罪犯与精神分裂症患者暴力行为相关因素研究
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摘要
目的：探讨精神分裂症患者和罪犯暴力行为相关心理社会因素的差异和共性，为预测和控制暴力行为提供理论依据。
方法：采用病例对照研究方法，收集49例暴力罪犯和35例暴力违法的精神分裂症患者，应用人口学资料和既往史调查表、明尼苏达多相人格调查表（MMPI）、人格诊断问卷第四版 （PDQ4+）、早年（18岁以前）不良家庭环境问卷、家庭环境量表-中文版（FES-CV）进行调查和测试。
结果：（1） 精神分裂症组的攻击行为史、父母精神病史多于罪犯组，而早年家庭结构不完整及遭受父母虐待、父母有不良教养方式、酒精滥用史少于罪犯组，差异有统计学意义（P＜0.05＝。（2）MMPI测试结果显示精神分裂症组的F、D、Hs、Hy、Pa分高于罪犯组，差异有统计学意义（P＜0.05＝。（3）PDQ4+的测定结果显示精神分裂症组的偏执型、分裂样、分裂型、表演型、依赖型、被动攻击型、抑郁型人格障碍评分高于罪犯组，而反社会人格障碍评分低于罪犯组，差异有统计学意义（P＜0.05＝。（4）两组在家庭环境量表的亲密度、情感表达、成功性、娱乐性、组织性方面存在差异，差异有统计学意义（P＜0.05＝。 （5） Logistic回归分析结果显示精神分裂症患者暴力
行为的
危险因素是既往攻击行为史、MMPI的F、Pa高分及早年父母的精神病史 ；而罪犯暴力行为的危险因素是早年遭受父母虐待、父母的不良教养方式、反社会人格障碍、既往酒精滥用史。
结论：两组暴力行为的相关因素既有差异，也存在一些共同的病理性人格特点。
Objective: To study the psychosocial factors associated with violent behavior in schizophrenic patients and violent criminals.
Methods: A controlled study was conducted between 49 violent criminals and 35 schizophrenic patients with violent behavior. They were assessed using demographic information questionnaire，past history questionnaire，Minnesota Multiphasic Personality Inventory(MMPI)，Personality Diagnostic Questionnaire－4th Version(PDQ4+)，Early deviant family environment questionnaire (before 18 years old) and Family Environment Scale-Chinese version(FES－CV).
Results: (1) There are more instances with history of aggressive behavior and parental psychotic history in schizophrenic patients than in violent criminals. There are more instances with history of alcohol abuse，
parental unsound rearing styles, suffering parental abuse and family defect in early years in violent criminals than in schizophrenic patients . (2) Schizophrenic patients have higher F, D, Hs, Hy, Pa scores of MMPI than violent criminals. (3) Significant differences between two groups are found in cohesion, achievement，entertainment，organization subscales of the Family Environment Scale. (4) Compared with violent criminals ，Schizophrenic patients have higher scores in paranoid，schizoid，schizotypal，hysteric，dependent， passive aggressive and depressive personality disorder and have lower scores in antisocial personality disorder of PDQ4+. (5) Logistic regression analyses suggests that the main risk factors for violent behavior of schizophrenic patients are the history of aggressive behavior，the F，Pa scores of MMPI and parental psychotic history，while the risk factors for violent behavior of criminals are the suffering parental abuse in early years，parental unsound rearing styles，antisocial personality disorder and the history of alcohol abuse.
Conclusion: There are significant differences between two groups in psychosocial factors，but each group has some similar personality deviation.
方法：采用病例对照研究方法，收集49例暴力罪犯和35例暴力违法的精神分裂症患者，应用人口学资料和既往史调查表、明尼苏达多相人格调查表（MMPI）、人格诊断问卷第四版 （PDQ4+）、早年（18岁以前）不良家庭环境问卷、家庭环境量表-中文版（FES-CV）进行调查和测试。
结果：（1） 精神分裂症组的攻击行为史、父母精神病史多于罪犯组，而早年家庭结构不完整及遭受父母虐待、父母有不良教养方式、酒精滥用史少于罪犯组，差异有统计学意义（P＜0.05＝。（2）MMPI测试结果显示精神分裂症组的F、D、Hs、Hy、Pa分高于罪犯组，差异有统计学意义（P＜0.05＝。（3）PDQ4+的测定结果显示精神分裂症组的偏执型、分裂样、分裂型、表演型、依赖型、被动攻击型、抑郁型人格障碍评分高于罪犯组，而反社会人格障碍评分低于罪犯组，差异有统计学意义（P＜0.05＝。（4）两组在家庭环境量表的亲密度、情感表达、成功性、娱乐性、组织性方面存在差异，差异有统计学意义（P＜0.05＝。 （5） Logistic回归分析结果显示精神分裂症患者暴力
行为的
危险因素是既往攻击行为史、MMPI的F、Pa高分及早年父母的精神病史 ；而罪犯暴力行为的危险因素是早年遭受父母虐待、父母的不良教养方式、反社会人格障碍、既往酒精滥用史。
结论：两组暴力行为的相关因素既有差异，也存在一些共同的病理性人格特点。
Objective: To study the psychosocial factors associated with violent behavior in schizophrenic patients and violent criminals.
Methods: A controlled study was conducted between 49 violent criminals and 35 schizophrenic patients with violent behavior. They were assessed using demographic information questionnaire，past history questionnaire，Minnesota Multiphasic Personality Inventory(MMPI)，Personality Diagnostic Questionnaire－4th Version(PDQ4+)，Early deviant family environment questionnaire (before 18 years old) and Family Environment Scale-Chinese version(FES－CV).
Results: (1) There are more instances with history of aggressive behavior and parental psychotic history in schizophrenic patients than in violent criminals. There are more instances with history of alcohol abuse，
parental unsound rearing styles, suffering parental abuse and family defect in early years in violent criminals than in schizophrenic patients . (2) Schizophrenic patients have higher F, D, Hs, Hy, Pa scores of MMPI than violent criminals. (3) Significant differences between two groups are found in cohesion, achievement，entertainment，organization subscales of the Family Environment Scale. (4) Compared with violent criminals ，Schizophrenic patients have higher scores in paranoid，schizoid，schizotypal，hysteric，dependent， passive aggressive and depressive personality disorder and have lower scores in antisocial personality disorder of PDQ4+. (5) Logistic regression analyses suggests that the main risk factors for violent behavior of schizophrenic patients are the history of aggressive behavior，the F，Pa scores of MMPI and parental psychotic history，while the risk factors for violent behavior of criminals are the suffering parental abuse in early years，parental unsound rearing styles，antisocial personality disorder and the history of alcohol abuse.
Conclusion: There are significant differences between two groups in psychosocial factors，but each group has some similar personality deviation.
引文
Ford AB，Rushforth NB. Urban violence in the united states implication for health and for Britain in the future. J R Soc Med，1983，76(4)：283-288
Walsh E，Buchanan A，Fahy T，etc. Violence and schizophrenia. Br J Psychiatry，2002，180(6): 490-495
费立鹏，郑延平，邹定辉. 家庭环境量表中文版心理卫生评定量表手册. 中国心理卫生杂志，1993，增刊：93-101
杨德森主编， 行为医学[ M ]，湖南：湖南科学技术出版社，1998，190
刘协和主编，法医精神病学[M]，北京：人民卫生出版社，1997，46.
郭翔，鲁士恭主编，犯罪学辞典[M]，上海：上海人民出版社，1989，688-690.
王小平，杨德森，李凌江等.男性分裂症患者和罪犯攻击行为相关因素对照研究. 中国心理卫生杂志，1997，11（2）：103-106
Convit A，Jaeger J，Lin SP，etc. Predicting assaultiveness in psychiatry inpatients. Hosp Community Psychiatry，1988，39(4)：429-434
王小平，杨德森，李凌江等.精神分裂症患者攻击行为的预测. 中华精神科杂志，1997，2（30）：20-24
Arango C，Calcedo A，Gonzalez S，etc. Violence in inpatients with schizophrenia. Schizophr Bull，1999，25 (3)：493-503
Soliman AE，Reza H. Risk factors and correlates of violence among acutely ill adult psychiatric inpatients. Psychia Serv，2001，52(1)：75-80
Poldrugo F. Alcohol and criminal behaviour. Alcohol Alcohol，1998，33(1)：12-15
Yoshino A，Fukuhara T，Kato M. Premobid risk factors for alcohol dependence in antisocial personality disorder. Alcohol Clin Exp Res，2000，24(1)：35-38
Mungas D. Discrimination validation of an MMPI measure of aggression. J Consul Clini Psychol，1984，52(2)：313-314
朱连成，王丽娟，陈利等. 具有凶杀行为的精神分裂症患者 MMPI的对照研究.
中国心理卫生杂志，2001，15（2）：110
纪术茂，戴郑生主编,明尼苏达多相人格调查表[ M ]， 北京： 科学出版社， 2004，77
Hocomb WR，Adams NA，Ponder HM，etc. Cognitive and behavioral predictors of MMPI scores in pretrial psychological evaluations of murderers. J Clin Psychol，1984，40(2)：592-597
Cheung P，Schweitzer I，Crowley k，etc. Violence in schizophrenia.Schizophr Res，1997，26(2):181-189
Kemph JP, Braley RO,Ciotola PV. A comparison of youthful inmates who have committed violent versus nonviolent crimes. J Am Acad Psychiatry Law, 1998, 26(1)67-74.
Steinert T，Wolfle M，Gebhardt RP. Measurement of violence during in patient treatment and association with psychopathology，Acta Psychiatr Scand， 2000，102(2)：107
Valliant PM，Gristey C，Pottier D，etc. Risk factors in violent and nonviolent offenders. Psycho Rep，1999，85(2)：675-680
徐莉萍，王小平，谢永标等. 男性少年暴力罪犯人格特征对照研究. 中国行为医学科学，2003，12（2）：188-189
Valliant PM，Freeston A，Pottier D，etc. Personality and executive functioning as risk factors in recidivist. Psycho Rep，2003，92(1) ：299-306
Davision S，Leese M，Taylor PJ. Examination of the screening properties of the personality diagnostic questionnaire 4+(PDQ4+) in a prison population. J Personal Disord，2001，15(2)：180-194
杨蕴萍，沈东郁，王久英等.人格诊断问卷（PDQ4+）在中国应用的信效度研究.中国临床心理学杂志，2002，10（3）：165-168
Yang J，Mccrae RR，Costa PT，etc. The cross-cultural generalizability of Axis-Ⅱconstructs. J Personal Disord，2000，14(3)：249-263
Blackburn R，Coid JW， Empirical clusters of DSM-Ⅲ personality disorders in
violent offenders. J Personal Disord，1999，13(1)：18-34
沈东郁，杨蕴萍. 人格诊断问卷在成年违法犯罪人群中的应用. 中国行为医学科，2002，11（5）：531-532
New AS， Hazlett EA， Buchsbaum MS，etc. Blunted prefrontal cortical 18-fluorodeoxyglucose positron emission tomography response to meta- chlorophenylpiperazine in impulsive aggression. Arch Gen Psychiatry，2002，59(7)：621-629
Mcburnett K，Kerckhoff C，Capasso L，etc. Antisocial personality，substance abuse， and exposure to parental violence in males refered for domestic violence. Violence Vict，2001，16(5)：491-506
Hodgins S， Kratzer L，Mcneil TF. Obstetric complication ,parenting and risk of criminal behavior. Arch Gen Psychiatry，2001，58(8)：746-752.
Rain A， Brennan P，Mednick SA. Interaction between birth complication and early materal rejection in predisposing individual to adult violence. Am J Psychiatry，1997，154(9)：1265-1271
Caspi A，Mcclay J，Terrie E，etc. Role of genotype in the cycle of violence in maltreated children . Science，2002，297(5582)：851-854
Dodge KA, Bates JE, Pettit GS. Mechanisms in the cycle of violence. Science，1990， 250 (4998):1678-1683
Bischof GP，Stith SM，Whitney ML. Family environments of adolescent sex offenders and other juvenile delinquents. Adolescence，1995，30(117)：157-170
崔小媛，王小平，郭艳梅. 住院精神分裂症患者攻击行为的短期预测. 中国临床心理学，2002，10（4）：285-286
Walsh E，Buchanan A，Fahy T，etc. Violence and schizophrenia. Br J Psychiatry，2002，180(6): 490-495
费立鹏，郑延平，邹定辉. 家庭环境量表中文版心理卫生评定量表手册. 中国心理卫生杂志，1993，增刊：93-101
杨德森主编， 行为医学[ M ]，湖南：湖南科学技术出版社，1998，190
刘协和主编，法医精神病学[M]，北京：人民卫生出版社，1997，46.
郭翔，鲁士恭主编，犯罪学辞典[M]，上海：上海人民出版社，1989，688-690.
王小平，杨德森，李凌江等.男性分裂症患者和罪犯攻击行为相关因素对照研究. 中国心理卫生杂志，1997，11（2）：103-106
Convit A，Jaeger J，Lin SP，etc. Predicting assaultiveness in psychiatry inpatients. Hosp Community Psychiatry，1988，39(4)：429-434
王小平，杨德森，李凌江等.精神分裂症患者攻击行为的预测. 中华精神科杂志，1997，2（30）：20-24
Arango C，Calcedo A，Gonzalez S，etc. Violence in inpatients with schizophrenia. Schizophr Bull，1999，25 (3)：493-503
Soliman AE，Reza H. Risk factors and correlates of violence among acutely ill adult psychiatric inpatients. Psychia Serv，2001，52(1)：75-80
Poldrugo F. Alcohol and criminal behaviour. Alcohol Alcohol，1998，33(1)：12-15
Yoshino A，Fukuhara T，Kato M. Premobid risk factors for alcohol dependence in antisocial personality disorder. Alcohol Clin Exp Res，2000，24(1)：35-38
Mungas D. Discrimination validation of an MMPI measure of aggression. J Consul Clini Psychol，1984，52(2)：313-314
朱连成，王丽娟，陈利等. 具有凶杀行为的精神分裂症患者 MMPI的对照研究.
中国心理卫生杂志，2001，15（2）：110
纪术茂，戴郑生主编,明尼苏达多相人格调查表[ M ]， 北京： 科学出版社， 2004，77
Hocomb WR，Adams NA，Ponder HM，etc. Cognitive and behavioral predictors of MMPI scores in pretrial psychological evaluations of murderers. J Clin Psychol，1984，40(2)：592-597
Cheung P，Schweitzer I，Crowley k，etc. Violence in schizophrenia.Schizophr Res，1997，26(2):181-189
Kemph JP, Braley RO,Ciotola PV. A comparison of youthful inmates who have committed violent versus nonviolent crimes. J Am Acad Psychiatry Law, 1998, 26(1)67-74.
Steinert T，Wolfle M，Gebhardt RP. Measurement of violence during in patient treatment and association with psychopathology，Acta Psychiatr Scand， 2000，102(2)：107
Valliant PM，Gristey C，Pottier D，etc. Risk factors in violent and nonviolent offenders. Psycho Rep，1999，85(2)：675-680
徐莉萍，王小平，谢永标等. 男性少年暴力罪犯人格特征对照研究. 中国行为医学科学，2003，12（2）：188-189
Valliant PM，Freeston A，Pottier D，etc. Personality and executive functioning as risk factors in recidivist. Psycho Rep，2003，92(1) ：299-306
Davision S，Leese M，Taylor PJ. Examination of the screening properties of the personality diagnostic questionnaire 4+(PDQ4+) in a prison population. J Personal Disord，2001，15(2)：180-194
杨蕴萍，沈东郁，王久英等.人格诊断问卷（PDQ4+）在中国应用的信效度研究.中国临床心理学杂志，2002，10（3）：165-168
Yang J，Mccrae RR，Costa PT，etc. The cross-cultural generalizability of Axis-Ⅱconstructs. J Personal Disord，2000，14(3)：249-263
Blackburn R，Coid JW， Empirical clusters of DSM-Ⅲ personality disorders in
violent offenders. J Personal Disord，1999，13(1)：18-34
沈东郁，杨蕴萍. 人格诊断问卷在成年违法犯罪人群中的应用. 中国行为医学科，2002，11（5）：531-532
New AS， Hazlett EA， Buchsbaum MS，etc. Blunted prefrontal cortical 18-fluorodeoxyglucose positron emission tomography response to meta- chlorophenylpiperazine in impulsive aggression. Arch Gen Psychiatry，2002，59(7)：621-629
Mcburnett K，Kerckhoff C，Capasso L，etc. Antisocial personality，substance abuse， and exposure to parental violence in males refered for domestic violence. Violence Vict，2001，16(5)：491-506
Hodgins S， Kratzer L，Mcneil TF. Obstetric complication ,parenting and risk of criminal behavior. Arch Gen Psychiatry，2001，58(8)：746-752.
Rain A， Brennan P，Mednick SA. Interaction between birth complication and early materal rejection in predisposing individual to adult violence. Am J Psychiatry，1997，154(9)：1265-1271
Caspi A，Mcclay J，Terrie E，etc. Role of genotype in the cycle of violence in maltreated children . Science，2002，297(5582)：851-854
Dodge KA, Bates JE, Pettit GS. Mechanisms in the cycle of violence. Science，1990， 250 (4998):1678-1683
Bischof GP，Stith SM，Whitney ML. Family environments of adolescent sex offenders and other juvenile delinquents. Adolescence，1995，30(117)：157-170
崔小媛，王小平，郭艳梅. 住院精神分裂症患者攻击行为的短期预测. 中国临床心理学，2002，10（4）：285-286