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Bo S, Sharp C, Lind M, Simonsen S, Bateman A. Mentalizing mediates the relationship between psychopathy and premeditated criminal offending in schizophrenia: a 6-year follow-up study. Nord J Psychiatry 2023; 77:547-559. [PMID: 36897045 DOI: 10.1080/08039488.2023.2186483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/09/2023] [Accepted: 02/23/2023] [Indexed: 03/11/2023]
Abstract
PURPOSE Research has shown that schizophrenia augments the risk for criminal behaviour and variables both defining- and related to schizophrenia, increase criminal offending. Premeditated criminal offending is considered a severe form of criminal offending, however, very little is known about what predicts future premeditated criminal offending in schizophrenia. METHOD AND MATERIALS In this 6-year follow-up study we explored which factors underlie future premeditated criminal behaviour in a sample of patients diagnosed with schizophrenia (N = 116). We also investigated if a specific mentalizing profile underlie part of the variance of premeditated criminal offending. RESULTS Results showed that psychopathy underlie future premeditated crime in schizophrenia, and that a specific mentalizing profile, comprised of a dysfunctional emotional and intact cognitive mentalizing profile in relation to others, mediated parts of the relation between psychopathy and premeditated criminal offending. Finally, our results indicated that patients with schizophrenia with a specific mentalizing profile (see above) engaged in premeditated criminal behaviour earlier during the 6-year follow-up period compared to patients with other mentalizing profiles. CONCLUSIONS Our findings suggest that mentalization should carefully be inspected in patients with schizophrenia in relation to future premeditated offending.
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Affiliation(s)
- Sune Bo
- Department of Psychology, University of Copenhagen, DK and Department of Psychiatry, Denmark
| | - Carla Sharp
- Department of Psychology, University of Houston, USA
| | - Majse Lind
- Department of Psychology, University of Aalborg, Denmark
| | - Sebastian Simonsen
- Department of Psychology, University of Copenhagen, and Stolpegaard Psychotherapy Centre, Denmark
| | - Anthony Bateman
- Psychoanalysis Unit, University College London, United Kingdom
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Løvgren PJ, Laake P, Narud K, Reitan SK, Bjørkly S. Are symptoms assessed differently for schizophrenia and other psychoses in legal insanity evaluations of violent crimes? BMC Psychiatry 2023; 23:487. [PMID: 37420230 PMCID: PMC10329321 DOI: 10.1186/s12888-023-04992-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 06/30/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Forensic evaluations of legal insanity include the experts' assessment of symptoms present at the mental state examination (MSE) and the mental state at the time of offense (MSO). Delusions and hallucinations are most important. We explored how often symptoms were recorded in written forensic reports. DESIGN This exploratory, cross-sectional study included 500 reports of legal insanity written in 2009-2018 from cases of violent crimes in Norway. The first author read all reports and coded symptoms recorded from the experts' assessments of the offenders. Two co-authors repeated this procedure for 50 randomly selected reports. Interrater reliability was calculated with Gwet's AC1. Generalized Linear Mixed Models with Wald tests for fixed effects and Risk Ratios as effect sizes were used for the statistical analyses. RESULTS Legal insanity was the main conclusion in 23.6% of the reports; 71.2% of these were diagnosed with schizophrenia while 22.9% had other psychotic disorders. Experts recorded few symptoms from MSO, but more from MSE, although MSO is important for insanity. We found a significant association between delusions and hallucinations recorded present in the MSO and legal insanity for defendants with other psychotic disorders, but no association for defendants with schizophrenia. The differences in symptom recordings between diagnoses were significant. CONCLUSION Few symptoms were recorded from the MSO. We found no association between presence of delusions or hallucinations and legal insanity for defendants with schizophrenia. This may indicate that a schizophrenia diagnosis is more important to the forensic conclusion than the symptoms recorded in the MSO.
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Affiliation(s)
- Pia Jorde Løvgren
- Faculty of Medicine, University of Oslo, Oslo, Norway.
- The Regional Centre for Research and Education in Forensic Psychiatry for the South-Eastern Norway Regional Health Authority, Oslo University Hospital, Oslo, Norway.
| | - Petter Laake
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
| | - Kjersti Narud
- Faculty of Medicine, University of Oslo, Oslo, Norway
- The Regional Centre for Research and Education in Forensic Psychiatry for the South-Eastern Norway Regional Health Authority, Oslo University Hospital, Oslo, Norway
| | - Solveig Klæbo Reitan
- Department of mental health, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
- Nidelv Center of Community Mental Health, St. Olav's Hospital, Molde, Norway
| | - Stål Bjørkly
- The Regional Centre for Research and Education in Forensic Psychiatry for the South-Eastern Norway Regional Health Authority, Oslo University Hospital, Oslo, Norway
- Faculty of Health and Social Sciences, Molde University College, Molde, Norway
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Gröning L, Dimitrova S. Criminal insanity in Bulgaria and Norway: Analysing the prospect of a common approach. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2023; 87:101866. [PMID: 36724723 DOI: 10.1016/j.ijlp.2023.101866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
This article raises the question of the prospect of a common approach to mentally ill offenders in Europe, through a comparative discussion of the criminal insanity rules and systems in Norway and Bulgaria. The underlying motivation is to fill a gap in current legal research where the insanity discourse is still to a certain extent nationally oriented. Bulgaria is to date not represented at all in the international discussion of criminal insanity. Starting out from recognizing the different history, rules, culture and welfare of Norway and Bulgaria, the authors argue that these countries have a similar practical understanding of insanity and how it is associated with mental disorders as well as common challenges in their forensic and legal systems. These insights can provide a basis for further comparative explorations concerning a possible harmonization of insanity law in Europe.
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Affiliation(s)
- Linda Gröning
- Faculty of Law, University of Bergen & Regional Centre for Research and Education in Forensic Psychiatry and Psychology, Haukeland University Hospital of Bergen, Norway.
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Sun D, Wang Q, Xu Y. Influencing factors for assessment of criminal responsibility in patients with mental disorders: A forensic case analysis between 2010 and 2020. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2023; 86:101854. [PMID: 36528930 DOI: 10.1016/j.ijlp.2022.101854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND In China, police departments usually initiate assessment of criminal responsibility after patients with mental disorders commit crimes. However, the specific conditions demanding assessment are not clearly stipulated by law. Few studies have been conducted on the epidemiological characteristics and assessment of criminal responsibility in patients with mental disorders. This study aimed to analyze the features and identify influencing factors for assessment of criminal responsibility for patients with mental disorders in a single-center cohort. METHODS Cases undergoing criminal responsibility assessment at the Center of Forensic Science, East China University of Political Science and Law in Shanghai (CFS, ECUPL) between 2010 and 2020 were retrospectively reviewed. Criminal responsibility was categorized as criminal irresponsibility, diminished criminal responsibility, and full criminal responsibility. Differences among the groups were then statistically analyzed. RESULTS In the study period, 437 patients including 361 males (82.61%) were referred for criminal responsibility assessment. Their ages ranged from 15 years to 91 years. After assessment, the number of cases with criminal irresponsibility, diminished criminal responsibility, and full criminal responsibility were 196 (44.85%), 181 (41.42%), and 60 (13.73%), respectively. The Chi-square test and nominal regression analysis showed that influencing factors for assessment of criminal responsibility comprised crime in public places (OR = 14.734; 95% CI: 1.463-148.424), crime in victim's residence (OR = 10.852; 95% CI: 1.068-110.214), crime in suspect's residence (OR = 9.542; 95% CI: 1.046-87.092), forensic psychiatric diagnosis of F1X (OR = 0.014,0.011; 95%CI:0.001-0.261,0-0.5), F2X (OR = 5.75; 95%CI:1.315-23.145), F4X (OR = 0.077; 95%CI:0.016-0.38,) and F6X (OR = 0.112,0.075; 95% CI: 0.022-0.558,0.006-0.959), criminal object of property (OR = 9.989; 95% CI: 1.305-76.455), cases of theft (OR = 0.09, 0.087; 95% CI: 0.013-0.648,0.012-0.654), and cases of endangering public security (OR = 0.152, 0.205; 95% CI: 0.034-0.678, 0.045-0.931). CONCLUSION Crime in public places, suspect's residence and victim's residence, forensic psychiatric diagnosis of F1X, F2X, F4X and F6X, criminal object of property, case types of theft and endangering public security were influencing factors in assessment of criminal responsibility. Therefore, special attention should be paid to patients with mental disorders under such circumstances in order to avoid bias on assessment of criminal responsibility.
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Affiliation(s)
- Daming Sun
- Forensic Science Center, East China University of Political Science and Law, Shanghai, China
| | - Qiang Wang
- Forensic Science Center, East China University of Political Science and Law, Shanghai, China.
| | - Yajun Xu
- Department of psychology, Wannan Medical College, Wuhu, China.
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Fovet T, Baillet M, Horn M, Chan-Chee C, Cottencin O, Thomas P, Vaiva G, D'Hondt F, Amad A, Lamer A. Psychiatric Hospitalizations of People Found Not Criminally Responsible on Account of Mental Disorder in France: A Ten-Year Retrospective Study (2011-2020). Front Psychiatry 2022; 13:812790. [PMID: 35449565 PMCID: PMC9016162 DOI: 10.3389/fpsyt.2022.812790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/17/2022] [Indexed: 12/04/2022] Open
Abstract
Background Criminal responsibility is a key concept in the criminal sanctioning of people diagnosed with mental health disorders who have committed crimes. In France, based on the recommendations of one or more expert psychiatrists, a judge can declare a person not criminally responsible on account of mental disorder (NCRMD) if, at the time of the offense, the person was presenting a psychiatric disorder that abolished or altered his/her capacity for discernment and/or ability to control his/her actions. In such a case, the judge also generally orders an involuntary psychiatric hospitalization. The objectives of this study were to (1) describe longitudinal retrospective administrative data of psychiatric hospitalizations for people found NCRMD, (2) identify the age, sex, and principal diagnoses of these individuals, and (3) characterize the trajectories of their psychiatric care before and after NCRMD psychiatric hospitalization. Methods We used discharge reports from the French national hospital database called Programme de médicalisation des systèmes d'information (PMSI) to gather longitudinal data that describe psychiatric hospitalizations for people found NCRMD between 2011 and 2020, the age, sex, and principal diagnoses of these patients, the length of their hospitalization, and the trajectories of their psychiatric care before and after their NCRMD psychiatric hospitalization. Results We identified 3,020 patients who were hospitalized for psychiatric care after having been found NCRMD between 2011 and 2020. The number of admissions on these grounds has remained stable over this period, ranging from 263 in 2011 to 227 in 2021. They were mostly young men diagnosed with a psychotic disorder (62%). The majority (87%) were hospitalized in general psychiatric hospitals, and only 13% were admitted to maximum-security units (Unités pour malades difficiles, UMD). The median duration of hospitalization for these patients was 13 months. Our results show that 73% of the patients had already been hospitalized prior to their NRCMD hospitalization. The rehospitalization rate within 5 years of discharge from NCRMD psychiatric hospitalization was 62%. Conclusion We conducted the first study investigating the psychiatric hospital treatment of people declared NCRMD in France. There is an urgent need for further studies to investigate the clinical characteristics of these patients.
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Affiliation(s)
- Thomas Fovet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France
- Psychiatry and Addiction Medicine Department, CHU Lille, Lille, France
- Centre national de ressources et de résilience Lille-Paris (CN2R), Lille, France
| | - Maëlle Baillet
- Univ. Lille, Faculté Ingénierie et Management de la Santé, Lille, France
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de santé et des Pratiques médicales, Lille, France
| | - Mathilde Horn
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France
- Psychiatry and Addiction Medicine Department, CHU Lille, Lille, France
| | | | - Olivier Cottencin
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France
- Psychiatry and Addiction Medicine Department, CHU Lille, Lille, France
| | - Pierre Thomas
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France
- Psychiatry and Addiction Medicine Department, CHU Lille, Lille, France
| | - Guillaume Vaiva
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France
- Psychiatry and Addiction Medicine Department, CHU Lille, Lille, France
- Centre national de ressources et de résilience Lille-Paris (CN2R), Lille, France
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France
- Psychiatry and Addiction Medicine Department, CHU Lille, Lille, France
- Centre national de ressources et de résilience Lille-Paris (CN2R), Lille, France
| | - Ali Amad
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France
- Psychiatry and Addiction Medicine Department, CHU Lille, Lille, France
| | - Antoine Lamer
- Univ. Lille, Faculté Ingénierie et Management de la Santé, Lille, France
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de santé et des Pratiques médicales, Lille, France
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Gröning L, Haukvik UK, Morse SJ, Radovic S. Remodelling criminal insanity: Exploring philosophical, legal, and medical premises of the medical model used in Norwegian law. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2022; 81:101776. [PMID: 35101774 DOI: 10.1016/j.ijlp.2022.101776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/06/2022] [Accepted: 01/08/2022] [Indexed: 06/14/2023]
Abstract
This paper clarifies the conceptual space of discussion of legal insanity by considering the virtues of the 'medical model' model that has been used in Norway for almost a century. The medical model identifies insanity exclusively with mental disorder, and especially with psychosis, without any requirement that the disorder causally influenced the commission of the crime. We explore the medical model from a transdisciplinary perspective and show how it can be utilised to systematise and reconsider the central philosophical, legal and medical premises involved in the insanity debate. A key concern is how recent transdiagnostic and dimensional approaches to psychosis can illuminate the law's understanding of insanity and its relation to mental disorder. The authors eventually raise the question whether the medical model can be reconstructed into a unified insanity model that is valid across the related disciplinary perspectives, and that moves beyond current insanity models.
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Affiliation(s)
- Linda Gröning
- Faculty of Law, University of Bergen, University of Bergen, PB 7806 5020, Bergen, Norway; Regional Centre for Research and Education in Forensic Psychiatry and Psychology, Haukeland University Hospital of Bergen, PB 1400, 5021, Bergen, Norway.
| | - Unn K Haukvik
- Department of Mental Health and Addiction, Institute for Clinical Medicine, University of Oslo & Centre for University of Bergen, Norway; Regional Centre for Research and Education in Forensic Psychiatry and Psychology, Oslo University Hospital, PB 4956, Nydalen, 0424 Oslo, Norway.
| | - Stephen J Morse
- Law School & Psychiatry Department, University of Pennsylvania, 3501 Sansom St., Philadelphia, PA 19104-6204, USA.
| | - Susanna Radovic
- Department of Philosophy, Linguistics and Theory of Science & Centre for Ethics, Law and Mental Health, University of Gothenburg, PB 100, SE-405 30 Gothenburg, Sweden.
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Albarbari HS, Al-Awami HM, Bazroon AA, Aldibil HH, Alkhalifah SM, Menezes RG. Criminal behavior and mental illness in the Arab world. J Forensic Sci 2021; 66:2092-2103. [PMID: 34498734 DOI: 10.1111/1556-4029.14882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/15/2021] [Accepted: 08/25/2021] [Indexed: 11/29/2022]
Abstract
Numerous studies have highlighted significant correlations between major psychiatric disorders and criminal behavior. However, the plethora of literature on criminality among patients with major psychiatric disorders originated in the West. The objective of the present paper is to review criminal behavior among individuals with mental illness in Arab countries. Attributes of individuals assessed by forensic psychiatric committees and identifying various aspects that may reinforce criminality among individuals with mental illness were considered. Following the PRISMA guidelines, a systematic review of literature from three databases (Scopus, PubMed, and Web of Science) was carried out. A total of 20 articles were included. The publications span between 1975 and 2020 and originated in seven different Arab countries including Egypt, Kuwait, Iraq, Saudi Arabia, Tunisia, Jordan, and Algeria. Individuals evaluated by forensic psychiatric committees were predominantly males. Excluding substance use disorder, psychotic disorders were the most commonly diagnosed disorders among individuals evaluated by forensic psychiatry committees. Concerning schizophrenia, concomitant substance use and nonadherence to therapy were significantly associated with increased criminality. The review demonstrates that substance use is certainly linked to violence. There is a significant association between mental illness and criminal behavior. Therefore, awareness of different characteristics and risk factors behind criminal behavior among mentally ill offenders could allow us to design and implement effective preventative measures. The Arab's contribution in this field of forensic psychiatry is relatively small. Indeed, further investigation and contributions from the Arab world are required.
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Affiliation(s)
- Hassan S Albarbari
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hashim M Al-Awami
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ali A Bazroon
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hassan H Aldibil
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Salman M Alkhalifah
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ritesh G Menezes
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Abstract
Sense of Agency, the phenomenology associated with causing one's own actions and corresponding effects, is a cornerstone of human experience. Social Agency can be defined as the Sense of Agency experienced in any situation in which the effects of our actions are related to a conspecific. This can be implemented as the other's reactions being caused by our action, joint action modulating our Sense of Agency, or the other's mere social presence influencing our Sense of Agency. It is currently an open question how such Social Agency can be conceptualized and how it relates to its nonsocial variant. This is because, compared with nonsocial Sense of Agency, the concept of Social Agency has remained oversimplified and underresearched, with disparate empirical paradigms yielding divergent results. Reviewing the empirical evidence and the commonalities and differences between different instantiations of Social Agency, we propose that Social Agency can be conceptualized as a continuum, in which the degree of cooperation is the key dimension that determines our Sense of Agency, and how it relates to nonsocial Sense of Agency. Taking this perspective, we review how the different factors that typically influence Sense of Agency affect Social Agency, and in the process highlight outstanding empirical questions within the field. Finally, concepts from wider research areas are discussed in relation to the ecological validity of Social Agency paradigms, and we provide recommendations for future methodology.
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