Trait Anger,Physical Aggression,and Violent Offending in Antisocial and Borderline Personality Disorders

Antisocial personality disorder (ASPD) and borderline personality disorder (BPD) are common conditions in forensic settings that present high rates of violence. Personality traits related to the five‐factor model personality domains of neuroticism and agreeableness have shown a relationship with physical aggression in nonclinical and general psychiatric samples. The aim of the present investigation was to examine the association of these personality traits with violence and aggression in ASPD and BPD. Results revealed that trait anger/hostility predicted self‐reported physical aggression in 47 ASPD and BPD subjects (β = 0.5, p = 0.03) and number of violent convictions in a subsample of the ASPD participants (β = 0.2, p = 0.009). These preliminary results suggest that high anger and hostility are associated with physical aggression in BPD and ASPD. Application of validated, self‐report personality measures could provide useful and easily accessible information to supplement clinical risk assessment of violence in these conditions.     

Antisocial personality disorder comorbid with borderline pathology and psychopathy is associated with severe violence in a forensic sample

Background: Evidence suggests the relationship between personality disorder (PD) and violence in offenders might be clarified by considering sub-groups of PD offenders defined by patterns of PD comorbidity. Aim: to identify patterns of PD comorbidity associated with severe violence, defined by its severity, quantity and age of onset (Violence Index: VI) in a forensic sample of 100 PD offenders. Methods: Correlations were first computed between VI and a range of personality and criminological variables; next, patients with antisocial/borderline comorbidity were compared with other PD patients; finally, regression analysis was conducted to identify unique predictors of VI. Results: The antisocial deviance factor of psychopathy and antisocial/borderline comorbidity were each significantly and independently associated with severe violence. Patients showing both a high psychopathy score and antisocial/borderline comorbidity had a significantly greater VI than those without these characteristics. Conclusion: PD patients with high psychopathy co-occurring with borderline and antisocial PDs show a criminal profile characterised by a high degree of serious violence.     

The Relationship Between Mental Disorders and Types of Crime in Inmates in a Brazilian Prison

This cross‐sectional study conducted in prisons in the city of Salvador, Bahia, Brazil, investigated the association between the presence of psychiatric disorders in 462 prisoners and the types of crimes committed by them. Psychiatric diagnosis was obtained by means of the Brazilian Portuguese version of the Mini‐International Neuropsychiatric Interview. A statistically significant association was found between some psychiatric disorders and specific groups of crime: lifelong substance addiction with sex crimes and homicide; antisocial personality disorder with robbery and with kidnapping and extortion; borderline personality disorder with sex crimes; and lifelong alcohol addiction with fraud and conspiracy and with armed robbery and murder. It was concluded that the mental disorders considered more severe (psychosis and bipolar disorder) were not associated with violent crimes, suggesting that the severity of the psychotic disorder may be the factor that has caused psychosis to be associated with violent crimes in previous studies.     

What attracts men who batter to their partners? An exploratory study

Men who batter, because of particular personality traits and sense of entitlement, may select partners whom they perceive will be dependent on them, meet their emotional needs, or be "objects" of physical attractiveness. During treatment intake, 181 offenders responded to the question, "What attracted you to her (your partner)?" We explored whether men who mentioned their own needs or her physical traits would engage in more frequent and severe violence and would have specific forms of personality disorder dimensions or personality traits. Six categories of attraction, including "her physical traits" and "his needs," were derived from the men's responses. The results showed that men who focused on their partners' physical attractiveness were more likely to be violent after treatment. Men who cited their own needs for their attraction had higher scores on borderline personality, alcohol abuse, and psychotic thinking and lower scores on compulsive-conforming.     

The testosterone/cortisol ratio moderates the proneness to anger expression in antisocial and borderline intimate partner violence perpetrators

Several studies have provided evidence that antisocial, borderline and narcissistic personality traits of intimate partner violence (IPV) perpetrators significantly increase proneness to violence. In addition, an imbalance between testosterone (T) and cortisol (C) levels has been observed in this population, making individuals prone to violence. We aimed to establish whether IPV perpetrators differ in personality traits, T/C ratio and anger expression from controls, and also to examine the moderating role of the T/C ratio in the relationship between personality traits and anger expression. The sample consisted of 16 IPV perpetrators and 20 controls. T/C ratio was obtained as the quotient between salivary T and C levels. Anger expression and personality traits were measured with STAXI-2 and MCMI-III, respectively. Our results indicate that IPV perpetrators have higher antisocial, borderline and narcissistic personality traits and anger expression than controls. Nonetheless, they did not differ in basal T/C ratio. Finally, only in IPV perpetrators there was a positive relationship between these variables, the T/C ratio playing a moderating role in the relationship of antisocial and borderline traits with anger expression. In IPV perpetrators the T/C ratio may explain why certain personality traits are associated with high risk of becoming violent.     

Female impulsive aggression: A sleep research perspective

The rate of violent crimes among girls and women appears to be increasing. One in every five female prisoners has been reported to have antisocial personality disorder. However, it has been quite unclear whether the impulsive, aggressive behaviour among women is affected by the same biological mechanisms as among men. Psychiatric sleep research has attempted to identify diagnostically sensitive and specific sleep patterns associated with particular disorders. Most psychiatric disorders are typically characterized by a severe sleep disturbance associated with decreased amounts of slow wave sleep (SWS), the physiologically significant, refreshing part of sleep. Among men with antisocial behaviour with severe aggression, on the contrary, increased SWS has been reported, reflecting either specific brain pathology or a delay in the normal development of human sleep patterns. In our preliminary study among medication-free, detoxified female homicidal offenders with antisocial personality disorder, the same profound abnormality in sleep architecture was found. From the perspective of sleep research, the biological correlates of severe impulsive aggression seem to share similar features in both sexes.     

Attachment,personality and female perpetrators of intimate partner violence

This study examined explanations of intimate partner violence in female offenders. The sample of 92 female offenders completed measures of attachment, borderline and anti-social personality dimensions, psychological and physical aggression. Participant’s most recent and previous relationships were explored to examine the patterns of perpetrating and being victimised in relationships. Female offenders reported higher levels of attachment anxiety than attachment avoidance. Attachment insecurity was found to predict victimisation but not perpetrating intimate partner violence in recent relationships. Borderline and anti-social personality dimensions were significantly associated with offenders perpetrating intimate partner violence and being victimised in their most recent relationship. In previous relationships, borderline personality scores were associated with victimisation whereas anti-social personality scores were associated with perpetrating intimate partner violence. Personality dimensions were also found to mediate relationships between attachment anxiety and victimisation in offenders’ most recent relationships. Potential treatment pathways for this population are discussed and future research directions are recommended.     

Psychopathology in women arrested for domestic violence

This study examined the prevalence of psychopathology among women arrested for violence and whether the experience of intimate partner violence (IPV) was associated with Axis I psychopathology. Women who were arrested for domestic violence perpetration and court referred to violence intervention programs (N= 103) completed measures of IPV victimization, perpetration, and psychopathology. Results revealed high rates of posttraumatic stress disorder (PTSD), depression, generalized anxiety disorder (GAD), panic disorder, substance use disorders, borderline personality disorder, and antisocial personality disorder. Violence victimization was significantly associated with symptoms of psychopathology. Logistic regression analyses showed that sexual and psychological abuse by partners were associated with the presence of PTSD, depression, and GAD diagnoses. Results highlight the potential importance of the role of violence victimization in psychopathology. Results suggest that Axis I and Axis II psychopathology should routinely be assessed as part of violence intervention programs for women and that intervention programs could be improved by offering adjunct or integrated mental health treatment.     

Measures of aggression and mood changes in male weightlifters with and without androgenic anabolic steroid use

Supraphysiologic doses of testosterone are associated with increased aggression that is hypothesized to be a function of testosterone serum concentrations, mood, and personality. The study attempted to characterize this relationship among weightlifters who were users (n = 10) and nonusers (n = 18) of anabolic steroids. Participants were interviewed using the Modified Mania Rating Scale and Hamilton Rating Scale for Depression to assess mood, the Buss-Durkee Hostility Inventory (BDHI) and Point Subtraction Aggression Paradigm (PSAP) to assess aggression, and the Personality Disorder Questionnaire (PDQ-R) to assess personality. Blood samples were obtained for the determination of total, free, and weakly bound testosterone. Comparisons of continuous variables between testosterone users and non-users were performed with a parametric (unpaired t-test) or non-parametric (Mann-Whitney) test where appropriate. Correlations with testosterone were examined separately for testosterone users and non-users, using Spearman rank correlation. The subjective (BDHI) and objective (PSAP) assessments of aggression found that supranormal testosterone concentrations were associated with increased aggression. However, the PDQ-R results suggest that this finding was confounded by the personality disorder profile of the steroid users, because steroid users demonstrated Cluster B personality disorder traits for antisocial, borderline, and histrionic personality disorder.     

Violent women: a multicentre study into gender differences in forensic psychiatric patients

To gain insight into the relatively small, but increasing group of women in forensic psychiatry, a retrospective multicentre study was started gathering information from the files of 275 female patients of four Dutch forensic psychiatric hospitals on characteristics and violence risk factors. Overall, a picture emerged of severely traumatized women with complex psychopathology with multiple previous treatment failures and many incidents during treatment. The present study investigates specific psychiatric and criminal characteristics of female patients by comparing their data to those of 275 male forensic psychiatric patients. Various prominent differences were found, for example, women had more complex histories of victimization, were more often diagnosed with borderline personality disorder, were more likely to commit homicide and arson and less likely to commit sexual offenses, and were more often involved in inpatient aggression than their male counterparts. Several recommendations for gender-responsive treatment and directions for future research are provided.     

The relation of ADHD and violent aggression: What can we learn from epidemiological and genetic studies?

Disruptive behavior includes psychopathological and behavioral constructs like aggression, impulsivity, violence, antisociality and psychopathy and is often closely related with diagnostic categories like conduct disorder (CD), attention deficit disorder (ADHD) and antisocial personality disorder (ASP). There is now clear evidence that neurobiological and environmental factors contribute to these phenotypes. A mounting body of evidence also suggests interactive effects of genetic and environmental risks.In this selective review we give an overview over epidemiological aspects of the relation between ADHD and antisocial behavior, including violent aggression and psychopathy. Moreover, we summarize recent findings from molecular genetic studies and particularly discuss pleiotropic effects of a functional polymorphism of the serotonin transporter promoter gene (5HTTLPR) and childhood adversity on ADHD and violent behavior. The reported gene–environment interactions are not only informative for understanding the neurobiological underpinnings of disruptive behavior, but also throw some light on the relation between ADHD and violent behavior from a genetic perspective. The impact of genetic research on forensic psychiatry and future directions of neurobiological research are discussed.     

Mental disorder in violent women in secure settings: Potential relevance to risk for future violence

The relevance to women of common violence risk factors identified in men has in many instances yet to be established. Consequently, there is a reluctance to accept without question the application to women of practices relating to violence risk assessment and management developed from research into men. This study examines mental disorder in women who are violent in order comment on its relevance to the practice of violence risk assessment and management. A sample of 95 violent women in high secure prison and forensic psychiatric care were assessed. Structured assessments of Axis I and II mental disorders and psychopathy were undertaken on all women and conviction histories were recorded. Very high levels of psychiatric morbidity were noted and patterns in comorbidity were detected. Among Axis I conditions, psychotic disorders and disorders of mood co-occurred at a very high rate. Among the Axis II conditions, dimensional ratings of borderline personality disorder (PD) correlated with dimensional ratings of avoidant, dependent and paranoid PDs while ratings of antisocial PD correlated with those of narcissistic, histrionic and obsessive–compulsive PDs. Women who had been incarcerated for a major violent offence were four times more likely to have a diagnosis of borderline PD than women whose index offence was one of minor violence. A number of the findings reported are in contrast to those reported in similar studies of men. Findings suggest that practitioners are right to question the application to women of knowledge derived from research into men. The practice of violence risk assessment and management with women should emphasise the development of individual risk formulations and responding to psychiatric comorbidity should be the rule rather than the exception with this population.     

Developmental Pathways in Youth Sexual Aggression and Delinquency: Risk Factors and Mediators

Childhood exposure to violence against females and male-modeled antisocial behavior were examined as risk factors for sexual aggression, and nonsexual aggression and delinquency, in a sample of 182 adolescent male sex offenders using structural equation modeling. Both risk factors produced direct and indirect effects on nonsexual aggression and delinquency with Psychosocial Deficits and Egotistical–Antagonistic Masculinity playing important mediating roles. Exposure to violence against females helped explain sexual aggression through the mediating role of Psychosocial Deficits. As hypothesized, youth who sexually offended against prepubescent children manifested greater deficits in psychosocial functioning, committed fewer offenses against strangers, and demonstrated less violence in their sexual offending than offenders against pubescent females. Findings are discussed within the context of two major evolutionary psychological concepts for explaining human sexual behavior: intrasexual selection and intersexual selection.     

Personality Disorder Symptoms in Women as a Result of Chronic Intimate Male Partner Violence

This study explores the personality disorder symptoms of women victims of intimate male partner violence (IPV), after controlling for the contribution of experiences of childhood abuse. Victims of both physical and psychological violence (n = 73) or psychological violence alone (n = 53) were compared with non-abused control women (n = 52). Information about sociodemographic characteristics, childhood abuse, and personality characteristics (MCMI-II) was obtained through face-to-face structured interviews. Women victims of IPV had higher scores than controls in schizoid, avoidant, self-defeating personality scales, as well as in the three pathological personality scales (schizotypal, borderline and paranoid). Both physical and psychological IPV were strongly associated with personality disorder symptomatology, regardless of the effects of childhood abuse. These findings underscore the need to screen for personality disorder symptoms in women victims of IPV when dealing with therapeutic interventions.     

Antisocial Personality Disorder and Physical Partner Violence Among Single and Dual Substance-Abusing Couples

The current study examined how antisocial personality disorder (APD) and substance use disorder contributed to partners’ reports of physical partner violence among single and dual substance-abusing couples. Participants were 69 heterosexual couples entering treatment in which one or both partners met criteria for substance use disorder. APD diagnosis of the male partner was linked to significantly higher male-to-female and female-to-male perpetration of physical partner violence and victimization. Female partner’s APD diagnosis was associated with women’s reports of victimization by their male partners. Dual substance use diagnosis emerged as a moderator, in which the effect of men’s APD diagnosis on men’s perpetration of physical partner violence and victimization was significantly reduced if both partners had substance use disorder. Findings underscore the importance of both partners’ APD diagnosis and substance use status for understanding physical partner violence among single and dual substance-abusing couples.     

Evidence-based practice in group work with incarcerated youth

As a result of the Youth Criminal Justice Act's increased focus on restorative justice, treatment, rehabilitation, and reintegration of youth, many more juvenile offenders require mental health services while resident in youth detention facilities [Youth Criminal Justice Act (2002, c.1). Ottawa: Department of Justice Canada. Retrieved September 19, 2008 from http://laws.justice.gc.ca/en/Y-1.5]. Several common characteristics such as violence, aggression, and other antisocial behaviors, associated with criminal behavior, have been identified among male and female offenders. Dialectical behavior therapy, originally developed by Linehan [Linehan, M. M., 1993a. Cognitive–behavioural treatment of borderline personality disorder. New York: Guildford Press] for chronically parasuicidal women diagnosed with borderline personality disorder, has been successfully modified for use with other populations, including violent and impulse-oriented male and female adolescents residing in correctional facilities. The intent of this article is to encourage the wider use of dialectical behavior therapy (DBT) with young offenders. It includes an extensive review of the evidence-base to date and describes some of the creative modifications that have been made to standard DBT program format to meet the particular needs of various groups in both Canada and the United States. In keeping with the movement toward more evidence-based practice, the authors argue that DBT is a promising approach in group work with incarcerated adolescents and should be more widely used.     

Risk Factors for Men’s Intimate Physical Aggression in Spain

This study tests a model of physical aggression in a sample of 194 men being treated for physical or psychological aggression in the greater Madrid area of Spain. The prevalence of aggression in this sample was lower than in a US batterer sample. In the path model highlighted here, borderline personality traits and alcohol problems were identified as risk factors for physical aggression perpetration and the role of borderline traits was mediated by psychological aggression. A reciprocal relationship was found between psychological perpetration and victimization but not physical perpetration and victimization. These findings are discussed within a cross-cultural context; conceptual and treatment implications are also addressed.     

Juvenile-Perpetrated Sex Crimes: Patterns of Offending and Predictors of Violence

Criminal record reviews were conducted on 126 juveniles arrested for sex offenses against children (n = 62) or peers and adults (n = 64). Peer/adult offenders were found more consistently to offend against females who were strangers or acquaintances, more frequently to commit their crimes in a public area, and more often to act in a group with other offenders. Peer/adult offenders were also more likely to commit the sex crime in association with other criminal activity, and they evidenced higher overall levels of aggression and violence. In general, the aggression of child molesters tended to intimidation rather than physical force, whereas the aggression of peer/adult offenders was more injurious, and perhaps gratuitous. Violence in peer/adult offenders, but not of child molesters, was predicted by the interactive influence of the victim's gender, age, and level of resistance.     

Roles of Psychopathic Personality,Mental Health,and Recidivism in Criminal Behavior: Survey of Brunei Inmates

The survey investigated the contributions of sociodemographics, psychopathic personality, mental health, and recidivism to criminal behavior in a random sample of 64 Brunei convicts representing both genders. Participants committed five major types of crime related to stealing, drugs, sex, violence, and deception. Hierarchical multiple regression analysis revealed gender, age, the inmates’ marital status and marital status of the inmates’ parents as significant demographic predictors of criminality. Multinomial logistic regression analysis identified the demographic, psychopathic, and mental health variables that were related to committing the specific crimes. Significant psychopathic predictors were interpersonal and affective (stealing-related offenses), interpersonal and affective (drug crimes), interpersonal (sex offenders), and interpersonal (violent/ aggressive felonies). The best mental health predictors included: depression and psychoticism (stealing-related offenses); depression, hostility, and psychoticism (drug crimes); psychoticism (sex offenses); and depression, paranoid ideation, and psychoticism (violence/aggression). Binary logistic regression analysis showed male gender and inmates with married parents as the main predictors of recidivism (while other variables with high odds for re-offending included age-group 30–35, inmates with primary education, affective, lifestyle, antisocial, interpersonal sensitivity, depression, paranoid ideation, and psychoticism). Future research which incorporates interviews with probes and appropriate interventions to address crimes were recommended.     

Prospective associations among borderline personality disorder symptoms, interpersonal problems, and aggressive behaviors

This study examined the prospective relationships among borderline personality disorder (BPD) symptoms, interpersonal problems, and types of aggressive behaviors (i.e., experiencing psychological and physical victimization and perpetrating psychological and physical aggression) in a psychiatric sample (N = 139) over the course of 2 years. We controlled for other PD symptoms and demographic variables. BPD symptoms at baseline were associated with interpersonal sensitivity, interpersonal ambivalence, interpersonal aggression, need for social approval, and lack of sociability 6 months later. In turn, interpersonal sensitivity predicted not experiencing physical aggression, interpersonal aggression predicted experiencing physical aggression and perpetrating both psychological and physical aggression, need for social approval predicted experiencing both psychological and physical aggression, and lack of sociability predicted perpetrating physical aggression 2 years later. Results demonstrated that interpersonal problems mediated the relationship between BPD and later violent behaviors. Our findings suggest the importance of distinguishing between these groups of aggressive behaviors in terms of etiological pathways, maintenance processes, and treatment interventions.