Introduction
Many people involved in the forensic psychiatry system have experienced traumatic events during childhood. They sometimes show traits of psychopathy or engage in self-harming behaviours. Researchers have often studied these issues separately, but the study explores possible connections. Specifically, the researchers ask whether psychopathy can help explain the relationship between adverse childhood experiences (ACEs) and self-harming behaviours. Do childhood traumas increase the likelihood of developing psychopathy, which then leads to self-harm? The study focused on individuals assessed under the Ontario Review Board (ORB). It aimed to better understand interactions between these factors to improve care and prevention for this vulnerable group.
Methods
The researchers reviewed records of 593 forensic psychiatric patients in Ontario from 2014 to 2015. The team assessed all participants using the Psychopathy Checklist-Revised (PCL-R), a widely used tool for measuring psychopathic traits. The team collected information about each person’s history of childhood trauma. This included physical or emotional abuse, loss of a parent, or living in foster care. They also investigated whether self-harming behaviours began during the previous year or at any point in the participants’ lives. The team also collected demographic information (i.e., age, gender, education) along with clinical details like mental illness or substance use. The analysis used a method known as the Baron and Kenny mediation model. This allowed researchers to test whether psychopathy served as a bridge linking ACEs to self-harming behaviours.
Findings
The study found that psychopathy partly explained the link between adverse childhood experiences and self-harming behaviours over a person’s lifetime. In cases involving recent self-harm, psychopathy played a weaker role. Two types of ACEs stood out in particular: child abuse and having an incarcerated family member. Individuals with these experiences tended to score higher on the psychopathy scale and showed greater likelihood of having self-harmed. While only 7.5% of participants met full criteria for psychopathy, these participants showed more severe traits. More than 60% of the people studied had experienced at least one ACE, the average number being slightly over one. People with less education, a history of substance use, or other medical conditions had higher numbers of ACEs. Men, individuals with lower education, and individuals who used substances showed higher psychopathy levels.
Implications
The results of this study offer important insights into the connections between childhood trauma, psychopathy, and self-harm. The findings suggest that trauma during childhood can lead to the development of psychopathic traits. This in turn can increase the risk of self-harming behaviours. There are clear implications for care and prevention. Health professionals working with forensic patients should closely monitor those with histories of trauma, especially child abuse or family incarceration. These individuals can benefit from targeted mental health support to help manage psychopathic traits and reduce the risk of self-harm. More broadly, the study highlights the need for early intervention and trauma-informed care for people in the forensic system.
Limitations
There are some limitations to consider when interpreting these results. First, not all forensic patients undergo assessment with the PCL-R. Thus, findings do not necessarily apply to everyone in the system. Secondly, researchers recorded self-harm based on reports or the observations of others. This means that the study could have missed some cases. Thirdly, the study looked at data from one point in time. It cannot prove that ACEs cause psychopathy or self-harm, only that there is a relationship. Fourth, the PCL-R’s popularity does not mean it captures all aspects of psychopathy that relate to self-harming behaviours. Finally, results may not be generalizable to individuals with antisocial personality disorder. APD symptoms can overlap with psychopathy but can have different causes and risks.
Reference
Kaggwa, M. M., Chaimowitz, G. A., Erb, B., Moulden, H., Prat, S., Davids, A., & Olagunju, A. T. (2024). Adverse childhood events and self-harming behaviours among individuals in Ontario forensic system: the mediating role of psychopathy. BMC Psychiatry, 24(332). https://doi.org/10.1186/s12888-024-05771-7
About the Author
Maryam Dawood is an Honours Bachelor of Science graduate in Forensic Psychology from the University of Toronto, with research experience centered on legal decision-making, correctional psychology, and the stigmatization of offenders. She intends to pursue a Master of Science in Forensic Psychology, where she will explore wrongful convictions and self-stigma among justice-involved individuals to support evidence-based reforms and rehabilitation. Connect with Maryam on LinkedIn.
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