| 1. |
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| 2. |
- Dåderman, Anna Maria, 1953-, et al.
(författare)
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Degree of psychopathy : implications for treatment in male juvenile delinquents
- 2003
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Ingår i: International Journal of Law and Psychiatry. - Oxford : Pergamon Press. - 0160-2527 .- 1873-6386. ; 26:3, s. 301-315
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Tidskriftsartikel (refereegranskat)abstract
- Longitudinal studies have consistently shown that psychopathy in adulthood has its roots in childhood. The psychopathy concept described by Cleckley (1976) involves interpersonal, affective, and behavioral aspects. Moreover, children who show low levels of anxiety respond more poorly to treatment. The aim of the present study was to assess psychopathy in 56 male juvenile delinquents with conduct disorder, treated in youth correctional institutions for severe offenders. We used a modified Psychopathy Checklist-Revised (PCL-R) that has been used for young people (Forth et al., 1990). Each participant received PCL-R assessments from one rater, based on the file information and an extensive interview. Twenty-eight participants (50%) were rated by the second rater. Both the ICC and Cohens’s kappa revealed that the PCL-R ratings were reliable: the ICC(2,1) of the PCL-R total scores was 0.90, F(27, 28) = 11.70, P < .0001; Cohen’s kappa = 0.64, P < .001. The final scores on the PCL-R showed that the base rate for psychopathy (defined as a score of 30 or more) in the sample was 59% (33 of 56 juvenile delinquents). The mean PCL-R total score for all 56 participants was 29.3 (S.D. = 7.8), and ranged between 12 and 40. The high rates of psychopathy found in juvenile delinquents with conduct disorder should alert clinicians to the necessity of psychopathy scoring, and shows that high-quality treatment programs are needed. Psychopathy is not currently considered when assessing and treating young people in state-administered observational and correctional institutions for juvenile delinquents in Sweden.
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| 3. |
- af Klinteberg, Britt, et al.
(författare)
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Projective risk variables in early adolescence and subsequent disinhibitory psychopathology
- 2008
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 31:3, s. 210-218
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to examine early adolescent projective risk indicators for the development of antisocial behaviour as related to adult personality traits, psychopathy, and violent behaviour over the life span. Assessment data included Rorschach (Rr) ratings (at age 11-14 years), personality inventories (EPQ-I and KSP scales), and a shortened Psychopathy Check List (PCL) (administered at age 32-40 years), obtained from a group of 199 male subjects; and smoking habits (at age 36-44 years) obtained from 125 of those subjects. Results, controlled for intelligence, indicated that the high and very high risk groups, as determined by level of total Rr risk scores, were (1) significantly higher on self-rated IVE Impulsiveness, the anxiety-related KSP Muscular Tension, and nonconformity traits, as compared to the low Rr risk group - the very high risk group also scoring significantly higher on the EPQ Psychoticism scale, related to aggressiveness and cruelty; (2) higher on clinically rated PCL total sum and factor scores; and (3) they were overrepresented among Ss with subsequent violent offence, and Ss with heavy smoking habits. The results are discussed in terms of the possible usefulness of psychodynamic oriented cognitive-emotional indicators in the search for underlying mechanisms in the development of disinhibitory psychopathology.
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| 4. |
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| 5. |
- Anckarsäter, Henrik, 1966
(författare)
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Beyond categorical diagnostics in psychiatry: Scientific and medicolegal implications.
- 2010
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Ingår i: International journal of law and psychiatry. - : Elsevier BV. - 1873-6386 .- 0160-2527. ; 33:2, s. 59-65
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Tidskriftsartikel (refereegranskat)abstract
- Conforming to a medical disease model rooted in phenomenology and natural science, psychiatry classifies mental disorders according to signs and symptoms considered to be stable and homogeneous across individuals. Scientific studies addressing the validity of this classification are scarce. Following a seminal paper by Robins and Guze in 1970, validity of categories has been sought in specific criteria referring to symptoms and prognosis, aggregation in families, and "markers", preferentially laboratory tests. There is, however, a growing misfit between the model and empirical findings from studies putting it to the test. Diagnostic categories have not been shown to represent natural groups delineated from the normal variation or from each other. Aetiological factors (genetic and/or environmental), laboratory aberrations, and treatment effects do not respect categorical boundaries. A more adequate description of mental problems may be achieved by: 1) a clear definition of the epistemological frame in which psychiatry operates, 2) a basic rating of the severity of intra- and interpersonal dysfunctions, and 3) empirical comparisons to complementary rather than exclusive dimensions of inter-individual differences in context-specific mental functions, treatment effects, and laboratory findings. Such a pluralistic understanding of mental health problems would fit empirical models in the neurosciences and postmodern notions of subjectivity alike. It would also clarify the assessment of dysfunction and background factors in relation to the requisites for penal law exemptions or insurance policies and make them empirically testable rather than dependent on expert opinion on issues such as whether a specific dysfunction is "psychiatric", "medical", or ascribable to "personality".
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| 6. |
- Anckarsäter, Henrik, 1966, et al.
(författare)
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Mental disorder is a cause of crime: The cornerstone of forensic psychiatry
- 2009
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 32:6, s. 342-347
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Tidskriftsartikel (refereegranskat)abstract
- The assumption that mental disorder is a cause of crime is the foundation of forensic psychiatry, but conceptual. epistemological. and empirical analyses show that neither mental nor crime, or the causation implied, are clear-cut concepts. "Mental" denotes heterogeneous aspects of a per-son such as inner experiences. cognitive abilities, and behaviour patterns described in a non-physical vocabulary. In psychology and psychiatry, mental describes law-bound, caused aspects of human functioning that are predictable and generalizable. Problems defined as mental disorders are end-points of dimensional inter-individual differences rather than natural categories. Deficits in cognitive faculties, such as attention, verbal understanding, impulse control, and reality assessment, may be susceptibility factors that relate to behaviours (Such as crimes) by increasing the probability (risk) for a negative behaviour or constitute causes in the sense of INUS conditions (insufficient but Non-redundant parts of Unnecessary but Sufficient conditions). Attributing causes to complex behaviours such as crimes is not an unbiased process, and mental disorders will attract disproportionate attention when it comes to explanations of behaviours that we wish to distance ourselves from. Only by rigorous interpretation of what psychiatry actually can inform us about, using empirical analyses of quantified aggressive antisocial behaviours and their possible explanatory factors, can we gain a clearer notion of the relationship between mental disorder and crime. (C) 2009 Elsevier Ltd. All rights reserved.
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| 7. |
- Andershed, Henrik, et al.
(författare)
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Does the three-factor model of psychopathy identify a problematic subgroup of young offenders?
- 2008
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 31:3, s. 189-198
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Tidskriftsartikel (refereegranskat)abstract
- The present study tests the utility of the personality-based three-factor model of psychopathy according to the Hare Psychopathy Checklist: Screening Version (PCL:SV). This model of psychopathy excludes aspects of criminal behavior as opposed to other models of psychopathy. The main research question was to what extent the three-factor model of psychopathy can identify a problematic subgroup of young offenders. The sample consisted of 148 incarcerated young male criminal offenders, between 15 and 25 years of age (mean=19.07, SD=2.11) who were recruited from a central detention center for young offenders in a northern German county. Model-based cluster analysis of the three psychopathy factors showed that three different clusters labeled: (i) Unemotional/Impulsive-Irresponsible, (ii) Low traits, and (iii) Psychopathic personality, had the best fit to the data. The psychopathic personality cluster with high scores on all three factors of the PCL:SV exhibited, as expected, a significantly higher prevalence of conduct disorder and substance use problems, but was not significantly different from the other clusters on past criminality and previous incarcerations. In conclusion, the results showed that the three-factor model of psychopathy can be useful in identifying a problematic subgroup of young offenders. (C) 2008 Published by Elsevier Inc.
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| 8. |
- Bergenheim, Åsa, 1954-
(författare)
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Sexual assault, irresistible impulses, and forensic psychiatry in Sweden
- 2014
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier. - 0160-2527 .- 1873-6386. ; 37:1, s. 99-108
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Tidskriftsartikel (refereegranskat)abstract
- After forensic psychiatry was firmly established in Sweden in the 1930s, many rapists and individuals charged with assaulting children underwent a forensic psychiatric examination. The physicians found that most of them had not been “in control” of their senses or not “in complete control” of their senses at the time of the crime. If the court ordered a forensic psychiatric examination, the defendant had a very good chance of either being discharged or having his sentence reduced considerably. By the 1950s psychological perspectives began to dominate in forensic psychiatry. In the forensic records of the 1950s we can notice a shift from a biomedical to a socio-psychological perspective, and crime was increasingly related to conditions that were not seen as mental derangement from a legal point of view. As a result, it became less and less common, from the 1950s onwards, for sentences to be commuted or defendants discharged.
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| 9. |
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| 10. |
- Dahlin, Moa Kindstrom, et al.
(författare)
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Mentally disordered criminal offenders : Legal and criminological perspectives
- 2009
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 32:6, s. 377-382
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Tidskriftsartikel (refereegranskat)abstract
- Legal research in Sweden has traditionally focused on a systematization of the legal rules and their practical application, while the task of studying the effects of the application of the laws has been handed over to other branches of the social sciences. In contrast, new legal theories focusing on proactive and therapeutic dimensions in law have gained increasing attention in the international arena. These approaches may be better suited for evaluating legislation governing compulsory psychiatric care. Theoretical discussions and studies of causal mechanisms underlying criminal behaviour, as well as the implementation and value of instruments for predicting behaviour, are relevant to contemporary criminological research. Criminal behaviour varies across different groups of perpetrators, and the causes can be sought in the interplay between the individual and social factors. Multi-disciplinary efforts, integrating research from forensic psychiatry, psychology, sociology, and criminology, would be beneficial in leading to a better understanding of the causes underlying criminal behaviour.
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| 11. |
- Diesen, Christian, et al.
(författare)
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Sex crime legislation : Proactive and anti-therapeutic effects
- 2010
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 33:06-maj, s. 329-335
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Tidskriftsartikel (refereegranskat)abstract
- Therapeutic jurisprudence may have its major role within law practice, but analysis of the law from a therapeutic perspective is a task that should not be neglected: how a piece of legislation is designed and formulated certainly influences the therapeutic outcome of a legal process. This article uses sex legislation as an example to demonstrate how the old rape law based on coercion has anti-therapeutic effects on rape victims. If the law requires resistance, it implies that a woman is sexually available until she resists physically, resulting in an attitude that a woman reporting rape without injuries should be mistrusted. This mistrust of the victim and the victim's attendant feelings of self-blame aggravate the victim's trauma. On the other hand, a modern rape law based on lack of consent gives the signal that a woman is not available until she has given her consent, resulting in a different starting position for the investigation. Since the will of the victim must be respected, the victim herself must be respected in the legal process. Furthermore, being able to tell one's story in a respectful atmosphere can be more important for the well-being of the victim than the outcome of the reported case.
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| 12. |
- Dåderman, Anna Maria, 1953-, et al.
(författare)
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Psychopathy-related personality traits in male juvenile delinquents : an application of a person-oriented approach
- 2004
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Ingår i: International Journal of Law and Psychiatry. - Göttingen : Elsevier. - 0160-2527 .- 1873-6386. ; 27:1, s. 45-64
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Tidskriftsartikel (refereegranskat)abstract
- Some personality characteristics, such as impulsiveness, thrill seeking, and the need for change, are clearly relevant when studying psychopathy. Psychopaths are certainly avid sensation seekers. The primary aim of the present study was to identify common patterns with respect to psychopathy-related personality traits in a sample of 56 juveniles from four Swedish national correctional institutions for juvenile delinquents. Karolinska Scales of Personality (KSP), the Impulsiveness scale from the Impulsiveness–Venturesomeness–Empathy (IVE) inventory and the Total Sensation-Seeking scale from the SSS-V were used to determine personality traits. Cluster analysis was performed with SLEIPNER. Ward’s hierarchical minimum variance clustering method was used. We discovered seven clusters of participants. The mean T scores of the profiles of personality traits in the clusters (the cluster centroids) have been used to describe the clusters. Three multideviant clusters emerged, into which 31 (63%) of the classified participants could be placed. To describe the clusters, the prevalence of participants with a high degree of psychopathy (cutoff PCL-R score 27or above) was computed for each cluster and was complemented with data on previous treatment occasions and reoffending. The results indicated that psychopaths may develop different personality pattern; each cluster contained participants with high values of the PCL-R. Deviant personality is not currently considered when assessing and treating people in state administered observational and correctional institutions for juvenile delinquents in Sweden. The present results suggest that young people with psychopathy are not a homogenous group but may develop various personality traits. This should have implications for risk assessment and treatment.
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| 13. |
- Grann, Martin, et al.
(författare)
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Methodological development : structured outcome assessment and community risk monitoring (SORM)
- 2005
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 28:4, s. 442-456
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Tidskriftsartikel (refereegranskat)abstract
- This paper describes an effort to develop a clinical tool for the continuous monitoring of risk for violence in forensic mental health clients who have left their institutions and who are dwelling in the community on a conditional release basis. The model is called Structured Outcome Assessment and Community Risk Monitoring (SORM). The SORM consists of 30 dynamic factors and each factor in SORM is assessed in two ways: The current absence, presence or partial och intermittent presence of the factors, which is an actuarial (systematized and 'objective') assessment. Secondly, the risk effect, i.e. whether the presence/absence of factors currently increases, decreases or is perceived as unrelated to violence risk, is a clinical (or impressionistic) assessment. Thus, the factors considered via the SORM can be coded as risk factors or protective factors (or as factors unimportant to risk of violence) depending on circumstances that apply in the individual case. Further, the SORM has a built-in module for gathering idiographical information about risk-affecting contextual factors. The use of the SORM and its potential as a risk monitoring instrument is illustrated via preliminary data and case vignettes from an ongoing multicenter project. In this research project, patients leaving any of the 9 participating forensic hospitals in Sweden is assessed at release on a variety of static background factors, and the SORM is then administered every 30 days for 2 years.
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| 14. |
- Grazier, Kyle L, et al.
(författare)
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Rationing psychosocial treatments in the United States
- 2005
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier. - 0160-2527 .- 1873-6386. ; 28:5, s. 545-560
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Tidskriftsartikel (refereegranskat)abstract
- This paper briefly reviews the recent history of psychosocial treatment for adults with severe mental illnesses in the United States. It examines the current sources and financing of such care, revealing the planned and unplanned reclassification of entitled beneficiaries and eligible patients, appropriate treatment, acceptable outcomes, and levels and sources of payment. One illustration of this phenomenon is seen in current efforts to identify and deliver only those public services that are covered by Medicaid, so as to allocate state resources only when they can be matched by federal monies. Another is the reliance on private health insurance, tied in the U.S. almost exclusively to employment, for medical care delivered under an acute, rather than a chronic care model. These analyses conclude with a discussion of the implicit and explicit mechanisms used to ration access to psychosocial treatment in the United States. The implications for individuals with serious mental illnesses, their families, and the general public are placed in historical and current policy contexts, recognizing the economic, social, and clinical variables that can moderate outcomes.
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| 15. |
- Höglund, Pontus, et al.
(författare)
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Accountability and psychiatric disorders: How do forensic psychiatric professionals think?
- 2009
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Ingår i: International journal of law and psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 32:6, s. 355-361
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Tidskriftsartikel (refereegranskat)abstract
- Swedish penal law does not exculpate on the grounds of diminished accountability; persons judged to suffer from severe mental disorder are sentenced to forensic psychiatric care instead of prison. Re-introduction of accountability as a condition for legal responsibility has been advocated, not least by forensic psychiatric professionals. To investigate how professionals in forensic psychiatry would assess degree of accountability based on psychiatric diagnoses and case vignettes, 30 psychiatrists, 30 psychologists, 45 nurses, and 45 ward attendants from five forensic psychiatric clinics were interviewed. They were asked (i) to judge to which degree (on a dimensional scale from 1 to 5) each of 12 psychiatric diagnoses might affect accountability, (ii) to assess accountability from five case vignettes, and (iii) to list further factors they regarded as relevant for their assessment of accountability. All informants accepted to provide a dimensional assessment of accountability on this basis and consistently found most types of mental disorders to reduce accountability, especially psychotic disorders and dementia. Other factors thought to be relevant were substance abuse, social network, personality traits, social stress, and level of education.
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| 16. |
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| 17. |
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| 18. |
- Kindström Dahlin, Moa, et al.
(författare)
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Swedish Legal Scholarship Concerning Protection of Vulnerable Groups : Therapeutic and Proactive Dimensions
- 2010
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 33:5-6, s. 398-405
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents a brief overview of the legal theoretical problems that arise in connection with the societal ambition of protecting vulnerable groups. One of the central difficulties in legislation with proactive and therapeutic ambitions arises from the link between law and philosophy of science, i.e., the relationship between facts and norms. It is shown that Therapeutic Jurisprudence differs in several aspects from Swedish legal scholarship that follows Scandinavian Legal Realism. It is also demonstrated that Therapeutic Jurisprudence has several similarities with the so-called Proactive Approach. This paper suggests that Therapeutic Jurisprudence may serve as a useful legal theoretical perspective in Swedish legal scholarship, especially when studying complex and vague regulations with a future focus. Two examples from Swedish legislation are examined: (a) Laws regulating compulsory care of abused or neglected children, and (b) laws related to the mentally ill. This paper illustrates the complexity in these acts, and poses the question of whether the regulations serve their purpose of providing adequate care for and protection of those in need.
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| 19. |
- Kjellin, Lars, et al.
(författare)
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Compulsory psychiatric care in Sweden : development 1979-2002 and area variation
- 2008
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Ingår i: International Journal of Law and Psychiatry. - Amsterdam : Elsevier. - 0160-2527 .- 1873-6386. ; 31:1, s. 51-59
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Tidskriftsartikel (refereegranskat)abstract
- As in many other countries, the Swedish legislation on compulsory psychiatric care has been revised several times during the last four decades. Great regional differences within the country in the use of compulsory psychiatric care have been reported. The aims of this study were to describe the development of compulsory psychiatric care in Sweden 1979–2002, and to analyse differences between two groups of counties, one group with high and one with low civil commitment rates, in terms of psychiatric care structure, resources and processes. Data on civil commitments and forensic psychiatric care in Sweden 1979–2002 were collected from public statistics. At least one responsible person in leading position (administrative manager or chief psychiatrist) in each of the included counties was interviewed. The total number of involuntarily hospitalised patients decreased about 80% between censuses in 1979 and 2002, but the rates of forensic patients were unchanged. No clear-cut differences were found in the analyses of structure, resources and processes of psychiatric services between counties with high and counties with low levels of compulsory care. The equality before the law may be questioned. The importance of leadership is emphasised for future analyses.
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| 20. |
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| 21. |
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| 22. |
- Laurell, Jenny, et al.
(författare)
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Psychopathy (PCL-R) in a forensic psychiatric sample of homicide offenders : Some reliability issues
- 2007
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 30:2, s. 127-135
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Tidskriftsartikel (refereegranskat)abstract
- Several studies have shown that psychopathy is overrepresented among homicide offenders. There is a consensus that Hare's Psychopathy Checklist-Revised PCL-R is currently the most valid and useful tool for rating psychopathy (e.g., [Fulero, S. M. (1995). Review of the Hare Psychopathy Checklist-Revised. In J. C. Conoley & J. C. Impara (Eds.), Twelfth Mental Measurements Yearbook (pp. 453-454). Lincoln, NE: Buros Institute]). Usually, when making a rating of psychopathy, both an interview and an examination of the subject's files are used. However, it has been discussed what is really required to be able to rate psychopathy in a reliable manner. The aim of the present study was to retrospectively rate the degree of psychopathy in 35 homicide offenders being subjected to forensic psychiatric assessment. These ratings of psychopathy were carried out using forensic psychiatric files and courts'; verdicts only. Another aim was to examine the reliability of PCL-R in this specific Swedish sample of homicide offenders. There was a good agreement between the two raters with respect to the categorical diagnosis of psychopathy (Cohen's kappa=.81, p<.001), which indicates that retrospective ratings of psychopathy are well suited for research purposes. The prevalence of psychopathy among the homicide offenders was 31.4% (using a cut-off score of 30), which means that the construct of psychopathy may contribute to the understanding of the phenomenon of homicide. In the planning of treatment for homicide offenders, a consideration of possible psychopathy is necessary. As criminal psychopaths are known to relapse into violent criminality, it is very important that they are given efficient treatment, placement and management.
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| 23. |
- Levin, Sara, 1974-, et al.
(författare)
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Adherence to planned risk management interventions in Swedish forensic care : What is said and done according to patient records
- 2019
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier. - 0160-2527 .- 1873-6386. ; 64, s. 71-82
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Tidskriftsartikel (refereegranskat)abstract
- Both structured and unstructured clinical risk assessments within forensic care aim to prevent violence by informing risk management, but research about their preventive role is inconclusive. The aim of this study was to investigate risk management interventions that were planned and realized during forensic care by analysing patient records. Records from a forensic clinic in Sweden, covering 14 patients and 526 months, were reviewed. Eight main types of risk management interventions were evaluated by content analysis: monitoring, supervision, assessment, treatment, victim protection, acute coercion, security level and police interventions. Most planned risk management interventions were realized, both in structured and clinical risk assessments. However, most realized interventions were not planned, making them more open to subjective decisions. Analysing risk management interventions actually planned and realized in clinical settings can reveal the preventive role of structured risk assessments and how different interventions mediate violence risk.
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| 24. |
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| 25. |
- Maycraft Kall, Wendy Katherine, 1962-
(författare)
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Same law - same rights? : Analyzing why Sweden's disability legislation failed to create equal rights in mental health
- 2014
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Ingår i: International Journal of Law and Psychiatry. - Oxford : Pergamon Press. - 0160-2527 .- 1873-6386. ; 37:6, s. 609-618
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Tidskriftsartikel (refereegranskat)abstract
- This article analyzed the apparent paradox of disability rights in Sweden. Despite strong welfare state traditions and stated Government ambitions to create generous statutory entitlements for all disabled people using a single, comprehensive Disability Act, psychiatric disabilities were principally excluded from the Disability Act's rights and provisions. The study focused on Sweden's Mental Health Reform and Disability Reform using governance perspectives that traced and analyzed the policy-processes of both reforms. Theoretically guided analytical frameworks were developed to help understand the divergent reform outcomes. The first focused on legislative arguments of regulatory specificity and legal enforcement mechanisms to consider whether the Disability Act was formulated in a manner that was easier to apply to certain disabilities. The second analyzed ideological arguments and the influence of Government political beliefs that signaled specific reform ‘visions’ to implementers and thereby influenced policy implementation. The main findings are that both perspectives matter as the dual influences of legislative and ideological differences tended to exclude mental health service users from the Act's generous disability rights. The overall conclusion was that while legislation was an important regulatory mechanism, the Government's underlying ideological reform vision was also an essential governance instrument that signaled Government intentions to implementing agencies and thus influenced the creation of enduring disability rights.
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| 26. |
- Noland, Ebba, et al.
(författare)
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Historical, clinical and situational risk factors for post-discharge recidivism in forensic psychiatric patients – A Swedish registry study
- 2021
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier. - 0160-2527 .- 1873-6386. ; 79
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate which factors, known at the time of discharge, correlate with post-discharge recidivism in forensic psychiatric patients in Sweden.Subjects and methods: A database was constructed based on registry data taken from the Swedish National Forensic Psychiatric Register, as well as data on post-discharge convictions sourced from the National Council of Crime Prevention and demographic data from Statistics Sweden. The sample consisted of all individuals discharged from forensic psychiatric services in Sweden during 2009–2018 (n = 1150), and the follow-up period was 2009–2018. Survival analyses were used to investigate predictors of an increased likelihood for recidivism using both bivariate comparisons and multivariate Cox regression analyses.Results: The Cox regression analyses showed that out of the demographic background factors, higher age at discharge was significantly associated with a lower likelihood of recidivism within the follow-up period. The two discrete historical factors of having a history of substance abuse and having been sentenced before the index crime, and the clinical factor of presence of personality disorder without the presence of psychosis were associated with an increase in the likelihood of recidivism. The situational factors of having a trustee or limited guardian and main living accommodation being supported living were associated with a decrease in the likelihood of recidivism. The results support previous research regarding historical and pre-treatment factors, but also show that situational factors related to increased support and supervision in everyday life are associated with a decreased likelihood of recidivism. This knowledge may help the administrative courts and forensic psychiatric services to prevent future recidivism.
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| 27. |
- Nordström, Annika, et al.
(författare)
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Schizophrenia and violent crime: The experience of parents
- 2006
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 29:1, s. 57-67
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Tidskriftsartikel (refereegranskat)abstract
- Individuals with schizophrenia have an increased risk of committing a violent crime, although their contribution to the overall criminality in society is small. In this qualitative study we have interviewed parents of adult sons, diagnosed with schizophrenia and who recently had been referred to forensic psychiatric treatment due to a violent crime, with an aim to explore the parents' experiences and emotional reactions. Four events, or status passages, emerged as crucial and common for all parents. These were the onset of the mental disorder, the diagnosis of schizophrenia, the violent behaviour/criminality and the recent referral to forensic psychiatric treatment. Every passage evoked strong emotional reactions such as guilt, fear, disappointment, anger and relief, which in return led to different actions taken. Unawareness of the character and severity of their sons' mental illness and the type of violent criminality they had committed were common and complicated contacts both between the parents and their sons, and also between family members and official authorities. The findings emphasize that psychiatric healthcare professionals must take the initiative and responsibility for information, education and support of family members.
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| 28. |
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| 29. |
- Radovic, Susanna, 1969, et al.
(författare)
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Explanations for violent behaviour - An interview study among forensic in-patients
- 2014
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 37:2, s. 142-148
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Tidskriftsartikel (refereegranskat)abstract
- The alleged relation between mental disorder and violent criminal behaviour has been investigated mainly from an epidemiological perspective. Population-based registry studies have shown that violence occurs more frequently among people with mental disorders, like schizophrenia and bipolar disorder, compared with control subjects, but that the increased risk is largely mediated by drug abuse and socio-economic deprivation. The aim of this study was to explore how patients who have committed violent or sexual crimes and have been sentenced to forensic psychiatric care by a Swedish court of law construed their criminal actions in terms of causes. Forty-six participants from six different Swedish forensic psychiatric clinics were included in the study. A semi-structured interview study was conducted and the data was analysed using a thematic analysis. A large group of the participants did not believe that the mental disorder played any role in the criminal events. Contributing causes that were mentioned were drug abuse and social factors.
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| 30. |
- Reitan, Therese, 1965-
(författare)
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Commitment without confinement : Outpatient compulsory care for substance abuse, and severe mental disorder in Sweden
- 2016
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 45, s. 60-69
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, a person with severe substance abuse or a severe mental disorder may be committed to compulsory care according to two different legislations. Both acts include an option of providing involuntary care outside the premises of an institution - care in other forms (COF) and compulsory community care (CCC), respectively. As co-occurring disorders are commonplace many individuals will be subject to both types of compulsory care. The structures of both legislations and their provisions for compulsory care in the community are therefore scrutinized and compared. Based on a distinction between "least restrictive" or "preventative" schemes the article compares COF and CCC in order to determine whether they serve different purposes. The analysis shows that COF and CCC both share the same avowed aims of reducing time spent in confinement and facilitating transition to voluntary care and the community. But they also serve different purposes, something which is reflected in disparate scopes, eligibility criteria, rules, and practices. Overall, COF was found to be a more "least restrictive" and CCC a more "preventative" scheme. The distinction is associated with COF being an established part of legislation on compulsory care for substance abuse with a universal scope and CCC being a recent addition to compulsory psychiatric care legislation with a selective character.
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| 31. |
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| 32. |
- Sjöström, Stefan
(författare)
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Invocation of coercion context in compliance communication : power dynamics in psychiatric care
- 2006
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 29:1, s. 36-47
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Tidskriftsartikel (refereegranskat)abstract
- This article draws on observations from ethnographic fieldwork to develop a theoretical understanding of the power dynamics in psychiatric care. The aim is to analyze how psychiatric clinicians solve compliance problems by invoking "coercion context".It is suggested that clinicians take a rather instrumental approach to laws regulating coercive intervention. Clinicians may invoke a coercion context even with voluntary patients. For example, they may use wordings that connote coercion, or they may make use of how treatment wards are set up to accommodate involuntary patients, thus stalling voluntary patients who cannot exit through locked doors. A coercion context can also be invoked to solve mundane practical problems, e.g. when clinicians talk about "coerced showers". The management of information and maintaining a suitable "awareness context"with regards to coercion is an essential feature in clinical attempts to achieve compliance from patients.In conclusion, the notion of coercion context helps explain the confusing findings from previous research about patients' apparent misconceptions of their formal legal status. Furthermore, it is argued that research that rely on decontextualised, objectifications of "coercion" risk to miss the meaning coercion is assigned in everyday clinical practice.
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| 33. |
- Sjöström, Stefan, 1965-, et al.
(författare)
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Why community compulsion became the solution : reforming mental health law in Sweden
- 2011
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 34:6, s. 419-428
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Tidskriftsartikel (refereegranskat)abstract
- The aimof this article is to understand how compulsory community care (CCC) has become a solution in mental health policy in so many different legal and social contexts during the last 20 years. The recent introduction of CCC in Sweden is used as a case in point, which is then contrasted against the processes in Norway, England/Wales and New York State. In Sweden, the issue of CCC was initiated following high-profile acts of violence. Contrary to several other states, therewas agreement about the (lack of) evidence about its effectiveness. Rather than focusing on dangerousness, the government proposal about CCC was framedwithin an ideology of integrating the disabled. The new legislation allowed for a broad range ofmeasures to control patients at the same time as itwas presented as a means to protect positive rights for patients. Compared to previous legislation in Sweden, the scope of social control has remained largely the same, although the rationale has changed — from medical treatment via community treatment and rehabilitation, to reducing the risk of violence, and then shifting back to rehabilitation in the community. The Swedish approach to CCC is similar to Norway, while New York and England/Wales have followed different routes. Differences in ideology, social control and rights orientations can be understood with reference to the general welfare and care regimes that characterize the four states.
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| 34. |
- Ståhlberg, Ola, et al.
(författare)
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A 3-year follow-up study of Swedish youths committed to juvenile institutions : Frequent occurrence of criminality and health care use regardless of drug abuse
- 2017
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 50, s. 52-60
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Tidskriftsartikel (refereegranskat)abstract
- This 3-year follow-up study compares background variables, extent of criminality and criminal recidivism in the form of all court convictions, the use of inpatient care, and number of early deaths in Swedish institutionalized adolescents (N = 100) with comorbid substance use disorders (SUD) and Attention-Deficit/Hyperactivity Disorder (ADHD) (n = 25) versus those with SUD but no ADHD (n = 30), and those without SUD (n = 45). In addition it aims to identify whether potential risk factors related to these groups are associated with persistence in violent criminality. Results showed almost no significant differences between the three diagnostic groups, but the SUD plus ADHD group displayed a somewhat more negative outcome with regard to criminality, and the non-SUD group stood out with very few drug related treatment episodes. However, the rate of criminal recidivism was strikingly high in all three groups, and the use of inpatient care as well as the number of untimely deaths recorded in the study population was dramatically increased compared to a age matched general population group. Finally, age at first conviction emerged as the only significant predictor of persistence in violent criminality with an AUC of .69 (CI (95%) .54–.84, p = .02). Regardless of whether SUD, with or without ADHD, is at hand or not, institutionalized adolescents describe a negative course with extensive criminality and frequent episodes of inpatient treatment, and thus requires a more effective treatment than present youth institutions seem to offer today. However, the few differences found between the three groups, do give some support that those with comorbid SUD and ADHD have the worst prognosis with regard to criminality, health, and untimely death, and as such are in need of even more extensive treatment interventions.
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| 35. |
- Svalin, Klara, et al.
(författare)
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Police employees' violence risk assessments : the predictive validity of the B-SAFER and the significance of protective actions
- 2018
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier. - 0160-2527 .- 1873-6386. ; 56, s. 71-79
-
Tidskriftsartikel (refereegranskat)abstract
- Violence risk assessment and management is conducted in police settings in order to prevent repeat victimization. One of the most frequently used violence risk assessment tools in this specific context is called the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER), which focuses on intimate partner violence (IPV). The present study examines B-SAFER assessments conducted by police employees, related protective actions and repeat IPV crimes in order to study: 1) to what extent risk- and victim vulnerability factors in the B-SAFER predicted global risk assessments, 2) the predictive accuracy of each B-SAFER item and the global risk assessments with regard to repeat IPV, 3) to what extent recommended protective actions were implemented and 4) the preventive effect of the implemented protective actions on repeat IPV. There were a large number of missing cases in the assessments and the risk and victim vulnerability factors only contributed to the global risk assessments to a minor extent. The predictive validity was low overall, few protective actions were implemented and those which were actually implemented did not appear to prevent repeat IPV. The continuous education and training of assessors is required to improve the work of violence risk assessment and management in police settings.
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| 36. |
- Svensson, Olof, et al.
(författare)
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The decision-making process in Swedish forensic psychiatric investigations.
- 2022
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Ingår i: International journal of law and psychiatry. - : Elsevier BV. - 1873-6386 .- 0160-2527. ; 80
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Tidskriftsartikel (refereegranskat)abstract
- Forensic psychiatric investigations in Sweden can have a major impact on the choice of sentence in criminal cases. Previous research shows that the decisions in several forensic fields, including forensic psychiatry, can be affected in a negative way by factors not relevant to the case. In the present study, the decision-making process of forensic psychiatric investigations was explored by using semi-structured interviews with experts (n=38) and analyzing these interviews thematically. The results showed that the decision-making process is both complex and iterative, where the experts use and shape a substantial amount of information to reach their decisions. The experts work in teams, which add both benefits and risks to the process, and feel that particularly time constraints may reduce the quality of their decisions. In summary, the decision-making process of Swedish forensic psychiatric investigations creates a potential for high validity, but also contains risks for bias effects that could warrant further mitigation.
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| 37. |
- van Baardewijk, Yoast, et al.
(författare)
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Measuring psychopathic traits in children through self-report : The development of the Youth Psychopathic traits Inventory-Child Version
- 2008
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 31:3, s. 199-209
-
Tidskriftsartikel (refereegranskat)abstract
- The current article investigates whether self-reports of children provide reliable and valid information concerning psychopathic personality traits and behaviours. For this purpose, we developed a downward extension of an existing adolescent self-report measure; the Youth Psychopathic traits Inventory [YPI; Andershed, H., Kerr, M., Stattin, H., & Levander, S. (2002). Psychopathic traits in non-referred youths: Initial testof a newassessment tool. In E.S. Blaauw, L (Ed.), Psychopaths: Current international perspectives (pp. 131-158): The Hague: Elsevier), called the Youth Psychopathic traits Inventory-Child Version (YPI-CV). The reliability and validity of the YPI-CV were tested in n = 360 children from the general population. The YPI-CV had good internal consistency and a three factor structure similar to the original adolescent version. Test-retest reliability over a 6-month period was adequate. In validating the instrument, both self, teacher and peer report were used. The convergent and divergent validity of the three YPI-CV dimensions was examined by relating each of them to an external criterion measures assessing the same construct. It was concluded that psychopathic traits can be measured reliably and meaningfully through self-report in 9 to 12 year olds and that the YPI-CV is potentially a useful instrument for doing so. (C) 2008 Elsevier Inc. All rights reserved.
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| 38. |
- Veen, Violaine C., et al.
(författare)
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Cross-ethnic generalizability of the three-factor model of psychopathy : the youth psychopathic traits inventory in an incarcerated sample of native Dutch and Moroccan immigrant boys
- 2011
-
Ingår i: International Journal of Law and Psychiatry. - : Pergamon Press. - 0160-2527 .- 1873-6386. ; 34:2, s. 127-130
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous research provides support for the existence of the psychopathy construct in youths. However, studies regarding the psychometric properties of psychopathy measures with ethnic minority youths are lacking.METHODS: In the present study, the three-factor structure of the Youth Psychopathic Traits Inventory (YPI) was examined for both native Dutch youth (N=158) and an ethnic minority group, Moroccans (N=141), in an incarcerated adolescent population in the Netherlands.RESULTS: Our results showed that the three-factor structure of the YPI is comparable across an ethnic majority and an ethnic minority group in an incarcerated sample in the Netherlands. Moreover, associations between psychopathic traits and mental health problems were similar for both ethnic groups.CONCLUSION: The results support the cross-ethnic generalizability of the three-factor model of psychopathy as measured through the Youth Psychopathic Traits Inventory.
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| 39. |
- Väfors Fritz, Marie, et al.
(författare)
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Antisocial process screening device : Validation on a Russian sample of juvenile delinquents with the emphasis on the role of personality and parental rearing
- 2008
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 31:5, s. 438-446
-
Tidskriftsartikel (refereegranskat)abstract
- The objectives of the present study were 1) to validate the Antisocial Process Screening Device (APSD) in a sample of Russian juvenile delinquents; 2) to examine subgroups of delinquents with higher versus lower levels of childhood problem behaviors with respect to the APSD subscales, personality traits, and parental rearing; and 3) to attempt to replicate the previous finding that the APSD subscale measuring callous/unemotional traits can differentiate subgroups of delinquents with different precursors for problem behaviors (predominantly biological versus predominantly social). A group of 250 Russian juvenile inmates (mean age = 16.4) was examined by means of the APSD completed by the staff at the correctional institution. The inmates completed several self-reports assessing their current and childhood behavior problems, personality traits and experienced parental rearing practices. A factor structure of the APSD was obtained that is similar, albeit not identical, to that from the original studies by Frick and colleagues [Frick, P.J., O'Brien, B.S., Wootton, J.M., McBurnett, K., (1994). Psychopathy and conduct problems in children. Journal of Abnormal Psychology, 103, 700–707]; [Frick, P.J., Barry, C.T., Bodin, S.D., (1999). Applying the concept of psychopathy to children: Implications for the Assessment of antisocial youth. In Gacono, C.B. (Ed), The clinical and forensic assessment of psychopathy: A practitioners guide. Hillsdale, NJ: Erlbaum]; [Frick, P.J., Lilienfeld, S.O., Ellis, M., Loney, B., Silverthorn, P., (1999). The association between anxiety and psychopathy dimensions in children. Journal of Abnormal Child Psychology, 27, 383–392]; callous unemotional traits in the present sample were expressed in manipulative behavior. Results further disclosed higher levels of antisocial and aggressive activities, higher levels of personality attributes such as narcissism and novelty seeking, as well as lower cooperativeness, and negatively perceived parental rearing in a subgroup with higher (versus lower) number of childhood symptoms of conduct disorder and oppositional disorder. The juvenile delinquents with higher levels as compared to lower levels of callous unemotional traits also perceived their parents as using more negative rearing strategies. The findings are discussed in terms of interactional processes between personality of the juvenile delinquents and parental rearing in the development of antisocial behavior.
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| 40. |
- Väfors Fritz, Marie, et al.
(författare)
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Psychopathy and violence in juvenile delinquents : What are the associated factors?
- 2008
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 31:3, s. 272-279
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of the present study was a) to examine the discriminative power of the Antisocial Process Screening Device (APSD), aggressive traits, impulsiveness, antisocial attitudes and alcohol-related problems between subgroups of Russian juvenile delinquents (n = 175) with low versus high levels of violent behavior; and b) to compare the predictive value of these variables in two subgroups defined by higher versus lower levels of psychopathic traits. Results demonstrated that the APSD score, traits of physical aggression and alcohol-related problems were able to discriminate between groups with various levels of violence. Furthermore, the level of violence was the only variant factor when comparing levels of psychopathy. Finally, different sets of predictors emerged for the group with higher versus lower psychopathy scores. The results are discussed in relation to specific features of psychopathy and environmental factors in general and the use of alcohol in particular.
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| 41. |
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| 42. |
- Wiklund, Gunnar, et al.
(författare)
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Pro-bullying attitudes among incarcerated juvenile delinquents : Antisocial behavior, psychopathic tendencies and violent crime
- 2014
-
Ingår i: International Journal of Law and Psychiatry. - New York : Elsevier BV. - 0160-2527 .- 1873-6386. ; 37:3, s. 281-288
-
Tidskriftsartikel (refereegranskat)abstract
- The objective was to evaluate a new scale aimed at assessing antisocial attitudes, the Pro-bullying Attitude Scale (PAS), on a group of 259 voluntarily-recruited male juvenile delinquents from a juvenile correctional institution in Arkhangelsk, North-western Russia. Exploratory factor analysis gave a two-factor solution: Factor 1 denoted Callous/Dominance and Factor 2 denoted Manipulativeness/Impulsiveness. Subjects with complete data on PAS and Childhood Psychopathy Scale (CPS) (n = 171) were divided into extreme groups (first and fourth quartiles) according to their total scores on PAS and the two factor scores, respectively. The extreme groups of total PAS and PAS Factor 1 differed in CPS ratings and in violent behavior as assessed by the Antisocial Behavior Checklist (ABC). They also differed in the personality dimension Harm Avoidance as measured by use of the Temperament and Character Inventory (TCI), and in delinquent and aggressive behavior as assessed by the Youth Self Report (YSR). The extreme groups of PAS Factor 2, in turn, differed in aggressive behavior as assessed by the YSR, and in the TCI scale Self-Directedness. When PAS was used as a continuous variable, total PAS and PAS Factor 1 (Callous/Dominance) were significantly positively related to registered violent crime. The possible usefulness of PAS in identifying high-risk individuals for bullying tendencies among incarcerated delinquents is discussed.
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| 43. |
- Yourstone, Jenny, et al.
(författare)
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Women who kill : A comparison of the psychosocial background of female and male perpetrators convicted of lethal violence in Sweden between 1995-2001
- 2008
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 31:4, s. 374-383
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to compare the psychosocial background of female and male perpetrators convicted of homicide in Sweden between 1995–2001. All women (n = 43) who were convicted for lethal violence during the period and a corresponding number of randomly chosen men (n = 43) were examined. In total, information about 86 individuals was collected retrospectively. Areas of interest were psychosocial variables during childhood and at the time of the current crime. Results showed that both female and male perpetrators were psychosocially encumbered already at an early age. Homicidal women had more severe childhood circumstances, but less aggressive childhood behaviour than did their male counterparts. At the time of the crime, women had a more ordered social situation, had more often been exposed to violence and searched for help than had the men. These gender differences suggest that specific actions are needed for preventing women's homicidal behaviour.
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| 44. |
- Zetterberg, Liv, 1982-, et al.
(författare)
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The compliant court : procedural fairness and social control in compulsory community care
- 2014
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier. - 0160-2527 .- 1873-6386. ; 37:6, s. 543-550
-
Tidskriftsartikel (refereegranskat)abstract
- Compulsory community care (CCC) was introduced in Sweden in 2008. This article investigates all written court decisions regarding CCC over a 6 month period in 2009 (N = 541). The purpose is to examine how the legal rights of patients are protected and what forms of social control patients are subjected to. 51% of CCC patients are women and 84% are being treated for a psychosis-related disorder. In the court decisions, only 9% of patients are described as dangerous to themselves, while 18% are regarded a danger to others. The most common special provisions that patients are subjected to are medication (79%) and a requirement that they must maintain contact with either community mental health services (51%) or social services (27%). In the decisions, both the courts and court-appointed psychiatrists agree with treating psychiatrists in 99% of cases. Decisions lack transparency and clarity, and it is often impossible to understand the conclusions of the courts. There is considerable variation between regional courts as regards the provisions to which patients are subjected and the delegation of decision-making to psychiatrists. This means that decisions fail to demonstrate clarity, transparency, consistency and impartiality, and thus fail to meet established standards of procedural fairness. Surveillance techniques of social control are more common than techniques based on therapy or sanctions. Because of the unique role of medication, social control is primarily imposed on a physical dimension, as opposed to temporal and spatial forms. The article concludes that patients are at risk of being subjected to new forms of social control of an unclear nature without proper legal protection.
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| 45. |
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