Prevalence of Borderline Personality Disorder and its Tendency to Sex Offending Among Inmates in Omdurman Jail (Sudan)

This research aimed at investigating the prevalence of borderline personality disorder(BPD) and its tendency to sex offending, among inmates in Omdurman jail, in the light of some other variables. To achieve this aim, the researcher used the descriptive survey method, through using a primary information form collected with sample, in addition to an inventory measuring borderline personality disorder which was prepared by the researcher as data collection administered on inmates at Al- Huda Prison in Omdurman. The study sample consisted of (230) prisoners: (120) males and (110) females. The collected data was analyzed by using some statistical procedures of (SPSS), such as: Pearson correlation, Alpha Cronbach formula, one sample T-test, Chi-square test, and Multiple Regression Analysis (path analysis). The findings indicated that: The prevalence of BPD among inmates was higher significant statistical, also there was significant relationship between gender and sex offending, in addition to individuals with BPD were significantly affected by substance use and unemployment. At the end of this research, some recommendations were drawn as well as suggestion for future studies.

1.     Introduction

Personality disorder is rather complicated phenomenon, its prevalence in the prisons is significantly higher. Over the last decade, personality disorder has become well-understood owing to the development of diagnostic criteria such as (DSM5) as well as psychometric procedures.

Existence of personality disorder is often resulted in an impaired functioning in varying personal and social settings; any symptoms of personality disorder which is considered as problematic extension of normal personality traits, is threatening to security.

On the other hand, sex offending regarding its link to personality disorder, its etiology, development, and classification, is often deemed to be a rather controversial and complicated issue. Nevertheless, researches in the field of evolutionary theories, have excluded the hypotheses that cause sexual offending because of their limitation.

To elaborate and give an insight to the nature of relationship between BPD and sex offending among inmates, consequently, this issue has received an intensive attention from the researchers recently.

In fact, BPD is the product of an interaction between genetic, neurobiological, and psychosocial influences that affect personality development over time.

There are some comorbid psychiatric disorders connected with BPD, such as substance use disorders, might be present in patients suffering from personality disorder. That is why BPD causes a therapeutic challenge for clinical practitioners.

1.2 Scope of the Problem

Owing to the fact that clinical manifestation of BPD is more complicated, and the severity of personality dysfunction vary greatly across cultures. Moreover, assessment and measuring the traits displayed by individuals with BPD, is also considered as crucial in diagnosing the and identifying the different types of sex offenses.

This current research attempts to seek an accurate answer for the following questions:

1- What is significance of the prevalence of BPD among inmates?

2- To what extent does gender correlate with sex offending?

3- How do both substances use and unemployment affect individuals with BPD?

1.3 Importance

Based on the significance of understanding the potential risk behind prevalence of (BPD), and its tendency to sex offending against the others, this study seeks to provide an insight into an outbreak of sex offenders as observed through an increasingly growing numbers of inmates. In addition to get acquainted with preventive procedures against such anti-social tendencies.

1.4  Objectives

1. To measure the prevalence of borderline personality disorder among inmates in Omdurman jail.

2. To examine the relationship between (BPD) and tendency to pedophilia.

3. To investigate the mutual effect of substance use and unemployment on BPD.

1.5 Hypotheses

1. The prevalence of BPD among inmates was significantly higher.

2. There was significant relationship between gender and sex offending.

3. Individuals with BPD were significantly affected by substance use and unemployment.

 

1.6 Limitation

This research was carried out in the year (2019-2020), and also this study is limited by specific geographical area (Sudan-Omdurman Central Jail). 

1.7 Definition of the terms often repeated

i. Borderline Personality Disorder:

Borderline personality disorder (BPD), which is also recognized as emotionally unstable personality disorder(EUPD), defined by (Stone, MH. 2015), who pointed out that BPD is mental condition characterized by prolonged unstable ties, and severe emotional reactions associated with dangerous behavior.

ii. Sex Offending:

Sexual offenses are generally defined as deviant sexual acts and assault that make the victims frightened or threatened. Sexual offending comprises several forms such as pedophilia, rape, harassment, incest, homosexuality, and pornography (Marshall, W.L. 2015).

iii. Inmates:

Those who are sentenced for jail or prisoners as convicts for sex crimes.

2.Literature Review

2.1. Borderline Personality Disorder

Borderline personality disorder(BPD) or emotionally unstable personality disorder(EUPD), is acute disturbance marked by constant pattern of fluctuating emotion, and disturbed social relationships. According to the diagnostic and statistical manual for mental disorders(DSM-5), classified (BPD) as diagnosable illness.

Many researchers view that individuals with borderline personality disorder suffer from impulsive acts, reckless behavior (without thinking or caring about the consequences of an action).

Borderline personality disorder starts during puberty and early adulthood, however, some researchers claimed that early symptoms and signs of the disorder may appear during childhood (Paris, J. 2010).            

Borderline personality disorder is considered as difficult to treat, nevertheless, recent studies have shown that (BPD) can be cured effectively, and many patients suffering from this illness improve over time. Moreover, some people with this disorder may recover without any treatment (Ruocco, A.C. 2012).

Borderline personality disorder often linked with other disturbances which makes it difficult to diagnose borderline personality disorder, particularly when these illnesses overlap with the clinical manifestations of borderline personality disorder (Pally, R. 2014).

Concerning an etiology of borderline personality disorder, research on the possible causes of (BPD) indicated that both genetic and environmental factors are involved. According to studies carried out on identical twins show that the disorder is significantly inherited. Furthermore, some psychologists revealed that an individual can inherit his/her personality traits such as impulsiveness and aggression, hence, biological psychologists are studying genes that responsible for emotions in order to find possible links to borderline personality disorder (Asherson, P. & Young, A.H. 2014).

Socio-cultural factors may also support the potential risk for (BPD), and consequently an increase of violence, rape, and other forms of sexual offences provoked by borderline personality disorder. (Alison, S. (2015).

The obvious characteristic of (BPD) is that patient presented with impairment in personality functioning as well as pathological personality traits. The most essential feature of incidence is that (BPD) has been diagnosed in about 5% of the general population, and in 75% of those who are in jails. Moreover, this pattern of disturbed personality prevails throughout the individual's life, its onset in adolescence, and causes a disturbance on almost all areas of functioning ( Herpertz, SC. 2015).

 

2.2. Sex Offenses and Offenders

In an attempt to integrate available literature concerning the factors that can contribute to the etiology of sexual offending and lead to its prevalence among inmates with borderline personality disorder. The researcher, hereby discusses biological influences, childhood experiences, psychological factors, and socio-cultural factors, all of these factors must be taken into account when interpreting the occurrence of sex offending (Ward.T & Siegret, R. 2012).

Biological theories focus on abnormalities in the structure of the brain, glandular system, and genetic makeup. Studies that linked hormonal defects with sexual offending have emphasized the role of specific hormones such as testosterone, and also consideration has been paid to the possibility of a genetic defect in sex offenders that makes them more likely to engage in sex crimes (Andrews, D.A.,2010).

Personality theories are the earliest attempts to explain sexual offending and its prevalence in inmates. Classical psychodynamic approach, tried to correlate abnormal sexual behavior with early childhood attachment experiences (Jenkins, P. 2011).

Personality types theory, has also endeavored to elaborate on the origin of sexually disturbed behavior. Researchers in this area, have postulated that sex offenses may exist within the personalities of sex offenders (Schwartz, B.K. 2014).

Cognitive theories have also participated in the understanding of sex offending and offenders. According to the investigators, there is an evidence demonstrating that sex offenders have cognitive distortion and irrational thoughts responsible for sex offending in individuals with BPD (Wood, R.M. 2011).

Behavioral theories explain sex offending as acquired learning condition or process. Behavioral theorists have hypothesized that sexual stimuli often play a major role in the incidence of sex crimes, and offenders in such situations are believed to be more vulnerable to commit sexually violent behavior, therefore, the continuity and extinction of sex offenses depends extremely on reinforcement and punishment (Hood,R. & Wilcox, A. 2012).

Social learning theory, suggested that seeking for the possible explanation, regarding sex offending in its all patterns; that children who were sexually abused, will grow into sexually deviant adults, and that sexually explicit act facilitates to sex offending ( Prentky, R.A. 2010).

Using social learning theory, investigators have examined the mechanism through which this learning takes place, and the main variables that help to determine whether sexual offending patterns will be adopted later. Moreover, identifying the link between being sexually abused and later exhibiting sexually disturbed behaviors such as age of victim, type of sex crime, and duration.

As a matter of fact, understanding sexual offenses and offenders, has been a rather complicated issue, owing to confusion in the definition of sexual perversion in general and thus sex offending in particular (Batds G., 2011).

The most common feature and criterion for sex offending concerns the unusual nature of the source of arousal e.g. (pedophilia, exhibitionism, rape, and sexual harassment). Furthermore, previous research has shown that sexual offenders generally report more deviant sexual behaviors than non-offenders (Watts & Litienfield, 2017).

With regard to previous studies on borderline personality disorder(BPD) and its tendency to sex offending, there are several case reports in the literature indicating that patients or individuals with (BPD) tended to be sex offenders.

Hurlbert, DF &White, LC (2013), conducted an empirical study to investigate sexual indulgence among (32) women with (BPD), and they found that there was an inclination towards sexual acts. Lavan, H. & Johnson, JG. (2010) examined relationship between personality disorder and high-risk sexual behavior among (403) participants, they revealed that borderline personality disorder associated with high-risk sexual behavior.

Neelman ( 2011) concluded that patients with BPD show high sexual impulsivity as well as vulnerability to homosexual experiences.

Sansone, RA. (2008) studied the relationship between BPD and various sexual behaviors among (76) women outpatients, and found a statistically significant correlation between individuals with BPD and likelihood of rape.

 

3. Methodology & Procedures

3.1. Methodology

In this study, a survey research method is adopted which seeks to collect data from a pre-defined group of individuals (here refer to inmates) to achieve research objectives.

Such methodology can be used to study a wide variety of applied researches in the different domains of psychology (Weathington, B.I. (2010).

 

3.2. Participants

This study comprised a survey sample of (230) participants: (120) males and (110) females, who were condemned for sex crimes in Omdurman(Sudan) central jail and were sentenced accordingly.

 

3.3. Instruments

     In this study, a twelve items questionnaire was administered to measure BPD traits in inmates(attached as appendix). The questionnaire was reviewed by some psychometricians and psychologists, and regarding the psychometric properties, there was procedure taken as follows concerning internal consistency:

Table 1

Сorrelation coefficients for each items on BPD questionnaire

 

 

Reliability & Validity

Reliability was calculated by Cronbach's Alpha (0.85), and thus validity = (0.92)

 

4. Results

 

 

Hypothesis (1)

 

Table 2

Result of One-sample T-test to verify statistical significance of BPD prevalence in inmates

 

 

The table indicated that a significant prevalence of BPD (.000) was found in inmates.

 

Hypothesis (2)

 

Table 3

Result of Chi-square test to identify the significant of relationship between gender and sex offending

 

The table pointed out that a significant relationship (0.05) between gender and sex offending.

Hypothesis (3)

Table 4

Result of Multiple Regression Analysis to test the significance of mutual efficacy of sex offending, substance use, and unemployment

 

Variables Entered/Removed^b

 

 

a. all the requested variables entered.

b. Dependent Variable: BPD.

 

Model Summary

 

 

 

 

a. predictors(constant), sex offending, substance use, unemployment.

 

Coefficients

 

b. Dependent Variable: BPD.

(ANOVA)

 

 

a. predictors(constant), sex offending, substance use, unemployment.

b. Dependent Variable: BPD.

 

All the above-mentioned tables connected with multiple regression analysis (path analysis), showing that a significant efficacy of other variables such as substance use and unemployment on the occurrence of sex offending.

5. Discussions & Conclusion

Based on the result obtained by the first hypothesis, which maintained the prevalence of (BPD) was significantly higher among inmates. As a matter of fact, consequently, patients suffering from this disease, are in the border of neurosis and psychosis. Moreover, BPD is a prevalent disorder, estimated to occur in 1- 2% of the population, and patients with borderline personality disorder are reported to have higher levels of anger and recurrent impulsive and aggressive behaviors. Also, chronic feelings of emptiness which may lead individuals with BPD to drugs abuse and thus sex offending.

Regarding the result of the second hypothesis, found that there were some sex offenses committed by inmates with BPD. Some previous research findings pointed out that BPD symptoms existed among sex offenders (Craissati,J. & Blundell, R.( 2013). And also, Chen, Y. & Hung,D. (2016), found that, in a sample comprised (68) sex offenders, 59% were diagnosed with personality disorder. Moreover, Kingston, D.& Bradford, J. (2015), found that 74% of sex offending linked with borderline personality disorder being the most common.       

Concerning the discussion of the result of the third hypothesis, which highlighted that individuals with BPD were significantly affected by substance use and unemployment. That also maintained that individuals with BPD, showed greater sexual offenses as indicated by higher levels of impulsivity, recklessness and aggression. In addition, these patients showed greater victimization as indicated by high-risk sexual behavior such as rape, being forced to have sex, and prostitution. The most common characteristic of borderline personality disorder encountered in abnormal patterns of behaving such as alcohol and substance dependence, eating disorders, and difficulty regulating money.

Nevertheless, unemployment and difficulty in maintaining work is highly marked by individuals with BPD, as they often characterized by impulsivity and pervasive pattern of instability in interpersonal relations, as well as incompetence. As a matter of fact, such occupational disability among patients with BPD, perhaps due to high levels of stress they often experience and malfunctioning (Hengartner, MP, 2014).

On the other hand, many individuals with BPD who are substance depended, use substance as a mean or a way to cope with trauma they passed throughout their early childhood (Pennay, A. 2011).     

6. Recommendations

1.  Family counselling is needed for promoting community mental health.

2.  To implement sex counselling sessions for victims of sex offending.

3.  Clinicians should carefully diagnose comorbid psychiatric disorders in patients with BPD.

 

7. Suggestions

1.               To study the relationship between personality disorders and pedophilia.

2.               To investigate psychopathy and its prevalence in specific types of sex crimes.

3.               To examine comorbidity of mood disorder in patients with BPD.

 

 

Appendix (1): BPD Questionnaire

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