Assessing treatability in mentally disordered offenders

The research literature on the treatability of forensic patients is sparse and fragmented. Employing available studies, we argue for a radical rethinking of treatability within the criminal justice system as a complex predictive task that tests the very limits of clinical competence. Issues that must be addressed in examining treatment needs of mentally disordered offenders include (a) making crosssituational predictions, (b) determining the relationship, if any, between the mental disorder and criminal behavior, and (c) estabilishing the likelihood of treatment compliance, favorable treatment response, and the availability at some future date of recommended interventions.     

Early criminal recidivism among mentally disordered offenders

Criminal recidivism was studied during 2 years in a Swedish population-based cohort (N = 318) of mentally disordered male offenders who had undergone a pretrial forensic psychiatric investigation, been convicted in subsequent trials, and been sentenced to forensic psychiatric treatment (FPT; n = 152), prison (n = 116), or noncustodial sanctions (n = 50). Recidivism was analysed in relation to index sanctions, levels of supervision, diagnoses, and criminological factors. Significantly lower recidivism in the FPT group was related to lower crime rates during periods at conditional liberty in this group alone, and recidivism was significantly more common among offenders with at least one of the two diagnoses of substance abuse disorder and personality disorder than among those with psychotic or other mental disorders alone. Age at index crime and number of previous crimes emerged as significant predictors of recidivism. The results of this study suggest that the relapse rates depend as much on level of supervision as on individual characteristics.     

Homeless mentally disordered offenders and violent crimes

This study examines the prevalence of homelessness in a cross-sectional sample of 150 patients retained in a maximum-security hospital for mentally disordered offenders in New York City. The homeless mentally ill comprise only 2% of the city's mentally ill population, yet they account for 50% of the admissions to this forensic facility from the community. Compared to population base rate estimates, forensic patients are homeless at 25 times the rate found in the rest of the city's mentally disordered population and are 50 times more likely to be homeless than the general population. Further, there is a significant association between homelessness at the time of the instant offense and charges for violent crimes, after controlling for age, sex, race, and diagnosis. These data suggest that homelessness greatly increases the risk that mentally disordered persons will be forensically hospitalized and is closely associated with indictments for violent criminal behavior. Alternative explanations for these findings are discussed, emphasizing risk, vulnerability, and criminalization perspectives.Some of the data reported in this article were presented at the 42nd Annual Meeting of the American Academy of Forensic Sciences, February 24, 1990, in Cincinnati, Ohio. Thanks to Joel Dvoskin, John Monahan, Edward Mulvey, Charles D. H. Parry, Nancy Pruett, Henry Steadman, and three anonymous reviewers for their helpful comments on an earlier draft of this article.     

精神障碍吸毒者刑事责任能力研究

随着毒品在我国的蔓延,吸毒的人数渐渐增多,精神障碍的吸毒者犯罪也开始引起相关部门的注意,对这一特殊犯罪人群能否比照精神病人来处理意见不统一。笔者介绍了其他诸国的相关法律规定,结合本国国情和相类似的法律规定,阐明了对精神障碍的吸毒者犯罪一般作完全刑事责任能力评定为最优的观点。     

精神障碍吸毒者刑事责任能力研究

随着毒品在我国的蔓延,吸毒的人数渐渐增多,精神障碍的吸毒者犯罪也开始引起相关部门的注意,对这一特殊犯罪人群能否比照精神病人来处理意见不统一.笔者介绍了其他诸国的相关法律规定,结合本国国情和相类似的法律规定,阐明了对精神障碍的吸毒者犯罪一般作完全刑事责任能力评定为最优的观点.     

Integrating risk,the Good Lives Model and recovery for mentally disordered sexual offenders

Abstract

Personality disordered and mentally disordered sexual offenders (MDSOs) with complex diagnoses such as schizophrenia, developmental disorders and mood disorders face challenges of restoring their mental health, living more safely with personality- and offence-related risks, while addressing concerns about their capacity to reintegrate into society; this has been termed “secure recovery”. This paper reviews the literature on recovery, demonstrating its commonality with the Good Lives Model (GLM) as applied to MDSOs' offending treatment. GLM appears to provide a better fit with the recovery needs of MDSOs than the Risk–Need–Responsivity model because it emphasises approach goals, enhanced responsivity and skills acquisition. Recovery needs to integrate coping with mental disorders with risk management and a healthy, future lifestyle. Both secure recovery and GLM support the need for client–clinician collaboration, promoting self-determination and a shared narrative about coping with enduring risk and the hope of sustained well-being.     

An examination of the role of neuropsychological deficits in mentally disordered sex offenders

Abstract

The present study examines the neuropsychological model of sexual offending proposed by Flor-Henry (1987) in relation to a group of mentally disordered sex offenders and a control group of mentally disordered non-sex offenders. The model predicts that the sex offender group would show specific left fronto-temporal dysfunction as compared with the control group. The results, while in the predicted direction, failed to reach statistical significance. Implications and limitations of the study are discussed.     

Characteristics that predict firesetting in male and female mentally disordered offenders

Few studies have adequately explored the characteristics of male and female mentally disordered firesetters and compared these to those of non-firesetting mentally disordered offenders. Furthermore, there is a paucity of research examining the characteristics which can predict repeat firesetting within this population. The current study aimed to examine similarities and differences in the characteristics of (1) male and female mentally disordered firesetters, (2) male and female mentally disordered firesetters compared to non-firesetting offenders, and (3) one-time and repeat firesetters. Furthermore, the ability of these characteristics to predict offence status (i.e. firesetter or non-firesetter) and repeat firesetting was explored. Information was collected from patient hospital records for 77 (43 firesetters, 34 non-firesetters) mentally disordered offenders; including sociodemographic, family and personal background, psychiatric, and offence history factors. The findings suggest that mentally disordered firesetters are similar to their non-firesetting counterparts on key characteristics; however, firesetters are more likely to have an expressed interest in fire/explosives and a diagnosis of a schizophrenic disorder and female firesetters are more likely to have a higher number of firesetting incidents than males. Furthermore, findings suggest that fire interest is the largest predictor of repeat firesetting. Clinical implications in terms of treatment and risk assessment are discussed.     

Personality traits,personality disorders and sensational interests in mentally disordered offenders

Purpose. Sensational interests (e.g. an interest in the occult or the methods of violence) in mentally disordered offenders are claimed to signify greater risk of psychopathology, but evidence to support this view is slight. Methods. The relationships between self‐reported DSM‐IV personality disorder (PD), general personality traits and sensational interests were examined in 155 of 167 consecutively referred offenders to a forensic psychology service. The subscales of the PD and personality trait measures were reduced to the four basic PD/trait dimensions (asocial, antisocial, anxious and anankastic) using confirmatory factor analysis. Results. Those high on the ‘antisocial’ factor (which was primarily defined by low Agreeableness, low Conscientiousness, and substantial elements of Paranoid, Antisocial and Borderline PD) were more interested in ‘violent‐occult’ and militaristic topics. Conclusions. The aspects of the antisocial factor primarily associated with an interest in sensational and potentially violent topics cover a wide range of putative disorders. However, the factors reflecting asocial, anxious or anankastic disorders do not show a reliable association with measures of sensational interests. These results suggest that the personality dimensions reflecting an interest in ‘sensational’ topics in mentally disordered offenders are relatively specific.     

An evaluation of a maximum security therapeutic community for psychopaths and other mentally disordered offenders

Psychopaths present serious problems for the criminal justice system because they are responsible for many serious crimes and appear to be very resistant to treatment. The present study was a retrospective evaluation of the efficacy of a maximum security therapeutic community program in reducing recidivism among mentally disordered offenders, some of whom were psychopaths. The study employed a matched group, quasiexperimental design. The results showed that, compared to no program (in most cases prison), treatment was associated with lower recidivism (especially violent recidivism) for nonpsychopaths and higher violent recidivism for psychopaths. The clinical and research utility of Hare's Psychopathy Checklist was strongly supported.     

The relationship between schemas and offence supportive attitudes in mentally disordered sexual offenders

Abstract

The study of schemas in sexual offenders is a relatively new approach in attempts to understand the deviant beliefs and attitudes of sexual offenders. Emerging findings suggest that offence supportive attitudes may be the product of an offender's underlying schemas. This study aims to establish the relationship between offence supportive attitudes and schemas in a sample of mentally disordered sexual offenders (MDSOs). Thirty-one male sexual offenders held within low through high security forensic mental health units were assessed using the Young Schema Questionnaire - Short Version 3 and the Questionnaire on Attitudes Consistent with Sex Offending. Correlational analyses suggested a pattern of relationships in which Insufficient Self-control, Entitlement and Enmeshment arose as the schemas associated with most offence supportive attitudes. This supports a relationship between schemas and offence supportive attitudes in MDSOs and is consistent with the literature to date. Implications for further research and treatment are considered.     

A profile of mentally disordered offenders admitted to inpatient psychiatric services in the United States

This research note presents data about mentally disordered offenders (MDOs) treated in inpatient psychiatric services. Data are derived from 1980 admission surveys by the Survey and Reports Branch, National Institute of Mental Health (NIMH). These data report for the first time inpatient services provided to MDOs by non-Federal general and private hospitals. A total of 31,773 MDOs were admitted, with 85% going to state and county mental hospitals. The largest group, including admissions for evaluation, was ISTs (58%), followed by mentally disordered prisoners (32%), NGRIs (8%), and MDSOs (3%). Women and whites tended to be overrepresented among MDOs as compared to prison and jail inmates. Clear diagnostic differences by legal status were found, with schizophrenia predominant among NGRIs (81%) and alcohol and drug abuse disorders more frequent among ISTs. Overall, state and county hospitals in both 1967 and 1980 were the primary locus of care for mentally disordered offenders.