Assessing occupational participation among justice-involved people 'with a personality disorder': Quantitative assessments and their properties.
Catriona Connell, Elizabeth Anne McKay
PMID 40336880WHAT IT FOUND
Assessments identified communication and relationship difficulties in justice-involved people with personality disorder traits.
However, the OPHI-II tool failed to fit expected patterns because these patients often lack a history of stable, prosocial occupational identity, challenging the tool's assumptions.
Key findings
01Participants showed significant limitations in communication and interaction skills compared to a matched mental health sample, reflecting the relational challenges central to personality disorder.
02The OPHI-II scales frequently produced scores that did not fit the manual's expected pattern because participants had low past occupational identity, contradicting the tool's assumption of a previously stable life disrupted by illness.
03Employed participants scored significantly higher on occupational identity and competence than unemployed participants, suggesting the tools may detect differences in participation levels within this group.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The sample size was very small (18 participants), making all results preliminary and underpowered for subgroup comparisons. Participants were not formally diagnosed with personality disorder; they were screened into a service pathway based on risk. The comparison method was inexact because published data did not allow for direct statistical testing against the study sample. A single rater scored the assessments, introducing potential bias, although standardised criteria were used. The study did not include a comparison group of justice-involved people without personality disorder traits.
Declared interests
The author declared no conflicts of interest. The research was funded by a National Institute for Health Research and Health Education England Clinical Doctoral Research Fellowship.
The easy way to misread this
Do not assume the OPHI-II is invalid simply because scores did not fit the manual's expected pattern. The deviation reflects the population's lack of prior prosocial occupational success, not necessarily a tool failure. However, do not use the manual's recommended adjustment (excluding 'past' items) without considering that it removes critical data about lifelong occupational barriers.