The Relationship of Early Maladaptive Schemas and Schema Modes with Violence Risk in Persons Acquitted by Reason of Insanity

The legal term “insanity defense” is used to describe people who commit a crime under the influence of a mental disorder. The assessment of the violence risk posed by such individuals is complex, and in global practice, it is typically conducted by a multiprofessional team. However, in Russian practice, psychological evaluation is not carried out since it is believed that psychological drivers lose their significance in the presence of a mental disorder. The article describes the results of a study on the relationship between early maladaptive schemas and schema modes with violence risk in persons acquitted by reason of insanity. Measurements were taken from 58 male patients at the St. Petersburg Psychiatric Hospital, a specialized facility with intensive supervision, ranging in age from 18 to 61 years. These measurements included the level of severity of early maladaptive schemas (assessed using the Young Schema Questionnaire — Short Form Revised), the level of severity of dysfunctional schema modes (evaluated through the Schema Mode Inventory), and the level of violence risk (measured using the Historical Clinical Risk Management Scales — HCR-20 V2). The results obtained using Spearman’s rank correlation coefficient and the Benjamini — Hochberg procedure lead to the conclusion that a weak reliable relationship exists between the schema “Insufficient Self-Control” and the level of violence risk in persons acquitted by reason of insanity. Consequently, it is inferred that this schema can be considered a psychological driver of violence risk. The conducted research is the first of its kind in Russia.

Alfarnes, S. A., Bulygina, V. G. (2009). Structural dynamic violence risk assessment procedures using HCR-20 and V-RISK-10. Rossiiskii Psikhiatricheskii Zhurnal, 6, 12–18. (In Russian)