[Personality profile and psychic deviations in offenders examined for psychiatric-forensic appraisal]

Toward a Differentiated Assessment of Narcissism in Forensic Contexts: Validating the Narcissistic Admiration and Rivalry Questionnaire-Short Scale (NARQ-S) in a Forensic Sample

Grandiose narcissism is a multidimensional construct consisting of agentic and antagonistic aspects with markedly distinct correlates and consequences. However, this complexity has not been reflected in how grandiose narcissism is measured and investigated in forensic contexts. To provide a more nuanced picture of narcissism in a forensic context, we harnessed the Narcissistic Admiration and Rivalry Concept. More precisely, we investigated the psychometric properties of the Narcissistic Admiration and Rivalry Questionnaire-Short Scale (NARQ-S) in self- and informant reports of 199 male prisoners. Results confirmed the two-dimensional structure, acceptable internal consistency, moderate self-other agreement, and a differentiated nomological network for the NARQ-S. Admiration and rivalry showed distinct associations with criminal history, institutional misbehaviors, and social status in the group of prisoners. Together, the findings provide initial evidence for the validity and utility of self- and informant reports of the NARQ-S in forensic contexts and its contribution to security and treatment recommendations.

Can we clinically recognize a vascular depression? The role of personality in an expanded threshold model

The vascular depression (VD) hypothesis postulates that cerebrovascular disease may "predispose, precipitate, or perpetuate" a depressive syndrome in elderly patients. Clinical presentation of VD has been shown to differ to major depression in quantitative disability; however, as little research has been made toward qualitative phenomenological differences in the personality aspects of the symptom profile, clinical diagnosis remains a challenge.We attempted to identify differences in clinical presentation between depression patients (n = 50) with (n = 25) and without (n = 25) vascular disease using questionnaires to assess depression, affect regulation, object relations, aggressiveness, alexithymia, personality functioning, personality traits, and counter transference.We were able to show that patients with vascular dysfunction and depression exhibit significantly higher aggressive and auto-aggressive tendencies due to a lower tolerance threshold. These data indicate that VD is a separate clinical entity and secondly that the role of personality itself may be a component of the disease process. We propose an expanded threshold disease model incorporating personality functioning and mood changes. Such findings might also aid the development of a screening program, by serving as differential criteria, ameliorating the diagnostic procedure.

Aggressiveness in different presentations of cluster headache: Results from a controlled multicentric study

Background: The hypothalamus has been discussed as a pivotal structure for both cluster headache (CH) and aggressiveness, but little is known about the extent of self-reported aggressiveness in patients with CH.

Patients and methods: Twenty-six patients with chronic, 25 with active episodic and 22 with episodic CH outside the active period were examined interictally with a validated questionnaire quantifying factors of aggression and compared with 24 migraine patients and 31 headache-free volunteers.

Results: The ANOVA was significant for the subscale ‘self-aggression/depression’ ( F4, 123 = 5.771, p < 0.001) with significant differences between chronic and episodic CH and healthy volunteers. No significant changes were found for other subscales and the sum scale ( F4, 123 < 1.421, p > 0.230). Especially in the clinically most affected group of patients (chronic CH and active episodic CH), high levels of “self-aggression/depression” correlate with higher prevalence of depressive symptoms and higher impairment measured on an emotional and functional level.

Discussion: Self-aggressive and depressive cognitions with highest scores in chronic CH seem to be reactive as they correlate with depressive symptoms and impairment. They should be considered as an important therapeutic target since they impair the patient’s life significantly.

Violence and personality in forensic patients: is there a forensic patient-specific personality profile?

Concerning the discussion about the connection of personality traits, personality disorders, and mental illness, this study focused on the personality profiles of male forensic patients, prison inmates, and young men without criminal reports. The main topic centered on group-specific personality profiles and identifying personality facets corresponding with mental illness. The authors therefore used the Rasch model-based Trier Integrated Personality Inventory. They individually tested 141 German forensic patients with different crime backgrounds, 122 prison inmates, and 111 soldiers of the German army. Within group differences they found that the individuals with mental retardation differ from patients with a personality disorder or psychosis. Patients with mental retardation displayed higher neurotic and/or paranoid personality accents and tended to be low organized and self-confident.

Gender- and violence-related prevalence of mental disorders in prisoners

OBJECTIVES

To clarify the prevalence of mental diseases including personality disorders in a sample of German prisoners regarding delinquency and gender specificity.

METHOD

Crime history, present state and lifetime mental disorders, as well as personality disorders, were assessed amongst 415 inmates and compared regarding gender and type of delinquency.

RESULTS

Female offenders more often committed homicide while male offenders more frequently committed assault and robbery. Men had a higher prevalence of alcohol abuse and dissocial PD while women more often showed depression, anxiety disorders and Borderline PD. Violent offences were related to a higher prevalence of alcohol abuse and dissocial PD, as well as higher comorbidities of mental disorders.

CONCLUSION

Results emphasize the complexity of the needs and requirements of imprisoned offenders. Our findings reveal an urgent need for psychiatric-psychotherapeutic services to provide suitable care to inmates in order to contribute to a more favorable legal prognosis.