Recent life events and subjective well-being of personality disordered forensic outpatients

Purpose: The majority of patients treated at forensic psychiatric outpatient facilities suffer from personality disorders, especially Cluster B disorders. Life events have been shown to influence subjective well-being, severity of psychopathology and delinquent behaviour of patients with different personality disorders. However, the influence of life events on subjective well-being of patients suffering from Cluster B personality disorders has rarely been studied. Following General Strain Theory and the dynamic equilibrium model, we hypothesised that negative life events would negatively influence subjective well-being, and that subjective well-being would change when an instability of life events occurs. Methods: Fifty-six adult male forensic psychiatric outpatients were interviewed on their subjective wellbeing and filled out a self-report life event questionnaire, at three time-points, with an interval of three months. Life events were categorized along two dimensions: positive / negative and controllable uncontrollable. Results: Patients had a stable pattern of positive, negative controllable and uncontrollable life events. Positive controllable events did not have a stable pattern. Results indicated that only negative controllable events correlated negatively with subjective well-being. Furthermore, positive and positive controllable events correlated with a positive change in subjective well-being and uncontrollable events correlated negatively with this change. Conclusions: Forensic psychiatric outpatients seem to experience a relatively stable 'load' of stressful life events, that does not influence change in subjective well-being. We did not find unequivocal support for General Strain Theory. In line with the dynamic equilibrium model, forensic outpatients seemed less used to positive controllable life events, which influenced positive change in subjective well-being. In outpatient forensic treatment, attempts to limit negative life events together with enhancing behaviour which results in positive events should be targeted. This might result in better lives for patients and in reduced criminal behaviour.