Über die Autorin bzw. den Autor

Mary McMurran is Professor of Personality Disorder Research at the University of Nottingham. She is series editor for the Wiley Series in Forensic Clinical Psychology and her previous books include Motivating Offenders to Change, commended by the BMA. She is co-editor of Criminal Behaviour and Mental Health and associate editor of both The Journal of Forensic Psychiatry and Psychology and Legal and Criminological Psychology. She received the Senior Award for Significant Lifetime Contribution from the British Psychological Society in 2005.

Richard Howard is Senior Research Fellow at The Peaks Academic and Research Unit at Rampton Hospital in the UK, and Reader in Personality Disorder Research at the University of Nottingham.

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'The role of personality disorder in violence remains one of the key concerns in modern forensic practice. The editors are to be congratulated for having created this excellent volume bringing together leading scholars and practitioners in the field. The result is a volume that is scientifically robust yet clinically relevant; a comprehensive volume that has much for both the researcher and the clinician. It is not merely focused on the usual suspect - psychopathy - but provides a much broader perspective by formulating the causal processes underpinned by problems in attachment, empathy and cognition. A must -read for those who work with offenders.' - David J Cooke

'This book makes a timely and important contribution to the field of forensic psychology, exploring the relationship between personality disorder, traits, cognition and affect and antisocial and criminal behaviour. The internationally respected authors are expert sin their fields. Finding constructive approaches that reduce offending behaviours is in everyone's interest.' - Professor Kate Davidson

New in the Wiley Series in Forensic Clinical Psychology, Personality, Personality Disorder and Violence takes an evidence-based look at personality traits and types of psychological functioning that may contribute to personality disorder and violence, and the connections that lie between them.

Each chapter tackles a specific area of personality or psychological functioning and is theoretically based, including a developmental perspective, discussion of what should be assessed for gauging risk and evaluating risk reduction, and an outline of effective treatments. Personality traits covered include impulsivity, aggressiveness, narcissism, and The Big Five (neuroticism, extraversion, openness, agreeableness and conscientiousness). Psychological functioning analysis includes neuroaffective processing, emotion recognition and empathy deficits. The book concludes with implications for research and practice.

Aus dem Klappentext

'The role of personality disorder in violence remains one of the key concerns in modern forensic practice. The editors are to be congratulated for having created this excellent volume bringing together leading scholars and practitioners in the field. The result is a volume that is scientifically robust yet clinically relevant; a comprehensive volume that has much for both the researcher and the clinician. It is not merely focused on the usual suspect - psychopathy - but provides a much broader perspective by formulating the causal processes underpinned by problems in attachment, empathy and cognition. A must -read for those who work with offenders.' - David J Cooke

'This book makes a timely and important contribution to the field of forensic psychology, exploring the relationship between personality disorder, traits, cognition and affect and antisocial and criminal behaviour. The internationally respected authors are expert sin their fields. Finding constructive approaches that reduce offending behaviours is in everyone's interest.' - Professor Kate Davidson

New in the Wiley Series in Forensic Clinical Psychology, Personality, Personality Disorder and Violence takes an evidence-based look at personality traits and types of psychological functioning that may contribute to personality disorder and violence, and the connections that lie between them.

Each chapter tackles a specific area of personality or psychological functioning and is theoretically based, including a developmental perspective, discussion of what should be assessed for gauging risk and evaluating risk reduction, and an outline of effective treatments. Personality traits covered include impulsivity, aggressiveness, narcissism, and The Big Five (neuroticism, extraversion, openness, agreeableness and conscientiousness). Psychological functioning analysis includes neuroaffective processing, emotion recognition and empathy deficits. The book concludes with implications for research and practice.

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Personality, Personality Disorder and Violence

John Wiley & Sons

Chapter One

Mary McMurran University of Nottingham, UK

INTRODUCTION

Few would argue that interpersonal violence, in its many forms, is a major social problem, causing considerable harm to individuals, families and communities. Indeed, the World Health Organisation (WHO) (2002) has recognised violence as a significant public health issue. The WHO report acknowledges that there are multiple factors that need to be taken into account in explaining violence, including individual, relationship, social, cultural and environmental factors. These are represented in an ecological model (see Figure 1.1). While all levels are clearly important, the focus in this book is on individual-level explanations.

Beginning with the basics, it is useful to define violence. Violence is defined as a range of behaviours intended to harm a living being who is motivated to avoid harm (Baron and Richardson, 1994). This definition is useful in that it excludes harmful acts that are accidental (e.g. a road traffic accident), consensual (e.g. sadomasochism) and ultimately beneficial (e.g. medical procedures). A distinction may be made between violence and aggression: violence is the forceful infliction of physical harm, whereas aggression is behaviour that is less physically harmful (e.g. insults, threats, ignoring), although it is often severely psychologically damaging. Because aggression can be as damaging to the victim as actual physical violence, and sometimes even more so, many mental health and criminal justice practitioners opt to use the term violence to refer to both aggression and physical violence. This avoids appearing to collude with the belief that aggression is not serious or harmful.

There is wide variation between individuals in their proneness to violence, and the agenda in this book is to investigate individual variation in relation to personality and personality disorder. The psychological study of personality relates to the understanding of how individual differences (i.e. personality traits) and personality processes (i.e. cognitive, emotional and motivational processes) relate to behaviour (Brody and Ehrlichman, 1998). The study of personality disorder relates to a range of clinically important problems with thoughts, feelings and behaviour whose regularities are defined in specific personality pathologies (Livesley, 2001). The term 'personality disorder' references diagnostic categories (see the next section for an elaboration); however, there are mostly no categorical cut-offs for problems in personality traits and personality processes. Hence, in referencing problems in the personality domain, the term 'personality problems' is used here. In this book, both fields of study are represented so that we may best advance our understanding of individual variation in violence.

One of the major reasons for studying personality, personality disorder and violence is to advance psychological and psychiatric treatments. Both criminal justice and mental health professionals play a role in treating and managing people who are violent. Broadly speaking, differing organisational agendas mean that criminal justice personnel see society as the primary client and aim to control crime, whereas mental health professionals view the patient as the client and aim to improve functioning and reduce distress. These days, however, most interventions offered by either group of professionals are designed both to promote individual well-being and reduce risk (Ward, 2002; Ward and Brown, 2004). Nonetheless, the latter aim is still viewed as highly contentious by some mental health professionals (Grounds, 2008).

The contributors to this book, all of whom are internationally renowned researchers and practitioners, will expand on issues related to personality, personality disorder and violence. In this chapter, the aim is to set the scene by addressing some fundamental questions about detention, punishment and treatment of people with personality problems or personality disorders who are violent. Unlike people whose violence is connected with mental illness or developmental disabilities, for whom there is largely agreement on the appropriateness of treatment, the issue of whether or not to treat those with personality disorders or personality problems and an offending history is more controversial. The case for punishment, treatment or a combination of the two requires exploration. If treatment is to be offered, then what should be the treatment goals? Where should treatment be offered: in criminal justice or mental health service locations? However, before embarking on these topics, the scale and nature of the problem needs to be put into perspective.

PERSONALITY DISORDERS AND VIOLENCE

Personality disorders are described in the two major diagnostic classification systems: the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV; American Psychiatric Association, 1994, 2000) and the International Classification of Diseases 10 (ICD-10; World Health Organisation, 1992). DSM-IV defines personality disorder as

An enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment (p. 629).

ICD-10 defines personality disorder as

... deeply ingrained and enduring behaviour patterns, manifesting themselves as inflexible responses to a broad range of personal and social situations. They represent either extreme or significant deviations from the way the average individual in a given culture perceives, thinks, feels, and particularly relates to others. Such behaviour patterns tend to be stable and to encompass multiple domains of behaviour and psychological functioning. They are frequently, but not always, associated with various degrees of subjective distress and problems in social functioning and performance (p. 200).

The personality disorders are listed in Table 1.1, along with their key features. DSM-IV groups the personality disorders in three clusters: Cluster A - odd or eccentric (paranoid, schizoid and schizotypal); Cluster B - dramatic or flamboyant (antisocial, borderline, histrionic and narcissistic); and Cluster C - anxious or fearful (avoidant, dependent and obsessive-compulsive). Psychopathy, a personality disorder that is covered extensively in later chapters, lacks specific status as a personality disorder in DSM-IV and ICD10, although aspects of it are captured in antisocial and dissocial personality disorders. Extensive research on features of psychopathy over recent years has led to it being considered for inclusion in the forthcoming DSM-V.

In a recent study of a representative sample of the UK general population, using a structured clinical interview, the prevalence of personality disorder was identified as 4.4%, with men more likely to have a personality disorder (5.4%) than women (3.4%) (Coid et al., 2006b). Thus, an estimated three and a quarter million people in the United Kingdom have a personality disorder. Most of these are unlikely to be violent. Indeed, in Coid et al.'s study, even among those people diagnosable as having an antisocial personality disorder, about half had not been violent in the...