Although there is evidence for the effectiveness of early interventions among Ultra-high risk (UHR) for psychosis, detection and intervention in forensic patients is lacking. This study aimed to establish the prevalence of UHR among this population and its relationship with aggression. Because there are indications that the relationship between prodromal symptoms and aggression might be particularly strong in antisocial personality disorder (ASPD), we specifically looked at the relationships within this group. Data were collected by using the Prodromal Questionnaire (PQ-16) and the Aggression Questionnaire (AQ), the semi-structured interview CAARMS and file study. Participants with ASPD (N = 30) and without this disorder (N = 44) were compared. Within this forensic setting, the prevalence of ultra-high risk for psychosis was significantly higher compared to regular mental health care. We found a significant relationship between prodromal psychotic symptoms and aggressive feelings (anger and hostility). In patients with ASPD, we also found a significant relation between prodromal psychotic symptoms and physical violence. This implies that patients in the prodromal phase have a higher risk to behave aggressively.
References
[1]
Aerts, J. E. M., Rijckmans, M. J. N., Bogaerts, S., & van Dam, A. (2023). Establishing an Optimal Working Relationship with Patients with an Antisocial Personality Disorder. Aspects and Processes in the Therapeutic Alliance. PsychologyandPsychotherapy:Theory,ResearchandPractice,96, 999-1014. https://doi.org/10.1111/papt.12492
[2]
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Edition). Washington DC.
[3]
Azevedo, J., Vieira-Coelho, M., Castelo-Branco, M., Coelho, R., & Figueiredo-Braga, M. (2020). Impulsive and Premeditated Aggression in Male Offenders with Antisocial Personality Disorder. PLOSONE,15, e0229876. https://doi.org/10.1371/journal.pone.0229876
[4]
Brucato, G., Appelbaum, P. S., Lieberman, J. A., Wall, M. M., Feng, T., Masucci, M. D. et al. (2018). A Longitudinal Study of Violent Behavior in a Psychosis-Risk Cohort. Neuropsychopharmacology,43, 264-271. https://doi.org/10.1038/npp.2017.151
[5]
Brucato, G., Appelbaum, P. S., Masucci, M. D., Rolin, S., Wall, M. M., Levin, M. et al. (2019). Prevalence and Phenomenology of Violent Ideation and Behavior among 200 Young People at Clinical High-Risk for Psychosis: An Emerging Model of Violence and Psychotic Illness. Neuropsychopharmacology,44, 907-914. https://doi.org/10.1038/s41386-018-0304-5
[6]
Burns, A. M. N., Erickson, D. H., & Brenner, C. A. (2014). Cognitive-Behavioral Therapy for Medication-Resistant Psychosis: A Meta-Analytic Review. PsychiatricServices,65, 874-880. https://doi.org/10.1176/appi.ps.201300213
[7]
Coid, J. W., Ullrich, S., Bebbington, P., Fazel, S., & Keers, R. (2016). Paranoid Ideation and Violence: Meta-Analysis of Individual Subject Data of 7 Population Surveys. SchizophreniaBulletin,42, 907-915. https://doi.org/10.1093/schbul/sbw006
[8]
Currie, M. R., Wood, C. E., Williams, B., & Bates, G. W. (2012). Aggression Replacement Training (ART) in Australia: A Longitudinal Youth Justice Evaluation. Psychiatry,PsychologyandLaw,19, 577-604. https://doi.org/10.1080/13218719.2011.615807
[9]
Dalteg, A., Zandelin, A., Tuninger, E., & Levander, S. (2014). Psychosis in Adulthood Is Associated with High Rates of ADHD and CD Problems during Childhood. NordicJournalofPsychiatry,68, 560-566. https://doi.org/10.3109/08039488.2014.892151
[10]
De Wit-De Visser, B., Rijckmans, M., Vermunt, J. K., & van Dam, A. (2023). Pathways to Antisocial Behavior: A Framework to Improve Diagnostics and Tailor Therapeutic Interventions. Frontiers in Psychology, 14, Article 993090. https://doi.org/10.3389/fpsyg.2023.993090
[11]
Dickens, G., Picchioni, M., & Long, C. (2013). Aggression in Specialist Secure and Forensic Inpatient Mental Health Care: Incidence across Care Pathways. TheJournalofForensicPractice,15, 206-217. https://doi.org/10.1108/jfp-09-2012-0017
[12]
Evans, C., Forrester, A., Jarrett, M., Huddy, V., Campbell, C. A., Byrne, M. et al. (2017). Early Detection and Early Intervention in Prison: Improving Outcomes and Reducing Prison Returns. TheJournalofForensicPsychiatry&Psychology,28, 91-107. https://doi.org/10.1080/14789949.2016.1261174
[13]
Fazel, S., Gulati, G., Linsell, L., Geddes, J. R., & Grann, M. (2009). Schizophrenia and Violence: Systematic Review and Meta-Analysis. PLOSMedicine,6, e1000120. https://doi.org/10.1371/journal.pmed.1000120
[14]
First, M. B., Williams, J. B. W., Benjamin, L. S., & Spitzer, R. L. (2015). User’s Guide for the SCID-5-PD (Structured Clinical Interview for DSM-5 Personality Disorder). American Psychiatric Association.
[15]
Fusar-Poli, P., Bonoldi, I., Yung, A. R., Borgwardt, S., Kempton, M. J., Valmaggia, L., Bar-ale, F., Caverzasi, E., & McGuire, P. (2012). Predicting Psychosis: Meta-Analysis of Tran-sition Outcomes in Individuals at High Clinical Risk. JAMA Psychiatry. 69, 220-229.
[16]
Huber, C. G., Hochstrasser, L., Meister, K., Schimmelmann, B. G., & Lambert, M. (2016). Evidence for an Agitated-Aggressive Syndrome in Early-Onset Psychosis Correlated with Antisocial Personality Disorder, Forensic History, and Substance Use Disorder. SchizophreniaResearch,175, 198-203. https://doi.org/10.1016/j.schres.2016.04.027
[17]
Ising, H. K., Kraan, T. C., Rietdijk, J., Dragt, S., Klaassen, R. M. C., Boonstra, N. et al. (2016). Four-year Follow-Up of Cognitive Behavioral Therapy in Persons at Ultra-High Risk for Developing Psychosis: The Dutch Early Detection Intervention Evaluation (EDIE-NL) Trial. SchizophreniaBulletin,42, 1243-1252. https://doi.org/10.1093/schbul/sbw018
[18]
Ising, H. K., Veling, W., Loewy, R. L., Rietveld, M. W., Rietdijk, J., Dragt, S. et al. (2012). The Validity of the 16-Item Version of the Prodromal Questionnaire (PQ-16) to Screen for Ultra High Risk of Developing Psychosis in the General Help-Seeking Population. SchizophreniaBulletin,38, 1288-1296. https://doi.org/10.1093/schbul/sbs068
[19]
Joubert, D., & Zaumseil, B. (2020). Physical Violence by Men and Psychosis in a Mental Health Setting: Associations with Symptom Profile, Treatment Engagement, and Psychosocial Stressors. TheJournalofForensicPsychiatry&Psychology,31, 759-778. https://doi.org/10.1080/14789949.2020.1792963
[20]
Loewy, R. L., Pearson, R., Vinogradov, S., Bearden, C. E., & Cannon, T. D. (2011). Psychosis Risk Screening with the Prodromal Questionnaire—Brief Version (PQ-B). SchizophreniaResearch,129, 42-46. https://doi.org/10.1016/j.schres.2011.03.029
[21]
McGlashan, T. H. (1999). Duration of Untreated Psychosis in First-Episode Schizophrenia: Marker or Determinant of Course? BiologicalPsychiatry,46, 899-907. https://doi.org/10.1016/s0006-3223(99)00084-0
[22]
Meesters, C., Muris, P., Bosma, H., Schouten, E., & Beuving, S. (1996). Psychometric Evaluation of the Dutch Version of the Aggression Questionnaire. BehaviourResearchandTherapy,34, 839-843. https://doi.org/10.1016/0005-7967(96)00065-4
[23]
Raballo, A., Nelson, B., Thompson, A., & Yung, A. (2011). The Comprehensive Assessment of At-Risk Mental States: From Mapping the Onset to Mapping the Structure. SchizophreniaResearch,127, 107-114. https://doi.org/10.1016/j.schres.2010.12.021
[24]
Rietdijk, J., & van der Gaag, M. (2014). De detectie van mensen met een verhoogd risico op een psychose: Detectiemethoden en basiskenmerken van de populatie. Tijdschriftvoorpsychiatrie, 56, 257-265.
[25]
Rietdijk, J., Dragt, S., Klaassen, R., Ising, H., Nieman, D., Wunderink, L. et al. (2010). A Single Blind Randomized Controlled Trial of Cognitive Behavioural Therapy in a Help-Seeking Population with an at Risk Mental State for Psychosis: The Dutch Early Detection and Intervention Evaluation (EDIE-NL) Trial. Trials,11, Article No. 30. https://doi.org/10.1186/1745-6215-11-30
[26]
Rietdijk, J., Klaassen, R., Ising, H., Dragt, S., Nieman, D. H., van de Kamp, J. et al. (2012). Detection of People at Risk of Developing a First Psychosis: Comparison of Two Recruitment Strategies. ActaPsychiatricaScandinavica,126, 21-30. https://doi.org/10.1111/j.1600-0447.2012.01839.x
[27]
Rossler, W., Joachim Salize, H., van Os, J., & Riecher-Rössler, A. (2005). Size of Burden of Schizophrenia and Psychotic Disorders. EuropeanNeuropsychopharmacology,15, 399-409. https://doi.org/10.1016/j.euroneuro.2005.04.009
[28]
Salazar de Pablo, G., Radua, J., Pereira, J., Bonoldi, I., Arienti, V., Besana, F. et al. (2021). Probability of Transition to Psychosis in Individuals at Clinical High Risk. JAMAPsychiatry,78, 970-978. https://doi.org/10.1001/jamapsychiatry.2021.0830
[29]
Simon, G. E., Stewart, C., Hunkeler, E. M., Yarborough, B. J., Lynch, F., Coleman, K. J. et al. (2018). Care Pathways before First Diagnosis of a Psychotic Disorder in Adolescents and Young Adults. AmericanJournalofPsychiatry,175, 434-442. https://doi.org/10.1176/appi.ajp.2017.17080844
[30]
Valmaggia, L. R., Byrne, M., Day, F., Broome, M. R., Johns, L., Howes, O. et al. (2015). Duration of Untreated Psychosis and Need for Admission in Patients Who Engage with Mental Health Services in the Prodromal Phase. BritishJournalofPsychiatry,207, 130-134. https://doi.org/10.1192/bjp.bp.114.150623
[31]
van Dam, A., Rijckmans, M., & van den Bosch, L. (2022). Explaining the Willingness of Clinicians to Work with Patients with Antisocial Personality Disorder Using the Theory of Planned Behaviour and Emotional Reactions. ClinicalPsychology&Psychotherapy,29, 676-686. https://doi.org/10.1002/cpp.2661
[32]
van der Gaag, M., van den Berg, D., & Ising, H. (2019). CBT in the Prevention of Psychosis and Other Severe Mental Disorders in Patients with an At Risk Mental State: A Review and Proposed Next Steps. SchizophreniaResearch,203, 88-93. https://doi.org/10.1016/j.schres.2017.08.018
[33]
Van Dongen, J. D. M., Buck, N. M. L., Barendregt, M., Van Beveren, N. M., De Beurs, E., & Van Marle, H. J. C. (2015). Anti‐social Personality Characteristics and Psychotic Symptoms: Two Pathways Associated with Offending in Schizophrenia. CriminalBehaviourandMentalHealth,25, 181-191. https://doi.org/10.1002/cbm.1923
[34]
Whiting, D., Lichtenstein, P., & Fazel, S. (2021). Violence and Mental Disorders: A Structured Review of Associations by Individual Diagnoses, Risk Factors, and Risk Assessment. TheLancetPsychiatry,8, 150-161. https://doi.org/10.1016/s2215-0366(20)30262-5
[35]
Winsper, C., Singh, S. P., Marwaha, S., Amos, T., Lester, H., Everard, L. et al. (2013). Pathways to Violent Behavior during First-Episode Psychosis; a report from the UK Nation-al Eden study. JAMAPsychiatry,70, 1287-1293. https://doi.org/10.1001/jamapsychiatry.2013.2445
[36]
Wojciechowski, T. W. (2020). The Salience of Antisocial Personality Disorder for Predicting Substance Use and Violent Behavior: The Moderating Role of Deviant Peers. JournalofDrugIssues,50, 35-50. https://doi.org/10.1177/0022042619877935
[37]
Wykes, T., Steel, C., Everitt, B., & Tarrier, N. (2008). Cognitive Behavior Therapy for Schizophrenia: Effect Sizes, Clinical Models, and Methodological Rigor. SchizophreniaBulletin,34, 523-537. https://doi.org/10.1093/schbul/sbm114
[38]
Yung, A. R., Yung, A. R., Pan Yuen, H., Mcgorry, P. D., Phillips, L. J., Kelly, D. et al. (2005). Mapping the Onset of Psychosis: The Comprehensive Assessment of At-Risk Mental States. Australian&NewZealandJournalofPsychiatry,39, 964-971. https://doi.org/10.1080/j.1440-1614.2005.01714.x
