Those Who Commit Violent Crimes can be Traumatised by Their Offences: A Systematic Review of Offence-Specific Post-Traumatic Stress Disorder

Abstract

ABSTRACT Post-traumatic stress disorder (PTSD) has focused on victims, with minimal attention given to perpetrators of violent crimes who might subsequently develop offense-specific PTSD from their own offenses. Its prevalence and associations are not well-established. In accordance with PRISMA guidelines, 10 databases were searched to identify studies examining offense-specific PTSD in perpetrators of violent crimes. Fourteen unique studies were identified across prison, forensic hospital, and community settings. Sample sizes ranged from 19 to 339, with 8 studies assessed to be of at least adequate quality. Prevalence rates of offense-specific PTSD ranged from 1.5% to 76.6%, with 8 studies identifying a prevalence of 33.3% or greater. Associations with offense-specific PTSD were examined by 8 studies, with PTSD from prior trauma and post-offense guilt and shame the most-studied. Post-offense guilt and shame was consistently associated with offense-specific PTSD. Other associates included alexithymia, co-morbid anxiety and depression, certain personality subtypes, and intentional perpetration. Offense-specific PTSD is present in a significant proportion of perpetrators of violent crimes. More research of higher quality is required on this condition and its associations. Increased recognition of offense-specific PTSD and viewing perpetrators of violent crimes as potentially-affected persons could guide clinicians in forensic settings toward a more trauma-informed approach.