| 1. |
- Anckarsäter, Henrik, 1966, et al.
(författare)
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Mental disorder is a cause of crime: The cornerstone of forensic psychiatry
- 2009
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 32:6, s. 342-347
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Tidskriftsartikel (refereegranskat)abstract
- The assumption that mental disorder is a cause of crime is the foundation of forensic psychiatry, but conceptual. epistemological. and empirical analyses show that neither mental nor crime, or the causation implied, are clear-cut concepts. "Mental" denotes heterogeneous aspects of a per-son such as inner experiences. cognitive abilities, and behaviour patterns described in a non-physical vocabulary. In psychology and psychiatry, mental describes law-bound, caused aspects of human functioning that are predictable and generalizable. Problems defined as mental disorders are end-points of dimensional inter-individual differences rather than natural categories. Deficits in cognitive faculties, such as attention, verbal understanding, impulse control, and reality assessment, may be susceptibility factors that relate to behaviours (Such as crimes) by increasing the probability (risk) for a negative behaviour or constitute causes in the sense of INUS conditions (insufficient but Non-redundant parts of Unnecessary but Sufficient conditions). Attributing causes to complex behaviours such as crimes is not an unbiased process, and mental disorders will attract disproportionate attention when it comes to explanations of behaviours that we wish to distance ourselves from. Only by rigorous interpretation of what psychiatry actually can inform us about, using empirical analyses of quantified aggressive antisocial behaviours and their possible explanatory factors, can we gain a clearer notion of the relationship between mental disorder and crime. (C) 2009 Elsevier Ltd. All rights reserved.
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| 2. |
- Höglund, Pontus, et al.
(författare)
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Accountability and psychiatric disorders: How do forensic psychiatric professionals think?
- 2009
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Ingår i: International journal of law and psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 32:6, s. 355-361
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Tidskriftsartikel (refereegranskat)abstract
- Swedish penal law does not exculpate on the grounds of diminished accountability; persons judged to suffer from severe mental disorder are sentenced to forensic psychiatric care instead of prison. Re-introduction of accountability as a condition for legal responsibility has been advocated, not least by forensic psychiatric professionals. To investigate how professionals in forensic psychiatry would assess degree of accountability based on psychiatric diagnoses and case vignettes, 30 psychiatrists, 30 psychologists, 45 nurses, and 45 ward attendants from five forensic psychiatric clinics were interviewed. They were asked (i) to judge to which degree (on a dimensional scale from 1 to 5) each of 12 psychiatric diagnoses might affect accountability, (ii) to assess accountability from five case vignettes, and (iii) to list further factors they regarded as relevant for their assessment of accountability. All informants accepted to provide a dimensional assessment of accountability on this basis and consistently found most types of mental disorders to reduce accountability, especially psychotic disorders and dementia. Other factors thought to be relevant were substance abuse, social network, personality traits, social stress, and level of education.
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| 3. |
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| 4. |
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| 5. |
- Andreasson, Helena, et al.
(författare)
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Predictors of length of stay in forensic psychiatry: The influence of perceived risk of violence
- 2014
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 37:6
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Tidskriftsartikel (refereegranskat)abstract
- This study describes the prevalence of adverse events and length of stay in forensic psychiatric patients with and without a restriction order. Detailed clinical and administrative information from medical records and written court decisions was gathered retrospectively from admission until discharge for a Swedish population-based, consecutive cohort of forensic psychiatric patients (n = 125). The median length of stay for the whole cohort was 951 days, but patients with a restriction order stayed in hospital almost five times as long as patients without. Restriction orders were related to convictions for violent crime, but not for any other differences in demographic or clinical variables. The majority of the patients (60%) were involved in adverse events (violence, threats, substance abuse, or absconding) at some time during their treatment. Patients with restriction orders were overrepresented in violent and threat events. Previous contact with child and adolescence psychiatric services, current violent index crime, psychotic disorders, a history of substance, and absconding during treatment predicted longer length of stay. Being a parent, high current Global Assessment of Functioning scores, and mood disorders were all significantly related to earlier discharge. In a stepwise Cox regression analysis current violent index crime and absconding remained risk factors for a longer hospital stay, while a diagnosis of mood disorder was significantly related to a shorter length of stay.
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| 6. |
- Degl'Innocenti, Alessio, 1961, et al.
(författare)
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First report from the Swedish National Forensic Psychiatric Register (SNFPR)
- 2014
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 37:3, s. 231-237
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Tidskriftsartikel (refereegranskat)abstract
- To the best of our knowledge, the present register is the only nationwide forensic psychiatric patient register in the world. The aim of this article is to describe the content of the Swedish National Forensic Psychiatric Register (SNFPR) for Swedish forensic patients for the year 2010. The subjects are individuals who, in connection with prosecution due to criminal acts, have been sentenced to compulsory forensic psychiatric treatment in Sweden. The results show that in 2010, 1476 Swedish forensic patients were assessed in the SNFPR; 1251 (85%) were males and 225 (15%) were females. Almost 60% of the patients had a diagnosis of schizophrenia, with a significantly higher frequency among males than females. As many as 70% of the patients had a previous history of outpatient psychiatric treatment before becoming a forensic psychiatric patient, with a mean age at first contact with psychiatric care of about 20 years old for both sexes. More than 63% of the patients had a history of addiction, with a higher proportion of males than females. Furthermore, as many as 38% of all patients committed crimes while under the influence of alcohol and/or illicit drugs. This was more often the case for men than for women. Both male and female patients were primarily sentenced for crimes related to life and death (e.g., murder, assault). However, there were more females than males in treatment for general dangerous crimes (e.g., arson), whereas men were more often prosecuted for crimes related to sex. In 2010, as many as 70% of all forensic patients in Sweden had a prior sentence for a criminal act, and males were prosecuted significantly more often than females. The most commonly prescribed pharmaceuticals for both genders were antipsychotics, although more women than men were prescribed other pharmaceuticals, such as antidepressants, antiepileptics, and anxiolytics. The result from the present study might give clinicians an opportunity to reflect upon and challenge their traditional treatment methods. (C) 2013 Elsevier Ltd. All rights reserved.
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| 7. |
- Görtz, Daniel, et al.
(författare)
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The stage-value model: Implications for the changing standards of care.
- 2015
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 42-43, s. 135-143
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Tidskriftsartikel (refereegranskat)abstract
- The standard of care is a legal and professional notion against which doctors and other medical personnel are held liable. The standard of care changes as new scientific findings and technological innovations within medicine, pharmacology, nursing and public health are developed and adopted. This study consists of four parts. Part 1 describes the problem and gives concrete examples of its occurrence. The second part discusses the application of the Model of Hierarchical Complexity on the field, giving examples of how standards of care are understood at different behavioral developmental stage. It presents the solution to the problem of standards of care at a Paradigmatic Stage 14. The solution at this stage is a deliberative, communicative process based around why certain norms should or should not apply in each specific case, by the use of "meta-norms". Part 3 proposes a Cross-Paradigmatic Stage 15 view of how the problem of changing standards of care can be solved. The proposed solution is to found the legal procedure in each case on well-established behavioral laws. We maintain that such a behavioristic, scientifically based justice would be much more proficient at effecting restorative legal interventions that create desired behaviors.
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| 8. |
- Hofvander, Björn, et al.
(författare)
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Continuity of aggressive antisocial behavior from childhood to adulthood: The question of phenotype definition.
- 2009
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 32:4, s. 224-234
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Tidskriftsartikel (refereegranskat)abstract
- Aiming to clarify the adult phenotype of antisocial personality disorder (ASPD), the empirical literature on its childhood background among the disruptive behaviour disorders, such as attention deficit/hyperactivity disorder (AD/HD), oppositional defiant disorder (ODD), conduct disorder (CD), or hyperkinetic conduct disorder (HKCD), was reviewed according to the Robins and Guze criteria for nosological validity. At least half of hyperactive children develop ODD and about a third CD (i.e. AD/HD+CD or HKCD) before puberty. About half of children with this combined problem constellation develop antisocial personality disorder (ASPD) in adulthood. Family and adoption/twin studies indicate that AD/HD and CD share a high heritability and that, in addition, there may be specific environmental effects for criminal behaviours. "Zones of rarity" delineating the disorders from each other, or from the normal variation, have not been identified. Neurophysiology, brain imaging, neurochemistry, neurocognition, or molecular genetics have not provided "external validity" for any of the diagnostic categories used today. Deficient mental functions, such as inattention, poor executive functions, poor verbal learning, and impaired social interaction (empathy), seem to form unspecific susceptibility factors. As none of today's proposed syndromes (e.g. AD/HD or psychopathy) seems to describe a natural category, a dimensional behavioural phenotype reflecting aggressive antisocial behaviours assessed by numbers of behaviours, the severity of their consequences and how early is their age at onset, which will be closely related to childhood hyperactivity, would bring conceptual clarity, and may form the basis for further probing into mental, cognitive, biological and treatment-related co-varying features.
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| 9. |
- Khoshnood, Ardavan, et al.
(författare)
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Deadly violence in Sweden: Profiling offenders through a latent class analysis
- 2020
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 71:July-August
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSweden has in recent years witnessed increasing rates of firearm-related violence and homicide, which has contributed to increased rates of deadly violence. Attempts to profile offenders committing such crimes are of major importance, because such efforts may contribute to better preventive measures. We therefore aimed to study the characteristics of individuals convicted and/or suspected of homicide, attempted homicide, preparation to commit homicide as well as conspiration to commit homicide (for simplicity called homicide+) in Sweden.MethodsBy using information from the Swedish Crime Register and the Swedish Criminal Suspect Register, individuals being 15–60 years old and convicted and/or suspected of homicide+ between 2000 and 2015 were included in the study. Using these registers and also other population and health care registers, information on previous criminality, substance abuse, and psychiatric disorders were added to the Latent Class Analysis (LCA) that was used to identify latent classes of individuals convicted and/or suspected for homicide+. In addition, several individual variables were added for validation purposes.ResultsA total of 14,466 individuals were included in the analysis. The majority were male (n = 12,802; 88.5%) and Swedish-born with Swedish-born parents (n = 8247; 57.0%). The LCA identified three classes where Conviction Class (CC) contained mostly convicted individuals whereas Mixed Class A (MCA) and Mixed Class B (MCB) contained almost equal rates of both convicted and suspected individuals. The CC was characterized by individuals with low rates of previous criminality, substance abuse and psychiatric disorders. The MCA and the MCB were characterized by individuals with higher rates of previous criminality, substance abuse, and psychiatric disorders as well as lower education and worse economy in comparison with the CC.ConclusionWhile MCA and MCB may be constituted by “traditional” criminals often well known by the police and/or the social authorities, the CC was mainly constituted by convicted offenders who may more easily escape the radar of the authorities.
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| 10. |
- Larsson Lindahl, Marianne, et al.
(författare)
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Experiences of coercion during investigation and treatment.
- 2005
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 28:6, s. 613-621
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Tidskriftsartikel (refereegranskat)abstract
- According to Swedish legislation (LVM) compulsory treatment shall be decided on if someone, due to ongoing abuse of alcohol, drugs or volatile solvents, is in need of care to overcome abuse and if a voluntary intervention is not possible. Very little research has been conducted in Sweden on this particular legislation with regard to the clients' experiences of entire process from assessment to aftercare. We interviewed 74 subjects who were being assessed prior to the court's decision on involuntary care (n = 39), or with previous experience of assessment and involuntary care (n = 35). The assessment group more often reported having the opportunity to express their opinions to the social worker during the assessment period (55% vs. 21%, p < .05) and they were more positive towards the final decision (60% vs. 24%, p < .05). In spite of the law, 18% were not contacted by the social services while in coercive treatment. The clients who did meet with a social worker, often described the conferences as more of a perfunctory nature with a lack of focus on the actual situation and aftercare planning. This study points at a need of studying the subjects' experiences of the whole continuum of the coercive process: from the investigation, to treatment and to aftercare. It also points at the need for new instruments to be developed covering all aspects of the coercive process and in particular the period of investigation prior to the decision on involuntary care.
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