اختلالات شخصیت در متجاوزان به عنف و قاتلان از زندان های با امنیت حداکثر در برزیل

International literature on Forensic Psychiatry and Forensic Psychology has revealed high rates of psychopathic traits or immature personalities in prisoners from maximum security prisons (Andersen et al., 1999, Cunninghan and Reidy, 1998, Edens et al., 2000 and Hare, 1999). Individuals with personality disorders (IPDs) tend to display criminal behavior more frequently than do controls. Compared to other criminals, IPDs start their “crime careers” much earlier, commit more crimes and have a broader range of criminal activities (Hart and Hare, 1996a and Hart and Hare, 1996b). Although there is no consensus in the literature regarding the Anti Social Personality Disorder (ASPD) etiology, or the correct term to be used (DSM IV, ICD-10), we have adopted the term psychopathic in the present article, as suggested by Hare (1991). Many scholars in the psychopath field follow a broad clinical tradition, whose approach is based on a wide range of intensely structured personality aspects such as pathologic egocentrism, high level of manipulation, pathological lies, setting responsibilities to others, affective insensibility, empathy and remorse absence ( Cleckley, 1955, Hare, 1991, Millon, 1998 and Moltó et al., 2001). It is important to point out the enormous social, economic and personal suffering caused by psychopathic attitudes and behaviors, as previously stated by Hare (1999). For such individuals, social rules are not a limiting force and the idea of a common well-being is merely a non comprehensible and inconvenient abstraction. Hare calls them intra-species predators that use charm, manipulation, intimidation, and violence to control others and satisfy their own needs. By means of a lack of trust and feelings for others, they get what they want in a cold manner, violating the social rules without any perception of guilt or regret. The PCL-R (Psychopath Checklist-Revised) – a bi-factorial model of psychopathic assessment – is one of the most relevant instruments of evaluation in forensic psychiatry. However, the PCL-R was not used in this study since we carried out this research before its validation in Brazil.

Introduction International literature on Forensic Psychiatry and Forensic Psychology has revealed high rates of psychopathic traits or immature personalities in prisoners from maximum security prisons (Andersen et al., 1999, Cunninghan and Reidy, 1998, Edens et al., 2000 and Hare, 1999). Individuals with personality disorders (IPDs) tend to display criminal behavior more frequently than do controls. Compared to other criminals, IPDs start their “crime careers” much earlier, commit more crimes and have a broader range of criminal activities (Hart and Hare, 1996a and Hart and Hare, 1996b). Although there is no consensus in the literature regarding the Anti Social Personality Disorder (ASPD) etiology, or the correct term to be used (DSM IV, ICD-10), we have adopted the term psychopathic in the present article, as suggested by Hare (1991). Many scholars in the psychopath field follow a broad clinical tradition, whose approach is based on a wide range of intensely structured personality aspects such as pathologic egocentrism, high level of manipulation, pathological lies, setting responsibilities to others, affective insensibility, empathy and remorse absence ( Cleckley, 1955, Hare, 1991, Millon, 1998 and Moltó et al., 2001). It is important to point out the enormous social, economic and personal suffering caused by psychopathic attitudes and behaviors, as previously stated by Hare (1999). For such individuals, social rules are not a limiting force and the idea of a common well-being is merely a non comprehensible and inconvenient abstraction. Hare calls them intra-species predators that use charm, manipulation, intimidation, and violence to control others and satisfy their own needs. By means of a lack of trust and feelings for others, they get what they want in a cold manner, violating the social rules without any perception of guilt or regret. The PCL-R (Psychopath Checklist-Revised) – a bi-factorial model of psychopathic assessment – is one of the most relevant instruments of evaluation in forensic psychiatry. However, the PCL-R was not used in this study since we carried out this research before its validation in Brazil. IPDs are more likely to be engaged in violence, albeit within the community or prison. There is a high correlation between personality disorders and forensic problems (Hart and Hare, 1996a, Hart and Hare, 1996b, Stälenheim and Von Knorriing, 1998a and Ställehein and Von knorring, 1998b), with IPDs having a distinguished “criminal career” and antisocial behavior which differs from non-psychopathic criminals (Junginger, 1996). Reimprisonment rates in IPDs are significantly higher than in other criminals (Hart and Hare, 1996a and Hart and Hare, 1996b). The main characteristics of IPDs were described by Kristiansson (1995): superficial charm, lack of credibility, falseness, lack of remorse or shame, incapacity to learn with experience, incapacity to love and poor affection. According to data from the United Nations (UN), Brazil ranks third in relation to prison overpopulation. Even in developed states such as São Paulo, which has approximately 80 maximum-security prisons and where 11 centers for provisory detention (CPDs) and 10 centers of resocialization (RSs) have been recently built, the rate of criminal reincidence stands at 45%. In recent studies, personality disorders were found to be the major risk factor for crime recidivism (Hart and Hare, 1996a and Hart and Hare, 1996b). The possible implications of personality disorders and crimes could be directly implemented in public policies regarding the prison system. However, the correlation between personality disorders and crime requires broader and more in-depth studies in order to be relevant. Nevertheless, we point out the work of Moscatello (1999), which reported a 20% rate of personality disorders in 100 prisoners' records studied at the Custody and Treatment Psychiatric Hospital “Prof. André Teixeira Lima” (formerly “Judiciary Asylum”). We focused our study on the personalities of prisoners convicted for homicide and/or rape, both abhorrent crimes, punishable with the most severe penalties in Brazil. Homicide is defined by Article 121 of the Brazilian Criminal Code as “the act of killing someone” whilst rape is defined by Article 213 as “the act of forcing sexual intercourse, by violence or threats”. The study of homicides requires a multidisciplinary approach in order to determine the possible etiologic factors, which in turn are multiple (Yarvis & Swanson, 1996). Homicide quite often has its origins in arguments over trivial matters, which evolve to fights and eventually lead to homicide, in a progressive scale of aggressiveness. We agree with Malmquist's statement: “The greatest contribution of Psychiatry resides in the comprehension of how such behaviors, apparently common, lead to homicides, and such comprehension can be achieved by examining vulnerability and functioning of the personality and studying the impact of emotions in human beings” (Malmquist, 1996). In Brazil, previous reports have shown a high rate of homicides, acting as a thermometer for the level of violence in our society. The occurrence of homicides corresponds to a concerning index of 21:100,000, especially when compared to other settings such as the USA (10.4:100,000) or England (0.6:100,000) (Hare, 1996). According to the Inter-American Development Bank, the direct and indirect cost of violence in Brazil is more than 85 billion dollars per year (Jozef & Silva, 2003); this is more related to homicides than to other kinds of crime such as rape. Rape is not included in the various types of sexual deviations in any of the International Classification of Diseases (WHO, 1993). There are cultural myths supporting rape, such as the acceptance of interpersonal violence and stereotyped gender roles (Burt, 1980). Rapists are not motivated by a predominantly sexual desire. Instead, sex is driven by non-sexual needs and urges, such as rage and power (Groth, Burges, & Holmstrom, 1977). Thus, rape can be classified into two groups according to the motivation — rape for rage and rape for power. In actions motivated by rage, feelings of anger, hate and despise for the victims lead the rapist to submitting them to degrading acts, assaulting them both physically and psychologically. Rapes for power are characterized by dominance over the victim.

. Conclusions Mental disorder, when defined as a “definite picture of qualitative psychic changes, such as for example, schizophrenia, affective disorders and other psychosis” (Gattaz, 1998) is not a major determinant of criminality, according to the results of this study. Hence, special measures of social exclusion should not be directed towards individuals with mental disorders. However, we did find high rates of personality disorders (antisocial and sadistic personality disorders) in both rapist and murderer groups studied, which is consistent with findings in the literature. Murderers showed higher rates of dependent and histrionic personality disorders than rapists. Moreover, drug use was associated both with homicides and rapes whereas cocaine was most used by rapists. This study represents a valuable contribution to the field, although correlation between personality disorders, use of drugs and crime, requires larger and more detailed studies in order to be relevant. The findings of this study are pertinent to all those who investigate criminal behavior, whether they be professionals of Forensic Psychiatry, Justice or other sciences. This study may also further understanding of investigation programs, penalty application and rehabilitation processes within the Brazilian prison system, since it brings scientific methods to bear in the field.