Boundary violations and personality traits among psychiatrists.

Objective: To demonstrate that sexual abuse of patients by psychiatrists can be due to a variety of contributors, which may include therapists' psychopathic and narcissistic personality styles.
Method: Data from a prospective cohort of residents training in psychiatry were examined to evaluate the personality traits of 2 psychiatrists subsequently convicted of boundary violations.
Results: The 2 psychiatrists who lost their licenses were identifiable at the beginning of their residency training as individuals with significant character pathology.
Conclusions: For some psychiatrists, repetitive sexual abuse of patients represents one aspect of an ongoing pattern of exploitative relationships. The professional and ethical implications of these findings as they relate to early identification for those at risk are considered.