| 1. |
- Andiné, Peter, et al.
(författare)
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Behandling och bedömning i rättspsykiatrisk vård – En kartläggning av systematiska översikter : SBU Kartlägger • Rapport 264/2017
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Statens beredning för medicinsk och social utvärdering (SBU) har gjort denna kartläggning för att ta reda på inom vilka områden det finns behov av kunskap kring insatser i rättspsykiatrisk vård. Uppdraget kommer från Socialdepartementet som efterlyser ökad kunskap om evidensläget för rättspsykiatrisk vård. Kartläggningen visar att behovet av väl genomförd forskning är stort för behandlingar i rättspsykiatrisk vård. Samtliga domäner som SBU har kartlagt saknar tillförlitligt sammanställd forskning specifikt för personer som vårdas inom rättspsykiatri.
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| 2. |
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| 3. |
- Caman, Shilan, et al.
(författare)
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Differentiating Male and Female Intimate Partner Homicide Perpetrators : A Study of Social, Criminological and Clinical Factors
- 2016
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Ingår i: International Journal of Forensic Mental Health. - : Informa UK Limited. - 1499-9013 .- 1932-9903. ; 15:1, s. 26-34
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Tidskriftsartikel (refereegranskat)abstract
- It is recognized that the majority of intimate partner homicide (IPH) victims are female; simultaneously, when females do commit homicide, they are more likely to perpetrate against an intimate partner. To date, there are only a few studies that discuss IPH across gender, leading to a gap of knowledge with regard to gender aspects of perpetration. The present nationwide study has a retrospective design, based on registries of all female (n = 9) and stratified male (n = 36) IPH committed in Sweden between 2007 and 2009. Our study suggests that female perpetrators are more likely to be unemployed, to have suffered from a substance abuse disorder at some point in life and to have been victimized by the victim. In other words, scrutiny of these characteristics reveals that females who commit partner-related homicides are qualitatively and clinically different from their male counterparts. Furthermore, the prevailing feature of intoxication in connection to the crime, both in male and female perpetrators, indicates that perpetrators might benefit from elements of substance abuse treatment in interventions targeting partner violence.
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| 4. |
- Frick, Andreas, et al.
(författare)
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Classifying social anxiety disorder using multivoxel pattern analyses of brain function and structure
- 2014
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Ingår i: Behavioural Brain Research. - : Elsevier BV. - 0166-4328 .- 1872-7549. ; 75:9, s. 358S-358S
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Tidskriftsartikel (refereegranskat)abstract
- Functional neuroimaging of social anxiety disorder (SAD) support altered neural activation to threat-provoking stimuli focally in the fear network, while structural differences are distributed over the temporal and frontal cortices as well as limbic structures. Previous neuroimaging studies have investigated the brain at the voxel level using mass-univariate methods which do not enable detection of more complex patterns of activity and structural alterations that may separate SAD from healthy individuals. Support vector machine (SVM) is a supervised machine learning method that capitalizes on brain activation and structural patterns to classify individuals. The aim of this study was to investigate if it is possible to discriminate SAD patients (n = 14) from healthy controls (n = 12) using SVM based on (1) functional magnetic resonance imaging during fearful face processing and (2) regional gray matter volume. Whole brain and region of interest (fear network) SVM analyses were performed for both modalities. For functional scans, significant classifications were obtained both at whole brain level and when restricting the analysis to the fear network while gray matter SVM analyses correctly classified participants only when using the whole brain search volume. These results support that SAD is characterized by aberrant neural activation to affective stimuli in the fear network, while disorder-related alterations in regional gray matter volume are more diffusely distributed over the whole brain. SVM may thus be useful for identifying imaging biomarkers of SAD.
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| 5. |
- Frick, Andreas, et al.
(författare)
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Cortical thickness alterations in social anxiety disorder
- 2013
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Ingår i: Neuroscience Letters. - : Elsevier BV. - 0304-3940 .- 1872-7972. ; 536, s. 52-55
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Tidskriftsartikel (refereegranskat)abstract
- Social anxiety disorder (SAD) has been associated with aberrant processing of socio-emotional stimuli and failure to adaptively regulate emotion, corroborated by functional neuroimaging studies. However, only a few studies of structural brain abnormalities in SAD have been reported, and among these only one investigated cortical thickness. In the present study we used magnetic resonance imaging (MRI) in conjunction with an automated method to measure cortical thickness in patients with SAD (n=14) and healthy controls (n=12). Results showed significantly increased thickness of the left inferior temporal cortex in SAD patients relative to controls. Within the patient group, a negative association was found between social anxiety symptom severity and thickness of the right rostral anterior cingulate cortex. The observed alterations in brain structure may help explain previous findings of dysfunctional regulation and processing of emotion in SAD.
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| 6. |
- Howner, Katarina, et al.
(författare)
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Brain processing of fearful facial expression in mentally disordered offenders
- 2011
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Ingår i: Journal of Behavioral and Brain Science. - Irvine, CA : Scientific Research Publishing. - 2160-5866 .- 2160-5874. ; 1:3, s. 115-123
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Tidskriftsartikel (refereegranskat)abstract
- Emotional facial expressions are important cues for interaction between people. The aim of the present study was to investigate brain function when processing fearful facial expressions in offenders with two psychiatric disorders which include impaired emotional facial perception; autism spectrum disorder (ASD) and psychopathy (PSY). Fourteen offenders undergoing forensic psychiatric assessment (7 with ASD, and 7 psychopathic offenders) and 12 healthy controls (HC) viewed fearful and neutral faces while undergoing functional magnetic resonance imaging (fMRI). Brain activity (fearful versus neutral faces) was compared both between HC and offenders and between the two offender groups (PSY and ASD). Functional co-activation was also investigated. The offenders had increased activity bilaterally in amygdala and medial cingulate cortex as well as the left hippocampus during processing fearful facial expressions compared to HC. The two subgroups of offenders differed in five regions compared with each other. Results from functional co-activation analysis suggested a strong correlation between the amygdala and anterior cingulate cortex (ACC) in the left hemisphere only in the PSY group. These findings suggest enhanced neural processing of fearful faces in the amygdala as well as in other facial processing brain areas in offenders compared to HC. Moreover, the co-activation between amygdala and ACC in the PSY but not the ASD group suggested qualitative differences in amygdala activity in the two groups. Since the sample size is small the study should be regarded as a pilot study.
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| 7. |
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| 8. |
- Howner, Katarina
(författare)
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Offenders with mental disorder : psychosocial and neurobiological aspects
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main hypothesis of this thesis is that certain functions, or symptoms, in mentally disordered offenders are connected to biological correlates. There is no specific diagnosis that explains antisocial or violent behaviour. Among offenders some functions or symptoms are considered more common, such as impulsivity and reduced empathy. To date, biological factors related to antisocial and violent behaviour are still not fully understood. This is particularly true in the field of brain imaging, where research-findings are mixed and sometimes contradictive. Biological mechanism associated with antisocial and violent behaviour may have an impact on several forensic psychiatric areas, such as diagnostic assessments, provision of treatment options, risk assessment, and treatment evaluation. Therefore, increased knowledge of these biological factors will be important on many levels in forensic psychiatry and the criminal justice system. In this thesis mentally disordered offenders are studied, using a multi-dimensional approach, with parallel investigation of behaviour and peripheral physiology as well as brain structure and function. The findings imply that there are specific subgroups of offenders. These subgroups differ in crime scene behaviour, psychosocial functioning, and emotional processing, reflected by peripheral physiological reactivity as well as cerebral emotional processing. In study I, crime scene behaviour was studied and the results suggest subgroups of offenders, with respect to differences in psychosocial factors and crime scene behaviour. In study II, emotional reactivity was investigated by measuring peripheral physiological reactivity in response to negative and neutral pictures. In this study, healthy controls and mentally disordered offenders, with different degrees of antisocial behaviour but without psychopathy, were studied. The offenders showed significant lower physiological reactivity in comparison to the controls. Moreover, the attenuated emotional reactivity was a characteristic shared by the offenders overall, thus antisocial behaviour was not a differential factor. In study III, cerebral structural changes were investigated. Cortical thickness was compared between a group of mentally disordered offenders with lack of empathy and healthy controls. The offender group showed thinner cortex in the frontal lobes bilaterally. Also, a negative correlation was found between scores on the psychopathy checklist and cortical thickness in the frontal lobes bilaterally, the right temporal lobe, and right hemisphere, suggesting that these areas are of importance in psychopathy. In study IV, emotional reactivity, reflected by cerebral functioning, was assessed with fMRI, during presentation of fearful and neutral facial expressions. Mentally disordered offenders were compared to healthy controls, moreover, two subgroups of offenders were also compared, the psychopathy group and the autism spectrum disorder group. The results indicated higher cerebral activity in specific brain areas in the mentally disordered offenders, implying altered perception and processing of fearful facial expressions in these subjects. Also, there were differences between the subgroups in the communication between the amygdala and other parts of the limbic system, suggesting that processing of fearful facial expressions differ in the two groups. The results from this thesis suggest that biological factors, in addition to social and psychological factors should be considered in order to advance the understanding of different mechanism underlying antisocial and violent behaviour. Future studies are needed to confirm some of the findings, to further increase knowledge about these biological factors.
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| 9. |
- Howner, Katarina, et al.
(författare)
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Thinner cortex in the frontal lobes in mentally disordered offenders
- 2012
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Ingår i: Psychiatry Research. - : Elsevier BV. - 0165-1781 .- 1872-7123 .- 0925-4927. ; 203:2-3, s. 126-131
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Tidskriftsartikel (refereegranskat)abstract
- Antisocial and violent behaviour have been associated with both structural and functional brain abnormalities in the frontal and the temporal lobes. The aim of the present study was to assess cortical thickness in offenders undergoing forensic psychiatric assessments, one group with psychopathy (PSY, n = 7) and one group with autism spectrum disorder (ASD, n = 7) compared to each other as well as to a reference group consisting of healthy non-criminal subjects (RG, n = 12). A second aim was to assess correlation between scores on a psychopathy checklist (PCL-SV) and cortical thickness. Magnetic resonance imaging (MRI) and surface-based cortical segmentation were used to calculate cortical thickness. Analyses used both regions of interest and statistical maps. When the two groups of offenders were compared, there were no differences in cortical thickness, but the PSY group had thinner cortex in the temporal lobes and in the whole right hemisphere compared to RG. There were no differences in cortical thickness between the ASD group and RG. Across subjects there was a negative correlation between PCL-SV scores and cortical thickness in the temporal lobes and the whole right hemisphere. The findings indicate that thinner cortex in the temporal lobes is present in psychopathic offenders and that these regions are important for the expression of psychopathy. However, whether thinner temporal cortex is a cause or a consequence of the antisocial behaviour is still unknown.
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| 10. |
- Kraus, Jakub, et al.
(författare)
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Amygdala reactivity and connectivity during social and non-social aversive stimulation in social anxiety disorder
- 2018
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Ingår i: Psychiatry Research. - : Elsevier BV. - 0925-4927 .- 1872-7506. ; 280, s. 56-61
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Tidskriftsartikel (refereegranskat)abstract
- Social anxiety disorder (SAD) is characterized by exaggerated amygdala reactivity in response to symptom provocation, but it is unclear if such hyper-reactivity is elicited by disorder-specific challenges only or characterizes reactions to aversive stimuli in general. Here, using functional magnetic resonance imaging in 14 patients with SAD, as compared to 12 healthy controls, we found that amygdala hyper-reactivity is confined to disorder-relevant social stimulation. SAD patients displayed increased amygdala reactivity to fearful as compared to neutral facial pictures, but not in response to generally aversive but mainly non-social stimulation when compared to neutral pictorial stimuli taken from the International Affective Picture System. The increased amygdala reactivity was not mediated by an altered prefrontal inhibition among SAD patients as compared to controls, suggesting increased bottom-up processes rather than attenuated top-down control. In conclusion, the enhanced amygdala reactivity in SAD seems specific to socially relevant stimuli rather than aversive stimuli in general.
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| 11. |
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| 12. |
- Nilsonne, Gustav, et al.
(författare)
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Effects of 25 mg oxazepam on emotional mimicry and empathy for pain : a randomized controlled experiment
- 2017
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Ingår i: Royal Society Open Science. - : The Royal Society. - 2054-5703. ; 4:3
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Tidskriftsartikel (refereegranskat)abstract
- Emotional mimicry and empathy are mechanisms underlying social interaction. Benzodiazepines have been proposed to inhibit empathy and promote antisocial behaviour. First, we aimed to investigate the effects of oxazepam on emotional mimicry and empathy for pain, and second, we aimed to investigate the association of personality traits to emotional mimicry and empathy. Participants (n= 76) were randomized to 25mg oxazepam or placebo. Emotional mimicry was examined using video clips with emotional expressions. Empathy was investigated by pain stimulating the participant and a confederate. We recorded self-rated experience, activity in major zygomatic and superciliary corrugator muscles, skin conductance, and heart rate. In the mimicry experiment, oxazepam inhibited corrugator activity. In the empathy experiment, oxazepam caused increased self-rated unpleasantness and skin conductance. However, oxazepam specifically inhibited neither emotional mimicry nor empathy for pain. Responses in both experiments were associated with self-rated empathic, psychopathic and alexithymic traits. The present results do not support a specific effect of 25mg oxazepam on emotional mimicry or empathy.
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| 13. |
- Nilsonne, Gustav, et al.
(författare)
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Oxazepam and cognitive reappraisal : A randomised experiment
- 2021
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 16:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cognitive reappraisal is a strategy for emotional regulation, important in the context of anxiety disorders. It is not known whether anxiolytic effects of benzodiazepines affect cognitive reappraisal.Aims: We aimed to investigate the effect of 25 mg oxazepam on cognitive reappraisal.Methods: In a preliminary investigation, 33 healthy male volunteers were randomised to oxazepam or placebo, and then underwent an experiment where they were asked to use cognitive reappraisal to upregulate or downregulate their emotional response to images with negative or neutral emotional valence. We recorded unpleasantness ratings, skin conductance, superciliary corrugator muscle activity, and heart rate. Participants completed rating scales measuring empathy (Interpersonal Reactivity Index, IRI), anxiety (State-Trait Anxiety Inventory, STAI), alexithymia (Toronto Alexithymia Scale-20, TAS-20), and psychopathy (Psychopathy Personality Inventory-Revised, PPI-R).Results: Upregulation to negative-valence images in the cognitive reappraisal task caused increased unpleasantness ratings, corrugator activity, and heart rate compared to downregulation. Upregulation to both negative- and neutral-valence images caused increased skin conductance responses. Oxazepam caused lower unpleasantness ratings to negative-valence stimuli, but did not interact with reappraisal instruction on any outcome. Self-rated trait empathy was associated with stronger responses to negative-valence stimuli, whereas self-rated psychopathic traits were associated with weaker responses to negative-valence stimuli.Conclusions: While 25 mg oxazepam caused lower unpleasantness ratings in response to negative-valence images, we did not observe an effect of 25 mg oxazepam on cognitive reappraisal.
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| 14. |
- Pauli, Malin, et al.
(författare)
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Gendered Expressions of Psychopathy : Correctional Staffs' Perceptions of the CAPP and CABP Models
- 2018
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Ingår i: International Journal of Forensic Mental Health. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 1499-9013 .- 1932-9903. ; 17:2, s. 97-110
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Tidskriftsartikel (refereegranskat)abstract
- It has been suggested that psychopathy and borderline personality disorder (BPD) are associated and that they could be differently gendered variants of the same underlying phenotype. This study explored gender-specific perceptions of the Comprehensive Assessment of Psychopathic Personality (CAPP) and the Comprehensive Assessment of Borderline Personality (CABP). Correctional staff (n = 87) were asked to rate the prototypicality of these models for women and men with psychopathy. The results provide further support for the CAPP model as a promising conceptualization of psychopathy. Findings show few gender differences and lend support to psychopathy and BPD as overlapping constructs.
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| 15. |
- Siponen, Rebecca, 1993-
(författare)
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The role of psychiatric diagnoses among youth offenders : An investigation of crime and later adverse outcomes
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is a strong tradition in criminological research to uncover risk factors for crime in youth and, more recently, to examine risk factors for subsequent adverse outcomes among youth offenders. This knowledge serves not only for crime prevention but also to mitigate future harm resulting from youth crime. Psychiatric diagnoses are recognized as important risk factors for youth crime, yet questions persist regarding their extent and nature of association with crime and later adverse outcomes in youth offenders.In this dissertation, the overarching aim was to expand the knowledge about the role of psychiatric diagnoses in the risk of crime in youth and later injuries, mortality, and reoffending among youth offenders. Study I examined the association between psychiatric diagnoses, including comorbidities, and risk of criminal conviction in youth. Study II examined the association between psychiatric diagnoses and risk of unintentional injuries and premature death among non-imprisoned and imprisoned youth offenders. Lastly, study III examined the role of psychiatric diagnoses in the association between violent victimization and reoffending among youth offenders.The overall findings of the present dissertation suggest that psychiatric diagnoses are important risk factors for crime in youth and later adverse outcomes, but their significance and magnitude vary depending on type of diagnosis, presence of comorbidities, type of crime committed, sex, crime history, and presence of other important risk factors such as violent victimization. This dissertation highlights the heterogeneity in risk patterns among youth offenders, which is highly important to consider in both risk assessments and prevention strategies to better target youth at risk of these outcomes.
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| 16. |
- Sygel, Kristina, et al.
(författare)
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The effect of gender on the outcome of forensic psychiatric assessment in Sweden : A case vignette study
- 2017
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Ingår i: CBMH. Criminal behaviour and mental health. - : Wiley. - 0957-9664 .- 1471-2857. ; 27:2, s. 124-135
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrevious research suggests that female violent offenders at risk of a prison sentence are more likely than their male counterparts to be assessed as having mental health problems of a nature or degree that would lead to a court requirement for hospital treatment.Aims/hypothesesTo test the hypothesis that there is bias towards hospital disposal of female compared with male violent offenders with mental disorder.MethodsIn Sweden, the National Board of Forensic Medicine oversees all assessments of mental disorder for the criminal courts. Twenty-six Board appointed forensic psychiatrists, psychologists and social workers each independently assessed six case vignettes for fit with criteria for ‘severe mental disorder’, a prerequisite for hospital disposal from court. Each gender neutral vignette described a person who had been convicted of serious assault and had a major mental disorder. A gender was then assigned to each offender randomly within a block design, thus varying between sets. Participants were blind to the main aim of the study and the gender variation.ResultsThere was no significant association between gender of the person assessed and judgement that s/he had a ‘severe mental disorder’. An offender depicted as having mental retardation was more likely to be assessed as at high risk of criminal recidivism if portrayed as female, regardless of the sex, place of work or level of experience of the assessor.ConclusionWe found no evidence of gender bias in determining appropriateness of a hospital disposal of an offender with mental disorder. The difference in assessment of recidivism according to sex of the patient was only in relation to mental retardation; further research would be needed to able to interpret this. As researchers in other countries have reported gender bias in disposals from court, our findings may provide support for a centralised forensic psychiatric assessment board and formal, on-going training.
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| 17. |
- Sörman, Karolina, et al.
(författare)
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Forensic Mental Health Professionals’ Perceptions of Psychopathy : a Prototypicality Analysis of the Comprehensive Assessment of Psychopathic Personality in Sweden
- 2014
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Ingår i: Law and human behavior. - : American Psychological Association (APA). - 0147-7307 .- 1573-661X. ; 38:5, s. 405-417
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Tidskriftsartikel (refereegranskat)abstract
- Assessments of psychopathic traits are used on a routine basis in forensic evaluations across Westernized countries. Despite this, consensus has not yet emerged concerning what exactly are the “core” features of this construct. Moreover, relatively little is known about how practitioners in the field construe this disorder. This study explored perceptions and attitudes regarding psychopathy among individuals working in the forensic mental health system (N = 90) in Sweden. Participants provided prototype ratings of what they considered to be core psychopathy features based on the Comprehensive Assessment of Psychopathic Personality (CAPP), a model that increasingly is the focus of research in North America and Europe. The study protocol also included questions regarding (a) global perceptions and attitudes about a number of aspects of the psychopathy construct (e.g., personal experience, perceived prevalence), and (b) attitudinal scales that assessed perceived correlates of psychopathic traits across a variety of domains (e.g., violence proneness, treatment amenability) and moral judgments and attitudes concerning how psychopathic offenders should be treated within the legal system. The majority of the 33 individual CAPP items and the six CAPP scales were rated as at least moderately prototypical of psychopathy, with Dominance, Self, and Attachment domains obtaining the highest mean ratings. Participants viewed psychopaths as more likely to commit crimes than the average criminal, without being blatantly “evil” people. We believe our results help to advance our understanding of the psychopathy construct by exploring forensic professionals’ perceptions of this disorder in general and in relation to the CAPP model specifically.
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| 18. |
- Sörman, Karolina, et al.
(författare)
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Perceptions of Mental Health Conditions in Criminal Cases : A Survey Study Involving Swedish Lay Judges
- 2020
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Ingår i: Criminal Justice and Behavior. - : SAGE Publications. - 0093-8548 .- 1552-3594. ; 47:6, s. 688-711
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Tidskriftsartikel (refereegranskat)abstract
- Perceptions of mental health conditions influence how individuals with psychiatric diagnoses are treated within the community, in the legal system, and at different institutions. We examined perceptions of mental health conditions among lay judges (N = 643), working at district and appellate courts throughout Sweden. Participants read a web-based survey including a crime vignette in which the person charged with a crime was described as having schizophrenia (n = 186), antisocial personality disorder (ASPD) with psychopathic traits (n = 219), or intellectual disability (n = 238). Participants' perceptions of schizophrenia were largely in line with Swedish legislation regarding the medicolegal concept of severe mental disturbance (SMD). Findings were more varied for the other two conditions, however. Perceptions of individuals with ASPD with psychopathic traits were not consistent with the Swedish SMD legislation. The results highlight the complexity of legislation addressing mental illness and criminality.
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| 19. |
- Sörman, Karolina, et al.
(författare)
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Reliability and Construct Validity of the Psychopathic Personality Inventory-Revised in a Swedish Non-Criminal Sample : A Multimethod Approach including Psychophysiological Correlates of Empathy for Pain
- 2016
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:6
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Tidskriftsartikel (refereegranskat)abstract
- Cross-cultural investigation of psychopathy measures is important for clarifying the nomological network surrounding the psychopathy construct. The Psychopathic Personality Inventory-Revised (PPI-R) is one of the most extensively researched self-report measures of psychopathic traits in adults. To date however, it has been examined primarily in North American criminal or student samples. To address this gap in the literature, we examined PPI-R’s reliability, construct validity and factor structure in non-criminal individuals (N = 227) in Sweden, using a multimethod approach including psychophysiological correlates of empathy for pain. PPI-R construct validity was investigated in subgroups of participants by exploring its degree of overlap with (i) the Psychopathy Checklist: Screening Version (PCL:SV), (ii) self-rated empathy and behavioral and physiological responses in an experiment on empathy for pain, and (iii) additional self-report measures of alexithymia and trait anxiety. The PPI-R total score was significantly associated with PCL:SV total and factor scores. The PPI-R Coldheartedness scale demonstrated significant negative associations with all empathy subscales and with rated unpleasantness and skin conductance responses in the empathy experiment. The PPI-R higher order Self-Centered Impulsivity and Fearless Dominance dimensions were associated with trait anxiety in opposite directions (positively and negatively, respectively). Overall, the results demonstrated solid reliability (test-retest and internal consistency) and promising but somewhat mixed construct validity for the Swedish translation of the PPI-R.
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