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The Paradox of Childhood Cumulative Adversity in Antisocial Personality Disorder: Reconsidering Trauma-Informed Approaches in Carceral Settings Cover

The Paradox of Childhood Cumulative Adversity in Antisocial Personality Disorder: Reconsidering Trauma-Informed Approaches in Carceral Settings

Open Access
|Feb 2026

Figures & Tables

Comparison between groups with high cumulative adversity (≥4) (N=25) and those with low cumulative adversity (<4) (N=22)

Patients with score ≥ 4 High cumulative burden (n=25)Patients with score < 4 low cumulative burden (n=22)Student t testP value
Difficulty in Emotions Regulation Scale DERS
Score total98.2 ± 29.3285.86 ± 21.46−1.630.11
Awareness17.88 ± 5.816.18 ± 4.44−1.120.27
Clarity13.08 ± 5.9610.36 ± 3.02−1.930.06
Non Acceptance15.4 ± 6.3713.64 ± 5.01−1.040.3
Impulse control15.52 ± 6.8414.72 ± 6.04−0.420.67
Goals15.84 ± 5.4413.5 ± 6.81−1.310.2
Strategies21.16 ± 8.0218.04 ± 6.22−1.480.15
Psychopathy Check List of Hare PCL
Score total31.48 ± 4.1932 ± 2.910.490.63
Levenson Self Report Psychopathy LSRP
Score total60.84 ± 12.7762.82 ± 9.440.60.55
Primary psychopathy36.72 ± 8.8939.27 ± 6.961.0803
Secondary psychopathy24.12 ± 5.5923.55 ± 4.63−0380.71
BARRAT Impulsivity Scale BIS-11
Score total68.4 ± 10.5464.68 ± 8.39−1.330.19
Cognitive impulsivity18.8 ± 3.9917.32 ± 2.83−1.450.15
Motor Impulsivity23.64 ± 4.1722.09 ± 4.06−1.290.2
Difficult planification25.96 ± 5.1125.27 ± 4.3−0.50.62
Buss Perry Aggression questionnaire BPAQ
Score total93.92 ± 16.596.14 ± 15.540.470.64
Physical agressivity30.36 ± 6.3433.6 ± 6.791.690.1
Verbal agressivity18.52 ± 3.7817.59 ± 4.34−0.790.44
Anger21.08 ± 6.9321.09 ± 4.830.010.1
Hostility24.08 ± 6.3223.86 ±6.21−0.120.9

Descriptive statistics of the sample for the various psychometric measures (N=47)

Psychometric measureMean ± SDIC95%
AGE32.4 ± 8.59[29.94 – 34.86]
ACE3.94 ± 2.25[3.3 – 4.58]
DERS92.43 ± 26.41[84.88 – 99.98]
BIS66.66 ± 9.67[63.9 – 69.43]
PCL31.72 ± 3.62[30.69 – 32.76]
LSRP61.77 ± 11.26[58.55 – 65]
LSRP – Primary psychopathy37.91 ± 8.06[35.61 – 40.21]
LSRP – Secondary psychopathy23.85 ± 5.11[22.39 – 25.31]
BPAQ94.96 ± 15.92[90.41 – 99.51]

Correlation between subscales and corrected total score for the psychometric measures used in the study

Difficulty in Emotions Regulation Scale (DERS)
SubscaleCorrected totalIC95%Interpretation (per Cohen)
Awareness0.17[−0.12, 0.44]N.S
Clarity0.76***[0.6, 0.86]large
Non-Acceptance0.41**[0.14, 0.62]medium
Impulse control0.75***[0.59, 0.85]large
Goals0.75***[0.59, 0.85]large
Strategies0.76***[0.6, 0.86]large
Levenson Self-Report Psychopathy Scale (LSRP)
Primary Psychopathy0.43**[0.16, 0.64]medium
Secondary Psychopathy0.43**[0.16, 0.64]medium
Barrat Impulsivity Scale (BIS-11)
Cognitive Impulsivity0.38**[0.1, 0.6]medium
Motor Impulsivity0.56***[0.33, 0.73]medium
Difficult Planning0.52***[0.27, 0.7]medium
Buss Perry Aggression Questionnaire (BPAQ)
Physical Aggression0.47***[0.21, 0.67]medium
Verbal Aggression0.22[−0.072, 0.48]N.S.
Anger0.59***[0.36, 0.75]large
Hostility0.35**[0.07, 0.58]medium

Correlation between score on Adverse Childhood Experiences (ACE) and other psychological constructs (N=47)

ACEDERSBISPCLLSRPBPAQ
ACE1
DERS0.261
BIS0.320.37**1
PCL−0.010.030.37*1
LSRP0.020.54***0.290.121
BPAQ0.010.67***0.43*0.140.63***1

Subscales Intercorrelations for the psychometric measures in the study

Difficulty in Emotions Regulation Scale (DERS)
AwarenessClarityNon-AcceptanceImpulse controlGoalsStrategies
Awareness1
Clarity0.33*1
Non-Acceptance−0.050.46*1
Impulse Control0.270.61*0.261
Goals0.20.58*0.51*0.69*1
Strategies0.190.67*0.43*0.77*0.67*1
Levenson Self-Report Psychopathy Scale (LSRP)
Primary PsychopSecondary Psychop
Primary Psychop10.43*
Secondary Psychop0.43*1
Barrat Impulsivity Scale (BIS-11)
Cognitive impulsivityMotor impulsivityDifficult planning
Cognitive impulsivity1
Motor impulsivity0.35*
Difficult planning0.31*0.53*1
Buss Perry Aggression Questionnaire (BPAQ)
PhysicalVerbalAngerHostility
Physical1
Verbal021
Anger0.53*0.231
Hostility0.260.080.39*1
Language: English
Page range: 49 - 62
Submitted on: Dec 2, 2025
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Accepted on: Feb 6, 2026
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Published on: Feb 17, 2026
In partnership with: Paradigm Publishing Services
Publication frequency: Volume open

© 2026 Ahmed Rady, Celia Rupaire, Manuel Bermejo, Jerome Lacoste, published by International Platform on Mental Health
This work is licensed under the Creative Commons Attribution 4.0 License.