Personality disorder, temperament, and childhood adversity: findings from a cohort of prisoners in England and Wales

Adverse childhood experiences and childhood temperamental features are known to contribute to the development of personality disorder. The aim of this study was to examine associations between personality disorder, childhood temperament, adverse childhood experiences, and victimisation. The Prisoner Cohort Study was carried out as part of the dangerous and severe personality disorder (DSPD) service development programme commissioned by the Home Office. The study comprised 1396 male offenders interviewed with the Structured Clinical Interview (SCID II) to diagnose personality disorders in addition to reveal self-reported experiences of childhood victimisation and disadvantage. Independent and joint relationships were examined between reported temperament and adverse childhood experiences and Axis II disorders measured at interview. Prisoners with personality disorder reported adverse childhood experiences and victimisation more frequently than those with no personality disorder. Different childhood experiences were interrelated with specific personality disorder categories. Associations between temperamental features and specific personality disorders were increased by the addition of adverse childhood experiences (joint effects). A difficult temperament and childhood adversity increase the likelihood of personality disorder in prisoners and may be risk factors to target for future early intervention.