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Psychopathy, violence, and violent victimisation in schizophrenia
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posted on 17.01.2017by McGregor, Kate Elena
There is a substantial amount of research examining how psychopathy (as measured by the PCL-R and its derivatives) is associated with violence in samples of individuals with schizophrenia. Research has recently turned to understanding how the factors and facets of psychopathy are differentially associated with violence in this population, and more generally in samples of individuals with major mental disorder. Unfortunately, very little relevant research has been conducted in Australian samples of individuals with schizophrenia, particularly within naturalistic, community-based settings. Additionally, despite emerging literature which suggests that predictors of violent victimisation are similar to predictors of violence in samples of individuals with schizophrenia, no study has yet investigated how psychopathy may be associated with violent victimisation in this population. The aforementioned represent gaps in knowledge which pose conceptual and practical implications. The goal of the present study was two-fold: first, to investigate the relationship between the four-facet model of PCL-R psychopathy and violence in a community-based sample of Australian men with schizophrenia; and, second, to investigate the relationship between psychopathy, violence and violent victimisation within this sample. The sample comprised 94 male civil and forensic psychiatric outpatients with a diagnosis of schizophrenia, drawn from community mental health services within Victoria, Australia. Participants were administered the PCL-R, utilising both interview and file review information. Lifetime violence and violent victimisation was measured retrospectively through self-report, hospital record, and official police record. The results indicated that PCL-R total scores, Factor 1 and Factor 2 scores, and Facet 2, 3, and 4 scores were significant predictors of lifetime violence group membership, with Factor 2 demonstrating a significantly more robust relationship with violence than Factor 1. The predictive validity of PCL-R scores remained significant after controlling for substance abuse. Results also indicated that PCL-R psychopathy was a significant predictor of lifetime violent victimisation group membership. The findings also showed a history of violence to be significantly associated with a history of violent victimisation within this sample. This study reaffirmed the association between PCL-R psychopathy and violence within a naturalistic Australian sample of outpatients with schizophrenia and provided some indication of which aspects of psychopathy were more robustly associated with violence in this population. It also provided empirical evidence for an association between PCL-R psychopathy and violent victimisation and suggested that individuals with schizophrenia who perpetrate violence are at increased risk for being victims of violence also. These findings have implications for the assessment, treatment, and management of male community mental health clients with schizophrenia.