Schema modes in criminal and violent behaviour of forensic cluster B PD patients: A retrospective and prospective study

Authors

  • Marije E. Keulen-de Vos,

    Corresponding author
    1. Forensic Psychiatric Centre ‘de Rooyse Wissel’, Venray, The Netherlands
    2. Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
    • Correspondence should be addressed to Marije E. Keulen-de Vos, FPC de Rooyse Wissel, P.O. Box 433, Venray 5800 AK, The Netherlands (email: mkeulen-devos@derooysewissel.nl).

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  • David P. Bernstein,

    1. Forensic Psychiatric Centre ‘de Rooyse Wissel’, Venray, The Netherlands
    2. Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
    3. Expertise Centre for Forensic Psychiatry, Utrecht, The Netherlands
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  • Silke Vanstipelen,

    1. Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
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  • Vivienne de Vogel,

    1. Forensic Psychiatric Centre ‘Van der Hoeven Kliniek’, Utrecht, The Netherlands
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  • Tanja P. C. Lucker,

    1. Forensic Psychiatric Centre ‘Oostvaarderskliniek’, Almere, The Netherlands
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  • Mariët Slaats,

    1. Forensic Psychiatric Centre ‘Veldzicht’, Balkbrug, The Netherlands
    2. Forensic Psychiatric Centre, Van Mesdag Kliniek, Groningen, The Netherlands
    3. ‘FPK Assen’, Assen, The Netherlands
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  • Marloes Hartkoorn,

    1. Forensic Psychiatric Centre ‘De Kijvelanden’, Poortugaal, The Netherlands
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  • Arnoud Arntz

    1. Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
    2. Netherlands Institute for Advanced Study in the Humanities and Social Sciences, Wassenaar, The Netherlands
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Abstract

Purpose

A clear understanding of an offender's criminal behaviour is a prerequisite for determining suitable treatment. In the literature, several specific frameworks or therapeutic approaches that aim to explicate criminal behaviour can be distinguished (e.g., cognitive analytic therapy, offence paralleling behaviour paradigm), but Schema Therapy (ST) is becoming an increasingly popular paradigm. According to forensic ST's theoretical framework, criminal and violent behaviour can be explained by an unfolding sequence of schema modes, or moment-to-moment states that represent emotions, cognitions, and behaviour. In this study, we examine the validity of this theory and the relationship between schema modes, psychopathy, and institutional violence.

Methods

Schema modes were assessed retrospectively from descriptions of patients’ crimes in a sample of 95 hospitalized cluster B personality disordered offenders. Psychopathy was rated with the Psychopathy Checklist-Revised and institutional transgressions were coded from daily hospital reports.

Results

Our findings show that criminal behaviour is often preceded by schema modes that refer to feelings of vulnerability and abandonment, loneliness, and states of intoxication. Criminal behaviour itself is characterized by schema modes that refer to states of impulsivity, anger, and the use of overcompensatory strategies involving threats, intimidation, and aggression. Schema modes involving bullying and manipulation were positively correlated with the interpersonal facet of psychopathy; the vulnerable child mode was negatively correlated with the affective facet of psychopathy. The schema modes in this study moderately predicted later institutional transgressions.

Conclusions

Our findings suggest that the schema mode concept is of explanatory value in understanding criminal and violent behaviour.

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