The prevalence of personality disorders in Portuguese male prison inmates: Implications for penitentiary treatment

Nélio Brazão, Carolina da Motta, Daniel Rijo, José Pinto-Gouveia

Abstract


Prison inmates are known to be a population with a high prevalence of mental disorders. Most of these disorders are chronic and difficult to treat, particularly in what concerns Cluster B Personality Disorders, which prevalence in forensic samples  are even higher than in the general population. This study assesses the prevalence of Personality Disorders in a sample of 294 Portuguese male prison inmates, interviewed with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). The results showed a global prevalence rate of 79.9%, with 42.8% of the participants diagnosed with Antisocial Personality Disorder as the main diagnosis. Paranoid, Passive-Aggressive, Borderline, and Narcissistic Personality Disorders were the most common comorbid diagnosis associated with Antisocial Personality Disorder. These results strongly suggest that Personality Disorders should be taken into account when deciding and planning the intervention inside prison.


Keywords


Prevalence; Personality Disorders; Male Prison Inmates; Penitentiary Treatment.

References


American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (DSM-IV). Washington, DC: American Psychiatric Association.

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Washington, DC: American Psychiatric Association.

Bernstein, D., Arntz, A., & Vos, M. (2007). Schema focused therapy in forensic settings: Theoretical model and recommendations for best clinical practice. International Journal of Forensic Mental Health, 6, 169-183. doi: 10.1080/14999013.2007.104712 61

Birmingham, L., Mason, D., & Grubin, D. (1996). Prevalence of mental disorder in remand prisoners: Consecutive case study. British Medical Journal, 313, 1521-1524. doi: 10.1136/bmj.313.7071.1521

Black, D. W., Gunter, T., Allen, J., Blum, N., Arndt, S., Wenman, G., & Sieleni, B. (2007). Borderline personality disorder in male and female offenders newly committed to prison. Comprehensive Psychiatry, 48, 400-405. doi: 10.1016/j.comppsych.2007.04.0 06

Brooke, D., Taylor, C., Gunn, J., & Maden, A. (1996). Point prevalence of mental disorder in unconvicted male prisoners in England and Wales. British Medical Journal, 313, 1524-1527. Retrieved from http://europepmc.org/backend/ptpmcrender.fcgi?ac cid=PMC2353052&blobtype=pdf

Coid, J. W. (2002). Personality disorders in prisoners and their motivation for dangerous and disruptive behaviour. Criminal Behavior and Mental Health, 12, 209–226. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/cbm.497/pdf

Coid, J., Kahtan N., Gault S., & Jarman, S. (1999). Patients with personality disorder admitted to secure forensic psychiatry services. British Journal of Psychiatry, 175, 528-36. doi: 10.1192/bjp.175.6.528

de Ruiter, C. D. & Trestman, R. L. (2006). Prevalence and treatment of personality disorders in Dutch forensic mental health services. Journal of the American Academy of Psychiatry and the Law, 35, 92-97. Retrieved from http://www.jaapl.org/content/35/1 /92.full.pdf+html

Duggan, C. & Howard, R. (2009). The 'functional link' between personality disorder and violence: A critical appraisal. In M. McMurran & R. Howard (Eds.), Personality, personality disorder, and violence: An evidence based approach (pp. 19-37). New York: Wiley-Blackweel.

Farrell, J. M., Shaw, I. A., & Webber, M. A. (2009). A schema-focused approach to group psychotherapy for outpatients with borderline personality disorder: A randomized clinical trial. Journal of Behavior Therapy and Experimental Psychiatry, 40, 317-328. doi: 10.1016/j.jbtep.2009.01.002

Fazel, S. & Danesh, J. (2002). Serious mental disorder in 23000 prisoners: A systematic review of 62 surveys. Lancet, 359, 545–550. doi:10.1016/S0140-6736(02)07740-1

First, M. B.., Gibbon M., Spitzer R. L. , Williams, J. B. W., & Benjamin, L. S. (1997). Structured Clinical Interview for DSM-IV Axis II Personality Disorders, (SCID-II). Washington, D.C.: American Psychiatric Press, Inc. [Portuguese version by Pinto Gouveia, J., Matos, A.P., Rijo, D., Castilho, P., & Salvador, M. C., 1999].

Gandhi, N., Tyrer, P., Evans, K., McGee, A., Lamont, A., & Harrison-Read, P. (2001). A randomized controlled trial of community-oriented and hospital-oriented care of discharged psychiatric patients. Influence of personality disorder on police contacts. Journal of Personality Disorders, 15, 94-102. doi: 10.1521/pedi.15.1.94.18644

Gilbert, F. & Daffern, M. (2011). Illuminating the relationship between personality disorder and violence: Contributions of the General Aggression Model. Psychology of Violence, 1, 230–244. doi:10.1037/a0024089

Grella, C. E., Greenwell, L., Prendergast, M., Sacks, S., & Melnick, G. (2008). Diagnostic profiles of offenders in substance abuse treatment programs. Behavioral Sciences & the Law, 26, 369-388. doi: 10.1002/bsl.825

Hiscoke, U. L., Långström, N., Ottosson, H., & Grann, M. (2003). Self-reported personality traits and disorders (DSM-IV) and risk of criminal recidivism: A prospective study. Journal of Personality Disorders, 17, 293–305. doi: 10.1521/pedi.17.4.293.23966

Johnson, J., Cohen, P., Smailes, E., Kasen, S., Oldham, J., Skodol, A., & Brook, J. (2000). Adolescent personality disorders associated with violence and criminal behaviour during adolescence and early adulthood. American Journal of Psychiatry, 157, 1406-12. doi:10.1176/appi.ajp.157.9.1406

Kjelsberg, E., Harting, P., Bowitz, H., Kuisma, I., Norbech., Rustad, A., … Vik, T. (2006). Mental health consultations in a prison population: A descriptive study. BMC Psychiatry, 6(27), 1-9. doi: 10.1186/1471-244X-6-27

Kropp, P. R., Hart, S. D., Webster, C. D., & Eaves, D. (1995). Manual for the spousal assault risk assessment guide. Vancouver, BC, Canada: The British Columbia Institute on Family Violence.

Nadort, M., Arntz, A., Smit, J. H., Giesen-Bloo, J., Eikelenboom, M., Spinhoven, P., ... & van Dyck, R. (2009). Implementation of outpatient schema therapy for borderline personality disorder with versus without crisis support by the therapist outside office hours: A randomized trial. Behavior Research and Therapy, 47, 961–973. doi: 10.1016/j.brat.2009.07.013

Penner, E., Roesch, R., & Viljoen, J. (2011). Young offenders in custody: An international comparison of mental health services. International Journal of Forensic Mental Health, 10, 215-232. doi: 10.1080/14999013.2011.598427

Rijo, D., Sousa, M. N., Lopes, J., Pereira, J., Vasconcelos, J., Mendonça, M. C., … Massa, S. (2007). Gerar Percursos Sociais: Programa de prevenção e reabilitação para jovens com comportamento social desviante [Growing Pro-Social: Prevention and rehabilitation program for youths with deviant social behavior]. Ponta Delgada: EQUAL.

Roberts, A. & Coid, J. (2010). Personality disorder and offending behaviour: Findings from the national survey of male prisoners in England and Wales. Journal of Forensic Psychiatry & Psychology, 21, 221-237. doi: 10.1080/14789940903303811

Rotter, M., Way, B., Steinbacher, M., Sawyer, D., & Smith, H. (2002). Personality disorders in prison: Aren't they all antisocial? Psychiatric Quarterly, 73, 337-349. Retrieved from http://link.springer.com/article/10.1023%2FA%3A1020468117930

Sansone, R. A. & Sansone, L. A. (2009). Borderline personality and criminality. Psychiatry, 6(10), 16-20. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC27903 97/

Schroeder, M., Iffland, J. S., Hill, A., Berner. W., & Briken, P. (2013). Personality disorders in men with sexual and violent criminal offenses histories. Journal of Personality Disorders, 27, 519-530. doi 10.1521/pedi_2012_26_050

Short, V., Lennox, C., Stevenson, C., Senior, J., & Shaw, J. (2012). Mental illness, personality disorder and violence: A scoping review. Manchester: Offender Health Research Network.

Steadman, A. J., Osher, F. C., Clark-Robbins, P., Case, B., & Samuels, S. (2009). Prevalence of serious mental illness among jail inmates. Psychiatric Services, 60, 761-765. doi: 10.1176/ps.2009.60.6.761

Tardiff, K. (2001). Axis II disorders and dangerousness. In G. F. Pinard & L. Paganini (Eds.), Clinical assessment of dangerousness: Emprical contributions (pp. 103-120). New York: Cambridge University Press.

Teplin, L. (1994). Psychiatric and substance abuse disorders among male urban jail detainees. American Journal of Public Health, 84, 290-293. doi: 10.2105/AJPH.84.2.290

Thornton, A. J. V., Graham-Kevan, N., & Archer, J. (2010). Adaptive and maladaptive personality traits as predictors of violent and nonviolent offending behavior in men and women. Aggressive Behavior, 36, 177-186. doi: 10.1002/ab.20340

van Asselt, A.D., Dirksen, C.D, Arntz, A., Giesen-Bloo, J.H., van Dijk, R., Spinhoven, P., ... Severens, J.L. (2008). Outpatient psychotherapy for borderline personality disorder: Cost-effectiveness of schema-focused therapy versus transference-focused therapy. British Journal of Psychiatry, 192, 450-457. doi: 10.1192/bjp.bp.106.033597

Warren, J. I., Burnette, M., South, S. C., Chauhan, P., Bale, R., & Friend, R. (2002). Personality disorders and violence among female prison inmates. The Journal of the American Academy of Psychiatry and the Law, 30, 502–509. Retrieved from http://www.jaapl.org/content/30/4/502.full.pdf

Warren, J. I. & South, S. C. (2009). A symptom level examination of the relationship between cluster B personality disorders and patterns of criminality and violence in women. International Journal of Law and Psychiatry, 32, 10–17. doi: 10.1016/j.ijlp.2008.11.0 05

Watzke, S., Ulrich, S., & Marneros, A. (2006). Gender -and violence- related prevalence of mental disorders in prisoners. European Archives of Psychiatry and Neurosciences, 256, 414-421. doi: 10.1007/s00406-006-0656-4

Webster, C. D., Douglas, K. S., Eaves, D., & Hart, S. D. (1997). HCR-20. Assessing risk for violence. Version 2. Vancouver, BC, Canada: Simon Fraser University, Mental Health, Law and Police Institute.

Wolf., N. (2006). Intervenção em saúde mental para pessoas com comportamento anti-social: 10 pontos de interface. [Mental health intervention for individuals with antisocial behavior: 10 point of interface]. (D. Rijo, Trans.). In A. C. Fonseca, M. Simões, M. C. T. Simões, & M. S. Pinho (Eds.), Psicologia Forense (pp.559-582). Coimbra: Nova Almedina.

Yu, R., Geddes, J. R., & Fazel, S. (2012). Personality disorders, violence and antisocial behavior: A systematic review and meta-regression analyses. Journal of Personality Disorders, 26, 775-792. doi: 10.1521/pedi.2012.26.5.775

Zlotnick, C., Clarke, J. G., Friedmann, P. D., Roberts, M. B., Sacks, S., & Melnick, G. (2008). Gender differences in comorbid disorders among offenders in prison substance abuse treatment programs. Behavioral Sciences & The Law, 26, 403-412, doi: 10.1002/bsl.8 31




DOI: https://doi.org/10.14417/ap.975

Refbacks

  • There are currently no refbacks.


Nº ERC: 107494 | ISSN (in print): 0870-8231 | ISSN (online): 1646-6020 | Copyright © ISPA - CRL, 2012 | Rua Jardim do Tabaco, 34, 1149-041 Lisboa | NIF: 501313672 | The portal and metadata are licensed under the license Creative Commons CC BY-NC