ABSTRACT
Personality disorders (PDs) are ingrained dysfunctional patterns of cognition, emotion, and behavior. PDs, especially Cluster B PDs, are related to an increased violence risk and are highly prevalent in offender populations. Patients with PDs may suffer from dysregulated affect in a sense that they experience many maladaptive emotional states and relatively few healthy emotional states. It was therefore hypothesized that violence risk can be predicted by emotional states. It was expected that a decrease in maladaptive emotional states or an increase in healthy emotional states would precede a decrease in violence risk.
The study sample consisted of 103 male offenders with a Cluster B PD, hospitalized in the Netherlands. We used the Schema Mode Inventory-Revised (SMI-R) to assess healthy and maladaptive emotional states and the Short-Term Assessment of Risk and Treatability (START) to assess short-term violence risk and to monitor changes thereof. Assessments were repeated after 6 months, 12 months, and 18 months.
We conducted hierarchical regression analyses with START Risks or Strengths as outcome variables, predicted by START scores, SMI healthy, and maladaptive total scores at an earlier time point and the change over time. Results show that all models were highly significant, but neither the healthy and maladaptive emotional states nor the change over time was a significant predictor. The exception was at 6 and 12 months of START Strengths, where an SMI healthy score was a significant predictor in the model. Our hypothesis was only partially supported, which is likely explained by limitations of the study.
Acknowledgements
We kindly thank all participating subjects for their time and effort spent on this study and the directors of all participating hospitals for their support, time, and resources.
Disclosure statement
The authors have no interests to declare.