Boris Schiffer

LWL-University Hospital Bochum · Division of Forensic Psychiatry

Patients with schizophrenia are the largest population in forensic hospitals, and treatment-resistant psychosis is associated with length of stay. For patients with severe and treatment-resistant psychotic disorders, electroconvulsive therapy (ECT) is a potentially effective treatment. Data regarding the use of ECT in forensic psychiatry are scarce...

Dieses Buch vermittelt alle notwendigen Grundlagen, um in der Forensischen Psychiatrie tätig werden zu können, ist aber auch für alle im Maßregelvollzug tätigen Personen mit fortgeschrittenen Kenntnissen geeignet. Es behandelt zunächst die relevanten rechtlichen Grundlagen in Deutschland, inklusive der Menschenrechte, die Begutachtung v.a. im str...

Zusammenfassung Bei steigenden Zahlen von Unterbringungen gemäß § 64 StGB und zugleich hohen Erledigungsquoten über 50 % besteht großer Bedarf an einer differenzierten Analyse der Risikoprofile und entsprechender Behandlungsbedarfe in der Gruppe der suchtkranken Straftäter. Das Level of Service Inventory – Revised (LSI-R) ist ein strukturiertes Ins...

Zusammenfassung 2016 erfolgte eine Novellierung des Rechts der Unterbringung in einem psychiatrischen Krankenhaus. Dabei wurden die Voraussetzungen für eine Erledigung der Maßregel gem. § 63 StGB aus Gründen der Unverhältnismäßigkeit explizit geregelt. Seither kam es gerade in Nordrhein-Westfalen zu zahlreichen Entlassungen, die auf dieser Grundlag...

The hypothalamus regulates sexual behavior and is simultaneously associated with aggression and violence. Consequently, this brain region is relevant in research of pedophilia and child sexual offenses (CSO). The distinction between these two phenomena is of great importance and was the object of consideration of this study. We analyzed exclusively...

Ziel der Studie: Evaluation der Resozialisierungsverläufe von aus Gründen der Unverhältnismäßigkeit aus der psychia trischen Maßregel gem. § 63 StGB entlassenen Patienten nach der Gesetzesnovelle 2016. Methodik: Durch Interviews mit Führungsaufsichtsstellen wurden Informationen zum sozialen Umfeld, zum somatischen und psychischen Gesundheitszustand...

Zusammenfassung Das nordrhein-westfälische Maßregelvollzugsgesetz regelte in § 17a Abs. 2 bis vor Kurzem die Zwangsbehandlung einwilligungsunfähiger Patienten zur „Erreichung der Entlassfähigkeit“. Bislang ist wenig über die Effekte derartiger Zwangsbehandlungen auf dieses vorgegebene Ziel bekannt. Ziel der Arbeit stellt daher die Evaluation antips...

The ability to inhibit behavior is thought to be an import skill for avoiding criminal conduct, especially when combined with personal predispositions or criminogenic needs such as a pedophilic preference disorder. While previous research emphasized the relationship between impulsivity and child sexual offending, not pedophilia per se, studies on t...

Mit der Novellierung des § 67d Abs. 6 StGB im Jahr 2016 wurden die Voraussetzungen für eine Erledigung der Maßregel gem. § 63 StGB aus Gründen der Verhältnismäßigkeit neu geregelt. Die vorliegende Arbeit untersucht die Therapieverläufe aller gem. § 63 StGB in NRW untergebrachten Patienten, deren Unterbringung zwischen dem 01.08.2016 und 31.07.2018...

The externalizing spectrum describes a range of heterogeneous personality traits and behavioral patterns, primarily characterized by antisocial behavior, disinhibition, and substance (mis)use. In psychopathology, abnormalities in neural threat, reward responses and the impulse-control system may be responsible for these externalizing symptoms. With...

Behavioral studies found evidence for superior cognitive empathy (CE) in pedophilic men without a history of child sexual offending (P-CSO) compared to pedophilic men with a history of CSO (P+CSO). Functional magnetic resonance imaging (fMRI) studies also point to differences between P-CSO and P+CSO. Neural processing associated with CE has not yet...

Zusammenfassung Im Jahr 2016 trat u. a. die Novellierung des § 67d Absatz 6 Strafgesetzbuch (StGB) in Kraft, der unter dezidierter Berücksichtigung des Verhältnismäßigkeitsgebotes nun erstmals klare gesetzliche Vorgaben für eine Fortdauerentscheidung bei einer mehr als 6 bzw. 10 Jahre vollzogenen Unterbringung in einem psychiatrischen Krankenhaus g...

Numerous studies have shown associations between anomalies of the serotonergic system and impulsive behavior, depression, or traumatic life events. However, it is currently unknown, whether pedophilia or child sexual offending (CSO) is also related to alterations of the serotonergic system. Using a two by two factorial paradigm within a multisite c...

The externalizing spectrum is characterized by disinhibition, impulsivity, antisocial-aggressive behavior as well as substance (mis)use. Studies in forensic samples and mentally impaired children suggested that higher rates of externalization are linked to lower cortisol stress responses and altered affect-related neural activation. In this fMRI-st...

Deficits in cognitive empathy (CE) have been associated with a child sexual offense (CSO) history in paedophilia. However, these results have been obtained in cross-sectional comparison. There are no longitudinal studies yet. We performed a longitudinal study with a 3-year interval and investigated CE and emotional empathy (EE) using the Multifacet...

Die 2016 erfolgte und damit jüngste Novellierung des Maßregelrechts zielte primär darauf, die Verweildauern im Rahmen einer Unterbringung im psychiatrischen Krankenhaus gem. § 63 StGB zu reduzieren. Dies geschah in erster Linie durch die Stärkung des Verhältnismäßig-keitsgrundsatzes bei der jährlichen Überprüfung der wei-teren Vollstreckung der Maß...

Eine Unterbringung in der Entziehungsanstalt gemäß § 64 Strafgesetzbuch (StGB) darf nur dann angeordnet werden, wenn eine hinreichend konkrete Aussicht auf einen Behandlungserfolg besteht. Als solcher gilt primär die Straffreiheit nach Entlassung aus dem Maßregelvollzug. Ungeachtet der Forderung nach einer dezidiert positiven Behandlungsprognose un...

Eine Unterbringung in der Entziehungsanstalt gemäß § 64 Strafgesetzbuch (StGB) darf nur dann angeordnet werden, wenn eine hinreichend konkrete Aussicht auf einen Behandlungserfolg besteht. Als solcher gilt primär die Straffreiheit nach Entlassung aus dem Maßregelvollzug. Ungeachtet der Forderung nach einer dezidiert positiven Behandlungsprognose un...

Objectives: Paedophilic disorder is characterised by sexual attraction towards children. Classification of a counterpart as sexually attractive likely occurs rapidly, and involves both conscious and unconscious attentional and cognitive processes. Magnetoencephalography (MEG) is an imaging method especially well-suited to examine visual and attenti...

Zusammenfassung Bestehende Studien zur Gefährlichkeit von Patienten gemäß § 64 StGB beziehen sich primär im Sinne querschnittlicher Forschungsdesigns auf die Legalbewährung von Patienten unter Be-rücksichtigung von BZR-Einträgen-in einigen Fällen unter Einbezug klinischer und anamnes-tischer Informationen. Dabei konnten sowohl Unterschiede in der L...

The Taylor Aggression Paradigm (TAP) is widely used to measure reactive aggression in laboratory settings. While modified versions (mTAPs) with various stimulus characteristics (shocks, noise, pressure, heat) have already been established, a modified version with monetary stimuli has only been introduced very recently. In this experiment, 209 young...

High prevalence of child sexual offending stand in contradiction to low conviction rates (one-tenth at most) of child sexual offenders (CSOs). Little is known about possible differences between convicted and non-convicted pedophilic CSOs and why only some become known to the judicial system. This investigation takes a closer look at the two sides o...

Empathy is regarded as dynamic risk factor of child sexual offending. However, empathy research in the context of child sexual abuse suffers from various problems. First, prior studies failed to differentiate between pedophilic and nonpedophilic sexual offenders. Second, there is no distinction made between cognitive and affective empathy. Third, c...

Im Zuge der Novelle der Maßregelvollzugsparagrafen nehmen Verhältnismäßigkeitserledigungen aus Unterbringungen gem. § 63 StGB zu. Dies stellt Sozialarbeit und Psychotherapie im Maßregelvollzug auf mehreren Ebenen vor große Herausforderungen. Der vorliegende Artikel skizziert nach einem kurzen Überblick über die Novelle und ihrer Implikationen deren...

Background: Pedophilic disorder is characterized by increased sexual interest towards children, with comparatively lesser interest towards adults. In real life, the behavior of subjects with pedophilic disorder is shaped by evaluative processes in response to sexually relevant cues. Therefore, brain activation during anticipation of sexually releva...

The affiliations. Originally, Kolja Schilz was named last in the affiliations, implying that he is the senior author. This has been corrected; Kolja Schilz is now mentioned after Martin Walter in both the html and PDF versions of the article.

Child sexual offending (CSO) places a serious burden on society and medicine and pedophilia (P) is considered a major risk factor for CSO. The androgen system is closely linked to sexual development and behavior. This study assessed markers of prenatal brain androgenization, genetic parameters of androgen receptor function, epigenetic regulation, a...

The Sexual Inhibition/Sexual Excitation Scales (SIS/SES) measure sexual excitation and sexual inhibition proneness. We used SIS and SES scores of 62 heterosexual teleiophilic men (Mage 34.3, SD = 9.9) to predict brain activation levels during the presentation of male and female visual sexual stimuli in a magnetic resonance imaging (MRI) scanner. St...

Context The research network ‘Neural mechanisms underlying pedophilia and sexual offending against children: origins, assessment and therapy’ investigates mechanisms of sexual abuse of children and pedophilia by means of fMRI imaging, clinical interviews, and psychological testing. While pedophiles’ sexual fantasies refer to pre-pubertal children o...

In Germany, there has been a constant increase of patients in forensic psychiatric detention (Art. 63 of the penal code) for more than 30 years. Especially over the last 10 years, an extension of length of stay in hospitals has contributed substantially to this increase. Meanwhile, every third patient has continuously been living for 10 years and m...

Pedophilia is a heterogeneous disorder for which the neurobiological correlates are not well established. In particular, there are no biological markers identifying individuals with high risk to commit child sexual offense (CSO). Pedophiles with CSO (P+CSO; N = 73), pedophiles without CSO (P-CSO; N = 77), and non-pedophilic controls (NPC; N = 133)...

This chapter reviews evidence about individuals who display antisocial behavior throughout their lives. This syndrome is diagnosed as antisocial personality disorder (ASPD) in adulthood and conduct disorder (CD) prior to age 15. The chapter focuses on the majority of these individuals who present low or no traits of psychopathy. It presents a descr...

Background Child sexual abuse and neglect have been related to an increased risk for the development of a wide range of behavioral, psychological, and sexual problems and increased rates of suicidal behavior. Contrary to the large amount of research focusing on the negative mental health consequences of child sexual abuse, very little is known abou...

Contrary to public perception, child sex offending (CSO) and paedophilia are not the same. Only half of all cases of CSO are motivated by paedophilic preference, and a paedophilic preference does not necessarily lead to CSO. However, studies that investigated clinical factors accompanying and contributing to paedophilia so far mainly relied on paed...

A pedophilic disorder is characterised by abnormal sexual urges towards prepubescent children. Child abusive behavior is frequently a result of lack of behavioral inhibition and current treatment options entail, next to suppressing unchangeable sexual orientation, measures to increase cognitive and attentional control. We tested, if in brain region...

Previous research found increased brain responses of men with sexual interest in children (i.e., pedophiles) not only to pictures of naked children but also to pictures of child faces. This opens the possibly that pedophilia is linked (in addition to or instead of an aberrant sexual system) to an over-active nurturing system. To test this hypothesi...

Complex trends in occupancy determined by many influencing factors, clear state-specific differences in imprisonment practices as well as recently implemented statutory alterations to the appropriate paragraphs in criminal law, underline the necessity for qualitative high-grade concomitant research of German forensic commitment; however, neither th...

Pedophilia is a sexual preference that is often associated with child sex offending (CSO). Sexual urges towards prepubescent children and specifically acting upon those urges are universally regarded as immoral. However, up until now, it is completely unknown whether moral processing of sexual offenses is altered in pedophiles. A total of 31 pedoph...

Objectives: Pedophilia (P) is a psychiatric disease associated with sexual attraction toward children and often accompanied by child sexual offending (CSO). Consequently, it is important to address the understanding of executive dysfunctions that may increase the probability of CSO. Moreover, this research field has been lacking to disentangle exe...

Pedophilia is a psychiatric disorder that is inter-related with but distinct from child sexual offending (CSO). Neural alterations reportedly contribute to both pedophilia and CSO, but until now, no study has distinguished the brain structural anomalies associated with pedophilia from those specifically associated with CSO in pedophilic men. Using...

The presence of pedophilic sexual interests is considered of high importance for predicting recidivism among individuals who have committed sexual offenses. However, objective and valid assessment methods that are robust against confounding issues such as cognitive capacity and manipulation are sparse. We applied the Approach–Avoidance Task (AAT) f...

Among violent offenders with schizophrenia, there are 2 sub-groups, one with and one without, conduct disorder (CD) and antisocial personality disorder (ASPD), who differ as to treatment response and alterations of brain structure. The present study aimed to determine whether the 2 groups also differ in Theory of Mind and neural activations subsumi...

Neurobehavioral models of pedophilia and child sexual offending suggest a pattern of temporal and in particular prefrontal disturbances leading to inappropriate behavioral control and subsequently an increased propensity to sexually offend against children. However, clear empirical evidence for such mechanisms is still missing. Using a go/nogo para...

Introduction We aimed to investigate differential activation patterns in brain areas subserving attentional control of behavior and perception of salient stimuli in pedophilia using ultra-high magnetic resonance imaging (fMRI). Moreover, we wanted to measure whether behavioral inhibition deficits can be observed in those brain regions on the level...

Introduction Pedophilia is a disorder where sexual preferences of adults are directed towards children. This disorder impacts society with 1–2 out of every 10 children being sexually approached by an adult, often resulting in prolonged negative psychological effects. Prior research reported structural and functional amygdala alterations in pedophil...

A pedophilic disorder is recognized for its impairment to the individual and for the harm it may cause to others. Pedophilia is often considered a side issue and research into the nature of pedophilia is delayed in comparison to research into other psychiatric disorders. However, with the increasing use of neuroimaging techniques, such as functiona...

Background. Pedophilia is a disorder recognized for its impairment to the individual and for the harm it may cause to others. However, the neurobiology of pedophilia and a possible propensity to sexually abuse children are not well understood. In this study, we thus aimed at providing new insights in how functional integration of brain regions may...

In the last few years, the public debate on the sexual abuse of children and adolescents has led to an intensification of research endeavour focusing both on perpetrators and victims. In terms of prevention, interest attaches particularly to investigations that improve our understanding of deviant and delinquent sexual behaviour and home in on caus...

Schizophreniekranke haben im Vergleich zur restlichen Bevölkerung eine erhöhte Aggressionsneigung und ein erhöhtes Risiko, Gewalttaten und Tötungsdelikte zu begehen. Psychotische Symptome erklärten nur das in akuten Phasen häufige aggressive Verhalten, nicht aber vergleichbares Verhalten vor Ausbruch der Erkrankung oder außerhalb akuter Krankheitsp...

People with schizophrenia are at increased risk, as compared to the general population, to acquire convictions for violent crimes and homicide. They also show elevated levels of aggressive behaviour. While psychotic symptoms explain aggressive behaviour that is common during acute episodes, they do not explain such behaviour at other stages of illn...

Men are traditionally thought to have more problems in understanding women compared to understanding other men, though evidence supporting this assumption remains sparse. Recently, it has been shown, however, that meńs problems in recognizing women's emotions could be linked to difficulties in extracting the relevant information from the eye region...

Conduct disorder (CD) prior to age 15 is a precursor of schizophrenia in a minority of cases and is associated with violent behavior through adulthood, after taking account of substance misuse. The present study used structural magnetic imaging to examine gray matter (GM) volumes among 27 men with schizophrenia preceded by CD (SZ+CD), 23 men with s...

The impact of alcoholism (ALC) or alcohol dependence on the neural mechanisms underlying cognitive and affective empathy (i.e. the different routes to understanding other people's minds) in schizophrenic patients and non-schizophrenic subjects is still poorly understood. We therefore aimed at determining the extent to which the ability to infer oth...

Context Studies aimed at identifying structural brain alterations associated with persistent violent behavior or psychopathy have not adequately accounted for a lifetime history of substance misuse. Thus, alterations in gray matter (GM) volume that have been reported to be correlates of violent behavior and/or psychopathy may instead be related to...

There is some evidence that child molesters show neuropsychological abnormalities which might reflect specific structural and/or functional brain alterations, but there are also inconsistencies in the existing findings which need to be clarified. Most of the different outcomes can either be explained by the fact that different types of child molest...

Studies aimed at identifying structural brain alterations associated with persistent violent behavior or psychopathy have not adequately accounted for a lifetime history of substance misuse. Thus, alterations in gray matter (GM) volume that have been reported to be correlates of violent behavior and/or psychopathy may instead be related to lifelong...

Despite the high prevalence of comorbid substance abuse in schizophrenia, there is still little knowledge about the influence of comorbidity on neuro-cognitive function, impulsivity and its impact on the brain. The present study sought to determine whether addicted and non-addicted schizophrenic patients are impaired differentially on relevant doma...

Despite a high prevalence of schizophrenia patients with comorbid substance abuse, little is known about possible impacts on the brain. Hence, our goal was to determine whether addicted and non-addicted schizophrenic patients suffer from different brain deficits. We were especially interested to determine if grey matter volumes were affected by imp...