Hiscoke Ulrika L, Långström Niklas, Ottosson Hans, Grann Martin
Centre for Violence Prevention, Karolinska Institute, Stockholm, Sweden.
J Pers Disord. 2003 Aug;17(4):293-305. doi: 10.1521/pedi.17.4.293.23966.
Assessment and management of criminal offenders require valid methods to recognize personality psychopathology and other risk and protective factors for recidivism. We prospectively explored the association between dimensional and categorical measures of personality disorder (PD) measured with the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q, Ottosson et al., 1995) and registered reconvictions in adult offenders. One hundred and sixty-eight offenders consecutively referred for pre-sentencing forensic psychiatric evaluation in Sweden during 1995-1996 completed DIP-Q self-reports. The subjects received different types of sanctions and were followed for an average of 36 months after release from prison, discharge from a forensic psychiatric hospital, or onset of nondetaining sentences. Age-adjusted odds ratios revealed a 4.8 times higher risk for any recidivism and a 3.7 times higher risk for violent recidivism among subjects whose self-reports suggested a categorical diagnosis of antisocial PD as compared to offenders without antisocial PD. The remaining nine categorical DSM-IV PD diagnoses were not significantly related to recidivism. In dimensional analyses, each additional antisocial and schizoid PD symptom endorsed by participants at baseline increased the risk for violent reoffending. Our results suggest a relationship between self-reported behavioral instability and interpersonal dysfunction captured primarily by DSM-IV antisocial and schizoid PD constructs, and criminal re-offending also in a multi-problem sample of identified offenders.
对刑事罪犯的评估和管理需要有效的方法来识别个性精神病理学以及其他再犯的风险和保护因素。我们前瞻性地探讨了用《精神疾病诊断与统计手册》第四版(DSM-IV)和《国际疾病分类》第十版个性问卷(DIP-Q,奥托松等人,1995年)所测量的个性障碍(PD)的维度和分类测量与成年罪犯登记再定罪之间的关联。1995年至1996年期间,在瑞典连续被转介进行量刑前法医精神病学评估的168名罪犯完成了DIP-Q自我报告。这些受试者受到了不同类型的制裁,并在从监狱获释、从法医精神病医院出院或非拘留刑期开始后平均随访36个月。年龄调整后的优势比显示,自我报告表明患有反社会PD分类诊断的受试者再次犯罪的风险比没有反社会PD的罪犯高4.8倍,暴力再犯的风险高3.7倍。其余九种《精神疾病诊断与统计手册》第四版PD分类诊断与再犯没有显著关联。在维度分析中,参与者在基线时认可的每一个额外的反社会和分裂样PD症状都会增加暴力再犯的风险。我们的结果表明,自我报告行为不稳定和人际功能障碍之间存在关联,这主要由《精神疾病诊断与统计手册》第四版反社会和分裂样PD结构所体现,并且在已识别罪犯的多问题样本中也存在犯罪再犯情况。