OBJECTIVE Borderline and antisocial personality disorders are characterized by pervasive psychosocial impairment, disproportionate criminal justice involvement, and high mental health care utilization. Although some evidence suggests that systemic bias may contribute to demographic inequities in criminal justice and mental health care among persons experiencing these mental health conditions, no research to date has explicitly examined such differences. HYPOTHESES Women and White persons would be more likely to endorse internalizing symptoms and have a more extensive history of mental health service utilization, whereas men, persons from minoritized racial groups, and persons identifying as Hispanic/Latino would be more likely to endorse externalizing symptoms and have more extensive histories of involvement with the criminal justice system. METHOD This study examined gender, racial, and ethnic differences in symptom presentation, criminal justice history, and mental health care utilization in a sample of 314 adults with comorbid borderline and antisocial personality disorders enrolled in prison-based substance use treatment programs in the United States. RESULTS Results suggested that men with these personality disorders were more likely to have early extensive criminal justice involvement, whereas women and White people had more extensive mental health treatment histories. Women were also more likely to endorse a range of internalizing symptoms, and White and non-Hispanic participants were more likely to endorse a history of reckless behavior. Notably, however, many associations-particularly, racial differences in symptom presentation and mental health utilization history and gender differences in symptom presentation-did not persist after we controlled for preincarceration employment and educational attainment. CONCLUSION Results highlight a range of gender, racial, and ethnic inequities in criminal justice involvement and mental health utilization among this high-risk high-need population. Findings attest to the likely impact of societal, structural, and systemic factors on trajectories of persons affected by this comorbidity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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监狱还是治疗？患有边缘性和反社会人格障碍的被监禁者在精神卫生保健利用和刑事司法历史方面的性别、种族和族裔不平等。


目的 边缘性人格障碍和反社会人格障碍的特点是普遍的社会心理障碍、不成比例的刑事司法参与以及较高的精神卫生保健利用率。尽管一些证据表明，系统性偏见可能会导致经历这些心理健康状况的人在刑事司法和心理保健方面的人口不平等，但迄今为止还没有研究明确检验这种差异。假设 女性和白人更有可能认可内化症状，并且拥有更广泛的心理健康服务利用历史，而男性、少数种族群体以及西班牙裔/拉丁裔人士则更有可能认可外化症状，并且拥有更广泛的心理健康服务利用历史。具有更广泛参与刑事司法系统的历史。方法 本研究以 314 名美国监狱药物使用治疗计划中患有共病边缘性和反社会人格障碍的成年人为样本，考察了症状表现、刑事司法史和心理保健利用方面的性别、种族和民族差异。 。结果 结果表明，患有这些人格障碍的男性更有可能在早期广泛参与刑事司法，而女性和白人则有更广泛的心理健康治疗史。女性也更有可能认可一系列内化症状，白人和非西班牙裔参与者更有可能认可鲁莽行为的历史。 然而值得注意的是，在我们控制了监禁前就业和教育程度后，许多关联——特别是症状表现和心理健康利用史的种族差异以及症状表现的性别差异——并没有持续存在。结论 结果凸显了这一高风险高需求人群在刑事司法参与和心理健康利用方面存在的一系列性别、种族和民族不平等。研究结果证明了社会、结构和系统因素可能对受这种合并症影响的人的轨迹产生影响。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。