Criminal Recidivism After Forensic Psychiatric Treatment. A Multicenter Study on the Role of Pretreatment,Treatment-Related,and Follow-Up Variables

This study examined associations between criminal recidivism after discharge from forensic treatment and variables related to either the time before the current forensic treatment, or the current forensic treatment, or the follow-up after discharge. Participants were treated in 12 forensic clinics according to section 63 of the German penal code. A patient was classified as a criminal recidivist when the patient or the aftercare reported that the patient was delinquent at follow-up. Patients without criminal recidivism were patients for which both perspectives (patient and aftercare) reported no delinquency at follow-up. Mann–Whitney U-tests and Fisher's exact tests were performed. Data to classify patients were available for N = 249 patients. Fifteen patients (6%) were classified as criminal recidivists. The follow-up was M = 12.58 (SD = 1.84) months, and the criminal acts occurred M = 6.00 (SD = 5.55) months after discharge. Differences between patients with and without criminal recidivism were found in pretreatment (young age at first crime, early onset of mental disorder, previous forensic treatments), treatment-related (disorder due to psychoactive substance use, gradual release abuses, outbreaks, assaults against staff, criminal act during treatment, type of discharge, outcome ratings), as well as follow-up variables (no specified housing situation, not being abstinent from psychoactive substances, inpatient readmission, course of outpatient treatment, course of mental disorder) (all p < 0.05). To conclude, it is important to consider variables related to the time before the current treatment, treatment-related variables, and variables related to the follow-up to identify the patients at risk of criminal recidivism after discharge from forensic treatment.     

Ancestry and BMI Influences on Facial Soft Tissue Depths for A Cohort of Chinese and Caucasoid Women in Dunedin,New Zealand

This study measured and assessed facial soft tissue depths (FSTDs) in adult female Chinese and New Zealand (NZ) Europeans (Caucasoids). Ultrasound was used to obtain depths at nine landmarks on 108 healthy subjects (51 Chinese, 57 NZ European), erect positioned, of same age group (18–29 years). Height and weight were also recorded. Statistical analysis focused on comparison of tissue depth between the two ancestry groups and the influence of Body Mass Index (BMI) (kg/m²). Results showed mean depth differences at Supra M2 and Infra M2 landmarks significantly greater for Chinese than Caucasoid women for all three BMI Classes (BMI <20, 20 ≤ BMI < 25, 25 ≤ BMI < 30), even BMI <20. For both groups BMI positively correlated with FSTD values at all landmarks except Labrale superius. This study enabled ancestry and BMI influence on FSTDs to be observed and compared for two distinct groups. Results add to knowledge about facial tissue depth variation.     

Incidence of Low Body Mass Index in the Elderly in Forensic Cases—A Possible Marker for Frailty Syndrome?

Diagnosing frailty syndrome at autopsy may be difficult if no adequate clinical history is provided. As low body mass index (BMI) may be associated with frailty in the elderly, the following study was undertaken to determine the percentage of medicolegal cases with BMIs < 18.5 in decedents aged over 75 years. Review was undertaken over three time periods: January to December 1986, January to December 2006, and January to December 2012. In 1986, 16% (15 of 93) of individuals aged ≥75 years had BMIs < 18.5, in 2006, 15% (50 of 336), and in 2012, 13% (35 of 274). In no case was frailty syndrome mentioned. This study demonstrates that frailty syndrome appears to be an underappreciated diagnosis in forensic practice despite a significant percentage of elderly decedents (13–16% over a 27‐year period) having low BMIs. Prospective assessment of this group is required to determine the incidence and contribution to mortality of frailty syndrome in a forensic context.     

光谱成像检验同种同色涂抹掩盖字迹研究

目的建立一种无损、灵敏、直观的同种同色涂抹掩盖字迹的显现方法。方法依据涂抹掩盖字迹油墨物质的同色异谱特征,利用可见光滤波型多光谱成像检验系统进行检验。结果黑色圆珠笔、蓝色圆珠笔、黑色签字笔和蓝色签字笔相互涂抹掩盖形成的同种同色涂抹掩盖样本,利用可见光滤波型多光谱成像检验系统进行检验,显效率分别为90.5%、69.1%、49.5%、78.6%,显现效果良好。结论多光谱成像技术可以显现同种同色涂抹掩盖字迹,且具有良好的显现效果。     

Hands Tied with Bag Full of Books in Suicidal Hanging

Hanging deaths associated with binding of limbs, masking of a face, and gagging are always suspicious. In suicidal hanging, the victim uses these added techniques to prevent him from backing out of his decision and to ensure death. However, binding of limbs and adding extra weight to the suspension in hanging are not reported. Herein, we report a case where the victim tied a bag containing books weighing 7 kg (15.4 lbs) to both his hands during hanging. The forensic specialist must be aware of the unusual presentation of suicidal hanging which may suggest foul play. The manner of death must be established after detailed analysis of circumstantial evidence, information obtained from the witnesses, complete autopsy, and toxicological examination.     

Homicide by a Forensic Female Sample in Brazil: A Preliminary Study

The objective of the study was to evaluate the mental status of all women (n = 14) who were acquitted by reason of insanity of charges of murder or attempted murder and committed to a forensic psychiatric hospital in the state of Rio de Janeiro, Brazil. All cases were retrospectively examined, including medical files, technical records, and forensic experts' official reports. A conclusive psychiatric diagnosis was established using the Structured Clinical Interview for DSM‐IV Axis I and II Disorders and clinical and forensic records. The most common diagnosis was schizophrenia/schizoaffective disorders (n = 8; 57.3%). Most victims (n = 12; 75%) were close relatives of the patients. We found that 43% (n = 6) of the patients had a previous history of violent behavior. According to the initial psychiatric forensic evaluation, 5 patients (35.7%) had psychotic symptoms. It is expected that a growing understanding of motivational factors underlying homicidal behavior in mentally disturbed female offenders may further the implementation of effective preventive and therapeutic interventions.     

Extra information about treatment is too much for the patient with psychosis

BackgroundCase law across jurisdictions requires ever more complete disclosure of material facts when obtaining consent to treatment.AimsTo determine whether giving extra information impairs the mental capacity to make decisions about treatment.MethodThe MacCAT-T, MacCAT-FP, PANSS and GAF were administered to 88 detained forensic patients with psychosis. Two positive and two negative facts were given about each of two anti-psychotic drugs, and no treatment (twelve items). A choice was elicited. The criterion for incompetence was inability to express a choice. Two extra positive and two extra negative facts about each of the three options were given (twelve extra items) and a choice was again elicited, while repeating the MacCAT-T.ResultsGiving extra information led to a decline in the total score on the MacCAT-T. Twenty one were initially unable to make a choice (24%). After additional information, 33 were incapable (37.5%, Chi-squared p < 0.001). Those initially incapable had the lowest scores on all measures of functional capacity and GAF, with highest scores for symptoms. Those able to choose a treatment option had the highest levels of function and least symptoms. Those who became incapable had intermediate scores.ConclusionsGiving extra information made an extra 15% unable to choose. Clinical judgement must be exercised concerning the amount of information disclosed. Deciding what is material to the individual is arbitrary when so few items of information can be processed. Greater use of guardianship and independent second opinions is recommended.     

Fatal Diabetic Ketoacidosis and Antipsychotic Medication

Hyperglycemia and new onset diabetes have been described with certain antipsychotic medications and some of the initial presentations are fatal diabetic ketoacidosis (DKA). We report 17 deaths due to DKA in psychiatric patients treated with second generation antipsychotic medications. Death certificates and toxicology data were searched for DKA and hyperglycemia. We reviewed the medical examiner records which included the autopsy, toxicology, police, and medical examiner investigators' reports. The decedents ranged in age from 32 to 57 years (average 48 years). There were 15 men and two women. The immediate cause of death was DKA in all. The psychiatric disorders included: 10 schizophrenia, three bipolar/schizophrenia, two bipolar, and two major depression. The most frequent atypical antipsychotic medications found were quetiapine and olanzapine followed by risperidone. In 16 deaths, we considered the medication as primary or contributory to the cause of death.     

浅谈左手书写者左右手笔迹的特点及变化规律

目的为左手书写者左手笔迹及右手笔迹的检验鉴定提供参考依据。方法收集左手书写者的左手正常笔迹和其右手笔迹,进行比对检验和实验数据统计分析。探讨左手书写者左手笔迹和右手笔迹的特点及变化规律。将左手书写者的左、右手笔迹的特点和变化规律与右手书写者的右、左手笔迹的特点和变化规律进行比较。结果左手书写者的左手笔迹和右手笔迹在笔顺、写法、错别字等特征上保持稳定。结论左手书写者的笔迹检验应结合其左手笔迹和右手笔迹的特点和变化规律,并注意其与右手书写者的右手笔迹和左手笔迹的特点和变化规律的区别与联系。     

Effects of Motivational Enhancement on Immediate Outcomes of Batterer Intervention

This article presents results of a quasi-experimental trial of a 6 week motivation enhancing intervention for batterers highly resistant to intervention. One hundred and forty one (29%) highly resistant batterers were identified from a consecutive sample of 486 men referred to a large batterer intervention program. Resistant batterers attended either standard intervention (16 weeks) or a specialized 6 week motivation enhancing group followed by 10 weeks of standard intervention. Observation of counselor behaviors confirmed significant differences in rates of confrontation across groups. Analyses of immediate program outcomes provide some support for the value of motivation enhancing intervention. Resistant batterers who attended specialized intervention completed intervention at a significantly higher rate (84.2%) than both resistant clients in standard intervention (46.5%) and non-resistant clients (61.1%). Differences were maintained even after controlling for demographic and lifestyle related predictors of attrition. Advantages of specialized intervention did not extend to counselor-rated success at meeting core treatment goals. Discussion focuses on the implications of these results for the use of motivation enhancing intervention strategies to improve attendance at batterer intervention programs.     

尺划字检验初探

本文叙述了尺划字检验的理论依据,尺画字的特点,稳定性及检验方法。依据人书写习惯的相对稳定性,尺画字具有以下特点:组字笔画通常无弧度和连笔,某些短小笔画自由画写,组字运笔方向部分改变。尺画字的稳定特征:尺画字具有运笔方向、组字结构、搭配比例、书写水平、笔顺以及基本写法相对不变的稳定性特征。尺画字的检验方法:研究案情,研究检材,研究样本,比较检材和样本,确定稳定特征,进行综合评断。     

Longevity of spermatozoa in the post-ejaculatory urine of fertile men

Many scientists of varying clinical backgrounds have described the phenomenon of spermaturia in animals, adolescents as well as fertile and infertile men. Nevertheless, research for an expert opinion on a law case in the field of forensic medicine revealed a lack of valid information about the longevity of spermatozoa in post-ejaculatory urine (PEU) of fertile men.Our goal was to measure the appearance of vivid sperm in PEU while considering the factor of time in order to predict a realistic interval, in which positive sperm findings might occur. Therefore ten healthy, young men donated their sperm for fertility analysis and a urine sample prior to and after ejaculation. The time intervals between ejaculation and the first micturition were preset ranging between 30 min and maximal 11 h. Each ejaculate underwent a semen analysis. The pre- and post-ejaculatory urine samples were screened for the presence of viable and motile spermatozoa. Semen parameters were determined and related to the sperm findings in the precipitate of the urine samples. The amount, the viability and motility status of the detected spermatozoa were recorded after each preset time interval.The results showed that none of the 10 participants had sperm in their urine samples prior to ejaculation. The average sperm concentration was 50.1 ± 25.8 million/ml. After a time span of 30 min 59.5% of the first fractions of PEU samples were sperm positive, after 2 and 4 h still 70%, and after 5 h sperm were no longer detected. The last motile spermatozoa could be found after 4.5 h. It seems that remaining sperm in the urethra are washed out with the first micturition in the majority of fertile men, however, the conclusion as to whether sperm findings >5 h after ejaculation are improbable needs to be confirmed by further investigations.     

Self‐reported Mental Health Issues Among Arrestees in the Paris,France Area

We studied (May–September 2014) all arrestees who reported mental health issues during the medical examination performed by a forensic physician for the assessment of fitness for detention. Among 4814 arrestees, 420 (9%) reported a current mental health issue. The suspected crimes among arrestees reporting a current mental health issue were more often related to violent behaviors (physical assault, 23% vs. 16%, p < 0.001, sexual assault, 3% vs. 1%, p = 0.01) and less often drug offenses (18% vs. 29%, p < 0.001). Among arrestees reporting mental health issues, 80% reported psychiatric or psychological care, of whom 33% reported previous mental health care. Decisions of unfitness for detention were more frequent among arrestees reporting mental health issues than in other detainees (3% vs. 1%, p < 0.001). The high proportion of patients with interrupted mental health care among those reporting mental disorders suggests that the medical examination during custody could be a significant opportunity to restore psychiatric care.     

Informing regional taphonomy research using retrospective forensic anthropology cases in the Western Cape,South Africa

The post-mortem interval (PMI) is important in death investigations as it can assist in reconstructing the context of the case and the identification of the unknown individual. However, in some instances the PMI is challenging to estimate due to the absence of regional taphonomy standards. To conduct accurate and locally relevant forensic taphonomy research, investigators require insight into the regional hotspot recovery areas. Thus, forensic cases examined by the Forensic Anthropology Cape Town (FACT) in the Western Cape (WC) province of South Africa between 2006 and 2018 (n = 172 cases; n = 174 individuals) were retrospectively reviewed. In our study, a considerable number of individuals did not have the PMI estimations (31 %; 54/174) and the ability to estimate a PMI was significantly associated with skeletal completeness, unburnt remains, absence of clothing and the absence of entomological evidence (p < 0.05 for each). Significantly fewer cases had the PMI estimated after FACT was formalised in 2014 (p < 0.0001). One third of cases with PMI estimations were made with large open-ended ranges, making them less informative. Factors significantly associated with these broad PMI ranges were fragmented remains, absence of clothing and absence of entomological evidence (p < 0.05 for each). Most decedents (51 %; 87/174) were discovered in police precincts from high crime areas, yet a considerable number (47 %; 81/174) were also found in low crime and sparsely populated areas regularly used for recreational activities. Common sites of body discovery were vegetated areas (23 %; 40/174), followed by the roadside (15 %; 29/174), aquatic environments (11 %; 20/174) and farms (11 %; 19/174). Decedents were discovered exposed (35 %; 62/174), covered with items such as bedding or shrubs (14 %; 25/174) or buried (10 %; 17/174). Our data highlight gaps in forensic taphonomy studies and clearly informs what regional research is needed. Overall, our study demonstrates how forensic case information can inform regional forensic taphonomy studies to locate common areas and contexts for the discovery of decomposed bodies and encourages similar studies in other areas of the world.     

Tobacco status,impulsivity, and the five-factor of the PANSS in paranoid schizophrenia

There is consistent evidence that impulsivity is linked to tobacco consumption and to symptomatology in schizophrenia. In the current study, we propose a new integrative model of the relationship between impulsivity, psychopathological symptoms, and tobacco status in patients with paranoid schizophrenia. We investigated 33 paranoid schizophrenia patients and 37 healthy controls using a battery of psychopathological scales included the Structured Clinical Interview for DSM-IV (SCID), the five-factor model of the Positive and Negative Symptom Scale (PANSS), the Barratt Impulsiveness Scale (BIS-10), and the UPPS Impulsive Behavior scale (UPPS). Step-wise regression analysis revealed that positive factor of the PANSS and tobacco status contributed positively and significantly to the explained variance of impulsivity. In addition, non-planning impulsivity and sensation-seeking emerged as significant predictors of tobacco status, while smoking predicted non-planning impulsivity and sensation-seeking. Our results suggest that the relationship between sensation-seeking and tobacco use is reciprocal and proposes a new integrative model of the relationship between impulsivity, positive symptoms and tobacco status in patients with paranoid schizophrenia. However, the exact mechanisms for these relationships deserve further investigation.     

A Retrospective Population-Based Study of Hospitalized Injuries Associated with Intimate Partner Violence in Taiwan from 1997 Through 2009

The study used Taiwanese National Health Insurance Research Database to investigate the types of injuries suffered by those patients hospitalized for intimate partner violence and the types of hospital care provided to victims 18 years of age or older from 1997 to 2009. In total, there were 836 cases and 3.57 times more female than male, the average hospital stay length was 9.37 days, and the average hospital costs totaled approximately NT$ 47,563.53. On average, there were approximately 2.86 injuries per abuse victim, and intracranial injuries were the most common injury (28.83 %). Many of the abused patients went to regional hospitals (44.14 %), and the largest percentage of hospitalized patients (50.24 %) was among 25–44-year-olds. In the study period, the hospitalization rate for females was significantly higher than for males; moreover, the overall rate of hospitalization for intimate partner violence increased significantly.     

万用表测量字迹电阻方法的初步研究

目的介绍一种鉴定添加变造黑色笔迹的新方法—万用表测量字迹电阻法。方法用万用表的探针测量字迹笔画的电阻值数值,根据数值的大小范围来判断字迹是否存在添加变造。结果该方法简便快速,不破坏原件,不受检测条件及环境的限制,成本低,效率高,便于广泛推广应用。结论凡是可测出电阻值数值的,证明书写色料中的成份是以碳黑为主,凡电阻值为正无穷大时,证明书写色料中不含碳黑,而是由多种色料拼色而成的,从而可分析判断字迹是否被添加变造。     

Discussion of "Using Stationarity Tests in Antitrust Market Definition"

Send correspondence to: Daniel Hosken, Federal Trade Commission, 600 Pennsylvania Ave. NW, Washington, DC 20850; E-mail: dhosken@ftc.gov. The first 150 words of the full text of this article appear below.