صفات شخصیتی مربوط به اختلالات فکری و روانی در بزهکاران نوجوان مرد: استفاده از یک رویکرد شخص گرا

Deviations from the normal, including pathological deviations, are frequently regarded as disorders of personality. Measuring personality traits is an important research method when studying deviant populations. Self-report personality inventories are used to measure personality traits. One such inventory is the Karolinska Scales of Personality (KSP), which is intended to measure certain vulnerability factors that underlie aspects of deviancy—in particular, psychopathy (Schalling, 1978). Some personality characteristics, such as impulsiveness, thrill seeking, and the need for change, are clearly relevant when studying psychopathy. Psychopaths are certainly avid sensation seekers. The most recent definition of sensation seeking is: “a trait defined by the seeking of varied, novel, complex, and intense sensations and experiences, and the willingness to take physical, social, legal, and financial risks for the sake of such experience” (Zuckerman, 1994, p. 27). The KSP Impulsiveness scale, which refers to impulsive behavior, preference for speed rather than accuracy, and carefreeness, is intended to measure the construct of impulsiveness (prompt reactions without thinking). The KSP includes the Monotony Avoidance scale, which measures sensation seeking by mere general items and is highly correlated with the Total sensation-seeking scale from the Zuckerman Sensation-Seeking Scales (SSS-V; Zuckerman, 1994). The KSP Socialization scale includes abridged and modified (with reversed scoring) items from a psychopathy scale. This scale is the Gough Delinquency scale (Gough, 1960), and it is theoretically linked to the concept of psychopathy (Hare & Cox, 1978). Some empirical results showed, however, that the KSP Socialization scale (at least in criminal populations) reflects negative childhood experiences, poor adjustment in school and in the family, social isolation, and current general dissatisfaction, rather than indicating psychopathy. The factors that explain a low score on the Socialization scale may be associated with more fundamental problems, such as unidentified dyslexia and hyperactivity disorder (Dåderman & Jonsson, submitted for publication).

Low anxiety has been consistently associated with a diagnosis of psychopathy (e.g., Cleckley, 1976). Two different types of anxiety scales have been developed, and both are included in the KSP. These two types are known as somatic anxiety (autonomic disturbances, concentration difficulties, vague distress, and panic attacks) and psychic anxiety (worry, insecurity and social anxiety, and anticipatory anxiety). This distinction is based on a two-factor theory of anxiety Buss, 1962 and Schalling et al., 1975. This theory analyzes these anxiety constructs and suggests that they arise from two different biological factors. Some items regarding muscular tension were included in the first version of the KSP Psychic Anxiety scale, but psychometrical analyses showed that muscular tension is a separate construct, and this led to the inclusion in the KSP of the Muscular Tension scale, together with other similar items concerned with trembling, feeling stiff, gnashing jaws, and tenseness in the muscles. All aggressiveness and hostility scales from the KSP are adapted from the Buss–Durkee Hostility Inventory (Buss, 1961). 1.2. A two-factor model of psychopathy measured by the PCL-R Psychopathy, as assessed by the Psychopathy Checklist—Revised, PCL-R (Hare, 1991), consists of interpersonal and affective personality traits, and socially deviant behavior. The PCL-R is a 20-item tool. Factor analyses performed in different settings have arrived at a stable two-factor solution (e.g., Harpur et al., 1988, Harpur et al., 1989, Hobson & Shine, 1998, Molto et al., 2000 and Reiss et al., 2001). The first factor, denoted “selfish, callous, and remorseless use of others,” comprises eight items that load .40 or above onto it. This factor contains the interpersonal/affective characteristics and is characterized by shallow and superficial emotions, an absence of guilt and empathy, and a callous use of others. The second factor, denoted “chronically unstable, antisocial, and socially deviant lifestyle,” comprises nine items that load above .40 onto it and is characterized by a short temper, irresponsible and impulsive actions, and criminal activities. The correlation coefficient between the two factors is approximately .50, and the occurrence of these psychopathic characteristics in the same person seems to describe a person who is likely to show a severe and chronic pattern of deviant behavior. Based on a forensic psychiatric sample of adult offenders in the Netherlands, Hildebrand, de Ruiter, de Vogel, and van der Wolf (2002) have recently published results that did not confirm the traditional two-factor (Harpur et al., 1989) model nor the three-factor model (Cooke & Michie, 2001) of psychopathy. Future research in this area may clarify different external correlates (e.g., violence) to these factor models. Although some researchers (e.g., Cooke & Michie, 2001 and Darke et al., 1998) postulated that the PCL-R might consist of more than two factors, the present research applied the presentation of results based on the two-factor solution, proposed by Harpur et al. (1988) and confirmed by others. Factor analyses, for example, in a sample of conduct-disordered children (Frick, O'Brien, Wootton, & McBurnett, 1994), in a sample of adolescent male sexual offenders committed to a U.S. state training school (Hume, 1997), and in a sample of incarcerated adolescent offenders (Brandt, Kennedy, Patrick, & Curtin, 1997) showed that the factor structures in these samples resembled the two-factor solution found in adults. 1.3. Validity of the PCL-R Several studies have established the discriminate, congruent, and predictive validity of the PCL-R in samples of inmates serving their sentences in North America (e.g., Hare, 1980, Harpur et al., 1989 and Kosson et al., 1990), and in Europe (e.g., Cooke, 1989, Cooke & Michie, 1999 and Raine, 1985). Recently, Reiss et al. (2001) showed good construct validity of the PCL-R through retrospective assessments of psychopathy (only medical files were used) in a sample of young patients (mean age=20.5 years) from a British high security hospital with “the legal classification of psychopathic disorder.” Several researchers (e.g., Hare, 1985, Harpur et al., 1989 and Hart et al., 1991) showed, however, that self-report inventories, such as MMPI-2 or the CPI, did not correlate well with clinical diagnoses of psychopathy, indicating that the construct of psychopathy measured by the PCL or PCL-R does not overlap the construct of psychopathy measured by self-report measures. 1.4. Psychopathy (PCL-R) in relation to deviant personality traits measured by the KSP Previous research in a male sample of forensic psychiatric patients in Sweden (Stålenheim & von Knorring, 1998) has found that high scores on the KSP scales of Impulsiveness, Monotony Avoidance and Verbal Aggression, and low scores on the scales of Socialization, Inhibition of Aggression, and Social Desirability are related to a high degree of psychopathy measured by the PCL-R. In male Spanish prisoners, aged 19–44 years, the two PCL-R factors showed different patterns of intercorrelations with several self-reported measures of personality, demographic, and variables concerning criminal history, which confirmed the construct validity of the PCL-R (Molto et al., 2000). For example, the PCL-R scores were positively correlated to the KSP Impulsiveness scale, and negatively correlated to the Socialization scale. Research suggests that most personality traits assessed by the KSP and, particularly, personality traits related to psychopathy are stable over both time and situation. This has been shown both for nonpatient samples (Gustavsson, Weinryb, Göransson, Pedersen, & Åsberg, 1997) and for patient samples (Perris et al., 1979). It has also been found for patients admitted to forensic psychiatric assessment (Stålenheim, 1997). 1.5. Aims of the present study We have recently indicated a high degree of psychopathy (PCL-R) in a sample of male juvenile delinquents with conduct disorder and with severe criminality and substance abuse (Dåderman & Kristiansson, 2003); about 60% of the participants fulfill the diagnostic criteria for psychopathy according to the manual (Hare, 1991). In addition, three out of four participants in the sample satisfied the diagnostic criteria for psychopathy used by some other researchers who chose lower PCL-R scores (an optimal cutoff point of 26; Grann et al., 1998 and Rasmussen & Levander, 1996). The primary aim of the present study was to identify common patterns with respect to psychopathy-related personality traits in the same sample of juvenile delinquents. We formed the hypothesis, based on previous research, that the PCL-R scale scores are related to certain personality traits of both theoretical and practical relevance. Using pattern-based methods, we expected to find clusters of juveniles with reasonably homogeneous patterns of psychopathy-related personality traits. We used complementary information regarding reoffending to complete our investigation.

We have shown that delinquents can be classified using pattern-based methods. (Some minor limitations in our methods do not affect the validity of these conclusions.) We suggest that the classification will be helpful in managing therapeutic efforts. Our findings show that personality inventories can be used for adolescents who have previous childhood psychiatric or psychological contacts. These measures will contribute to the early identification of deviant personality traits. The present results suggest that young people with psychopathy are not a homogenous group but may develop various personality traits. This should have implications for risk assessment and treatment. The lack of beneficial treatment results in adult psychopaths may be related to an assumption that all people with antisocial behaviour could benefit from one specific programme. Increased knowledge and awareness of patterns of personality traits in subgroups of psychopaths may be especially important in juvenile delinquents. The need for individually tailored treatment approaches in young people with antisocial functioning and incipient psychopathy must be highlighted.