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

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 functionin...

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Published inPsychiatry research Vol. 121; no. 3; pp. 271 - 280
Main Authors Soderstrom, Henrik, Sjodin, Anna-Kari, Carlstedt, Anita, Forsman, Anders
Format Journal Article
LanguageEnglish
Published Shannon Elsevier Ireland Ltd 2004
Elsevier
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Abstract 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.
AbstractList 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.
Author Carlstedt, Anita
Soderstrom, Henrik
Sjodin, Anna-Kari
Forsman, Anders
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Issue 3
Keywords 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
Language English
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Snippet To describe lifetime mental disorders among perpetrators of severe inter-personal crimes and to identify the problem domains most closely associated with...
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SubjectTerms 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
Title Adult psychopathic personality with childhood-onset hyperactivity and conduct disorder: a central problem constellation in forensic psychiatry
URI https://dx.doi.org/10.1016/S0165-1781(03)00270-1
https://www.ncbi.nlm.nih.gov/pubmed/14675746
https://search.proquest.com/docview/71597747
https://gup.ub.gu.se/publication/112163
Volume 121
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