Mental disorder and violence: personality dimensions and clinical features

This review examines the role of personality dimensions in the greater rates of violence that have now been established to accompany certain classes of mental disorders.

Empirical studies are reviewed that have often used objective measures of personality and epidemiological samples with low levels of subject selection biases.

The risk of violence may be understood in terms of four fundamental personality dimensions: 1) impulse control, 2) affect regulation, 3) narcissism, and 4) paranoid cognitive personality style. Low impulse control and affect regulation increase the risk for violence across disorders, especially for primary and comorbid substance abuse disorders. By contrast, paranoid cognitive personality style and narcissistic injury increase the risk for violence, respectively, in persons with schizophrenia spectrum disorders and in samples of both college students and individuals with personality disorders.

This review supports the hypothesis that these four fundamental personality dimensions operate jointly, and in varying degrees, as clinical risk factors for violence among groups with these classes of mental disorders.