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Facets of psychopathy among mentally disordered offenders: Clinical comorbidity patterns and prediction of violent and criminal behavior

Journal article
Authors Märta Wallinius
Thomas Nilsson
Björn Hofvander
Henrik Anckarsäter
G. Stalenheim
Published in Psychiatry Research
Volume 198
Issue 2
Pages 279-284
ISSN 0165-1781
Publication year 2012
Published at Institute of Neuroscience and Physiology
Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Centre for Ethics, Law, and Mental Health
Pages 279-284
Language en
Keywords Psychopathic personality, Antisocial personality disorder, Forensic psychiatry, Violence, Risk, forensic psychiatric population, substance use disorders, personality-disorders, axis-i, pcl-r, antisocial-behavior, conduct, disorder, validity, traits, recidivism
Subject categories Clinical Medicine


The complexity and consequences of psychopathy are still debated, and its relation to other mental disorders, pathological personality traits, and criminality needs to be further investigated by clinical, longitudinal studies using structured diagnostic instruments. The present study used two groups of mentally disordered offenders (N=153) investigated with in-depth clinical assessments and prospective long-term follow-up to identify the convergence between 1) the four facets of psychopathy defined by the Psychopathy Checklist-Revised (PCL-R; Interpersonal, Affective, Lifestyle, and Antisocial), 2) mental disorders according to SOD I and II interviews. 3) personality traits as measured by the Karolinska Scales of Personality, and 4) criminal recidivism. The Interpersonal facet differed substantially from the other three facets by not being significantly associated with substance use disorders, antisocial personality disorder (the other facets at P <= 0.001 level), or personality traits involving impulsive and aggressive antisocial behaviors (the other facets at P<0.01 level). Furthermore, the interpersonal facet could not predict violent recidivism better than random. The Antisocial facet outperformed not only the other facets but also the total PCL-R score in the prediction of violent recidivism, P<0.001. The findings confirm psychopathy as a heterogeneous phenomenon and have clinical implications for assessments of psychopathy and violence risk assessments in clinical and forensic contexts. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

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