The victim-offender dichotomy in psychiatry
background In the minds of those involved in psychiatric care there is a striking dichotomy, often with a moral overtone, between victims and offenders. Victims are frequently deemed to be innocent and beyond reproach whereas offenders are seen as contemptible and despicable. However, there is a complex relationship between victimisation, delinquency and psychopathology.
aim To review the literature in order to find links between victimisation and delinquent behaviour and between victimisation and psychopathology; thereafter to find out whether there might be ways in which these two lines of research can be merged.
method The Medline database was scanned to reveal the literature published from 1966 up to present day and the Psycinfo database was searched for the literature published from 1980 up to the present day. The search was based on the following key words: victim, victimisation, offender, perpetrator, delinquency, mental disorder, psychopathology.
results Experiences of victimisation in childhood seem to be a sizable risk factor for both psychopathology and delinquency. However, an even greater risk factor is the general dysfunctional and deprived background that is associated with victimisation in childhood. No linear link in no particular direction was found.
conclusion The assumption that there is a victim-offender dichotomy is incorrect. There is a clear relationship between victimisation and delinquency/psychopathology. Further prospective research is needed in order to expose the underlying mechanisms. This should lead to the development of more effective methods for prevention and treatment.