Characteristics and offences of women with borderline personality disorder in forensic psychiatry: a multicentre study

ABSTRACT

Although female forensic patients diagnosed with borderline personality disorder (BPD) are generally considered taxing in clinical practice, little is known about their specific characteristics or offences. In this study, 156 female forensic psychiatric patients diagnosed with BPD were compared to 113 diagnosed otherwise. Information on demographic and psychiatric characteristics, victimization, index offences, and incidents during treatment was gathered from patient files. Risk factors for recidivism were assessed using the PCL-R and historical items of the HCR-20, including items from the new Female Additional Manual (FAM). Compared to non-BPD women, BPD women were more likely to have been abused as children and to have a history of outpatient treatment. While less likely to be convicted for (attempted) homicide, a higher percentage of BPD women was convicted for arson. Comorbid substance abuse was more frequent in the BPD group and incidents towards others and themselves were more violent in nature. The PCL-R and the H-scale of the HCR-20/FAM indicated several risk factors especially important for BPD women, such as poor behavioural control, impulsivity, and irresponsibility. The results support the clinical impression that women diagnosed with BPD are a subgroup within the female forensic psychiatric population, with specific focus points for treatment and management.

KEYWORDS:

• Female offenders
• borderline personality disorder
• forensic psychiatry
• patient management
• risk factors

Acknowledgement

The authors thank Gerjonne Akkerman-Bouwsema, Anouk Bohle, Yvonne Bouman, Nienke Epskamp, Susanne de Haas, Loes Hagenauw, Paul ter Horst, Stéphanie Klein Tuente, Jeantine Stam, Eva de Spa, Nienke Verstegen and all other colleagues from FPC Oldenkotte, FPC Woenselse Poort, FPK Assen and the Van der Hoeven Kliniek who contributed to this study.

Disclosure statement

The authors declare that they have no relevant or material financial interests that relate to the research described in this paper.