Hard to treat forensic patients: the development and initial validation of the Mind-scale

The construction of the Mind-scale was initiated by therapeutic experiences with forensic patients that are not easy to treat. They impressed by their emotional disconnection and misleading psychological insight. Moreover, these patients strongly advocate a self-assured autonomy, bluntly saying that mandatory treatment is unnecessary. Winnicott’s Theory of Mind describes and explains these clinical characteristics and inspired, together with clinical experience, the formulation of 46 candidate items of the Mind-scale. A principal component analysis with varimax rotation was conducted on the item scores of 286 clinical participants. The scree plot directed to a one-component solution that formed the basis for the Mind-scale, containing 22 items. The Mind-scale shows good internal consistency (reliability), test–retest reliability, and constructs validity. The results are discussed in relation to different constructs and measures of psychopathy and the specific meaning of ‘positive adjustment’ in a clinical...