Character is a result of adapting to changes through the effects of environmental factors, family, and education. Temperament comprises structural properties that are genetically transmitted and undergo little change throughout life. 16 However, personality is formed by the merging of temperament and character. Although it is basically defined as a personality dimension, impulsivity is a complex concept with both behavioral and cognitive aspects. 15 Impulsivity is defined as an action or behavior that is done suddenly, quickly, without thinking about the end, and without making a plan. 12–15 In addition, childhood traumas were also reported to be associated with pleasure and excitement seeking, attention deficit, and impulsive behaviors such as making sudden decisions, anger control problems, violence, and criminal tendency. 11 Childhood traumas have been linked to the development of many psychiatric diseases such as depressive disorder, bipolar disorder, psychotic disorder, low self-esteem and suicidal thoughts, and personality pathologies. Child abuse is a multidimensional phenomenon and is divided into 5 groups: emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect. 8–10Ĭhild abuse is defined as the preventable behaviors, excluding accidents, by a child’s caregiver that could impair physical and psychosocial development of the child. In addition, childhood traumas were reported to be risk factors for violent behavior and commitment of criminal acts by psychiatric patients. 6 In another study, 7 mood disorders, alcohol-substance abuse, and personality disorders were found to be linked with violence. This rate was reported to be 20 times higher when substance abuse was involved. A study 6 with bipolar disorder patients found that the likelihood of violent behavior increased 3-fold compared to the population without psychiatric illness. In many of the available studies, psychiatric disease rates were investigated among people who committed crimes. 5 Studies 1,4,6 on psychiatric illnesses and crime are limited. 4 In other words, compared to the general population, people with psychiatric diseases are not more dangerous, but there is a dangerous subgroup in psychiatric diseases. Violent behavior does not increase in every psychiatric disease, but it is more common especially in psychiatric diseases such as bipolar disorder and schizophrenia. It has even been reported that the risk of violent behavior increases in people with serious psychiatric diseases. 2 Psychiatric diseases have been suggested for many years to be associated with violent behavior and criminality. 1 It is the basis of criminal behavior, which has detrimental effects on individuals and communities. Violence is described as damaging, destructive behavior that could result in psychological damage, injury, or death. Taking into account the temperaments of bipolar I disorder in treatment plans and providing psychosocial support to these patients could help prevent violent behaviors and the possibility of crime. Hyperthymic temperament was dominant in bipolar I patients involved in crime. For dominant temperament, hyperthymic temperament scores of the criminal history bipolar group were higher than that of the control group ( P < .001).Ĭonclusions: Patients with bipolar I disorder were found to have experienced more childhood traumas, and the criminal history bipolar group and those who were admitted to prison had suffered more physical abuse. Of quantitative variables, physical abuse and emotional abuse subscales and total CTQ score were significantly higher in both patient groups compared to healthy controls ( P < .001 for all scores). Results: The mean age was higher ( P = .029) and education level lower ( P = .045) among the criminal history bipolar patients than the other 2 groups. Subjects were enrolled in the study between April 1, 2019, and March 1, 2020. All participants completed the Childhood Trauma Questionnaire (CTQ), the Barratt Impulsiveness Scale (BIS-11), and the TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire). Methods: A total of 144 subjects in 3 groups (62 criminal history bipolar patients, 40 non-criminal bipolar patients, and 42 controls) participated in this cross-sectional study. Objective: To examine impulsivity, dominant temperaments, and childhood trauma in patients with bipolar I disorder who committed crimes by comparing them with bipolar I patients with no criminal history and with healthy controls.
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