Psychopathy

精神病
  • 文章类型: Journal Article
    背景:据报道,患有反社会人格障碍(ASPD)和边缘性人格障碍(BPD)的人具有高度精神病性,对治疗工作构成严峻挑战。在这些人的样本中,两种治疗的效果,基于心理的治疗(MBT)和统一协议(UP),对三个结果进行了调查:(I)精神病特质领域,三位一体精神病模型(TPM)提出的大胆和抑制;(ii)反社会和临界症状严重程度;(iii)其共同特征的严重程度,包括冲动,愤怒的表达和自我伤害。
    方法:对163名BPD+ASPD患者进行筛选,55例随机接受MBT治疗,53例随机接受UP治疗。以6个月至36个月的间隔评估治疗结果。
    结果:两种治疗方法的精神病特征均出现短期减少,反社会和边缘性人格症状的严重程度,愤怒失调,冲动和自我伤害,但两个治疗组在36个月随访时症状几乎完全复发.UP比MBT具有更持久的效果。
    结论:尽管治疗时间相当短,UP至少与MBT一样有效,并且在某些方面更优越。从长远来看,任何一种治疗都无法缓解症状。与之相关的精神病和边缘/反社会合并症在某种程度上可以通过心理治疗来补救,但只是在短期内。
    结论:冲动性和去抑制性高的患者在心理治疗后可能复发,治疗后应密切监测。
    BACKGROUND: Those with cooccurring antisocial personality disorder (ASPD) and borderline personality disorder (BPD) are reported to be highly psychopathic and to represent a severe challenge to treatment efforts. In a sample of such individuals, the effects of two treatments, mentalization-based therapy (MBT) and the unified protocol (UP), were investigated on three outcomes: (i) the psychopathy trait domains of meanness, boldness and disinhibition proposed by the triarchic psychopathy model (TPM); (ii) antisocial and borderline symptom severity; and (iii) the severity of their common features including impulsivity, anger expression and self-harm.
    METHODS: Of 163 individuals with BPD + ASPD screened for eligibility, 55 were randomized to MBT treatment and 53 to UP treatment. Outcomes of treatment were assessed at 6-month intervals to 36 months.
    RESULTS: Short-term reductions were seen following both treatments in traits of psychopathy, antisocial and borderline personality symptom severity, anger dysregulation, impulsivity and self-harm, but both treatment groups showed almost complete relapse of symptoms at the 36-month follow-up. UP had more durable effects than MBT.
    CONCLUSIONS: Despite being a considerably shorter treatment, UP was at least as effective as MBT and in some respects superior. Remission of symptoms was not achieved by either treatment in the long term. Psychopathy and borderline/antisocial comorbidity with which it is associated are to some extent remediable through psychotherapy, but only in the short term.
    CONCLUSIONS: Patients with high levels of impulsivity and disinhibition are likely to relapse following psychotherapy and should be closely monitored after treatment.
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  • 文章类型: Journal Article
    目标:尽管有令人震惊的证据表明对妇女的性暴力,人们对男性对强奸的情绪反应以及这些可能如何参与性暴力动态知之甚少。因此,我们的目的是捕捉如何在情感上评估强奸场景。方法:本研究评估了男性(N=30)的自我报告和心理生理情绪反应(面部肌电图,皮肤电活动)到强奸现场,并将其与他们对描绘非性暴力和非暴力男女互动的刺激的反应进行了对比。男人的情绪反应和他们对强奸神话的认可之间的联系,个性,还检查了性特征。结果:研究结果表明,强奸现场导致更高的负面影响,主观上和通过增加的面部肌电图(瓦楞纸板活动)索引,比其他两个刺激。此外,神经质的人格特质,较低的宜人性,较低的意识,精神病倾向,以及较低的性抑制倾向,都与强奸的主观性唤起有关。结论:研究结果增加了有关推定情感过程的文献,这些情感过程是对妇女的性暴力评估的基础。
    Objective: Despite alarming evidence on sexual violence against women, little is known about men\'s emotional responses to rape and how these may be involved in sexual violence dynamics. Accordingly, our aim was to capture how rape scenarios are emotionally appraised. Methods: The current study evaluated men\'s (N = 30) self-reported and psychophysiological emotional responses (facial EMG, electrodermal activity) to a rape scene, and contrasted it with their responses to stimuli depicting nonsexual violence and nonviolent male-female interactions. The associations between men\'s emotional responses and their endorsement of rape myths, personality, and sexual traits were also examined. Results: Findings revealed that the rape scene resulted in higher negative affect, both subjectively and indexed by increased facial EMG (corrugator activity), than the other two stimuli. Additionally, personality traits of neuroticism, lower agreeableness, lower consciousness, psychopathic tendencies, as well as lower sexual inhibition proneness, were all associated with higher subjective sexual arousal toward rape. Conclusions: Findings add to the literature on the putative emotional processes underpinning the appraisal of sexual violence against women.
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  • 文章类型: Journal Article
    精神病是一种多方面的人格障碍,其特征是不同的情感/人际关系特征,包括冷酷-单调乏味/卑鄙,这通常被认为是移情缺陷的标志。有人认为,处理他人的痛苦可能在移情能力中起重要作用。这项研究旨在研究在与精神病性冷酷有关的疼痛处理过程中,透视对皮层电反应的影响。测量了晚期正电位(LPP)-一种公认的持续关注动机上重要的刺激的电生理指标,同时有100名女大学生观看了描绘身体伤害的图像,同时采用了想象自我或想象他人的观点。冷酷因子得分-根据EFA的三个相关自我报告测量值计算为基于回归的分量得分-在想象-其他(但不是想象-自我)视角下预测的降低的LPP振幅到疼痛图片,即使在控制其他LPP条件后。这一结果表明,高度冷酷的个体表现出对他人痛苦的大脑反应能力减弱,可能导致在精神病中观察到的移情缺陷。这一发现凸显了LPP的有用性,并从疼痛处理的研究角度出发,以完善我们对生物行为学上精神病的低同理心特征的理解。
    Psychopathy is a multifaceted personality disorder characterized by distinct affective/interpersonal traits, including callousness-unemotionality/meanness, which are often considered the hallmarks of empathic deficits. It has been posited that the processing of others\' pain could play an important role in empathy capabilities. This study aimed to investigate the influence of perspective taking on electrocortical responses during pain processing in relation to psychopathic callousness. The late positive potential (LPP) -a well-established electrophysiological indicator of sustained attention to motivationally significant stimuli- was measured while 100 female undergraduates viewed images depicting bodily injuries while adopting an imagine-self or an imagine-other perspective. Callousness factor scores -computed as regression-based component scores from EFA on three relevant self-report measures of this dimension- predicted reduced LPP amplitudes to pain pictures under the imagine-other (but not imagine-self) perspective, even after controlling for other LPP conditions. This result suggests that high-callous individuals exhibit diminished brain responsiveness to others\' distress, potentially contributing to the empathic deficits observed in psychopathy. This finding highlights the usefulness of the LPP and perspective taking in studies on pain processing to refine our understanding of the low empathy characteristics of psychopathy in biobehavioral terms.
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  • 文章类型: Journal Article
    精神病特征与参与刑事法律制度的青少年的再逮捕有关。以前的大部分工作都集中在白色样本上,短期跟进窗口,和相对低风险的年轻人。当前的研究旨在评估Hare精神病清单:青年版(PCL:YV)在大量高风险样本中预测一般和暴力重罪累犯的实用性,主要是西班牙裔/拉丁裔,男性青少年(n=254),随访5年。结果表明,较高的PCL:YV得分和较低的全面估计IQ得分与较短的重罪和暴力重罪逮捕时间显着相关。这些影响普遍适用于西班牙裔/拉丁裔青少年(n=193),该群体面临着被拘留或被关押在美国青少年教养所的不成比例的风险。这些结果表明,专家评估的精神病特征和智商指标是可靠的预测因素随后在高风险男性青少年中重罪和暴力重罪再次逮捕。
    Psychopathic traits have been associated with rearrest in adolescents involved in the criminal legal system. Much of the prior work has focused on White samples, short follow-up windows, and relatively low-risk youth. The current study aimed to evaluate the utility of the Hare Psychopathy Checklist: Youth Version (PCL:YV) for predicting general and violent felony recidivism in a large sample of high-risk, predominantly Hispanic/Latino, male adolescents (n = 254) with a five-year follow-up period. Results indicated higher PCL:YV scores and lower full-scale estimated IQ scores were significantly associated with a shorter time to felony and violent felony rearrest. These effects generalized to Hispanic/Latino adolescents (n = 193)-a group that faces disproportionate risk of being detained or committed to juvenile correctional facilities in the U.S. These results suggest that expert-rated measures of psychopathic traits and IQ are reliable predictors of subsequent felony and violent felony rearrest among high-risk male adolescents.
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  • 文章类型: Journal Article
    物质使用障碍(SUDs)和创伤后应激障碍(PTSD)显著共存;因此,确定这两种疾病的潜在相关因素对于推进预防策略很重要。这项研究的目的是比较患有和不患有PTSD的SUD妇女的潜在相关变量,并调查这些因素是否与SUD严重程度相关。
    95名在土耳其接受门诊治疗的SUD参与者(女性)使用边缘人格问卷进行评估,童年创伤问卷,成瘾概况指数,莱文森自我报告精神病问卷,和基本的移情量表。
    患有PTSD的参与者的成瘾严重程度明显更高,童年创伤,边缘性格特征,二级精神病评分,与没有PTSD的参与者相比,情感移情得分(P=.013,P=.012,P=.008,P=.031,P=.040)。
    我们的研究表明,PTSD和SUD合并症导致更复杂的表现。对于从业者来说,筛查患有严重SUD和复杂临床表现的女性的PTSD症状似乎至关重要。
    UNASSIGNED: Substance use disorders (SUDs) and post-traumatic stress disorder (PTSD) significantly coexist; thus, identifying potential related factors of both illnesses is important for advancing the prevention strategies. The goals of this study were to compare women with SUD with and without PTSD in terms of potentially related variables and to investigate if those factors are associated with SUD severity.
    UNASSIGNED: Ninety-five participants (women) with SUD who had been admitted to the outpatient treatment clinic in Turkey were assessed with borderline personality questionnaire, childhood trauma questionnaire, addiction profile index, Levenson self-report psychopathy questionnaire, and basic empathy scale.
    UNASSIGNED: Participants with PTSD had significantly higher severity of addiction, childhood trauma, borderline personality traits, secondary psychopathy scores, and affective empathy scores than participants without PTSD (P = .013, P = .012, P = .008, P = .031, P = .040).
    UNASSIGNED: Our study suggested that comorbid PTSD and SUD resulted in more complicated presentation. It seems to be crucial for practitioners to screen PTSD symptoms in women with severe SUD and complicated clinical presentations.
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  • 文章类型: Journal Article
    背景:患有人格障碍的罪犯在治疗中的参与和保留可能具有挑战性。英国罪犯人格障碍(OPD)途径旨在主动和响应地识别和接触人格障碍的罪犯。然而,已发现道路上的罪犯亚群未被接受任何OPD服务,因此未能进展。
    目的:本研究旨在识别和描述OPD途径中未能进展的罪犯,并了解个体未能在该途径中进展的因果驱动因素。
    方法:将被拒绝接受至少两种OPD服务的50名OPD途径罪犯(非进展组)与接受OPD服务的100名罪犯(对照组)进行比较。偏最小二乘结构方程模型用于对不被OPD服务接受的因果因素进行建模。
    结果:结构模型中的路径系数表明,非进展中影响最大的因素是对治疗的态度(β=.41;P<.001;f2=0.25)以及精神病理学(β=.41;P<.001;f2=0.25),具体来说,精神病,精神病,和共同发生的人格障碍。
    结论:该研究的结果为将来如何与该人群合作以增加接受OPD服务的可能性提供了基础。
    BACKGROUND: Offenders with personality disorder can be challenging to engage and retain in treatment. The UK Offender Personality Disorder (OPD) pathway aims to proactively and responsively identify and engage offenders with personality disorder. However, a subpopulation of offenders on the pathway have been found to not be accepted into any OPD service and therefore fail to progress.
    OBJECTIVE: This study aims to identify and describe offenders on the OPD pathway who fail to progress and to understand the causal drivers by which individuals fail to progress in the pathway.
    METHODS: A sample of 50 offenders on the OPD pathway who had been refused from at least two OPD services (nonprogression group) were compared to 100 offenders accepted into OPD services (control group). Partial least squares structural equation modeling was used to model the causal factors involved in not being accepted into OPD services.
    RESULTS: The path coefficients in the structural model showed that the most influential factor in nonprogression was attitude toward treatment (β=.41; P<.001; f2=0.25) alongside those with psychopathology (β=.41; P<.001; f2=0.25), specifically, psychopathy, psychosis, and co-occurring personality disorder.
    CONCLUSIONS: The findings of the study provide a basis of how to work with this population in the future to increase the likelihood of acceptance into OPD services.
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  • 文章类型: Journal Article
    精神病及其前体似乎与异常的情感反应有关。例如,患有精神病的人对不愉快的刺激表现出降低的心理生理反应,这可能解释了精神病患者的低同理心,以及他们追求个人目标而不考虑他人的福祉。为了与精神病理学最好表现在连续统一体上的观念保持一致,三元模型表明,精神病的特征是三个特征的高度:大胆,卑鄙和抑制。了解这些特征如何与对情绪刺激的心理生理反应相关,将有助于验证三元模型,同时也桥接到其他精神病理学光谱(例如,内化精神病理学,其特点是胆量低)。这里,N=123名年轻人被动地认为不愉快,记录了愉快和中性的图片,同时记录了主观和皮质电反应。控制其他三权分立特征,具有较高自我报告的卑鄙性的个体对愉快和不愉快的图片具有较小的晚期正电位(LPP),而胆量较高的个体对不愉快的图片有较大的LPP。此外,那些卑鄙程度较高的人认为不愉快的照片更令人愉快,情感上不那么激动。解除抑制与LPP或评级无关。卑鄙似乎会对以前在精神病患者中观察到的令人不快的照片做出迟钝的反应,也可能与一般愉快刺激的参与减少有关。此外,结果与先前关于跨诊断相关性其他特征的工作趋同(例如,外向),以及内化症状,在精神病和其他形式的精神病理学之间架起一座桥梁。
    Psychopathy and its precursors appear to be associated with abnormal affective response. For example, individuals high in psychopathy show reduced psychophysiological response to unpleasant stimuli, which might explain low levels of empathy in psychopathic individuals, and their pursuit of individual goals without regard for others\' wellbeing. In keeping with the notion that psychopathology is best represented on a continuum, the triarchic model suggests that psychopathy is characterized by elevations on three traits: boldness, meanness and disinhibition. Understanding how these traits relate to psychophysiological response to emotional stimuli would help validate the triarchic model, while also bridging to other psychopathological spectra (e.g., internalizing psychopathology, which is characterized by low boldness). Here, N = 123 young adults passively viewed unpleasant, pleasant and neutral pictures while subjective and electrocortical response were recorded. Controlling for the other triarchic traits, individuals with higher self-reported meanness had smaller late positive potentials (LPPs) to both pleasant and unpleasant pictures, whereas individuals higher in boldness had larger LPPs to unpleasant pictures. In addition, those higher in meanness rated unpleasant pictures as more pleasant and less emotionally arousing. Disinhibition was not associated with the LPP or ratings. Meanness appears to drive blunted response to unpleasant pictures that has previously been observed among those high on psychopathy, and may also be associated with reduced engagement with generic pleasant stimuli. Moreover, results converge with prior work on other traits of transdiagnostic relevance (e.g., extraversion), as well as internalizing symptoms, providing a bridge between psychopathy and other forms of psychopathology.
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  • 文章类型: Journal Article
    研究表明,精神分裂症会增加犯罪行为的风险,以及与精神分裂症定义和相关的变量,增加刑事犯罪。有预谋的刑事犯罪被认为是一种严重的刑事犯罪,然而,对精神分裂症未来有预谋的刑事犯罪的预测知之甚少。
    在这项为期6年的随访研究中,我们探索了被诊断为精神分裂症(N=116)的患者样本中未来有预谋的犯罪行为的基础因素。我们还调查了特定的心智化特征是否构成有预谋的刑事犯罪差异的一部分。
    结果表明,精神病是精神分裂症未来有预谋犯罪的基础,以及一个特定的心态简介,由与他人相关的功能失调的情绪和完整的认知心态构成,精神病与有预谋的刑事犯罪之间关系的调解部分。最后,我们的结果表明,与具有其他心理表现的患者相比,具有特定心理表现的精神分裂症患者(见上文)在6年随访期间更早发生有预谋的犯罪行为.
    我们的研究结果表明,在精神分裂症患者中,应仔细检查与未来有预谋的犯罪有关的心理。
    UNASSIGNED: Research has shown that schizophrenia augments the risk for criminal behaviour and variables both defining- and related to schizophrenia, increase criminal offending. Premeditated criminal offending is considered a severe form of criminal offending, however, very little is known about what predicts future premeditated criminal offending in schizophrenia.
    UNASSIGNED: In this 6-year follow-up study we explored which factors underlie future premeditated criminal behaviour in a sample of patients diagnosed with schizophrenia (N = 116). We also investigated if a specific mentalizing profile underlie part of the variance of premeditated criminal offending.
    UNASSIGNED: Results showed that psychopathy underlie future premeditated crime in schizophrenia, and that a specific mentalizing profile, comprised of a dysfunctional emotional and intact cognitive mentalizing profile in relation to others, mediated parts of the relation between psychopathy and premeditated criminal offending. Finally, our results indicated that patients with schizophrenia with a specific mentalizing profile (see above) engaged in premeditated criminal behaviour earlier during the 6-year follow-up period compared to patients with other mentalizing profiles.
    UNASSIGNED: Our findings suggest that mentalization should carefully be inspected in patients with schizophrenia in relation to future premeditated offending.
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  • 文章类型: Journal Article
    精神病的三位一体模型强调三个表型人格域(大胆,卑鄙,和解除抑制)已使用完善的多维人格问卷进行了操作。本研究试图进一步验证MPQ-Tri量表,并从达尼丁多学科健康与发展研究的两个时间点(18岁和26岁)检查其时间稳定性和预测有效性。人口代表性和纵向样本(N=1,037)。这项调查需要修改MPQ-Tri量表,以便在更广泛的样品中使用。包括达尼丁研究.修订后的MPQ-Tri量表显示出良好的时间稳定性,相关性和多元线性回归分析主要显示与理论预期一致的关联。总的来说,这些发现为MPQ-Tri量表提供了可靠的支持,稳定,以及三位一体结构的有效度量,这提供了一个独特的机会,可以在各种样本中检查有关精神病的高度新颖的研究问题。
    The triarchic model of psychopathy emphasizes the role of three phenotypic personality domains (boldness, meanness, and disinhibition) that have been operationalized using the well-established Multidimensional Personality Questionnaire. The present study sought to further validate the MPQ-Tri scales and examine their temporal stability and predictive validity across two time points (ages 18 and 26) from the Dunedin Multidisciplinary Health and Development Study, a population-representative and longitudinal sample (N = 1,037). This investigation necessitated modification of the MPQ-Tri scales to enable their use in a broader range of samples, including the Dunedin Study. The revised MPQ-Tri scales demonstrated good temporal stability, and correlation and multiple linear regression analyses predominantly revealed associations consistent with theoretical expectations. Overall, the findings provide support for the MPQ-Tri scales as reliable, stable, and valid measures of the triarchic constructs, which provide a unique opportunity to examine highly novel research questions concerning psychopathy in a wide variety of samples.
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  • 文章类型: Observational Study
    精神分裂症谱系障碍(SSD)与暴力行为之间的关联是复杂的,需要进一步研究。暴力行为的认知相关性,特别是,还有待进一步调查。本研究的目的是全面评估SSD暴力罪犯的认知和临床特征,并评估暴力行为的个体预测因素。将50名在法医精神病学环境中因暴力犯罪被定罪并被诊断患有SSD的囚犯与50名年龄相匹配的非罪犯患者进行比较,性别,教育,和诊断。根据社会人口统计学对罪犯和非罪犯参与者进行了比较,临床,和认知变量使用非参数检验来选择暴力行为的潜在预测因子。然后进行多变量逻辑回归以确定暴力行为的个体预测因子。罪犯参与者表现出更多的学校失败,药物使用的患病率更高,较高的临床总体印象严重程度量表(CGI-S)和阳性和阴性综合征量表兴奋分量(PANSS-EC)评分,更差的工作记忆和更好的注意力表现,较高的历史临床和风险管理量表20(HCR-20)和野兔精神病检查表(PCL-R)在所有子领域和因素。学校失败,更高的PANSS-EC分数,更差的工作记忆和处理速度,更好的注意力表现,HCR-20管理分量表和PCL-R“Callous”因子中的较高得分成为暴力行为的预测因子。更好的注意力表现与更高的PCL-R“Callous”因子得分相关,在PCL-R“不稳定”因子得分较高的几个领域中,认知表现较差。总之,本研究强调了在所有临床中仔细评估有暴力行为的SSD患者的重要性,认知,和行为方面。
    The association between schizophrenia spectrum disorders (SSD) and violent behavior is complex and requires further research. The cognitive correlates of violent behavior, in particular, remain to be further investigated. Aims of the present study were to comprehensively assess the cognitive and clinical profile of SSD violent offenders and evaluate individual predictors of violent behavior. Fifty inmates convicted for violent crimes in a forensic psychiatry setting and diagnosed with SSD were compared to fifty non-offender patients matched for age, gender, education, and diagnosis. Offender and non-offender participants were compared based on socio-demographic, clinical, and cognitive variables using non-parametric testing to select potential predictors of violent behavior. Multivariate logistic regressions were then performed to identify individual predictors of violent behavior. Offender participants showed more school failures, higher prevalence of substance use, higher Clinical Global Impression Severity Scale (CGI-S) and Positive and Negative Syndrome Scale Excited Component (PANSS-EC) scores, worse working memory and better attention performance, higher Historical Clinical and Risk Management scale 20 (HCR-20) and Hare Psychopathy Checklist (PCL-R) scores in all subdomains and factors. School failures, higher PANSS-EC scores, worse working memory and processing speed, better attention performance, higher scores in HCR-20 Management subscale and the PCL-R \"Callous\" factor emerged as predictors of violent behavior. Better attentional performance was correlated with higher PCL-R \"Callous\" factor scores, worse cognitive performance in several domains with higher PCL-R \"Unstable\" factor scores. In conclusion, the present study highlights the importance of carefully assessing SSD patients with violent behavior in all clinical, cognitive, and behavioral aspects.
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