The role of psychopathic traits and substance abuse in predicting violent victimization in patients with schizophrenia spectrum disorders.

We examined the relationship between psychopathic traits and substance abuse and violent victimization in 94 community patients meeting DSM-IV criteria for schizophrenia spectrum disorders in contact with public mental health services in Victoria, Australia. Data on violence and victimization were collated from multiple sources and combined to categorize patients into victims of serious violence (VV; n = 74) and those who were not victims of serious violence (NVV; n = 20) groups. The VV group had higher rates of unemployment and previous violence but did not differ from the NVV on current symptom ratings. The VV group has significantly higher substance abuse and psychopathy scores, but only psychopathy score significantly contributed to the prediction of victimization. All psychopathy facets were reasonably good predictors of victimization status, but the antisocial facet contributed most to the prediction of victimization. A better understanding of the role and contribution of antisocial (particularly psychopathic) traits in violent victimization in mentally ill populations is needed to better inform community management plans.

Criminally violent victimisation in schizophrenia spectrum disorders: the relationship to symptoms and substance abuse.

BACKGROUND: Violent victimisation among people with major mental illness is well-documented but the risk factors for criminal violent victimisation are not well understood. METHODS: We examined the relationship between illness-related variables, indices of substance abuse and previous history of violence in a sample of 23 male criminally violently victimized and 69 non-criminally violently victimized male patients with DSM-IV-TR diagnoses of schizophrenia and schizoaffective disorder that were resident in the community and in contact with public mental health services in Victoria Australia. Data on criminal victimisation was acquired from the police database. RESULTS: Demographic, a history of violence or illness-related variables did not distinguish between those had been the victim of a violent crime and those who had not. Our data indicated that drug abuse was a key factor in distinguishing between the groups, but the age of onset of substance abuse was not a significant factor. Scores on measures of drug abuse were modest predictors of criminal victimisation status in our Receiver Operator Characteristic analyses. CONCLUSION: Overall, our findings suggest that substance abuse (particularly drug abuse) is a key predictor of violent victimisation based on criminal statistics. The latter has implications for mental health professions involved in the care planning and community management of patients with major mental illness and work points to the importance of substance abuse treatment in the prevention of victimisation as well as violence perpetration.

Schizophrenia spectrum disorders, substance misuse, and the four-facet model of psychopathy: the relationship to violence.

OBJECTIVE: 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-spectrum disorders. METHOD: A community sample of 94 males with schizophrenia-spectrum disorders was recruited from mental health services within Victoria, Australia. Psychopathy was measured using the PCL-R. Measures of substance misuse and lifetime violence were also administered. RESULTS: PCL-R-total, Facets 2, 3, and 4 scores and substance misuse (DAST) scores were predictive of Violent versus Non-Violent group membership. The regression equation indicated that the predictive validity of PCL-R scores remained significant after controlling for substance misuse. An additional regression indicated that only Facets 3 and 4 were significant in predicting violence group membership. CONCLUSION: Psychopathy (particularly the antisocial and behavioural components) was associated with lifetime violence, even after controlling for substance misuse. These findings have implications for the assessment, treatment, and management of health clients with schizophrenia-spectrum disorders.