Hodgins S, Côté G
Centre de Recherche Philippe Pinel, Université de Montréal, Québec.
Bull Am Acad Psychiatry Law. 1993;21(2):155-60.
Much evidence now suggests that patients with major mental disorders are at increased risk for crimes and violence. Leading experts in forensic psychiatry have proposed that the illegal behaviors are a consequence of these major disorders. Yet, longitudinal studies have consistently indicated that adult criminality is preceded by a childhood history of antisocial behavior. We hypothesized that among offenders with major mental disorders there are two groups: (1) the first group has a secondary diagnosis of antisocial personality disorder (APD), and a childhood history of antisocial and criminal behavior preceding the onset of the major disorder; (2) the second group do not meet the criteria for APD, and behave criminally only as adults. This hypothesis was tested on a representative sample of penitentiary inmates with major mental disorders. It was found that those with APD had a significant childhood history of criminal activity and antisocial behavior, endorsing, on average, eight of ten possible indices. In comparison, the mentally disordered inmates without APD endorsed on average two indices. The mentally disordered offenders with APD began their criminal careers earlier, and had significantly more convictions and more convictions for nonviolent offenses than those without APD. APD was not associated with violence among men with major mental disorders.
现在有大量证据表明，患有严重精神障碍的患者实施犯罪和暴力行为的风险更高。法医精神病学领域的顶尖专家提出，这些非法行为是这些严重精神障碍的结果。然而，纵向研究一直表明，成年犯罪行为之前往往有童年期的反社会行为史。我们假设，在患有严重精神障碍的罪犯中存在两类人群：（1）第一类人群有反社会人格障碍（APD）的二级诊断，且在严重精神障碍发作之前有童年期的反社会和犯罪行为史；（2）第二类人群不符合反社会人格障碍的标准，仅在成年后实施犯罪行为。这一假设在患有严重精神障碍的监狱囚犯代表性样本中进行了检验。结果发现，患有反社会人格障碍的人有显著的童年期犯罪活动和反社会行为史，平均认可十个可能指标中的八个。相比之下，没有反社会人格障碍的精神障碍囚犯平均认可两个指标。患有反社会人格障碍的精神障碍罪犯开始其犯罪生涯的时间更早，与没有反社会人格障碍的罪犯相比，他们有更多的定罪记录，且非暴力犯罪的定罪记录显著更多。在患有严重精神障碍的男性中，反社会人格障碍与暴力行为无关。
