Psychiatry & Psychosomatic Medicine

Mental health problems have a direct relationship with violent offending in that people with a diagnosis of antisocial personality disorder (ASPD) and a proportion of those with a diagnosis of schizophrenia are at most risk of committing violent crimes. Individuals who as children experienced psychosocial adversity, in particular sexual or physical abuse, are known to have a heightened risk of developing mental disorders, and although the majority of these do not commit any violent offences as an adult, they are on average more likely to engage in violent crimes than those who did not experience abuse. A number of studies indicate a range of common and distinct neuropsychological deficits in groups of offenders with schizophrenia-alone, APD-alone or with comorbid schizophrenia and ASPD. Violent mentally-disordered individuals with ASPD or schizophrenia also display an array of structural and functional deficits in brain regions that are widely implicated in regulation of violence through their involvement in decision-making, empathy, impulse control and emotion regulation. Some of these abnormalities in violent mentally-disordered offenders appear to be explained by their histories of stressful childhood experiences. Current and future therapies aiming to reduce violence in such populations would benefit by attending to biological and behavioural correlates of childhood abuse.