This course deals with one of the biggest problems in forensic mental health: personality disorders (PDs). PDs are found in approximately 10% of the adult population and approximately 50%-80% of the forensic psychiatric and prison population. They are mental disorders defined by chronic, maladaptive personality traits that cause dysfunctional behaviour. In the forensic field, this behaviour includes aggression and criminality. The most prevalent PDs in forensic populations are Antisocial, Borderline, and Narcissistic PDs, although the entire range of DSM-V PDs are represented. Within the forensic field, the most attention has been given to so-called Psychopaths, which is the most severe subgroup of patients with Antisocial PD. People with PDs consider their personality traits to be normal (i.e., "ego syntonic"), although they may perceive some of the effects of the disorder as undesirable. Consequently, there is often no clear request for help. At times, clients only start treatment under pressure or force (i.e., by order of the law). PDs can only be diagnosed in adulthood, at age 18, because before that, personality has not yet sufficiently consolidated. However, in many patients, chronic patterns of antisocial behaviour are often evident by adolescence or even earlier. Historically, PDs have always had a negative connotation. People suffering from these disorders are generally perceived as untreatable, though there is little solid evidence to support this view. Recently, a number of treatments for PDs have been developed which show good evidence of effectiveness, including some promising approaches for forensic patients with PDs. In this course, we consider PDs from a theoretical, research, and treatment perspective with particular attention to the forensic field.
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Knowledge of: Diagnostic/clinical description of PDs, particularly as they appear in forensic settings; the connection between PDs, crime, and violence; the development of PDs; the cognitive and neurobiological bases of PDs; and the treatment alternatives for PDs. Skills: execute diagnostic personality disorder interviews; diagnose personality disorders; relate to patients during interviewing.