What are the features of psychopathology for men who commit stalking offences? A systematic review

Background A systematic review of the bespoke psychopathology features of men who stalk was necessary for informing clinical practice. The absence of such served to perpetuate conjectured links between psychopathology and stalking. Aim To systematically review and narratively synthesise published empirical work exploring the psychopathology of men who stalk. Method The PICO (Population, Intervention, Comparator and Outcome) model was utilised to determine the scope of the review. Key inclusion criteria were studies with men who had committed stalking offences, drawn from forensic or clinical settings, employing a non-stalking comparator group that explored psychopathology features. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) process guided this systematic review, followed by a narrative synthesis of study findings. Results The systematic review resulted in seven studies, all containing mixed gender samples (typically comprising 90% male) of individuals who had stalked. There were no published men-only comparative studies investigating psychopathology amongst those who stalk. The narrative synthesis highlighted prominent features amongst those who stalk, which were having an insecure (preoccupied) attachment style, and a Personality Disorder - Not Otherwise Specified. Previous assumptions about stalkers having higher intelligence levels than other offenders, and higher prevalence of mental disorders, were challenged. Tentative conclusions were made regarding other psychopathology features. Conclusions The links between psychopathology and stalking remain empirically inconclusive. There were few confidently distinct and common psychopathology features amongst stalker samples, unsurprising given study and stalker sample heterogeneity. This systematic review recommended that with the heterogeneity of stalkers as a client group, a case formulation approach to understanding their behaviours is crucial in clinical practice. This is to avoid reliance on limited empirical findings and conjecture surrounding the psychopathology of stalkers as a group. Typology specific, evidence-based literature should underpin clinical and forensic decision-making. Further reviews may benefit from synthesising empirical evidence based on separate typologies, and differentiate between the psychopathology features of males and females who stalk