Crime and Violence in Older Adults: Findings From the 2002 to 2017 National Survey on Drug Use and Health

Criminal behavior in alcohol-related dementia and Wernicke-Korsakoff syndrome: a Nationwide Register Study

BACKGROUND

Chronic heavy alcohol use may lead to permanent brain damage, cognitive impairment, and dementia. While the link between alcohol use and crime is strong, virtually no research exists on the criminal behavior of patients with the alcohol-related neurocognitive disorders of Wernicke-Korsakoff syndrome (WKS) and alcohol-related dementia (ARD).

METHODS

The study population included all persons diagnosed with WKS (n = 1149) or ARD (n = 2432) in Finland in 1998-2015. Data on diagnoses, mortality, and crime were obtained from Finnish nationwide registers. Crime incidences were calculated 4 years before and after diagnosis. Crime types, incidences, and mortality were compared between disorders and with the general population.

RESULTS

Altogether 35.6% of WKS patients and 23.6% of ARD patients had committed crimes in the 4 years preceding diagnosis, most commonly property and traffic crimes, followed by violent crimes. The incidence of criminal behavior decreased significantly after diagnosis; in WKS patients, the standardized criminality ratio (SCR), the ratio of observed to expected number of crimes (95% CI), was 3.91 (3.72-4.10) in 4 years before and 2.80 (2.61-3.00) in 4 years after diagnosis. Likewise, in ARD patients, the SCRs were 2.63 (2.51-2.75) before and 0.84 (0.75-0.92) after diagnosis. No significant difference emerged in mortality between persons with and without a criminal history.

CONCLUSIONS

Persons with alcohol-related neurocognitive disorders frequently engage in criminal behavior prior to diagnosis, especially multiple offending. In the 4 years before and after diagnosis, crime rates declined in a linear fashion, with a marked reduction after diagnosis.

Surviving Senior Psychopathy: Informant Reports of Deceit and Antisocial Behavior in Multiple Types of Relationships

A prevailing view among researchers and mental health clinicians is that symptoms of antisocial personality disorder (ASPD)/psychopathy decrease as affected individuals reach middle age. In the current investigation, informants were surveyed about the behavior of individuals who they believed showed traits of ASPD/psychopathy and were over the age of 50. A final sample of 1,215 respondents rated the index individuals according to the ASPD/psychopathy traits derived from the pre-publication first draft of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, revealing high endorsement of traits associated with ASPD. Survey respondents reported their observations that individuals who met a threshold for putative ASPD/psychopathy continued to engage in antisocial behavior after age 50, and as a result the respondents endured significant harm, including material losses, financial losses, and various self-reported mental health problems. Those who knew the index individuals both before and after the age of 50 were specifically asked whether there was a change in the individual's engagement in manipulation, deceit, and antisocial behavior; 93% of respondents reported that the behavior was just as bad or worse after age 50. Other researchers have suggested that the DSM diagnostic criteria do not accurately describe ASPD/psychopathy symptoms and behavior in older adults, and that the disorder remains stable, but its manifestation changes with age. This study supports those conclusions.

Self-reported and general practitioner recorded indicators of lifetime health up to age 48 according to offender type in the Cambridge Study in Delinquent Development

BACKGROUND

Previous research has suggested that people with a history of offending have worse health compared to non-offenders, but it is less clear whether all types of offenders are at similar health risks. In a New Zealand birth cohort study, Moffitt evidenced three main offending trajectories-life-course-persistent (LCP), adolescence-limited (AL) and late-onset (LO) offending, subsequently confirmed in other substantial longitudinal studies.

AIMS

Our aim was to explore the relationship between these offending trajectories and both self-reported (SR) and general practitioner (GP) (primary care) recorded health indicators.

METHODS

Self-reported medical data at age 48 were obtained for 394 men followed since age 8 years in the Cambridge Study in Delinquent Development. In addition, medical records were obtained from GPs for 264 of them. Health indicators from both sources were compared between each of the three established trajectories of offenders across the life course-LCP, AL, LO and the non-offenders.

RESULTS

LCP offenders were found to have over twice the likelihood of disabling medical conditions according to both self-report and GP records. They were also more likely to have GP records indicating mental health problems and treatment for them. According to GP records alone, the LO offenders were also more likely to have mental health problems. The health of AL offenders appeared to be no different from that of the crime-free controls.

CONCLUSIONS

Our findings add weight to the growing evidence that LCP offending and offending that only occurs relatively late in life are likely to be the indicators of generally unhealthy and disrupted lives. This suggests that if lifestyle is to change for the better, interventions are likely to be needed for health as well as antisocial behaviour.