CRIME & MENTAL DISORDER. Aileen Wuornos. Personal Quote: "I'd just like to say I'm sailing with the rock and I'll be back like Independance day with Jesus, June 6, like the movie, big mothership and all. I'll be back." Last words before being executed.
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Issue of normality – criteria fluctuate
The current version lists many mental disorders.
What is a mental disorder?
Two basic guiding principles:
A dysfunction of internal process
Axis I – Clinical Syndromes
Axis II – Personality Disorders and Mental Retardation
Axis III – General Medical Disorders
Axis IV – Psychosocial/Environmental Problems
Axis V – Global Assessment of Functioning (GAF)
This classification system is gone with the DSM-V
Anxiety Disorders (e.g., Agoraphobia, Obsessive Compulsive Disorder, Panic Disorder)
Depressive Disorders (e.g. Major Depressive Disorder)
Dissociative Disorders (Depersonalization Disorder -outside looking in- , Dissociative Amnesia, Dissociative Fugue, Dissociative Identity Disorder)
Psychotic Disorders (Delusional Disorder, Schizoaffective Disorder, Schizophrenia, Substance-Induced Psychotic Disorder)
Dissociative Disorders involve the:
Dissociation, or splitting apart, of components of the personality that are normally integrated.
Dissociation (adaptive process)
involuntary response to psychological stress
Partial or total forgetting of past experiences,
Not an organic cause; response to psychological stress.
Taking a sudden, unexpected trip away from home.
Dissociative Identity Disorder
Form of unconscious behaviour or actions done in an altered state of consciousness
R. v. Parks
A mental disorder characterized by a system of false beliefs.
In delusional disorder
Major Affective Disorders
Extremely depressed for at least a 2 week period (inability to anticipate happiness or pleasure)
Accompanied by a generalized slowing down of mental and physical activity.
Depression and Criminality
Depression may be strongly linked with delinquency (in females)
Indifference to personal safety/consequences
A hallucination is
A sensory perception experienced in the absence of an external stimulus.
Different from an illusion, which is a misperception of an external stimulus.
Auditory hallucinations that instruct a person to act in a specific way.
Fixed or persistent false beliefs that have no basis in reality and may accompany a variety of psychological conditions.
Most widely experienced positive symptom of schizophrenia
Types of delusions may include
Delusions relevant to violence or aggression
Persecutory delusions and violence:
Experience of delusional distress
Co-occurrence of “distress factors” (low self-esteem, high anxiety, anger) and persecutory delusions increase risk for violence.
Violence may appear as a forced choice in patients who experience persecutory delusions associated with a strong idiosyncratic conviction of being threatened and forced to defend oneself.
1) Unfit to Stand Trial (FIT)
2) Not Criminally Responsible on Account of Mental Disorder
3) Mentally disordered sex offenders (MDSO)
4) Administratively transferred from a prison to a mental hospital (transfers)
Most mentally disordered committed involuntarily during trial, especially if found NCRMD
-state of mind at time during trial proceedings vs. at time of offense
Severe breakdowns in
Disorganization and failure to correspond to reality.
Schizophrenia– is a psychotic disorder marked by a severe breakdown in thoughts, emotions & perceptions
Command hallucinations and violence
McNeil, Eisner, and Binder (2000)
Study of 103 psychiatric inpatients
33% reported having a command hallucination
22% reported they complied with such commands
Command Hallucinations and Compliance:
Who obeys and when? (R. Erkwoha, 2000)
Three psychopathological characteristics
Who obeys and when? (R. Borum, 1998)
How often have you…
Affective disorders– disorders of mood or emotion
Depression– a period of great sadness associated with decreased levels of mental and physical activity
Mania– a period of intense elation indicated by symptoms of talkativeness, distractibility, flight of ideas, grandiose plans & purposeless activity
Bipolar– episodes of mania & depression; or mania alone
Compared to non-mentally disordered persons:
Epidemiological Studies Conclusions schizophrenia)
Jeffrey Swanson – ECA Project
Principle of rationality-within-irrationality – violence may be a ‘rational’ behavioural response to ‘irrational’ psychotic symptoms
Violence is more likely where psychosis involves symptoms of threat/control-override
(Link & Stueve, 1994)
Link and Stueve Study
Participants with TCO symptoms were…
Factors increasing compliance(Bjorkly, 2002)
(Douglas & Hart, 1996)
Most people who have mental disorders are not violent
Likewise, most people who commit violence do not have a mental disorder
However, some mental disorders are associated with a greater likelihood of committing violent acts
In general, the more serious disorders carry a greater risk for violence
People who have delusions may be at specific risk
In the manic phase of bipolar disorder, people can be impatient and easily angered
Psychosis and substance use both have independent effects
Psychosis and substance use have exponential effects, when the co-occur
Psychosis, substance use, and violence influence each other over time
Mental disorder is indirectly related to violence through substance abuse