Adverse Childhood Experiences and Their Relationship With Psychological Disorders and Violent Criminal Behaviour Within a Forensic Psychiatric Cohort

ABSTRACT

Background

Adverse childhood experiences (ACEs) are traumatic events occurring before the age of 18 that may undermine a child’s sense of safety, stability and attachment. ACEs can have lifelong consequences, including an elevated risk of developing psychological disorders and an increased likelihood of engaging in delinquent or violent behaviour later in life. Clinical practice suggests that many forensic psychiatric patients have a history of ACEs, but scientific research on ACEs within this population remains limited.

Aim

To study the prevalence of ACEs before the age of 18 within a large Dutch forensic psychiatric prison cohort and the relationship between repeated ACEs and psychopathology or violent criminal behaviour.

Methods

Data collected from 3421 adults (91% men) who had been admitted to one of the four penitentiary psychiatric centres (PPCs) in the Netherlands were used to examine the prevalence of ACEs and their association with different clusters of psychological disorders or violent criminal behaviour.

Results

Over half of the men (1,633, 53%) and nearly two thirds of the women (198, 62%) had experienced repeated ACEs. The men with repeated ACEs had greater odds of having a neurobiological developmental disorder, having committed a violent offence and developing a substance use or addiction disorder, a personality disorder and/or a trauma- or stress-related disorder. The women with repeated ACEs had greater odds of developing a personality disorder.

Conclusions

Our findings underscore the importance of incorporating assessment of trauma histories and trauma-informed service for forensic psychiatric offenders. We also add evidence for the potential for early intervention, given that repeated ACEs were associated with certain mental disorders and with violent offending, in particular for men.