Abstract

A previous history of self‐mutilation was found in 7.5% of women on reception to a London prison. Although research has highlighted the additional importance of environmental influences, self‐mutilation as a single variable identified a subgroup of female prisoners with severe personality disorder and multiple disorders of impulse. Their early family environment was characterised by disruption and deprivation and by more extensive experience of physical and sexual abuse when compared to controls. In adulthood many showed abnormal psychosexual development and ‘polymorphous perversity’. Their criminal histories were characterised by an early onset of persistent, serious and wide‐ranging patterns of offending. Despite multiple and severe forms of psychopathology and frequent psychiatric contact, many of these women currently receive long periods of care and containment within the penal system. They fail to cooperate with and respond poorly to conventional psychiatric treatment, and psychiatric hospitals are unwilling or unable to cope with their behaviour.

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