Violence prevention in psychiatry: an umbrella review of interventions in general and forensic psychiatry

Relative risks of violence in psychiatric patients are high compared to the general population and existing evidence in non-psychiatric populations may not translate to reductions in violence in psychiatric populations. We searched 10 databases including Medline, EMBASE, CINAHL and Scopus, from inception until August 2015 for systematic reviews and meta-analyses of violence prevention interventions in psychiatry. Reviews were included if they used a hard outcome measure (i.e. police or hospital recorded violence, or reincarceration) and contained randomized or non-randomized controlled studies. Five reviews met our inclusion criteria (n = 8876 patients in total), of which four received a GRADE rating of ‘low’ or ‘very low’. Three randomized studies (n = 636) reported that therapeutic community interventions may reduce reincarceration in drug-using offenders with co-occurring mental illness (‘moderate’ GRADE rating). The lack of intervention research in violence prevention in general and forensic psychiatry suggests that interventions from non-psychiatric populations may need to be relied upon.     

Either or? Reconciling Findings on Mental Health and Extremism using a Dimensional Rather than Categorical Paradigm

The background for this paper is the debate over what role mental illness plays in radicalization to violent extremism. While one camp points to cases of abnormal functioning of perpetrators, another argues that normal psychological mechanisms are central. Through a review of these perspectives, it becomes clear that mental illness cannot be ruled out as an epi‐phenomenon, but is not a necessary condition either. The paper draws on work in psychiatric nosology on dimensional and categorical conceptions of illness and argues that the perspectives in this literature reflect a categorical approach to normal and abnormal functioning. Under a dimensional perspective, findings converge. The paper concludes by showing how this new dimensional approach to the role of mental illness in radicalization has implications for the design of risk assessment tools and leads to the recommendation for stronger inter‐agency cooperation between mental health professionals, social services, and police and intelligence services.     

Cranial Nonmetric Variation and Estimating Ancestry*

Abstract: Historically, when predicting the ancestry of human skeletal remains, forensic anthropologists have not fully considered the variation within human populations, but instead have relied on a typological, experience‐based approach. Unfortunately, reliance on observer experience has produced a method that is as much an art as it is a science. This research focuses on the frequency distribution and inter‐trait correlations of 11 common morphoscopic traits to demonstrate that the experience‐based approach to ancestry prediction is indeed an art that is unscientific, because it is unreplicable, unreliable, and invalid. Ten of 11 traits examined had frequency distributions with significant differences (p < 0.001) between groups, but the range in variation of these traits far exceeds previous assumptions. Such within group variation clearly demonstrates that extreme trait expressions are not reliable for estimating ancestry through visual observation alone, but instead that these traits should be analyzed within a statistical framework.     

简易精神症状自陈量表对主观夸大精神症状的测试分析

目的 应用简易精神症状自陈量表检测法医精神鉴定中主观夸大精神症状的情况,并分析其测试结果。方法 对206名不同类型的法医精神鉴定的被鉴定人用该量表进行检测．并由两名鉴定专业人员对被鉴定人是否有主观夸大精神症状分别进行评定。结果 （1）以该量表判断主观故意或夸大精神症状的划界分（13分）对测试的被鉴定人进行检测,206例被鉴定人中有71例被判定为主观夸大精神症状（34．5％）。与专家评定的结果相比,量表评定的假阴性为19．8％,假阳性率为1．7％;总准确率为90．8％。（2）工伤和交通事故精神伤残理赔鉴定案例主观夸大精神症状的比例较高（51％）。结论 简易精神症状自陈量表是检测主观夸大精神症状的有效评定工具。     

人格的事件相关电位研究

事件相关电位技术具有毫秒级的高分辨率,运用它能够对大脑内稍纵即逝的心理加工过程进行分程分析,在探索人格形成机制上具有重要意义。用事件相关电位指标来评价人格,也较人格量表更为客观。文章重点介绍了有关Brebner-Cooper、Gray、C loninger、“大五”四种人格理论的事件相关电位研究,并对该领域的研究现状进行了评论。     

The influence of prisons on inmate misconduct: A multilevel investigation

This article presents the results of multilevel analyses of prisoners' misconduct for the population of over 120,000 federal prisoners incarcerated in June 2001. Prior research has focused on individual-level explanations of inmate misconduct, but this study explicitly examines whether prisons vary in their influence on such misconduct. The study demonstrates that model specification makes a difference in our understanding of which variables are related to misconduct, that the type of misconduct is important for understanding the effects of covariates of misconduct, and that results of multilevel models can easily be used to compare the performance of prisons.     

微流控芯片技术在刑事科学中的应用

目的　阐述微流控芯片技术在法庭科学上的应用。方法　研究国内外已报道的微流控芯片快速、灵敏、高通量技术的有关资料。结果　提出在法医DNA检验、毒剂和毒物检测、麻醉剂或毒品检测、爆炸残留物检测等刑事技术上的应用前景。结论　从刑事侦查的角度看出该技术的巨大发展潜力     

97例杀人后自杀案件法医学特点分析

目的分析97例杀人后自杀案件特点,为同类案件的法医现场勘验及法医学鉴定提供参考和借鉴。方法收集上海市公安局物证鉴定中心参与鉴定的97例杀人后自杀案件,共死亡207人,其中加害人98名,被害人109名。对加害人、被害人双方的性别、年龄、关系及案发场所、死亡方式等方面的资料进行分析。结果上海地区杀人后自杀案件涉及的死者多为18~59岁青壮年,相互之间多熟识,起因多为家庭矛盾及感情纠纷;被害人女性为主,加害人男性居多;案发场所多为同一室内环境或相邻室内外;杀人多选择机械性暴力手段,而自杀则多采用自缢和高坠。结论上述关于此类案件的特点有助于法医在鉴定过程中对杀人后自杀案件做出快速、准确地判断。     

Screening for mental disorder using the UK national offender assessment system

Probation officers have large caseloads with high levels of psychiatric morbidity but receive minimal training in recognising/managing mental health problems. In the UK, there is no national screening procedure for mental illness among offenders that is considered effective. This study’s aim was to develop a screening system for mental/personality disorders using the Offender Assessment System. Seven screens for mental disorder were developed using items from assessments on 574 prisoners: alcohol misuse, drug dependence, antisocial personality disorder, psychopathy, learning difficulties, psychosis and severe mood disturbance. Internal validation showed that the screens performed well across accuracy estimates. Prevalence of mental disorders identified with the screens in test and validation samples was similar. However, the psychopathy and severe mood disturbance screens may be more effective in screening for true negatives. The screens are an economical method for prioritising mental health needs of the UK prison and probation population using routinely collected data.     

Vicious dogs part 2: criminal thinking, callousness, and personality styles of their owners

Every year over 885,000 dog bites require serious medical attention. Based on human injury and insurance claims, six dog breeds were designated as "vicious" (Akitas, Chows, Dobermans, Pit Bulls, Rottweilers, and Wolf-mixes). This study was conducted to expand on previous research examining antisocial tendencies and personality styles of people choosing to own vicious breeds. Seven hundred and fifty-four college students completed a questionnaire assessing type of dog owned, criminal thinking, callousness, personality, alcohol usage, and deviant lifestyle behaviors. Vicious dog owners reported significantly higher criminal thinking, entitlement, sentimentality, and superoptimism tendencies. Vicious dog owners were arrested, engaged in physical fights, and used marijuana significantly more than other dog owners. However, the homogeneous sample utilized could impact the generalizability of these findings. Choosing to own a vicious dog may be a "thin slice" indicator of more antisocial tendencies.     

Personality disorders and criminal responsibility in the Spanish supreme court

The aim of this study is to determine how personality disorders (PDs) are viewed in relation to criminal responsibility (CR) within the jurisprudence of the Spanish Supreme Court. All sentences with PD from 2000 to 2006 were included. The most frequently occurring PDs are cluster B and nonspecific disorders, alongside another Axis I disorder. The Spanish Supreme Court admitted appeals on 50%, and sentencing criteria were changed in 25% of the cases. The most frequent outcome was in the first instance a minor reduction in CR and second full CR being upheld. The borderline PD and the comorbidity between a PD and an Axis I disorder are the variables associated with the decrease in CR. The assessment of CR in PD should be undertaken using the diagnosis as a base taking into account other elements, such as the type of PD, its seriousness, comorbidity, and relationship with the criminal behavior on trial.     

胰岛素中毒法医学研究进展

胰岛素作为一种临床上常见的降血糖药物,可以有效控制糖尿病患者血糖,使之维持在正常范围。但过量胰岛素可导致死亡,其中以意外中毒最多见,其次为自杀,胰岛素他杀虽极为罕见,但值得高度重视。胰岛素中毒致死的法医学鉴定极为困难,虽然相关研究已取得一定的进展,但在法医学实践中,这类案件仍然是一大难题。本文从法医病理学的角度,对胰岛素中毒的死亡机制、病理学改变、检测手段、注意要点及诊断要点进行综述,为法医学实践提供帮助。