Injury‐Related Healthcare Use and Risk of Filicide Victimization: A Population‐Based Case–Control Study

Research on child‐related risk factors for filicide is scant. We investigated whether prior healthcare use for injury (including poisoning) influences filicide risk. Victims (0–14 years; n = 71) were identified in a national autopsy database for the years 1994–2012 and compared to matched, general population controls (n = 355). Healthcare use data were retrieved from a national patient registry. Risks were estimated using odds ratios (ORs) and 95% confidence intervals (CIs). For females, prior inpatient care for injury conferred a statistically significant sevenfold risk (OR = 6.67 [95% CI: 1.49–29.79]), and any prior injury‐related healthcare use conferred a statistically significant fourfold risk (OR = 3.57 [95% CI: 1.13–11.25]), of filicide victimization. No statistically significant risks were found for males. Healthcare personnel should be aware that children treated for injuries, especially females, may be at an elevated risk of filicide victimization. Nevertheless, the filicide base rate remains low, and parents may be stigmatized by unfounded alerts; thus, prudent reflection should precede reports to the authorities.     

Neuropsychological and Criminological Features of Female Homicide Offenders

Few studies have examined life history and cognitive characteristics unique to female homicide offenders. Understanding these characteristics could aid in risk assessment for extreme violence in this group of offenders. The current study utilized t‐tests or chi‐square tests to compare 27 female and 81 male homicide offenders on psychiatric, neurologic, criminal, and cognitive characteristics. Additionally, we explored the role of abuse history in female offenders through Kruskal–Wallis or Fisher's exact tests. Results indicate that in comparison with male counterparts, females are more likely to have history of mood disorder, borderline personality disorder, and abuse. Cognitively, female homicide offenders exhibit circumscribed cognitive impairment in verbal abilities and perform similarly to male homicide offenders across most cognitive tasks. Within the female offender group, history of sexual abuse is associated with higher rates of impulsive homicide and poorer verbal abilities. These findings provide preliminary evidence for distinct factors associated with homicide in women.     

Persistence of Biological Traces at Inside Parts of a Firearm from a Case of Multiple Familial Homicide

Backspatter from wounds caused by contact shots against a biological target had before been shown to be propelled into firearms' barrels where they can persist and be retrieved from as relevant forensic evidence. Herein, that insight was applied to the investigation of a case of multiple familial homicide with a firearm. Samples of backspatter were collected from the firearm using DNA‐free swabs. DNA was extracted from the swabs, and 16 STR systems were PCR‐amplified to generate DNA profiles of all victims shot by the firearm. The quality of the resulting DNA profiles was sufficient to exclude the perpetrator as donor and to differentiate the three closely related victims thereby proving that all three victims had been shot by the same firearm from very close or contact distance. A key insight gained from this case was that not only a firearms' barrel inside but other inner surfaces may be charged with profilable DNA.     

Toxicology and Circumstances of Death of Homicide Victims in New South Wales, Australia 1996–2005

Abstract:  To determine the prevalence and circumstances of psychoactive substances amongst homicide victims, 485 consecutive cases autopsied at the NSW Department of Forensic Medicine (1/1/1996–12/31/2005) were analyzed. Substances were detected in 62.6% of cases, and illicit drugs in 32.8%. Alcohol, cannabis, opioids, and psychostimulants were most commonly detected. Alcohol and cannabis were both more prevalent amongst males. Mean ages were significantly younger for decedents who tested positive for a substance and for an illicit drug. Cases where death resulted from a physical altercation were more likely to have had alcohol and cannabis present. Illicit drugs were prominent amongst firearms deaths. The proportion of alcohol positive cases increased from 25.0% on Monday to 49.4% for Saturdays/Sundays. Alcohol was more common in incidents in the 0001–0600 h and 1800–2400 h periods. Psychoactive substances appear to substantially increase the risk of homicide, although there are important differences between drug classes in the circumstances of such incidents.     

Patient Profiles of Criminal Behavior in the Context of Traumatic Brain Injury

Traumatic brain injury (TBI) can lead to significant post‐traumatic disturbances in mood and behavior, with the frontal lobes playing a key role in emotional and behavioral regulation. Injury to the frontal lobe can result in disinhibition and aggression which can result in police intervention and/or incarceration. We highlight four adult cases with a history of severe TBI with frontal lobe injuries and the presence of post‐TBI criminal behaviors. There is evidence to support an anatomical basis for aggressive behaviors, yet there are other risk factors to be considered. Behaviors must be investigated thoroughly by obtaining adequate pre‐ and post‐TBI psychiatric and psychosocial histories. By having a comprehensive understanding of aggression while appreciating the complex relationship between TBI, aggression, and premorbid risk factors, clinicians can more adequately treat patients with TBI, with the aim of potentially preventing criminal behaviors and recidivism.     

Juvenile and Adult Offenders Arrested for Sexual Homicide: An Analysis of Victim–Offender Relationship and Weapon Used by Race*

Abstract: Limited information is available on racial offending patterns of sexual homicide offenders (SHOs). This study used a 30‐year U.S. Supplementary Homicide Reports sample of SHOs arrested in single‐victim situations (N = 3745). The analysis strength was used to determine whether the findings yielded meaningful patterns for offender profiling. Several important findings emerged for the juvenile offenders. Juvenile White SHOs were likely to target victims with whom they shared a mutual relationship. In contrast, Black juveniles were equally likely to murder strangers and those with whom they had prior and familial relationships. Notably, no juvenile Black SHOs were arrested for murdering intimate partners. Juvenile White SHOs were twice as likely to use edged weapons as their Black counterparts. Black juveniles, conversely, were more likely than White juveniles to use personal weapons. Beyond these findings, known victim–offender relationships and weapon used may not have significant utility for investigators in identifying the SHO race, even after controlling for offender age. Limitations and future directions are discussed.     

Forensic Epidemiologic and Biomechanical Analysis of a Pelvic Cavity Blowout Injury Associated with Ejection from a Personal Watercraft (Jet‐Ski)

Jet‐propelled personal watercraft (PWC) or jet‐skis have become increasingly popular. The means of propulsion of PWC, which is a jet of water forced out of small nozzle at the rear of the craft, combined with a high risk of falling off of the seat and into close proximity with the water jet stream, raise the potential for a unique type of injury mechanism. The most serious injuries associated with PWC falls are those that occur when the perineum passes in close proximity to the jet nozzle and the high‐pressure water stream enters the vaginal or rectal orifice. We describe the forensic investigation into a case of an anovaginal “blowout” injury in a passenger who was ejected from the rear seat position of a PWC and subsequently suffered life‐threatening injuries to the pelvic organs. The investigation included a biomechanical analysis of the injury mechanism, a summary of prior published reports of internal pelvic injuries resulting from PWC falls as well as other water sports and activities, and a comparison of the severity of the injuries resulting from differing mechanisms using the New Injury Severity Score (NISS). The mean (±standard deviation [SD]) NISS values for reported PWC injuries [not including the NISS of 38 in this case study] were 11.2 (±9.5), while the mean value for reported water‐skiing falls was half that of the PWC group at 5.6 (±5.2). It was concluded that the analyzed injuries were unique to a PWC ejection versus other previously described non‐PWC‐associated water sport injuries. It is recommended that PWC manufacturers help consumers understand the potential risks to passengers with highly visible warnings and reduce injury risk with revised seat design, and/or passenger seat “deadman” switches.     

Homicide,Psychopathy, and Aging—A Nationwide Register‐based Case‐comparison Study of Homicide Offenders Aged 60 Years or Older*

Abstract: With populations aging there have been some concerns on elderly offending. We compared elderly homicide offenders with a younger comparison group with special emphasis on psychopathy. We analyzed nationwide register‐based material on all homicide offenders aged 60 or older who were in a forensic psychiatric examination in Finland 1995–2004 and their gender‐matched comparison group of younger homicide offenders. The offenders 60 years or older were diagnosed less often than the younger ones with drug dependence and personality disorders and more often with dementia and physical illnesses. The mean Psychopathy Checklist—Revised total scores as well as factor and facet scores were lower in the 60 or older age group. The group 60 years or older had significantly lower scores on eight individual items of social deviance. The interpersonal/affective factor 1 scores did not differ. Understanding the possible underlying phenomena of violent behavior may provide help for developing services for the elderly.     

Compatibility Between Mental Disorder and Mental Capacity: Analysis of a Particular Case of Group Sexual Homicide

Abstract: On the night of August 19, 2000, at the foot of Castel del Monte, an 8‐year‐old girl was brutally murdered. The perpetrators were identified as five young men who captured their victim and sexually abused her. The policemen found the cadaver by following “Mario,” one of the five, who had been discovered lying on the ground, near the castle. Investigation led to demonstrate that the murder was not premeditated. The only desire of the group was to sexually molest the little girl. Mario showed signs of psychiatric pathology and for that he underwent psychiatric evaluation by judicial authorities. Analysis of this case, combined with a criminological and medical‐legal perspective led to conclusions very much different from the expectations of Mario’s defense attorneys. Mario, a marginal figure and seemingly the least intelligent, played the role of group instigator, both in the initiation of sexually abusing the child, as well as in the elimination of an inconvenient witness. However, the group was able to activate Mario’s sadistic fantasies and his sexual perversions, and he ended up in a catalyzing role influencing the behavior of others and realizing what would otherwise remain only fantasies. The circularity of the group allows people like Mario, who are apparently subordinate, to influence the behavior of others. Mario was found to have a mental disorder but it was not sufficient to diminish his personal responsibility related to the crime. In fact, according to Italian judicial code, it is necessary that the motivation for the crime was psychopathological. It was for this reason that, according to Italian law, all of the members of the group were considered to be responsible for the crimes committed and were condemned.     

Traumatic Injury Pattern Analysis in a Light Rail Transit Death: A Retrospective Case Study

Within the context of medical examiner's offices, forensic anthropologists are increasingly being asked to assist with the interpretation of traumatic skeletal injury. This case study presents an example of trauma analysis performed by forensic anthropologists at the Maricopa County Forensic Science Center in Phoenix, Arizona. The primary goal of this study is to document an uncommon pattern of traumatic injury—severe grinding abrasions of the lower appendage that macroscopically resemble sharp force trauma, especially as observed in dismemberment cases—resulting from an individual being dragged beneath a Light Rail train for c. 1.7 miles. The abraded skeletal elements include a femoral shaft fragment, a femoral head portion, and the right foot. Second, this study aims to illustrate the efficacy of forensic anthropological analysis of patterned skeletal trauma. Finally, this study demonstrates the critical importance of analyzing scene information before drawing conclusions as to the etiology of a traumatic injury pattern.     

Domestic Homicide: Neuropsychological Profiles of Murderers Who Kill Family Members and Intimate Partners

Domestic homicide is the most extreme form of domestic violence and one of the most common types of homicide. The objective was to examine differences between spontaneous domestic homicide and nondomestic homicide offenders regarding demographics, psychiatric history, crime characteristics, and neuropsychological status, utilizing neuropsychological test data from forensic examinations of 153 murderers. Using standard crime classification criteria, 33% committed spontaneous domestic homicides (SDH) and 61% committed nondomestic homicides (NDH). SDH offenders were more likely to manifest psychotic disorders, but less likely to be diagnosed with antisocial personality disorder or to have prior felony convictions. SDH offenders manifested significantly worse neuropsychological impairments than NDH offenders. The mean number of victims was lower for the SDH than the NDH group and only 14% of SDH offenders used a firearm, whereas 59% of NDH offenders used a firearm. These findings corroborate the notion that spontaneous domestic homicide may represent a discernible criminological phenotype.     

An Empirical Analysis of 30 Years of U.S. Juvenile and Adult Sexual Homicide Offender Data: Race and Age Differences in the Victim–Offender Relationship

Abstract: Little is known about the racial patterns of crimes committed by sexual homicide offenders (SHOs). This study examined race and age influences on victim–offender relationship for juvenile and adult SHOs. A large sample (N = 3868) from the Supplemental Homicide Reports (1976–2005) was used. Analyses of victim–offender patterns included examining victim age effects (child, adolescent, adult, and elderly). The findings revealed several race‐ and age‐based differences. Black offenders were significantly overrepresented in the SHO population. This finding held for juveniles and adults independently. White SHOs were highly likely to kill within their race, “intra‐racially” (range 91–100%) across four victim age categories, whereas Black SHOs killed both intra‐racially (range 24–82%) and inter‐racially (18–76%), with the likelihood of their killing inter‐racially increasing as the age of the victim increased. This study underscores the importance of considering victim–offender racial patterns in sexual murder investigations, and it offers practical implications for offender profiling.     

Histologic evidence of repetitive blunt force abdominal trauma in four pediatric fatalities

In cases of acute fatal child abuse, certain injuries, including cutaneous blunt force trauma, skull fractures, subdural hematomas, intra-abdominal hemorrhage, and retinal hemorrhages are common and well described in the pediatric and forensic literature. These gross findings at autopsy, when taken into consideration with scene investigation and interviews with caregivers, may indicate both a clear manner and cause of death. In such cases, the discovery of additional pathologic changes attributable to older abusive injuries helps support a conclusion of death due to inflicted trauma. We discuss four cases of fatal child abuse in which acute blunt force abdominal trauma was the cause of death. In each of these cases, careful examination with proper sectioning and microscopy of select abdominal tissues revealed that the acute tissue trauma was superimposed on a background of older, healing injury. This older trauma was characterized by classic histologic elements of tissue repair, including fibroblast proliferation, early scar formation, increased vascularity, and hemosiderin-laden macrophages. Iron and trichrome stains were used to confirm the presence of hemosiderin and fibrosis in all four cases, but the recognition of fibroblast proliferation and a reactive vascular pattern was best seen on routine hematoxylin and eosin stains. The gross and microscopic autopsy findings, along with available investigative information, established the diagnosis of chronic physical abuse.     

The Homicide–Suicide Phenomenon: Findings of Psychological Autopsies

Homicide–suicide represents a single episode of violence which may decimate an entire family. This study aimed to further describe motives and context of these tragedies. Psychological autopsies were completed for 18 homicide–suicide cases in Dallas, Texas. This included postevent interviews with surviving family members and review of police and coroner records. Two‐thirds of perpetrators had made either verbal or written threats prior to the homicide–suicide. A simplified typology describing victim–perpetrator relationship and motive type is suggested for future studies and clinical ease. Two‐thirds of perpetrators fell into the category of Intimate‐Possessive, most of whom were depressed men who were abusing substances and undergoing separation. Additional categories included Intimate‐Ailing, Filial‐Revenge, Familial‐Psychotic, and Friend‐Psychotic. Further, implications from this psychological autopsy study regarding risk assessment include use of collateral interviews regarding threats and past violence.     

Blast Injury and the Human Skeleton: An Important Emerging Aspect of Conflict‐Related Trauma

Recent decades have seen an accelerating trend in warfare whereby a growing proportion of conflict‐related deaths have been caused by explosions. Analysis of blast injury features little in anthropological literature. We present a review of clinical literature that includes prevalence of injury to anatomical regions and potential indicators of blast injury which can be used by forensic anthropologists. This includes high prevalence of extremity (22.8–91.2%) and facial (19.6–40%) injury in combat contexts, lower limb fractures (19–74.3%) in suicide bombing, traumatic amputation (3–43%) and diffuse fracture patterns in terrorist bombings. Potential indicators of blast trauma include blowout fractures in sinus cavities from blast overpressure, transverse mandibular fractures, and visceral surface rib fractures. Ability to recognize blast trauma and distinguish it in the skeleton is of importance in investigations and judicial proceedings relating to war crimes, terrorism, and human rights violations and likely to become increasingly crucial to forensic anthropology knowledge.     

Evaluation of Non‐Natural Deaths among Veterans: New Mexico Medical Examiner‐Investigated Deaths, 2002–2011

While it is recognized that veterans have increased rates of depression, post‐traumatic stress disorder (PTSD), suicide, and substance use disorders, rates of homicide and unintentional injury deaths in veterans have been minimally investigated. We evaluated all non‐natural deaths in New Mexico veterans between 2002 and 2011 in comparison with non‐natural deaths among non‐veterans. We reviewed all decedents in New Mexico with a history of military service and investigated by the medical examiner, excluding natural deaths and deaths due to fall from standing height. The most common manner of death was unintentional injury (62%), most of these deaths due to motor vehicle accidents (29%) followed by unintentional overdose (26%). Suicide rates among veterans were consistently higher than the general population. The most common mechanism of suicide in men was gunshot wound (72%), and intentional overdose in women (49%). Services are needed for veterans that are tailored to all ages and both sexes.     

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.     

Discrimination of Falls and Blows in Blunt Head Trauma: A Multi‐Criteria Approach

Abstract: In the discrimination of falls versus blows, the hat brim line (HBL) rule is mentioned in several textbooks as the most useful single criterion. Recent studies, however, have found that the HBL rule is only moderately valid and that its use on its own is not recommended. The purpose of this 6‐year retrospective study was to find additional individually useful criteria in the distinction of falls from blows. Overall, the following criteria were found to point toward blows: more than three lacerations, laceration length of 7 cm or more, comminuted or depressed calvarial fractures, lacerations or fractures located above the HBL, left‐side lateralization of lacerations or fractures, more than four facial contusions or lacerations, presence of ear lacerations, presence of facial fractures, and presence of postcranial osseous and/or visceral trauma. Based on the most discriminating criteria, a decision tree was constructed to be potentially applicable to future cases.