Personality Disorders, Psychopathy, and Crime in a Norwegian Prison Population,☆☆

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Introduction

Many studies suggest that the prevalence rates of major mental disorders (schizophrenia, schizophreniform disorder, major depression, bipolar disorder, atypical bipolar disorder, organic brain syndrome) are considerably higher among incarcerated offenders than in the general population. Coté and Hodgins (1990) found prevalence rates among prisoners in a Canadian penitentiary to vary between 1.2 and 14.8% for various major mental disorders. In a large study employing the Diagnostic Interview Schedule, Teplin (1994) reports prevalence rates for lifetime diagnosis of any of the major mental disorders of 8.9% among male jail detainees. In a Swedish study of a group of local prisons, 5% of the inmates had a major mental disorder, and 20% had a personality disorder (Somander, 1991). A similar Swedish study yielded the same frequency for major mental disorders (5%), but a much higher frequency for personality disorders (75%, Levander, Svalenius, & Jensen, 1997).

Mentally disordered offenders have been reported to commit crimes at a higher rate than nondisordered offenders; they are also more prone to violence Adams 1983, Ashford 1989. In addition studies on mentally disordered offenders frequently report the presence of more than one disorder Coté and Hodgins 1990, Levander et al. 1997, Pietrowski, Losacco, & Guze 1976.

Antisocial personality disorder (APD) and substance abuse/dependence disorders have been reported to be frequent among prison inmates. Coté and Hodgins (1990) found a lifetime prevalence rate of 62% for APD, 67% for alcohol abuse/dependence, and 49% for drug abuse/dependence. Corresponding data from the United States reported by Teplin (1994) were 49% for APD, 51% for alcohol abuse/dependence, and 32% for drug abuse/dependence.

The concept of psychopathy is strongly related to APD. It has, however, a more narrow definition. In general, individuals who are diagnosed as psychopaths fulfill the criteria for an APD diagnosis, but the reverse is not necessarily true (Hart & Hare, 1989). The prevalence rate for psychopathy in North American prison populations has been reported to be between 15 and 25% (Hare, 1996).

Studies of mentally ill psychiatric patients show that personality disorders are more prominently represented among violent patients Benezech, Bourgeois, & Yesavage 1980, Krakowski, Volavka, & Brizer 1986, Rasmussen & Levander 1996a. Hodgins and Coté (1993) found that mentally ill offenders with co-occurring APD had more convictions than those without APD, but APD was not associated with violence in their study. However, several researchers have reported a relationship between psychopathy and violent crime Hare & McPherson 1984, Kosson, Smith, & Newman 1990, and Rasmussen, Levander, and Sletvold (1995) found that high scores in psychopathy contributed most to the discrimination between aggressive and nonaggressive schizophrenic patients.

The present project was primarily designed to investigate the prevalence of mental disorder, personality disorders, and neuropsychological dysfunction in an unselected prison population in Norway by the use of standardized diagnostic instruments. Such an investigation has not been previously undertaken in this country. Data from North America might not be representative for a Norwegian population. The United States has a frequency rate for detaining perpetrators in prison that is about 10 times as high as the rate for Norway. This could very well be reflected in the prevalence of mental disorders among prisoners, since the requirements for imprisonment seem to be higher in Norway.

In studies from North America, it has also repeatedly been reported that a strong relationship between psychopathy and the type and frequency of crimes (e.g., Hare, 1996). So far no studies have been conducted to see if the same pattern can be reproduced in a Scandinavian population.

Section snippets

Subjects

The subjects were prisoners serving time in four male units at the Tunga Kretsfengsel in Trondheim. The four participating units had 80 places, and all of the inmates were asked to participate. Forty-four prisoners of these units, of which three were not eligible because of language problems, agreed to participate, yielding a response rate of approximately 50%. All participants signed a written informed consent. None of the subjects received any reward for participation, which might explain why

Representativeness of the Sample

In order to check for representativeness of our sample, some data were made available to us from the prison files from a random sample of 66 prisoners, not including our subjects. This check was done toward the end of the project period. The reason it includes more individuals than the expected 39 nonparticipants was that many prisoners had ended their sentence and new ones had come in. Due to anonymity demands, the names of nonparticipants were not revealed to us. Thus, a direct comparison

Discussion

In contrast to data reported by Coté and Hodgins (1990) and by Teplin (1994), we failed to identify any individuals with a schizophrenic or schizophreniform disorder, as well as anyone with a present major mental disorder. The lifetime prevalence rate of major depression or bipolar disorder was, however, much higher in our sample than in the population. The prevalence rates for alcohol and substance abuse/dependence were on par with those reported in the North American studies.

The lack of any

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The present research was supported by “Rådet for psykisk helse.”

☆☆

The project was approved by the regional research ethics committee.

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