Iatrogenic interventions with personality disordered offenders

Typically, personality disordered offenders have long histories of unsuccessful and iatrogenic interventions. Understanding what has gone wrong and the nature of the harm caused by these interventions is critical to developing effective interventions for this population and to the task of theory building. In this paper a range of iatrogenic intervention processes are identified from the literature and a model accounting for adverse outcomes in terms of derailment of dissonance resolution reinforced by avoiding negative affect associated with dissonance is outlined. Strategies for practitioners and researchers to use information about adverse outcomes are suggested.