Criminal Behaviour and Mental Health

Childhood hyperactivity has previously been found to be closely connected to subsequent alcohol problems and violent offending among men considered to be without major mental disorders. For others, these associations might be moderated or confounded by other factors, predominantly comorbid conduct disorder. The purpose of the study was to investigate aspects of childhood hyperactive behaviour in relation to alcohol or violent offences in adult life, taking the possible confounders of early criminality and aggressive behaviour into account. Method A total of 192 young male law breakers and 95 non-criminal controls were followed from age 11-14 years into their thirties. Information on aspects of hyperactivity, aggressive behaviour, early criminality and later offences was included in the analyses. The results supported the hypothesis that aspects of childhood hyperactive behaviour were significantly associated with later drinking offences and violent offending. Further analyses revealed attention difficulties to be the component of hyperactivity most contributing to the relationship. When taking possible confounding variables into consideration, attention difficulties were related to subsequent violent offending among boys with early criminality, independently of early aggressive behaviour. Early criminality, attention difficulties and aggressive behaviour, however, often co-occurred in the same individual. Subsequent drinking offences or violent offending appeared seven times more often among individuals with all early behavioural problems as compared with those who had no such problems. Complex antisocial behaviours in adult life commonly represent persistence of complex childhood behavioural difficulties, but among young law breakers there does appear to be a subgroup of boys with a main problem of attention difficulties who go on to violent offending, even in the absence of early manifestation of aggression.

The main aim of this paper is to investigate to what extent self-reported bullying at Grade 5 predicts later violence, heavy drinking and marijuana use at age 21. Univariate and multivariate associations between bullying and later outcomes were examined based on a longitudinal community sample of 957 young people from the Raising Healthy Children project. Childhood bullying was significantly associated with violence, heavy drinking and marijuana use at age 21. These associations held up after controlling for prior risk factors. Childhood bullying had unique associations with risk of later violence and substance use among young adults. Early intervention to prevent childhood bullying may also reduce other adverse outcomes later in life.

The Beck Depression Inventory - Second Edition (BDI-II) is a self-report measure of depression. Studies have shown it to have good psychometric properties with adult and adolescent clinical and non-clinical populations. However, this research has mostly been conducted with North American samples. To examine the psychometric characteristics of the BDI-II with male young adult offenders in the UK. The BDI-II was administered to 117 incarcerated male young adult offenders aged 18-21 years from the UK. The BDI-II showed good internal consistency and concurrent validity. Factor analysis revealed two factors, relating to cognitive-affective items and somatic items. The items loading on the two factors were very similar to those found in a North American adolescent (13-17 years) psychiatric inpatient sample. CONCLUSIONS AND IMPLICATIONS FOR FUTURE RESEARCH: The findings suggest that the BDI-II can be used with confidence in young adult male offenders. It would be useful to confirm its psychometric properties in other offender samples and establish offender population norms.

Reliable epidemiological data on sexual homicide are sparse, especially on trends in its incidence over time and age at arrest. Our main aims were to study age at arrest and incidence trends for sexual homicide in the USA over about three decades (1976-2007). We conducted longitudinal analyses of data from the largest USA homicide database available for the years 1976-2007. The mean age at arrest for a sexual homicide was 26.3 years (range 7-76; modal 21 years). Three quarters of these offenders were young adults aged 18-35. Age at probable first arrest for a sexual homicide rose significantly from a mean of 25 to a mean of 29 years over the study period. The last decade of the three studied accounted for just one quarter of the homicides as charged in the whole period, but the proportion of sexual homicides specifically fell with each decade, so that the first period accounted for 56% of those in the whole period, the second for 33% and the final decade for just 11%. This was reflected in a reduction in the proportion of all homicides that were sexual, from 1.4% in the first decade to 0.8% in the second and 0.4% in the third, declining by a factor of five for adults and seven for juveniles. Use of official national criminal statistics has limitations in studying the epidemiology of any particular behaviour. Nonetheless, our findings of falling sexual homicide rates and of changes in at least one important demographic of these killers indicate a need for a considered reappraisal of such crimes. Establishment of accurate epidemiology and a study of associated factors may assist in the improvement of investigative and preventive strategies. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

The contribution of women to violent offending, including homicide, may be increasing as society changes. The aim of this paper was to test for trends in homicide by women in Finland. A retrospective register-based study was conducted by comparing two national cohorts: one from 1982 to 1992 and the other from 1993 to 2005. There was a small increase in the proportion of homicides committed by women over time, but the most striking difference between the cohorts was in the significantly higher frequency of alcohol abuse/dependence in the later cohort and of being under the influence of alcohol during the crime. Fewer perpetrators were regarded as lacking or being of diminished responsibility in the later cohort. The victims of the earlier cohort were emotionally closer to the offender than those of the later one. In Finland, there have been changes in characteristics of women who commit homicide and their crimes over time, with the apparent development of a subgroup of women who kill who are much more like men who kill than women in the 1980s and early 1990s. Preventing substance abuse and marginalization are likely to be important ways of preventing homicide by both female and male perpetrators.

In Sweden 20 000 cases of assault against women are reported to the police every year. All data on the perpetrators of spousal homicide in Sweden between 1990 and 1999 were investigated (n = 164). A control group of all other perpetrators of homicide in Sweden during the same period, i.e. cases of homicide not committed in the context of spouse violence (n = 690) was used. All verdicts, as well as all material in the police investigations, including interviews with all of the police investigators, were analysed. Copies of police examinations of the suspects, and forensic reports from the autopsies, were also examined. Data on all registered criminality were collected from the National Police Register, and in cases where the perpetrators had been subject to forensic psychiatric examinations, those reports were obtained from the Swedish National Board of Forensic Medicine. In addition, the Psychopathy Checklist: Screening Version scores were rated from the forensic psychiatric examinations. There was a four times higher suicide rate among the spousal homicide perpetrators (24%, n = 40) compared with the perpetrators in the control-group (6%, n = 39, chi-squared = 55,42 df = 1, p < 0.001). Consequently, suicidal ideation must be considered as an important risk factor for spousal homicide. In 79% of the cases the spousal homicide perpetrators were subject to forensic psychiatric examinations. All except 5% were diagnosed with at least one psychiatric diagnosis, and 34% were sentenced to forensic psychiatric treatment. If it is assumed that the psychiatric morbidity was high in the 24% of the perpetrators who committed suicide, then 80% of all perpetrators of spouse homicide during the study period can be characterized as mentally disordered. 'Psychopathic' perpetrators, who generally are over-represented in most violent criminality, were comparatively uncommon. Only seven (4%) in the study group met the diagnostic criteria for psychopathy as measured with the PCL:SV. The group of spouse killers studied here fits the dysphoric/borderline group of spouse assaulters. This is a group that may benefit from treatment. Perhaps police officers could help identify this kind of spouse assaulter before a fatality occurs.

It is generally considered that women who kill are more likely to have a psychiatric disorder than their male counterparts, but as a relatively small group, women are much less often studied than men in this context. To explore gender differences in the psychosocial history of homicide offenders. In this nationwide register-based study, data were extracted from the forensic psychiatric examination and crime reports of all 91 women prosecuted for homicide in Finland between 1995 and 2004 and from those of the next adjacent man convicted of a separate homicide (n = 91). Both female and male homicide offenders had a troubled childhood, but more women had witnessed or experienced family violence; more women had failed to complete their primary education. Men, however, were more likely to have had an offending history. Although there were no differences between the men and women in the frequencies of psychiatric diagnoses or of substance abuse, the women had more often received prior mental health treatment. The women were also more likely to have had a history of suicidal behaviour. Both female and male homicide offenders are a troubled group of people, with slightly different criminal careers. Many use mental health services and therefore prevention could be improved. The suggestion of a special sub-group of women characterised by early educational and behavioural difficulties needs replication, as it may have implications for service development.

Treatment and risk management of forensic patients relies heavily on diagnosing psychopathology, yet the reliability of clinical diagnoses of personality disorder has been found to be only fair to low. Structured instruments for the global assessment of personality disorder are infrequently used in clinical assessments possibly due to their limited validity and clinical utility. The Shedler-Westen Assessment Procedure-200 (SWAP-200) was developed in an effort to address these limitations. Although good reliability and validity in relation to clinicians' diagnosis of personality disorder has been reported, to date the validity of this instrument has not been assessed in relation to other standardized instruments or in a personality-disordered, forensic population. This study aims to establish the reliability and validity of the SWAP-200 against other diagnostic instruments and measures of interpersonal functioning in a personality disordered forensic population. This paper reports the results of 30 subjects from a high secure hospital in the UK who were assessed with the SWAP-200, the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II), the Adult Attachment Interview (AAI) and the Chart of Interpersonal Reactions in Closed Living Environments (CIRCLE). Preliminary results suggest that the SWAP-200 is a reliable instrument for the diagnosis of personality disorder in forensic patients. Although the small sample size allows only preliminary conclusions about the validity of this instrument, early results show a reduction of the diagnosis of comorbidity compared with the SCID-II, together with an increased number of expected associations between independent measures of interpersonal functioning and categories of personality disorder.

The high prevalence of mental disorders among women in prison is recognised worldwide. In England and Wales, successive governments and independent reports have argued that the equivalent of community care in prisons is acceptable but that some mental health assessment units (MHAUs), staffed by professional clinicians, should remain. These have not been researched. This paper aimed to explore patterns of use of a MHAU in a women's prison in England and to test the hypothesis that it was being used only, as intended - to hold women pending transfer to a health service hospital or in a bona fide crisis. Anonymised data on all women transferred to one MHAU between 1 January 2008 and 31 August 2010 were obtained from the prison files and subjected to descriptive analysis. Less than a third of these women were transferred to an outside hospital; this group stayed longest in the unit. An overlapping group of 52% of the women was under a special assessment, care in custody and teamwork protocol because of suicide or serious self-harm risk. Thus, 188 (68%) admissions fulfilled national protocol criteria for MHAU admissions. Two in five women admitted were released or returned to ordinary prison locations. Nevertheless, over 80% of the women were known to external mental health services, and 64 (30%) were so unwell on arrival in prison that they were transferred directly to the MHAU. Over a third of admissions were of women admitted more than once during the 32 months of study, and this was significantly more likely after release from prison directly to the community. Our hypothesis was not sustained, and it seems unlikely that this prison MHAU is unique in being used outside its strict remit. A shift from studying the epidemiology of mental disorder in prisons to the epidemiology of mental health needs could benefit this vulnerable group and the wider community alike. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

The literature on recidivism by homicide offenders is scarce despite its importance for individuals and for society. To establish the rate of seriously violent re-offending among homicide offenders and identify risk factors for such recidivism. A 1970s incident cohort of all homicide offenders, sane and insane, from two regions of Sweden (N = 153) was followed up until 2007 using data from the national crime register. Ten per cent of the cohort (n = 15) re-offended. The mean time from index offence to recidivism was 9.4 years. Five people (3%) committed a further homicide, and it was established that another five (3%) offenders had killed before the index offence. Prospective risk factors for violent recidivism were young age, psychotic disorder, male victim, acquainted victim and intoxicated victim. The prevalence of repeated homicide is higher than previously reported. Victim variables and mental disorder in conjunction with substance abuse appear to be two domains of particular significance for recidivism. Copyright © 2013 John Wiley & Sons, Ltd.

The number of sexual offences reported in Japan doubled between 1992 and 2002. This has prompted attention to assessment of risk of recidivism. To explore whether an actuarial assessment of risk widely used in the West can be meaningfully applied to Japanese men serving a prison sentence for sexual offences. All sex offenders incarcerated in Kitakyushu Medical Prison in Fukuoka at any time in a period of one year (1 July 2002-30 June 2003) were identified. Demographic data, characteristics of offences and the Static-99 were rated from records. Following a slightly modified application of coding rules, all items of the Static-99 were rateable. Nine offenders of 45 whose Static-99 score was over 6 were thus identified as high-risk offenders. The items distinguishing apparently high-risk men were history of institutionalization as a delinquent and mental retardation. The Static-99 may be a useful tool in assessing sex offenders in Japan. With apparently increasing recognition of sex crimes here, it seems timely to be developing a systematic approach to assessment. Further work is required to test its value in practice as a predictor of recidivism.

High cholesterol has been advanced as the most important factor in the development of coronary artery disease. Most panels have recommended population-wide dietary restrictions, yet a body of evolving data yields evidence of the hazards of low cholesterol, including links to aggression and hostility. The aim of this study was to compare the serum lipid profile and serum apolipoproteins A1 and B of men with a violent criminal record and men with no criminal history. Fasting blood samples were collected from 30 men with a known history of violent crime and 30 men with no criminal record. Serum lipid profile and serum apolipoproteins A1 and B were measured in each sample, and compared between the two groups. The group with the violent criminal record showed significantly lower total cholesterol, lower LDL cholesterol, higher apolipoprotein A1 and lower apolipoprotein B compared with the control group. Lower total cholesterol, lower LDL cholesterol, higher apolipoprotein A1 and lower apolipoprotein B could predispose to violence. Future research might explore the possibility that diets offered in prison could affect relevant pathways in lipid metabolism.

Antipsychotic drugs have been linked to sudden death among psychiatric patients, with a suggestion that prolongation of the QT-interval detectable on a standard electrocardiogram may be linked to fatal cardiac arrhythmias in these circumstances. Patients in secure forensic psychiatric facilities may be particularly likely to be on high-dose antipsychotic medication, and yet, as far as the authors are aware, no study of QT-intervals among such patients has been reported. To investigate the prevalence of QT-interval abnormalities and associated known risk factors for fatal cardiac arrhythmias in a sample of forensic patients. Participants had a 12-lead electrocardiogram taken at 50 mm/s. Information was collected on their age, gender, psychiatric diagnosis, history of cardiovascular, liver and kidney diseases, and smoking, on all medications and on history of seclusion over the previous 12 months. Analysis was carried out using binary logistic regression. Lower rates of QT-interval abnormalities than might be expected for this population were found. It was also found that a high dose of antipsychotics was associated with QTc prolongation (Adjusted OR = 9.5, 95% CI 2.6-34.2), a result consistent with previous literature. Forensic patients need not be at increased risk of QTc abnormality provided risk factors are properly managed. A high dose of antipsychotic medication increases the risk of QTc prolongation.

Rocky is an Aboriginal man in his 40s, who has spent half his life in jail. He seriously misused alcohol from his teens, which contributed both to his offending and to growing ill health, but he had rarely been able to access relevant health and social services or on the occasions when he had, sustain his contact with them. This time, as he left jail, heavily medicated, the Department of Corrections and Justice Worker referred him to the Gathering Place Health Service (GPHS), a healing programme for Indigenous Australians. After initial contact, he failed to attend. Two months later, a GPHS staff member found Rocky wandering the streets in a dazed state. He had not picked up his medications as he had no money. He was, thus, also in breach of his parole. The GPHS advocated for him with the parole board and had him mandated into the GPHS healing programme for Aboriginal and Torres Strait Islander people. Guided by the programme elders, he gradually found a connection with his spirituality and culture and a desire to break free from his destructive lifestyle. He began to improve, but, during one of his occasional lapses, heavily inebriated, he re-offended. Once again, he was looking at a long-jail term. Healing programme staff, with mental health colleagues, implemented an intensive spiritual healing and rehabilitation programme, tailored for Rocky. After demonstrating to the parole board his ability to remain sober for 6 months within this framework, he was given a non-custodial sentence. He has not re-offended and intends to work with Indigenous prisoners in similar circumstances. Rocky (alias) gave permission for his story to be told.

One of the more influential criminological theories advanced in recent years is Moffitt's developmental taxonomy. A line of research has tested the core propositions from her theory regarding the causes of life-course persistent offenders and the causes of adolescence-limited offenders, but very little research has investigated whether Moffitt's explanation of delinquency abstention is supported empirically. To examine the biosocial correlates of delinquency abstention. We used data from the National Longitudinal Study of Adolescent Health (Add Health) to examine the effects of two dopamine receptor genes (the dopamine D2 receptor gene (DRD2) and the dopamine D4 receptor gene (DRD4)), drug-using peers, neighbourhood problems, low self-control, public assistance, age, race, and gender on delinquency abstention. The statistical models were calculated by employing binary logistic regression. Analysis of the Add Health data revealed that exposure to drug-using peers and levels of self-control were associated with abstention from delinquency. In addition, there was some evidence suggesting that DRD2 and DRD4 had protective effects against delinquent involvement for males. A multifactorial arrangement of environmental and genetic factors contributes to delinquency abstention.

Animal abuse by preadolescents has been associated with their later family violence and/or criminal behaviour; less is known about animal abuse and concurrent experience of being a victim at home and/or school, or of contemporaneous aggression to peers. To establish the prevalence of animal abuse among Italian preadolescents and its relationship with experience of abuse at home and school (direct and witnessed), and to peer abuse (bullying). An Italian community sample of 268 girls and 264 boys (aged 9-12) completed a self-reported questionnaire about victimization at home and school, animal abuse and bullying. Two in five preadolescents admitted abusing animals at least once in their life, and one in three bullying peers at school, with a higher prevalence among boys. Over three-quarters of all participants reported at least one type of victim experience: one-third had experienced inter-parental violence; over one-third had themselves been abused by one or both parents; two in five had been directly or indirectly victimized at school. Individual tests of association suggested gender differences. Multivariate regression analyses conducted separately for boys and girls showed that the independent variable accounted for more than 25% of the variance for the girls, but less than 10% for the boys. Experiences of abuse were the key independent variables for the girls; other expressions of aggression were the key variables for the boys. The results suggest that discovery of animal abuse should prompt further enquiries about other problems that a child may have. Detection of animal abuse by a child could offer an early opportunity for intervention to alleviate internalized damage or other aggressive behaviour.

Personality-disordered patients have invariably suffered abuse at the hands of carers when young, and they tend to repeat an abusive relationship when they encounter care in later life. The provision of care in psychiatric, forensic, penal and other institutions may degenerate into a form of unconscious abuse perpetrated against those in care. This is almost always unrecognized and the experience of carers is often to mismanage their own frustrated inability to understand what is happening to them, their charges and the institution.

There is growing concern regarding juvenile sex offenders, and concomitant interest in a more scientific database which could help direct management and treatment resources. To investigate whether juveniles who sexually offend against children (or those at least five years younger than themselves) differ from those who sexually assault their peers or older victims. The study is based on data from psychological screenings conducted for the juvenile courts in the Netherlands. As hypothesized, juvenile child molesters scored higher on neuroticism, had experienced more social problems, and had been bullied more often at school than their peers who sexually assaulted same-age or older victims. Child molesters also reported a more negative self-image. When referred for screening, they were younger but had committed more sex offences, more often against males than females. The results were suggestive of greater need for psychological interventions in the child molester group, although in both groups substantial minorities had had experience of early childhood deprivation or abuse.

Various studies suggest that 20-30% of patients in England and Wales in high security could be safely managed in medium security but there are no objective criteria and little attention has been paid to differences of opinion. The authors compare the views of the referring and receiving team on the security needs of all special hospital patients from two London health authorities. Disagreements were found in only 8% of cases, and they were more likely to occur in patients detained under the legal category of psychopathic disorder. Between 21% and 33% of patients were rated as misplaced by one or other team but these figures include patients who were either already on trial leave in another hospital or on the waiting list for an identified placement. Patients for whom there was agreement on misplacement, with no identified route out of high security, account for 9% of the total. Most patients with treatment-resistant schizophrenia were not receiving atypical anti-psychotic medication. It may be more realistic to plan future services on the basis that only 9% of patients are misplaced, rather than the previous estimates that appear to have guided current policy. Patients detained under the legal category of psychopathic disorder present particular problems and there is a need to develop appropriate facilities at medium secure level. In the meantime, no patients should be admitted to high security without consultation with the catchment area service and a jointly agreed plan for future rehabilitation.