Psychopathological profiles in offenders with antisocial personality disorder: a comparison of violent and sexual crimes

This study examines psychopathy and aggression profiles in offenders with Antisocial Personality Disorder (ASPD) using standardized forensic assessment tools. It hypothesizes that higher psychopathy scores (PCL-R) will be significantly associated with greater aggression, providing insights for forensic risk evaluation and management. The study included incarcerated offenders evaluated at the Council of Forensic Medicine between 2014 and 2024 who were diagnosed with ASPD according to DSM-5 criteria. Participants voluntarily completed standardized assessments including the Psychopathy Checklist–Revised (PCL-R), Buss–Perry Aggression Questionnaire (BPAQ), Beck Depression and Anxiety Inventories, and the Interpersonal Cognitive Distortions Scale. Sociodemographic, clinical, and forensic data were collected through a semi-structured interview form and official court records. Group comparisons and correlation analyses were performed, with statistical significance set at p < 0.05. Among offenders with ASPD, violent offenders were more frequently unemployed (58.8%) and divorced (45.1%) compared to sexual offenders (31.6% and 18.4%, respectively; p = 0.009 and p = 0.022). Substance use (84.3% vs. 44.7%; p < 0.001), non-suicidal self-injury (86.3% vs. 28.9%; p < 0.001), and physical abuse (88.2% vs. 44.7%; p < 0.001) were markedly higher in the violent group, while sexual offenders more often reported sexual abuse (52.6%; p < 0.001). Psychopathy scores were significantly higher in violent offenders (Mean = 28.0 ± 5.8) than sexual offenders (Mean = 11.9 ± 3.7; p < 0.001), whereas depression scores were greater in sexual offenders (Mean = 35.2 ± 8.1 vs. 13.6 ± 5.3; p < 0.001). Logistic regression identified psychopathy as the strongest predictor of violent offending (β = 0.60, p < 0.001, OR = 1.82), explaining 83% of variance (Nagelkerke R² = 0.83). Violent and sexual offenders with ASPD exhibited distinct profiles, with psychopathy strongly associated with violent offending and internalizing symptoms and sexual trauma linked to sexual crimes. These findings emphasize the need for individualized, mechanism-based forensic interventions and risk assessments focusing on psychopathy and cognitive factors.