Methodological development: structured outcome assessment and community risk monitoring (SORM)

This paper describes an effort to develop a clinical tool for the continuous monitoring of risk for violence in forensic mental health clients who have left their institutions and who are dwelling in the community on a conditional release basis. The model is called Structured Outcome Assessment and Community Risk Monitoring (SORM). The SORM consists of 30 dynamic factors and each factor in SORM is assessed in two ways: The current absence, presence or partial och intermittent presence of the factors, which is an actuarial (systematized and 'objective') assessment. Secondly, the risk effect, i.e. whether the presence/absence of factors currently increases, decreases or is perceived as unrelated to violence risk, is a clinical (or impressionistic) assessment. Thus, the factors considered via the SORM can be coded as risk factors or protective factors (or as factors unimportant to risk of violence) depending on circumstances that apply in the individual case. Further, the SORM has a built-in module for gathering idiographical information about risk-affecting contextual factors. The use of the SORM and its potential as a risk monitoring instrument is illustrated via preliminary data and case vignettes from an ongoing multicenter project. In this research project, patients leaving any of the 9 participating forensic hospitals in Sweden is assessed at release on a variety of static background factors, and the SORM is then administered every 30 days for 2 years.     

Do bone elasticity and postmortem interval affect forensic fractographic analyses?

Forensic fractographic features of bone reliably establish crack propagation in perimortem injuries. We investigated if similar fracture surface features characterize postmortem fractures. Experimentally induced peri- and postmortem fractures were used to assess if fractographic features vary as bone elasticity decreases during the postmortem interval (PMI). Thirty-seven unembalmed, defleshed human femoral shafts from males and females aged 33–81 years were fractured at varying PMIs with a drop test frame using a three-point bending setup and recorded with a high-speed camera. Vital statistics, cause of death, PMI length, temperature, humidity, collagen percentage, water loss, fracture energy, and fractography scores were recorded for each sample. Results showed that fractographic features associated with perimortem fractures were expressed in PMIs up to 40,600 accumulated degree hours (ADH), or 60 warm weather days. Hackle was the most consistently expressed feature, occurring in all fractures regardless of ADH. The most variable characteristics were wake features (78.4%) and arrest ridges (70.3%). Collagen percentage did not correlate strongly with ADH (r = −0.04, p = 0.81); however, there was a strong significant correlation between ADH and water loss (r = 0.74, p < 0.001). Multinomial logistic regression showed no association between fractographic feature expression and ADH or collagen percentage. In conclusion, forensic fractographic features reliably determine initiation and directionality of crack propagation in experimentally induced PMIs up to 40,600 ADH, demonstrating the utility of this method into the recent postmortem interval. This expression of reliable fractographic features throughout the early PMI intimates these characteristics may not be useful standalone features for discerning peri- versus postmortem fractures.     

Assessing the relevance of self-reported ADHD symptoms and cognitive functioning for psychopathy using the PCL-R and the TriPM

Psychopathy and ADHD are highly comorbid disorders, possibly linked to the underlying trait of impulsivity. It is therefore likely that ADHD symptoms are also of importance when studying cognitive functioning linked to psychopathy. Few studies of psychopathy and cognitive functioning have taken ADHD symptoms into account. In this cross-sectional study, male offenders (n = 201 of whom 105 were neuropsychologically tested) were recruited from all high security correctional facilities in Sweden. The aim of the study was to investigate if self-reported ADHD symptoms and cognitive functioning could predict specific subcomponents of psychopathy in offenders. Results showed that self-rated ADHD symptoms (ASRS) and psychopathy were highly correlated. Furthermore, the associations of ASRS and PCL-R Facet 3, as well as TriPM Disinhibition, were remarkably high. As expected, ASRS was not related to either Facet 1 or 2 of the PCL-R, or to TriPM Boldness. Cognitive functioning did not contribute in predicting psychopathy beyond the effect of ASRS. The high overlap in reported symptoms highlights the importance of thorough clinical assessments to be able to distinguish psychopathic personality traits from ADHD and lessen the risk of misdiagnosis. Further, it points to the need of finding discriminative measures possibly linked to etiological underpinnings.     

Psychopathic traits in Finnish homicide offenders with schizophrenia

There is a paucity of studies examining psychopathy in comparable samples of violent individuals with and without psychotic illness. The main goal of the study was to assess the prevalence and nature of psychopathic traits as measured by PCL-R among Finnish homicide offenders with schizophrenia. Further, the impact of co-morbid psychopathy on the homicidal incidents, as well as the associations of psychopathy and offender background factors, among offenders with schizophrenia was investigated.A retrospective study was performed using extensive forensic psychiatric evaluation reports and crime reports as sources of information. The sample consisted of 72 homicide offenders with schizophrenia and 72 controls without psychotic illness.Psychopathic features were prevalent among Finnish homicide offenders with schizophrenia, although for the most parts to a lesser extent compared to other homicide offenders. Like non-mentally ill psychopathic offenders, offenders with schizophrenia and many psychopathic traits are likely to present early starting problems in many areas of life and they also commit homicides that resemble other psychopathic offenders' in their choice of victims, intoxication and post-offense behavior.The observed prevalence of psychopathic traits highlights the importance of psychopathy assessment among violence-prone individuals with schizophrenia. In most respects, offenders with schizophrenia and high levels of psychopathic traits seem to be similar to psychopathic offenders without psychotic illness, which has implications for early intervention and management.     

Spontaneous formation of γ-hydroxybutyric acid from γ-butyrolactone in tap water solutions

The spontaneous conversion of γ-butyrolactone (GBL) to γ-hydroxybutyric acid (GHB) in seven different Swedish tap waters was investigated. The waters used in the study were selected to represent the diversity among Swedish tap waters as well as possible, which was enabled by principal component analysis (PCA) of a number of water quality parameters. GBL solutions (5, 25 and 50% v/v) were prepared in each of the tap waters and in deionized water and the formation of GHB was followed over time. The GHB quantifications were made using a CZE method, employing a carrier electrolyte consisting of 25mM benzoic acid, 54mM tris(hydroxymethyl)aminomethane (Tris) and 1.7mM tetradecyltrimethylammonium bromide (TTAB), which was developed as a part of the current study. Data evaluation showed that the formation of GHB was largely dependent on the type of tap water. For example, there was a negative correlation between the kinetics of the GHB formation and the alkalinity of the tap waters (r(2)=0.990). This could be explained by a faster decrease in pH in the waters with low buffering capacity (i.e. low alkalinity), which catalysed the hydrolysis of GBL. Equilibrium was reached after 40-250 days depending on the initial GBL concentration and the type of tap water. The level of the equilibrium appeared to be dependent on the initial GBL concentration and ranged from 26 to 37%. Gained knowledge on the levels of the GHB/GBL equilibrium and the kinetics of the formation of GHB in tap water solutions of GBL, including the influence of the tap water quality, may be useful information for casework with the GHB/GBL problem in focus.     

The Intergenerational Cycle of Criminality—Association with Psychopathy*

Abstract: Preventive interventions early in life are likely to lower the risk of intergenerational transmission of criminal behavior. We investigated if psychopathy among homicidal offenders is associated with criminal offending among the offenders’ offspring. The basic sample consisted of consecutive Finnish homicide offenders (during 1995–2004) who had been subjected to a forensic psychiatric examination and rated for a file‐based PCL‐R, and their offspring. Criminal behavior among both genders of the offspring was more common than in the general population. In general, the offspring’s crimes against others (e.g., threat, intimidation, deprivation of freedom, breach of domicile) were associated with their parent’s psychopathy. A grandfather’s major mental disorder was associated with a high rate of crime committed by the offspring. Especially, the sons of male psychopathic homicidal offenders had the highest rate of committing crimes, which was often expressed as vandalism. However, both genders of offspring seem to require special preventive programs to ameliorate these problems.     

What Drives the Swing Voter in Africa?

What makes African voters “up for grabs”? Existing approaches to the swing voter have several liabilities. This article introduces a new measure enabling a more comprehensive assessment of swing voting, including the differentiation between clientelistic and collective goods motivations. The issue of swing voting is then brought to an environment where voters are rarely considered persuadable: Africa. Using a count‐model estimation technique and original survey data from Ghana's critical 2008 elections, the analysis challenges the near consensus in African politics on clientelism as the only electoral strategy. When voters perceive politicians as providing collective, developmental goods, the efficacy of clientelism as a tool to win over voters is reduced. Many persuadable voters can also be won over by both clientelistic and collective goods, thus contradicting the literature presenting these as mutually exclusive. Finally, the analysis shows that incumbents do better when they provide collective goods even in highly clientelistic environments.