The role of psychopathic personality traits in current psychological and physiological subclinical stress levels of forensic inpatients: a path analysis

Abstract

Stress levels in forensic patient samples are extraordinarily high and pose a threat to successful treatment outcome. The perception of and response toward stress is known to be strongly influenced by psychopathic traits, which in turn are prevalent among forensic patients. We examined current psychological and physiological stress symptoms and hypothesized that the psychopathy factors Fearless Dominance (FD) and Self-centered Impulsivity (ScI) should be related to separate trajectories of stress response. Our study was conducted on 126 forensic inpatients in mandatory drug treatment. Psychopathy and stress symptoms were assessed with self-report measures—the Psychopathy Personality Inventory (PPI-R) and the Subclinical Stress Questionnaire (SSQ-25). Overall, inpatients experienced a higher level of stress than general population samples. Path analyses revealed that ScI serves as a positive and FD as a negative predictor for psychological stress. Contrarily, physiological stress was not directly predicted by psychopathy, but by psychological stress. In line with extant research, FD generally serves as a resiliency factor mediating against the adverse effects of stress on mental and physical health, while ScI constitutes a risk factor for stress symptoms. These findings are important for risk assessment and the development of more specifically targeted forensic treatment programs.

Keywords:

• Psychopathy
• fearless dominance
• self-centered impulsivity
• stress symptoms
• forensic inpatients

Acknowledgments

We gratefully thank Verena Klein, head of the Department of Forensic Psychiatry, Isar-Amper-District Hospital Taufkirchen (Vils), and Detlef Schläfke, head of the Department of Forensic Psychiatry, University Hospital Rostock, for allowing and assisting the data collection at their clinics.