Criminality, cognition and personality
Table of Contents
Lecture 1: Introduction (Ch. 1) ................................................................................................... 3
1.1. PDs and violence............................................................................................................................. 4
1.2. Considerations on treatments of offenders with PDs .................................................................... 5
1.3. Identifying treatment targets ......................................................................................................... 6
Lecture 2: Predictors and explanations ...................................................................................... 8
1.1. Establishing causality ...................................................................................................................... 8
1.2. Empirical evidence linking PD to violent behaviour ....................................................................... 9
1.3. Consequences of limited causal models ....................................................................................... 10
1.4. Clinical and political considerations ............................................................................................. 11
1.5. Summary....................................................................................................................................... 11
1.6. Relationship between childhood impulsiveness and later violence ............................................. 11
1.6.1. Previous studies ....................................................................................................................... 12
1.6.2. Why should we focus on violence in particular? ..................................................................... 12
1.6.3. Current investigations.............................................................................................................. 12
Lecture 3: Basic personality traits (Ch. 4).................................................................................. 14
3.1. Why 5 dimensions of personality? ............................................................................................... 14
1. Eysenck’s PEN model ......................................................................................................................... 15
3.2. Associations between FFM and more specific ASB ...................................................................... 16
3.3. Developmental issues ................................................................................................................... 17
3.4. Violent crime and general offending ............................................................................................ 17
3.5. Sexual offending ........................................................................................................................... 18
3.6. Weapons carrying ......................................................................................................................... 18
3.7. Dimensional model of PDs............................................................................................................ 18
3.8. Conclusion .................................................................................................................................... 19
Lecture 4: Narcissism ............................................................................................................... 20
4.1. What is narcissism? ...................................................................................................................... 20
4.2. Narcissism and violence ............................................................................................................... 25
4.3. Risk assessment and management with narcissistic client........................................................... 27
4.4. Treatment ..................................................................................................................................... 28
4.5. Future directions .......................................................................................................................... 28
4.6. Conclusions ................................................................................................................................... 28
Lecture 5: antisocial PD (ASPD) ................................................................................................ 30
5.1. Introduction .................................................................................................................................. 30
5.2. Diagnosis of ASPD ......................................................................................................................... 30
5.3. Differential diagnosis .................................................................................................................... 31
5.4. Prevalence .................................................................................................................................... 31
5.5. Correlates of ASPD........................................................................................................................ 32
5.6. Comorbidities ............................................................................................................................... 32
5.7. Criminality .................................................................................................................................... 32
5.8. Violence ........................................................................................................................................ 32
5.9. Treatments ................................................................................................................................... 34
5.10. Conclusion .................................................................................................................................... 35
Lecture 6: Psychopathy ............................................................................................................ 36
6.1. Introduction .................................................................................................................................. 36
6.2. Concepts of primary and secondary psychopathy........................................................................ 38
6.3. Psychopathy, anxiety and personality .......................................................................................... 39
6.4. Empirical classifications ................................................................................................................ 40
6.5. Clinical implications ...................................................................................................................... 41
Lecture 7: Emotion and cognition in psychopathy .................................................................... 43
7.1. The processing of emotional expression information .................................................................. 43
1
, 7.1.1. Empathy ................................................................................................................................... 43
7.1.2. Responding to emotional expressions in psychopathy............................................................ 45
7.1.3. Difficulties in socialization ....................................................................................................... 46
7.1.4. Conclusions .............................................................................................................................. 46
7.2. Psychopathic violence: a cognitive-attention perspective ........................................................... 47
7.2.1. The clinical evidence ................................................................................................................ 47
7.2.2. The evolution of the response modulation (RM) model ......................................................... 48
7.2.3. Response modulation and psychopathic self-regulation ......................................................... 50
7.2.4. Summary and conclusion ......................................................................................................... 51
Lecture 8: Affect and emotion regulation ................................................................................. 52
8.1. Emotion and emotion regulation (ER) .......................................................................................... 52
8.2. Neurobiology of affective dyscontrol ........................................................................................... 52
8.2.1. Relationship between PD and violent offending ..................................................................... 53
8.2.2. Affective impulsivity and PDs................................................................................................... 53
8.2.3. Brain measures of affective impulsivity ................................................................................... 54
8.2.4. Implications for risk assessment .............................................................................................. 54
8.2.5. Sex differences in PDs .............................................................................................................. 55
8.2.6. Summary .................................................................................................................................. 55
8.3. Angry, affect, aggression and PD .................................................................................................. 55
8.3.1. Sexual aggression..................................................................................................................... 56
8.3.2. Theories of aggression ............................................................................................................. 56
8.3.3. Self-regulation ......................................................................................................................... 57
8.3.4. Anger in PD ppl ........................................................................................................................ 57
8.3.5. Conclusions .............................................................................................................................. 59
8.3.6. Treatment of anger in PDs ....................................................................................................... 59
Lecture 9: Cognition ................................................................................................................. 60
9.1. Social problems solving, PD and violence (Ch. 14) ....................................................................... 60
9.1.1. Social problem solving ............................................................................................................. 60
9.1.2. Treatment ................................................................................................................................ 62
9.1.3. Conclusion ............................................................................................................................... 63
9.2. Criminal thinking........................................................................................................................... 63
9.2.1. Definition ................................................................................................................................. 63
9.2.2. links with ASPD traits ............................................................................................................... 66
9.2.3. Conclusion ............................................................................................................................... 67
Lecture 10: Attachment and empathy ...................................................................................... 68
10.1. Attachment and difficulties .......................................................................................................... 68
10.1.1. Attachment problems and violence .................................................................................... 68
10.1.2. Towards a neurobiological model ....................................................................................... 70
10.1.3. Treatment ........................................................................................................................... 70
10.1.4. Conclusion ........................................................................................................................... 71
10.2. Empathy and offending behaviour ............................................................................................... 71
10.2.1. Conceptual issues................................................................................................................ 71
10.2.2. Models of empathy ............................................................................................................. 71
10.2.3. Measures of empathy ......................................................................................................... 72
10.2.4. Empathy deficits in offenders ............................................................................................. 72
10.2.5. Treatment ........................................................................................................................... 73
10.2.6. Conclusion ........................................................................................................................... 73
Lecture 11: Summary ............................................................................................................... 74
11.1. Introduction: Personality, PDs and violence ................................................................................. 74
11.2. Variants of psychopathy ............................................................................................................... 74
11.3. Mechanisms for understanding PD à violence ........................................................................... 75
11.4. Co-occurrence of disorders .......................................................................................................... 75
11.5. Affective & cognitive processes in a developmental context ....................................................... 76
11.6. Assessment and treatment of violence related to personality and PDs....................................... 76
2
,Lecture 1: Introduction (Ch. 1)
• Importance
o Heterogeneity in
§ Criminal: naïve <-> professional
§ Crimes: trivial <-> highly serious (e.g. violent crimes: injure victims,
spread fear through communities, heterogeneity: low-level aggression
<-> premediated violence)
o One particular group who commits violent crimes more often: ppl with
mental disorders (“mentally disordered offender”) à personality disorders
• Violence = behaviours intended to harm a living being who is motivated to avoid
harm
o No acts that are
§ Accidental
§ Consensual
§ Ultimately beneficial
• Violence vs aggression: violence is the forceful infliction of physical harm, whereas
aggression is behaviour that is less physically harmful, although it is often severely
psychologically damaging (in this course violence refers to aggression and physical
violence)
• Causing harm to individuals, families and communities
• The World Health Organization (WHO) has estimated that a single act of violence
costs on average € 1.5 million.
• Acts of violence are estimated to account for 1.43 million deaths worldwide annually
• Multiple factors to explain violence (Focus in
this course: individual-level explanations)
• Violence vs aggression
o Rationale: People differ in their
proneness to violence
§ Individual differences (personality traits)
§ Personality processes (cognitive, emotional, etc.)
§ Personality disorders (problems with thoughts,...)
• PDs in diagnostic classification systems
o DSM-5
§ Categorical (section II, same DSM-IV) AND
dimensional (section III) perspective
§ Section III (model for PD diagnosis and
conceptualization):
• Multi-axial system disappeared
• Dimensional:
o PD = extreme variants of general personality traits
3
, o Quantitative difference between normal and
dysfunction
o 6 PDs are retained: ASPD, APD, BPD, NPD, OCPD, STPD
o ICD-10
• PDs
•
1.1. PDs and violence
• Prevalence PDs (UK) = 4.4% (men: 5.4% vs women: 3.4%)
• Most are not violent; even antisocial PD: 50% not violent past 5 years
• But: Cluster B elevation criminal risk!
o 10x more likely criminal conviction
o 8x more likely spent time in prison
• PD offenders (vs. other mentally ill offenders):
o More likely to reoffend after discharge from hospital
o 7x more likely to commit a serious reoffense
o More likely to be reconvicted for a serious offense
§ But: majority not reconvicted at all à not all PD traits related to
violence
• ASPD and violence
4
Table of Contents
Lecture 1: Introduction (Ch. 1) ................................................................................................... 3
1.1. PDs and violence............................................................................................................................. 4
1.2. Considerations on treatments of offenders with PDs .................................................................... 5
1.3. Identifying treatment targets ......................................................................................................... 6
Lecture 2: Predictors and explanations ...................................................................................... 8
1.1. Establishing causality ...................................................................................................................... 8
1.2. Empirical evidence linking PD to violent behaviour ....................................................................... 9
1.3. Consequences of limited causal models ....................................................................................... 10
1.4. Clinical and political considerations ............................................................................................. 11
1.5. Summary....................................................................................................................................... 11
1.6. Relationship between childhood impulsiveness and later violence ............................................. 11
1.6.1. Previous studies ....................................................................................................................... 12
1.6.2. Why should we focus on violence in particular? ..................................................................... 12
1.6.3. Current investigations.............................................................................................................. 12
Lecture 3: Basic personality traits (Ch. 4).................................................................................. 14
3.1. Why 5 dimensions of personality? ............................................................................................... 14
1. Eysenck’s PEN model ......................................................................................................................... 15
3.2. Associations between FFM and more specific ASB ...................................................................... 16
3.3. Developmental issues ................................................................................................................... 17
3.4. Violent crime and general offending ............................................................................................ 17
3.5. Sexual offending ........................................................................................................................... 18
3.6. Weapons carrying ......................................................................................................................... 18
3.7. Dimensional model of PDs............................................................................................................ 18
3.8. Conclusion .................................................................................................................................... 19
Lecture 4: Narcissism ............................................................................................................... 20
4.1. What is narcissism? ...................................................................................................................... 20
4.2. Narcissism and violence ............................................................................................................... 25
4.3. Risk assessment and management with narcissistic client........................................................... 27
4.4. Treatment ..................................................................................................................................... 28
4.5. Future directions .......................................................................................................................... 28
4.6. Conclusions ................................................................................................................................... 28
Lecture 5: antisocial PD (ASPD) ................................................................................................ 30
5.1. Introduction .................................................................................................................................. 30
5.2. Diagnosis of ASPD ......................................................................................................................... 30
5.3. Differential diagnosis .................................................................................................................... 31
5.4. Prevalence .................................................................................................................................... 31
5.5. Correlates of ASPD........................................................................................................................ 32
5.6. Comorbidities ............................................................................................................................... 32
5.7. Criminality .................................................................................................................................... 32
5.8. Violence ........................................................................................................................................ 32
5.9. Treatments ................................................................................................................................... 34
5.10. Conclusion .................................................................................................................................... 35
Lecture 6: Psychopathy ............................................................................................................ 36
6.1. Introduction .................................................................................................................................. 36
6.2. Concepts of primary and secondary psychopathy........................................................................ 38
6.3. Psychopathy, anxiety and personality .......................................................................................... 39
6.4. Empirical classifications ................................................................................................................ 40
6.5. Clinical implications ...................................................................................................................... 41
Lecture 7: Emotion and cognition in psychopathy .................................................................... 43
7.1. The processing of emotional expression information .................................................................. 43
1
, 7.1.1. Empathy ................................................................................................................................... 43
7.1.2. Responding to emotional expressions in psychopathy............................................................ 45
7.1.3. Difficulties in socialization ....................................................................................................... 46
7.1.4. Conclusions .............................................................................................................................. 46
7.2. Psychopathic violence: a cognitive-attention perspective ........................................................... 47
7.2.1. The clinical evidence ................................................................................................................ 47
7.2.2. The evolution of the response modulation (RM) model ......................................................... 48
7.2.3. Response modulation and psychopathic self-regulation ......................................................... 50
7.2.4. Summary and conclusion ......................................................................................................... 51
Lecture 8: Affect and emotion regulation ................................................................................. 52
8.1. Emotion and emotion regulation (ER) .......................................................................................... 52
8.2. Neurobiology of affective dyscontrol ........................................................................................... 52
8.2.1. Relationship between PD and violent offending ..................................................................... 53
8.2.2. Affective impulsivity and PDs................................................................................................... 53
8.2.3. Brain measures of affective impulsivity ................................................................................... 54
8.2.4. Implications for risk assessment .............................................................................................. 54
8.2.5. Sex differences in PDs .............................................................................................................. 55
8.2.6. Summary .................................................................................................................................. 55
8.3. Angry, affect, aggression and PD .................................................................................................. 55
8.3.1. Sexual aggression..................................................................................................................... 56
8.3.2. Theories of aggression ............................................................................................................. 56
8.3.3. Self-regulation ......................................................................................................................... 57
8.3.4. Anger in PD ppl ........................................................................................................................ 57
8.3.5. Conclusions .............................................................................................................................. 59
8.3.6. Treatment of anger in PDs ....................................................................................................... 59
Lecture 9: Cognition ................................................................................................................. 60
9.1. Social problems solving, PD and violence (Ch. 14) ....................................................................... 60
9.1.1. Social problem solving ............................................................................................................. 60
9.1.2. Treatment ................................................................................................................................ 62
9.1.3. Conclusion ............................................................................................................................... 63
9.2. Criminal thinking........................................................................................................................... 63
9.2.1. Definition ................................................................................................................................. 63
9.2.2. links with ASPD traits ............................................................................................................... 66
9.2.3. Conclusion ............................................................................................................................... 67
Lecture 10: Attachment and empathy ...................................................................................... 68
10.1. Attachment and difficulties .......................................................................................................... 68
10.1.1. Attachment problems and violence .................................................................................... 68
10.1.2. Towards a neurobiological model ....................................................................................... 70
10.1.3. Treatment ........................................................................................................................... 70
10.1.4. Conclusion ........................................................................................................................... 71
10.2. Empathy and offending behaviour ............................................................................................... 71
10.2.1. Conceptual issues................................................................................................................ 71
10.2.2. Models of empathy ............................................................................................................. 71
10.2.3. Measures of empathy ......................................................................................................... 72
10.2.4. Empathy deficits in offenders ............................................................................................. 72
10.2.5. Treatment ........................................................................................................................... 73
10.2.6. Conclusion ........................................................................................................................... 73
Lecture 11: Summary ............................................................................................................... 74
11.1. Introduction: Personality, PDs and violence ................................................................................. 74
11.2. Variants of psychopathy ............................................................................................................... 74
11.3. Mechanisms for understanding PD à violence ........................................................................... 75
11.4. Co-occurrence of disorders .......................................................................................................... 75
11.5. Affective & cognitive processes in a developmental context ....................................................... 76
11.6. Assessment and treatment of violence related to personality and PDs....................................... 76
2
,Lecture 1: Introduction (Ch. 1)
• Importance
o Heterogeneity in
§ Criminal: naïve <-> professional
§ Crimes: trivial <-> highly serious (e.g. violent crimes: injure victims,
spread fear through communities, heterogeneity: low-level aggression
<-> premediated violence)
o One particular group who commits violent crimes more often: ppl with
mental disorders (“mentally disordered offender”) à personality disorders
• Violence = behaviours intended to harm a living being who is motivated to avoid
harm
o No acts that are
§ Accidental
§ Consensual
§ Ultimately beneficial
• Violence vs aggression: violence is the forceful infliction of physical harm, whereas
aggression is behaviour that is less physically harmful, although it is often severely
psychologically damaging (in this course violence refers to aggression and physical
violence)
• Causing harm to individuals, families and communities
• The World Health Organization (WHO) has estimated that a single act of violence
costs on average € 1.5 million.
• Acts of violence are estimated to account for 1.43 million deaths worldwide annually
• Multiple factors to explain violence (Focus in
this course: individual-level explanations)
• Violence vs aggression
o Rationale: People differ in their
proneness to violence
§ Individual differences (personality traits)
§ Personality processes (cognitive, emotional, etc.)
§ Personality disorders (problems with thoughts,...)
• PDs in diagnostic classification systems
o DSM-5
§ Categorical (section II, same DSM-IV) AND
dimensional (section III) perspective
§ Section III (model for PD diagnosis and
conceptualization):
• Multi-axial system disappeared
• Dimensional:
o PD = extreme variants of general personality traits
3
, o Quantitative difference between normal and
dysfunction
o 6 PDs are retained: ASPD, APD, BPD, NPD, OCPD, STPD
o ICD-10
• PDs
•
1.1. PDs and violence
• Prevalence PDs (UK) = 4.4% (men: 5.4% vs women: 3.4%)
• Most are not violent; even antisocial PD: 50% not violent past 5 years
• But: Cluster B elevation criminal risk!
o 10x more likely criminal conviction
o 8x more likely spent time in prison
• PD offenders (vs. other mentally ill offenders):
o More likely to reoffend after discharge from hospital
o 7x more likely to commit a serious reoffense
o More likely to be reconvicted for a serious offense
§ But: majority not reconvicted at all à not all PD traits related to
violence
• ASPD and violence
4
