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PubMed2005

Personality traits as predictors of occupational performance and life satisfaction among mentally disordered offenders.

The study investigated to what extent personality traits, e.g. socialization, proneness for anxiety, aggression and hostility were associated with and predictive of self-reported and observed occupational performance and perceived life satisfaction among male mentally disordered offenders (MDOs). Also, subjects with psychopathic-related personality traits were compared with subjects without such traits regarding demographic data and dependent variables. The MDOs were included from the Swedish National Board of Forensic Medicine. A total of 55 subjects were visited at their hospital ward for data collection with the Karolinska Scales of Personality (KSP), Capability to Perform Daily Occupation (CPDO), Allen Cognitive Level Screen (ACLS) and the Manchester Quality of Life Scale (MANSA). Seven KSP scales and two KSP factors correlated significantly with the dependent variables. Regression analyses revealed that the KSP Socialization scale, the KSP Anxiety-proneness and Psychopathy factors were the most important predictors. Subjects with psychopathy differed from remaining groups by having more conduct disorders before 15 years, being more often brought up in outcasted families and less subjected to measures of pupil welfare activities. The life history was concluded to be important influencing occupational performance and life satisfaction. Subjects with high anxiety proneness should be given attention in treatment planning.

Adolescent↗
PubMed1980

Drugs, alcohol and violence in 604 male offenders referred for inpatient psychiatric assessment.

Of 604 White and Coloured male offenders in the Cape referred for inpatient psychiatric observation, 52% habitually indulged heavily in alcohol, drugs (mostly dagga (cannabis)) or both. Indulpence in alcohol alone was frequently associated with violence and sexual assaults, alcohol and drugs together less, and drugs alone least. Those who indulged in drug-taking (i.e. dagga, LSD and hard drugs) were less frequently associated with violence, rape and other sex crimes than were those who did not; 60% of sex offenders were non-abusers. Out of 101 severely psychopathic patients in the sample, only 1 who indulged in drugs but not alcohol was charged with a crime of violence or sex. There was no evidence of a potentiating action between alcohol and dagga towards violent behaviour. Dagga appeared to diminish the action of alcohol, and may inhibit urges toward violence and rape in aggressive persons and psychopaths. Drugs did not release or set off violent reactions, and drug indulgence was associated with stealing without violence. Some implications for forensic psychiatry and arguments about drug indulgence as an extenuating factor in serius crime are discussed.

Alcohol Drinking↗
PubMed1979

Peptic ulcer in childhood. Psychological factors.

Thirty children (20 girls and 10 boys, aged 6-16 years) with primary peptic ulcers, matched in paris for age, sex and socio-economic standard to a group of 30 ulcer-free controls, were submitted to a structured psychiatric interview, a structured 'present psychiatric state' examination and to personality and intelligence tests. With one exception all patients suffered from duodenal ulcer; 3 male patients had personalities with psychopathic elements, 7 patients had nicknames, 5 suffered from psychiatric disorders, 3 had attempted suicide in the past, and 3 had had homosexual experiences. These parameters were negative in all controls. The patients had lower mean IQ, worse scholastic adaptation, more anxious and overprotective parents, higher frequency of faddiness in food and lower frequency of nail-biting than the controls. Psychotraumatic events had preceded the onset of ulcer symptomatology in 11 cases. The findings are discussed and the contribution of psychological factors in the pathogenesis of childhood peptic ulcer is stressed.

Adolescent↗
PubMed2005

Neuroimaging in psychopathy.

OBJECTIVE: The biological basis of psychopathy remains to be fully elucidated. Evidence suggests a genetic contribution and dysfunction of the serotonin system. The objective of this article is to review the contribution of the neuroimaging of the last decade to our understanding of psychopathy. METHOD: A literature search was conducted using PubMed and the words psychopath, antisocial personality disorder, dissocial personality disorder, violence, image and imaging. In addition, the reference lists of the identified papers, and recent textbooks, were perused for additional sources. RESULTS: Five structural and 15 functional neuroimaging studies were selected and examined. Structural studies have reported decreased prefrontal grey matter, decreased posterior hippocampal volume and increased callosal white matter, but to this point, these have not been replicated. Functional studies suggest reduced perfusion and metabolism in the frontal and temporal lobes. Abnormalities of function have been reported, predominantly in frontal and temporal lobe structures during classical conditioning and response inhibition tasks, and in the processing of emotional words and pictures. CONCLUSION: Functional neuroimaging strongly suggests dysfunction of particular frontal and temporal lobe structures in psychopathy. However, there are difficulties in selecting homogeneous index cases and appropriate control groups. Further studies are necessary. Responses depend on genetic endowment, early life experience, the sociocultural context and the significance of any stimulus to the individual.

Brain↗
PubMed1988

Mentally abnormal prisoners on remand: II--Comparison of services provided by Oxford and Wessex regions.

Most regional health authorities have or plan to have secure units for treating mentally abnormal offenders. A retrospective study was carried out to compare the effectiveness of the health care services for men remanded to Winchester prison from Oxford and Wessex regions over the five years 1979-83. Thirty seven (30%) of 124 prisoners from Oxford region were rejected for treatment compared with 36 (16%) of the 220 men from Wessex region. Men from Oxford region were significantly more likely to be recommended for admission to a special hospital than those from Wessex (13/124 (10%) v 9/220 (4%), respectively) and significantly less likely to be recommended for admission to a hospital in the catchment area (35/124 (28%) v 94/220 (43%)). Men on remand from Oxford region were significantly more often perceived as being disruptive or aggressive by hospital staff and more likely to be labelled as having psychopathic or personality disorders. These differences may have reflected different attitudes towards mentally abnormal offenders and the allowances in the services available in the two regions; in particular, Oxford region did not have a secure unit or a forensic psychiatrist. If mentally ill prisoners do not receive the treatment that they need they run the risk of being criminalised. Most such men are best treated in general psychiatric units; only a few require secure conditions and staff with specialised psychiatric skills.

Community Mental Health Services↗
PubMed1993

Long-term outcome in personality disorders.

Personality disorders meeting DSM or ICD criteria represent the severe end of the broad spectrum of personality configurations involving maladaptive traits. The literature regarding long-term outcome of personality disorders is sparse. Most attention is devoted to formerly institutionalised patients with borderline, antisocial, or schizotypal disorders. Borderline patients at 10-25-year follow-up have a wide range of outcomes, from clinical recovery (50-60%) to suicide (3-9%). Certain factors (e.g. artistic talent) conduce to higher recovery rates, others (e.g. parental cruelty) to lower rates. Schizoid and schizotypal patients tend to remain isolated, and to lead marginal lives. The long-term outcome in antisocial persons is bleak if psychopathic traits are prominent. Personality traits and their corresponding disorders are egosyntonic, harden into habit, and are both slow to change and hard to modify. There is no one treatment of choice. Psychoanalysis and related methods work best within the anxious/inhibited group; cognitive/behavioural techniques are well suited to the disorders requiring limit setting and the amelioration of maladaptive habits.

Adult↗
PubMed1989

[Psychotherapy of psychopathic patients and patients with slowly progressing schizophrenia with defensive manifestations using a method of creative self-expression].

Summarized is a several years' experience of the out-patient psychotherapy of 312 psychopathologic patients of different clinical groups manifesting defensive disorders (psychasthenic, asthenic, defensive cycloid, schizoid, epileptoid, defensive hysterical psychopathic, anankastic personalities) and patients with defensiveness due to slowly progressing schizophrenia. The described technique allowed steady remissions and compensation in 80.1% of the cases. The results of the 2-5-year therapy included the psychotherapeutically raised creative inspiration and capacity of seriously and efficiently coping with the patients' own pathology and everyday life problems through the knowledge of life and human nature.

Adolescent↗
PubMed2004

Annotation: understanding the development of psychopathy.

BACKGROUND: Psychopaths are not only antisocial, but also have a callous and unemotional personality profile. This article selectively reviews evidence that psychopathic personality traits are an important factor in understanding and predicting the development of persistent antisocial conduct. Cognitive neuroscience research and more tentative genetic work on psychopathy will be discussed, especially as they relate to possible developmental trajectories to psychopathy. RESULTS: A personality-based approach has been successful in clarifying the conceptual boundaries of psychopathy and delineating a group of antisocial individuals with a distinct profile of offending and clear neurocognitive markers indicating problems in processing distress in others and punishment directed to oneself. These markers are also present in children with psychopathic tendencies, suggesting that psychopathy may be a developmental disorder. The neurocognitive profile relates to the callous and unemotional personality traits at the core of psychopathy and may index particular vulnerability to persistent antisocial conduct. Preliminary twin studies suggest that personality traits at the core of psychopathy are much more highly heritable than other personality traits. There are as yet no molecular genetic studies of psychopathy. CONCLUSIONS: It is argued that an interdisciplinary approach that integrates cognitive neuroscience and genetics will enhance understanding of the development of psychopathy.

Antisocial Personality Disorder↗