Deceptive behaviour and instrumental violence among psychopathic and non-psychopathic violent forensic psychiatric patients

Deceptive behaviour and instrumental violence are well-known psychopathic features and as such play important roles in the assessment of psychopathy. This study examined first, the nature of the violence committed by offenders that have been admitted to forensic psychiatric care and whether scores on the Psychopathy Checklist: Screening Version (PCL:SV), Part 1, were associated with the instrumentality of violence. Second, we examined the proneness of offenders to re-frame the instrumentality in their past violent crimes, and whether this was associated with scores on the PCL:SV. The results show that the PCL:SV, Part 1 (interpersonal/affective features), was positively related to the officially coded instrumentality of the violent crimes. As expected, this association disappeared when the instrumentality was self-reported. However, the majority of the patients tended to exaggerate the reactivity of their violent crimes when it was self-reported, indicating that most offenders, independently of level of psychopathy, used deception when questioned about the characteristics of their past violent crimes. The reasons for, and implications of, the use of deception are discussed.     

35例性心理障碍的法医学鉴定分析

目的分析性心理障碍患者的医学和心理状况，总结该类案件的法医学鉴定体会。方法对35例经过调查取证、智力测验、MMPI测验的性心理障碍被鉴定人作回顾性分析。结果性心理障碍患者的智能多正常，存在不同程度的情绪和人格异常，以抑郁、强迫、焦虑、偏执、癔病、精神衰弱和病态人格为主；责任能力评定与被鉴定人的童年期性取向教育、恋爱经历、夫妻性关系、性心理障碍类型有关。结论性心理障碍患者发生特定犯罪行为的心理学机制不同于普通犯罪人群，评定责任能力不宜等同于正常犯罪。     

女精神病人的性防卫能力鉴定

目的　研究女性精神病人性防卫能力的特点和司法鉴定中应该注意的问题 ;方法　对过去 1 0年间鉴定过的 64例案例进行回顾总结 ;结果　性防卫能力丧失最常见于年轻的衰退期青春型精神分裂症病人、中度以上精神发育迟滞病人、首次发病的年轻轻型躁狂症病人 ,而其他类型的精神病人不容易发生性防卫能力丧失。结论　严重的智能障碍和情感障碍对于精神病人的性防卫能力的丧失有决定性作用 ;而且 ,病人对性行为的控制能力障碍对精神病人性防卫能力丧失有重要影响作用     

72例情感性精神障碍司法精神病鉴定分析

目的 探讨情感性精神障碍患者作案特征.方法 对杭州市公安局安康医院2000-2004年鉴定的72例情感性精神障碍案例进行分析.结果 情感性精神障碍患者作案与发作次数有一定关联性,躁狂症与抑郁症危害行为有统计学意义(P<0.01).情感性障碍患者作案特征与精神分裂症不同,主要是作案的病理性动机较少,现实动机较多.结论 反复发作是情感性精神障碍患者作案的预警性指标.在作案特征上与精神分裂症有各自不同的特点,可能与病因、病情发展、症状表现和严重程度等差异有关.     

道路交通事故所致精神损害的法医学评价

目的研究RTA所致PTSD的相关法医学问题,为司法实践中精神损害赔偿提供科学依据和司法建议。方法对156例因RTA申请伤残程度鉴定的被鉴定人,通过临床精神病学检查确定PTSD的诊断,法医临床学检查评定躯体损伤的伤残程度,并通过问卷调查进一步确定受害人的心理社会状态。结果156例被调查对象PTSD发生率为51.92%。男女PTSD的发生率具有统计学的显著性差异;随着伤残程度的严重性增加,发生PTSD的可能性也随着增加;PTSD组与非PTSD组在生活质量总均分和生理、心理、社会关系、环境四个维度以及焦虑、抑郁的各项得分中都有显著性差异;获得赔偿将明显降低PTSD的发生率。结论RTA作为创伤性事件,申请赔偿的RTA受害人存在较高的PTSD发生率,获得良好的赔偿可以明显地降低申请赔偿的RTA受害人PTSD的发生率。     

The prevalence of violence and relation to depression and illicit drug use among incarcerated women in Recife, Brazil

PurposeTo assess the prevalence and different types of violence experienced by women prisoners in Brazil and the effects of violence on women's depression and illicit drug use.MethodsParticipants (N = 377) were incarcerated women from a state prison in a northeastern city of Brazil. Multivariate logistic regression models (adjusted for age, education, partner status, prison history, drug related offense, and sentencing status) were used to assess associations between each type of violence (physical abuse, sexual abuse, and life threats) and each outcome variable: recent depression and illicit drug use.ResultsThe majority of participants (87%) reported experiencing some type of violence in their lifetime, including physical violence (83%), sexual victimization (36%), and threats on their life (29%.) Sexual violence was significantly related to both recent depression (Odds Ratio (OR) = 2.8; 95% Confidence Interval (CI) = 1.4–5.3) and recent substance use (OR = 2.7; 95% CI = 1.6–4.4) in adjusted models. Experiences of life threats were also significantly associated with illicit drug use (OR = 2.2; 95% CI: 1.3–3.7), as was physical violence (OR = 2.4; 95% CI: 1.2–4.9); however, neither of these latter two violence variables were significantly associated with depression.ConclusionReports of lifetime violence victimization among this incarcerated sample of women were extremely prevalent and relevant to women's depression and illicit drug use. Prison efforts to address women's depression and illicit drug use may be most effective by incorporating aspects related to women's history of victimization, especially given the high rates of violence experienced by women in this sample.     

Forty-five revolutions per minute: a qualitative study of Hybrid Order use in forensic psychiatric practice

Psychiatrists who recommend a Hybrid Order (Section 45A) as a disposal option at the point of sentencing accept that the convicted individual, as well as being mentally disordered and in need of treatment, is also culpable and deserving of criminal punishment. Ethical and clinical concerns have typically limited its clinical use. However, in 2015 the Court of Appeal specified in R v Vowles and others that the Hybrid Order disposal should be considered first in terms of potential mental health disposals. This judgement sets a high threshold for the use of the hospital order which has been the bedrock of inpatient forensic psychiatric practice since 1983. This study sought to explore the attitudes of consultant forensic psychiatrists towards the use of the Hybrid Order in the wake of the Vowles judgement. We interviewed 12 consultant forensic psychiatrists with longstanding experience of psychiatric sentencing recommendations. We found that the majority of consultants considered the Hybrid Order to be a valuable disposal option when used under specific circumstances. However, significant concerns were raised about its use in those with an enduring psychotic illness. Community aftercare arrangements for Hybrid Order disposals were viewed as inferior to community aftercare arrangements for Section 37/41 patients.