PSYCHOPATHIC BATTERERS IMPACT ON MENTAL HEALTH SERIVICE

描述（申请人摘要）：一些理论和

DESCRIPTION (Applicant's Abstract): A number of both theoretical and empirical sources have proposed that a significant group of domestic violence perpetrators exhibit more antisocial behavior, express more generalized violence, and generally are more resistant to mental health interventions. In a parallel literature, researchers have identified a subgroup of violence offenders that exhibit a number of characteristics similar to this more antisocial/generally violent group. Furthermore, as greater national attention has been focused on the problem of domestic violence, local communities are becoming aware of the impact of domestic violence upon their mental health care services. Perpetrators may enter the local service systems through women's shelters, outpatient counselors, emergency rooms, family physicians, and indirectly through the legal system. However, recent theories have proposed that a subgroup of these men that best can be identified as exhibiting psychopathic characteristics may pose special problems for mental health service delivery systems. The current study proposes that this subgroup of batterers can best be considered psychopaths and that there are a number of implications for the delivery of mental health services involving them. Specifically, it is proposed that psychopathic batterers (1) will perpetrate more severe and more frequent violence against their partners and have different motivations for doing so, (2) will respond differently on cognitive tasks that assess specific learning deficits and demonstrate more cognitive distortions relevant to the commission of violence, (3) will exhibit differential levels of pathology, (4) will be at greater risk for dual diagnosis, (5) will report greater use of the mental health care system, and (6) will be less likely to respond positively to current mental health services (i.e., will be less motivated and more likely to drop out of treatment). A group of 150 men who have been referred for treatment as a result of partner assault will be obtained from two local outpatient treatment facilities that provide the only treatment of perpetrators of domestic violence in the community. Upon referral, participants will undergo a clinical interview and respond to a number of psychological measures assessing both current and prior functioning. The frequency, severity and motivation for their violent behavior will be assessed. In addition, they will perform a cognitive task that has shown the ability to differentiate psychopaths from nonpsychopaths in regard to their learning inability. Participants' treatment amenability and likelihood of completion will be assessed by their therapists prior to treatment completion. Finally, participants will be asked to respond to a number of questions designed to reveal the extent to which they have used the community mental health resources.