Emotional, cognitive and behavioral self-regulation in forensic psychiatric patients: changes over time and associations with childhood trauma, identity and personality pathology

The construct of self-regulation is of particular interest to the forensic psychiatric practice due to its associations with both clinical and criminal outcomes, as well as recidivism. However, research on different components of self-regulation within forensic psychiatric practice is rare. The current study aimed to gain knowledge on the construct of self-regulation in a sample of forensic psychiatric patients (N = 94). Firstly, by investigating change of emotional, behavioral and cognitive self-regulation over the course of 12 months in state-mandated care in a treatment facility. Secondly, by looking at the associations between these three elements of self-regulation and childhood trauma, identity dysfunction and personality pathology. Repeated measures ANOVA showed little to no difference in average self-regulation over time (only for behavioral regulation), and rank-order stability was relatively high in most cases. Path analysis showed that: emotion regulation was associated with all outcomes; behavioral regulation with all except childhood trauma and detachment; and cognitive regulation only with antagonism and negative affectivity. Findings suggest short-term changes are unlikely and indicate relative importance of emotional, and to some extent behavioral regulation for clinical practice. However, due to sample size restrictions, interpretations should be made with caution.