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Personality disorders and violence potential.

William H Reid, Stephen A Thorne

    Journal of Psychiatric Practice
    |August 2, 2007
    PubMed
    Summary
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    Understanding violence in personality disorders requires viewing it as a distinct syndrome. This study categorizes eight types of violence to aid clinicians in selecting appropriate management strategies for patients with personality disorders.

    Area of Science:

    • Psychiatry
    • Clinical Psychology
    • Forensic Psychology

    Background:

    • Violence is a complex issue often associated with personality disorders.
    • Existing diagnostic frameworks may not fully capture the nuances of violence in this population.
    • Effective clinical management requires a deeper understanding of the specific patterns of violent behavior.

    Purpose of the Study:

    • To categorize patterns of violence associated with personality disorders.
    • To provide clinicians with a framework for understanding and managing violence in patients with personality disorders.
    • To differentiate violence as a syndrome from psychiatric diagnostic labels.

    Main Methods:

    • Descriptive analysis of violence patterns in individuals with personality disorders.

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  • Development of a classification system for eight distinct categories of violence.
  • Identification of key principles governing the relationship between personality disorders and violence.

    • Main Results:

    • Eight categories of violence associated with personality disorders were identified: purposeful instrumental, purposeful non-instrumental, purposeful targeted defensive, targeted impulsive, non-targeted impulsive incidental to emotional escape, random but purposeful, violence related to perceived loss/abandonment, and violence related to chronic paranoia.
    • These categories are not mutually exclusive and do not form a decision tree.
    • Key principles include personality disorders being ego-syntonic, frequent comorbidity, and the association of violence with intoxication.

    Conclusions:

    • Viewing violence as a syndrome, separate from diagnosis, offers a more effective clinical approach.
    • The proposed categorization aids in tailoring treatment and management strategies for personality disorder-related violence.
    • Clinicians should consider comorbidity and intoxication when assessing violence risk in this population.