Dimensions of personality disorders in offenders.

Background: Owing to criticisms of current concepts of personality disorders such as high comorbidity, criteria overlap and arbitrary thresholds of categorical diagnoses, a dimensional assessment is proposed that considers interrelations between different personality disorders. Results of previous factor analyses using dimensional personality disorder scores have indicated that one underlying dimension shows strong similarities to the concept of psychopathy and is similarly related to criminal recidivism.

Aim: The authors examined the underlying dimensions of ICD-10 personality disorders, to analyse their association with criminal behaviour in general, and with specific criminal history variables.

Method: Study samples included 105 offenders and 80 non-criminal controls. Personality disorders were measured using a clinical structured interview (IPDE), measures of personality using self-report (NEO-FFI, IPC, HDHQ), and criminal history variables obtained from court records.

Results: Three underlying personality disorder factors could be identified, which showed identical structures in both the forensic and the non-forensic sample. Factor 1 comprised emotionally unstable, histrionic, paranoid and dissocial traits and showed strong similarity to the construct of psychopathy. Factor 2 was defined by anankastic personality disorder scores and an inverse relation to schizoid personality features. Factor 3 showed high negative loadings of anxious and dependent personality disorders. Self-report measures of personality and criminal history variables yielded different associations with the three PD dimensions. Offenders with high scores on factor 1 were highly aggressive, violent and impulsive.

Conclusions: The findings generally replicated previous analyses using DSM-III personality disorder scores. Differences can be explained by the different constructs of personality disorders included in ICD-10. Although a diagnosis of psychopathy is not currently included in these diagnostic systems, the authors' findings indicate that a highly inter-related pattern of personality disorder scores constitutes psychopathic personality disorder and can be used to identify impulsive, hostile and violent offenders.