NCJ Number
57468
Date Published
1976
Length
10 pages
Annotation
A PSYCHIATRIST DISCUSSES HIS WORK WITH PATIENTS WHO, COMPLAINING OF IMPULSE DISORDERS RESULTING IN EPISODIC VIOLENCE, ADMITTED THEMSELVES TO A CLINIC. THEIR PROBLEMS AND THOSE OF SELECTED PRISON INMATES APPEAR RELATED.
Abstract
THE PATIENTS, LARGELY MALE AND WHITE, HAD A NUMBER OF COMMON CHARACTERISTICS. MOST HAD ARREST AND CONVICTION RECORDS FOR CRIMES OF PERSONAL VIOLENCE, ACKNOWLEDGED ACTS OF VIOLENCE PRECEDED BY SOME PRODROMAL STATE WHICH THEY COULD OFTEN IDENTIFY, AND VIOLENTLY OVERREACTED TO SOME TYPE OF PROVOCATION. THEY EVIDENCED A FAIRLY CONSISTENT PATTERN OF PATHOLOGICAL AGGRESSION AND APPEARED PASSIVE AND INEFFECTUAL. THEY EXPERIENCED VIOLENT ATTACKS FROM 4 TO 20 TIMES A YEAR AND ALTHOUGH HAD PREVIOUSLY SOUGHT HELP, THEY HAD GENERALLY BEEN TURNED AWAY BY OTHER HOSPITALS, PROBABLY BECAUSE PATIENTS SUFFERING FROM TEMPORAL LOBE AND IMPULSE DISORDERS ARE DIFFICULT TO WORK WITH AND OFTEN TERMINATE TREATMENT OR BECAUSE MEDICAL PERSONNEL HAVE NO STRATEGY FOR WORKING WITH SUCH DISORDERS. VARIOUS METHODS WERE TRIED WITH THIS GROUP; SOME WERE PLACED IN GROUP OR INDIVIDUAL THERAPY, WHILE OTHERS WERE GIVEN DRUGS OR WERE SUBJECTED TO ENVIRONMENTAL MANIPULATIONS. IN THE COURSE OF THE INITIATIVE, HOWEVER, SEVERAL THINGS BECAME CLEAR. FIRST, THEY SUFFERED A BEHAVIOR PROBLEM OR SYNDROME THAT IS THOROUGHLY NEGLECTED IN MEDICINE. SECOND, THEY DO NOT FALL WITHIN THE TRADITIONAL FRAMEWORK OF EXISTING DIAGNOSTIC OR THERAPEUTIC STRATEGIES (I.E., IT IS NOT CLEAR WHAT CAN BE DONE ABOUT THEM). MOREOVER, A BIOMEDICAL EXAMINATION OF A PRISON POPULATION REVEALED A SIGNIFICANT PRELIMINARY RESULT: THERE WAS AMONG AN INSTITUTIONAL POPULATION AN IDENTIFIABLE GROUP OF INMATES WHOSE VIOLENT TENDENCIES WERE CHARACTERISTIC OF THE CLINIC PATIENTS. FURTHER RESEARCH IS NEEDED TO IDENTIFY THESE SUBGROUPS AS WELL AS AN EFFECTIVE TREATMENT REGIMEN. REFERENCES ARE NOTED. (DAG)