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Persönlichkeitsstörungen

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Forensische Psychiatrie

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Zusammenfassung

Die aktuellen Konzeptionen von Persönlichkeitsstörung (PS) in den dominierenden Nosologien, DSM-5 und ICD-11, werden kurz besprochen und kritisch kommentiert. Eine angemessene Beurteilung von PS sollte weiter gehen als kategoriale sowie merkmalsbasierte Konzepte, indem ein nomothetischer (merkmalsbasierter) Ansatz mit einem idiografischen (personenzentrierten) Ansatz kombiniert wird. Insbesondere ist es nötig, bei der Diagnose von PS Motivation (und Emotion als Aspekt dieser) als wesentliches Element zu betrachten. Die Verbindung zwischen Persönlichkeitsstörungen (PS) und Gewaltdelikten wird im Kontext der motivationalen Heterogenität von Gewalt kritisch betrachtet. Dabei wird argumentiert, dass paranoides Denken und emotionale Impulsivität intrapersonelle Schlüsselfaktoren für das Verständnis der Verbindung zwischen PS und Gewalttaten darstellen, der interpersonelle Kontext jedoch ebenso wichtig ist. Das Good Lives Model ist hier der favorisierte Rehabilitationsansatz für an PS erkrankte Straftäter*innen, da es Motivation als zentralen Aspekt der Rehabilitation sieht.

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Notes

  1. 1.

    Der Vorschlag der ICD-Arbeitsgruppe, vollständig auf PS-Kategorien zu verzichten, rief beträchtlichen Widerstand bei denjenigen hervor, die daran interessiert waren, die Borderline-PS beizubehalten (Livesley 2021). Ihre Lobbyarbeit führte zu der Entscheidung, BPS als eigenständige kategoriale Diagnose in der ICD-11 beizubehalten.

  2. 2.

    Psychopathy wird hier entsprechend der Definition von Hare verwendet.

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  1. Wiesbaden, Deutschland

    Richard C. Howard

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  1. Richard C. Howard
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  1. Klinik für Forensische Psychiatrie, Rostock, Deutschland

    Birgit Völlm

  2. Abteilung für Forensische Psychiatrie und Psychotherapie, LWL-Universitätsklinikum Bochum c/o LWL-Maßregelvollzugsklinik, Herne, Deutschland

    Boris Schiffer

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Howard, R.C. (2023). Persönlichkeitsstörungen. In: Völlm, B., Schiffer, B. (eds) Forensische Psychiatrie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-64465-2_11

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