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Full summary etiology of offender types
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– Etiology of Offender Types Summary -1: Psychosis & psychopathy
Main lecture takeaways / learning goals
(1) What are disorders mostly associated with insanity (so decreased accountability)?
(2) What is the difference between ES, LS and FO? What characterises them?
(3) What is the relationship between paranoid/persecutory delusions <-> violence?
(4) What is psychopathy? How does it differ from ASPD?
(5) What is assessed with the PCL-R? What is F1 and F2?
→ Case Bart
- Bart van U. killed sister and a woman, received TBS but not prison for killing her (due to mental
disorder, was delusional when stabbing sister)
- Joran, who was involved in killing of Nathalee Holloway exhibits psychopathic traits
- Art. 39 states one is not punishable if they commit a crime which can't be accounted to them due
to a defective development/mental disorder
→Levels of accountability Netherlands: range from fully accountable to fully unaccountable
Fully accountable No mental disorder or not present during offence A shoplifter with no history
Slightly Mild mental disorder or slightly of influence during Mild anxious person gets into a fight during panic attack
diminished
accountability
Diminished Severe mental disorder at influence during offensive BPD person becomes violent
accountability
Greatly Combination of severe disorders or the severe disorder Person with schizophrenia and DID commits a crime largely
diminished had great influence due to disorders
accountability
Not accountable Offence fully the result of mental disorder that the Person with untreated schizophrenia believes they're
person had at time of offence following alien orders when committing arson.
→TBS
- 2 possible sanctions in dutch law
- Punishment for those commit crime
- Custodial measure for those committing crimes but are found diminished
accountable/fully unaccountable.
- TBS
- TBS with compulsory psychiatric treatment
- TBS with conditions if compulsory psychiatric treatment doesn’t seem necessary to
present recidivism
→Subtyping offenders with a psychotic disorder (Hodgins,
1995/2008)
- Early starters (ES)→ criminal behaviour before start of
psychotic disorder (probably due to early conduct
problems/SA, antisocial traits)
- Late starters (LS)→ criminal behaviour after psychotic
disorder (prob because of positive symptoms of the disorder
delusions/hallucinations)
, - First offenders (FO) → in their 30s or older when they suddenly commit a very serious
offence (in this case, WITH psychosis!)
→ First offenders have highest family member as victims (often mother), and also higher murder
manslaughter
→ First offenders can be distinguished as a subgroup within late starter group
→ Implications for practice
(1) Tailored treatment interventions → personalised and custom approaches to addressing an
individual's specific needs and circumstances
(a) Early diagnosis/intervention
(b) Different types of treatment
(2) Differential diagnostics & analysis of behaviour
(a) Profiling and crime analysis
→ Psychopathy: PCLR (Hare, 1991)
F1 → Interpersonal/affective
- Interpersonal → superficial charm,
grandiose self worth, lying, manipulative
- Affective → lack of remorse, shallow affect,
lack of empathy, failure to accept
responsibility
F2 → Lifestyle/antisocial
- Lifestyle → prone to boredom, parasitic
lifestyle, lack of realistic long term goals,
impulsive, irresponsible
- Antisocial → Poor behavioural controls,
early behavioural problems, juvenile
delinquency, revocation of condition,
criminal versatility
→ Scholars differ about definition of psychopathy: some factor 2 only, others include factor 2
→ Prevalence differs per sex (Males often diagnosed antisocial, females BPD). Why? →females display
more manipulative tendencies, whereas men are more overly aggressive and hence can more easily be
diagnosed (not necessarily true prevalence rates, can also be bias in diagnosis) →
→ Gender differences: Women with psychopathy compared to men with psychopathy committed more
fraud, offended more often out of relational frustration, were more often diagnosed with BPD, and
showed less physical violence, but more manipulative and self-destructive behavior during treatment.
→ Sociopathy is viewed as a secondary version of psychopathy (eg: Hannibal lecter = developed it as a
result of sister trauma), also more often have F2, compared to F1 problems.
1
,Vinkers (2011) - The relationship between mental disorders and different types of crime
Aim: to examine the relationship between type of mental disorders and crime in pre-trial defendants.
Key focus was on the degree of accountability, which was assessed based on the connection between a
defendant's mental disorder and the committed crime
Accountability in NL → assessed based on the relationship between a mental disorder and the
committed crime.
There are five recognized degrees of responsibility (Van Marle, 2000):
(1) Complete responsibility → implies the defendant committed the crime while mentally sound,
either due to the absence of a mental disorder or because the disorder is unrelated to the crime
(2) Slightly diminished responsibility
(3) Diminished responsibility
(4) Severely diminished responsibility
(5) Total absence of responsibility → Presence of a severe mental disorder, typically of a psychotic
nature
→ Factors can be distinguished on basis of extent of mental impairment and the degree to which the
mental disorder is linked to the committed crime
Deviance hypothesis → states that severe crimes are more often related to mental disorders
Method
- 21,857 reports for 19,414 defendants were identified for 7 years, 2000–2006.
- Compared disorders:
- Axis 1 disorders
- Personally disorders
- Intellectual functioning
- SA
- In defendants charged with following crimes:
- Homicide, attempted/threatened homicide, assault, battery, rape, sexual crimes, arson,
property crimes
- Relationship between mental disorder and crime examined through accountability →
prevalence of indicted crime per grade of accountability was compared using chi-square tests
Results
- Prevalence mental disorders related to crime
- Highest total prevalence in property crime cases (58.0%)
- Lowest total prevalence in homicide cases (40.0%; p <0.001)
- Prevalence Psychotic → battery/homicide
- Prevalence Personality → battery/property
- Prevalence Developmental → sex crimes
- Prevalence IQ < 85 → rape
- Prevalence Alcohol use → Arson
- Crime & accountability
- Most diminished (unaccountable) → arson, battery, homicide
- Least diminished (accountable)→ sexual/property
→ interesting, as prevalence is highest in property, and lowest in homicide…
- Relationships mental disorders and crime (through accountability)
- Total mental disorder <-> all, especially arson, battery, homicidal attempt/threat
- Psychotic <-> all, except rape
- Personality <-> homicide, sexual
- Developmental <-> homicide
- IQ < 85 <-> sexual
- Cannabis <-> arson
Conclusion
2
, → Support deviance hypothesis: Defendants of homicide have a low prevalence of mental disorders,
but they are relatively often considered as diminished accountable. This is in line with the deviance
hypothesis, which states that severe crimes are more often related to mental disorders (Silver et al.,
2008). Basically there's a stigma of people that commit these crimes. → Although the percentage of
individuals with diagnosed mental disorders among homicide defendants is low, they are still more often
considered as having diminished accountability due to the assumption that their actions may be related
to underlying mental health issues.
→ Important to recognize that the relationship between mental health and criminal behavior can be
complex and influenced by various factors beyond the presence of a mental disorder. --> other factors,
known as confounding factors, may play a role. For example, it mentions that shoplifting by a person with
schizophrenia might be related to factors like poverty rather than their psychotic symptoms
Lau (2019) - Latent class analysis identified phenotypes in individuals with schizophrenia
spectrum disorder who engage in aggressive behaviour towards others
Aim: Identify number of subgroups of typology of offenders with schizophrenia spectrum disorders
(SSD), using LCA
Schizophrenia spectrum disorders (SSD) → have elevated risk of being convicted of (non)/violent
criminal offences/homicide. Nonetheless there is variation!
Hodgins Theoretical Framework
(1) Early starters (ES) → those who commit an offence before age 18 or are diagnosed with
conduct disorder before age 15 or offend before SMI.
(2) Late starters (LS) → those who commit an offence after age 18, are not diagnosed with conduct
disorder before age 15, or offend after SMI
(3) Late late starters/first offenders (FO) → small group of predominantly male offenders in their
late 30s with chronic schizophrenia, but without any prior history of aggressive or antisocial
behaviour, who typically engage in homicide of those familiar to them
→ Studies have been inconsistent in identifying typology
Study's objectives
(1) Resolve inconsistencies in the number of subgroups among offenders with Schizophrenia
Spectrum Disorders (SSD) - 2 or 3?
(2) Use new methods to analyse and categorise these subgroups (LCA)
(3) Explore different variables that may influence these subgroups - different variables?
Method
- N=370 offenders with schizophrenia disorders
- Case files of patients admitted to the Centre for Inpatient Forensic Therapies at Zurich
University Hospital of Psychiatry from 1982-2016, containing information from: anamneses,
psychiatric reports, police records, court proceedings, social worker reports, and nursing and
care staff reports
- LCA, a model for analysing categorical data, was conducted to categorise items into the overall
best fit representing the entire data set of 71 items and 370 observations
- Variables that contribute to the separation of classes are considered more effective in
distinguishing between subgroups.
- Different numbers of classes (1 to 4) were evaluated to determine the best-fit model
- Class Analysis 1/4 → 4, each item was assigned the same prior probability of belonging
to a set class, given that no particular expectation regarding classification was available
from the literature
- Class Analysis 2 → used a covariate, the "crime-schizophrenia-sequence variable," to
classify patients into two latent classes (ES and LS)
- Class Analysis 3 → similar to Class Analysis 2, used the "crime-schizophrenia-sequence
variable" to classify patients into 3 latent classes (ES, LS, and FO)
- ES → had entries in criminal registry prior to 1st symptoms SSD
- LS → symptoms of a SSD prior to an entry in the criminal registry that had to be recorded for a
3
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