Identification of the psychopathic batterer: The clinical,legal, and policy implications

A number of theoretical and empirical sources have proposed that a subgroup of domestically violent men exhibit more antisocial behavior, express more generalized violence, and are generally more resistant to mental health intervention than others. In a parallel literature, researchers have identified a subgroup of violent criminal offenders (i.e., psychopaths) that exhibit a number of similar characteristics to this more antisocial/generally violent group of batterers. Moreover, the offender literature on psychopathy describes the violence tendencies, physiological responses, cognitive impairments, interpersonal/affective characteristics, and treatment responsiveness of these individuals in much greater depth and breadth than the current domestic violence literature. The present article seeks to compare and contrast these two literatures, proposing that there is a subgroup of batterers that can be characterized as exhibiting significant psychopathic characteristics. The clinical, legal, and policy implications of identifying a subgroup of batterers in this manner also are explored.     

Autonomic correlates of attention-deficit/hyperactivity disorder and oppositional defiant disorder in preschool children

Numerous studies have revealed autonomic underarousal in conduct-disordered adolescents and antisocial adults. It is unknown, however, whether similar autonomic markers are present in at-risk preschoolers. In this study, the authors compared autonomic profiles of 4- to 6-year-old children with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD; n = 18) with those of age-matched controls (n = 20). Children with ADHD and ODD exhibited fewer electrodermal responses and lengthened cardiac preejection periods at baseline and during reward. Although group differences were not found in baseline respiratory sinus arrhythmia, heart rate changes among ADHD and ODD participants were mediated exclusively by parasympathetic withdrawal, with no independent sympathetic contribution. Heart rate changes among controls were mediated by both autonomic branches. These results suggest that at-risk preschoolers are autonomically similar to older externalizing children.     

Neural correlates of deficient response inhibition in mentally disordered violent individuals

In this study, response inhibition and associated neural activation during a motor inhibition paradigm were investigated in (i) men with antisocial personality disorder (APD) with a history of violence (n = 14), (ii) men with schizophrenia with a history of violence (n = 12), (iii) men with schizophrenia without a history of violence (n = 12), and (iv) healthy control subjects (n = 14) using functional magnetic resonance imaging (fMRI). At the behavioural level, individuals with schizophrenia showed impaired performance across all conditions, whereas an increased error rate was seen in the APD group only during the conditions requiring inhibition. At the neural level, both violent groups showed reduced thalamic activity, compared with controls, in association with modulation of inhibition by task demands. In addition, the violent schizophrenia group, compared with controls, showed reduced activity in the caudate nucleus during the condition requiring inhibition. It is concluded that violence may not be specifically associated with impaired voluntary inhibition in schizophrenia but this is likely in APD. Reduced thalamic function, perhaps due to its known association with sensorimotor disturbances, is implicated in violent behaviour across both disorders. In addition, caudate dysfunction may contribute, given its role in timing and temporal processing as well as suppression of motor actions, to deficient inhibition and violent behaviour in schizophrenia.     

Testosterone,aggressiveness, and antisocial personality

Testosterone levels were examined in prisoners convicted of violent crimes (n = 13), in men previously convicted of violent crimes but currently not in prison (n = 15), in nonviolent alcoholics (n = 15), and in randomly selected control males (n = 16). Morning, afternoon, and evening testosterone levels were assessed after a minimum alcohol abstinence period of 24 hr. Violent and nonviolent men did not differ in plasma total testosterone level on any sampling occasion. In violent men, however, testosterone levels were significantly correlated with hostility, as measured by the Derogatis Symptom Check List. Most violent men were diagnosed with Antisocial Personality Disorder (ASP) [DSM‐III‐R; 301.70], and the unweighted ASP symptom count also correlated significantly with testosterone levels in these subjects. We suggest that individuals whose life histories involve numerous antisocial behaviors tend to have high testosterone levels even when interpersonal violence is excluded. This, however, does not eliminate the possibility that males who are characterized by high hostility may also have elevated testosterone levels. Violent predisposition and antisocial conduct beginning in early adolescence predict adult aggressive behaviors, which are augmented by power‐related alcohol expectancies and alcohol abuse. Aggr. Behav. 25:113–123, 1999. © 1999 Wiley‐Liss, Inc.     

Assessing male batterers with the Personality Assessment Inventory

In this study, we sought to provide empirical data on the utility of the Personality Assessment Inventory (PAI; Morey, 1991) for the assessment of male batterers. The sample consisted of 93 men who were court mandated to treatment. In the study, we were able to replicate 2 of 3 clusters (borderline/dysphoric and nonelevated) commonly found in the literature on male batterers; however, we only partially replicated the 3rd cluster (antisocial/narcissistic). This new finding may reflect a difference in the assessment instrument used to assess male batterers (i.e., PAI). In this study, we also investigated a previously understudied subgroup of batterers, specifically, men who engage in positive impression management. In this study, we conclude that the PAI is a potentially useful instrument in assessing male batterers and provide suggestions for future research.     

Verläufe bei sexuellen Tötungen

This article summarizes main results of studies on forensic psychiatric court reports on 166 men who had been persecuted between 1963 and 1991 for a sexual offence leading to the death of the victim. Comparing perpetrators with a single victim and those with multiple victims we found similar results as in two previous studies with smaller samples: Multiple sexual homicide perpetrators showed more often sexual sadism and other paraphilias, as well as antisocial, schizoid and sadistic personality disorders. Follow-up data from the federal criminal records could be obtained for 139 offenders. Ninety perpetrators had been released after a mean detention of 12.2 years, whereas the 49 offenders who were still in prison or forensic psychiatric hospitals had been detained for a mean period of 20.6 years. The non-released offenders showed more often paraphilias as well as antisocial and sadistic personality disorders than the released perpetrators. Paraphilias and antisocial personality traits are empirically well proven risk factors for criminal recidivism with sexual reoffences. In addition, the non-released sexual homicide perpetrators had higher scores in all applied risk assessment instruments (PCL-R, HCR-20, SVR-20, Static-99). Among the released offenders only 1.1% (n=1) reoffended with a completed homicide and 2.2% (n=2) with attempted homicide. The recidivism rates with sexual and other violent reoffences in this sample of sexual homicide perpetrators were similar to those in a large meta-analysis on recidivism in sexual offenders by Hanson and Morton-Bourgon (4). Since well established risk factors had apparently been “used-up” for the decisions about release or non-release, in the follow-up data about the released offenders only age at the sexual homicide and age at the time of release were found as risk factors for recidivism with any violent (sexual or non-sexual) reoffence, i.e. the younger the offender at the time of the homicide and the younger at the time of release, the more likely is the risk of violent reoffending.     

Mental illness, criminal risk factors and parole release decisions

Research has not examined whether higher rates of parole denial among inmates with mental illness (MI) are the result of the increased presence of criminal risk factors among this population. Employing a representative sample of inmates with (n = 219) and without (n = 184) MI receiving parole release decisions in 2007, this study tested whether the central eight risk factors for recidivism considered in parole release decisions intervened in the relationship between MI and parole release. MI was associated with possession of a substance use disorder, antisocial personality disorder and violent charges while incarcerated; however, these factors were not related to release decisions. MI was found to have neither a direct nor an indirect effect on release decisions. While results indicate that release decisions appear, to some extent, to be evidence-based, they also suggest considerable discretion is being implemented by parole board members in release decisions above and beyond consideration of criminal risk factors.     

Interaction between Prenatal Maternal Stress and Autonomic Arousal in Predicting Conduct Problems and Psychopathic Traits in Children

Evidence has suggested that neurobiological deficits combine with psychosocial risk factors to impact on the development of antisocial behavior. The current study concentrated on the interplay of prenatal maternal stress and autonomic arousal in predicting antisocial behavior and psychopathic traits. Prenatal maternal stress was assessed by caregiver’s retrospective report, and resting heart rate and respiratory sinus arrhythmia (RSA) were measured in 295 8- to 10-year-old children. Child and caregiver also reported on child’s antisocial behavior and psychopathic traits. Higher prenatal maternal stress was associated with higher caregiver-reported antisocial and psychopathy scores, even after the concurrent measure of social adversity was controlled for. As expected, low heart rate and high RSA were associated with high antisocial and psychopathic traits. More importantly, significant interaction effects were found; prenatal stress was positively associated with multiple dimensions of psychopathic traits only on the conditions of low arousal (e.g., low heart rate or high RSA). Findings provide further support for a biosocial perspective of antisocial and psychopathic traits, and illustrate the importance of integrating biological with psychosocial measures to fully understand the etiology of behavioral problems.     

Domestic violence and psychopathic traits: distinguishing the antisocial batterer from other antisocial offenders

The proliferation of specialized domestic batterer treatment programs suggests that batterers differ from other offenders in important ways. The psychopathic personality represents a constellation of personality traits, which may be relevant to the differentiation of batterers from other offenders. In a sample of 172 county jail inmates, we examined whether antisocial batterers can be distinguished from the larger pool of antisocial offenders on the basis of the four-facet model of psychopathy identified for the Psychopathy Checklist-Revised (PCL-R). Batterer/non-batterer status was positively related to the PCL-R affective facet and negatively related to the lifestyle facet, but there was no significant relationship between PCL-R total scores and this criterion. Results suggest that antisocial batterers are characterized by deficient affective experience and by reduced impulsivity and irresponsibility compared with other antisocial offenders. Implications are discussed in light of specialized treatments for batterers.     

Sexual and nonsexual marital aggression: Legal considerations, epidemiology, and an integrated typology of perpetrators

In this paper, the legal history of marital rape and the current status of “marital rape allowances” to sexual assault statutes are reviewed. The prevalence of marital rape and its comorbidity with nonsexual violence, as well as the physical and psychological sequelae found to be specifically associated with sexual aggression in marriage is reviewed. Our current limited theoretical understanding of the relationship between sexual and nonsexual violence in marriage is extended by integrating marital rape and marital violence batterer typology research. Specifically, we offer a four-type batterer typology integration (i.e., family-only, dysphoric/borderline, generally violent/antisocial, and sexually obsessive batterers) that fully describe husbands that are only nonsexually violent, both physically and sexually violent, or only sexually violent. Theoretical and practical implications of this integration are identified. Future research directions are outlined, and the need for greater clinical attention to the phenomena of sexual violence in marriage is highlighted.     

Self-reported personality traits and disorders (DSM-IV) and risk of criminal recidivism: a prospective study

Assessment and management of criminal offenders require valid methods to recognize personality psychopathology and other risk and protective factors for recidivism. We prospectively explored the association between dimensional and categorical measures of personality disorder (PD) measured with the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q, Ottosson et al., 1995) and registered reconvictions in adult offenders. One hundred and sixty-eight offenders consecutively referred for pre-sentencing forensic psychiatric evaluation in Sweden during 1995-1996 completed DIP-Q self-reports. The subjects received different types of sanctions and were followed for an average of 36 months after release from prison, discharge from a forensic psychiatric hospital, or onset of nondetaining sentences. Age-adjusted odds ratios revealed a 4.8 times higher risk for any recidivism and a 3.7 times higher risk for violent recidivism among subjects whose self-reports suggested a categorical diagnosis of antisocial PD as compared to offenders without antisocial PD. The remaining nine categorical DSM-IV PD diagnoses were not significantly related to recidivism. In dimensional analyses, each additional antisocial and schizoid PD symptom endorsed by participants at baseline increased the risk for violent reoffending. Our results suggest a relationship between self-reported behavioral instability and interpersonal dysfunction captured primarily by DSM-IV antisocial and schizoid PD constructs, and criminal re-offending also in a multi-problem sample of identified offenders.     

Sexual and nonsexual marital aggression: Legal considerations, epidemiology, and an integrated typology of perpetrators

In this paper, the legal history of marital rape and the current status of “marital rape allowances” to sexual assault statutes are reviewed. The prevalence of marital rape and its comorbidity with nonsexual violence, as well as the physical and psychological sequelae found to be specifically associated with sexual aggression in marriage is reviewed. Our current limited theoretical understanding of the relationship between sexual and nonsexual violence in marriage is extended by integrating marital rape and marital violence batterer typology research. Specifically, we offer a four-type batterer typology integration (i.e., family-only, dysphoric/borderline, generally violent/antisocial, and sexually obsessive batterers) that fully describe husbands that are only nonsexually violent, both physically and sexually violent, or only sexually violent. Theoretical and practical implications of this integration are identified. Future research directions are outlined, and the need for greater clinical attention to the phenomena of sexual violence in marriage is highlighted.     

Batterer men in prison and in court-referred treatment programmes: what is the difference?

This paper describes the demographic, gender violence and psychopathological characteristics of 399 men in a specialized treatment programme for gender violence. Furthermore, a comparison of all the variables studied among the subjects referred by the court to the treatment programme (n = 276) and those who were imprisoned (n = 123) was conducted. The results showed the existence of numerous statistically significant differences between groups, primarily in psychopathological variables and in cognitive bias about women and violence use. In general, imprisoned batterers showed more irrational beliefs both about women and about violence as a strategy to cope with everyday difficulties. Moreover, batterers in prison had significantly higher scores on all psychopathological symptoms as assessed by SCL-90-R, as well as in most of STAXI-2 subscales. According to these results, batterers in prison showed a higher severity in variables studied than those who were referred by the court to the treatment programme. Implications of these results for further research and clinical practice are also commented on.     

The Disruptive Adolescent as a Grown-Up: Predicting Adult Startle Responses to Violent and Erotic Films from Adolescent Conduct Problems and Callous-Unemotional Traits

The current study aimed to identify heterogeneous groups of adolescents differing on their levels of conduct problems (CP) and callous-unemotional (CU) traits, and compare them on startle reactivity to emotional videos (violent/erotic) during young adulthood. A Latent Profile Analysis, conducted among a longitudinal sample of 2306 adolescents, provided evidence for the existence of heterogeneous CP and CU subgroups (i.e., CP-only, CU-only, and CP+CU groups). Three years later, 82 young adults (Mage?=?19.95), randomly selected from the identified groups, participated in an experiment assessing their startle eye-blink responses during violent, erotic and neutral video scenes. Self-report ratings of fear, valence and arousal to affective scenes were also collected. Findings suggested that adolescents high on CP and low on CU traits showed high startle potentiation when viewing violent scenes during young adulthood, while those high on both CP and CU traits showed diminished startle reactivity to violent stimuli. Individuals high on CU traits without CP showed similar startle reactivity to controls. Further, the findings indicate that startle potentiation to violent stimuli can be a reliable physiological marker to distinguish antisocial individuals with and without CU traits. The finding that the CU only group was not differentiated from the control group on startle reactivity when viewing violent stimuli might explain their lower likelihood of engaging in antisocial behavior.     

Psychopathology and substance-related problems during early adolescence: a survival analysis.

Examined the chronological and statistical relations among onsets of psychopathology, alcohol and cannabis use, and substance-related problem psychopathology, alcohol and cannabis use, and substance-related problems from late childhood through early adolescence in boys of fathers with substance use disorder (SUD; high average risk: n = 177) and without SUD (low average risk: n = 203) using survival analysis. Proportional hazard models indicated that antisocial disorders were predicted by risk group and mediated the observed relation between risk group and substance-related problems. Negative affect disorders were predicted by risk group but did not predict substance involvement in early adolescence. Results support a model in which paternal SUD predisposes to increased antisocial and negative affect disorders in boys, and antisocial disorders lead to substance-related problems in early adolescence.     

Domestic violence and group treatment for male batterers

This paper examines the violent behavior of male batterers toward their female partners. Three major theoretical perspectives addressing the etiology of the male batterer's abusive behavior are reviewed. These perspectives, along with an understanding of personality characteristics common among batterers, offer insight into intervention and treatment options. Group intervention has proven to be the most effective form of treatment for batterers. Outcome studies suggest a decline in batterers' abusive behavior as a result of group treatment.     

Personality characteristics of partner violent men: a Q-sort approach

Our objective was to develop a personality profile of men who are violent toward their partners. A total of 52 experienced clinicians described either a current male patient who was violent toward his partner (and only toward his partner) or who was maritally distressed but nonviolent using the Shedler-Westen Assessment Procedure-200 (SWAP-200), a Q-sort instrument designed to harness the judgments of clinicians. Partner-violent patients showed significantly higher scores on the SWAP-200 antisocial and borderline personality disorder scales. In contrast, patients who were maritally distressed evidenced higher scores on the SWAP-200 obsessive, avoidant, and high-functioning depressive scales. The men who were violent toward their partners were more antisocial and emotionally dysregulated, which is consistent with theory, and less obsessive, which has not been theoretically explored. The groups did not differ on theoretically important dimensions of personality including paranoid, dependent, and hostile features.     

Psychopathy in women: a review of its clinical usefulness for assessing risk for aggression and criminality

Despite a flurry of studies examining psychopathy in women, and the recent release of the second version of the Hare Psychopathy Checklist--Revised manual, there is still little consensus whether the lateral extension of the current conceptualization of psychopathy to women is appropriate. In particular, very little agreement exists concerning the clinical utility of the Hare psychopathy measures to assess women's risk of future offending and violence. This article presents a comprehensive review of studies of the association between psychopathy, antisocial behavior, and violence, in diverse samples of women, and looks at similarities and differences between these constructs in males and females. Findings from inmates and offenders, civil and forensic psychiatric patients, substance abusers, and community samples indicate a consistently lower base rate of psychopathy among women than among men. With some exceptions, correlates of psychopathy in women relevant to risk assessments for crime and violence tend to be modest and significant, generally mirroring what we see in men. Clinicians and policy makers charged with the care and management of women at risk for criminal offending and violence are likely to find the PCL-R and PCL:SV have clinical utility; however, cautious application is called for and ongoing research is required.     

The prediction of violent and nonviolent criminal behavior in a methadone maintenance population

The utility of traits associated with Antisocial Personality Disorder in making risk assessments of violent and nonviolent crimes was examined in 254 subjects sampled from a methadone maintenance population. A factor analysis of a number of baseline measures resulted in five factors measuring hostility, insecure attachment, impaired reality testing, antisocial personality, and empathy. These factors were used in logistic regression analysis to predict charges for violent and nonviolent crimes over a 2-year period. Individuals with high scores on the antisocial personality factor had an increased risk of both violent and nonviolent criminal charges. Individuals with low scores on the empathy factor were at high risk for violent crimes. In an analysis using the factor components rather than the factors, the measures of perspective-taking and a socialization were associated with violent criminal charges, and the measure of psychopathy, but not antisocial behavior, was associated with nonviolent criminal charges. The results support the use of measures of personality traits in addition to measures of a history of antisocial behavior in making violence risk assessments in substance-dependent patients. The DSM construct and diagnosis of Antisocial Personality Disorder may be enhanced by greater emphasis on personality traits associated with antisocial behavior.     

BATTERERS' EXPERIENCES OF BEING VIOLENT

Nine male batterers were interviewed about their experiences of being violent in domestic relationships. Interviews were analyzed using a phenomenological method to uncover themes in the structure of violent experiences. Results indicated two levels of themes: Contextual themes that described comparisons of self with other, forming the relational setting for violence, and focal themes that described experiences of being violent. Results were discussed in terms of social learning theory and gender-role attitudes, concluding that for some men, being violent in domestic relationships is a failed attempt to assert a preferred identity and avoid a devalued one. The violence ultimately reproduces the relational context of perceived polarized identities from which it emerges. Implications of findings for the victim were discussed and suggestions made to expand treatment interventions to focus on the polarized and unstable terms by which the men in this study framed their identities in domestic relationships.