Research has shown that psychiatric patients with criminal histories report attitudes reminiscent of the prison culture that predict therapeutic alliance. This study examined the impact of these "correctional adaptations" on the behavior of a sample of 75 discharged civil psychiatric patients whose medical charts were reviewed for incidents of institutional misconduct including cigarette dealing, drug use, and weapons possession. Patients had been previously administered the Psychopathy Checklist-Screening Version (PCL-SV), Brief Psychiatric Rating Scale (BPRS), and Structured Assessment of Correctional Adaptation (SACA). Of the sample, 53 percent (n = 40) committed at least one act of misconduct, with an average of M = 2.8 (range = 0-18, SD = 4.27) incidents. Bivariate analyses revealed a significant relationship between incidents and the total SACA score, r s(74) = .33, p = .004. Ordinal regression analyses showed the SACA to be significantly predictive of misconduct, regardless of arrest history. Abstract published by arrangement with Sage Journals.