Stress levels in forensic patient samples are extraordinarily high and pose a threat to successful treatment outcome. The perception of and response toward stress is known to be strongly influenced by psychopathic traits, which in turn are prevalent among forensic patients. We examined current psychological and physiological stress symptoms and hypothesized that the psychopathy factors Fearless Dominance (FD) and Self-centered Impulsivity (ScI) should be related to separate trajectories of stress response. Our study was conducted on 126 forensic inpatients in mandatory drug treatment. Psychopathy and stress symptoms were assessed with self-report measures—the Psychopathy Personality Inventory (PPI-R) and the Subclinical Stress Questionnaire (SSQ-25). Overall, inpatients experienced a higher level of stress than general population samples. Path analyses revealed that ScI serves as a positive and FD as a negative predictor for psychological stress. Contrarily, physiological stress was not directly predicted by psychopathy, but by psychological stress. In line with extant research, FD generally serves as a resiliency factor mediating against the adverse effects of stress on mental and physical health, while ScI constitutes a risk factor for stress symptoms. These findings are important for risk assessment and the development of more specifically targeted forensic treatment programs.
Stefanie Maria Nigel, Judith Streb, Katharina Leichauer, Barbara Hennig, Stefanie Otte, Irina Franke, Elisa Helms, Roland Weierstall & Manuela Dudeck
International Journal of Forensic Mental Health, 18 Jan 2019