Sadomasochistic Representations in a Rage Murderer: An Integrative Clinical and Forensic Investigation.

This study used the Adult Attachment Interview (AAI), and the Rorschach Inkblot Method (RIM; Rorschach, 1921/1942) to investigate the personality structure and internal dynamics of a rage murderer. Contrasting AAI and Rorschach findings, interpreted within an attachment-oriented framework, suggested the presence of a borderline spectrum, dual personality organization, characterized by a split between a more benign, overcontrolled upfront, and a self, fused by sexualized urges and sadistic rage. I present inferences regarding the murder and discuss issues related to future violence risk and treatment.

Incarcerated Violent Offenders' Ability to Avoid Revealing Their Potential for Violence on the Rorschach and the MMPI-2.

Recently, Hartmann and Hartmann (2014) found that psychiatric outpatients, both with and without access to Internet-based information about the Rorschach Inkblot Method (RIM; Weiner, 2003 ) and the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989 ), were unable to imitate healthy test performance on these tests. We replicated the study by administering the RIM and the MMPI-2 to 63 incarcerated violent offenders using similar testing conditions. As in the previous study, comparisons were made not only among the 3 subgroups of incarcerated offenders, but also between these offender groups and the group of nonpatients examined in the previous study. On the RIM, Internet-coached and uncoached "faking good" offenders produced records with significantly higher F% and X-% and significantly lower M, m, SumC, X+%, P, AG, and COP than nonoffenders under standard instructions (effect sizes between d = 0.24 and d = 2.39). For AgC, AgPot, AgPast, and TCI% there were no significant differences between the faking offenders and the nonoffenders under standard instructions. On the MMPI-2 clinical scales, there were no significant differences between the faking good groups and the nonoffenders under standard instructions, except on Hs, Pd, and Sc. Both faking groups were identifiable by their high L scale scores. Although both faking groups managed to avoid giving responses with aggressive and generally psychopathological content on the RIM, they were unable to produce test profiles demonstrating healthy test performance on any of the tests; nevertheless, Internet-based test information might weaken test validity.

Identification With a Violent and Sadistic Aggressor: A Rorschach Study of Criminal Debt Collectors.

This study examined personality functioning in a group of 27 incarcerated criminal debt collectors as assessed by the Rorschach Inkblot Method (RIM; Rorschach, 1921/1942) and the Psychopathy Checklist-Revised (PCL-R; Hare, 2003 ). To explore whether these individuals represent a distinct subgroup within the violent offender population, we compared them to a group of incarcerated homicide offenders (n = 23) without a previous history of significant violence and a group who had committed less serious violent crimes (n = 21). Results revealed significantly more Rorschach indicators of past trauma (Trauma Content Index), aggressive urges (Aggressive Potential) and identification (Aggressive Content) among the debt collectors than the 2 other groups. In addition, debt collectors displayed significantly more interpersonal interest (Sum Human content), and significantly higher scores on the PCL-R. Our findings suggest that the debt collector might be viewed as a hostile variant of psychopathy.

Self-protective strategies, violence and psychopathy: theory and a case study.

Although it has been proposed that attachment is a key factor in psychopathy and violence, conceptualization of its potential role remains limited. This article uses the dynamic-maturational model of attachment and adaptation (DMM; Crittenden, 2008 ) and a case study to illustrate an etiological model of psychopathy and violence. The Adult Attachment Interview (AAI; George, Kaplan, & Main, 1984 -1996), coded according to the DMM system (Crittenden & Landini, 2011 ), was used to identify the participant's self-protective attachment strategies, and to explore indexes indicating opportunities for change. To allow a more elaborated understanding of this participant's personality, AAI findings were compared and contrasted with the Rorschach method (Rorschach, 1921 /1942). The AAI indicated unresolved loss and trauma, alternation between delusionally idealizing dismissive (Type A) and menacing-paranoid entangled (Type C) strategies, possible depression, and the potential for reorganization. The Rorschach showed many similarities with the AAI findings. Implications for the understanding of psychopathy, violence, and treatment are presented.

DMM assessments of attachment and adaptation: Procedures, validity and utility.

This article gives a brief over view of the Dynamic-Maturational Model of attachment and adaptation (DMM; Crittenden, 2008) together with the various DMM assessments of attachment that have been developed for specific stages of development. Each assessment is discussed in terms of procedure, outcomes, validity, advantages and limitations, comparable procedures and areas for further research and validation. The aims are twofold: to provide an introduction to DMM theory and its application that underlie the articles in this issue of CCPP; and to provide researchers and clinicians with a guide to DMM assessments.

Psychopathic and nonpsychopathic violent offenders on the rorschach: discriminative features and comparisons with schizophrenic inpatient and university student samples.

We examined discriminant and convergent validity of theoretically relevant Rorschach Comprehensive System (CS) variables (Exner, 2003) and Meloy and Gacono's (1992) aggression variables in distinguishing between imprisoned violent offenders (VO) who were psychopathic (P-VO) and nonpsychopathic (NP-VO) under psychiatric treatment, schizophrenic inpatients (ISs), and university students (USs). A total of 7 of 12 variables discriminated significantly between P-VO and NP-VO, which suggests more aggressive, cognitive, and interpersonal disturbances among P-VO. We also found significant differences between VOs, ISs, and USs. Logistic regression analyses revealed that AgPast accumulated incrementally in the classification of P-VO versus NP-VO, and AgC accumulated incrementally in the classification of VO versus IS when entered after CS variables. The findings support the view that psychopathy is a distinctive form of antisocial personality disorder (Diagnostic and Statistical Manual of Mental Disorders; American Psychiatric Association, 1994) organized at a more severe pathological level.

Mental health consultations in a prison population: a descriptive study.

BACKGROUND: The psychiatric morbidity among prison inmates is substantially higher than in the general population. We do, however, have insufficient knowledge about the extent of psychiatric treatment provided in our prisons. The aim of the present study was to give a comprehensive description of all non-pharmacological interventions provided by the psychiatric health services to a stratified sample of prison inmates. METHODS: Six medium/large prisons (n = 928) representing 1/3 of the Norwegian prison population and with female and preventive detention inmates over-sampled, were investigated cross-sectionally. All non-pharmacological psychiatric interventions, excluding pure correctional programs, were recorded. Those receiving interventions were investigated further and compared to the remaining prison population. RESULTS: A total of 230 of the 928 inmates (25 %) had some form of psychiatric intervention: 184 (20 %) were in individual psychotherapy, in addition 40 (4 %) received ad hoc interventions during the registration week. Group therapy was infrequent (1 %). The psychotherapies were most often of a supportive (62 %) or behavioural-cognitive (26 %) nature. Dynamic, insight-oriented psychotherapies were infrequent (8 %). Concurrent psychopharmacological treatment was prevalent (52 %). Gender and age did not correlate with psychiatric interventions, whereas prisoner category (remanded, sentenced, or preventive detention) did (p < 0.001). Most inmates had a number of defined problem areas, with substance use, depression, anxiety, and personality disorders most prevalent. Three percent of all inmates were treated for a psychotic disorder. Remand prisoners averaged 14 sessions per week per 100 inmates, while sentenced inmates and those on preventive detention averaged 22 and 25 sessions per week per 100 inmates, respectively. Five out of six psychiatric health services estimated the inmates' psychiatric therapy needs as adequately met, both overall and in the majority of individual cases. CONCLUSION: Our results pertain only to prisons with adequate primary and mental health services and effective diversion from prison of individuals with serious mental disorders. Given these important limitations, we do propose that the service estimates found may serve as a rough guideline to the minimum number of sessions a prison's psychiatric health services should be able to fulfil in order to serve the inmates psychiatric needs. The results rely on the specialist services' own estimates only. Future studies should take other important informants, including the inmates themselves, into consideration.