Forensic Psychology & Law In A Nutshell (2223PSY3343)
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Task 1
Literature:
· Trestman (2007) Current and Lifetime Psychiatric Illness Among Inmates Not Identified as
Acutely Mentally Ill at Intake in Connecticut's Jails
· Appelbaum, PS (2006).Violence and mental disorders: Data and public policy (editorial).
American Journal of Psychiatry , 163, 1319-1321.
· Elbogen , E.B., & Johnson, S.C. (2009). The intricate link between violence and mental
disorder: Results from the national epidemiologic survey on alcohol and related conditions.
Archives of General Psychiatry , 66, 152-161.
· Silver, E., & Teasdale, B. (2005). Mental disorder and violence: An examination of stressful life
events and impaired social support. Social Problems , 52, 62-78.
· Kingston, DA, Olver , ME, Harris, M., Booth, BD, Gulati, S. & Cameron, C. (2016) The
relationship between mental illness and violence in a mentally disordered offender sample:
evaluating criminogenic and psychopathological predictors. Psychology, Crime & Law, 22,
678-700
· Samuels, A., O'driscoll , C., & Allnutt , S. (2007). When killing isn't murder: psychiatric and
psychological defenses to murder when the insanity defense is not applicable. Australasian
Psychiatry , 15, 474-479.
· Van Marle, H. J. C. (2002). The Dutch Entrustment Act (TBS): Its principles and innovations.
International Journal of Forensics Mental Health, 1, 83-92.
· Edworthy, R., Sampson, S., & Völlm , B. (2016). Inpatient forensic-psychiatric care: legal
frameworks and service provision in three European countries. International Journal of Law
and Psychiatry , 47, 18-27.
· McSherry, B. (2003). Voluntariness, intention, and the defense of mental disorder: Toward a
rational approach. Behavioral Sciences and the Law, 21, 581-599.
Trestman (2007) Current and Lifetime Psychiatric Illness
Among Inmates Not Identified as Acutely Mentally Ill at
Intake in Connecticut's Jails
*this article wants to reinforce the need for appropriate screening and referral for treatment at
intake in prison
STUDY:
- Estimates of current and lifetime psychiatric illness among inmates not identified as acutely
mentally ill at intake in all 5 adult prisons in Connecticut
- Through Structured Clinical Interview for DSM-IV (SCID), Clinical-administered PTSD scale,
Global assessment of functioning (GAF)
- Reported by gender and race/ethnicity
Results:
- More than 2 in 3 inmates met criteria for at least 1 lifelong psychiatric disorder
o Almost half for anxiety disorder
, o More than 1/3 for affective disorder
o More women than men
- Psychiatric morbidity was higher in women excluding antisocial personality disorder
(ASPD)
- Borderline Personality Disorder 23.2% in women and 12.9% in men diagnosed
- Lifetime history of mental impairment was associated with significantly decreased Global
Assessment of Functioning (GAF) scores
- Current lifelong psychiatric morbidity is increased in newly incarcerated adults who have no
obvious signs of serious mental illness and are associated with functional impairment
- Comorbid depression and PTSD
Axis 1 & 2
- 39.3% with the criteria for Axis 1 (lifetime) disorders
o Men: 27.5%
Comorbid: depression, PTSD (10.3%)
o Female: 55.9%
Comorbid: panic disorder, depression
- 23.1% with criteria for Axis 2 disorders
o Men: more than 1 axis 2 disorder (20.7%
Comorbid: borderline personality disorder, antisocial personality disorder
(9.9%)
o Woman: 26.6% for more than 1 axis2 disorder
Comorbid: borderline personality disorder, antisocial personality disorder
- 1 in 3 had at least one axis 1 disorder coexisting with axis 2 disorder
o Men: 27%
Comorbid: depressive and antisocial personality (13.5%)
o Female: 42%
Comorbid: depression, borderline personality
Conclusion:
- Number of inmates with current or lifelong psychiatric illness who were not identified as
mentally ill were highly supported fact that new inmates should be better assessed for
mental illness
Appelbaum, PS (2006).Violence and mental disorders:
Data and public policy (editorial). American Journal of
Psychiatry , 163, 1319-1321.
*article is about: 1) To what extent do mental disorders increase the risk of violent behaviour? 2) And
which steps can help to reduce violent incidents in people who have a mental disorder? paper is
about figures in Sweden (lower violence figures than USA)
1.To what extent do mental disorders increase the risk of violent behavior?
People with psychosis are 4 times more likely than the general population to be convicted of a
violent crime
- But psychotic group only accounts for 5% of such crimes
- Age, gender, diagnosis and type of offense contribute to whether something can be
attributed to persons with psychoses
,There is an increased risk of violence in people with mental disorders but this group has only a
small percentage in the total register of violence
- Perception of people with mental disorders is exaggerated and disproportionately covered
by media
2.And which steps can help to reduce violent incidents in people who have a mental disorder?
1) Outpatient commitment: can reduce risk of violence
o But whether this mandatory treatment is effective depends on the extent to which
the violence is actually linked to psychiatric symptoms, efficiency of treatment in
reducing these symptoms, availability of treatment, degree of adherence and
positive transfer effects after treatment.
2) Restriction on access to firearms
o Since only a small part of violence (and gun violence) comes from people with mental
disorders, they make little effort to abolish it
o Linking violence and mental disorder in public by banning firearms reinforces
stigmatization
Silver, E., & Teasdale, B. (2005). Mental disorder and
violence: An examination of stressful life events and
impaired social support. Social Problems , 52, 62-78.
Stressful life events and limited social support are significantly associated with the onset and course
of a mental disorder and with the occurrence of violence
when stressful life events and limited social support are controlled, association between
mental disorder and violence is reduced
Earlier link between violence and mental disorders especially in patients with paranoid psychotic
symptoms (e.g. schizophrenia) they engage in violent behavior because this would be a knocking
response to the distorted realities they see through their disorder
Stressful life events
- Acute life events = unaffected by the individual's behavior or psychological functioning
- Chronic stressors = influenced by an individual's psychological functioning or behavior
Social Support
- 2 aspects
1. The objective support is independent of the perception of support people do
not receive support mechanically, but interpret, assess and anticipate support in
the context of social situations
2. Social support consists of 2 types:
a. Instrumental= contains the relationship as a means to an end in which
they seek information, advice, guidance, material or financial assistance
b. Expressive = refers to the relationship as an end in itself, in which
individuals seek intimacy by sharing love and affection, expressing
frustrations, and mutually affirming each other's worth and dignity
- Receive emotional support Most important for psychological well-being
Social stress model Stressful life events increase psychological disturbances, while social
support decreases it
theory of general strain Stressed individuals are more likely to experience negative affect that
creates internal pressures leading to a ' corrective action'
, what constitutes violent behavior when violence is seen as an
alternative means of achieving ends
Social bond theory The more social support someone has, the less crime occurs. Social
support leads to social control
someone cannot be violent because they risk losing valuable support
HYPOTHESES:
1. relationship between mental disorder and violence will decrease when stressful life events
and social support are taken into account by the influence they have on both violence and
mental disorder
2. stressful life events lead to violence by increasing the occurrence of blocked targets and
therefore corrective actions are made which may include violence
3. social support will reduce violence by facilitating informal social control and participation in
social capital
STUDY :
- Uses acute life events
- Cross-sectional data from National Institute of Mental Health's epidemiological Catchment
Area surveys
- N=3.438
- Hypothesis: The relationship between mental disorder and violence will be reduced when
stressful life events and social support are taken into account due to the influence these 2
factors have on the occurrence of violence and mental disorder
- Measurements:
Violence Five items from the ECA survey were used to measure violent behavior within the past
year
Mental Major mental disorder: lifetime criteria for a given disorder or symptoms were
disorder present during last year (schizophrenia, affective disorder)
Substance abuse disorder: may include other mental disorder
Less severe disorder: phobias, panic, eating disorders
Stressful life Questions focusing on health, family, and living situations, work and finances.
events PP need to experience these events as negative
social support Duke social support scale – focused on satisfaction with social support, perceived
social support, frequency of social interaction, size of social network and instrumental
support
demographic Age, gender, race, living with a spouse or partner, socioeconomic status
controls
Result:
- Consistent with the hypothesis that the relationship between mental disorder and violence is
partly due to higher levels of stress and social impairment experienced by people with
mental disorder
o Size decreased significantly when adjusting for reduced social support and stressful
life events but relationship between mental disorder and violence remained
significantly high
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