Mentally Disordered Offenders and Crime

Presented By: Syeda Fatima Hasnain Roll no: 01 BS (Hons) Semester IV Presented To : Ms. Uzma Zaidi
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Definition of Mental Disorder

Criminality

Relationship between Mental Disorders and Crime

Classification of Mentally Disordered Offenders ( Disorders, Crime, Research Evidence and Assessment)

Mental Health Act 2007

any disorder or disability of the mind

Mental disorders which accompany or are associated with

the use of or stopping the use of alcohol or drugs, even if they arise from dependence on those substances Dependence on alcohol or drugs (Mental Health Act 1983)
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Psychosis (e.g., schizophrenia and bipolar disorder etc ) Neuroses ( e.g., depression, anxiety etc)

(Encyclopedia Britannica, 2010)

The quality or state of being a criminal; criminal activity (Webster's dictionary , 2010)
This term refers to a pattern of human behavior or a specific act violating a law (Menaster, 2008).

There is no clear-cut causal connection or relationship between mental disorders (disturbances) and crime or criminality
The two phenomena are not directly comparable

Prins (2005)

Individuals who commit crime

The term Mentally disordered offenders has been used to refer to many different type of offenders
Examples

(Hodgins & Isberner, 2001)

Classification of Mentally Disordered Offenders

Offenders

with Schizophrenia Offenders with Major Affective Disorders Offenders with Personality Disorders Offenders with Brain Damage The Neuroses/Psychoneuroses/Neurotic Reactions and Crime Mental impairment (learning disability), chromosomal abnormalities and crime
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A psychotic disorder characterized by:

loss of contact with the environment

noticeable deterioration in the level of functioning

in everyday life, and disintegration of personality expressed as disorder of : feeling, thought (as in delusions), perception (as in hallucinations), and Behavior
(Merriam-Webster Online Dictionary, 2010)
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People with schizophrenia appear to have a higher rate of criminal and violent behavior (Hodgins & Isberner, 2001)
Co-morbid conditions (alcoholism and/ or substance abuse)
Tiihonen et al, 1997: The prevalence of offenses

was the highest among males with alcohol-induced psychoses and male schizophrenic subjects with coexisting alcohol abuse
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Patients were 5 times more likely to have been convicted of violent crimes, 2 1/2 times more likely to have been convicted of crimes against property, and almost 3 times more likely to have violated drug laws. Criminality rates in schizophrenia depended, however, not only on the type of offense but also on the type or stage of the illness (Ammann & Modestin, 1996)

Research Evidence
Life time prevalence of criminal behavior in a population of male schizophrenia patients
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(National Institute for Health and Clinical Excellence, 2010)

Ascertain symptoms, previous history and consider possible causes

Family

Substance/alcohol misuse
Past medical history Stress Differentential diagnosis Possible investigations : FBC, ESR profiles, TFT,

LFTs, urine screen, vision and hearing tests

(National Institute for Health and Clinical Excellence, 2010)
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Mental disorder characterized by dramatic changes or extremes of mood. Affective disorders may include
Manic or
Depressive episodes, and often combinations of the two (Bipolar Disorder ) Delusions, hallucinations, or other loss of contact

with reality.
(Encyclopedia Britannica, 2010)
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Manic people : Impatience or hostility, physically abuse , conflict with the law Substance abuse: Example; heavy alcohol consumption Depression: Serious violence, tension, assault, homicide. Case; The boy was in his early twenties attempted to kill his mother, sister and then himself
(David, 2008; Eaves, Tien & Wilson, 2001)
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 Kaplan and Sadock (1991) reported that 75% of manic patients are assaultive or threatening. Ammann, Hug and Modestin (1996) studied Prevalence of criminal behavior in a population of 261 male in patients with affective disorders. Altogether, 42% of patients and 31% of non-patients had a criminal record. A higher criminality rate was found in bipolar patients.

Research Evidence

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A past history of depression Significant physical illnesses causing disability, Other mental health problems, such as dementia Key and Associated Symptoms should be present for at least 2 weeks Patients should be assessed for risk of: Self-harm, harm to others, self-neglect and child protection issues Depression Assessment Tools Differential diagnoses

(National Institute for Health and Clinical Excellence, 2010)

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Antisocial Personality Disorder (APD)

Psychopathy Borderline Personality Disorder (BPD)

Narcissistic Personality Disorder (NPD)

Paranoid Personality Disorder (PPD)

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Personality disorder is a chronic disturbance in ones relation with self, others and the environment that results in distress or failure to fulfill social roles and obligations [e.g. American Psychiatric Association (APA), 1994; World Health Organization (WHO), 1992].

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Extreme sexual jealousy ( Borderline or paranoid)

Example

Co-morbid with acute mental disorders

Example

(Burke & Hart, 2002).

Antagonism or hostility is characteristic of at least 8 of the 11 personality disorders in DSM IV (Widiger & Trull, 1994).
Impulsivity is characteristic of many other ( Webster & Jackson, 1997).

Prevalence of personality disorders among offenders and forensic patients ( Brooke et al., 1996, ) Results of studies show positive association between personality disorders and past or future criminality ( although small to moderate in magnitude ( Hart & Hare, 1997; Webster et al., 1994; Wediger & Trull, 1994)

Structured Personality Disorder Assessment Instruments Self-report Checklists Structured Clinical Interviews Numerous Instruments Unstructured assessments Interview based

Clinical interview Psychodynamic formulation

Other Rorschach test (Rorschach 1964) Thematic Apperception Test (Morgan 1935)
(Hunt 1992; Clark 2001).

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The Psychiatric and General Medical Literature

ORGANIC AETIOLOGY.

ORGANIC BRAIN DISORDERS

Aggression is either a diagnostic or an associated feature

Dementia of Alzheimer

Associated with violence, although their link is not as well proved (Fawa, 1997).

type (DAT) Dementia caused by Head trauma Personality change due to general medical condition (Aggressive type) Post-concossional disorder

Epilepsy Hungtingtons Chorea Korsakow psychosis Brain tumors Mental retardation

(Nedopil, 2001)

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Violent crime has repeatedly been associated with organic brain dysfunction
Rivara and Farrington (1994) concluded that the impact of

head injury on criminal behavior is somewhat confusing and not consistent

However, prenatal complication and early brain injury

appear to be most important in children at high risk for criminality

Acquired brain injury in later life has been found to

increase the risk of violent behavior but not of other types of criminal behavior
(Nedopil, 2001)
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Dementia: Violent crimes; aggression (Nidopil, 1996; Rabins, Mace & Lucas 1982) Brain injury: Frontal lobe involvement; aggression, including physical violence (Vietnam Head Injury Study , 1996) Epilepsy: Fenwick, Lumsden and Wong (1994) concluded there was no obvious association between criminal behavior and seizures in the patients with epilepsy, confirming previous findings
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(Burke, 2009).

Lesion of the ventromedial frontal cortex; History of criminality before the head injury; History of substance abuse before and after head injury; Disintegration of family structures: and Disorientation, impairment of cognitive functioning and increased irritability (Fagute et al., 1997) Standardized neuropsychological test batteries the Lurianebraska and Lalsted-reitan , topographical brain mapping, Mri and CT scans Neuropsychological Assessment
(Burke, 2009)
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MILD DEPRESSION

Instance of mild depression may not always be recognized immediately. This is because the behavior of the individual concerned may depart only slightly from the norm

ANXIETY STATES Anxiety states in their pure form do not often account for criminality. But morbidly anxious individuals may feel so driven by their anxieties that they may commit an impulsive offence. Example

Example

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Alcoholic Brain

poisoning and crime

trauma, tumor, brain disease and crime

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Prevent the understanding of acts

Easily caught in a criminal act

Easily used by others in delinquent May be associated with the organic disorder May be provoked quite readily in to an uncharacteristic act of violence.
May account for the high proportions of sexual offenders

Especially vulnerable to changed in their social environment. Example

(Prins, 2005)
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Extra Y chromosome (XYY)

Subsequent research has proved inconclusive concerning the prevalence of such abnormalities not only in penal and similar populations but also in the community at large

(Prins, 2005)

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Affective disorder. (2010). In Encyclopedia Britannica. Retrieved

April 14, 2010, from Encyclopedia Britannica Online: http://www.britannica.com/EBchecked/topic/7688/affective-

disorder

Burke, L. H. (2009). Neuropsychological Testing. Retrieved April 7, 2010 from http://www.brain-injury

therapy.com/services/neuropsychological_testing.htm

Hodgins, S., & Isberner, M. R. (2001). Violence, Crime and Mentally Disordered Offenders. New York: John Willey &

Sons, Ltd.
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National Institute for Health and Clinical Excellence. (2010).

Assessment. Retrieved April 7, 2010 from http://www.nice.org.uk/

Prins, H. (2005). Offenders, Deviants or Patients? (3nd ed.). USA:

Routledge Taylor & Francis Group

Reid, T. S. (2000). Crime and Criminology (9th ed.). USA: McGraw Hill

The Crown Prosecution Service. (2010). Mentally Disordered Offenders. Retrieved April 1, 2010, from http://www.cps.gov.uk/legal/l_to_o/mentally_disordered_offenders/

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Thank You
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