Article

Analyzing Offense Patterns as a Function of Mental Illness to Test the Criminalization Hypothesis

Department of Psychology and Social Behavior, University of California, Irvine, CA 92697-7085, USA.
Psychiatric services (Washington, D.C.) (Impact Factor: 2.41). 12/2010; 61(12):1217-22. DOI: 10.1176/appi.ps.61.12.1217
Source: PubMed

ABSTRACT

Programs for offenders with mental illness seem to be based on a hypothesis that untreated symptoms are the main source of criminal behavior and that linkage with psychiatric services is the solution. This study tested this criminalization hypothesis, which implies that these individuals have unique patterns of offending.
Participants were 220 parolees; 111 had a serious mental illness, and 109 did not. Interview data and records were used to reliably classify offenders into one of five groups, based on their lifetime pattern of offending: psychotic, disadvantaged, reactive, instrumental, or gang- or drug-related affiliation. The distributions of those with and without serious mental illness were compared.
A small but important minority of offenders with a mental illness (7%, N=8) fit the criminalization hypothesis, in that their criminal behavior was a direct result of psychosis (5%, N=6) or comprised minor "survival" crimes related to poverty (2%, N=2). However, the reactive group contained virtually all offenders with a mental illness (90%, N=100) and the vast majority of offenders without a mental illness (68%, N=74), suggesting that criminal behavior for both groups chiefly was driven by hostility, disinhibition, and emotional reactivity. For most offenders with a mental illness in the reactive group, crime was also driven by substance dependence.
Offenders with serious mental illness manifested heterogeneous patterns of offending that may stem from a variety of sources. Although psychiatric service linkage may reduce recidivism for a visible minority, treatment that targets impulsivity and other common criminogenic needs may be needed to prevent recidivism for the larger group.

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Available from: Jillian Peterson, Oct 28, 2015
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    • "The prevalence of patients who commit an offense as a direct result of a psychosis is small. Most patients with a mental illness have committed an offense as a result of hostility or emotional reactivity, consistent with risk factors found for patients in the mixed profile, explaining the low number of the typical psychotic patient (Peterson et al., 2010). However seldom it occurs, homicide is still considered the most significant complication of a psychosis (Bo, Abu-Akel, Kongerslev, Haahr, & Simonsen, 2011). "
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    ABSTRACT: Forensic psychiatry embodies a highly heterogeneous population differing widely in terms of diagnoses, crimes committed, and risk factors. All of these are vitally important for treatment indications and should be accounted for in research. However, there is limited empirical knowledge of patient profiles. This study constructed patient profiles on the basis of the three domains mentioned above. Participants were found guilty of having committed crimes due to psychiatric disorders and were admitted to Forensic Psychiatric Center (FPC) 2landen or FPC De Kijvelanden in the Netherlands. Retrospective data were retrieved from patient files. Diagnoses were assessed according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria and risk factors according to the Historical Clinical Future-30 (HKT-30) instrument. Latent class analysis was conducted to define typologies; external variables were included for validation. Four different classes or "patient risk profiles," with varying psychopathologies, risk factors, and crimes, were identified. Results were consistent with previous studies, and external validation with the Psychopathy Checklist-Revised (PCL-R) two-factor model and the four facets of the PCL-R agreed with results found. Results display specific risk factors for specific psychopathology/offense combinations.
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    • "Results from the current study, taken from a sample of individuals undergoing an assessment of criminal responsibility , align most closely with Taylor and colleagues' (1998) research in a high security hospital setting, and suggest that approximately three-quarters of individuals offended as a primary result of illness, and that symptoms were of a primarily psychotic nature. It is reasonable to expect that the rate of psychotic motivation in samples such as these would be higher as compared to justice-involved samples (e.g., Junginger et al., 2006; Peterson et al., 2010). These latter samples contain a greater degree of diagnostic and offense heterogeneity, whereas forensic psychiatric samples tend to be more diagnostically homogeneous and contain a higher prevalence of individuals who have committed violent offenses. "
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    ABSTRACT: Research on violence perpetrated by individuals with major mental illness (MMI) typically focuses on the presence of specific psychotic symptoms near the time of the violent act. This approach does not distinguish whether symptoms actually motivate the violence or were merely present at the material time. It also does not consider the possibility that non-illness-related factors (e.g., anger, substance use), or multiple motivations, may have been operative in driving violence. The failure to make these distinctions clouds our ability to understand the origins of violence in people with MMI, to accurately assess risk and criminal responsibility, and to appropriately target interventions to reduce and manage risk. This study describes the development of a new coding instrument designed to assess motivations for violence and offending among individuals with MMI, and reports on the scheme's interrater reliability. Using 72 psychiatric reports which had been submitted to the court to assist in determining criminal responsibility, we found that independent raters were able to assess different motivational influences for violence with a satisfactory degree of consistency. More than three-quarters (79.2%) of the sample were judged to have committed an act of violence as a primary result of illness, whereas 20.8% were deemed to have offended as a result of illness in conjunction with other non-illness-based motivating influences. Current findings have relevance for clarifying the rate of illness-driven violence among psychiatric patients, as well as legal and clinical issues related to violence risk and criminal responsibility more broadly. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
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    • "Rather, people with mental illnesses are involved in criminal activity similar to those perpetrated by their peers of the same socioeconomic status. For example, Peterson et al. (2010) found no distinct difference between the offending patterns of those with serious mental illnesses and their peers without diagnoses. Like other offenders, people with mental illnesses engage in crimes involving property and drugs, crimes that also are unlikely to end in instrumental violence (Draine et al., 2002; Fisher et al., 2006). "
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