Homicides with Mutilation of the Victim's Body

Abstract:  Information on homicide offenders guilty of mutilation is sparse. The current study estimates the rate of mutilation of the victim's body in Finnish homicides and compares sociodemographic characteristics, crime history, life course development, psychopathy, and psychopathology of these and other homicide offenders. Crime reports and forensic examination reports of all offenders subjected to forensic examination and convicted for a homicide in 1995–2004 ( n  = 676) were retrospectively analyzed for offense and offender variables and scored with the Psychopathy Check List Revised. Thirteen homicides (2.2%) involved mutilation. Educational and mental health problems in childhood, inpatient mental health contacts, self-destructiveness, and schizophrenia were significantly more frequent in offenders guilty of mutilation. Mutilation bore no significant association with psychopathy or substance abuse. The higher than usual prevalence of developmental difficulties and mental disorder of this subsample of offenders needs to be recognized.     

Potentially Lethal Behaviors Associated With Rapid Eye Movement Sleep Behavior Disorder: Review of the Literature and Forensic Implications

Abstract:  Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by loss of the muscle atonia of REM sleep, with release of complex and violent behaviors that are often attempted dream-enactments. This study reviewed the literature on RBD with regard to potentially lethal behavior. A total of 39–41 clinical cases of RBD associated with potentially lethal behaviors to self and/or others were found, involving a child and adults of all age groups, that manifested as choking/headlock ( n  = 22–24), defenestration/near-defenestration ( n  = 7), and diving from bed ( n  = 10). A total of 80.8% ( n  = 21) were males; 19.2% ( n  = 5) were females; mean age was 65.6 ± (SD) 13.8 years (range: 27–81 years, and a child). (Gender/age data were not listed in the remaining cases.) An etiologic association of RBD with a neurologic disorder (or with pharmacotherapy of psychiatric disorders, n  = 4) was present in 21–23 patients. Thus, RBD carries well-documented, potential forensic consequences during RBD episodes that could possibly have been misinterpreted as suicidal or homicidal behavior.     

Psychopathy among condemned capital murderers

Psychopathy is an important forensic mental health construct. Despite this importance, the research base of psychopathy among individuals convicted of capital murder is limited. Archival data were collected from a sample of 636 persons convicted of capital murder and sentenced to death in the State of California. Psychopathy was assessed using the Psychopathy Checklist – Revised (PCL-R) instrument. Data on criminal careers and other behavioral disorders were also extracted. The sample mean PCL-R total score was 23.31 (SD = 9.92) and one-third of individuals in this sample were considered clinically psychopathic with PCL-R total scores of 30 or greater. Factor analytic examination yielded support for four facets: affective, interpersonal, lifestyle, and antisocial. Criterion validity findings revealed positive correlations of psychopathy scores with Antisocial Personality Disorder (ρ = 0.72), Conduct Disorder (ρ = 0.46), sexual sadism (ρ = 0.24), Oppositional Defiant Disorder (ρ = 0.20), ADHD (ρ = 0.15), arrest charges (r = 0.56), prison sentences (r = 0.53), and age of arrest onset (r = −0.57). Individuals convicted of capital murder and sentenced to death reflect heterogeneity in psychopathy with some individuals exhibiting pronounced psychopathic features.     

A New Index for the MMPI‐2 Test for Detecting Dissimulation in Forensic Evaluations: A Pilot Study

This pilot study is the starting point of a potentially broad research project aimed at identifying new strategies for assessing malingering during forensic evaluations. The forensic group was comprised of 67 males who were seeking some sort of certification (e.g., adoption, child custody, driver's license, issuance of gun permits, etc.); the nonforensic group was comprised of 62 healthy male volunteers. Each participant was administered the MMPI‐2. Statistical analyses were conducted on obtained scores of 48 MMPI‐2 scales. In the first step, parametric statistics were adopted to identify the best combination of MMPI‐2 scales that differentiated the two groups of participants. In the second step, frequency‐based, nonparametric methods were used for diagnostic purposes. Results: A model that utilized the best three predictors (“7‐Pt”, “L,” and “1‐Hs”) was developed and used to calculate the Forensic Evaluation Dissimulation Index (FEDI), which features satisfactory diagnostic accuracy (0.9), sensitivity (0.82), specificity (0.81), and likelihood ratio indices (LR+ = 4.32; LR? = 0.22).     

Psychopathy (PCL-R) in a forensic psychiatric sample of homicide offenders: some reliability issues

Several studies have shown that psychopathy is overrepresented among homicide offenders. There is a consensus that Hare's Psychopathy Checklist-Revised PCL-R is currently the most valid and useful tool for rating psychopathy (e.g., [Fulero, S. M. (1995). Review of the Hare Psychopathy Checklist-Revised. In J. C. Conoley & J. C. Impara (Eds.), Twelfth Mental Measurements Yearbook (pp. 453-454). Lincoln, NE: Buros Institute]). Usually, when making a rating of psychopathy, both an interview and an examination of the subject's files are used. However, it has been discussed what is really required to be able to rate psychopathy in a reliable manner. The aim of the present study was to retrospectively rate the degree of psychopathy in 35 homicide offenders being subjected to forensic psychiatric assessment. These ratings of psychopathy were carried out using forensic psychiatric files and courts'; verdicts only. Another aim was to examine the reliability of PCL-R in this specific Swedish sample of homicide offenders. There was a good agreement between the two raters with respect to the categorical diagnosis of psychopathy (Cohen's kappa=.81, p<.001), which indicates that retrospective ratings of psychopathy are well suited for research purposes. The prevalence of psychopathy among the homicide offenders was 31.4% (using a cut-off score of 30), which means that the construct of psychopathy may contribute to the understanding of the phenomenon of homicide. In the planning of treatment for homicide offenders, a consideration of possible psychopathy is necessary. As criminal psychopaths are known to relapse into violent criminality, it is very important that they are given efficient treatment, placement and management.     

The inverse relation between psychopathy and faking good: not response bias,but true variance in psychopathic personality

The possibility to assess psychopathy through self-report is debated, amongst others, because psychopathic individuals may deliberately underreport psychopathic features (fake good). Meta-analytic research has shown an inverse relation between faking good and self-reported psychopathy, possibly indicating that faking good lowered psychopathy scores (response bias). Low faking good scores, could, however, also reflect true variance in psychopathic personality to the extent that it reflects a disregard of social conventions. Through a secondary analysis (n = 675), we show that controlling for faking good significantly weakens, rather than strengthens, the associations between psychopathy scores and antisocial behavior (alcohol and drug abuse, indirect aggression, and delinquency). These findings indicate that the inverse relation between faking good and self-reported psychopathy reflects true variance in psychopathy personality (i.e. low social desirability), not a response bias.     

Psychopathy (PCL-R) Predicts Violent Recidivism Among Criminal Offenders with Personality Disorders in Sweden

Psychopathy as conceptualized with Hare's Psychopathy Checklist Revised, PCL-R, has attracted much research during the 1990s. In the Scandinavian countries, few studies that empirically support the validity of North American risk assessment techniques in our regional context have been published. The purpose of this paper is to explore the predictive power of the PCL-R in a population of personality-disordered violent offenders subjected to forensic psychiatric evaluation in Sweden. Following release from prison (n = 172), discharge from forensic psychiatric treatment (n = 129), or probation (n = 51), a total of 352 individuals were followed for up to 8 years (mean = 3.7 years) with reconviction for violent crime as endpoint variable (base rate 34%). As the estimate of predictive power, the area under the curve of a receiver operating characteristic (AUC of ROC) analysis was calculated. For PCL-R scores to predict 2-year violent recidivism, AUC of ROC was .72 (95% CI: .66–.78). In addition, the personality dimension of psychopathy (Factor 1) and the behavioral component (Factor 2) both predicted 2-year recidivism significantly better than random: AUC of ROC .64 (95% CI: .57–.70) and .71 (95% CI: .65–.77), respectively. We conclude that psychopathy is probably as valid a predictor of violent recidivism in Swedish forensic settings as seen in previous North American studies.     

Diagnosis of antisocial personality disorder and criminal responsibility

The present study empirically investigates whether personality disorders and psychopathic traits in criminal suspects are reasons for diminished criminal responsibility or enforced treatment in high security hospitals. Recently, the tenability of the claim that individuals with personality disorders and psychopathy can be held fully responsible for crimes has been questioned on theoretical bases. According to some interpretations, these disorders are due to cognitive, biological and developmental deficits that diminish the individual's accountability.The current article presents two studies among suspects of serious crimes under forensic evaluation in a Dutch forensic psychiatric observation clinic. The first study examined how experts weigh personality disorders in their conclusions as far as the degree of criminal responsibility and the need for enforced forensic psychiatric treatment are concerned (n = 843). The second study investigated associations between PCL-R scores and experts' responsibility and treatment advisements (n = 108).The results suggest that in Dutch forensic practice, the presence of a personality disorder decreased responsibility and led to an advice for enforced forensic treatment. Experts also take characteristics of psychopathy concerning impulsivity and (ir)responsibility into consideration when judging criminal accountability. Furthermore, they deem affective deficiencies sufficiently important to indicate suspects' threat to society or dangerousness and warrant a need for forensic treatment.     

Psychopathy (PCL-R) as a Predictor of Violent Recidivism Among Criminal Offenders with Schizophrenia

Hare's Psychopathy Checklist-Revised (PCL-R) was used to test the hypothesis that psychopathy predicts violent recidivism in a cohort subjected to forensic psychiatric investigation and consisting of male violent offenders with schizophrenia (N = 202). Psychopathy was assessed with retrospective file-based ratings. Mean follow-up time after detainment was 51 months. Twenty-two percent of the offenders had a PCL-R score 26 (cutoff), and the base rate for violent recidivism (reconvictions) during follow-up was 21%. Survival analysis revealed that psychopathy was strongly associated to violent recidivism (log-rank = 17.71, df = 1, p < 0.0001). The area under the curve (AUC) of the receiver operating characteristics (ROC) of PCL-R total score to predict violent recidivism varied between different time frames from .64 to .75. Cox regression analyses revealed that other potential risk factors could not equally well or better explain violent recidivism in the cohort than psychopathy as measured by PCL-R.     

Sex Assessment from the Sacral Base by Means of Image Processing

Abstract:  To help improve sex assessment from skeletal remains, the present study considers the diagnostic value of the sacral base (basis osseus sacri) based on its planar image and related metric data. For this purpose, 114 adult sacra of known sex and age from two early 20th century Italian populations were examined, the first from Bologna, northern Italy ( n  = 76), and the second from Sassari, Sardinia ( n  = 38). Digital photos of the sacral base were taken with each bone in a standardized orientation. Technical drawing software was used to trace its profile and to measure related dimensions (area, perimeter, and breadth of S1 and total breadth of the sacrum). The measurements were subjected to discriminant and classification function analyses. The sex prediction success of 93.2% for the Bolognese sample, 81.6% for the Sassarese sample, and 88.3% for the pooled sample indicates that the first sacral vertebra is a good character for sex determination.     

Psychopathic traits and change on indicators of dynamic risk factors during inpatient forensic psychiatric treatment

The main objective of the present study was to investigate the impact of treatment on forensic psychiatric inpatients, examining changes on 22 indicators of five dynamic risk factors for violence (i.e., egocentrism, hostility, impulsivity, lack of insight, and negative distrustful attitudes), and to relate these potential changes to level of psychopathy assessed with the Hare Psychopathy Checklist - Revised (PCL-R). Also, we studied the relationship between psychopathy and treatment compliance, as indicated by the attendance rate of therapeutic activities. Eighty-seven male patients (due to missing data on at least one measure, sample size varies from 58 to 87; 42 patients have complete datasets) were administered a standardized psychological assessment battery (self-report inventories, performance-based personality test, observer ratings) upon admission (T1) and after on average 20 months of treatment (T2). Upon admission, psychopathy (median split, PCL-R score≥22) was significantly related to a higher score on five of the 22 indicators of dynamic risk. The analyses showed no significant differences between psychopathic and non-psychopathic patients on the indicators of dynamic risk factors during 20 months of inpatient forensic psychiatric treatment. However, psychopaths showed the expected pattern of treatment noncompliance, compared to non-psychopaths. The clinical and research implications of these findings are discussed.     

Assessing change in dynamic risk factors in forensic psychiatric inpatients: relationship with psychopathy and recidivism

This study explored change in dynamic risk for violence using the Clinical and Risk Management subscales of the Historical Clinical and Risk Management-20 version 3 (HCR-20 v3) and sought to determine whether change was associated with violent recidivism. The association between the magnitude of change and psychopathy was also assessed. Participants were 40 male (n = 32) and female (n = 8) forensic psychiatric inpatients discharged from a secure forensic mental health service. Results showed that participants significantly improved on the HCR-20v3 Clinical subscale but significantly worsened on the Risk Management subscale. Psychopathy was unrelated to change in Clinical and Risk Management subscales. The hypothesis that changes in dynamic risk would predict recidivism over and above total pre-treatment risk (HCR-20v3 Total score) and psychopathy was not supported. These results suggest that improvements in mental state risk factors alone are insufficient with regard to lowering violence risk.     

Among a German Sample of Forensic Patients,Previous Animal Abuse Mediates Between Psychopathy and Sadistic Actions

In an attempt to explain the relationship between psychopathy and severe violent behavior, this study associates previous animal abuse, psychopathy, and sadistic acting in forensic patients. Two topics are addressed: (i) whether previous animal abuse can be identified by a patient's Psychopathy Checklist profile and (ii) whether animal abuse statistically mediates between psychopathy and sadistic acting. In a German forensic hospital, 60 patients were investigated. Animal abuse was assessed using face‐to‐face interviews and the Psychopathy Checklist: Screening Version (PCL:SV), and sadistic acting was identified by file records.Discriminant analysis separated previous animal abuse (10/60) by high adolescent antisocial behavior, superficiality, lack of remorse, lack of empathy, and grandiosity. The mediation from psychopathy to sadistic acting (6/60) through animal abuse was found to be complete.The results, although sample size is limited and base rate of animal abuse and sadistic acting are low, fit with a model suggestive of animal abuse as a causal step toward sadistic crimes. Animal abuse correlates with callous, unemotional traits, and a development of sadistic crimes.     

Self-reported personality traits in forensic populations: a meta-analysis

The current study covers a systematic review and meta-analysis of the prevalence of self-reported deviant or disruptive personality traits: anger, aggression, hostility, antisocial traits, psychopathy, and impulsivity in forensic populations worldwide. A computer-based search of titles was carried out using the PubMed electronic database for articles published in English that included a self-report instrument for personality characteristics in combination with a forensic population (i.e. detained in remand, sentenced and/or in enforced treatment, or on parole). The final sample consisted of 39 studies (N?=?11,716) that together used 17 different instruments and reported on 32 subscales or constructs that fitted our current interest. Results showed significantly higher levels of self-reported antisocial and psychopathic features in forensic samples, including a significant effect of the assessment instrument and subscale used. No significant differences were found for self-reported impulsivity, anger, aggression, or hostility in forensic populations compared to norm scores of non-forensic samples. Possible explanations, including suggestions that forensic populations are prone to providing socially desirable answers on self-report questionnaires, possibly to gain advantages such as a lower prison sentence or to avoid enforced treatment, are discussed, as well as limitations, and suggestions for future research and clinical practice.     

The Relationship Between Psychopathic Personality Features and Malingering Symptoms of Major Mental Illness

This study examined the relationship between psychopathy and malingering in a subsample of male prison inmates (n = 55) participating in a larger study of the clinical utility of various assessment measures in correctional settings. Participants' capacity to feign major mental illness successfully was evaluated using standard cutoff scores for the detection of malingering on a variety of instruments, including the Structured Inventory of Malingered Symptomatology (SIMS; G. P. Smith & G. O. Burger, 1997), the Structured Interview of Reported Symptoms (SIRS; R. Rogers, R. M. Bagby, & S. E. Dickens, 1992), and the Personality Assessment Inventory (PAI; L. Morey, 1991). Psychopathic traits were assessed via the Psychopathic Personality Inventory (PPI; S.O. Lilienfeld & B. P. Andrews, 1996). Correlations between the malingering indices and the PPI were low (–.14 to .14) and not statistically significant. These findings fail to support the clinical intuition that individuals with higher levels of psychopathy are likely to be more adept at malingering.     

Psychopathy Among Mexican American Gang Members: A Comparative Study

High-risk Mexican American males were assessed for levels of psychopathy. The Hare Psychopathy Checklist-Screening Version was compared in a random sample of gang members with a matched community sample of violent non-gang members and samples of forensic and psychiatric patients and undergraduate students. Analysis involved t-test, chi-square, and Cronbach's alpha statistics. More than half of the gang sample were categorized as low, 44% as moderate, and only 4% as high on psychopathy. The gang members had higher scores on the total, affective, and behavioral scores than the non-gang members. High scores on adolescent antisocial behavior, poor behavioral controls, and lack of remorse were found in both samples. Gang members scored twice as high as non-gang members on lack of empathy. Both samples were lower on psychopathy than the forensics and higher than psychiatric patients and undergraduates. The results provide grounds for early intervention efforts for this high-risk population.     

Effects of Positive Impression Management on the Psychopathic Personality Inventory

The Psychopathic Personality Inventory (PPI; S. O.Lilienfeld & B. P. Andrews, 1996) is a self-report test that has shown considerable promise as a screening measure for psychopathy. A current limitation of the PPI is that no data exist regarding the impact of response sets such as positive impression management. Although the PPI contains a validity scale (Unlikely Virtues) designed to identify response biases such as faking good, its utility has not yet been assessed. In this study a repeated measures analogue design was employed in which 186 respondents completed the PPI both under standard conditions and with specific instructions to create a favorable impression of themselves. In the fake good condition, participants were able to appear significantly less psychopathic, with those who obtained higher scores in the standard instruction condition showing the largest decreases in their PPI scores. Receiver Operating Characteristic analyses indicated that, although the Unlikely Virtues scale significantly differentiated between fake good and honest protocols (area under the curve = .73), a considerable number of misclassifications occurred. The clinical and forensic implications of these findings are discussed.     

Preliminary Data on the Role of Emotional Intelligence in Moderating the Link between Psychopathy and Aggression in a Nonforensic Sample

This short report presents preliminary data on the role of emotional intelligence (EI) in moderating the relationship between psychopathy and aggression in a nonforensic sample. A sample of 109 volunteer men was administered the Psychopathic Personality Inventory‐Revised (PPI‐R), the Reactive‐Proactive Aggression Questionnaire, and the Mayer‐Salovey‐Caruso emotional intelligence Test in individual sessions. Correlation and moderation analyzes showed that, at low levels of EI (in terms of strategic ability to understand and manage one's own and others’ emotions), people scoring high on the total PPI‐R and impulsivity dimension seemed to be both reactively and proactively aggressive. By contrast, at high levels of strategic ability, the relationships between psychopathy and aggression were no longer significant. These preliminary results encourage further investigation into the role of EI ability in mitigating aggressive outcomes in psychopathic subjects.     

The relation of ADHD and violent aggression: What can we learn from epidemiological and genetic studies?

Disruptive behavior includes psychopathological and behavioral constructs like aggression, impulsivity, violence, antisociality and psychopathy and is often closely related with diagnostic categories like conduct disorder (CD), attention deficit disorder (ADHD) and antisocial personality disorder (ASP). There is now clear evidence that neurobiological and environmental factors contribute to these phenotypes. A mounting body of evidence also suggests interactive effects of genetic and environmental risks.In this selective review we give an overview over epidemiological aspects of the relation between ADHD and antisocial behavior, including violent aggression and psychopathy. Moreover, we summarize recent findings from molecular genetic studies and particularly discuss pleiotropic effects of a functional polymorphism of the serotonin transporter promoter gene (5HTTLPR) and childhood adversity on ADHD and violent behavior. The reported gene–environment interactions are not only informative for understanding the neurobiological underpinnings of disruptive behavior, but also throw some light on the relation between ADHD and violent behavior from a genetic perspective. The impact of genetic research on forensic psychiatry and future directions of neurobiological research are discussed.     

Juvenile Psychopathy from a Developmental Perspective: Implications for Construct Development and Use in Forensic Assessments

D. Seagrave and T. Grisso (2002) provide a review of the emerging research on the construct of juvenile psychopathy and make the important point that use of this construct in forensic decision-making could have serious consequences for juvenile offenders. Furthermore, the existing literature on the construct of psychopathy in youth is not sufficient to justify its use for most forensic purposes. These basic points are very important cautions on the use of measures of psychopathy in forensic settings. However, in this response, several issues related to the reasons given for why concern over the potential misuse of measures of psychopathy should be greater than that for measures of other psychopathological constructs used to make decisions with potentially serious consequences are discussed. Also, the rationale for some of the standards proposed to guide research on measures of juvenile psychopathy that focus on assumptions about the construct of psychopathy that are not clearly articulated and that are only peripherally related to validating their use in forensic assessments is questioned.