| 1. |
- Alm, Charlotta, et al.
(författare)
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Classification of offenders with mental health problems and problematic substance use using the Addiction Severity Index version 6 : Analysis of three-year follow-up data and predictive validity
- 2014
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Ingår i: Mental Health and Substance Use. - Abingdon : Routledge. - 1752-3281 .- 1752-3273. ; 7:4, s. 431-445
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Tidskriftsartikel (refereegranskat)abstract
- Previous research is scarce on the problems and needs of the “triply troubled” – among offenders with mental health problems and problematic substance use. Classifying this population into clusters based on problem profiles may provide information about individual needs for treatment. In a previous study, we identified four clusters of triply troubled: less troubled, severely triply troubled, triply troubled with medical problems, and working triply troubled. The present study explored the stability and predictive validity of these clusters in a naturalistic design. In total, 125 triply troubled individuals included in any of the four clusters were followed for approximately three years with regard to their inpatient and outpatient treatment participation. They were also interviewed with the 6th version of the Addiction Severity Index, the Psychopathy Checklist–Revised, and the World Health Organization Quality of Life–Bref. The main finding of the study was that on average the participants of all four clusters exhibited substantial improvements over the course of time but that improvements were cluster-specific rather than sample-specific. Implications of the study are discussed.
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| 2. |
- Alm, Charlotte, et al.
(författare)
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Gender differences in re-offending among psychiatrically examined Swedish offenders
- 2010
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Ingår i: CBMH. Criminal behaviour and mental health. - : Wiley. - 0957-9664 .- 1471-2857. ; 20:5, s. 323-334
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Tidskriftsartikel (refereegranskat)abstract
- Background: The gender gap for violent offending is narrowing in the general population. Substance abuse and mental health problems are known risk factors for criminality. While substance abuse treatment has been associated with reduced risk of re-offending, women seem less likely to engage than men. People misusing substances tend to be high users of emergency room (ER) services. Such use may be an indicator both of treatment failure for substance misuse and offending. Little is known about gender differences in this respect. Aims: This study aims to test for gender differences in re-offending, use of substance abuse treatment, and hospital ER visits among offenders referred for forensic psychiatric assessment in Sweden. Method: The study used a longitudinal retrospective design. Data on all 31 women from a 2-year (2000–2001) cohort of serious offenders referred for forensic psychiatric assessment in Stockholm county, and 31 men from the same cohort, were extracted from forensic service and national records. Selection of the men was by initial random sampling followed by matching on age and substance misuse. The two resulting samples were compared on health service use and re-offending data between release and the census date (30 April 2004). Results: There were no gender differences for violent re-offending or for engagement in planned substance abuse treatment, in spite of longer time at risk for the men. Re-offending was reduced for women but not men who did not present in the ER with physical health problems. Conclusions: Our study is limited by sample size, although it included all women referred to the specialist forensic psychiatric service over 2 years, but it does indicate that differences between men and women in this situation are likely, and worthy of further study. The only way of achieving adequate sample sizes is likely to be through multi-centre collaboration.
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| 3. |
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| 4. |
- Arborelius, Lotta, et al.
(författare)
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A new interactive computer simulation system for violence risk assessment of mentally disordered violent offenders
- 2013
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Ingår i: CBMH. Criminal behaviour and mental health. - : Wiley. - 0957-9664 .- 1471-2857. ; 23:1, s. 30-40
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Tidskriftsartikel (refereegranskat)abstract
- Background Assessment of risk of future violence has developed from reliance on static indicators towards a more dynamic approach. In the latter context, however, the offender is seldom confronted with real life situations. Aims The aim of this study is to evaluate a computer-based system Reactions on Display, which presents human interactions based on real-life situations for its effectiveness in distinguishing between potentially violent offenders with mental disorder and a healthy comparison group. Methods Male offenders with autism spectrum disorders or psychosis were recruited from specialist forensic psychiatric units in Sweden and healthy participants from the local communities. Each consenting participant was presented with film clips of a man in neutral and violent situations, which at critical moments stopped the story to ask him to predict the thoughts, feelings and actions of the actor. Results Offender patients, irrespective of diagnosis, detected fewer emotional reactions in the actor in the non-violent sequence compared with controls. When asked to choose one of four violent actions, the offender patients chose more violent actions than did the controls. They also reported fewer physical reactions in the actors when actors were being violent. There were also some examples of incongruent or deviant responses by some individual patients. Conclusions and implications for practice The use of interactive computer simulation techniques is not only generally acceptable to offender patients, but it also helps to differentiate their current response style to particular circumstances from that of healthy controls in a way that does not rely on their verbal abilities and may tap more effectively into their emotional reactions than standard verbal questions and answer approaches. This may pave the way for Reactions on Display providing a useful complement to traditional risk assessment, and a training route with respect to learning more empathic responding, thus having a role in aiding risk management.
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| 5. |
- Bennet, Tova, et al.
(författare)
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Den rättspsykiatriska vården är inte rättssäker – agera nu
- 2020
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Ingår i: Göteborgs-Posten. - Göteborg : Göteborgposten. - 1103-9345. ; :Oktober 19
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Det svenska rättssystemet som tillåter att vi dömer psykiskt sjuka för brott och att personer som saknar vårdbehov kan hållas frihetsberövade inom rättspsykiatrin under mycket lång tid med oklart vårdinnehåll, är unikt och har fått rättmätig kritik under lång tid. Ändå händer ingenting.
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| 6. |
- Berman, Anne H., et al.
(författare)
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Design and Development of a Telephone-Linked Care (TLC) System to Reduce Impulsivity among Violent Forensic Outpatients and Probationers
- 2012
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Ingår i: Journal of medical systems. - : Springer Netherlands. - 0148-5598 .- 1573-689X. ; 36:3, s. 1031-1042
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Tidskriftsartikel (refereegranskat)abstract
- Forensic services face the challenge of reducing relapse among clients with a history of violent crime. An automated interactive voice response (IVR) service of the complex Telephone-Linked Care (TLC) type, with a focus on reducing impulsivity, could improve the adequacy of service responses to client needs. Theoretically based in Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy (CBT) and Motivational Interviewing (MI), the forensic TLC system offers interactive conversations on coping with the emotions of anger, shame and loneliness; activities of daily life such as getting out of bed, asking for help, visiting social services and taking medication; and other areas such as hearing voices, drinking alcohol and self-critical thoughts. We describe the user´s flow through the system, with an in-depth synopsis of the hearing voices intervention. Issues regarding voluntary versus mandatory use of the system are addressed in connection with prospective introduction of the system in forensic settings.
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| 7. |
- Bromander, Sara, et al.
(författare)
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Cerebrospinal fluid insulin during non-neurological surgery.
- 2010
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Ingår i: J Neural Transm (Vienna, Austria:1996). - : Springer Science and Business Media LLC. - 1435-1463 .- 0300-9564. ; 20, s. 328-329
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Tidskriftsartikel (refereegranskat)abstract
- Insulin plays an important metabolic and transmitter role in the central nervous system, but few studies have investigated the relationship between central and peripheral insulin concentrations. 35 patients undergoing knee surgery had cerebrospinal fluid (CSF) samples drawn before, 3 h after, and in the morning following surgery. Serum insulin concentrations increased after surgery and CSF insulin concentrations changed in the same direction with far smaller amplitude. These results indicate that the blood-brain barrier protects the brain from stress-induced peripheral hormonal fluctuations.
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| 8. |
- Bromander, Sara, et al.
(författare)
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Changes in serum and cerebrospinal fluid cytokines in response to non-neurological surgery: an observational study.
- 2012
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Ingår i: Journal of neuroinflammation. - : Springer Science and Business Media LLC. - 1742-2094. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: Background: Surgery launches an inflammatory reaction in the body, as seen through increased peripheral levels of cytokines and cortisol. However, less is known about perioperative inflammatory changes in the central nervous system (CNS). Our aim was to compare inflammatory markers in serum and cerebrospinal fluid (CSF) before and after surgery and evaluate their association with measures of blood–brain barrier (BBB) integrity. Methods: Thirty-five patients undergoing knee arthroplastic surgery with spinal anesthesia had CSF and serum samples drawn before, after and on the morning following surgery. Cytokines and albumin in serum and CSF and cortisol in CSF were assessed at all three points. Results: Cytokines and cortisol were significantly increased in serum and CSF after surgery (Ps <0.01) and CSF increases were greater than in serum. Ten individuals had an increased cytokine response and significantly higher CSF/serum albumin ratios (Ps <0.01), five of whom had albumin ratios in the pathological range (>11.8). Serum and CSF levels of cytokines were unrelated, but there were strong correlations between CSF IL-2, IL-10 and IL-13, and albumin ratios (Ps <0.05) following surgery. Conclusion: Cytokine increases in the CNS were substantially greater than in serum, indicating that the CNS inflammatory system is activated during peripheral surgery and may be regulated separately from that in the peripheral body. CSF cytokine increase may indicate sensitivity to trauma and is linked to BBB macromolecular permeability.
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| 9. |
- 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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| 10. |
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| 11. |
- Durbeej, Natalie, et al.
(författare)
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Validation of the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test in a Swedish sample of suspected offenders with signs of mental health problems : results from the Mental Disorder, Substance Abuse and Crime study
- 2010
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Ingår i: Journal of Substance Abuse Treatment. - : Elsevier BV. - 0740-5472 .- 1873-6483. ; 39:4, s. 364-377
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Tidskriftsartikel (refereegranskat)abstract
- Substance abuse is common among offenders. One method widely used for the detection of substance abuse is screening. This study explored the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) screening tools in relation to (a) substance abuse and dependency diagnoses and (b) three problem severity domains of the sixth version of the Addiction Severity Index in a sample of 181 suspected offenders with signs of mental health problems. The screening tools showed moderate to high accuracy for identification of dependency diagnoses. The AUDIT was associated with alcohol problem severity, whereas the DUDIT was associated with drug and legal problem severity. Administering the screening tools in the current population yields valid results. However, the suggested cutoff scores should be applied with caution due to the discrepancy between present and previous findings.
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| 12. |
- 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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| 13. |
- Dåderman, Anna Maria, 1953-, et al.
(författare)
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Degree of psychopathy and patterns of personality traits : implications for treatment in male juvenile delinquents
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- We have assessed psychopathy in male juvenile delinquents, and examined the relationships between patterns of psychopathy-related personality traits and psychopathy (PCL-R). Our results are complemented by data regarding previous treatment occasions and reoffending, with the aim of discussing treatment strategies.We studied 56 male juvenile delinquents whose ages ranged from 14 to 20 years, with a mean of 17 years (SD = 1.2) from four youth correctional institutions in Sweden. All of the young people had shown early onset of conduct disorder. The modified version of the Hare Psychopathy Checklist – Revised (PCL-R), designed to be used with young people (Forth, Hart, & Hare, 1990), was used to assess psychopathy. Personality traits were measured along five dimensions: impulsiveness, monotony avoidance, socialization, verbal aggression, and somatic anxiety; scales were taken from the Karolinska Scales of Personality.The mean PCL-R score was 29.3 in this sample (SD = 7.8), and 73% had scores between 27 and 40, indicating high degree of psychopathy; 59% of the participants had scores above 30, and, according to the manual, were classified as psychopaths. No significant correlations were found between the personality scale scores and the PCL-R scores. We discovered seven clusters; three of these were multi-psychopathological clusters (the members of these clusters had all traits deviant from what is normal), three of these consisted of participants for who the majority of traits were deviant (only one or two traits were within the normal range), and one of these consisted of participants for who all traits were within the normal range. We suggest that the classification will be helpful in managing therapeutic efforts.The results indicate that psychopathy is common in male juvenile delinquents, and that personality profile may have implications for early intervention strategies in male adolescents with conduct disorder.
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| 14. |
- Dåderman, Anna Maria, 1953-
(författare)
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“Dr Jekyll and Mr Hyde?” : Abuse of potent benzodiazepines, exemplified by flunitrazepam, in mentally disordered male offenders
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Flunitrazepam (FZ) is an example of a sedative-hypnotic benzodiazepine whose pharmacokinetic properties include a rapid onset of action and an intermediate duration of action. It has a high affinity to central benzodiazepine receptors and affects them profoundly. These properties, and its profile of activity, increase the probability of abuse by those who have access to it. Known side effects of FZ are abuse and amnesia. FZ is widely abused and it has become a drug of choice among opioid abusers, as a club drug, and as a classic “date-rape” drug. FZ is often involved in fatal intoxication. It is therefore expected that FZ abuse is common in serious offenders. I have studied the reasons for FZ abuse and mapped the prevalence of the abuse, with the objective of studying the personalities and the background factors of the abusers, and of drawing some conclusions about assessment procedures of FZ abuse and the position of FZ in society.The participants in the studies summarised here were fifty-six juvenile delinquents from Swedish youth correctional institutions, aged 14-20 years, and sixty non-psychotic male offenders referred for a forensic psychiatric evaluation (FPE), aged 16-35 years. The participants answered questions regarding their abuse, and this enabled us to understand why they abused just FZ (and not another substance). The participants also completed a number of self-reported inventories, which enabled us to obtain measures of personality traits. They were also rated for psychopathy. Five forensic psychiatric cases of FZ abusers were studied in more detail. Furthermore, the forensic psychiatric participants’ psychiatric diagnoses, and both groups’ crime-related measures, were obtained from their files.About 40% of the juvenile delinquents and 30% of the offenders referred for a forensic psychiatric evaluation abused FZ. The main reason for the FZ abuse was to change a perception of reality and to obtain an increased feeling of power and self-esteem, a feeling that everything was possible. Both samples of offenders differed from the normal population in many personality traits, suggesting that the participants possessed a high level of vulnerability for developing mental disorders, but only a few differences in personality traits were found between FZ abusers and non-FZ abusers. The juvenile delinquent FZ abusers had higher scores than non-FZ abusers in the verbal aggression and sensation-seeking boredom susceptibility scales. In the juvenile sample, FZ abuse was associated with the abuse of amphetamines and/or cocaine, cannabis, and opiates, and with childhood psychological/psychiatrical contact, with living in a metropolitan housing area, and with recidivism into crimes leading to care in a juvenile correctional institution. In this sample, FZ abuse was also associated with weapons offences and narcotics-related crimes. In the forensic psychiatric sample, FZ abuse was significantly associated with previous admission to an FPE, and convictions for robbery, for weapons-related offences, for narcotics-related offences and for theft. The results show that FZ is more common in offenders who score high on Facet 4 (Antisocial) in the Hare psychopathy model, and that FZ abuse has high correlation with Item 20 (Criminal versatility). All of the FZ abusers reported side effects from FZ that resulted in the brutality of their violent acts and anterograde amnesia. FZ abusers, when intoxicated with FZ, had a reduced capacity for both empathy and anticipatory anxiety, in contrast to their “daily” behaviour and “ordinary” (i.e., without the influence of the FZ) personality characteristics. They were not characterised by classic characteristics of psychopathy, such as lack of empathy. This may indicate that FZ induces psychopathic-like state-dependant (FZ intoxication) traits, and temporary dissociate states (“Dr Jekyll and Mr Hyde”?).In conclusion, FZ abuse is common in the population of young offenders with mental disorders, and FZ is often used for nonmedical purposes. The practical implications of these conclusions are that clinicians and those who develop or manage therapeutic programs should be aware of FZ abuse when choosing the most effective treatment for male offenders. General practitioners who prescribe potent sedative compounds should be aware of their possible adverse effects. The availability of FZ should be limited further, because FZ is frequently abused in vulnerable male offenders, and because FZ has serious adverse mental health-related effects and is related to robbery and weapons‑related crimes.
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| 15. |
- Dåderman, Anna Maria, 1953-, et al.
(författare)
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Flunitrazepam intake in male offenders
- 2012
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Ingår i: Nordic Journal of Psychiatry. - : Informa Healthcare. - 0803-9488 .- 1502-4725. ; 66:2, s. 131-140
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Tidskriftsartikel (refereegranskat)abstract
- The abuse of flunitrazepam (FZ) compounds is worldwide, and several studies have reflected on the consequences with regard to violence, aggression and criminal lifestyle of FZ users. Criminals take high doses of FZ or some other benzodiazepines to "calm down" before the planned crime. There is support from earlier studies that most likely, all benzodiazepines may increase aggression in vulnerable males. Chronic intake of high doses of FZ increases aggression in male rats. Because psychopathy involves aggression, we have examined whether psychopathy as well as any of the four facets of the Psychopathy Checklist-Revised (PCL-R) (Interpersonal, Affective, Lifestyle and Antisocial) are related to different substance use disorders, with the focus on FZ. We have also examined the relationship between each PCL-R item and FZ use. Participants were 114 male offenders aged 14-35 years, all of whom were convicted for severe, predominantly violent, offences. Substance use, including FZ, was not more common in those who scored high in psychopathy. Use of FZ was more common in offenders who scored high in Facet 4 (Antisocial) of the PCL-R (odds ratio = 4.30, 95% CI 1.86-9.94). Only one of the PCL-R items, "Criminal versatility", was significantly associated with FZ use (odds ratio = 3.7). It may be concluded that intake of FZ has a specific relationship to only one of the facets and not to psychopathy per se. ; The findings have also important theoretical implications because Facet 4 is not a key factor of the construct of psychopathy. Clinical implications of the article: We have used the new two-factor and four-facet theoretical model of psychopathy in the young offender population, many of them with one or more substance use disorders. The present results suggest that antisocial behavior defined by Facet 4 (poor behavioral control, early behavior problems, juvenile delinquency, revocation of conditional release and criminal versatility) in the studied subjects is more typical for FZ users than it is for non-FZ users. This may have implications for assessment and treatment. Clinicians should be aware that criminals with high scores on Facet 4 have a more than fourfold odds of being a FZ user. This conclusion has an important clinical implication because FZ abuse is very common and is not always the focus of a forensic psychiatric assessment. ;
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| 16. |
- Dåderman, Anna Maria, 1953-, et al.
(författare)
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Psychopathic traits and lifestyle in flunitrazepam abusers
- 2005
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The abuse of flunitrazepam (FZ) compounds is world-wide. We have examined whether any of the four facets of the Psychopathy Checklist-Revised (PCL-R) (Interpersonal, Affective, Lifestyle, and Antisocial) (Hare, 2003) is related to different substance use disorders, with the focus on FZ abuse. Participants were 114 male offenders aged 14-35 years, all of whom were convicted for severe, predominantly violent, offences. Abuse of FZ was more common in offenders who scored high in Facet 4 (Antisocial) of the PCL-R (odds ratio = 4.30, 95% C.I. 1.86 - 9.94). Using all 20 PCL‑R items as individual predictors of being an FZ abuser, only one of the items, Item 20) (Criminal versatility) was significantly associated with FZ abuse (odds ratio = 3.72, 95% C.I. 1.85 - 7.50). We suggest that abuse of FZ is more common in offenders who score high in Facet 4, and that FZ abuse is significantly associated with Item 20. Our results show that clinicians and those who develop or manage therapeutic programs should be aware of FZ abuse when choosing the most effective treatment for young mentally disordered severe offenders.
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| 17. |
- 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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| 18. |
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| 19. |
- Dåderman, Anna Maria, 1953-, et al.
(författare)
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Violent behavior, impulsive decision-making, and anterograde amnesia while intoxicated with Flunitrazepam and alcohol or other drugs : A case study in forensic psychiatric patients
- 2002
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Ingår i: The journal of the American Academy of Psychiatry and the Law. - Bloomfield, CT, USA. - 1093-6793 .- 1943-3662. ; 30:2, s. 238-251
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Tidskriftsartikel (refereegranskat)abstract
- It is known that many male juvenile delinquents commit violent crimes while intoxicated with flunitrazepam (FZ), often in combination with alcohol or other drugs. We have also noted the combined abuse of FZ with, for example, alcohol in male forensic psychiatric patients. Our objective was to study violent behavior, impulsive decision making, and amnesia in male forensic psychiatric patients who were intoxicated predominantly with FZ, to increase knowledge of the abuse of FZ in vulnerable subjects. We studied five forensic psychiatric patients, all of whom were assessed in 1998. All of the subjects reported earlier reactions to FZ, including hostility and anterograde amnesia. At the time of their crimes they were all intoxicated with FZ, often in combination with alcohol or other drugs, such as amphetamine or cannabis. In contrast to their behavior based on their ordinary psychological characteristics, their crimes were extremely violent, and the subjects lacked both the ability to think clearly and to have empathy with their victims. Our observations support the view that FZ abuse can lead to serious violent behavior in subjects characterized by vulnerable personality traits, and that this effect is confounded by the concurrent use of alcohol or other drugs. It is evident that FZ causes anterograde amnesia. Previous research and the results presented herein allow us to draw the following conclusion: on the basis of the neuropsychopharmacologic properties of FZ, legal decisions, such as declaring FZ an illegal drug, are needed in countries where it is now legal.
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| 20. |
- Eriksson, Åsa, et al.
(författare)
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Offenders with mental health problems and substance misuse : cluster analysis based on the Addiction Severity Index version 6 (ASI-6)
- 2013
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Ingår i: Mental Health and Substance Use. - : Informa UK Limited. - 1752-3281 .- 1752-3273. ; 6:1, s. 15-28
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Tidskriftsartikel (refereegranskat)abstract
- There is an urgent need to improve assessment and treatment among offenders with mental health problems and substance misuse (the “triply troubled”). An examination of the usefulness of the recently published Addiction Severity Index version 6 (ASI-6; Cacciola, J.S., Alterman, A.I., Habing, B., & McLellan, A.T. (2011). Recent status scores for version 6 of the Addiction Severity Index (ASI-6). Addiction, 106, 1588–1602) in classifying offenders with mental health problems and substance misuse was undertaken. A total of 207 offenders with suspect mental disorder and substance misuse about to go through a forensic psychiatric evaluation in Sweden were interviewed with the ASI-6. Data were cluster analyzed. Four distinct clusters emerged: (1) “less troubled” (n=35), (2) “severely triply troubled” (nfl30), (3) “triply troubled with medical problems” (n=52) and (4) “working triply troubled” (n=87). The ASI-6 proved useful in the classification of offenders with mental health problems and substance misuse. The authors suggest that the ASI-6 be used in research on the classification of the triply troubled.
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| 21. |
- 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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| 22. |
- 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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| 23. |
- Gustafsson Asting, Annika, et al.
(författare)
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Genetic Copy Number Variations in Colon Mucosa Indicating Risk for Colorectal Cancer.
- 2014
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Ingår i: Journal of Cancer Therapy. - : Scientific Research Publishing, Inc.. - 2151-1934 .- 2151-1942. ; 5:14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sporadic colorectal tumors probably carry genetic alterations that may be related to familiar clusters according to risk loci visualized by SNP arrays on normal tissues. The aim of the present study was therefore to search for DNA regions (copy number variations, CNVs) as biomarkers associated to genetic susceptibility for early risk predictions of colorectal cancer. Such sequence alterations could provide additional information on phenotypic grouping of patients. Material and Methods: High resolution 105K oligonucleotide microarrays were used in search for CNV loci in DNA from tumor-free colon mucosa at primary operations for colon cancer in 60 unselected patients in comparison to DNA in buffy coat cells from 44 confirmed tumor-free and healthy blood donors. Array-detected CNVs were confirmed by Multiplex ligation-dependent probe amplification (MLPA). Results: A total number of 205 potential CNVs were present in DNA from colon mucosa. 184 (90%) of the 205 potential CNVs had been identified earlier in mucosa DNA from healthy individuals as reported to the Database of Genomic Variants. Remaining 21 (10%) CNVs were potentially novel sites. Two CNVs (3q23 and 10q21.1) were significantly related to colon cancer, but not confirmed in buffy coat DNA from the cancer patients. Conclusion: Our study reveals two CNVs that indicate increased risk for colon cancer; these DNA alterations may have been acquired by colon stem cells with subsequent appearance among epithelial mucosa cells. Impact: Certain mucosa CNV alterations may indicate individual susceptibility for malignant transformation in relationship to intestinal toxins and bacterial growth.
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| 24. |
- Hedlund, Jonatan, et al.
(författare)
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A population-based study on toxicological findings in Swedish homicide victims and offenders from 2007 to 2009
- 2014
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Ingår i: Forensic Science International. - : Elsevier. - 0379-0738 .- 1872-6283. ; 244, s. 25-29
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Tidskriftsartikel (refereegranskat)abstract
- Background and objectives: Previous research on the toxicology of homicide has shown that about half of offenders and victims have psychoactive substances in their blood. The purpose of this study was to examine this topic in a Swedish setting. Methods: Toxicological data were sought in a database for all victims (n = 273) and perpetrators (n = 257) of homicide in Sweden from 2007 to 2009. Sufficient tests were identified for 97.1% of all victims (n = 265) and 46.7% of all offenders (n = 120). Additional information was obtained from court records and police reports. Results: A majority of individuals involved in homicides displayed positive toxicology (57.0% of victims and 62.5% of offenders). The most commonly detected substances, in both victims and offenders, were ethanol (44.9% vs. 40.8%) and benzodiazepines (8.3% vs. 19.2%). The difference between offenders and victims concerning benzodiazepines was statistically significant (OR 2.6; p = 0.002). Perpetrators of homicide-suicide had a lower prevalence of positive toxicology (30.8%) than other homicide offenders (66.4%; p = 0.04) and victims in unsolved cases more often exhibited positive drug toxicology compared to victims in solved cases (36.1% vs. 8.3%; p less than 0.001). Conclusions: The results of the study support the notion that substance abuse is firmly linked to committing homicide and to becoming a victim thereof.
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| 25. |
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| 26. |
- 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
-
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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| 27. |
- Högman, Lennart, 1960-, et al.
(författare)
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Cognition, prior aggression, and psychopathic traits in relation to impaired multimodal emotion recognition in psychotic spectrum disorders
- 2023
-
Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Psychopathic traits have been associated with impaired emotion recognition in criminal, clinical and community samples. A recent study however, suggested that cognitive impairment reduced the relationship between psychopathy and emotion recognition. We therefore investigated if reasoning ability and psychomotor speed were impacting emotion recognition in individuals with psychotic spectrum disorders (PSD) with and without a history of aggression, as well as in healthy individuals, more than self-rated psychopathy ratings on the Triarchic Psychopathy Measure (TriPM). Methods: Eighty individuals with PSD (schizophrenia, schizoaffective disorder, delusional disorder, other psychoses, psychotic bipolar disorder) and documented history of aggression (PSD+Agg) were compared with 54 individuals with PSD without prior aggression (PSD-Agg) and with 86 healthy individuals on the Emotion Recognition Assessment in Multiple Modalities (ERAM test). Individuals were psychiatrically stable and in remission from possible substance use disorders. Scaled scores on matrix reasoning, averages of dominant hand psychomotor speed and self-rated TriPM scores were obtained. Results: Associations existed between low reasoning ability, low psychomotor speed, patient status and prior aggression with total accuracy on the ERAM test. PSD groups performed worse than the healthy group. Whole group correlations between total and subscale scores of TriPM to ERAM were found, but no associations with TriPM scores within each group or in general linear models when accounting for reasoning ability, psychomotor speed, understanding of emotion words and prior aggression. Conclusion: Self-rated psychopathy was not independently linked to emotion recognition in PSD groups when considering prior aggression, patient status, reasoning ability, psychomotor speed and emotion word understanding.
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| 28. |
- Högman, Lennart, 1960-, et al.
(författare)
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Impaired facial emotion perception of briefly presented double masked stimuli in violent offenders with schizophrenia spectrum disorders
- 2020
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Ingår i: Schizophrenia Research. - : Elsevier BV. - 2215-0013. ; 19
-
Tidskriftsartikel (refereegranskat)abstract
- Social interactions require decoding of subtle rapidly changing emotional cues in others to facilitate socially appropriate behaviour. It is possible that impairments in the ability to detect and decode these signals may increase the risk for aggression. Therefore, we examined violent offenders with schizophrenia spectrum disorders (SSD) and compared these with healthy controls on a computerized paradigm of briefly presented double masked faces exhibiting 7 basic emotions. Our hypotheses were that impaired semantic understanding of emotion words and low cognitive ability would yield lowest emotion recognition. SSD exhibited lower accuracy of emotion perception than controls (46.1% compared with 64.5%, p = 0.026), even when considering the unbiased hit rate (22.4% compared with 43%, Z = 2.62, p < 0.01). Raw data showed uncommon but significant misclassifications of fear as sad, disgust as sad, sad as happy and angry as surprise. Once guessing and presentation frequencies were considered, only overall accuracy differed between SSD and healthy controls. There were significant correlations between cognitive ability, antipsychotic dose, speed and emotion accuracy in the SSD group. In conclusion, that there were no specific emotion biases in the SSD group compared to healthy controls, but particular individuals may have greater impairments in facial emotion perception, being influenced by intellectual ability, psychomotor speed and medication dosages, rather than specifically emotion word understanding. This implies that both state and trait factors influence emotion perception in the aggressive SSD group and may reveal one source of potential misunderstanding of social situations which may lead to boundary violations and aggression.
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| 29. |
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| 30. |
- Johansson, Anette G. M., et al.
(författare)
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Psychotically driven aggression is associated with greater mentalizing challenges in psychotic spectrum disorders
- 2020
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Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 20:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Some aggressive acts committed by individuals with psychotic spectrum disorders (PSD) are understandable in the context of interpersonal conflict or goal attainment, yet others are unpredictable, arising from delusions or hallucinations (psychotically driven aggressive acts, PDA). It is unknown if there are underlying differences in cognitive or perceptive social cognition in relation to aggression motivation in PSD.Method: We compared differences in social cognition performance between 49 individuals with PSD who had committed PDA with those exhibiting other types of aggression (n = 31) (non-PDA) and to community controls (n = 81) on the Swedish version of Double Movie for the Assessment of Social Cognition – Multiple Choice (DMASC-MC). Participants with PSD had more than 3 months of clinical stability and substance use abstention and stable antipsychotic medication doses. General intellectual ability was assessed with the information and matrix reasoning subtests of the Wechsler Intelligence Scales.Results: The PSD group with a history of PDA exhibited lower total and perceptive social cognition scores on the DMASC-MC than the non-PDA group and controls. In addition, they also showed lower cognitive scores compared to typical controls. Lower total scores were associated with lower scores on Wechsler intelligence subtests information and matrix reasoning. Taking this into account, the PDA group still had lower social cognition scores. There were no associations of antipsychotic medication dosages, positive or negative symptoms with social cognition scores. Higher antipsychotic dosage at the time of DMASC-MC testing and social cognition scores predicted a past history of PDA.Conclusions: We conclude that impaired social cognition, particularly perceptive social cognition, is associated with PDA in individuals with PSD.
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| 31. |
- Johansson, Anette, et al.
(författare)
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Severity of past aggression coupled to higher baseline oxygenated hemoglobin in right dorsolateral prefrontal cortex in schizophrenia
- 2019
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: Are there differences in working memory task related oxygenated hemoglobin (HbO) in dorsolateral prefrontal cortex in those with schizophrenia, who had committed instrumental violence as opposed to reactive aggression? Is there any relationship to the severity of such aggression?Methods: 22 stable forensic psychiatric inpatients with schizophrenia spectrum disorders (20 schizophrenia) were rated on symptom scales. Their most severe aggressive act was rated according to Cornell’s classification of instrumental or reactive aggression. The severity of aggression was also noted. Subjects completed a computerized Corsi-block-tapping test during functional near infrared spectroscopy (fNIRS). Correlation analyses and GLM were used to identify factors that correlated with oxygenated hemoglobin signal in optodes 1 and 15 (dorsolateral prefrontal cortex DLPFC).Results / Discussion: Spearman Rank correlations with task-minus-baseline HbO in optode 1(left DLPFC) were found for total antipsychotic daily dose and scores on block 5 of the Corsi task, as well as between daily dose and negative symptom scores. Correlations were found between baseline HbO in optode 1 and 15, as well as in task-minus-baseline. There was no effect of type of aggression on optode 1 or 15 baseline or task-minus-baseline HbO when controlled for the above. Past severe aggression, controlled for SANS, daily dose and Corsi correct responses correlated with higher HbO at baseline in optode 15 (F=9.45 p=0.007, adj R2=0.33, p=0.032) as opposed to task related HbO. Baseline and task-minus baseline optode 1 HbO correlated only with antipsychotic dose and Corsi score.
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| 32. |
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| 33. |
- Kristiansson, Marianne
(författare)
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Aspects on the cytokine load in trauma with special reference to blood components and local versus systemic cytokine activity
- 1997
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cytokines and their inhibitors are thought to be involved in many of the pathophysiological changes associated with trauma and infection. Therapeutic measures such as transfusion of blood components could have a bearing on the systemic cytokine load in these conditions. The relationship between local wound and systemic cytokine activity in humans has not been elucidated. The aims were to investigate the cytokine pattern in infected and not infected patients in the early postoperative period and the local and systcmic responses to trauma as reflected by the cytokine network and coagulation/fibrinolysis parameters and to characterize the content of cytokines in retrieved blood and in stored red blood cell concentrates (RBCs). Material and Methods: Activation of the immune system was assessed by determining the concentrations of ~he following components: tumour necrosis factor a (TNF), interleukin-l B (IL-I), interleukin-2 (IL-2), interleukin-6 (IL-6). interleukin-8 (IL-8), interleukin-10 (IL-10), soluble TNF receptors I and 11 (sTNF-R 1, sTNF-R 11), IL-I receptor antagonist (IL-I ra), a soluble form of the IL-6 receptor (slL-6-R). soluble E-Selectin (sE-Selectin), soluble intercellular adhesion molecule-l (slCAM 1), and soluble vascular adhesion molecule- I (sVCAM-I). Haemostatic mechanisms were assessed by determining thrombin-antithrombin complexes, fibrin, soluble, antithrombin, fibrin D-dimer, prothrombin fragment l+ 2, protein C and protein S. Tbe systemic proinflammatory cytokines were studied in 20 patients subjected to moderate or major surgery, 9 with infections and 11 without. The local and systemic immune/haemostatic responses were studied in 10 patients undergoing hip arthroplasty. The charactersistics of blood retrieved from a local tMuma site were investigated in 10 patients undergoing arthroplasty (hip or knee). Twenty-two units of stored RBCs were examined during the storage period. The effects of leukocyte filtration on the content of cytokines and soluble TNF receptors in RBCs were studied. Results: Patients with infections had higher IL-6 concentrations than those without. Interindividual variations of the plasma IL-6 concentrations were great in both groups. Wound drainage blood from a local trauma site hl patients undergoing arthroplasty displayed a more marked activation of the immune system, - in particular the anti-inflammatory components -, and of the haemostatic mechanisms than did the systemic circulation. In retrieved blood, intended for autotransfusion, marked hypercoagulability and increased concentrations of IL-6 were found. In stored RBCs, the concentrations of IL- I and IL-8 increased during the storage period. IL-2 was never detected. The concentrations of cytokines and solublc TNF receptors were higher in non-filtered than in prestorage filtered units of RBCs. Filtration at the end of the storage period did not affect the concentrations of cytohnes and soluble TNF receptors. Conclusions: The present data suggest that monitoring of the systemic concentrations of components of the cytokine network does not accurately reflect the local immune response. The amount of retrieved blood retransfused to patients ought to be considered. Stored RBCs contained cytokines, but we remain about the clinical implications of this finding. Prestorage leukocyte filtration reduced the occurrence of cytokines and soluble TNF receptors in RBCs which may suggest that the handling of blood components should be modified accordingly.
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| 34. |
- Kristiansson, Marianne, et al.
(författare)
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Sekretess hinder för hantering av högriskindivider.
- 2014
-
Ingår i: Svenska Dagbladet. - 1101-2412. ; :21 nov 2014
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- För att olika myndigheter ska kunna samverka när det gäller personer med psykisk sjukdom som riskerar att begå brott, krävs att nuvarande sekretessbestämmelser förändras.
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| 35. |
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| 36. |
- Kristiansson, Marianne, et al.
(författare)
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"Sjuk eller frisk" i rättspsykiatrisk mening. Vad säger lagen?
- 2014
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Ingår i: MAD, SAD or BAD? Nedslag i svensk rättspsykiatrisk forskning - en festskrift till Anders Forsmans 70-årsdag. Henrik Anckarsäter, Thomas Nilsson, Susanna Radovic (red.). - : Göteborgs universitet. Institutionen för filosofi, lingvistik och vetenskapsteori. - 1652-0459. - 9789163754357 ; , s. 75-80
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Denna översiktsartikel presenterar det svenska rättspsykiatriska systemet i förhållande till lagstiftningen och förslag till förändringar i den. Kapitlet har tidigare varit publicerat i Läkartidningen och författarna var vid tiden för den ursprungliga publikationen verksamhetschefer för de två stora statliga utredningsenheterna i Sverige, i Stockholm och Göteborg.
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| 37. |
- Lagerstedt, Kristina, 1976, et al.
(författare)
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Genes with relevance for early to late progression of colon carcinoma based on combined genomic and transcriptomic information from the same patients.
- 2010
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Ingår i: Cancer informatics. - 1176-9351. ; 9, s. 79-91
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Genetic and epigenetic alterations in colorectal cancer are numerous. However, it is difficult to judge whether such changes are primary or secondary to the appearance and progression of tumors. Therefore, the aim of the present study was to identify altered DNA regions with significant covariation to transcription alterations along colon cancer progression. METHODS: Tumor and normal colon tissue were obtained at primary operations from 24 patients selected by chance. DNA, RNA and microRNAs were extracted from the same biopsy material in all individuals and analyzed by oligo-nucleotide array-based comparative genomic hybridization (CGH), mRNA- and microRNA oligo-arrays. Statistical analyses were performed to assess statistical interactions (correlations, co-variations) between DNA copy number changes and significant alterations in gene and microRNA expression using appropriate parametric and non-parametric statistics. RESULTS: Main DNA alterations were located on chromosome 7, 8, 13 and 20. Tumor DNA copy number gain increased with tumor progression, significantly related to increased gene expression. Copy number loss was not observed in Dukes A tumors. There was no significant relationship between expressed genes and tumor progression across Dukes A-D tumors; and no relationship between tumor stage and the number of microRNAs with significantly altered expression. Interaction analyses identified overall 41 genes, which discriminated early Dukes A plus B tumors from late Dukes C plus D tumor; 28 of these genes remained with correlations between genomic and transcriptomic alterations in Dukes C plus D tumors and 17 in Dukes D. One microRNA (microR-663) showed interactions with DNA alterations in all Dukes A-D tumors. CONCLUSIONS: Our modeling confirms that colon cancer progression is related to genomic instability and altered gene expression. However, early invasive tumor growth seemed rather related to transcriptomic alterations, where changes in microRNA may be an early phenomenon, and less to DNA copy number changes.
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| 38. |
- Lavett, Ivar, 1986-
(författare)
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Tillräknelighet som straffrättslig ansvarsförutsättning
- 2024
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This doctoral thesis examines the doctrine of imputability in relation to Swedish criminal law. According to said doctrine, individuals may be held criminally liable only if they possessed the capacity to comprehend and be guided by the norms of the criminal law at the time of the act (capacity-responsibility). Most criminal law systems express this normative idea through a so-called insanity rule, which exempts from criminal liability perpetrators who acted in a severely aberrant mental state. In Swedish criminal law, however, no such rule exists. Building upon this premise, the thesis aims to enhance understanding of criminal imputability as a prerequisite for criminal liability in the Swedish legal discourse. Specifically, the thesis pursues two main objectives: first, to elucidate how the doctrine of criminal imputability is manifested in Swedish criminal law despite the absence of an insanity rule, and second, to highlight the potential functions that such a rule could perform within the Swedish criminal law system. The thesis argues that although the Swedish Criminal Code lacks an insanity rule related to criminal liability, the doctrine of imputability to some extent influences both the general rules of sanctions and liability. Regarding the potential functions of an insanity rule, the thesis proposes three such functions: a practical function to facilitate the examination of liability in cases involving significantly aberrant mental states, a backward-looking function to ensure individuals lacking capacity-responsibility are not unjustly held criminally liable, and a forward-looking function to prevent automatic release into society of perpetrators acquitted under criminal law due to lack of capacity-responsibility at the time of the offense.
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| 39. |
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| 40. |
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| 41. |
- 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
-
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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| 42. |
- 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
-
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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| 43. |
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| 44. |
- Nilsson, Thomas, 1954, et al.
(författare)
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Neurochemical measures co-vary with personality traits: Forensic psychiatric findings replicated in a general population sample
- 2010
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Ingår i: Psychiatry Research. - : Elsevier BV. - 1872-7123 .- 0165-1781. ; 178:3, s. 525-530
-
Tidskriftsartikel (refereegranskat)abstract
- Neurobiological markers in cerebrospinal fluid (CSF) and in serum, previously found to co-vary with destructive personality traits in violent offenders, were explored in a general population sample of 21 patients undergoing knee surgery. Results on the Karolinska Scales of Personality (KSP) and the Temperament and Character Inventory (TCI) were compared with CSF/serum albumin ratios and serum concentrations of beta-trace protein (beta TP) (as markers for blood-brain barrier (BBB) permeability), to CSF/serum albumin ratios between the dopamine and serotonin metabolites homovanillic acid (HVA)/5-hydroxyindoleacetic acid (HIM) and to CSF and serum ratios between activated thyroid hormone (T3) and its precursor T4. Serum beta TP concentrations correlated with CSF/serum albumin ratios (P=0.018), but not with preoperative serum creatinine concentrations. Serum beta TP correlated significantly with Monotony Avoidance and Impulsiveness: CSF HVA/5-HIAA ratios with Irritability and low Cooperativeness. The beta TP is a potential serum marker for the integrity of the BBB that does not necessitate lumbar puncture. Thyroid hormones did not correlate with personality traits. As reported in forensic psychiatric patients, aggressive, unempathic personality traits were thus associated with increased dopaminergic activity in relation to the serotonergic activity and impulsivity to increased BBB permeability also in a general population group. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
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| 45. |
- Oskarsson, Sofi, 1989-
(författare)
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Biological risk factors for crime : Adverse perinatal events and psychophysiology
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Biological risk factors for crime have been largely neglected within main-stream criminology. However, a large body of research has over the past few decades converged on the conclusion that it is important to consider biological risk factors for crime, as they may help to inform theory and etiology. We are gaining more knowledge about the biological underpinnings of crime in a rapidly evolving research field, but many questions remain to be answered.The overarching goal with the present dissertation was to expand the knowledge about biological risk factors, including adverse perinatal events and psychophysiology, for crime. Specifically, Study I aimed to examine the associations between adverse perinatal events and offspring crime in men and women respectively. Study II aimed to examine associations for resting heart rate and systolic blood pressure with reoffending in men. Study III aimed to examine associations for resting heart rate with crime in women. Lastly, Study IV aimed to synthesize existing evidence on the relationship between psychopathic personality and aversive startle potentiation. These aims were pursued through three studies utilizing Swedish population-based registers (Study I, Study II, and Study III), as well as one systematic review (Study IV).Taken together, the overall findings of the present dissertation suggest that biological risk factors are important for crime in various ways. Biological risk factors represent an important step forward to broaden our understanding of crime and may have the potential to inform theory and etiology as well as to ultimately improve prediction, prevention, and intervention strategies.
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| 46. |
- Persson, Mats, et al.
(författare)
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Self-reported violent ideation and its link to interpersonal violence among offenders with mental disorders and general psychiatric patients
- 2018
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Ingår i: Psychiatry Research. - : ELSEVIER IRELAND LTD. - 0165-1781 .- 1872-7123. ; 261, s. 197-203
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Tidskriftsartikel (refereegranskat)abstract
- This study aims at comparing mentally disordered offenders and general psychiatric patients regarding violent ideation and at exploring its association with interpersonal violence. We recruited 200 detainees undergoing forensic psychiatric evaluation and 390 general psychiatric patients at discharge. At baseline, they were asked about violent ideation; at the 20-week follow-up, information about violent acts was gathered from crime conviction registry, interviews, and records. The lifetime prevalence of violent ideation was 32.5% for offenders and 35.6% for patients; the corresponding two-month prevalence was 22.5% and 21.0%, respectively. For the both samples combined, those with violent ideation in their lifetime were significantly more prone to commit violent acts during follow-up than those without such ideation, OR = 2.65. The same applied to the patient sample, OR = 3.41. In terms of positive predictive values, fewer than 25% of those with violent ideation committed violent acts. Contrary to our hypothesis, the prevalence of violent ideation did not differ significantly between offenders and patients. However, there was support for the hypothesized association between violent ideation and violent acts on a group level. On an individual level, the clinician should consider additional factors when assessing the risk for violent acts.
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| 47. |
- Persson, Mats, et al.
(författare)
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Violence During Imprisonment, Forensic Psychiatric Care, and Probation: Correlations and Predictive Validity of the Risk Assessment Instruments COVR, LSI-R, HCR-20(V3), and SAPROF
- 2017
-
Ingår i: International Journal of Forensic Mental Health. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 1499-9013 .- 1932-9903. ; 16:2, s. 117-129
-
Tidskriftsartikel (refereegranskat)abstract
- This prospective, naturalistic, cohort study was designed to report the one-year rate of violence among Swedish forensic psychiatric clients, during forensic psychiatric care, prison, and probation. Another purpose was to validate the risk assessment instruments COVR, LSI-R, HCR-20(V3), and SAPROF in these settings. We assessed 200 detainees undergoing a forensic psychiatric investigation in Stockholm by means of the four instruments, 193 of them were followed up for one year. Violent acts were committed by 23.3% of the participants, and occurred more often at forensic psychiatric hospitals than correctional settings. According to the analyses, the predictive validity was small for COVR (AUC = .61), medium for LSI-R (AUC = .70), and large for HCR-20(V3) (AUC = .79) and SAPROF (AUC = .78).
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| 48. |
- Persson, Mats, et al.
(författare)
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Violent victimization and health service utilization in a forensic psychiatric context: a comparison between offenders with mental disorders and matched controls
- 2017
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Ingår i: BMC Psychiatry. - : BIOMED CENTRAL LTD. - 1471-244X. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Offenders with mental disorders constitute a particularly exposed group in society, with high rates of morbidity, mortality, and social deprivation. Often thought of primarily as perpetrators, these individuals may also be subjected to violence. Previous research indicates that violent victimization during lifespan is a risk factor for violent perpetration among psychiatric patients, but victimization studies on the group of offenders with mental disorders are scarce. Health services are pivotal to this group, but although most individuals do utilize these services, their vulnerability seems to remain. This study aimed at exploring the rates of victimization and health service utilization, including perceptions of unmet health care needs, among offenders with mental disorders. Methods: Two hundred detainees undergoing a forensic psychiatric evaluation in Stockholm were asked about violent victimization and health service utilization. Each detainee was compared with three controls from the general population, matched regarding age, sex, and occupation. Results: Victimization during the past year was reported by 52.3% of the detainees and 11.1% of the controls, with a corresponding risk ratio of 8.2. Health service utilization during the past three months was reported by 47.7 and 23.7%, respectively (risk ratio 2.0); and unmet health care needs by 42.2 and 16.7%, respectively (risk ratio 3.4). There was no distinct association between victimization and health service utilization among detainees. Conclusions: Offenders with mental disorders are at great risk of being victimized, and they experience impediments to receiving requisite health care. A possible way to reduce victimization and improve health service utilization may be to establish interdisciplinary yet specialized health centers with outreach teams but without complicated referral procedures.
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| 49. |
- Sturup, Joakim, et al.
(författare)
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Risk assessments and recidivism among a population-based group of Swedish offenders sentenced to life in prison
- 2016
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Ingår i: CBMH. Criminal behaviour and mental health. - : Wiley. - 0957-9664 .- 1471-2857. ; 26:2, s. 124-135
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn Sweden, the number of people serving life sentences has steadily increased. To date, few studies have examined the recidivism rate or the predictive validity of different risk assessment instruments in this group. AimsOur aim was to test the predictive validity among inmates serving life sentences of two different instruments used for assessing riskthe Historical, Clinical and Risk Management-20 (HCR-20), most widely used in clinical populations, and the Psychopathy Checklist-Revised (PCL-R), commonly applied in both penal and clinical settings. MethodNinety-eight life-sentenced prisoners were included, 26 of whom were released during the study period. Data on risk assessments and dates for release were collected from administrative records, while recidivism data were retrieved from a national database on criminal convictions. ResultsSex offenders obtained the highest scores and inmates charged with domestic violent offences obtained the lowest scores on both instruments. The released prisoners were followed for a mean period of 33months. During this time five prisoners (19%) reoffended, four of them violently, with an average time to recidivism of 10months. Only PCL-R Facet 4, which reflects antisocial features, was significantly associated with recidivism. ConclusionsThis small, but population-based, study demonstrates that antisocial behaviour shows incremental predictive validity for reoffending among life-sentenced offenders, but other measures have little to add for this specific task. The fact that those life sentenced prisoners who reoffended did so so soon after release should prompt allocation of earlier interventions towards preventing this.
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| 50. |
- Sturup, Joakim, et al.
(författare)
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Unsolved homicides in Sweden : A population-based study of 264 homicides
- 2015
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Ingår i: Forensic Science International. - : Elsevier BV. - 0379-0738 .- 1872-6283. ; 257, s. 106-113
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Tidskriftsartikel (refereegranskat)abstract
- The clearance rates for homicides have decreased internationally. This retrospective population-based study of all Swedish homicide incidents between 2007 and 2009 (n = 264) aims to investigate factors associated with solvability in homicides. Victims were identified in an autopsy registry and offenders in a criminal-conviction registry. Autopsy reports, police files, court verdicts and criminal records were systematically collected and linked. The clearance rate was 86.4% (n = 228), and almost three quarters of cases (71.9%) were solved within the first week. Nine factors were significantly associated with the case status; however, only four factors remained significant in the multivariate logistic-regression model. Cases were more likely to be solved if there was an eyewitness and if the victim was intoxicated with alcohol. Moreover, cases were less likely to be solved if the victim had a criminal record in the past five years and was killed by a firearm. In the final model, a Cox proportional-hazards model, where time to arrest was taken into account, only alcohol intoxication were positively and firearms negatively significantly associated with clearance status. The study concludes that cases involving these factors should be granted extra, intensive and lasting resources.
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