Personality disorders

Abstract Personality disorders (PDs) constitute a unique challenge in the diagnosis and management of incarcerated persons. Persons with these conditions are most likely to create difficulties in correctional settings in terms of interpersonal discord, conflict with other incarcerated persons and treatment staff, risk for suicide and self-injurious behavior, and risk for aggression and violence. Such difficulties are compounded by PDs being nosologically complex with epidemiological data that are limited by multiple confounders. However, available evidence suggests that PDs are more prevalent in correctional populations. The trend toward PDs characterized according to a dimensional model may improve diagnostic clarity and inform regarding appropriate psychotherapeutic management. This trend away from PDs as mere categorical entities by symptom or behavior checklists hearkens to a classification method that describes the most prevalent PDs in correctional populations as belonging to a borderline level of personality organization. Available data on diagnosis, epidemiology, and treatment of the most relevant of such conditions are reviewed in this chapter.