Personality disorder and violence in the national household population of Britain

Abstract

Background: Antisocial personality disorder (ASPD) is strongly associated with violence but the effects of other personality disorder (PD) categories are uncertain. Purpose: To investigate associations between 10 DSM-IV PD categories and effects of co-occurring disorders on self-reported violence. Method: Cross-sectional survey of 8397 adults aged 16–74 years in households in Great Britain. Results: ASPD contributed strongly to the burden of violence in the British population. Paranoid and obsessive–compulsive PD made additional independent contributions, and narcissistic PD contributed to intimate partner violence. The prevalence of violence correlated with the number of PD categories. Comorbid alcohol dependence further increased the risk. Conclusions: Risk of violence increases with increasing severity of PD, measured by the number of PD categories, and with co-occurring alcohol dependence. Not all PD categories are associated with violence, and avoidant PD was protective. Identification of targets for future interventions may be obscured using a classification based solely on severity.

Keywords:

• Violence
• risk
• population
• personality disorder

Ethical standards

The present study has been approved by the appropriate ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.