title: Personality traits as predictors of inpatient aggression in a high-security forensic psychiatric setting: prospective evaluation of the PCL-R and IPDE dimension ratings.
abstract: The Dangerous and Severe Personality Disorder (DSPD) initiative in England and Wales provides specialized care to high-risk offenders with mental disorders. This study investigated the predictive utility of personality traits, assessed using the Psychopathy Checklist-Revised (PCL-R) and the International Personality Disorder Examination, with 44 consecutive admissions to the DSPD unit at a high-security forensic psychiatric hospital. Incidents of interpersonal physical aggression (IPA) were observed for 39% of the sample over an average 1.5-year period following admission. Histrionic personality disorder (PD) predicted IPA, and Histrionic, Borderline, and Antisocial PDs all predicted repetitive (2+ incidents of) IPA. PCL-R Factor 1 and Facets 1 and 2 were also significant predictors of IPA. PCL-R Factor 1 and Histrionic PD scores were significantly associated with imminence of IPA. Results were discussed in terms of the utility of personality traits in risk assessment and treatment of specially selected high-risk forensic psychiatric patients in secure settings.
authors.affiliation: University of Nottingham, United Kingdom, University of Toronto, Ontario, Canada, Rampton Hospital, Retford, DN, United Kingdom. calvin.langton@utoronto.ca
authors.forename: Calvin M
authors.initials: CM
authors.lastname: Langton
authors.forename: Todd E
authors.initials: TE
authors.lastname: Hogue
authors.forename: Michael
authors.initials: M
authors.lastname: Daffern
authors.forename: Aisling
authors.initials: A
authors.lastname: Mannion
authors.forename: Kevin
authors.initials: K
authors.lastname: Howells
mesh_terms: D000293:Adolescent; D000328:Adult; D000374:Aggression / Q000523:psychology*; D000987:Antisocial Personality Disorder / Q000175:diagnosis* / Q000523:psychology*; D002605:Character; D057189:Checklist; D003134:Commitment of Persons with Psychiatric Disorders; D003617:Dangerous Behavior; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment / Q000706:statistics & numerical data*; D010554:Personality Disorders / Q000175:diagnosis* / Q000523:psychology*; D011329:Prisoners / Q000523:psychology*; D011446:Prospective Studies; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012307:Risk Factors; D012637:Security Measures; D014754:Violence / Q000523:psychology*; D055815:Young Adult