The co-morbidity of personality disorder and lifetime clinical syndromes in dangerous offenders (original) (raw)
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The co‐morbidity of personality disorder and clinical syndromes in prisoners
2009
Objectives Our aim was to examine patterns of Axis II co-morbidity using data from the national survey of psychiatric morbidity among prisoners in England and Wales. Methods A one-in-fi ve sub-sample of participants in a survey of psychiatric morbidity among prisoners in England and Wales was interviewed using the Schedule for Clinical Assessment in Neuropsychiatry and the Structured Clinical Interview for the fourth edition of the Diagnostic and Statistical Manual of Mental Health Disorders Axis II personality disorders (PD). Logistic regression analysis was conducted adjusting for confounders of associations with co-morbid psychopathology disorders, age and gender.
Co-morbidity of personality disorder and clinical syndrome in high-risk incarcerated offenders
The Journal of Forensic Practice, 2017
Purpose In light of the clinical importance of understanding co-morbidity within offender populations, the purpose of this paper is to examine the prevalence and comorbidities of clinical disorder (Axis I) and personality disorder (Axis II) within a sample of high risk, male offenders located in a high secure, prison-based personality disorder treatment service. Design/methodology/approach The study utilised clinical assessment data for both Axis I diagnoses (Structured Clinical Interview for DSM-IV) and Axis II diagnoses (International Personality Disorder Examination) of 115 personality disordered offenders who met the criteria for the treatment service between 2004 and 2015. Findings Co-morbidity between Axis I and Axis II diagnoses was high, with 81 per cent of the sample having co-morbid personality disorder and clinical disorder diagnosis. The most prevalent Axis I disorder was substance misuse, and Axis II was antisocial, borderline, and paranoid personality disorder. Followi...
Personality Disorders in Offenders: Categorical Versus Dimensional Approaches
Journal of Personality Disorders, 2001
The present study focused on the consequences of cut-off scores in personality disorder diagnoses for their association with criminal behavior. Using ICD-10 personality disorder criteria eliminating offence-related symptoms, we studied the distributions of categorically diagnosed personality disorders and of dimensional personality disorder scores in a group of offenders and a noncriminal control group. Whereas the dimensional scores of the offender group differed significantly from those of the control group for all personality disorders under study, the frequency of categorical diagnoses differed significantly for two personality disorders only. Moreover, prediction of group membership (offenders vs. nonoffenders) from personality disorder scores was substantially more precise than prediction from categorical diagnoses. It is concluded that a dimensional approach to personality disorder diagnosis is not only superior theoretically but also yields more precise information about the specific associations with criminal behavior.
Journal of Forensic Psychiatry & Psychology, 2010
Previous studies have related mental disorder and antisocial personality disorder to criminal behaviour, but little is known about the associations with other personality disorders. The aim of this study was to examine independent associations between offending behaviour over the lifetime and personality disorder in a representative sample of male and female offenders. A two-stage survey was carried out among prisoners in all prisons in England and Wales. DSM-IV personality disorder was measured using SCID-II in the second stage among 497 male and female prisoners. Independent relationships between personality disorder scores and lifetime offences were examined using multiple regression. Findings demonstrated several independent relationships between personality disorders and offending behaviour. Initial associations observed with Borderline personality disorder were confounded. Strongest associations were found between the conduct disorder and adult antisocial components of Antisocial personality disorder, with no evidence that these were the consequence of the other Axis II disorders. Future research should investigate the functional links between personality disorder and offending behaviour.
Journal of Forensic Psychiatry & Psychology, 2003
Mental health legislation in Britain has traditionally encouraged a distinctionbetweenpersonality disordered andmentally ill offenders, butresearchon co-morbidity indicates that few patients exhibit an Axis I or an Axis II disorder in isolation. This study compared male high-security hospital patients in the English Mental Health Act categories of psychopathic disorder (n=54) and mental illness (n=61) and the Scottish legal category of mental disorder (n = 60), using structured instruments to assess personality disorders, psychopathy and Axis I disorders. The mental illness and psychopathic disorder categories were not differentiated by personality disorders, psychopathy, or Axis I disorders, except for more lifetime drug abuse and more lifetime and current psychosis among the mentally ill. A majority of patients with mental disorder under Scottish legislation also exhibited personality disorders. Grouping by primary clinical diagnosis of personality disorder or mental illness produced few differences on Axis I or Axis II, and overall there was a relatively strong correlation between thepresence of an Axis I and an Axis II disorder. Legal and clinical attempts to separate personality disordered and mentally ill offenders may be ill-conceived because Axis I and Axis II disorders tend to coexist.
Aetiological risk factors for personality disorders
The British Journal of Psychiatry, 1999
Background Elucidation of aetiological processes leading to development of Axis II disorders is important in category validation and could lead to new treatments. Aims To establish aetiological associations between Axis II disorders and specific risk factors. Method Male and female subjects (n=260) in maximum security hospitals and prisons were interviewed to determine DSM-III Axis II and lifetime Axis I diagnoses. Aetiological risk factors were obtained at interview and from case files. Independent statistical associations were established by logistic regression. Results Axis II categories were divided into four groups: (a) disorders of character development, secondary to an adverse early environment: antisocial, self-defeating and paranoid; (b) disorders of temperament, secondary to constitutional aetiology: avoidant, dependent, schizoid and schizotypal; (c) a ‘mixed’ disorder of constitutional and environmental aetiology: borderline; and (d) aetiological associations not establis...
Predictors of personality disorders in prisoners
Journal of medicine and life, 2022
Personality disorders can lead to difficult social or occupational functional processes rooted in chronic maladaptive thoughts, feelings, and behaviors. This study aimed to investigate factors of personality disorder in prisoners from the central prison of Sanandaj, Iran. We conducted a cross-sectional study, which included all prisoners in the central prison of Sanandaj, Iran. The study sample includes 343 prisoners, of which 329 were male, and 14 were female, selected by randomized multistage sampling method. Participants filled in Millon's multi-axis clinical questionnaire. The data were analyzed using Chi-square, multiple logistic regression, and bootstrap analysis. There were 183 participants without personality disorders (53.4%) and 99 participants (28.9%) with cluster B personality disorders (narcissistic, histrionic, antisocial , and borderline). Male gender (OR=0.07) and elementary education level (OR=0.18) have a significant relationship with cluster A personality disorders (paranoid, schizoid, schizotypal). Cluster B has a significant relationship only with the elementary education level (OR=0.27). Cluster C (avoidant, dependent, obsessive-compulsive personality disorder) has a significant relationship with male gender (OR=0.20), elementary education level (OR=0.30), unemployment (OR=2.64), theft crime types (OR=0.38) and disputes and assaults (OR=0.18). Based on these results, psychological and psychiatric interventions in prisoners are suggested.
Borderline personality disorder in male and female offenders newly committed to prison
Comprehensive Psychiatry, 2007
Background: The objective of the study was to estimate the rate of borderline personality disorder (BPD) in male and female offenders newly committed to the Iowa Department of Corrections. We also compared clinical and demographic characteristics of offenders with and without BPD. Methods: A random sample of 220 offenders entering Iowa's prison system were evaluated by using a version of the Mini International Neuropsychiatric Interview, the BPD module of the Structured Interview for DSM-IV Personality Disorders, the Medical Outcome Survey Short Form-36 Health Survey, and the Level of Service Inventory-Revised. Results: Borderline personality disorder was present in 65 (29.5%) subjects, although 93.2% had at least one Diagnostic and Statistical Manual of Mental Disorders-IV BPD trait. The percentage of women meeting criteria for BPD was more than twice that for men. Subjects with BPD were more likely than those without to be married, employed, and to have a high suicide risk score. Offenders with BPD were more likely than others to report prior mental health treatment, and to have reported high levels of interference from their mental disorder. Offenders with BPD had worse quality of life than offenders without BPD as assessed with the Medical Outcome Survey Short Form 36 Health Survey, and higher rates of mood, anxiety, psychotic, and eating disorders; antisocial personality disorder; and attention deficit hyperactivity disorder. Borderline personality disorder was also associated with higher Level of Service Inventory-Revised total scores, which indicates their having a greater risk for recidivism than nonborderline offenders. These relationships were observed after adjusting for sex, age, race/ethnicity, and presence of antisocial personality disorder. Conclusion: Borderline personality disorder is relatively common among both male and female offenders in prison, and is associated with substantial psychologic stress and impaired quality of life. Early recognition and treatment of BPD in prisons may be warranted.