Empirical clusters of DSM-III personality disorders in violent offenders

Violent male offenders in a maximum security hospital and special units in prisons (N = 164) were interviewed with the Structured Clinical Interview f or DSM-III Axis II disorders (SCID-II). Cluster analysis of the personality disorder criteria sets identified six diagnostic patterns: (1) antisocial- narcissistic; (2) paranoid-antisocial; (3) borderline-antisocial-passive-ag gressive (4] borderline; (5) compulsive-borderline; and (6) schizoid, Offen ders in the first three groups had more extensive criminal careers, and mos t were identified as psychopaths by the Psychopathy Checklist-Revised (PCL- R), These Groups also had more frequent lifetime histories of substance abu se. A history of affective and anxiety disorders was more common in Groups 3 and 5, and almost two thirds of Group 2 had a history of psychotic disord er. The results emphasize that dangerous offenders are heterogeneous in per sonality pathology. They also suggest that personality disorder among viole nt offenders is more commonly represented by recurring patterns of covaryin g traits than by single categorical entities proposed in the DSM classifica tion.