ABSTRACT

Although there is an increasing focus on therapy alliance and its predictive factors, there has been limited exploration of these predictive factors within forensic services. Adverse childhood experiences (ACEs) could be one of these possible factors. In the present study, we examined whether ACEs are predictive for therapy alliance in male inpatients with cluster B personality disorders who are convicted for a violent offense. We were specifically interested in the predictive value of ACEs on therapy alliance at 18 months into treatment, and whether personality pathology mediates this relationship. ACEs, self-rated and observer-rated therapy alliance, and personality pathology were assessed within 103 male offenders and analyzed using hierarchical multiple regression analyses, and mediation analyses using PROCESS. Results show that self-rated agreement on therapy tasks was predicted by emotional neglect, whereas observer-rated agreement on therapy tasks was predicted by physical neglect. Physical, sexual, and emotional abuse were not predictive for therapy alliance. Personality disorders were no mediating factors. Despite limitations, this study emphasizes the importance of childhood neglect in treatment of male inpatients with convictions for violent offenses and contributes to our understanding of the concept of therapy alliance in people with convictions.

摘要

尽管越来越关注治疗联盟及其预测因素，但在法医服务中对这些预测因素的探索有限。不良童年经历 (ACE) 可能是这些可能的因素之一。在本研究中，我们检查了 ACE 是否可以预测因暴力犯罪而被定罪的患有 B 类人格障碍的男性住院患者的治疗联盟。我们特别感兴趣的是 ACE 在治疗后 18 个月对治疗联盟的预测价值，以及人格病理学是否介导了这种关系。在 103 名男性罪犯中评估了 ACE、自我评价和观察者评价的治疗联盟和人格病理学，并使用分层多元回归分析和使用 PROCESS 的中介分析进行了分析。结果表明，情绪忽视可以预测治疗任务的自我评价一致性，而身体忽视可以预测观察者评价治疗任务的一致性。身体、性和情感虐待不能预测治疗联盟。人格障碍不是中介因素。尽管存在局限性，但这项研究强调了童年忽视在治疗因暴力犯罪而被定罪的男性住院患者中的重要性，并有助于我们理解有罪者治疗联盟的概念。