The Violent Accounts of Men Diagnosed With Comorbid Antisocial and Borderline Personality Disorders.

This study explored the violent offence accounts of life-sentenced prisoners diagnosed with comorbid antisocial personality disorder (ASPD) and borderline personality disorder (BPD). The aim of the current study was to gain needed clinical insight into the mechanisms involved in this specific group offenders' use of violence against others. Six adult male personality-disordered offenders were interviewed via a semistructured interview schedule to collate individual offence accounts. Interview transcripts were analyzed by the lead researcher (first author) using interpretative phenomenological analysis (IPA) who compared and contrasted findings to develop superordinate themes across the group. External auditing analysis was conducted by the second researcher. Four superordinate themes resulted. These were "A victim of a hostile and rejecting world," "Self as unacceptable to others," "Unwanted emotions that cannot be tolerated or controlled," and "Violent revenge as catharsis." The results support the view that emotional dysregulation is central in driving acts of violence in those with comorbid ASPD/BPD; nevertheless, shame was particularly prevalent. Thus an argument is made for the adaptation of evidence-based treatments for this specific forensic population to ensure a particular focus on helping men tolerate feelings of shame. The limitations of the study are also discussed.