. METHODS: Forty-four male clients, with mild to borderline intellectual disabilities, were recruited. Data were collected by one key researcher during individual research interviews using the two structured instruments to measure self-esteem. Further data were then obtained from routinely recorded clinical information held on the hospital computer system. RESULTS: Unexpectedly, the majority of clients scored as having moderate or high self-esteem on both self-esteem measures. There was a statistically significant positive correlation between the two scales. In all, 64% of the population studied had committed either sexual offences or fire setting offences. Contrary to expectation, those who had evidence of disrupted attachments had slightly higher self-esteem than those who had not experienced disrupted attachments. CONCLUSIONS: Self-esteem is a complex personal concept with many influencing factors. Cognitive behaviour therapy has a unique role in realising and overcoming negative core beliefs and feelings of low self-worth. The offence types concurred with previously noted patterns of offending within the intellectually disabled forensic population.
Journal of intellectual disability research : JIDR, 2012 · doi:10.1111/j.1365-2788.2011.01447.x