Adult psychopathic personality with childhood-onset hyperactivity and conduct disorder: a central problem constellation in forensic psychiatry

• Published in: Psychiatry research Vol. 121; no. 3; pp. 271 - 280
• Main Authors: Soderstrom, Henrik, Sjodin, Anna-Kari, Carlstedt, Anita, Forsman, Anders
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 2004; Elsevier
• Subjects: Adolescent; Adult; Aggression; Aggression - psychology; Antisocial Personality Disorder; Antisocial Personality Disorder - diagnosis; Antisocial Personality Disorder - epidemiology; Antisocial Personality Disorder - psychology; Attention Deficit and Disruptive Behavior Disorders; Attention Deficit and Disruptive Behavior Disorders - diagnosis; Attention Deficit and Disruptive Behavior Disorders - epidemiology; Attention Deficit and Disruptive Behavior Disorders - psychology; Attention Deficit Disorder with Hyperactivity; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Disorder with Hyperactivity - psychology; Biological and medical sciences; Child; Child Behavior Disorders; Child Behavior Disorders - diagnosis; Child Behavior Disorders - epidemiology; Child Behavior Disorders - psychology; Commitment of Mentally Ill; Commitment of Mentally Ill - legislation & jurisprudence; Comorbidity; Crime; Crime - legislation & jurisprudence; Crime - psychology; diagnosis; Disruptive behavior disorders; epidemiology; Expert Testimony; Expert Testimony - legislation & jurisprudence; Female; Forensic Psychiatry; Humans; legislation & jurisprudence; Male; MEDICAL AND HEALTH SCIENCES; Medical sciences; MEDICIN OCH HÄLSOVETENSKAP; Middle Aged; Personality Assessment; Prisoners; Prisoners - psychology; Prisoners - statistics & numerical data; psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Recurrence; Risk factor; Sex Offenses; Sex Offenses - psychology; Sex Offenses - statistics & numerical data; statistics & numerical data; Violence; Violence - legislation & jurisprudence; Violence - psychology; Violence - statistics & numerical data; Violent crime; Forensic psychiatry; Violent crime; Comorbidity; Disruptive behavior disorders; Risk factor; Human; Prevalence; Aggression; Hyperactivity; Violence; Criminality; Conduct disorder; Infantile experience; Personality disorder; Medicolegal expertise; Concomitant disease; Attentional disorder; Age of onset; Cross sectional study; Diagnosis; Typology; Social behavior disorder; Antecedent; Psychopathic personality
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/S0165-1781(03)00270-1

To describe lifetime mental disorders among perpetrators of severe inter-personal crimes and to identify the problem domains most closely associated with aggression and a history of repeated violent criminality, we used structured interviews, clinical assessments, analyses of intellectual functioning, medical and social files, and collateral interviews in 100 consecutive subjects of pretrial forensic psychiatric investigations. Childhood-onset neuropsychiatric disorders [attention-deficit/hyperactivity disorder (AD/HD), learning disability, tics and autism spectrum disorders] affected 55% of the subjects and formed complex comorbidity patterns with adult personality disorders [including psychopathic traits according to the Psychopathy Checklist (PCL-R)], mood disorders and substance abuse. The closest psychiatric covariates to high Lifetime History of Aggression (LHA) scores and violent recidivism were the PCL-R scores and childhood conduct disorder (CD). Behavioral and affective PCL-R factors were closely associated with childhood AD/HD, CD, and autistic traits. The results support the notion that childhood-onset social and behavioral problems form the most relevant psychiatric symptom cluster in relation to pervasive adult violent behavior, while late-onset mental disorders are more often associated with single acts of violent or sexual aggression.