Abstract

The present paper utilized the case study of an incarcerated serial killer (“Keith”) to demonstrate how combining three assessment techniques (the Structured Clinical Interview for DSM-IV Axis II Personality Disorders, the Rorschach task, and a comprehensive battery of neuropsychological measures) within a multilevel personality assessment framework might elucidate possible personality-based underpinnings of extreme and repetitive violence—representing a “next wave” of serial killer research while also highlighting the empirical and clinical value of an empirically-neglected multilevel assessment approach. Gacono and Meloy’s multimethod “levels” model was selected as a multilevel framework, and Leary’s recommended examination of inter-level consistency was utilized as an integrative strategy. Results indicated marked divergencies among Keith’s data levels in areas of executive abilities, psychotic symptoms, affective/emotional disconnectivity, and sexual disturbance that suggested areas for potential change (perhaps in therapy), while consistencies among levels in social cognition and object relations suggested more stable characteristics that may be resistant to modification. The application of multilevel personality assessment methods to extremely and repetitively violent persons represents an important clinical approach worthy of future study—potentially having implications for research, clinical and forensic assessment, and treatment, and advancing empirical and clinical understandings of the continuum of interpersonal violence.

摘要

本文利用一个被监禁的连环杀手（“Keith”）的案例研究来展示如何结合三种评估技术（DSM-IV Axis II 人格障碍的结构化临床访谈、罗夏任务和一系列神经心理学测量）在多层次人格评估框架内，可能会阐明极端和重复暴力的可能基于人格的基础——代表了连环杀手研究的“下一波”，同时也强调了经验被忽视的多层次评估方法的经验和临床价值。Gacono 和Meloy 的多方法“层次”模型被选为多层次框架，Leary 推荐的层次间一致性检查被用作综合策略。结果表明，Keith 在执行能力、精神病症状、情感/情绪脱节和性障碍方面的数据水平存在显着差异，表明存在潜在变化的领域（可能在治疗中），而社会认知和客体关系水平之间的一致性表明更稳定可能抵抗修改的特性。将多层次人格评估方法应用于极端和反复暴力的人代表了一种值得未来研究的重要临床方法——可能对研究、临床和法医评估以及治疗产生影响，并促进对人际暴力连续性的经验和临床理解。和性障碍表明可能发生变化的领域（可能在治疗中），而社会认知和客体关系水平之间的一致性表明可能会抵抗修改的更稳定的特征。将多层次人格评估方法应用于极端和反复暴力的人代表了一种值得未来研究的重要临床方法——可能对研究、临床和法医评估以及治疗产生影响，并促进对人际暴力连续性的经验和临床理解。和性障碍表明可能发生变化的领域（可能在治疗中），而社会认知和客体关系水平之间的一致性表明可能会抵抗修改的更稳定的特征。将多层次人格评估方法应用于极端和反复暴力的人代表了一种值得未来研究的重要临床方法——可能对研究、临床和法医评估以及治疗产生影响，并促进对人际暴力连续性的经验和临床理解。