Dolan Mairead, Völlm Birgit
Monash University, Australia.
Int J Law Psychiatry. 2009 Jan-Feb;32(1):2-9. doi: 10.1016/j.ijlp.2008.11.002. Epub 2008 Nov 29.
Crime rates are low in women compared to men. The two disorders most commonly associated with offending behaviour, antisocial personality disorder (ASPD) and psychopathy, are also less prevalent in female samples. However, developments in forensic psychiatry have often ignored gender, and the utility of constructs such as psychopathy and their assessment instruments in female samples remains unclear. This article presents a review of studies looking at rates of ASPD and psychopathy and on the reliability and validity of assessment instruments of these disorders in women. Gender differences in symptom patterns will be considered. The literature seems to suggest that DSM-IV criteria for ASPD may lead to an underestimation of the prevalence of the disorder in women due to the requirement of childhood conduct disorder symptoms. The Psychopathy Checklist-Revised (PCL-R) is a valid and reliable instrument to identify psychopathy in women but there are gender differences in the factor structure and item loadings on this measure. Research to date seems to suggest a three-factor model may be most strongly supported in females. Preliminary evidence suggests the PCL-R may have some value in predicting future offending while the PCL:SV may be useful in predicting institutional violence. Clinical implications are discussed.
与男性相比，女性的犯罪率较低。与犯罪行为最常相关的两种障碍，即反社会人格障碍（ASPD）和精神病态，在女性样本中的患病率也较低。然而，法医精神病学的发展往往忽视了性别，精神病态等概念及其评估工具在女性样本中的效用仍不明确。本文对研究反社会人格障碍和精神病态的发生率以及这些障碍在女性中的评估工具的信效度的研究进行了综述。将考虑症状模式中的性别差异。文献似乎表明，由于需要童年品行障碍症状，美国精神疾病诊断与统计手册第四版（DSM-IV）中反社会人格障碍的标准可能导致对女性中该障碍患病率的低估。修订版精神病态量表（PCL-R）是识别女性精神病态的有效且可靠的工具，但在该量表的因子结构和项目负荷上存在性别差异。迄今为止的研究似乎表明，三因素模型在女性中可能得到最有力的支持。初步证据表明，PCL-R在预测未来犯罪方面可能有一定价值，而PCL:SV在预测机构暴力方面可能有用。文中还讨论了临床意义。
