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Summary Task 1 - All those violent lunatics

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Summary of Task 1 of Forensic and Legal Psychology in a Nutshell

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  • September 27, 2023
  • September 27, 2023
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TASK 1: ALL THOSE VIOLENT OPINIONS
MENTAL DISORDERS, VIOLENCE AND CRIMINALITY

THE INTRICATE LINK BETWEEN VIOLENCE AND MENTAL DISORDER (ELBOGEN, JOHNSON)

 Research on relationship between mental disorders & violence has mixed results
 Some studies support clear link
 Other studies support alcohol & drug use contribute to violence risk among adults
with mental disorders
 Reasons for inconclusive literature
 Necessary to demonstrate that mental illness precedes later violence
o Most studies are correlational
 Longitudinal research mainly focused on risk of violence for people already in
clinical settings
o We don’t know to what extent severe mental illness is risk factor in general
population
 Empirical studies often combine all violent acts into one composite variable
 Current study: longitudinal data set, examines (1) risk factors predicting violence, (2) do
severe mental disorders predict future violent behaviour, (3) how do different risk
factors predict different types of violence

METHODS

Sample  2-wave face-to-face survey
 Target population: civilian population in the US
 Collected through National Epidemiologic Survey on Alcohol & related
Conditions (NESARC)

Sample  Sample adjusted to be representative of US population for region, age,
weighting sex, race, ethnicity
 Aims to correct for bias due to undercoverage

Measures Severe mental  Wave 1: determined lifetime & recent diagnoses of major
illness & SA depression, bipolar disorder, substance use disorder
(SUD), schizophrenia
 Subjects put into 8 groups: (1) no major mental illness or
SUD, (2-5) each mental disorder on their own, (6-8) each
mental illness + SUD

Dispositional,  Historical factors – history of any violent behaviour
historical, clinical,  Clinical factors – diagnosis + perceived threats
contextual factors  Contextual factors – any factors in their life that could
(RISK factors) influence criminal behaviour

, Violent behaviour  Wave 2: subjects were asked about criminal / violent
betw. waves 1 & 2 behaviour between the two waves

RESULTS

 Approx. 42% had a lifetime diagnosis of severe mental disorder and / or SUD
 46% of those with severe mental illness had a lifetime history of comorbid SUD
 3 multivariate models: violence not predicted by schizophrenia, major depression, bipolar
disorder alone!
 Predictors of any violence: (1) historical factors, (2) contextual factors, (3)
dispositional factors, (4) comorbid mental health & SUD
o Accounts for ¼ of the variance in violent behaviour
 Predictors of serious / severe violence: (1) historical factors, (2) contextual factors,
(3) dispositional factors, (4) perception of hidden threats
o Accounts for ¼ of the variance in serious / severe violent behaviour
 Predictors of substance-related violence: (1) historical factors, (2) contextual
factors, (3) dispositional factors, (4) comorbid mental health & SUD
o Accounts for 30% of variance in substance-related violent behaviour


Multivariate  Predicted probability of violence for people with severe mental illness
model alone = predicted probability of violence for people with NO severe
mental illness
 Highest risk: dual-disordered subjects with history of violence

Simple  People with severe mental illness had sig. increased probability of
regression having history of violence
 Severe mental illness sig. associated with number of factors associated
with elevated risk of violence

VIOLENT BEHAVIOUR, SLIGHTLY HIGHER AMONG PEOPLE WITH SEVERE MENTAL ILLNESS, WAS ONLY SIG. HIGHER
FOR THOSE WITH COMORBID SUD

HISTORICAL, DISPOSTIONAL, CONTEXTUAL FACTORS WERE ASSOCIATED WITH FUTURE VIOLENCE

DISCUSSION

 People with severe mental illness: (1) more vulnerable to past histories, (2) prone to
experience environmental stressors that elevate violence risk
 Post hoc mediation analysis: link between severe mental illness & violence is reduced but
remains sig. after controlling for contextual factors
 Results point to dynamic factors  promising targets for develop approaches to
reduce violence risk
 Interventions

,  Vocational training, supported employment, other means of assisting people to
find stable jobs
 Family therapy / legal mediation in context of spousal conflict
 Integrated dual-disorder treatment
 CBT & psychotropic medications against anxiety related problems due to e.g.,
physical abuse


Limitations Advantages

 Self-reported violence likely  Variables included are conceptually
underestimates actual violence grounded in scientific literature of
 Severe/serious violence was not violence assessment
further specified (e.g., murder,  Findings provide data to support a simple
attempted murder?)  no generalisation decision rule physicians could use to detect
possible to severe mental illness people at higher risk for violence
associated with homicidal behaviour  Findings may help identify individuals
 Not all potential risk factors were who should undergo more formal
analysed violence risk assessment

MENTAL ILLNESS IS CLEARLY RELEVANT TO VIOLENCE RISK BUT ITS CAUSAL ROLES ARE COMPLEX


THE RELATIONSHIP BETWEEN MENTAL ILLNESS & VIOLENCE IN A MENTALLY DISORDERED OFFENDER
SAMPLE: EVALUATING CRIMINOGENIC & PSYCHOPATHOLOGICAL PREDICTORS (KINGSTON, ET. AL.)

 Mental illness is sig. overrepresented in the criminal justice system
 Correctional settings: 10-40%
 When definition includes SUD: 80-90%


RELATIONSHIP BETWEEN MENTAL ILLNESS & VIOLENCE

Psychopathologica  Untreated mental illness considered a direct cause of criminal
l theory of criminal behaviour
behaviour  Support: quantitative reviews & studies
 Individuals with psychiatric diagnosis more likely to be
arrested for a violent offense as compared to those who have
never been hospitalised
 Limitations: number of studies can’t replicate this result
 Possible confounder: sample composition – mental illness as
risk factor for violence among general population BUT effect
does not generalise to offenders

Social  Most studies using offender samples showed psychiatric
psychological diagnoses are unrelated to recidivism
explanations of  General Personality & Cognitive Social Learning (GPCSL) model

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