Hanna Saß

Leuphana University of Lüneburg ·  Business Education Unit

This chapter focuses on dangerousness‐based detention outside of the criminal justice system, in an alternative system of justice. “Psychopaths” have traditionally been cast as the paradigmatic “other” for whom normal protections of citizenship do not apply. The chapter explores how the use of contemporary preventive detention laws will be constrai...

Psychophysiological characteristics have been argued to tap the dynamic interface between psychological processes and physiological processes and to fit in the biopsychosocial models of the etiology of antisocial behavior. Low resting heart rate is thought to be the best‐replicated biological correlate of antisocial behavior in child and adolescent...

This chapter describes outpatient treatment, management, and supervision programs for psychopathy (e.g., forensic outpatient clinics, probation, and parole programs), including special problems and interventions for substance abusers and sexual offenders with psychopathy. It focuses on psychological interventions, especially cognitive‐behavioral th...

This chapter examines the relationships between psychopathy and personality disorders (PDs) as defined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5), with a focus on comorbidity, or the co‐occurrence of PDs with one another and with psychopathy. PDs listed in Section II of the DSM‐5 are grouped by themati...

This chapter discusses empirical studies on the effectiveness of psychotherapy and psychosocial rehabilitation and their implications on social policy considerations on psychopathic disorders. The severely decreased capability or incapacity to benefit from experience is an essential item for the diagnosis of psychopathy. Functional neuroimaging off...

Human aggression is typically distinguished in two forms. These are instrumental or proactive and impulsive or reactive. When sufficiently frequent and severe, individuals with impulsive aggression may meet the Diagnostic and Statistical Manual of Mental Disorders‐5th Edition diagnosis of Intermittent Explosive Disorder, a disorder with a lifetime...

Attention deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) represent two of the most common neurobehavioral disorders of childhood. This chapter summarizes the diagnostic criteria and epidemiological data as well as data on the symptomatology and course of antisocial behavior. It describes the role of ADHD in the etiology and pathoge...

This chapter provides a comprehensive review of the current empirical research on psychopathy in the workplace. It integrates findings from research in other settings or with other dark personalities. The chapter offers observations and hypotheses as to how we might apply these findings to psychopathy in business operations. It suggests recommendat...

The concept of psychopathy results from a confluence of views entertained in the French, German, and Anglo‐American psychiatric traditions. This chapter deals with all the three psychiatric traditions. The French psychiatry of the nineteenth and early twentieth centuries with its synthesis of doctrines of Pinel, Esquirol, Morel, and Magnan gave mom...

This chapter explores the relationship between the paraphilic disorders and psychopathy within a broad framework of clinical practice. It reviews the clinical features of paraphilic disorders and discusses the features and diagnosis of psychopathy and antisocial personality disorders. The chapter explores the association of psychopathy with the par...

This chapter discusses the various definitions and distinctions among psychopathy, antisocial personality, other disorders that are associated with antisocial behaviors, and simple antisocial behavior found without significant psychiatric diagnosis. It explores some treatments for adult characterologic antisocial behaviors, without either undue opt...

Intimate partner violence (IPV) is a serious problem that has profound effects on the victim, the perpetrator, other family members, and society. This chapter describes research that has been conducted on the role of antisocial spectrum disorders in the expression of IPV, including psychopathy where relevant; the dynamics of the domestically violen...

This chapter focuses upon two major conditions that are scientifically proved to cause acquired psychopathy. Those conditions are the behavioral variant of frontotemporal dementia and traumatic brain injury affecting frontal brain systems, specifically the ventromedial prefrontal cortex and its connections. Recent studies suggest that injury to the...

This chapter provides a literature review on studies published since 2009 and presents an updated neurobiological model of successful psychopathy. It focuses on emotion‐ and empathy‐related deficits, and summarizes empirical findings in the following two categories: deficits in empathy and emotion processing, and in decision‐making and cognition. T...

Traditionally, the psychopathy checklist measures have used a four‐facet structure for psychopathy: interpersonal, affective, lifestyle, and antisocial facets. This chapter reviews and presents new findings on social predictors of the four traditional facets of psychopathy. It focuses on results obtained in longitudinal surveys of criminal behavior...

In this chapter, the authors refer the term psychopathy to the construct as measured by the Psychopathy Checklist‐Revised and its derivatives. They argue that not only can we differentiate psychopathy from antisocial personality disorder but also that we can parse psychopathy itself into two meaningful variants. Drawing on the observations of clini...

This chapter examines the cognitive correlates of psychopathy. Cognitive correlates include all mental processes of an individual such as perception, information processing, learning, and memory. One interesting hypothesis for the behavioral deficits in people with psychopathy, specifically the lack of regard for others, is a disturbance in their t...

In 1910, in the wake of the Anglo‐Boer War, the two British colonies amalgamated with the two Boer republics to form the Union of South Africa. British legislation and medical practices were now applied throughout Southern Africa. The Society of Psychiatrists was established in 1956, and Chairs in Psychological Medicine were created at the Universi...

The “house of psychopath” is constructed on a foundation of no attachment, underarousal, and minimal anxiety. These appear to be necessary, related, but insufficient characteristics that provide certain biological predispositions for the development of the psychopathic character. In psychopathy, incorporative failures predict subsequent problems wi...

This chapter focuses on the psychopharmacology of impulsive aggression, a topic often overlooked in otherwise comprehensive studies on the programmatic treatment of psychopathic disorders and factors favoring successful conditional release, probation, and parole, as well as institutional treatment and management of psychopathically disordered inmat...

Among Social Security disability claims, those for mental disorders have increased 168% between 2000 and 2013, representing nearly 30% of all Social Security disability beneficiaries. Because antisocial personality disorders, by definition in DSM‐5, frequently show failure to sustain consistent work behavior, lack of income can act as a motivator f...

For assessing psychopathy, the Psychopathy Checklist‐Revised (PCL‐R) Version has been found to be the gold standard for most researchers. It is important that different and heterogeneous syndromes have been incorporated into the 20 items of the PCL‐R. In addition to the sample description, there are more fundamental methodological issues concerning...

Educational, social, and psychiatric factors within a family play an important role in the development of antisocial behavior. This chapter presents an overview of current findings on early familial factors as predictors for the development of antisocial behavior and the syndrome of psychopathy. It reports on current findings regarding the impact o...

To provide a more comprehensive review, this chapter incorporates findings associated with psychopathic traits from individuals with antisocial personality disorder, violent offenders, conduct disorder, and community samples. While the emphasis will be on structural and functional brain impairments, it discusses recent findings of disturbances in h...

For centuries, public policy commentators have recommended that individuals with psychopathic disorders be civilly committed. This would serve to protect the public from their violent and predatory acts, which are the result of psychopathy. Summarizing the civil commitment jurisprudence in four countries: Germany, Switzerland, Russian, and the Unit...

The psychiatric assessment of “psychopathy” or antisocial personality is an especially delicate and complicated subject, regardless of whether clinical, forensic, or research issues are concerned. Current psychiatric classification of legally relevant personality disorders is far from homogeneous. The main text of Diagnostic and Statistical Manual...

Acquired psychopathy is often seen following acquired physical injury to frontal brain systems and with neurodegenerative diseases such as the frontotemporal dementias, strokes, and traumatic brain injury. Acquired psychopathy is a term of art in the neuropsychiatric literature and more recently is used in the neurolaw literature. The main anatomic...

In the current Diagnostic and Statistical Manual of Mental Disorders version, there are four subtypes of attention deficit/hyperactivity disorder (ADHD): first, a predominantly inattentive type; second, a predominantly hyperactive‐impulsive type; third, a combined type; and fourth, a newly defined inattentive type. Children with ADHD are at high ri...

Without a co‐occurring psychiatric illness, people diagnosed with antisocial personality disorder (ASPD) would not be subject to involuntary inpatient hospitalization. This chapter explains why ASPD does not and should not qualify for civil commitment, and analyzes the question of whether it should qualify for the lesser intrusion of preventive out...

This chapter briefly summarizes the importance of genetic factors that contribute to the expression of psychopathic personality and the ethical and practice implications of these findings on offender risk assessment, the law, and health. It summarizes what is known about gene‐centric research and psychopathy, specifically research on heredity (twin...

The concept of psychopathy has occupied an important position in forensic psychiatry and psychology as well as in criminological research. The construct of psychopathy established its importance in legal and forensic practice. In European countries, the Psychopathy Checklist‐Revised (PCL‐R) is increasingly utilized for risk assessments of patients...

This chapter provides historical background for the development of insanity and diminished responsibility defenses, describes and explains the contemporary jurisprudence, and discusses the dispositional possibilities following a mental illness verdict. It explains special mental conditions that the law recognizes for mental illness defenses as well...

Psychopathic and substance use disorders have profound implications for both the law and public policy. This chapter examines how the financial consequences of addiction may affect the way we shape our legal and social policy responses to psychopathic disorders that frequently manifest themselves through substance use. The kinds of crime driven by...

This chapter focuses on the most widely accepted clinical/forensic measure of psychopathy, the Psychopathy Checklist‐Revised (PCL‐R). Although traditionally considered to be a personality disorder, some investigators view psychopathy as an evolutionary adaptive life strategy rather than as a disorder. The purpose of the PCL‐R was to measure the con...

The study of psychopathic disorders, which refers to both psychopathy and antisocial personality disorder (ASPD), has benefited from a rich array of neuroimaging and molecular genetic studies seeking to elucidate the neural underpinnings of these conditions and their symptom clusters. One genetic marker that has captivated the interest of researche...

Regarding aggressive behavior by imprisoned psychopathic personalities, there is often an unexpressed expectation that prison staff, including mental health workers, will control any disturbing behavior attributed to psychopathic personality traits. When a defendant in a forensic setting is labeled a “psychopath,” there is an inherent bias during f...

This chapter comprehensively discusses the role of sexual sadism and psychopathy in sexual homicide, and how the presence of these two mental disorders exacerbates the severity of the offense. Despite the many different definitions proposed to define sexual sadism, disagreement continues to exist in regard to the subjective defining and diagnostic...

This chapter examines the utility of, and evidence for, extending psychopathy, both as a construct and as a risk assessment tool, to female populations. It discusses gender differences in relation to psychopathy and other personality disorders, risk exposure, and gender‐role socialization to understanding the expression of psychopathy among females...

This chapter provides a concise overview of state‐of‐the‐art knowledge on the etiology and pathogenesis of brain trauma, ranging from epidemiology to molecular biology. The greater exposure to more distressing traumas and the greater likelihood of developing posttraumatic stress disorder (PTSD) once exposed are among the reasons for the higher life...

This chapter reviews more recent studies of the treatment of psychopathic and antisocial states of mind, and their associated problems. Forensic psychiatrists in both the US and Europe can expect to be involved in planning treatment programs for mentally disordered offenders, either within secure psychiatric facilities or within prisons. Some autho...

Diminished capacity and actuality are partial responsibility defenses, developed in the recognition that the irrationalities, dyscontrol, and compulsions generated by mental abnormalities that lead to criminal offending exist along a spectrum and are rarely all or none phenomena as what is required for the insanity defense. In the diminished capaci...

Most practitioners of forensic psychiatry in the United States, the United Kingdom, and Canada remain general psychiatrists employed in forensic settings. However, formal training in forensic psychiatry is now the preferred route into the subspecialty in these countries. A forensic program must be sponsored by an institution with an Accreditation C...

Workplace violence in the United States continues to be an alarming cause of stress, illness, disability, and death. This chapter focuses on U.S. law and statistics as they pertain to the actions of the psychopath in the workplace. Workplace violence can be defined as any communication or action that causes a victim to feel fear or intimidation. Co...

This chapter reviews contemporary research on the relationship between childhood psychological trauma and psychopathy, and discusses how findings of the research may help clinicians, researchers, and forensic professionals to better understand the development of psychopathic personalities. Child abuse and neglect can be conceived as significant ris...

Stalking has emerged over the past 25 years as a behavior of interest in forensic psychology and forensic psychiatry. This chapter provides an introduction and overview of stalking and also provides an understanding of stalkers and stalking typologies. It explores the prevalence of stalking and related matters and focuses on the relatively limited...

This chapter explores the concept of psychopathy through a cross‐cultural lens and comments on its use (and potential misuse) when applied across cultures in a forensic context. It begins by tracing the historical roots of the concept, distinguishing it from other similar terms that sometimes mistakenly are used interchangeably. It summarizes the l...

Traditionally, psychopathy has been hypothesized to reflect two correlated facets: interpersonal and affective features; and social deviance. This chapter reviews psychophysiological research pertaining to three factors: arrogant and deceitful interpersonal style (narcissism); deficient affective experience (callous/unemotional); and impulsive and...

This chapter considers techniques employed and scientific discoveries made during the neuroscience revolution and their admissibility and use in legal proceedings. It focuses on testimony related to human genetics and violence, as well as on the practical dilemmas of expert witnesses—such as psychiatrists, psychologists, and neurologists—who rely o...

The first known established death penalty laws were in the eighteenth century BCE in the Babylonian Code of Hammurabi, although the killing of miscreants is probably as old as Homo sapiens. While all the major religions of the world have things to say about people killing one another, only Buddhism is clear that life is so sacred that no creature s...

Comorbidity with other mental disorders in patients with antisocial personality disorder (ASPD) is underappreciated despite compelling evidence that such comorbidities are more the rule than the exception in clinical practice. This chapter reviews the prevalence of comorbidities in ASPD, potential etiopathological explanations for the frequent co‐o...

This chapter describes how the German criminal justice system deals with offenders with antisocial personality disorders. According to court decisions, there were only a few cases in which antisocial personality disorders led to a significant impairment of legal culpability. Sanctions of the German Criminal Code are penalties (fines and imprisonmen...

This chapter gives a brief history of the development of probation, including the changes from punishment and banishment, through the treatment model to the notion of risk management and effective practice. The criminal justice system in England and Wales has gone through many major changes. The chapter discusses changes in policy and practice in r...

This chapter describes the Mental Health Act (MHA) for England and Wales from 1983 including the significant amendments in 2007. There is consideration of case law from the Upper Tribunal and appellate courts with specific focus on those cases where personality disorder has been considered. Many cases concern patients detained under forensic sectio...

Insanity is a common law defense that applies to all types of crime, whether summary or indictable in nature. This chapter considers a much wider range of types of personality disorder rather than restrict the notion to “psychopathy,” reflecting the fact that types of personality disorder beyond “psychopathy,” “antisocial”, and “dissocial” personal...

This chapter looks at three specific populations that are frequently placed on some type of conditional release: defendants found guilty and placed on probation or paroled from prison; individuals adjudicated not guilty by reason of insanity (NGRI) and placed on conditional release in the community; and individuals convicted of sex offenses and com...

Child and adolescent psychiatry intersect with forensic psychiatry in child custody disputes and in assessments for child abuse. This chapter provides an overview of child custody, its history, evolution, and evaluations, and specifically assesses the various psychological screening tests for psychopathy and antisocial personality in adults that mi...

The single issue that makes psychopathy important to the law is its association with violence. This chapter emphasizes the combination of factors culminating in psychopathic behavior that has been shown to be harmful to individuals in the school and workplace. The violent workplace/school psychopath is primarily a product of their environment; some...

In accordance with old Roman law, Swiss criminal law provides for the defense or even exculpation, of mentally disordered offenders as a consequence of their mental condition. Under current legal practice, mental incapacity, according to Section 19, Paragraph 1 of the Revised Swiss Criminal Code, cannot be taken into account in the case of psychopa...

Attention deficit hyperactivity disorder (ADHD) is associated with profound disabilities of daily functioning and social adaptation in several domains of life and results in quality of life impairment, leading to serious personal and societal costs. Oppositional defiant disorder and conduct disorder are the most common comorbid disorders in childre...

Heritability and linkage studies on the genetics of psychopathy and antisocial personality have used a variety of partially overlapping phenotypes, including dimensionally measured personality traits, the antisocial personality disorder and conduct disorder diagnoses, and histories of criminality and delinquency in adults and youth. This chapter de...

The criminal acts of offenders with a psychopathic disorder can be perpetrated without normal self‐control or moral appreciation. Thus, there is room for some jurisdictions to allow for consideration of psychopathic disorders. This chapter examines the evolution of insanity jurisprudence in the United States and Australia and variations in state ju...

The relationship between psychiatry and the law is predicated on the understanding that what is punishable is not the criminal deed as such, but the guilty mind, or mens rea. Psychopaths are commonly found guilty as charged, usually of horrendous and/or serial crimes, and sentenced to prison, ordinarily for long periods of time. This chapter review...

To understand the American legal system, one must first possess some familiarity with the history and structure of the government. The United States began as 13 separate colonies along the Atlantic coast, whose citizens became increasingly aggrieved by various taxation and other policies imposed upon them by the king and government of Great Britain...

This chapter provides a brief discussion on malingering in general. A few different explanatory models have been proposed for the construct of malingering. These include the pathogenic model, the criminological model, and the adaptational model. Malingering must be distinguished from another form of conscious production of false symptoms: factitiou...

Antisocial disorders including conduct disorder, oppositional defiant disorder, and antisocial personality disorder are frequently associated with substance use disorders (SUDs), especially alcohol abuse. The development of an alcohol use disorder in adolescence may be an indicator of other problems: adolescents with alcohol use disorders have high...

In recent decades, the term psychopathy has undergone several changes in Austrian psychiatry. Compared with the general population, prison populations are characterized by higher rates of major mental disorders and substance abuse as well as by rates of personality disorders of up to 65% and of antisocial personality disorders of up to 47%. Therefo...

This chapter discusses capital punishment and its accompanying legal process in the United States. All U.S. jurisdictions with capital punishment employ bifurcated trials. The U.S. Supreme Court has ruled that the U.S. Constitution does not permit execution of juveniles, the intellectually disabled, or those found to be mentally incompetent to be e...

In contrast to continental Europe and many countries in South America, Asia, and Africa, where the procedural approach is generally based on the inquisitorial model, criminal procedure in the United States is based on the adversarial model. This chapter presents a selective overview of major U.S. Supreme Court decisions involving constitutional lim...

Antisocial spectrum disorders (ASDs) form a group of biobehavioral disorders characterized by rule‐breaking behavior, aggression, defiance, irresponsibility and/or behaviors that violate the rights of others or social norms. These include such diagnoses as conduct disorder, antisocial personality disorder and psychopathy. Because the task of behavi...

The Dangerous and Severe Personality Disorder (DSPD) program was a highly controversial initiative in England and Wales that was introduced to address concerns about serious offending by those with personality disorder. First introduced in 1999, DSPD was a highly contested operational as opposed to diagnostic term, used to define a population convi...

This chapter helps the reader to recognize similarities, but also remarkable, interesting differences in how seven countries—the United States, England, Canada, New Zealand, France, Spain, and Italy—balance the interests inherent in preserving confidentiality and interests that favor disclosure of information thought to protect against personal vio...

Oppositional defiant disorder (ODD) is characterized by a recurrent pattern of negativistic, hostile, and defiant behavior toward authorities, while children and adolescents with conduct disorder (CD) present a recurrent and persistent pattern of behavior that violates the basic rights of others, rules, and norms. Disruptive behavior disorders, or...

This chapter explains how unfitness for duty and impairments from mental disorders are handled in the U.S. military. It focuses on behavior consistent with antisocial personality disorder or adult antisocial behavior as defined in the Diagnostic and Statistical Manual, Fifth Edition. All branches of the U.S. military screen candidates in order to p...

In most countries, psychopathic offenders, if sentenced, are sent to prison. According to epidemiological research findings, prisoners with antisocial personality disorder showed a higher suicidal risk and had a higher incidence of co‐occurring diagnosis of a serious mental disorder. In general, there is no good evidence that psychopaths without a...

The Medical Treatment and Supervision Act (MTSA), enacted in 2005, was the first legislation on forensic mental health in Japan. Based on the act, inpatient and outpatient facilities specialized in forensic patient treatment became available. The immediate trigger for the establishment of this act was an elementary school massacre by a male psychop...

This chapter addresses the purposes of punishment, the role of mental health professionals in criminal sentencing, special offender statutes, and special considerations in sentencing individuals with psychopathic disorders. In theory, criminal punishment serves four purposes: retribution, deterrence, incapacitation, and rehabilitation. According to...

Competency to stand trial is one of the most commonly requested evaluations in forensic psychiatry. With some 60,000 evaluations in the United States of America annually, expertise, efficiency, and accuracy in the assessment and cost management of, and barriers to performing, such examinations remain an important focus of socio‐legal interest. Indi...

Deskriptive psychopathologische Befunderhebung – dieser Begriff meint zum einen ein methodenkritisches Vorgehen mit dem erklärten Ziel der Vermeidung impliziter theoretischer Vorannahmen. Zum anderen aber stößt er seinerseits an methodische und konzeptionelle Grenzen, an die es zu denken gilt, um bei der Untersuchung und Beschreibung der abnormen p...

Das Thema von Persönlichkeit und Persönlichkeitsstörung findet in der Allgemeinpsychiatrie sowie in der differenziellen und klinischen Psychologie zunehmend Aufmerksamkeit und ist wegen der gutachtlichen und therapeutischen Aufgaben von zentraler Bedeutung in der forensischen Psychiatrie. Für die rechtlichen Fragestellungen ist eine klare konzeptio...

Schuld, Verantwortung und Wahrheit sind Grundbegriffe der deutschen Strafrechtspflege. Nach dem Schuldprinzip darf nur bestraft werden, wer die mit Strafe bedrohte Handlung schuldhaft begangen hat. Mit der Bestrafung wird der schuldhaft handelnde Täter für die Tat zur Verantwortung gezogen. Die Verwirklichung des Schuldprinzips setzt voraus, dass i...

A dimensional diagnostic system for personality disorders (PD) postulates continuous transition from normal to disordered personalities (continuity hypothesis) and universal validity of basic personality dimensions (universal hypothesis). The present study investigates the validity of Leonhard's concept of attenuated personalities that define a con...

Qualifizierung und Zertifizierung in der strafrechtlichen Begutachtung sowie im Maßregelvollzug bildeten das Schwerpunktthema im Band 6, Heft 4 unserer Zeitschrift Forensische Psychiatrie, Psychologie, Kriminologie vom November 2012. Schon damals war hinzuweisen auf die verschärfte Beobachtung unseres Faches in der Öffentlichkeit, auf die Abhängigk...

The field of forensic psychiatry is defined by its scope, functions, and relationship to clinical psychiatry with its therapeutic purposes and to other forensic sciences with their predominantly investigative purposes. This chapter presents a review of forensic psychiatry, and begins with the general approach to forensic examinations. From the subs...

In the conceptual history of abnormal personality, in today's diagnostic nomenclature Personality Disorder, there has always been a large amount of overlap between issues of psychopathology and issues of dissocial behaviours. This is one reason why in this field there are close connections between sociological, political and psychiatric approaches....

In einem vom BMG geförderten 2-jährigen Projekt wurde anhand von insgesamt 1042 Behandlungsfällen an 4 psychiatrischen Kliniken unterschiedlicher Struktur in Nordrhein-Westfalen die Voraussetzung für eine externe Qualitätssicherung mit Hilfe der Tracer-Diagnose Schizophrenie geschaffen und durchgeführt. Ziele waren die Evaluation eines Erhebungsins...

Es wird über 2 Patienten mit einer paranoiden Schizophrenie berichtet, bei denen das Internet in einen Beziehungs-, Beeinflussungs- oder Verfolgungswahn einbezogen war. Von einem dieser Patienten wurden im Computer gespeicherte Dateien in phänomenologisch ähnlicher Weise als durch andere Personen lesbar bzw. abrufbar erlebt, wie es bezüglich der ei...

Die Übergänge von einer als wohl komponiert und gesund angesehenen Persönlichkeitsartung zu Verfassungen mit stärker akzentuierten Merkmalen bis hin zu ausgeprägten Persönlichkeitsstörungen im Sinne der gegenwärtig in der Psychiatrie gebräuchlichen Klassifikationssysteme sind ausgesprochen fließend. Gleiches gilt für Übergänge von den besonderen Pe...