This research was developed to explore the psychiatric conditions affecting female prison inmates with a particular eye to the role of Axis II pathology in contributing to precursors and behavior within the prison environment.
The project which was funded by the National Institute of Justice was developed and implemented by Professors Warren and Loper at the University of Virginia along with Patricia Bale, PhD and Roseanne Friend, PhD from the Virginia Department of Corrections.
The first stage of data collection involved 802 inmates who were screened in group session using the Brief Symptom, the Barratt Impulsivity Scale, the Prison Adjustment Questionnaire, the Prison Violence Inventory, and the Structured Clinical Interview for DSM-IV Personality Screening Questionnaires.
From this group 261 inmates were selected to undergo a full diagnostic work-up using the SCID-II and from this group a portion underwent assessment using the PTSD subscale of the Diagnostic Interview Schedule (DIS), the Psychopathy Checklist--Revised (PCL-R), and the HCR-20 structured assessment of violence risk. The P-Scan was also completed by the correctional officers who were providing security at the Institution.
Some of the major findings of the study include:
- Age and positive screening for Antisocial Personality Disorder accurately classified high institutional violence and low institutional violence inmates with 72.2% specificity and 71.2% sensitivity.
- The current sample obtained a PCL-R mean score of 22.5 with a range of 3 to 36. No significant differences were found with regard to age, race, and length of sentence.
- We found high degrees of correlation not only between the total scores on the PCL-R and HCR-20, but also between the factor and subscales scores of the two instruments.
- When we compared the constructs of psychopathy and Antisocial Personality Disorder, we found APD is associated with impulsive, aggressive, and irresponsible behavior, higher rates of childhood abuse, and greater co-morbidity with Cluster A PD. Psychopathy is characterized by higher rates of property crimes, previous incarceration, and the manifestation of remorselessness.
- Receiver Operator Characteristics (ROC) analyses show that the PCL-R and HCR:20 demonstrated an inverse ability to predict convictions for murder, a close to chance ability to predict violent crime, but a shared ability to predict property and minor crime with these female inmates.
- Broadly, these results suggest that psychopathic women are involved in chronic patterns of non-violent criminality, and in some instances robbery, while women charged and convicted of murder generally do not have elevated scores on the PCL-R or HCR:20.
- An exploratory factor analysis of the SCID II data found that the structure of these disorders was best accounted for by a four-factor solution that paralleled the Diagnostic and Statistical Manual (DSM-IV-TR; APA, 2000) classification scheme with some significant and notable exceptions.
- Of particular importance was the consistent relationship observed between narcissistic personality traits and threatening and violent behavior within the prison combined with the impulsive but less malignant presentation of antisocial personality traits among this sample of women.
- The P-SCAN did not correspond with psychopathy or psychopathy factor scores as measured by the PCL-R but did relate to other features, namely Cluster A psychopathology and security level.
A number of publication concerning this study can be located through the faculty site of Professor Warren's or through contacting her at jlw(at)virginia.edu.