Introduction: Substance abuse is related to re-offending. Substance abuse treatment may be effective in reducing recidivism. Psychopathy, another predictor of re-offending has been found to be negatively associated with utilization of substance abuse treatment. As many of the psychopathic personality traits hypothetically may function as barriers to treatment, the presence of such traits may be relevant for treatment perceptions. Exploring participants’ perspectives on treatment can be useful to improve retention rates.
Method: In order to explore treatment perceptions among offenders with mental health problems, substance use problems and various degrees of psychopathic personality traits, in-depth, semi structured interviews were conducted. Twelve males participated in the study. Six participants had a high degree of psychopathic personality traits (26 ≥ points of the PCL-R), referred to as the H-group, whereas the remaining informants had a low degree of such traits (0-5 points of the PCL-R), referred to as the L-group. Interviews were analyzed using Interpretative Phenomenological analysis (IPA). The analysis resulted in nine themes describing treatment perceptions among the participants.
Results and Discussion: Some treatment perceptions varied with degree of psychopathic personality traits. For example, H-participants stated that they had difficulties fulfilling treatment requirements whereas L-participants expressed that such requirements were manageable. Also, in contrast to informants of the L-group, members of the H-group stated that they felt inferior towards caregivers and that lack of previous treatment experiences contributed to the outsider-feeling in relation to the treatment system. Such differences in treatment perceptions between the groups may concern the influence of psychopathic personality traits.
Some treatment perceptions were also similar between the two groups. For instance, both H- and L- participants had experienced positive outcomes of treatment and suggested similar components that should be part of the ideal treatment. Such similarities indicate that degree of psychopathic personality traits may not influence treatment perceptions alone. Instead, the results suggest that the combination of degrees of psychopathic personality traits and other factors, such as treatment experiences, may be relevant for treatment perceptions. The findings illustrate the complexity of the relationship between the individual and the health care system, and may serve as a starting point for further studies on this topic.