DSM‐III diagnosis in criminal psychopaths: a way forward

Abstract

Research diagnostic instruments were administered to 243 subjects, consisting of three subsamples. These included men detained under the English legal category of psychopathic disorder from one special hospital, female ‘psychopaths’ from three special hospitals, and male prisoners from three special units developed in prisons for the containment and control of highly dangerous and disruptive inmates. Using the DSM‐III classification, subjects were found to have multiple Axis‐II personality disorder categories and multiple Axis‐I clinical syndromes over their lifetime. Borderline and antisocial personality disorder were the most prevalent diagnoses, often in combination. The remaining subjects comprised subgroups with schizoid personality disorder and ‘pseudopsychopaths’, who were later recognised as suffering from slowly developing chronic schizophrenia or organic psychoses. Problems of treatability of these subjects relate to the ‘severity’ of their personality disorder. This in turn is reflected in the multiple Axis‐II diagnoses which are required to encompass the sheer range of their psychopathology. Multiple recurring Axis‐I conditions, which are amenable to conventional psychiatric treatment, indicate a need for specialist medical services for these patients, irrespective of arguments over the treatability of their Axis‐II conditions.

Antisocial personality disorder: new directions

“…Several studies have shown higher levels of insecure attachment in violent offenders than in the normal population (van IJzendoorn 1997;Frodi 2001;Adshead 2004;Levinson 2004;Bogaerts 2005). This evidence is supported by studies which show that offenders in prison or secure forensic institutions are more likely to report having experienced separations, abuse and neglect from their early caregivers than the general population (Coid 1992;Heads 1997;Weeks 1998).…”

Forensic mental health services as a risk escalator: A case study of ideals and practice

“…Although the present paper has adopted a resolutely organisational approach, the resonances between the withholding of progress and patients' personal biographies, which often include abuse (Coid, 1992) as well as offending, should not be overlooked. Patients whose ability to form and sustain attachments has been disrupted by traumatic childhood experiences are expected to manage separation from external personal support networks, if any, frequent terminations of relationships with patient peers and staff.…”

Antecedents for aggression and the function analytic approach to the assessment of aggression and violence in personality disordered patients within secure settings

“…Cluster B personality disorders linked to offending have also been noted in the general population (Coid et al, 2006). Further, in a sample of male and female violent offenders in the UK, Coid (1992) found personality disorders to be common, with offenders being rated as having on average over three Axis II diagnoses each. Borderline (69%) and antisocial (53%) diagnoses were the most common co-morbid diagnoses, a combination that has previously been identifi ed in female inmates of a high-security prison (Warren et al, 2002).…”