| 1. |
- Anckarsäter, Henrik, 1966
(författare)
-
Beyond categorical diagnostics in psychiatry: Scientific and medicolegal implications.
- 2010
-
Ingår i: International journal of law and psychiatry. - : Elsevier BV. - 1873-6386 .- 0160-2527. ; 33:2, s. 59-65
-
Tidskriftsartikel (refereegranskat)abstract
- Conforming to a medical disease model rooted in phenomenology and natural science, psychiatry classifies mental disorders according to signs and symptoms considered to be stable and homogeneous across individuals. Scientific studies addressing the validity of this classification are scarce. Following a seminal paper by Robins and Guze in 1970, validity of categories has been sought in specific criteria referring to symptoms and prognosis, aggregation in families, and "markers", preferentially laboratory tests. There is, however, a growing misfit between the model and empirical findings from studies putting it to the test. Diagnostic categories have not been shown to represent natural groups delineated from the normal variation or from each other. Aetiological factors (genetic and/or environmental), laboratory aberrations, and treatment effects do not respect categorical boundaries. A more adequate description of mental problems may be achieved by: 1) a clear definition of the epistemological frame in which psychiatry operates, 2) a basic rating of the severity of intra- and interpersonal dysfunctions, and 3) empirical comparisons to complementary rather than exclusive dimensions of inter-individual differences in context-specific mental functions, treatment effects, and laboratory findings. Such a pluralistic understanding of mental health problems would fit empirical models in the neurosciences and postmodern notions of subjectivity alike. It would also clarify the assessment of dysfunction and background factors in relation to the requisites for penal law exemptions or insurance policies and make them empirically testable rather than dependent on expert opinion on issues such as whether a specific dysfunction is "psychiatric", "medical", or ascribable to "personality".
|
|
| 2. |
- Andreasson, Helena, et al.
(författare)
-
Predictors of length of stay in forensic psychiatry: The influence of perceived risk of violence
- 2014
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 37:6, s. 635-642
-
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.
|
|
| 3. |
- Bergenheim, Åsa, 1954-
(författare)
-
Sexual assault, irresistible impulses, and forensic psychiatry in Sweden
- 2014
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier. - 0160-2527 .- 1873-6386. ; 37:1, s. 99-108
-
Tidskriftsartikel (refereegranskat)abstract
- After forensic psychiatry was firmly established in Sweden in the 1930s, many rapists and individuals charged with assaulting children underwent a forensic psychiatric examination. The physicians found that most of them had not been “in control” of their senses or not “in complete control” of their senses at the time of the crime. If the court ordered a forensic psychiatric examination, the defendant had a very good chance of either being discharged or having his sentence reduced considerably. By the 1950s psychological perspectives began to dominate in forensic psychiatry. In the forensic records of the 1950s we can notice a shift from a biomedical to a socio-psychological perspective, and crime was increasingly related to conditions that were not seen as mental derangement from a legal point of view. As a result, it became less and less common, from the 1950s onwards, for sentences to be commuted or defendants discharged.
|
|
| 4. |
|
|
| 5. |
- Degl'Innocenti, Alessio, 1961, et al.
(författare)
-
First report from the Swedish National Forensic Psychiatric Register (SNFPR)
- 2014
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 37:3, s. 231-237
-
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.
|
|
| 6. |
- Diesen, Christian, et al.
(författare)
-
Sex crime legislation : Proactive and anti-therapeutic effects
- 2010
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 33:06-maj, s. 329-335
-
Tidskriftsartikel (refereegranskat)abstract
- Therapeutic jurisprudence may have its major role within law practice, but analysis of the law from a therapeutic perspective is a task that should not be neglected: how a piece of legislation is designed and formulated certainly influences the therapeutic outcome of a legal process. This article uses sex legislation as an example to demonstrate how the old rape law based on coercion has anti-therapeutic effects on rape victims. If the law requires resistance, it implies that a woman is sexually available until she resists physically, resulting in an attitude that a woman reporting rape without injuries should be mistrusted. This mistrust of the victim and the victim's attendant feelings of self-blame aggravate the victim's trauma. On the other hand, a modern rape law based on lack of consent gives the signal that a woman is not available until she has given her consent, resulting in a different starting position for the investigation. Since the will of the victim must be respected, the victim herself must be respected in the legal process. Furthermore, being able to tell one's story in a respectful atmosphere can be more important for the well-being of the victim than the outcome of the reported case.
|
|
| 7. |
|
|
| 8. |
- Kindström Dahlin, Moa, et al.
(författare)
-
Swedish Legal Scholarship Concerning Protection of Vulnerable Groups : Therapeutic and Proactive Dimensions
- 2010
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 33:5-6, s. 398-405
-
Tidskriftsartikel (refereegranskat)abstract
- This paper presents a brief overview of the legal theoretical problems that arise in connection with the societal ambition of protecting vulnerable groups. One of the central difficulties in legislation with proactive and therapeutic ambitions arises from the link between law and philosophy of science, i.e., the relationship between facts and norms. It is shown that Therapeutic Jurisprudence differs in several aspects from Swedish legal scholarship that follows Scandinavian Legal Realism. It is also demonstrated that Therapeutic Jurisprudence has several similarities with the so-called Proactive Approach. This paper suggests that Therapeutic Jurisprudence may serve as a useful legal theoretical perspective in Swedish legal scholarship, especially when studying complex and vague regulations with a future focus. Two examples from Swedish legislation are examined: (a) Laws regulating compulsory care of abused or neglected children, and (b) laws related to the mentally ill. This paper illustrates the complexity in these acts, and poses the question of whether the regulations serve their purpose of providing adequate care for and protection of those in need.
|
|
| 9. |
- Lund, Christina, et al.
(författare)
-
Violent criminal recidivism in mentally disordered offenders: A follow-up study of 13-20 years through different sanctions
- 2013
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 36:3-4, s. 250-257
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe criminal recidivism, especially violent recidivism, in a long-term follow-up of mentally disordered offenders sentenced to different types of sanctions. Subjects and methods: A population-based Swedish cohort of male offenders referred to pre-trial psychiatric investigations between 1988 and 1995, was sentenced to forensic psychiatric treatment (n = 163), prison (n = 120), or noncustodial sanctions (n = 52). They were followed from the beginning of their sanctions until the end of June, 2008, through official health and crime registers. Survival analyses were used to compare time until violent recidivism across different sanctions and mental disorders, and predictors of violent recidivism were investigated using univariate comparisons, a multivariate Cox regression analysis and Receiver Operating Characteristic (ROC) curves. Finally, all criminal reconvictions until the end of follow-up were assessed (a total time period of 13 to 20 years). Results: Forty-seven percent of all subjects were reconvicted for violent crimes during follow-up. There were no significant differences between sanction groups. By contrast, diagnostic groups that included substance abuse had significant effects, and stood out as the strongest predictor of violent reconvictions together with the number of previous violent crimes, and age at the first registered criminal offence. Variables identified in the multivariate model together predicted violent recidivism with an area under the ROC curve of 0.72, while the corresponding figure for the age at onset of criminality as the sole predictor was 0.71. Among the different sanction forms for different time periods, time in hospital and prison were significantly less associated with violent recidivism compared to time in conditional release/probation.
|
|
| 10. |
- Malmgren, Helge, 1945, et al.
(författare)
-
A philosophical view on concepts in psychiatry
- 2010
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 33, s. 66-72
-
Tidskriftsartikel (refereegranskat)abstract
- This essay first outlines a philosophical theory of concepts and then applies it to two areas of relevance to psychiatrists, especially forensic psychiatrists. In the philosophical theory, the respective roles of verbal and non-verbal definitions are illuminated, and the importance of the phenomenon of division of semantic labour is stressed. It is pointed out that vagueness and ambiguity of a term often result when the term is used for several practical purposes at the same time. Such multi-purpose uses of terms may explain both the current problems associated with the Swedish forensic–psychiatric concept of a severe mental disorder and some of the shortcomings of DSM-IV.
|
|
| 11. |
- Maycraft Kall, Wendy Katherine, 1962-
(författare)
-
Same law - same rights? : Analyzing why Sweden's disability legislation failed to create equal rights in mental health
- 2014
-
Ingår i: International Journal of Law and Psychiatry. - Oxford : Pergamon Press. - 0160-2527 .- 1873-6386. ; 37:6, s. 609-618
-
Tidskriftsartikel (refereegranskat)abstract
- This article analyzed the apparent paradox of disability rights in Sweden. Despite strong welfare state traditions and stated Government ambitions to create generous statutory entitlements for all disabled people using a single, comprehensive Disability Act, psychiatric disabilities were principally excluded from the Disability Act's rights and provisions. The study focused on Sweden's Mental Health Reform and Disability Reform using governance perspectives that traced and analyzed the policy-processes of both reforms. Theoretically guided analytical frameworks were developed to help understand the divergent reform outcomes. The first focused on legislative arguments of regulatory specificity and legal enforcement mechanisms to consider whether the Disability Act was formulated in a manner that was easier to apply to certain disabilities. The second analyzed ideological arguments and the influence of Government political beliefs that signaled specific reform ‘visions’ to implementers and thereby influenced policy implementation. The main findings are that both perspectives matter as the dual influences of legislative and ideological differences tended to exclude mental health service users from the Act's generous disability rights. The overall conclusion was that while legislation was an important regulatory mechanism, the Government's underlying ideological reform vision was also an essential governance instrument that signaled Government intentions to implementing agencies and thus influenced the creation of enduring disability rights.
|
|
| 12. |
- Radovic, Susanna, 1969, et al.
(författare)
-
Explanations for violent behaviour - An interview study among forensic in-patients
- 2014
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 37:2, s. 142-148
-
Tidskriftsartikel (refereegranskat)abstract
- The alleged relation between mental disorder and violent criminal behaviour has been investigated mainly from an epidemiological perspective. Population-based registry studies have shown that violence occurs more frequently among people with mental disorders, like schizophrenia and bipolar disorder, compared with control subjects, but that the increased risk is largely mediated by drug abuse and socio-economic deprivation. The aim of this study was to explore how patients who have committed violent or sexual crimes and have been sentenced to forensic psychiatric care by a Swedish court of law construed their criminal actions in terms of causes. Forty-six participants from six different Swedish forensic psychiatric clinics were included in the study. A semi-structured interview study was conducted and the data was analysed using a thematic analysis. A large group of the participants did not believe that the mental disorder played any role in the criminal events. Contributing causes that were mentioned were drug abuse and social factors.
|
|
| 13. |
- Sjöström, Stefan, 1965-, et al.
(författare)
-
Why community compulsion became the solution : reforming mental health law in Sweden
- 2011
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 34:6, s. 419-428
-
Tidskriftsartikel (refereegranskat)abstract
- The aimof this article is to understand how compulsory community care (CCC) has become a solution in mental health policy in so many different legal and social contexts during the last 20 years. The recent introduction of CCC in Sweden is used as a case in point, which is then contrasted against the processes in Norway, England/Wales and New York State. In Sweden, the issue of CCC was initiated following high-profile acts of violence. Contrary to several other states, therewas agreement about the (lack of) evidence about its effectiveness. Rather than focusing on dangerousness, the government proposal about CCC was framedwithin an ideology of integrating the disabled. The new legislation allowed for a broad range ofmeasures to control patients at the same time as itwas presented as a means to protect positive rights for patients. Compared to previous legislation in Sweden, the scope of social control has remained largely the same, although the rationale has changed — from medical treatment via community treatment and rehabilitation, to reducing the risk of violence, and then shifting back to rehabilitation in the community. The Swedish approach to CCC is similar to Norway, while New York and England/Wales have followed different routes. Differences in ideology, social control and rights orientations can be understood with reference to the general welfare and care regimes that characterize the four states.
|
|
| 14. |
- Svennerlind, Christer, 1963, et al.
(författare)
-
Mentally disordered criminal offenders in the Swedish criminal system
- 2010
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 33:4, s. 220-226
-
Tidskriftsartikel (refereegranskat)abstract
- Historically, the Swedish criminal justice system conformed to other Western penal law systems, exempting severely mentally disordered offenders considered to be unaccountable. However, in 1965 Sweden enforced a radical penal law abolishing exceptions based on unaccountability. Mentally disordered offenders have since then been subjected to various forms of sanctions motivated by the offender's need for care and aimed at general prevention. Until 2008, a prison sentence was not allowed for offenders found to have committed a crime under the influence of a severe mental disorder, leaving forensic psychiatric care the most common sanction in this group. Such offenders are nevertheless held criminally responsible, liable for damages, and encumbered with a criminal record. In most cases, such offenders must not be discharged without the approval of an administrative court. Two essentially modern principles may be discerned behind the “Swedish model”: first, an attempted abolishment of moral responsibility, omitting concepts such as guilt, accountability, atonement, and retribution, and, second, the integration of psychiatric care into the societal reaction and control systems. The model has been much criticized, and several governmental committees have suggested a re-introduction of a system involving the concept of accountability. This review describes the Swedish special criminal justice provisions on mentally disordered offenders including the legislative changes in 1965 along with current proposals to return to a pre-1965 system, presents current Swedish forensic psychiatric practice and research, and discusses some of the ethical, political, and metaphysical presumptions that underlie the current system.
|
|
| 15. |
- Veen, Violaine C., et al.
(författare)
-
Cross-ethnic generalizability of the three-factor model of psychopathy : the youth psychopathic traits inventory in an incarcerated sample of native Dutch and Moroccan immigrant boys
- 2011
-
Ingår i: International Journal of Law and Psychiatry. - : Pergamon Press. - 0160-2527 .- 1873-6386. ; 34:2, s. 127-130
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous research provides support for the existence of the psychopathy construct in youths. However, studies regarding the psychometric properties of psychopathy measures with ethnic minority youths are lacking.METHODS: In the present study, the three-factor structure of the Youth Psychopathic Traits Inventory (YPI) was examined for both native Dutch youth (N=158) and an ethnic minority group, Moroccans (N=141), in an incarcerated adolescent population in the Netherlands.RESULTS: Our results showed that the three-factor structure of the YPI is comparable across an ethnic majority and an ethnic minority group in an incarcerated sample in the Netherlands. Moreover, associations between psychopathic traits and mental health problems were similar for both ethnic groups.CONCLUSION: The results support the cross-ethnic generalizability of the three-factor model of psychopathy as measured through the Youth Psychopathic Traits Inventory.
|
|
| 16. |
- Wiklund, Gunnar, et al.
(författare)
-
Pro-bullying attitudes among incarcerated juvenile delinquents : Antisocial behavior, psychopathic tendencies and violent crime
- 2014
-
Ingår i: International Journal of Law and Psychiatry. - New York : Elsevier BV. - 0160-2527 .- 1873-6386. ; 37:3, s. 281-288
-
Tidskriftsartikel (refereegranskat)abstract
- The objective was to evaluate a new scale aimed at assessing antisocial attitudes, the Pro-bullying Attitude Scale (PAS), on a group of 259 voluntarily-recruited male juvenile delinquents from a juvenile correctional institution in Arkhangelsk, North-western Russia. Exploratory factor analysis gave a two-factor solution: Factor 1 denoted Callous/Dominance and Factor 2 denoted Manipulativeness/Impulsiveness. Subjects with complete data on PAS and Childhood Psychopathy Scale (CPS) (n = 171) were divided into extreme groups (first and fourth quartiles) according to their total scores on PAS and the two factor scores, respectively. The extreme groups of total PAS and PAS Factor 1 differed in CPS ratings and in violent behavior as assessed by the Antisocial Behavior Checklist (ABC). They also differed in the personality dimension Harm Avoidance as measured by use of the Temperament and Character Inventory (TCI), and in delinquent and aggressive behavior as assessed by the Youth Self Report (YSR). The extreme groups of PAS Factor 2, in turn, differed in aggressive behavior as assessed by the YSR, and in the TCI scale Self-Directedness. When PAS was used as a continuous variable, total PAS and PAS Factor 1 (Callous/Dominance) were significantly positively related to registered violent crime. The possible usefulness of PAS in identifying high-risk individuals for bullying tendencies among incarcerated delinquents is discussed.
|
|
| 17. |
- Zetterberg, Liv, 1982-, et al.
(författare)
-
The compliant court : procedural fairness and social control in compulsory community care
- 2014
-
Ingår i: International Journal of Law and Psychiatry. - : Elsevier. - 0160-2527 .- 1873-6386. ; 37:6, s. 543-550
-
Tidskriftsartikel (refereegranskat)abstract
- Compulsory community care (CCC) was introduced in Sweden in 2008. This article investigates all written court decisions regarding CCC over a 6 month period in 2009 (N = 541). The purpose is to examine how the legal rights of patients are protected and what forms of social control patients are subjected to. 51% of CCC patients are women and 84% are being treated for a psychosis-related disorder. In the court decisions, only 9% of patients are described as dangerous to themselves, while 18% are regarded a danger to others. The most common special provisions that patients are subjected to are medication (79%) and a requirement that they must maintain contact with either community mental health services (51%) or social services (27%). In the decisions, both the courts and court-appointed psychiatrists agree with treating psychiatrists in 99% of cases. Decisions lack transparency and clarity, and it is often impossible to understand the conclusions of the courts. There is considerable variation between regional courts as regards the provisions to which patients are subjected and the delegation of decision-making to psychiatrists. This means that decisions fail to demonstrate clarity, transparency, consistency and impartiality, and thus fail to meet established standards of procedural fairness. Surveillance techniques of social control are more common than techniques based on therapy or sanctions. Because of the unique role of medication, social control is primarily imposed on a physical dimension, as opposed to temporal and spatial forms. The article concludes that patients are at risk of being subjected to new forms of social control of an unclear nature without proper legal protection.
|
|
