Criminality, cognition and personality
*This summary does not guarantee a passing grade on the exam, please study the
materials yourself
*Summary about the lectures
Lecture 1 - introduction
Violence
A range of behaviours intended to harm living beings that are motivated to avoid
harm
Forceful infliction of physical harm
aggressive behaviour is less physical harmful but has severe psychological damage
abilities
Violence is a significant public health issue
o Causing harm to individuals, families and communities
Rationale: people differ in their proneness to violence
Individual differences → personality traits
Personality processes → cognitive and emotional functioning
Personality disorders → problems with thoughts
DSM-IV
Axis I: clinical disorders
Axis II
o A: odd eccentric
Paranoid, schizoid, schizotypal
o B: erratic-dramatic
Antisocial, borderline, histrionic, narcissistic
o C: worried-anxious
Avoidant, dependent, obsessive-compulsive
Negative detachment antagonism disinhibition psychoticism
affectivity
Emotional lability withdrawal manipulativeness irresponsibility Unusual beliefs or
experiences
anxiousness Intimacy deceitfulness Impulsivity Eccentricity
avoidance
Separation anhedonia grandiosity Distractibility Cognitive or
insecurity perceptual
dysregulation
submissiveness depressivity Attention seeking Risk taking
hostility Restricted callousness Rigid
affectivity perfectionism
perseveration suspiciousness
, DSM-V
Crit A: level of personality functioning scale
Crit B: personality inventory for DSM-V
o 25 maladaptive traits in 5 domains
Combination of traits leads to 6 personality disorders
Antisocial PD
Avoidant PD
Borderline PD
Narcissistic PD
Obsessive-compulsive PD
Schizotypal PD
PD offenders
More likely to reoffend after discharge form hospital
7x more likely to commit a serious re-offense
More likely to be reconvicted for a serious offense
o Keep in mind if violence is part of the definition, then the incidence of violence
among those with APD is higher than for those with diagnoses that do not
feature violence
Same problem for psychopathy when using PCL-R
Good predictor for future violence in convicted offenders
But items are a mix of descriptive behaviours (crime, violence
(and explanatory variables (traits)
Clinical risk factors for violence
Impulse control
Affect regulation
Narcissism
Paranoid cognitive personality style
Personality traits
Impulsiveness in children may later lead to increased antisocial behaviour and
aggression
Inhibition in children may later lead to decreased antisocial behaviour and
aggression
Across lifespan
o Interaction of biological, psychological, social and contextual factors determine
a person’s propensity to violence
Important to understand mechanism whereby personality traits increase violence risk
o E.g., emotion regulation, perception, responses to social cures
o Mechanism can be changed over time; this has the potential to reduce
violence
Considerations on the treatments of offenders with PD’s
o Mental illness: degree of choice in the use of violence (legal model)
E.g., there is no moral conflict, loss of control or distress
Formal model of reference
o Personality problems → do they meet PD criteria?
Disadvantages of categorical model
o Individual’s traits, history, thoughts and feelings
Dimensional model
Punishment
, Aims of punishment
o Signal for society: what is acceptable and what is not
o Prevent and reduce crime
We do know that punishment does not actually prevent reoffending
very effectively
Punishment is only effective when the patient understands that
punishment in relation to the deed
What is effective in reducing crime for offenders
o Punitive measures are not!
o Treatment works better than punishment
E.g., CBT is effective, reducing reoffending by 30-40% in adults and
60% in young offenders
To mitigate responsibility for antisocial behaviour/ violence: psychological
explanation/ diagnosis should identify deficiencies that impair person’s agency
o Impaired: rational decisions, control behaviour, awareness of harm
For mental illness, learning disabilities. Intellectual disability and dementia
o Unlikely to be punished
When there is perceived normality in PD patients, they are viewed as responsible
o So, note the difference between mental illness (not responsible) and
personality disorders (responsible)
o Antisocial PD: knows consequences but does not or cannot control behaviour
Intermittent explosive disorder or borderline PD
Violence driven by strong emotions (mostly anger)
Inability to control behaviour
o Emotional dysregulation
Psychopathy
Violence driven by possible gains
o Mostly premeditated
o Control over others and material benefits
o Usually do not want to change, reject treatment
Which of the following statements is wrong?
a. Not all persons with personality problems are violent
b. Patients with personality problems in forensic hospitals/ prisons are representative of
all patients with personality problems
c. Antisocial personality disorder is more strongly related to violence compared to other
personality disorders
d. The clinical risk factors impulse control, affect regulation, narcissism and paranoid
cognitive style can distinguish perpetrators of violence and non-violent offenders
Answer is b
Lecture 2: predictors and explanations
Dangerous and severe personality disorder program
Acknowledges treatability of PD’s
Introduces scientific basis for court decisions
Criteria for compulsory treatment in DPSD units
o Severe PD
High level of psychopathy
Combination of high psychopathy and at least one PD
, Or two or more PDs, when there is no psychopathy
o Risk of violence within 5 years needs to be high
Based on risk assessment
o Functional link between above 2 criteria
There needs to be covariation
There needs to be a causal connection
Establishing causality
Covariation
o Are PD’s and violence related?
o Problems
Combination of categorical (DSM) and dimensional constructs
(psychopathy)
Use of cut-off scores
Assumption that all PD’s are equally related to violence
Temporal precedence
o Can we assess that PD preceded the violence?
Examine beliefs, thoughts, feelings in the chain of events leading to
the offense
Exclusion of alternative explanations
o Third variables
E.g., substance abuse
Establishing logical connection
o How does X cause Y?
o Solution: breaking down the PD in its symptoms and analyse them in relation
to offense
Watch out for comorbidity!
PD’s and violence
Epidemiological surveys
o Presence of any PD related to increase in violence risk
o Partly accounted for by comorbid conditions (e.g., substance abuse)
o Comorbidity between PD’s magnifies risk
Compare prevalence of PDs in violent vs. non-violent offenders
o ASPD/ dissocial PD related, but not as strongly as substance use
Follow a cohort from childhood through adulthood
o Paranoid PD → burglary and threatening behaviour
o Narcissistic PD → arson, vandalism, physical fights, violence
o Borderline PD → same as NPD
o alcohol/ substance abuse mediates PD violence link longitudinally
Consequences for bad causal models
Incompatibility between causal models
o Implications for treatment
o Basically impossible to prove primacy
o Explanations
Predisposing factors
External or internal triggers
Organismic variables
Neurobiological functioning, capacity to reason
Presumption of unidirectionality
o Unidirectionality or bi-directionality influence treatment, you may focus more
on social network for example
o Example of psychopathy
*This summary does not guarantee a passing grade on the exam, please study the
materials yourself
*Summary about the lectures
Lecture 1 - introduction
Violence
A range of behaviours intended to harm living beings that are motivated to avoid
harm
Forceful infliction of physical harm
aggressive behaviour is less physical harmful but has severe psychological damage
abilities
Violence is a significant public health issue
o Causing harm to individuals, families and communities
Rationale: people differ in their proneness to violence
Individual differences → personality traits
Personality processes → cognitive and emotional functioning
Personality disorders → problems with thoughts
DSM-IV
Axis I: clinical disorders
Axis II
o A: odd eccentric
Paranoid, schizoid, schizotypal
o B: erratic-dramatic
Antisocial, borderline, histrionic, narcissistic
o C: worried-anxious
Avoidant, dependent, obsessive-compulsive
Negative detachment antagonism disinhibition psychoticism
affectivity
Emotional lability withdrawal manipulativeness irresponsibility Unusual beliefs or
experiences
anxiousness Intimacy deceitfulness Impulsivity Eccentricity
avoidance
Separation anhedonia grandiosity Distractibility Cognitive or
insecurity perceptual
dysregulation
submissiveness depressivity Attention seeking Risk taking
hostility Restricted callousness Rigid
affectivity perfectionism
perseveration suspiciousness
, DSM-V
Crit A: level of personality functioning scale
Crit B: personality inventory for DSM-V
o 25 maladaptive traits in 5 domains
Combination of traits leads to 6 personality disorders
Antisocial PD
Avoidant PD
Borderline PD
Narcissistic PD
Obsessive-compulsive PD
Schizotypal PD
PD offenders
More likely to reoffend after discharge form hospital
7x more likely to commit a serious re-offense
More likely to be reconvicted for a serious offense
o Keep in mind if violence is part of the definition, then the incidence of violence
among those with APD is higher than for those with diagnoses that do not
feature violence
Same problem for psychopathy when using PCL-R
Good predictor for future violence in convicted offenders
But items are a mix of descriptive behaviours (crime, violence
(and explanatory variables (traits)
Clinical risk factors for violence
Impulse control
Affect regulation
Narcissism
Paranoid cognitive personality style
Personality traits
Impulsiveness in children may later lead to increased antisocial behaviour and
aggression
Inhibition in children may later lead to decreased antisocial behaviour and
aggression
Across lifespan
o Interaction of biological, psychological, social and contextual factors determine
a person’s propensity to violence
Important to understand mechanism whereby personality traits increase violence risk
o E.g., emotion regulation, perception, responses to social cures
o Mechanism can be changed over time; this has the potential to reduce
violence
Considerations on the treatments of offenders with PD’s
o Mental illness: degree of choice in the use of violence (legal model)
E.g., there is no moral conflict, loss of control or distress
Formal model of reference
o Personality problems → do they meet PD criteria?
Disadvantages of categorical model
o Individual’s traits, history, thoughts and feelings
Dimensional model
Punishment
, Aims of punishment
o Signal for society: what is acceptable and what is not
o Prevent and reduce crime
We do know that punishment does not actually prevent reoffending
very effectively
Punishment is only effective when the patient understands that
punishment in relation to the deed
What is effective in reducing crime for offenders
o Punitive measures are not!
o Treatment works better than punishment
E.g., CBT is effective, reducing reoffending by 30-40% in adults and
60% in young offenders
To mitigate responsibility for antisocial behaviour/ violence: psychological
explanation/ diagnosis should identify deficiencies that impair person’s agency
o Impaired: rational decisions, control behaviour, awareness of harm
For mental illness, learning disabilities. Intellectual disability and dementia
o Unlikely to be punished
When there is perceived normality in PD patients, they are viewed as responsible
o So, note the difference between mental illness (not responsible) and
personality disorders (responsible)
o Antisocial PD: knows consequences but does not or cannot control behaviour
Intermittent explosive disorder or borderline PD
Violence driven by strong emotions (mostly anger)
Inability to control behaviour
o Emotional dysregulation
Psychopathy
Violence driven by possible gains
o Mostly premeditated
o Control over others and material benefits
o Usually do not want to change, reject treatment
Which of the following statements is wrong?
a. Not all persons with personality problems are violent
b. Patients with personality problems in forensic hospitals/ prisons are representative of
all patients with personality problems
c. Antisocial personality disorder is more strongly related to violence compared to other
personality disorders
d. The clinical risk factors impulse control, affect regulation, narcissism and paranoid
cognitive style can distinguish perpetrators of violence and non-violent offenders
Answer is b
Lecture 2: predictors and explanations
Dangerous and severe personality disorder program
Acknowledges treatability of PD’s
Introduces scientific basis for court decisions
Criteria for compulsory treatment in DPSD units
o Severe PD
High level of psychopathy
Combination of high psychopathy and at least one PD
, Or two or more PDs, when there is no psychopathy
o Risk of violence within 5 years needs to be high
Based on risk assessment
o Functional link between above 2 criteria
There needs to be covariation
There needs to be a causal connection
Establishing causality
Covariation
o Are PD’s and violence related?
o Problems
Combination of categorical (DSM) and dimensional constructs
(psychopathy)
Use of cut-off scores
Assumption that all PD’s are equally related to violence
Temporal precedence
o Can we assess that PD preceded the violence?
Examine beliefs, thoughts, feelings in the chain of events leading to
the offense
Exclusion of alternative explanations
o Third variables
E.g., substance abuse
Establishing logical connection
o How does X cause Y?
o Solution: breaking down the PD in its symptoms and analyse them in relation
to offense
Watch out for comorbidity!
PD’s and violence
Epidemiological surveys
o Presence of any PD related to increase in violence risk
o Partly accounted for by comorbid conditions (e.g., substance abuse)
o Comorbidity between PD’s magnifies risk
Compare prevalence of PDs in violent vs. non-violent offenders
o ASPD/ dissocial PD related, but not as strongly as substance use
Follow a cohort from childhood through adulthood
o Paranoid PD → burglary and threatening behaviour
o Narcissistic PD → arson, vandalism, physical fights, violence
o Borderline PD → same as NPD
o alcohol/ substance abuse mediates PD violence link longitudinally
Consequences for bad causal models
Incompatibility between causal models
o Implications for treatment
o Basically impossible to prove primacy
o Explanations
Predisposing factors
External or internal triggers
Organismic variables
Neurobiological functioning, capacity to reason
Presumption of unidirectionality
o Unidirectionality or bi-directionality influence treatment, you may focus more
on social network for example
o Example of psychopathy
