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Sousa M, Andrade J, de Castro Rodrigues A, Caridade S, Cunha O. The Effectiveness of Intervention Programs for Perpetrators of Intimate Partner Violence with Substance Abuse and/or Mental Disorders: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241270063. [PMID: 39180467 DOI: 10.1177/15248380241270063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2024]
Abstract
Despite the high prevalence and severity of intimate partner violence (IPV) perpetration among men with mental health (MH) problems and substance use (SU), there is limited evidence on the most effective ways to reduce IPV within these groups. Hence, the present systematic review aims to evaluate the effectiveness of psychological interventions for male IPV perpetrators with MH issues and SU problems. Five databases (B-On, Pubmed PsycInfo, Science Direct, and Scopus) were searched for studies examining the effectiveness of IPV interventions. Twenty-three studies met the inclusion criteria, with 13 interventions described. Interventions were grouped into (1) specific interventions for SU among IPV perpetrators (k = 8), (2) nonspecific interventions for SU among IPV perpetrators (K = 3), and (3) specific interventions targeting MH among IPV perpetrators (k = 2). Cognitive behavioral therapy and motivational interviewing techniques were the most common approaches. Both specific and nonspecific programs addressing SU problems showed some positive effects on perpetrators' behavior and attitudes. However, data from the two intervention programs focusing on MH showed reduced symptoms and re-assaults but without significant differences between the conditions. Despite methodological shortcomings in the studies, the specific and nonspecific interventions targeting SU and IPV show promise, which hinders drawing firmer conclusions. Nonetheless, further research is necessary to deepen our understanding of the MH impact interventions on IPV perpetrators.
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Affiliation(s)
- Marta Sousa
- School of Psychology, Psychology Research Center, University of Minho, Braga, Portugal
| | - Joana Andrade
- School of Psychology, Psychology Research Center, University of Minho, Braga, Portugal
| | | | - Sónia Caridade
- School of Psychology, Psychology Research Center, University of Minho, Braga, Portugal
| | - Olga Cunha
- Digital Human-Environment Interaction Lab, Universidade Lusófona do Porto, Porto, Portugal
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Sehlikoğlu Ş, Nalbant A, Sehlikoğlu K, Almiş BH. A retrospective descriptive study of male perpetrators of intimate partner violence referred by judicial authorities: an example from Turkey. Arch Womens Ment Health 2024:10.1007/s00737-024-01495-5. [PMID: 39023650 DOI: 10.1007/s00737-024-01495-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 07/09/2024] [Indexed: 07/20/2024]
Abstract
PURPOSE Our study examines the socio-demographic, forensic psychiatric, and childhood trauma exposure (CTE) data of Turkish intimate partner violence (IPV) perpetrators and draws comparisons with the violence data. METHODS Data of male perpetrators referred to the domestic violence outpatient clinic by judicial authorities between November 2019 and June 2022 were retrospectively examined, with a focus on CTE data. RESULTS The mean age of the male perpetrators examined in the study was 37.1 years. Among the overall sample, 16.2% (n = 17) had experienced violence at school in childhood, and 22.9% (n = 24) had experienced CTE. Regarding the frequency of domestic violence in their households, of the perpetrators admitted to the clinic for IPV, 40% (n = 42) reported rarely, 43.8% (n = 46) sometimes, and 16.2% (n = 17) often engaged in violent acts. There is a significant relationship between the frequency of IPV and the level of CTE (χ2: 13.052, SD: 2, p = 0.001, Cramer's V: 0.353). Similarly, individuals who witnessed domestic violence during childhood were found to commit partner violence more frequently (χ2: 8.157, SD: 2, p = 0.017, Cramer's V: 0.279). CONCLUSIONS In this study, we found a strong relationship between CTE and IPV. To the best of our knowledge, our study is only example that investigates the relationship between CTE and IPV in a Turkish sample.
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Affiliation(s)
- Şeyma Sehlikoğlu
- Faculty of Medicine, Department of Psychiatry, Adiyaman University, Adiyaman, Turkey.
| | - Ahmet Nalbant
- Can Sağlığı Foundation Contextual Behavioural Sciences Centre, Psychiatry, İstanbul, Turkey
| | - Kerem Sehlikoğlu
- Faculty of Medicine, Department of Forensic Medicine, Adiyaman University, Adiyaman, Turkey
| | - Behice Han Almiş
- Faculty of Medicine, Department of Psychiatry, Adiyaman University, Adiyaman, Turkey
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Lin Y, Guo Z, Zhou Y, Wei Y, Xu L, Tang X, Wang Z, Hu Y, Wang J, Mei Y, Wu H, Luo Y, Zhang T. Distribution of self-reported borderline personality disorder traits symptoms in a large-scale clinical population. Front Psychiatry 2024; 15:1424966. [PMID: 38988741 PMCID: PMC11234847 DOI: 10.3389/fpsyt.2024.1424966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/06/2024] [Indexed: 07/12/2024] Open
Abstract
Introduction Borderline Personality Disorder (BPD) traits play a crucial role in the prognosis of psychiatric disorders, as well as in assessing risks associated with negativity and impulsivity. However, there is a lack of data regarding the distribution characteristics of BPD traits and symptoms within clinical populations. Methods A total of 3015 participants (1321 males, 1694 females) were consecutively sampled from outpatients at the psychiatric and psycho-counseling clinics at the Shanghai Mental Health Center. BPD symptoms were assessed using a self-reported personality diagnostic questionnaire. Having BPD traits is defined as having five or more positive items in self-reported BPD characteristics. Participants were stratified into male and female groups, age groups, and diagnostic groups (schizophrenia, mood disorders, anxiety disorders). Exploratory factor analysis using principal components analysis was conducted. Three factors were identified: "F1: Affective Instability and Impulsivity", "F2: Interpersonal Unstable and Extreme Reactions", and "F3: Identity Disturbance". Results Among 3015 participants, 45.9% of the patients self-reported BPD traits. Comparing of male and female patients, there was no statistically significant difference in the occurrence rate of BPD traits (χ2 = 1.835, p=0.176). However, in terms of symptoms, female patients reported more symptoms than male patients. Female patients also exhibited more pronounced features on F2 compared to male patients (t =-1.972, p=0.049). There is a general decrease in BPD traits, symptoms, and factors with increasing age. Specifically, the proportion of positive BPD traits is approximately halved before the age of 30 and decreases to around one-third after the age of 30. BPD traits were most common in the Mood Disorders group at 55.7%, followed by the Anxiety Disorders group at 44.4%, and Schizophrenia group at 41.5% (χ2 = 38.084, p<0.001). Discussion Our study revealed the pervasive presence of BPD traits and symptoms among psychiatric outpatients, exhibiting distinctive distributions across gender, age, and diagnostic categories. These findings emphasize the significance of identifying and addressing BPD pathology in the clinical care of psychiatric outpatients.
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Affiliation(s)
- Yong Lin
- Department of Psychiatry, Kangci Hospital of Jiaxing, Tongxiang, Zhejiang, China
| | - ZiLei Guo
- Department of Psychiatry, Kangci Hospital of Jiaxing, Tongxiang, Zhejiang, China
| | - Yong Zhou
- Department of Psychiatry, Kangci Hospital of Jiaxing, Tongxiang, Zhejiang, China
| | - YanYan Wei
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - LiHua Xu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - XiaoChen Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Zixuan Wang
- Department of Psychology, Shanghai Xinlianxin Psychological Counseling Center, Shanghai, China
| | - YeGang Hu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - JiJun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Yi Mei
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - HaiSu Wu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - YanLi Luo
- Department of Psychological Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - TianHong Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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Leucci AC, De Giorgi I, Pelizza L, Bortolotti B, D'Adda F, Gammino L, Gibiino S, Lia L, Magro M, Pellegrini L, Menchetti M. Borderline personality disorder and aggressive behavior: A study based on the DSM-5 alternative model. J Psychiatr Res 2024; 173:367-371. [PMID: 38593695 DOI: 10.1016/j.jpsychires.2024.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 03/11/2024] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Unplanned reactive aggressive acts are a clinical feature of particular interest in patients with borderline personality disorder (BPD). The early identification of personality traits correlated to aggressive behavior is certainly desirable in BDP populations. This study analyzes a clinical sample of 122 adult outpatients with BPD referred to Adult Mental Health Services of the Department of Mental Health of Bologna, in Italy. METHODS The study examines the relationship with personality facets of the DSM-5 alternative model for personality disorders (AMPD), Personality Inventory for DSM (PID-5), with respect to the four main components of aggression measured by the Aggression Questionnaire (AQ): hostility, anger, verbal and physical aggression. Using robust regression models, the relationships between PID-5 facets and domains and the aggression components under consideration were identified. RESULTS Verbal and physical aggression in our sample of BPD outpatients is mainly associated to PID-5 antagonism domain. Physically aggressive behavior is also related to callousness facet. CONCLUSIONS The traits most consistently associated with aggression were the domain of Antagonism and the facet of Hostility. The study findings highlight the need for clinicians working with individuals with BPD to pay particular attention to traits of hostility, callousness, and hostility to understand aggression.
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Affiliation(s)
- Anna Caterina Leucci
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Ilaria De Giorgi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Lorenzo Pelizza
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy.
| | - Biancamaria Bortolotti
- Department of Mental Health and Pathological Addictions, Bologna Local Health Unit, Bologna, Italy
| | - Francesca D'Adda
- Department of Mental Health and Pathological Addictions, Bologna Local Health Unit, Bologna, Italy
| | - Lorenzo Gammino
- Department of Mental Health and Pathological Addictions, Bologna Local Health Unit, Bologna, Italy
| | - Sara Gibiino
- Department of Mental Health and Pathological Addictions, Bologna Local Health Unit, Bologna, Italy
| | - Loredana Lia
- Department of Mental Health and Pathological Addictions, Bologna Local Health Unit, Bologna, Italy
| | - Margherita Magro
- Department of Mental Health and Pathological Addictions, Bologna Local Health Unit, Bologna, Italy
| | - Luca Pellegrini
- Hertfordshire Partnership NHS University Foundation Trust, Welwyn Garden City, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy; Department of Mental Health and Pathological Addictions, Bologna Local Health Unit, Bologna, Italy
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Xiong P, Chen Y, Shi Y, Liu M, Yang W, Liang B, Liu Y. Global burden of diseases attributable to intimate partner violence: findings from the Global Burden of Disease Study 2019. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02637-x. [PMID: 38520514 DOI: 10.1007/s00127-024-02637-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 02/12/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE Our study aims to evaluate the global burden of disease attributable to IPV from 1990 to 2019 at global, regional, national, and socio-demographic index (SDI) levels. Our research question is: What is the global burden of disease attributable to intimate partner violence (IPV) from 1990 to 2019, and how does it vary at global, regional, national, and socio-demographic index (SDI) levels? METHODS Data parameters for the number of deaths, disability-adjusted life years (DALYs), and age-standardized rate were obtained from the Global Burden of Disease Study 2019. We calculated the percentage change and population attributable fraction with 95% uncertainty intervals. RESULTS IPV directly accounted for 0.14% [95% UI 0.09%, 0.21%] and 0.32% [95% UI 0.17%, 0.49%] of global all-cause deaths and DALYs in 2019, respectively. The age-standardized deaths and DALYs rates of IPV increased by 12.83% and 4.00% respectively from 1990 to 2019. Women aged 35-39 and 30-34 had the highest deaths and DALYs rate respectively. The highest age-standardized rates of IPV-related deaths and DALYs were observed in Southern Sub-Saharan. Both of deaths and DALYs were high in low-socio-demographic Index (SDI) quintile in 2019. CONCLUSIONS A higher level of deaths and DALYs attributable to IPV were reported in younger women, in the early 2000s, in Southern Sub-Saharan regions and in low SDI regions. Our study provides policymakers with up-to-date and comprehensive information.
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Affiliation(s)
- Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 West Huangpu Road, Guangzhou, 510632, People's Republic of China.
| | - Yuhan Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 West Huangpu Road, Guangzhou, 510632, People's Republic of China
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
| | - Yuchen Shi
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 West Huangpu Road, Guangzhou, 510632, People's Republic of China
- Capital University of Economics and Business, Beijing, People's Republic of China
| | - Min Liu
- Zhuhai Center for Maternal and Child Health Care, Zhuhai, People's Republic of China
| | - Weixin Yang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 West Huangpu Road, Guangzhou, 510632, People's Republic of China
- Department of Dermato-Venereology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Baolin Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 West Huangpu Road, Guangzhou, 510632, People's Republic of China
| | - Yaozhong Liu
- Guangzhou Huashang College, Guangzhou, People's Republic of China
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Krause-Utz A, Černáková R, Hoogenboom W, Schulze A, Büttner S, Demirelli Z, Mouthaan J, van Schie CC, Garnefski N, Kraaij V. Psychological Factors Linked to Intimate Partner Violence and Childhood Maltreatment: On Dissociation as a Possible Bridge Symptom. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:11400-11428. [PMID: 37431756 PMCID: PMC10515471 DOI: 10.1177/08862605231181377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Intimate partner violence (IPV) is a serious health concern, occurring worldwide in various forms and settings. Over the past years, multiple sources reported an increase of IPV globally, partly related to COVID-19 restrictions. Childhood maltreatment enhances the risk of IPV, possibly via alterations in emotion regulation, attachment, maladaptive core beliefs, dissociation, and psychopathological symptoms. However, studies investigating these associations simultaneously are still needed. This study aimed to investigate association between IPV, childhood maltreatment severity, maladaptive schemata (mistrust, alienation, enmeshment), attachment anxiety, social support, emotion regulation, dissociation, posttraumatic stress disorder (PTSD), and borderline personality disorder (BPD) symptoms. We further explored the complex interplay of all factors, accounting for their shared associations. An anonymous online survey was posted on international online platforms for people experiencing domestic violence and on research platforms. Regression analyses and graph-theoretical network analysis were used to explore associations between all variables. N = 434 participants (40% in treatment) completed the survey. IPV perpetration and victimization were highly correlated. Both were significantly associated with childhood maltreatment severity, early maladaptive schemata, dissociation, BPD features, and PTSD symptoms. When including all variables in one model, IPV was associated with dissociation, which indirectly linked it to childhood maltreatment experiences, PTSD symptoms, withdrawal, and self-blame. Our findings suggest that IPV perpetration and victimization often co-occur. Dissociation may be an important bridge symptom, linking IPV to childhood maltreatment experiences, PTSD symptoms, and maladaptive coping. Prospective studies are needed to corroborate these findings and to establish psychological mechanisms underlying IPV.
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Kolla NJ, Tully J, Bertsch K. Neural correlates of aggression in personality disorders from the perspective of DSM-5 maladaptive traits: a systematic review. Transl Psychiatry 2023; 13:330. [PMID: 37884552 PMCID: PMC10603082 DOI: 10.1038/s41398-023-02612-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 09/17/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, includes an alternative model of personality disorders (AMPD) focusing on a maladaptive trait model utilized to diagnose several personality disorders. Borderline personality disorder (BPD) and antisocial personality disorder (ASPD) are two conditions categorized by AMPD that exhibit high rates of violence and aggression. Several of the traits outlined in the AMPD, including hostility, impulsivity, risk-taking, and callousness, have been previously linked to aggression in BPD and ASPD. However, to the best of our knowledge, there has never been a synthesis of neuroimaging studies that have investigated links between these traits and aggression in BPD and ASPD. To overcome this gap, we conducted a systematic review under the PRISMA framework to locate neuroimaging articles published since the release of AMPD linking trait anger/hostility, impulsivity, risk-taking, and callousness to aggression in BPD and ASPD. Key findings included the following: i) anger/hostility, associated with alterations in the interplay between prefrontal and subcortical regions (primarily the amygdala), may be a common factor explaining aggressive reactions to response to interpersonal threat or provocation; ii) alterations of fronto-temporal-limbic regions and serotonergic and endocannabinoid signaling systems may link impulsivity to aggression in BPD and ASPD; iii) weaker cortico-striatal connectivity could relate to greater risk taking and greater proclivity for violence. Insufficient evidence from neuroimaging articles was discerned to describe a relationship between callousness and aggression. Overall, results of this review reveal a relative paucity of neuroimaging studies examining AMPD traits relevant to aggression in BPD and ASPD. In addition to encouraging further investigation of neuroimaging markers of AMPD traits linked to aggression, we recommend multi-methodological designs, including the incorporation of other biomarkers, such as hormones and indices of physiological arousal, to fully expand our understanding of aggression in BPD and ASPD.
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Affiliation(s)
- Nathan J Kolla
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada.
| | - John Tully
- Academic Unit of Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Katja Bertsch
- Department of Psychology, Ludwig-Maximilians-University, Munich, Germany
- NeuroImagine Core Unit Munich (NICUM), University Hospital LMU, Munich, Germany
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
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Senberg A, Schmucker M, Oster A, Zumbach J. Parental personality disorder and child maltreatment: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2023; 140:106148. [PMID: 37060689 DOI: 10.1016/j.chiabu.2023.106148] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 02/20/2023] [Accepted: 03/15/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Parental pathology may affect parenting capacity and is deemed a risk factor for child maltreatment. Especially parental personality disorder (PD) can significantly burden the relationship and interaction between parents and their children. OBJECTIVE This meta-analytic review aims to summarize and quantify the influence of parental PD on the occurrence / the risk of child maltreatment. PARTICIPANTS AND SETTING Studies had to meet the following inclusion criteria: They had to analyze a sample of parents with a diagnosed PD and the occurrence / risk of maltreating their children. To be included in the narrative synthesis and/or meta-analysis, they had to be case-control, cross-sectional, or longitudinal studies. Literature research was conducted in the databases Web of Science, Psychinfo, and Google Scholar up to January 2023. METHODS First, studies were analyzed on a narrative level, and eligible studies for the meta-analysis were identified. Studies were grouped according to the diagnosed PDs. Five different groups were included: borderline PD, antisocial PD, narcissistic PD, nondifferentiated PDs, and Cluster B PDs. Three different random-effects meta-analyses were computed (borderline PD, antisocial PD, Cluster B PDs). Meta-analyses were controlled for publication bias and different covariates (e.g., study quality, sample size). RESULTS After screening 41 full texts, 17 studies were included in the narrative synthesis, out of which 14 samples from 11 studies were included in the meta-analysis. Analysis of borderline PD showed an association with the occurrence / risk of child maltreatment (OR = 8.08; 95 % CI [2.51, 25.93]). However, after taking into account possible publication bias, this association was no longer significant. We found a significant and stable association between antisocial PD and the occurrence of / risk of child maltreatment (OR = 4.92; 95 % CI [3.26, 7.43]). Analysis of Cluster B PDs (antisocial, borderline, histrionic, narcissistic) revealed a significant overall association (OR = 4.23; 95 % CI [2.75, 6.5]), indicating that the presence of Cluster B PDs in parents significantly increases the occurrence of / the risk of child maltreatment. CONCLUSIONS Analyses indicated a significant association between of Cluster B PDs, and specifically between antisocial and borderline PD, with the occurrence of / the risk of child maltreatment. However, methodological limitations have to be taken into account, because results for borderline PD were no longer significant after controlling for possible publication bias. Moreover, the number of studies included was rather small, and results showed a substantial amount of heterogeneity. OTHER This work was not supported by any funding.
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Affiliation(s)
- Asne Senberg
- Department of Forensic Psychology, Psychologische Hochschule Berlin, Am Koellnischen Park 2, 10179 Berlin, Germany.
| | - Martin Schmucker
- Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg, Nägelsbachstraße 49b, 91052 Erlangen, Germany.
| | - Anna Oster
- Department of Forensic Psychology, Psychologische Hochschule Berlin, Am Koellnischen Park 2, 10179 Berlin, Germany.
| | - Jelena Zumbach
- Department of Forensic Psychology, Psychologische Hochschule Berlin, Am Koellnischen Park 2, 10179 Berlin, Germany.
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Fitzpatrick S, Liebman RE, Traynor J, Varma S, Norouzian N, Chafe D, Goss S, Earle E, Di Bartolomeo A, Latham M, Courey L, Monson CM. Protocol Development of Sage: A Novel Conjoint Intervention for Suicidal and Self-Injuring People With Borderline Personality Disorder and Their Significant Others. COGNITIVE AND BEHAVIORAL PRACTICE 2023. [DOI: 10.1016/j.cbpra.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Elsaid NMAB, Shehata SA, Sayed HH, Mohammed HS, Abdel-Fatah ZF. Domestic violence against women during coronavirus (COVID-19) pandemic lockdown in Egypt: a cross-sectional study. J Egypt Public Health Assoc 2022; 97:23. [PMID: 36372811 PMCID: PMC9659679 DOI: 10.1186/s42506-022-00117-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 09/15/2022] [Indexed: 11/15/2022]
Abstract
Background While it is necessary to limit the spread of the coronavirus (COVID-19) pandemic, efforts including social isolation, restricted travel, and school closures are anticipated to raise the probability of domestic violence (DV). This study aimed to estimate the prevalence, pattern, risk factors, and physical health outcomes of domestic violence against women during the COVID-19 pandemic. Methods A cross-sectional study was conducted using a convenient sample. The data collection tool was based on Sect. 11 of the Egyptian Demographic Health Survey, 2014, which is designed to measure domestic violence. We used a Google form-designed questionnaire and distributed the link to social media platforms from May 2020 to June 2020 till the collection of the required sample of 388 completed questionnaires. Results The prevalence of every form of DV was 31%. Emotional violence was the most prevalent (43.5%) followed by physical (38.9%) and sexual violence (17.5%). About 10.5% of women reported suffering from all types of violence. The husband was the most common perpetrator of DV. The determinants of ever experiencing any form of DV were low education level of women (OR = 7.3, 95% CI 2.8–18.8), unemployment (OR = 2.31, 95% CI 4–3.5), husband’s use of alcohol or substance (OR = 14.4, 95% CI 4.1–50.2), and insufficient income (OR = 2.01, 95% CI 2–3.2). The most common health consequences of DV were injuries such as cuts, bruises, and aches. Conclusions The prevalence of ever experiencing any form of DV was 31% which is considered high. Emotional violence was the most common whereas sexual violence was the least common. Identifying the risk factors of DV would support the development and implementation of preventive and screening programs for early identification and offering social support to the victims. Policies should be adopted for the early detection and protection of women suffering from violent behaviors. Access to adequate prompt support and health-care services is crucial in order to decrease the consequences of violence. It is necessary to implement alcohol or drug abuse interventions, preventive measures, and screening programs in families to reduce DV.
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Tyler KA, Brownridge DA. Family Violence, Personality Traits, and Risk Behaviors: Links to Dating Violence Victimization and Perpetration Among College Students. VIOLENCE AND VICTIMS 2022; 37:683-701. [PMID: 35973812 DOI: 10.1891/vv-2021-0106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Though dating violence (DV) is prevalent on college campuses, few studies have examined a multitude of risk factors that may better explain this process. As such, we examined the role of family violence (i.e., childhood physical abuse, witnessing parental violence), personality traits (i.e., entitlement, antisocial personality [ASP] and borderline personality [BP]) and risk behaviors (i.e., risky sexual behaviors, heavy drinking, marijuana use, illicit drug use) on DV victimization and perpetration among 783 college students. Path analysis revealed that witnessing parental violence was linked to DV perpetration while experiencing more physical abuse was positively correlated with entitlement (females only), ASP traits, and BP traits. ASP traits (both males and females) and entitlement (females only) were directly associated with high-risk behaviors. Among females, entitlement was also indirectly associated with DV victimization and perpetration through sexual risk behaviors. Findings highlight the importance of histories of physical abuse and personality traits in understanding DV.
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Huang Y, Wang X. Reseach progress in dual harm. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2022; 47:1267-1274. [PMID: 36411711 PMCID: PMC10930333 DOI: 10.11817/j.issn.1672-7347.2022.210653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Indexed: 06/16/2023]
Abstract
Growing evidence supports an association between self-harm and aggression, and the two behaviors frequently co-occur. The co-occurrence of self-harm and aggression is termed as dual harm. Existing evidence reveals that rather than a simple co-occurrence of self-harm and aggression, dual-harm may be an independent behavior different from a sole harm behavior. Identification of characteristics and influencing factors for dual harm may help develop effective prevention strategies for the affected population. A review of the literature yields a high incidence of dual harm among the clinical and forensic populations. Individuals with dual harm engage in an earlier, more frequent, and a wider range of harmful behaviors, with the increased use of lethal methods. Common factors that affect dual harm include childhood adversities, emotional dysregulation, personality traits, mental disorders, and biological factors. A comprehensive theory to explain dual harm is still not available. Currently, two main theories for explaining mechanism of dual harm are the two-stage model of countervailing forces and the cognitive-emotional model. An in-depth exploration of characteristics, influencing factors, and theories for dual harm is of great importance for the prevention of dual harm.
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Affiliation(s)
- Ying Huang
- National Clinical Research Center for Mental Disorders; Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha 410011, China.
| | - Xiaoping Wang
- National Clinical Research Center for Mental Disorders; Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha 410011, China.
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13
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McDonagh T, Travers Á, Murphy S, Elklit A. Assessing Personality Pathology Response Sets in Perpetrators of Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP14066-NP14088. [PMID: 33858259 DOI: 10.1177/08862605211001482] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Self-report personality inventories may be useful in directing perpetrators of intimate partner violence (IPV) to appropriate intervention programs. They may also have predictive capabilities in assessing the likelihood of desistance or persistence of IPV. However, validity problems are inherent in self-report clinical tools, particularly in forensic settings. Scores of the modifying indices (subsections of the scale designed to detect biases in responding) of the Millon Clinical Multiaxial Inventory-III (MCMI-III) often are not reported in research. This study analyses the response sets of a sample of 492 IPV perpetrators at intake to a Danish perpetrator program. Profiles were grouped into levels of severity, and the proportion of exaggerated or minimized profiles at each severity level was analyzed. Findings suggested that 30% of the present sample were severely disturbed or exaggerating their symptoms. As expected, there were significant levels of exaggerated profiles present in the severe pathology group and significant levels of minimized profiles in the low pathology group. Self-referred participants were more likely to exaggerate their pathology, but minimization was not associated with referral status. Nor was there an association between gender and the modifying indices. It is suggested that so-called "fake good" or "fake bad" profiles should not necessarily be treated as invalid, but that elevations in the modifying indices can be interpreted as clinically and forensically relevant information in their own right and should be reported on in research.
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Affiliation(s)
- Tracey McDonagh
- University of Southern Denmark, Campusvej 55, Odense M, Denmark
| | - Áine Travers
- University of Southern Denmark, Campusvej 55, Odense M, Denmark
| | | | - Ask Elklit
- University of Southern Denmark, Campusvej 55, Odense M, Denmark
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14
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Cavelti M, Thompson K, Betts J, Fowler C, Luebbers S, Cottton SM, Chanen A. Young People With Borderline Personality Disorder Have an Increased Lifetime Risk of Being the Victim of Interpersonal Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP10642-NP10660. [PMID: 33461382 DOI: 10.1177/0886260520986270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study aimed to examine the lifetime risk of being the victim of criminal or violent offenses among young people with borderline personality disorder (BPD) features (1-9 DSM-IV criteria). Demographic and diagnostic data from 492 outpatients who attended a specialist public mental health service for 15- to 25-year-olds between January 1998 and March 2008 were linked with offending data from a state-wide police database, collected between March 1993 and June 2017, in order to establish victimization history. This included information on criminal offenses perpetrated against these young people and intervention orders implemented to protect them from being victimized by another person's violent behavior. Logistic regression analyses, adjusted for sex and co-occurring mental state disorders, were conducted on n = 378 who had complete data (76.5% females). As hypothesized, BPD diagnosis and number of BPD criteria were both significantly associated with an increased risk of being the victim of a violent offense and the complainant of a family violence intervention order. Anger and impulsivity independently predicted a higher risk of being the victim of a violent offense, while unstable relationships, impulsivity, and affective instability independently predicted a higher risk of being the complainant of a family violence intervention order. No significant association was found between BPD and the risk of being the victim of a nonviolent offense. These findings indicate that young people with any BPD features (even below the DSM diagnostic threshold) are at increased risk for victimization by interpersonal violence. Moreover, this risk increases according to the number of BPD criteria. This issue needs to be addressed by prevention and early intervention programs (e.g., by working on self-assertion and interpersonal skills, taking into account the possible influence of previous traumatizing relationship experiences).
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Affiliation(s)
- Marialuisa Cavelti
- Orygen, Melbourne, Australia
- University of Melbourne, Australia
- University of Bern, Switzerland
| | | | - Jennifer Betts
- Orygen, Melbourne, Australia
- University of Melbourne, Australia
| | | | | | - Sue M Cottton
- Orygen, Melbourne, Australia
- University of Melbourne, Australia
| | - Andrew Chanen
- Orygen, Melbourne, Australia
- University of Melbourne, Australia
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15
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The Lancet Psychiatry Commission on intimate partner violence and mental health: advancing mental health services, research, and policy. Lancet Psychiatry 2022; 9:487-524. [PMID: 35569504 DOI: 10.1016/s2215-0366(22)00008-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 12/07/2021] [Accepted: 01/04/2022] [Indexed: 01/26/2023]
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16
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Cavelti M, Rinnewitz L, Walter M, van der Venne P, Parzer P, Josi J, Bertsch K, Brunner R, Resch F, Koenig J, Kaess M. Psychobiological Correlates of Aggression in Female Adolescents with Borderline Personality Disorder. Psychopathology 2022; 55:37-48. [PMID: 34872101 DOI: 10.1159/000520228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 10/07/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Aggressive behavior in reaction to threats, frustration, or provocation is prevalent in borderline personality disorder (BPD). This study investigated aggressive behavior and its biological correlates in adolescents with BPD. METHODS Twenty-one female adolescents with a DSM-IV BPD diagnosis and 25 sex- and age-matched healthy controls participated in the Taylor Aggression Paradigm (TAP), a laboratory-based experiment measuring aggressive behavior in the interpersonal context. Heart rate was measured and saliva samples were taken throughout the experiment. RESULTS Multilevel mixed-effects linear regression analyses revealed no significant group difference in aggressive behavior induced by the TAP. Additionally, the two groups did not differ in cortisol, testosterone, and heart rate responses to the aggression induction. The BPD group showed a significant cortisol increase in the time preceding the start of the TAP in contrast to the healthy control group, in whom a significant heart rate increase from baseline to the first block of the TAP was observed. DISCUSSION There was no evidence, either at the phenomenological or the biological level, of increased task-induced aggression in adolescents with BPD. The results may indicate that adolescents with BPD experienced fearful stress in anticipation of the experimental task in contrast to healthy controls who showed an adaptive response of the autonomic nervous system necessary to deal with the upcoming demand.
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Affiliation(s)
- Marialuisa Cavelti
- University Hospital for Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland,
| | - Lena Rinnewitz
- Department of Child and Adolescent Psychiatry, Section for Translational Psychobiology in Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Moritz Walter
- Department of Child and Adolescent Psychiatry, Section for Translational Psychobiology in Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Patrice van der Venne
- Department of Child and Adolescent Psychiatry, Section for Translational Psychobiology in Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Peter Parzer
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, Medical Faculty, University of Heidelberg, Heidelberg, Germany
| | - Johannes Josi
- University Hospital for Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katja Bertsch
- Department of Psychology, Ludwig-Maximilans-University Munich, Munich, Germany.,Department of Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Romuald Brunner
- Department of Child and Adolescent Psychiatry, University of Regensburg, Regenbsurg, Germany
| | - Franz Resch
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, Medical Faculty, University of Heidelberg, Heidelberg, Germany
| | - Julian Koenig
- University Hospital for Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Child and Adolescent Psychiatry, Section for Experimental Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- University Hospital for Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Child and Adolescent Psychiatry, Section for Translational Psychobiology in Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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17
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Cavelti M, Thompson K, Betts J, Fowler C, Luebbers S, Cotton SM, Chanen AM. Borderline Personality Disorder Diagnosis and Symptoms in Outpatient Youth as Risk Factors for Criminal Offenses and Interpersonal Violence. J Pers Disord 2021; 35:23-37. [PMID: 33779276 DOI: 10.1521/pedi_2021_35_503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The aim of the current study was to examine the risk for offending among outpatient youth with borderline pathology. Demographic and diagnostic data from 492 outpatients who attended a public mental health service for 15-to 25-year-olds between January 1998 and March 2008 were linked with information regarding criminal offenses and intervention orders collected from a statewide police database between March 1993 and June 2017. BPD diagnosis and number of BPD criteria were both associated with an elevated risk for violent and nonviolent offenses and family violence intervention orders. Moderation analyses revealed that the number of BPD criteria might affect males and females differently in terms of offending. Both impulsivity and anger independently predicted the risk for violent and nonviolent offenses and family violence intervention orders. Early detection of increased risk of offending among youth with BPD features is essential to develop targeted treatments for criminal or violent behavior.
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Affiliation(s)
- Marialuisa Cavelti
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.,University Hospital for Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katherine Thompson
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Jennifer Betts
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | | | - Stefan Luebbers
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Melbourne, Australia
| | - Sue M Cotton
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Andrew M Chanen
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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18
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Wojciechowski T. The dual mediating roles of impulsivity and emotion regulation of the borderline personality disorder-violence relationship: A structural equation modeling approach. J Forensic Sci 2021; 66:2329-2339. [PMID: 34286852 DOI: 10.1111/1556-4029.14807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/28/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
Although the past research has indicated that features of borderline personality disorder (BPD) increase the risk for violence, much less research has examined the mediators of this relationship. This study examined the mediating roles that impulsivity and emotion dysregulation may play in explaining the relationship between BPD and violence. The Pathways to Desistance data were used in analyses. Generalized structural equation modeling was used to estimate the direct effect of BPD features on violent offending risk and to examine the mediating roles of emotion dysregulation and impulsivity. Results indicated that the direct effect of BPD symptoms on violence was mediated to non-significance by key constructs, and the magnitude of the effect was reduced by around 40%. The total indirect effect was significant, and the mediation was attributed mainly to impulsivity. This indicates the importance of structuring treatment programming for BPD patients around impulsivity for reducing violence. Programming focused on improving impulsivity among individuals suffering from BPD may aid in reducing violent offending among this population, particularly those prior histories of involvement with the criminal justice system.
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Affiliation(s)
- Thomas Wojciechowski
- Michigan State University School of Criminal Justice, East Lansing, Michigan, USA
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19
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Krause-Utz A, Mertens LJ, Renn JB, Lucke P, Wöhlke AZ, van Schie CC, Mouthaan J. Childhood Maltreatment, Borderline Personality Features, and Coping as Predictors of Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:6693-6721. [PMID: 30596325 PMCID: PMC8202213 DOI: 10.1177/0886260518817782] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Intimate partner violence (IPV) is a serious mental and physical health concern worldwide. Although previous research suggests that childhood maltreatment increases the risk for IPV, the underlying psychological mechanisms of this relationship are not yet entirely understood. Borderline personality (BP) features may play an important role in the cycle of violence, being associated with interpersonal violence in both childhood and adult relationships. The present study investigated whether BP features mediate the relationship between childhood maltreatment and IPV, differentiating between perpetration and victimization, and taking maladaptive stress coping and gender into account. Self-reports on IPV, childhood trauma, BP features, and maladaptive stress coping were collected in a mixed (nonclinical and clinical) sample of 703 adults (n = 537 female, n = 166 male), using an online survey. A serial mediation analysis (PROCESS) was performed to quantify the direct effect of childhood maltreatment on IPV and its indirect effects through BP features and maladaptive coping. Childhood maltreatment severity significantly positively predicted IPV perpetration as well as victimization. BP features, but not coping, partially mediated this relationship. Follow-up analyses suggest that affective instability and interpersonal disturbances (e.g., separation concerns) play an important role in IPV perpetration, while interpersonal and identity disturbances may mediate the effect of childhood maltreatment on IPV victimization. In clinical practice, attention should be paid not only to histories of childhood abuse and neglect but also to BP features, which may be possible risk factors for IPV.
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Affiliation(s)
- Annegret Krause-Utz
- Leiden University, The Netherlands
- Leiden Institute for Brain and Cognition, The Netherlands
- Heidelberg University, Germany
| | | | | | | | | | - Charlotte C. van Schie
- Leiden University, The Netherlands
- Leiden Institute for Brain and Cognition, The Netherlands
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20
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Effects of Integrated Violence Intervention on Alexithymia, Cognitive, and Neurocognitive Features of Violence in Schizophrenia: A Randomized Controlled Trial. Brain Sci 2021; 11:brainsci11070837. [PMID: 34202608 PMCID: PMC8301770 DOI: 10.3390/brainsci11070837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/20/2021] [Accepted: 06/22/2021] [Indexed: 01/17/2023] Open
Abstract
Patients with schizophrenia and repetitive violence express core impairments that encompass multiple domains. To date, there have been few interventions integrating neurocognition, social cognition, alexithymia, and emotion regulation together as an approach to manage repetitive violence. The aim of this open-label randomized controlled trial was to examine more comprehensively the effectiveness of a novel Integrated Cognitive Based Violence Intervention Program on management of repetitive violence in patients with schizophrenia (vSZ). Sixty recruited patients were aged ≥20 years, diagnosed with schizophrenia for >2 years, had repetitive violent behavior within one year, and were psychiatrically hospitalized. The vSZ patients were randomly allocated to two groups and received either the intervention or treatment as usual. The intervention module, consisting of all defined 11 cognitive and social cognitive domains as well as emotion regulation, which were grouped into four modules. The intervention placed emphasis on the patients’ behavioral problems or intrinsic conflicts in relation to repetitive violence. The results indicate a statistically significant trend toward reducing impulsivity, anger with resentment, physical aggression, suspicion, and hostility (p < 0.05). The intervention significantly alleviated the intensity of cognitive failure, improved the management of alexithymic features and attribution styles and errors, and fostered adequate decision-making styles and emotion regulation capacity (p < 0.05). The intervention, when applied in conjunction with psychiatric standard care, could exert synergistic effects on alexithymia and cognitive, clinical, and neurocognitive features of repetitive violence in schizophrenia. This intervention provided patients a more active role to manage their violent behavior with the involvement of alexithymia.
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21
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Ford JD, Courtois CA. Complex PTSD and borderline personality disorder. Borderline Personal Disord Emot Dysregul 2021; 8:16. [PMID: 33958001 PMCID: PMC8103648 DOI: 10.1186/s40479-021-00155-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/09/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This article builds on a previous review (Ford and Courtois, Borderline Personal Disord Emot Dysregul 1:9, 2014) which concluded that complex posttraumatic stress disorder (cPTSD) could not be conceptualized as a sub-type of either PTSD or BPD. Recent research is reviewed that extends and clarifies the still nascent understanding of the relationship between cPTSD and BPD. MAIN BODY The circumscribed formulation of adult cPTSD that has been developed, validated, and included in the 11th Edition of the International Classification of Diseases has spurred research aimed at differentiating cPTSD and BPD both descriptively and empirically. A newly validated Developmental Trauma Disorder (DTD) syndrome for children and adolescents provides a basis for systematic research on the developmental course and origins of adult cPTSD and BPD. This review summarizes recent empirical findings regarding BPD, PTSD, and cPTSD in terms of: (1) prevalence and comorbidity; (2) clinical phenomenology; (3) traumatic antecedents; (4) psychobiology; (5) emotion dysregulation; (6) dissociation; and (7) empirically supported approaches to clinical assessment and psychotherapeutic treatment. CONCLUSION The evidence suggests that PTSD, cPTSD, and BPD are potentially comorbid but distinct syndromes. A hypothesis is advanced to stimulate scientific research and clinical innovation defining and differentiating the disorders, positing that they may represent a continuum paralleling the classic conceptualization of the stress response, with dissociation potentially involved in each disorder.
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Affiliation(s)
- Julian D Ford
- University of Connecticut Health Center MC1410, 263 Farmington Avenue, Farmington, CT, 06030-1410, USA.
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22
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Telles LEDB, Valença AM, Barros AJ, da Silva AG. Domestic violence in the COVID-19 pandemic: a forensic psychiatric perspective. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2021; 43:233-234. [PMID: 32491034 PMCID: PMC8136389 DOI: 10.1590/1516-4446-2020-1060] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/05/2020] [Indexed: 01/07/2023]
Affiliation(s)
- Lisieux E. de Borba Telles
- Departamento de Psiquiatria e Medicina Legal, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Alexandre M. Valença
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Alcina J.S. Barros
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Antônio Geraldo da Silva
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil
- Asociación Psiquiátrica de América Latina (APAL), Brasília, DF, Brazil
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23
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Sharma A, McClellan J. Emotional and Behavioral Dysregulation in Severe Mental Illness. Child Adolesc Psychiatr Clin N Am 2021; 30:415-429. [PMID: 33743948 DOI: 10.1016/j.chc.2020.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Emotional and behavioral dysregulation are common in severe mental illnesses, including schizophrenia, bipolar disorder, and borderline personality disorder. Emotional instability and behavioral outbursts can be driven by internal processes and/or environmental triggers and interpersonal interactions. Understanding the underlying diagnosis is important in determining the best course of treatment. Disorder-specific treatments are important in addressing underlying drivers of emotional dysregulation, irritability, and aggression. Coping skills training and behavioral modification strategies have broad applicability and are useful for aggression and irritability. Treatment planning to address emotion dysregulation and aggression in severe mental illness should address psychiatric comorbidities, substance use, and medication adherence.
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Affiliation(s)
- Aditi Sharma
- Department of Psychiatry and Behavioral Sciences, University of Washington, 4800 Sand Point WAY Northeast, MS OA.5.154, Seattle, WA 98105, USA
| | - Jon McClellan
- Department of Psychiatry and Behavioral Sciences, University of Washington, 8805 Steilacoom Boulevard Southwest, Lakewood, WA 98498, USA.
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24
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Krause-Utz A, Dierick T, Josef T, Chatzaki E, Willem A, Hoogenboom J, Elzinga B. Linking experiences of child sexual abuse to adult sexual intimate partner violence: the role of borderline personality features, maladaptive cognitive emotion regulation, and dissociation. Borderline Personal Disord Emot Dysregul 2021; 8:10. [PMID: 33789778 PMCID: PMC8015045 DOI: 10.1186/s40479-021-00150-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/05/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Child sexual abuse (CSA) has been linked to a higher risk of sexual re-victimization, including sexual intimate partner violence (IPV). The aim of this study was to investigate whether borderline personality disorder (BPD) features, dissociation, and maladaptive cognitive emotion regulation mediate the link between self-reported CSA severity and sexual IPV. Specifically, we were interested in the unique effect of each mediator variable, when accounting for the effect of the other variables. METHODS Data was assessed in a cross-sectional anonymous online survey, posted on platforms for people affected by domestic violence, and research platforms of Leiden University. Overall, n = 633 participants completed the survey (including n = 100 participants with CSA and n = 345 reporting at least one incidence of sexual IPV). Multivariate regression analyses and path-analytical modelling were performed for hypothesis testing. RESULTS Adult sexual IPV was predicted by more severe CSA, more severe BPD features, higher dissociation, and more maladaptive emotion regulation. Each mediator variable showed a significant effect in the separate mediation models. In the overall model, only dissociation and maladaptive emotion regulation, but not BPD features, mediated the association between CSA and sexual IPV. CONCLUSIONS Findings add to the existing literature, suggesting that CSA severity, BPD features, dissociation, and maladaptive emotion regulation are important risk factors for sexual IPV. Given the cross-sectional correlational design of our study, prospective studies are needed to corroborate our findings regarding potential psychological mechanisms underlying sexual re-victimization. Ultimately, this can help developing interventions aimed at breaking the cycle of abuse.
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Affiliation(s)
- Annegret Krause-Utz
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands.
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.
| | - Tara Dierick
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Tobias Josef
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Elianne Chatzaki
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Andries Willem
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Jan Hoogenboom
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Bernet Elzinga
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
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25
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Wojciechowski T. Presentation of Borderline Personality Disorder Symptoms in Adulthood: Development of Depression Mediates the Effect of Childhood and Adolescent Exposure to Violence. J Nerv Ment Dis 2021; 209:283-290. [PMID: 33346599 DOI: 10.1097/nmd.0000000000001291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Past research has linked the development of borderline personality disorder to earlier exposure to violence. However, the causal link by which this relationship exists has not yet been fully identified. The present study sought to examine how exposure to violence predicted heterogeneity in the development of depressive systems and results in the arousal of borderline personality disorder symptoms in adulthood. The Pathways to Desistance data were used in the analyses. This data set consisted of the responses of 1354 juvenile offenders followed across 7 years. Group-based trajectory modeling was used to identify latent trajectories of depressive symptoms. Ordinary least squares regression was used to model covariate effects on borderline personality disorder symptoms in adulthood. Results indicated that a three-group depression trajectory model best fit the data. Direct victimization early in life was associated with increased borderline personality disorder symptoms in adulthood. When trajectory group assignment was accounted for in the model, the relationship between direct victimization and borderline personality disorder symptoms was attenuated by around 30%. Implications are discussed.
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26
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Howard R, Hasin D, Stohl M. Substance use disorders and criminal justice contact among those with co-occurring antisocial and borderline personality disorders: Findings from a nationally representative sample. Personal Ment Health 2021; 15:40-48. [PMID: 32588546 DOI: 10.1002/pmh.1491] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/03/2020] [Accepted: 06/07/2020] [Indexed: 11/08/2022]
Abstract
One variant of borderline personality disorder (BPD), frequently encountered in forensic and correctional samples, is the 'dissocial' subtype that combines borderline and antisocial traits. We tested the hypothesis that this subtype, defined by the co-occurrence of antisocial personality disorder (ASPD) and BPD (ASPD + BPD), would be associated with high rates of substance use disorder and contact with the criminal justice (CJ) system in a large nationally representative sample of North American adults (N = 36 309). Results suggested that the dissocial variant of BPD was associated with a high risk for substance use disorders and CJ contact. The odds of these outcomes were significantly raised about fivefold in ASPD + BPD individuals in comparison with those who lacked either an ASPD or BPD diagnosis. ASPD + BPD, compared with BPD alone, was also associated with significantly (p < 0.0001) greater severity of borderline symptoms. Although CJ contact appears to be strongly driven by ASPD, substance use, primarily driven by severity of borderline symptoms, added to the risk of CJ contact. It is suggested that, in the 11th Revision of the International Classification of Diseases terms, the dissocial borderline variant is a severe form of personality disorder characterized by high levels of traits within domains of negative emotionality and dissociality. Further studies will be required to verify this suggestion. © 2020 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd.
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Affiliation(s)
- Richard Howard
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Deborah Hasin
- Department of Psychiatry and Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - Malki Stohl
- New York State Psychiatric Institute, New York, NY, USA
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Whiting D, Lichtenstein P, Fazel S. Violence and mental disorders: a structured review of associations by individual diagnoses, risk factors, and risk assessment. Lancet Psychiatry 2021; 8:150-161. [PMID: 33096045 DOI: 10.1016/s2215-0366(20)30262-5] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 02/08/2023]
Abstract
In this Review, we summarise evidence on the association between different mental disorders and violence, with emphasis on high quality designs and replicated findings. Relative risks are typically increased for all violent outcomes in most diagnosed psychiatric disorders compared with people without psychiatric disorders, with increased odds in the range of 2-4 after adjustment for familial and other sources of confounding. Absolute rates of violent crime over 5-10 years are typically below 5% in people with mental illness (excluding personality disorders, schizophrenia, and substance misuse), which increases to 6-10% in personality disorders and schizophrenia spectrum disorders, and to more than 10% in substance misuse. Past criminality and comorbid substance misuse are strongly predictive of future violence in many individual disorders. We reviewed national clinical practice guidelines, which vary in content and require updating to reflect the present epidemiological evidence. Standardised and clinically feasible approaches to the assessment and management of violence risk in general psychiatric settings need to be developed.
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Affiliation(s)
- Daniel Whiting
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Seena Fazel
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.
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28
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Valença AM, de Moraes TM, Meyer LF, Petribú KCLD, Nardi AE, Mendlowicz MV. Violent behavior by involuntarily committed female offenders with mental disorders: A population-based case series. J Forensic Sci 2020; 66:656-663. [PMID: 33253419 DOI: 10.1111/1556-4029.14638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 10/31/2020] [Accepted: 11/03/2020] [Indexed: 01/05/2023]
Abstract
The goal of the current study was to investigate the socio-demographic, psychiatric, and criminological characteristics of female violent offenders with mental disorders involuntarily committed to a forensic psychiatric hospital. The present study was a population-based retrospective case series including all female offenders with mental disorders found not guilty by reason of insanity by the criminal courts in the state of Rio de Janeiro, Brazil, and involuntarily committed to a forensic psychiatric facility (n = 27). Patients were assessed with Structured Clinical Interview for DSM-IV Axis I Disorders and the Positive and Negative Syndrome Scale. We found that most offenders were Afro-Brazilian, uneducated unmarried women. Schizophrenia with active psychotic symptoms was the most common clinical condition. Relatives were the frequent victims of aggressive behavior. Most patients had already been diagnosed with a mental disorder and placed under psychiatric treatment, but poor adherence and treatment dropout were common. Violent behavior in psychiatrically ill female patients is associated with a specific socio-demographic and clinical profile and is thus potentially amenable to prevention particularly if the mental health and social services are to provide the much-needed support for economically, socially, and psychologically vulnerable women.
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Affiliation(s)
- Alexandre M Valença
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ, Rio de Janeiro, RJ, Brazil.,Department of Psychiatry and Mental Health, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Talvane M de Moraes
- Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,National Academy of Medicine, Rio de Janeiro, RJ, Brazil
| | - Leonardo F Meyer
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ, Rio de Janeiro, RJ, Brazil
| | | | - Antonio E Nardi
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ, Rio de Janeiro, RJ, Brazil.,National Academy of Medicine, Rio de Janeiro, RJ, Brazil
| | - Mauro V Mendlowicz
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ, Rio de Janeiro, RJ, Brazil.,Department of Psychiatry and Mental Health, Universidade Federal Fluminense, Niterói, RJ, Brazil
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29
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Munro OE, Sellbom M. Elucidating the relationship between borderline personality disorder and intimate partner violence. Personal Ment Health 2020; 14:284-303. [PMID: 32162499 DOI: 10.1002/pmh.1480] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 02/18/2020] [Accepted: 02/22/2020] [Indexed: 11/11/2022]
Abstract
This study examined the established association between borderline personality disorder (BPD) and intimate partner violence (IPV). More specifically, it compared the DSM-5 traditional categorical personality disorder (PD) model with the DSM-5 Alternative Model of PD (AMPD) operationalizations of BPD in their relative associations with IPV. The effects of gender, as well as the associations between BPD and different forms of IPV were also considered. Additionally, we investigated the specific BPD-relevant AMPD personality traits that influence the BPD-IPV association. The study sample were 250 community-dwelling men and women recruited through an established crowdsourcing platform. Results revealed that both the 'traditional' and AMPD operationalizations of BPD were approximately equally associated with IPV perpetration, although the traditional BPD operationalization demonstrated some minor advantages in this regard. The AMPD trait facets of hostility (negative affectivity), suspiciousness (negative affectivity) and risk taking (disinhibition) were most strongly associated with IPV perpetration for the total sample, and additional negative affectivity trait facets were also associated with IPV for men only. Implications for these findings are discussed. © 2020 John Wiley & Sons, Ltd.
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Affiliation(s)
- Olivia E Munro
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Martin Sellbom
- Department of Psychology, University of Otago, Dunedin, New Zealand
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Zhang M, Liu N, Chen H, Zhang N. Oxytocin receptor gene, childhood maltreatment and borderline personality disorder features among male inmates in China. BMC Psychiatry 2020; 20:332. [PMID: 32580785 PMCID: PMC7315490 DOI: 10.1186/s12888-020-02710-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 06/01/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Borderline personality disorder (BPD) is caused by a variety of biological and environmental factors. Accumulating evidence suggests that childhood maltreatment is a risk environmental factor in the development of BPD, but research on the genetic pathology of BPD is still in its early stages, and very little is known about the oxytocin receptor (OXTR) gene. The purpose of this study is to further explore the interactive effects between OXTR gene polymorphisms and childhood maltreatment on BPD risk. METHODS Among the 1804 Chinese Han male inmates, 765 inmates who had BPD or antisocial personality disorder (ASPD) or highly impulsive or violent crime were considered as high-risk inmates and included in this study. Childhood maltreatment, BPD, antisocial personality disorder (ASPD) and impulsivity were measured by self-reported questionnaires. Peripheral venous blood was collected for the genotype test. RESULTS Analyses revealed that the BP group (inmates with BPD features) had higher rs53576 AA genotype frequency and rs237987 AA genotype frequency than the non-BP group, while the statistical significances were lost after Bonferroni correction. Total childhood maltreatment score, emotional abuse and neglect could positively predict BPD risk. Among the high-risk samples, rs53576 GG genotype carriers had higher BPD scores at higher levels of physical abuse and sexual abuse and had lower BPD scores at lower levels of physical abuse and sexual abuse. CONCLUSIONS The findings suggest that the interaction between OXTR gene variations and childhood maltreatment is an important mechanism for the development of BPD. The moderating role of the OXTR gene provides evidence for gene plasticity.
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Affiliation(s)
- Min Zhang
- grid.260474.30000 0001 0089 5711School of Psychology, Nanjing Normal University, Nanjing, 210000 China ,grid.452645.40000 0004 1798 8369Medical Psychology Department, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, 210000 China
| | - Na Liu
- Medical Psychology Department, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, 210000, China.
| | - Haocheng Chen
- grid.260474.30000 0001 0089 5711School of Psychology, Nanjing Normal University, Nanjing, 210000 China ,grid.452645.40000 0004 1798 8369Medical Psychology Department, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, 210000 China ,grid.89957.3a0000 0000 9255 8984The Forth School of Clinical Medicine, Nanjing Medical University, Nanjing, 210000 China
| | - Ning Zhang
- grid.452645.40000 0004 1798 8369Medical Psychology Department, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, 210000 China
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Cardona N, Berman AK, Sims-Knight JE, Knight RA. Covariates of the Severity of Aggression in Sexual Crimes: Psychopathy and Borderline Characteristics. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2020; 32:154-178. [PMID: 30394860 DOI: 10.1177/1079063218807485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Whereas risk assessment literature on sexual offending has primarily focused on prediction of subsequent sexual crimes, and not the severity of those crimes, the first aim of the present study was to identify variables that predict the amount of damage to victims in sexual crimes compared with those that predict general aggressiveness. The second aim was to ascertain whether adding emotional instability measurements, as in borderline personality disorder (BPD), would add incremental variance to that captured by the facets of the Psychopathy Checklist-Revised (PCL-R). Trained raters assessed on the PCL-R, BPD, and measures of severity of sexual and nonsexual violence 302 adults who had sexually offended. PCL-R's Antisociality and two externalizing BPD factors (one from the standard and one from the alternative criteria) were significant predictors of violence both in sexual and nonsexual crimes. In contrast, deficits in the PCL-R's Affective facet (2) predicted victim damage in sexual contexts only, whereas the Lifestyle Impulsivity facet (3) of the PCL-R predicted violence in nonsexual contexts only. These findings suggest that adding measures of emotional dysregulation to commonly used instruments like the PCL-R, which assesses callousness and antisociality, may be beneficial for predicting violence.
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32
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Romero DL, de Barros DM, Belizario GO, Serafim ADP. Personality traits and risky behavior among motorcyclists: An exploratory study. PLoS One 2019; 14:e0225949. [PMID: 31805128 PMCID: PMC6894775 DOI: 10.1371/journal.pone.0225949] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 11/15/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Personality traits have been associated with a series of dysfunctional behaviors, ranging from violence to drug abuse and other risky behaviors. However, few studies have investigated motorcycle riders' personality traits, and no research using the psychobiological model of personality was found. Thus, we investigated the association between temperament and character traits and the occurrence of Motorcycle Accidents (MAs). METHODS This cross-sectional study was conducted with a randomly selected of 153 Brazilian motorcycle riders (116 male and 37 female) with a mean age of 31.8randomly selected from the driver's license register, between 2015 and 2018. A sociodemographic questionnaire and the Temperament and Character Inventory (TCI) were used. RESULTS Of the 153 participants, 146 (95.4%) reported having been involved in previous accidents, with the main causes as follows: "other drivers' careless behavior" (34.9%); "personal disrespect of traffic rules" (18.5%) and "personal careless behavior" (20.6%). Motorcyclists exhibited higher scores for the temperament factors of novelty seeking and persistence and lower scores for harm avoidance and reward dependence in comparison to the Brazilian population). Considering the reason for motorcycle use, the group of riders that used their motorcycles for work exhibited more temperament factors associated with risk behaviors than those who did not. It was observed that 68.9% of them had low Harm Avoidance (HA) factor scores, whereas 72.1% had high Novelty Seeking (NS) factor scores. DISCUSSION The present study highlighted the influences of different personality traits on behaviors, decision-making and risk attitudes that can be potentially harmful to an individual and others. The results provided evidence that a lack of knowledge and experience in riding a motorcycle or any other vehicle, combined with personality traits, contribute to the adoption of risky behaviors that may act as triggers for most causes of Motorcycle Accidents.
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Affiliation(s)
- Daniel Luiz Romero
- Department of Psychology, Methodist University of São Paulo, São Bernardo do Campo, Brazil
| | - Daniel Martins de Barros
- Department and Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Gabriel Okawa Belizario
- Department and Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Antonio de Pádua Serafim
- Department of Psychology, Methodist University of São Paulo, São Bernardo do Campo, Brazil
- Department and Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
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Yu R, Nevado-Holgado AJ, Molero Y, D’Onofrio BM, Larsson H, Howard LM, Fazel S. Mental disorders and intimate partner violence perpetrated by men towards women: A Swedish population-based longitudinal study. PLoS Med 2019; 16:e1002995. [PMID: 31846461 PMCID: PMC6917212 DOI: 10.1371/journal.pmed.1002995] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/18/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) against women is associated with a wide range of adverse outcomes. Although mental disorders have been linked to an increased risk of perpetrating IPV against women, the direction and magnitude of the association remain uncertain. In a longitudinal design, we examined the association between mental disorders and IPV perpetrated by men towards women in a population-based sample and used sibling comparisons to control for factors shared by siblings, such as genetic and early family environmental factors. METHODS AND FINDINGS Using Swedish nationwide registries, we identified men from 9 diagnostic groups over 1998-2013, with sample sizes ranging from 9,529 with autism to 88,182 with depressive disorder. We matched individuals by age and sex to general population controls (ranging from 186,017 to 1,719,318 controls), and calculated the hazard ratios of IPV against women. We also estimated the hazard ratios of IPV against women in unaffected full siblings (ranging from 4,818 to 37,885 individuals) compared with the population controls. Afterwards, we compared the hazard ratios for individuals with psychiatric diagnoses with those for siblings using the ratio of hazard ratios (RHR). In sensitivity analyses, we examined the contribution of previous IPV against women and common psychiatric comorbidities, substance use disorders and personality disorders. The average follow-up time across diagnoses ranged from 3.4 to 4.8 years. In comparison to general population controls, all psychiatric diagnoses studied except autism were associated with an increased risk of IPV against women in men, with hazard ratios ranging from 1.5 (95% CI 1.3-1.7) to 7.7 (7.2-8.3) (p-values < 0.001). In sibling analyses, we found that men with depressive disorder, anxiety disorder, alcohol use disorder, drug use disorder, attention deficit hyperactivity disorder, and personality disorders had a higher risk of IPV against women than their unaffected siblings, with RHR values ranging from 1.7 (1.3-2.1) to 4.4 (3.7-5.2) (p-values < 0.001). Sensitivity analyses showed higher risk of IPV against women in men when comorbid substance use disorders and personality disorders were present, compared to risk when these comorbidities were absent. In addition, increased IPV risk was also found in those without previous IPV against women. The absolute rates of IPV against women ranged from 0.1% to 2.1% across diagnoses over 3.4 to 4.8 years. Individuals with alcohol use disorders (1.7%, 1,406/82,731) and drug use disorders (2.1%, 1,216/57,901) had the highest rates. Our analyses were restricted to IPV leading to arrest, suggesting that the applicability of our results may be limited to more severe forms of IPV perpetration. CONCLUSIONS Our results indicate that most of the studied mental disorders are associated with an increased risk of perpetrating IPV towards women, and that substance use disorders, as principal or comorbid diagnoses, have the highest absolute and relative risks. The findings support the development of IPV risk identification and prevention services among men with substance use disorders as an approach to reduce the prevalence of IPV.
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Affiliation(s)
- Rongqin Yu
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | - Yasmina Molero
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Brian M. D’Onofrio
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, United States of America
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Louise M. Howard
- Department of Women & Children’s Health, King’s College London, London, United Kingdom
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Abstract
OBJECTIVE This paper aims to provide a selective review of the co-occurrence of borderline personality disorder (BPD) and violence, a much less explored aspect of aggression with this cohort. CONCLUSIONS Violence in BPD patients is expressed particularly towards intimate partners and known persons, usually in the homes of perpetrators. Anger, impulsivity and avoiding abandonment are traits associated with violence while suicidal behaviour, identity disturbance and affective instability are not. These patients are disproportionately found in higher levels of secure care although most violence occurs in the community. In males it is more likely driven by substance use, often at transition from adolescence to adulthood, while more severe borderline pathology is implicated in women. Early identification of an at-risk cohort is recommended with development of collaborative safety plans with patients that include identification of a 'risk signature' that guides risk management. A multi-modal approach using risk management protocols with availability of contingency plans within a multi-agency forum in a local context is recommended.
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Affiliation(s)
- Jaydip Sarkar
- Consultant Forensic Psychiatrist, Victorian Institute of Forensic Mental Health, Forensicare, Fairfield, VIC, Australia
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35
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Cavelti M, Thompson KN, Hulbert C, Betts J, Jackson H, Francey S, Homan P, Chanen AM. Exploratory comparison of auditory verbal hallucinations and other psychotic symptoms among youth with borderline personality disorder or schizophrenia spectrum disorder. Early Interv Psychiatry 2019; 13:1252-1262. [PMID: 30485670 DOI: 10.1111/eip.12763] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/13/2018] [Accepted: 11/04/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study explored phenomenological aspects of auditory verbal hallucinations (AVH) and other psychotic symptoms among youth with borderline personality disorder (BPD). METHODS Sixty-eight outpatients, aged 15 to 25 years, were categorized into three groups according to their primary Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnosis and AVH symptom profile; BPD + AVH (n = 23), schizophrenia spectrum disorder (SZ) + AVH (n = 22) and BPD with no AVH (n = 23). RESULTS No differences in AVH were found between BPD + AVH and SZ + AVH. Compared with SZ + AVH, BPD + AVH scored lower on delusions and difficulty in abstract thinking and higher on hostility. BPD + AVH reported more severe self-harm, paranoid ideation, dissociation, anxiety and stress than BPD no AVH. CONCLUSIONS This study replicates, in a sample of youth, the finding from studies of adults that AVH in BPD are indistinguishable from those in SZ, when assessed with the Psychotic Symptom Rating Scales (PSYRATS). Clinicians should specifically enquire about AVH among youth with BPD. When present, AVH appear to be an indicator of a more severe form of BPD.
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Affiliation(s)
- Marialuisa Cavelti
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.,University Hospital for Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland
| | - Katherine N Thompson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Carol Hulbert
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer Betts
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Henry Jackson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Shona Francey
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Philipp Homan
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA.,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY, USA.,Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, USA
| | - Andrew M Chanen
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.,Orygen Youth Health, Melbourne, Victoria, Australia
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Redondo Rodríguez N, Gómez JLG, Montesino MLC, Muñoz-Rivas MJ. Psychometric Properties of a Measure of Borderline Personality Organization in a Spanish Court-Referred Partner-Violent Male Sample. Front Psychol 2019; 10:1653. [PMID: 31379680 PMCID: PMC6648580 DOI: 10.3389/fpsyg.2019.01653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/01/2019] [Indexed: 11/13/2022] Open
Abstract
Borderline personality organization (BPO) is a key personality component of some but not all partner-violent men. The study described in this paper examines the psychometric properties of the borderline personality organization scale (BPO Scale; Oldham et al., 1985) in a Spanish sample of 643 men undergoing court-mandated psychological treatment after conviction for episodes of intimate-partner violence. Three confirmatory factor analyses were carried out first, and the three-factor structure of the BPO scale was then tested. Results for concurrent validity show positive and significant correlations between the subscales and the overall BPO scale, and with other instruments that measure borderline and antisocial personality disorders (ASPDs), and impulsivity. The BPO scale also presents evidence of known-groups validity, since BPO scores decrease with age, and of discriminant validity, as the scale discriminates between participants who do and do not exceed the cutoff point on a borderline personality scale. The BPO Scale is a suitable instrument for evaluating BPO in partner-violent men.
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Jacob L, Haro JM, Koyanagi A. Association between intelligence quotient and violence perpetration in the English general population. Psychol Med 2019; 49:1316-1323. [PMID: 30058504 DOI: 10.1017/s0033291718001939] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Data on the relationship between intelligence quotient (IQ) and violence perpetration are scarce and nationally representative data from the UK adult population is lacking. Therefore, our goal was to examine the relationship between IQ and violence perpetration using nationally representative community-based data from the UK. METHODS We analyzed cross-sectional data from the 2007 Adult Psychiatric Morbidity Survey. IQ was estimated using the National Adult Reading Test (NART). Violence perpetration referred to being in a physical fight or having deliberately hit anyone in the past 5 years. We conducted logistic regression analysis to assess the association between IQ (exposure variable) and violence perpetration (outcome variable). RESULTS There were 6872 participants aged ⩾16 years included in this study. The prevalence of violence perpetration decreased linearly with increasing IQ [16.3% (IQ 70-79) v. 2.9% (IQ 120-129)]. After adjusting for demographic and behavioral factors, childhood adversity, and psychiatric morbidity, compared with those with IQ 120-129, IQ scores of 110-119, 100-109, 90-99, 80-89, and 70-79 were associated with 1.07 [95% confidence interval (CI) 0.63-1.84], 1.90 (95% CI 1.12-3.22), 1.80 (95% CI 1.05-3.13), 2.36 (95% CI 1.32-4.22), and 2.25 (95% CI 1.26-4.01) times higher odds for violence perpetration, respectively. CONCLUSIONS Lower IQ was associated with violence perpetration in the UK general population. Further studies are warranted to assess how low IQ can lead to violence perpetration, and whether interventions are possible for this high-risk group.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine,University of Paris 5,Paris 75006,France
| | - Josep Maria Haro
- Research and Development Unit,Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Dr Antoni Pujadas,42,Sant Boi de Llobregat,Barcelona 08830,Spain
| | - Ai Koyanagi
- Research and Development Unit,Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Dr Antoni Pujadas,42,Sant Boi de Llobregat,Barcelona 08830,Spain
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Sanatinia R, Afzal S, MacLaren T, McNulty A, Adele C, Morah A, Crawford M. Improved mental health among LABILE study participants: A qualitative exploration. Personal Ment Health 2019; 13:75-83. [PMID: 30848543 DOI: 10.1002/pmh.1440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/21/2018] [Accepted: 02/03/2019] [Indexed: 01/24/2023]
Abstract
Results of the LABILE trial showed no difference between people with BPD who were prescribed lamotrigine and those on placebo. However, most study participants experienced sustained improvement in their mental health during the trial. We conducted a thematic analysis of qualitative data from interviews with 47 LABILE study participants to identify factors that may have contributed to this improvement. We identified three main themes: initial reasons and expectations regarding trial participation, patients' experiences of the trial and areas of change. Reasons for participating in the trial included a search for consistent and stable professional care as well as altruistic motives. Improvements in symptoms over the course of the trial were explained by several factors including consistency provided by the research team, salience of the social context and the availability of alternative support networks. While participants appreciated the autonomy provided by the voluntary nature of the trial, they felt that improvements stemmed from the 'structure' brought about by their actively engaging in the study. This study highlights the importance of clear and transparent communication when treating people with BPD. Mental health professionals should ensure that services for people with BPD are consistent and structured. © 2019 John Wiley & Sons, Ltd.
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Affiliation(s)
| | | | - Thomas MacLaren
- Central and North West London NHS Foundation Trust, London, UK
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Tyrer P, Mulder R, Kim YR, Crawford MJ. The Development of the ICD-11 Classification of Personality Disorders: An Amalgam of Science, Pragmatism, and Politics. Annu Rev Clin Psychol 2019; 15:481-502. [PMID: 30601688 DOI: 10.1146/annurev-clinpsy-050718-095736] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The nomenclature of personality disorders in the 11th revision of the International Classification of Diseases and Related Health Problems represents the most radical change in the classification history of personality disorders. A dimensional structure now replaces categorical description. It was argued by the Working Group that only a dimensional system was consistent with the empirical evidence and, in the spirit of clinical utility, the new system is based on two steps. The first step is to assign one of five levels of severity, and the second step is to assign up to five prominent domain traits. There was resistance to this structure from those who feel that categorical diagnosis, particularly of borderline personality disorder, should be retained. After lengthy discussion, described in detail here, there is now an option for a borderline pattern descriptor to be selected as a diagnostic option after severity has been determined.
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Affiliation(s)
- Peter Tyrer
- Centre for Psychiatry, Department of Medicine, Imperial College London, London W12 0NN, United Kingdom; ,
| | - Roger Mulder
- Department of Psychological Medicine, University of Otago, Christchurch 8140, New Zealand;
| | - Youl-Ri Kim
- Department of Psychiatry, Seoul Paik Hospital, Inje University, Seoul 100-032, South Korea;
| | - Mike J Crawford
- Centre for Psychiatry, Department of Medicine, Imperial College London, London W12 0NN, United Kingdom; ,
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Apostolopoulos A, Michopoulos I, Zachos I, Rizos E, Tzeferakos G, Manthou V, Papageorgiou C, Douzenis A. Association of Schizoid and Schizotypal Personality disorder with violent crimes and homicides in Greek prisons. Ann Gen Psychiatry 2018; 17:35. [PMID: 30116288 PMCID: PMC6086037 DOI: 10.1186/s12991-018-0204-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/31/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Personality disorders (PDs) have been associated with both violent crimes and homicides in many studies. The proportion of PDs among prisoners reaches up to 80%. For male prisoners, the most common PD in the literature is antisocial PD. The aim of this study was to investigate the association between PDs and violent crimes/homicides of male prisoners in Greece. METHODS A sample of 308 subjects was randomly selected from a population of 1300 male prisoners incarcerated in two Greek prisons, one urban and one rural. The presence of PDs was assessed using the Mini International Neuropsychiatric Interview (MINI) and the Personality Diagnostic Questionnaire-4 (PDQ-4). Using logistic regression models PD types and PD "Clusters" (independent variables) were associated with "violent/non-violent crimes" and "homicides/non homicides" (dependent variables). RESULTS "Cluster A" PDs (Paranoid, Schizoid, and Schizotypal) were diagnosed in 16.2%, "Cluster B" (Antisocial, Borderline, Histrionic, Narcissistic) in 66.9% and "Cluster C" (Obsessive-Compulsive, Dependent, Avoidant) in 2.9% of the studied population. Violent crimes and homicides were found significantly associated with "Cluster A" PDs (p = 0.022, p = 0.020). The odds ratio of committing violent crimes was 2.86 times higher for patients with "Cluster A" PDs than the ones without PDs. In addition, the odds ratio of committing homicides was 4.25 times higher for patients with "Cluster A" PDs. In separate analyses, the commitment of violent crimes as well as homicides, was significantly associated with Schizoid (p = 0.043, p = 0.020) and Schizotypal PD (p = 0.017, p = 0.030). CONCLUSIONS The majority of prisoners was found to suffer from a PD, mainly the Antisocial "Cluster B", but the commitment of violent crimes and homicides was significantly associated only with "Cluster A" PDs and specifically with Schizoid and Schizotypal PD.
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Affiliation(s)
| | - Ioannis Michopoulos
- 2nd Psychiatric Department of the University of Athens, Attikon Hospital, Athens, Greece
| | | | - Emmanouil Rizos
- 2nd Psychiatric Department of the University of Athens, Attikon Hospital, Athens, Greece
| | - Georgios Tzeferakos
- 2nd Psychiatric Department of the University of Athens, Attikon Hospital, Athens, Greece
| | | | | | - Athanasios Douzenis
- 2nd Psychiatric Department of the University of Athens, Attikon Hospital, Athens, Greece
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Suicidal behavior and aggression-related disorders. Curr Opin Psychol 2018; 22:54-58. [DOI: 10.1016/j.copsyc.2017.08.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 08/03/2017] [Accepted: 08/03/2017] [Indexed: 11/18/2022]
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Elklit A, Murphy S, Jacobsen C, Jensen MK. Clinical and Personality Disorders in a Danish Treatment-Seeking Sample of Intimate Partner Violence Perpetrators. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2018; 62:3322-3336. [PMID: 29144189 DOI: 10.1177/0306624x17741603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Intimate partner violence (IPV) is a global public health concern with profound psychological consequences. Perpetrators often have a history of childhood trauma and a range of co-occurring psychiatric problems, which may have implications for treatment. This study examines the prevalence of psychiatric and personality disorders (PD) among perpetrators and the association between a range of demographic, childhood trauma, and adult criminality variables for the most prominent disorders. Data were collected from IPV perpetrators ( n = 529) engaging in a treatment program, ' Dialogue Against Violence'. High rates of childhood trauma were observed. There was significant variation in the prevalence of clinical disorders and PDs, with Antisocial PD and Anxiety Disorder being the most common. A clinical disorder was the strongest predictor of PDs, likewise a PD was the strongest predictor of clinical disorders. Findings demonstrated that IPV perpetrators have a number of personality and clinical disorders and traumatic histories that need to be considered within a treatment perspective.
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Affiliation(s)
- Ask Elklit
- 1 University of Southern Denmark, Odense, Denmark
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Moore KE, Gobin RL, McCauley HL, Kao CW, Anthony SM, Kubiak S, Zlotnick C, Johnson JE. The relation of borderline personality disorder to aggression, victimization, and institutional misconduct among prisoners. Compr Psychiatry 2018; 84:15-21. [PMID: 29660674 PMCID: PMC6002930 DOI: 10.1016/j.comppsych.2018.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 03/07/2018] [Accepted: 03/15/2018] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE Borderline personality disorder (BPD) is highly prevalent among incarcerated populations; however, research has yet to examine whether prisoners diagnosed with BPD experience greater interpersonal dysfunction and institutional misconduct while incarcerated. PROCEDURE This study drew from a sample of 184 male and female prisoners diagnosed with major depressive disorder (MDD) in a randomized trial of depression treatment. The presence of a BPD diagnosis (n = 69) was analyzed as a predictor of disciplinary incidents/infractions (i.e., fights, arguments with staff, disciplinary infractions, isolation), time spent in isolation, and types of aggression and victimization experiences during incarceration. RESULTS There was a trend suggesting prisoners with BPD were about twice as likely as those without BPD to report disciplinary incidents/infractions (OR = 1.76 [0.93, 3.32], p = 0.075). Having a BPD diagnosis was unrelated to time in isolation and overall aggression and victimization. However, prisoners with BPD were more likely than those without BPD to perpetrate and be victimized by psychological aggression. Due to high rates of antisocial personality disorder (ASPD) in the sample as a whole (72%), additional analyses compared outcomes across prisoners with no BPD or ASPD diagnosis, BPD diagnosis only, ASPD diagnosis only, and comorbid BPD and ASPD. Prisoners with comorbid BPD and ASPD were no more likely than prisoners with ASPD only to report disciplinary incidents/infractions, but were significantly more likely than those with ASPD only to report perpetrating and being victimized by psychological aggression. CONCLUSIONS Among prisoners with MDD, those with a BPD diagnosis have increased risk of psychological aggression and disciplinary infractions during incarceration.
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Affiliation(s)
- Kelly E. Moore
- Yale University School of Medicine, Department of Psychiatry, 389 Whitney Ave, New Haven, CT 06511,Correspondence concerning this article should be addressed to Kelly E. Moore [Address: 389 Whitney Avenue, New Haven, CT 06511; ; Cell: 203-785-3225]
| | - Robyn L. Gobin
- University of Illinois Urbana-Champaign, Department of Kinesiology and Community Health, 1206 South Fourth Street, Champaign, IL 61820
| | - Heather L. McCauley
- Michigan State University, Department of Human Development & Family Studies, 552 W. Circle Drive, 13E Human Ecology, East Lansing, MI 48824
| | - Chien-Wen Kao
- Columbia University, Department of Counseling and Clinical Psychology, 525 West 120th St., New York, NY 10027
| | - Stephanie M. Anthony
- Michigan State University, College of Human Medicine, Division of Public Health, 200 E. 1st Street, Flint, MI 48502
| | - Sheryl Kubiak
- Michigan State University, School of Social Work and Consortium on Gender-based Violence, 655 Auditorium Rd., East Lansing, MI 48824
| | - Caron Zlotnick
- Brown University Medical School and Butler Hospital, Department of Psychiatry and Human Behavior, 345 Blackstone Boulevard, Providence, RI 02906
| | - Jennifer E. Johnson
- Michigan State University, College of Human Medicine, Division of Public Health, 200 E. 1st Street, Flint, MI 48502
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Dellazizzo L, Dugré JR, Berwald M, Stafford MC, Côté G, Potvin S, Dumais A. Distinct pathological profiles of inmates showcasing cluster B personality traits, mental disorders and substance use regarding violent behaviors. Psychiatry Res 2018; 260:371-378. [PMID: 29247923 DOI: 10.1016/j.psychres.2017.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 12/04/2017] [Accepted: 12/04/2017] [Indexed: 10/18/2022]
Abstract
High rates of violence are found amid offenders with severe mental illnesses (SMI), substance use disorders (SUDs) and Cluster B personality disorders. Elevated rates of comorbidity lead to inconsistencies when it comes to this relationship. Furthermore, overlapping Cluster B personality traits have been associated with violence. Using multiple correspondence analysis and cluster analysis, this study was designed to differentiate profiles of 728 male inmates from penitentiary and psychiatric settings marked by personality traits, SMI and SUDs following different violent patterns. Six significantly differing clusters emerged. Cluster 1, "Sensation seekers", presented recklessness with SUDs and low prevalence's of SMI and auto-aggression. Two clusters committed more sexual offenses. While Cluster 2, "Opportunistic-sexual offenders", had more antisocial lifestyles and SUDs, Cluster 6, "Emotional-sexual offenders", displayed more emotional disturbances with SMI and violence. Clusters 3 and 4, representing "Life-course-persistent offenders", shared early signs of persistent antisocial conduct and severe violence. Cluster 3, "Early-onset violent delinquents", emerged as more severely antisocial with SUDs. Cluster 4, "Early-onset unstable-mentally ill delinquents", were more emotionally driven, with SMI and auto-aggression. Cluster 5, "Late-start offenders", was less severely violent, and emotionally driven with antisocial behavior beginning later. This study suggests the presence of specific psychopathological organizations in violent inmates.
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Affiliation(s)
- Laura Dellazizzo
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Jules R Dugré
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, Canada; School of Criminology, Faculty of Arts and Science, Université de Montréal, Montreal, Canada
| | - Marieke Berwald
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | | | - Gilles Côté
- Department of Psychology, Université du Québec, Trois-Rivières, Canada; Centre de recherche de l'Institut Philippe-Pinel de Montréal, Montreal, Canada
| | - Stéphane Potvin
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Alexandre Dumais
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, Canada; Centre de recherche de l'Institut Philippe-Pinel de Montréal, Montreal, Canada.
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Lowery Wilson M, Tenovuo O, Gissler M, Saarijärvi S. Association between parent mental health and paediatric TBI: epidemiological observations from the 1987 Finnish Birth Cohort. Inj Prev 2018; 25:283-289. [DOI: 10.1136/injuryprev-2017-042624] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/27/2017] [Accepted: 12/29/2017] [Indexed: 11/04/2022]
Abstract
BackgroundThis study examined whether parental mental illness has implications for child risk for traumatic brain injuries (TBI).MethodData on 60 069 Finnish children born in 1987 and their parents were examined for demographic and mental health-related variables in relationship with paediatric TBI. Altogether, 15 variables were derived from the cohort data with ICD-10 F-codes being available for mental health diagnoses for all parents. Bivariate and multivariate analyses were carried out using inpatient and outpatient diagnoses of child TBI.ResultsPaternal disorders due to psychoactive substance use (F10–F19) was associated with an increased inpatient TBI (OR=1.51; CI=1.07 to 2.14). Mood disorders (F30–F39) were associated with higher rates of outpatient TBI (OR=1.42; CI=1.06 to 1.90). Paternal personality and behavioural disorders (F60–F69) were linked with a twofold increase in risk across both categories of child TBI (OR=2.35; CI=1.41 to 3.90) and (OR=2.29; CI=1.45 to 3.61), respectively. Among the maternal mental health factors associated with child TBI, schizophrenia and other non-mood psychotic disorders (F20–F29) were associated with an increase in inpatient traumatic brain injuries (iTBI) (OR=1.78; 1.22 to 2.59). Mothers having mood disorders (F30–F39) were more likely to have had a child who experienced an iTBI (OR=1.64; CI=1.20 to 2.22). Mothers with personality and behavioural disorders (F60–F69) were also found to have had children with an increased risk for iTBI (OR=2.30; CI=1.14 to 3.65).ConclusionTaken together, these data should call attention to methods and strategies designed to augment and support caregiving environments with modalities that can foster mutually supportive households in cooperation with parents who have been diagnosed with a mental disorder.
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Bakolis I, Hammoud R, Smythe M, Gibbons J, Davidson N, Tognin S, Mechelli A. Urban Mind: Using Smartphone Technologies to Investigate the Impact of Nature on Mental Well-Being in Real Time. Bioscience 2018; 68:134-145. [PMID: 29599549 PMCID: PMC5862247 DOI: 10.1093/biosci/bix149] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Existing evidence on the beneficial effects of nature on mental health comes from studies using cross-sectional designs. We developed a smartphone-based tool (Urban Mind; www.urbanmind.info) to examine how exposure to natural features within the built environment affects mental well-being in real time. The tool was used to monitor 108 individuals who completed 3013 assessments over a 1-week period. Significant immediate and lagged associations with mental well-being were found for several natural features. These associations were stronger in people with higher trait impulsivity, a psychological measure of one's tendency to behave with little forethought or consideration of the consequences, which is indicative of a higher risk of developing mental-health issues. Our investigation suggests that the benefits of nature on mental well-being are time-lasting and interact with an individual's vulnerability to mental illness. These findings have potential implications from the perspectives of global mental health as well as urban planning and design.
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Affiliation(s)
- Ioannis Bakolis
- Lecturer, PhD student at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, United Kingdom
| | - Ryan Hammoud
- PhD student at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, United Kingdom
| | - Michael Smythe
- Artist and action-based researcher at Nomad Projects (https://nomadprojects.org) in London, United Kingdom
| | - Johanna Gibbons
- Landscape architects at J & L Gibbons (http://jlg-london.com) in London, United Kingdom
| | - Neil Davidson
- Landscape architects at J & L Gibbons (http://jlg-london.com) in London, United Kingdom
| | - Stefania Tognin
- Lecturer, PhD student at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, United Kingdom
| | - Andrea Mechelli
- Reader, PhD student at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, United Kingdom
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Fossati A, Somma A. Improving Family Functioning to (Hopefully) Improve Treatment Efficacy of Borderline Personality Disorder: An Opportunity Not to Dismiss. Psychopathology 2018; 51:149-159. [PMID: 29486480 DOI: 10.1159/000486603] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 12/26/2017] [Indexed: 11/19/2022]
Abstract
People having intimate relationships with persons suffering from borderline personality disorder (BPD) - for instance, members of their family - are likely to be involved in stormy, roller coaster relationships. Thus, they may feel overwhelmed by extreme, unpredictable feelings and situations, even when they do not suffer from any mental disorder or have no problems with mentalization. As a consequence of living with a BPD relative, family members often experience an emotional and financial burden, and may blame themselves for their relative's illness or for not being able to do more to help. This can lead to emotional pain including anxiety, guilt, anger, frustration, despair, and hopelessness. Available evidence suggests a possible usefulness of family interventions for relatives of BPD persons. Starting from these background considerations, a qualitative review of the published literature on family interventions for relatives of BPD persons was carried out. The main findings concerning specific contents and available effectiveness data of psychoeducational family interventions, family skills training, and mentalization-based family programs are reported, in the perspective of 3 family intervention scenarios: (a) taking care of the family of origin of the BPD person; (b) taking care of the new family that the BPD person has started; (c) helping the BPD person to be an effective parent.
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Affiliation(s)
- Andrea Fossati
- Vita-Salute San Raffaele University, Milan, Italy.,San Raffaele Turro Hospital, Milan, Italy
| | - Antonella Somma
- Vita-Salute San Raffaele University, Milan, Italy.,San Raffaele Turro Hospital, Milan, Italy
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Moore KE, Tull MT, Gratz KL. Borderline personality disorder symptoms and criminal justice system involvement: The roles of emotion-driven difficulties controlling impulsive behaviors and physical Aggression. Compr Psychiatry 2017; 76:26-35. [PMID: 28402839 DOI: 10.1016/j.comppsych.2017.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 03/10/2017] [Accepted: 03/10/2017] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE Borderline personality disorder (BPD) is associated with elevated risk for a variety of risky behaviors, including criminal behaviors. Yet, limited research has examined the relation of BPD to criminal justice (CJ) involvement, or the mechanisms underlying this relation. PROCEDURES This study examined the role of two mechanisms, emotion-driven difficulties controlling impulsive behaviors and physical aggression, in the relation between BPD symptom severity and CJ involvement among 118 patients in residential substance abuse treatment (76% male; 62% African-American). Participants completed measures of BPD symptom severity, CJ contact, diversity of CJ charges, emotion-driven impulse control difficulties, physical aggression, and covariates (substance use severity and antisocial personality disorder symptoms). RESULTS BPD symptom severity was associated with CJ contact through emotion-driven difficulties controlling impulsive behaviors, and with diversity of CJ charges through emotion-driven difficulties controlling impulsive behaviors and physical aggression; however, the indirect relations to diversity of CJ charges became non-significant when covariates were included. CONCLUSIONS Results highlight the important role of emotion-driven difficulties controlling impulsive behaviors in criminal behaviors among individuals with BPD symptoms, as well as the potential clinical utility of targeting this mechanism to prevent CJ involvement and/or recidivism.
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Affiliation(s)
- Kelly E Moore
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, United States.
| | - Matthew T Tull
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, United States
| | - Kim L Gratz
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, United States
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Robitaille MP, Checknita D, Vitaro F, Tremblay RE, Paris J, Hodgins S. A prospective, longitudinal, study of men with borderline personality disorder with and without comorbid antisocial personality disorder. Borderline Personal Disord Emot Dysregul 2017; 4:25. [PMID: 29225887 PMCID: PMC5719590 DOI: 10.1186/s40479-017-0076-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/22/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Some evidence suggests that the prevalence of Borderline Personality Disorder (BPD) is elevated among male criminal offenders. It is not presently known whether offending, and violent offending, are limited to those presenting comorbid Antisocial Personality Disorder (ASPD) who have a childhood history of conduct problems and whether offending is linked to psychopathic traits. METHODS A community sample of 311 males followed from age 6 to 33 years, one third of whom had a criminal charge between ages 18 and 24, completed diagnostic interviews and the Psychopathy Checklist-Revised interview. Information on childhood included parent-reported family characteristics and teacher-rated of hurtful and uncaring behaviours, conduct problems, hyperactivity and inattention, and anxiety at age 6, 10, and 12 years. Health files were obtained as were records of criminal convictions from age 12 to 33. RESULTS At age 33, 4% of the men presented BPD and not ASPD, 16% ASPD and not BPD, 8% BPD + ASPD, and 72% neither disorder (ND). Comorbid disorders were common: BPD were distinguished by high levels of anxiety disorders, BPD and BPD + ASPD by depression disorders, and BPD, BPD + ASPD, and ASPD by substance dependence. Official files indicated use of health services by all participants. One-third of participants with BPD and BPD + ASPD acquired a diagnosis of a personality disorder. More than one-third of participants with BPD + ASPD obtained scores indicative of the syndrome of psychopathy. Convictions for violent crimes varied across groups: In adolescence, BPD none, BPD + ASPD 16%, ASPD 16%, and ND 3.6%; from age 18 to 33, BPD 18%, ASPD 19%, BPD + ASPD 52%, and ND 4.4%. Offenders with BPD + ASPD were convicted, on average, for four times more violent crimes than offenders with ASPD and seven times more than ND offenders. In childhood, men with BPD + ASPD and with ASPD had obtained similarly elevated ratings for disruptive behaviours as compared to ND. CONCLUSION BPD comorbid with ASPD was associated with violent criminal offending in adolescence and most strongly in adulthood, elevated levels of psychopathic traits, and childhood disruptive behaviour. BPD showed similar characteristics but to a much less degree.
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Affiliation(s)
- Marie-Pier Robitaille
- Research Unit on Children's Psychosocial Maladjustment, Université de Montréal, Montréal, Québec H1N 3M5 Canada.,Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Canada.,Departement de psychiatrie, Université de Montréal, Montreal, Canada
| | - Dave Checknita
- Center for Clinical Research, Uppsala University, Västmanland County Council, Uppsala, Sweden
| | - Frank Vitaro
- Research Unit on Children's Psychosocial Maladjustment, Université de Montréal, Montréal, Québec H1N 3M5 Canada.,École de psychoéducation, Université de Montréal, Montréal, Canada
| | - Richard E Tremblay
- Research Unit on Children's Psychosocial Maladjustment, Université de Montréal, Montréal, Québec H1N 3M5 Canada.,Département de pédiatrie, Université de Montréal, Montréal, Canada.,School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Joel Paris
- Department of Psychiatry, McGill University, Montréal, Canada.,Institute of Community and Family Psychiatry, McGill University, Montréal, Canada
| | - Sheilagh Hodgins
- Research Unit on Children's Psychosocial Maladjustment, Université de Montréal, Montréal, Québec H1N 3M5 Canada.,Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Canada.,Departement de psychiatrie, Université de Montréal, Montreal, Canada
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50
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Webermann AR, Brand BL. Mental illness and violent behavior: the role of dissociation. Borderline Personal Disord Emot Dysregul 2017; 4:2. [PMID: 28138388 PMCID: PMC5260135 DOI: 10.1186/s40479-017-0053-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 01/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The role of mental illness in violent crime is elusive, and there are harmful stereotypes that mentally ill people are frequently violent criminals. Studies find greater psychopathology among violent offenders, especially convicted homicide offenders, and higher rates of violence perpetration and victimization among those with mental illness. Emotion dysregulation may be one way in which mental illness contributes to violent and/or criminal behavior. Although there are many stereotyped portrayals of individuals with dissociative disorders (DDs) being violent, the link between DDs and crime is rarely researched. METHODS We reviewed the extant literature on DDs and violence and found it is limited to case study reviews. The present study addresses this gap through assessing 6-month criminal justice involvement among 173 individuals with DDs currently in treatment. We investigated whether their criminal behavior is predicted by patient self-reported dissociative, posttraumatic stress disorder and emotion dysregulation symptoms, as well as clinician-reprted depressive disorders and substance use disorder. RESULTS Past 6 month criminal justice involvement was notably low: 13% of the patients reported general police contact and 5% reported involvement in a court case, although either of these could have involved the DD individual as a witness, victim or criminal. Only 3.6% were recent criminal witnesses, 3% reported having been charged with an offense, 1.8% were fined, and 0.6% were incarcerated in the past 6 months. No convictions or probations in the prior 6 months were reported. None of the symptoms reliably predicted recent criminal behavior. CONCLUSIONS In a representative sample of individuals with DDs, recent criminal justice involvement was low, and symptomatology did not predict criminality. We discuss the implications of these findings and future directions for research.
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Affiliation(s)
- Aliya R Webermann
- University of Maryland Baltimore County, 1000 Hilltop Circle, Math/Psychology Building Rm. 312, Baltimore County, Baltimore, MD 21250 USA
| | - Bethany L Brand
- Department of Psychology, Towson University, Towson, 21252 MD USA
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