• cocaine, inhalants, and sedatives, hypnotics, or anxiolytics

  • Nicotine withdrawal

  • Late luteal phase dysphoric disorder (women) occurring a few days before or after onset of menstruation

  • Mental retardation

  • Conduct disorder (children) and antisocial personality disorder (adults)

  • Posttraumatic stress syndrome.

Other categories available for classifying violent behavior include sexual sadism. Reportedly, fewer than 10 percent of rapists are classified in this category, which is categorized by fantasies, frequently beginning in childhood, and possibly including a history of sadistic acts increasing in severity over time. Mood disorders are a residual category for classifying violent behavior not due to any other physical or mental disorder. Injurious behavior to the self or others may also be present in categories that are defined by other symptoms of elevated activity.

Categories in the DSM-III-R were revised from early instruments (the first instrument was published almost 40 years ago) on the basis of clinical experience with early instruments; research conducted to test the validity and reliability of classification; and advancement of knowledge in psychology, medicine, and social psychology.

American Psychiatric Association members instrumental in constructing the current version of the instrument strongly caution that use of the classification scheme is appropriate only if it is a first step in diagnosis, carried out by a trained clinician who is sensitive to cultural differences, and used in clinical or research settings. In particular, they caution against use of this instrument for legal decisions, especially in light of the acknowledged noncomprehensiveness of the classification categories.

Correctional Classification

The primary purposes of correctional classification are to determine the level of security necessary for an inmate and the level of his or her needs for particular services or programs within the institution. Level of security required is usually based on both public risk and institutional risk. Public risk is commonly assessed on the basis of information about the conviction crime, prior convictions for violent crimes, and history of institutional escapes. Institutional risk is assessed from information about prior institutional and custodial behaviors, psychological and mental



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