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Beyond Actuarial Assessment to Informed Risk Management. Susan J. Sachsenmaier, Ph.D. Prepared for IAFMHS April 9, 2003 firstname.lastname@example.org With thanks to Robert Fein, Ph.D. for consultation. Methods for assessing probability of future violence.
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Susan J. Sachsenmaier, Ph.D.
Prepared for IAFMHS April 9, 2003
With thanks to Robert Fein, Ph.D. for consultation.
A. Traditional Clinical Judgment: unguided, intuitive
B. Actuarial Determination: Statistical
C. Structured Clinical Judgment: guided by research- selected factors
A. Traditional Clinical Judgment: unguided, intuitive
1. pro: individually specific
2. con: low reliability and validity
1. pro: statistical formulas are generally more reliable and valid than clinical judgment; specific probability over specific no. of years, likelihood of false positives and false negatives.
2. con: only applicable to certain well- defined populations with a high- enough base rate of violent acts
1. pro: can be applied to a specific individual in certain relevant contexts, with moderate or better reliability and validity, depending on stability of important factors
2. con: cannot give statistically accurate information such as probability of recidivism in a specific number of years, or likelihood of false positives and false negatives.
A. Salient factors in choosing proper method
1. military men are not included in any significant number in samples upon which actuarial methods have been developed
a. Trained in combat,
b. Trained to exercise caution and judgment in selecting targets of aggression, especially when under pressure
c. Trained to think clearly under high stress situations,
d. Trained to handle weapons with skill and discretion
e. Trained to evade capture when necessary,
f. Trained in the importance of maintaining high moral standards even when off-duty
g. Trained that civilians look to them for protection
h. Determined physically and mentally healthy at entry
i. Are generally above the average level of intelligence of civilian prisoners
e. several others not worth mentioning
a. actuarial methods do not fit this case
b. unguided clinical judgment or intuition is the less reliable and valid of the two remaining options
c. that leaves a research-supported, structured analysis of the relevant factors
d. U.S. Secret Service Model
A. targeted violence is the result of an understandable and often discernible process of thinking and behavior.
1. neither impulsive nor spontaneous
2. thinking about the attack dominates their lives and provides a sense of purpose or an attainable goal by which they see an end to their emotional pain
1. Consider relevant risk factors,
2. Consider development and evolution of ideas concerning the attack,
3. Consider preparatory behaviors leading to violent attack
4. Appraise how the individual has dealt with stress in the past, when usual coping mechanisms are ineffective
a. by becoming physically ill,
b. by becoming psychotic,
c. by becoming self-destructive, or
d. by becoming violent toward others.
6. Appraise the current situation and the previous and anticipated target(s).
a. What is the likelihood that past life events that have triggered consideration of self-destructive or violent behavior will recur (or are recurring)
b. Consider how others in the subject's environment have responded or are responding to his/her perceived stress and potential risk.
a.gender, ethnic, political, religious, work, other
b. subject's degree of familiarity with the target's work and lifestyle
c. target's vulnerability, accessibility to subject
d. target's sophistication about the need for caution.
A: What motivated the subject to make the statements, or take the action, that caused him/her to come to attention?
B: What has the subject communicated to anyone concerning his/her intentions?
C. Has the subject shown an interest in targeted violence, perpetrators of violence, weapons, extremist groups, or murder?
D. Has the subject engaged in attack- related behavior, including any menacing, harassing, and/or stalking-type behavior?
E. Does the subject have a history of mental illness? OR:
Does subject have substance abuse problems?
F. How organized is the subject? Can he/she develop and carry out a plan?
G. Has the subject experienced a recent loss and or loss of status, and has this led to feelings of desperation and despair?
H. Corroboration: What is the subject saying and is it consistent with his/her actions?
I. Is there concern among those that know the subject that he/she might take action based on inappropriate ideas?
J. What factors in the subject's life and/or environment might increase/decrease the likelihood of the subject attempting to attack a target?
I. Relevant Factors in Target Violence
A.Target Violence is understandable
1. Not Impulsive
a. he checked J’s schedule for that night, invited him to Landing Base
b. he stopped at home and changed to shorts with no underwear, t-shirt, socks, no shoes, in February.
2. Attainable Goal with belief it will end emotional pain
a. he felt wronged by his wife, but could not do anything about that, she had out-smarted him.
b. he felt loss of power when removed from Security Forces and wanted to regain sense of power.
B. Violence stems from interaction of attacker, past stressful events, and current situation.
a. Abused as child, abandoned by mother
b. Not popular with girls
c. Air Force was increasingly stressful
d. Increasing anger at others
e. Increasing physical aggression
f. Increasing addiction to alcohol
g. Increasing need for sadistic sex
a. 1998: finished H.S., joined Air Force.
b. 1998: sick with Mononucleosis, missed several weeks of duty.
c. 1999: met woman, got her pregnant, got married, all within 3 months.
d. 1999: wife miscarried.
e. 1999: complains of sleep problems, goes to sleep clinic.
f. 1999-00: lost authority to carry firearms, removed from Security Forces.
g. 2000: wife miscarried again.
h. 2000: attempts to return to S.F., fails.
i. 2001: wife leaves him.
a. angry, alcoholic, preoccupied with sex.
b. others are speaking negatively of victim
c. victim is vulnerable, accessible.
4. Preparatory Behaviors
a. gathered information
i. knew victim, husband
ii. knew victim’s car, husband’s car
iii. knew garage door left open when husband not home
iv. knew husband likes to go to Landing Base
i. told no one
ii. justified his anger
iii. talked to victim day of attack and asked about husband’s plans for the night
iv. invited husband out that night
v. arranged to have husband gone, victim alone
vi. chose victim with no training in self defense
i. went to friend’s house drinking; went to Landing Base and continued to drink; after closing went to friend’s house and continued to drink.
ii. Criminals planning a crime frequently heighten feelings of power and invincibility by using alcohol and/or drugs
iii. Went home and removed regular clothes, dressed in shorts with no underwear, t-28shirt, socks, no shoes, for easy, fast removal
iv. Checked garage and saw husband not home
i. Entered closed door uninvited
ii. Removed clothes rapidly as he went straight to bedroom
iii. Turned light off as soon as victim turned it on so she could not see him and it would increase her terror.
iv. Smothered her with pillow or hand so she could not breathe, to increase her terror and feelings of vulnerability
i. Raped victim several times and hurt her
ii. Covered her head with comforter so she could not see him, increase her terror.
iii. Twirled her around to make her dizzy and disoriented, with blanket over face, making it hard for her to breathe.
iv. Told her he would not hurt her, to keep her compliant and not try to escape.
v. told he he was taking her to kitchen to give her a drink of water, provided reason for looking in cupboards, keeping her compliant.
vi. Beat her over head with pan until she fell down and kept beating her.
a. physical illness: 1999, mononucleosis
b. psychosis: no, but depression, anxiety
c. self-destruction: 1999-01, alcoholism, suicide gesture
d. violent toward others: 1999-01, increasingly, beginning with wife and escalating with her, then escalated to rape and attempted murder of victim.
6. Subject’s history of responses to losses, trauma, major changes
a. joined Air Force, got Mono
b. wife miscarried, became suicidal
c. wife miscarried, became brutal, abusive
d. sexual troubles, became addicted to porn
e. sexual impotence, became sexual sadist
f. frustrated, became alcoholic
g. removed from S.F., became angry, hateful, blaming, felt wronged, self-pity
h. wife miscarried 2nd time, aggression grew, no empathy for her
i. disappointed by some women, developed anger toward all
a. likelihood that past events that trigger violence will recur
i. History of childhood abuse, abandonment
ii. Sees Air Force as stressful, disappointing
iii. Sees others as unfair to him
iv. Sees women as disappointing, vulgar
v. . Addiction to alcohol
vi. Does not have wife or children
vii. Not generally attractive to women
vii. Vulnerable victims accessible (women whose husbands are upset with them, or some other reason for projecting blame on them)
b. how others in environment perceive and react to subject’s aggression and potential risk
i. Air Force teaches respect for women
ii. Air Force discourages inappropriate aggression
iii. Air Force discourages alcoholism
iv. Wife gave him clear messages that violent sex not acceptable
v. grandmother taught him violence against women is wrong
vi. No known associates approved of this sort of violence, did not deter subject
i. subject familiar with target’s work and lifestyle, easy to do same with future target
ii. target was vulnerable and accessible, easy to locate similar victim in future
iii. Target was not sophisticated about need for caution, easy to locate similar victim- target
iv. Target appears to include any accessible female, tried to rape wife, beat wife, raped and beat current victim
1. to punish victim for perceived transgressions
2. to vent personal rage
3. to regain feeling of powerfulness
4. to commit heinous crime and get away with it
1. none known, no forewarning (one witness reported husband made comment implying he knew something would happen to wife that night – not substantiated, were lots of rumors going around)
2. planned with stealth, like a military attack
1. weapons: obsessed about Security Forces, being able to carry firearms
2. violence: spouse assault, attempted rape of spouse, sadistic sex, violence to victim, multiple rape of victim
3. murder: attempted murder, believed he was successful
1. setting up victim by inviting husband to Landing Base.
2. watching victim and husband until he knew their habits.
3. making frequent derogatory remarks to women
4. angry, sarcastic, challenging to authority when feels thwarted
5. threatened to kill anyone his estranged wife might date
1. no major mental illness
2. insomnia, anxiety, depression
3. serious alcohol abuse
1. very organized, stealthy
2. Security Forces training
3. anticipated evidence collection and destroyed his clothing,
4. concocted alibi
1. wife’s two miscarriages
2. wife’s divorce of him
3. removal from Security Forces
4. permanent ban against firearms
5. public arrest and confinement after 9 months thinking he got away with it.
6. no current girlfriend
7. loss of status in family of origin
8. loss of status in home town.
1. says he wants help, but did not want help until he was arrested
2. says he is sorry, but did not say so until arrested
3. says never meant to hurt anyone, but went to great effort to hurt someone
4. says history of manic-depression in family, but never said that until arrested, grandmother said no mental illness in family.
5. in 2000, said no potential for alcohol abuse, but was abusing alcohol then and continued to.
1. wife was afraid to come back to NM to get her belongings
2. wife allowed him to force her to have sex every day because she was afraid of him
3. officer who removed authority for firearms was afraid he would be violent, not just then but at any point in future
4. certainly any woman who would live in his neighborhood after this, if they knew
5. ex-wife, if he went to her home state
a. Chronic, pent-up rage
b. Blames others for own problems, actions
c. Hatred of those he thinks wrong him
d. Feels entitled to attack other – to point of death – who has not wronged him, but who is merely in his target victim group
e. escalating reaction to stress since leaving high school, grandmother’s home and home town, from verbal anger to rape to intended lethal violence
f. Sees people as objects to manipulate to meet his needs, no real sense of humanity of others, no ability to empathize with others, evidenced by:
i. attacking wife repeatedly after her miscarriages, focusing on own pain, no sense of her pain,
ii. getting garbage can to dump victim’s body in, as though it were garbage, not human
iii. frequently refers to women as sex objects only, is often rude and vulgar to them
g. No inherent sense of morality, shown by:
i. thoughts to kill himself when things did not go the way he wanted
ii. decision to rape and kill victim
iii. threat to kill anyone who might date his estranged wife
iv. ability to function normally after rape/attempted murder, with no apparent regret or remorse
v. willingness to let another man take blame for rape/attempted murder and even receive death penalty in subject’s place
h. Lies freely, several times during investigation
i. Lack of ability to anticipate negative consequences of actions
j. lack of ability to generate acceptable alternatives, such as adopting a baby, becoming a Big Brother, etc.
k. Inability to develop intimate relationships
l. Lack of concern over own behavior and role drinking may have played, did not stop drinking after rape/attempted murder
m. Has ability to plan attack, choose victim, attack, escape, evade capture
n. Overall tendency toward anger, disrespectfulness, esp. of women, but also some men
o. Poor judgment, such as freely venting hatred toward S.F. officer who removed his firearm.
p. Grievance against world in general; people who feel persecuted are more likely to be violent.
q. People who abuse alcohol are more likely to be violent
r. He is big and strong, body and hands can be lethal weapons
s. He knows how to kill someone and not get blood on himself (except for small amount on socks, but not enough to leave tracks to his house)
t. Takes on causes for vengeance that are not his, seeks opportunities: victim had never wronged him, never a negative interaction, he had no apparent sexual attraction to her or her for him.
2. decrease probability of violence
a. Has had no alcohol while confined; if he could stay off alcohol . . .
b. If he could be kept away from all vulnerable women . . .
c. If he could regain self-esteem and find acceptable way to feel powerful . . .
d. He might take antiandrogen medication to reduce testosterone, thus sexual drive and aggressive drive; medication can be easily counter-acted so must be frequent random blood checks.
f. If stressors could be reliably removed and controlled, responsibility lessened,
g. If morals could be taught and empathy, but this is unlikely at this age, as character is formed early in life and remains fairly consistent, but is not absolutely unalterable.
h. Some People with similar characteristics tend to show “burn-out,” that is, a reduction in criminal thinking, violent behavior, and sexually deviant violent behavior later in life.
i. Pornography fuels deviant fantasies: If he could be restricted from access to pornography in any form, including magazines, videotapes, and internet, he might not obsess about violent sex.
j. If he was in a stable, supervised environment with caring people and controlled so stressors do not interfere and unanticipated situations can be kept to a minimum, he might do better.
This is a person who has been deteriorating steadily since leaving high school.
But he has had periods of above average functioning in highly structured and supervised settings.
His reactions to stressors that are serious but not tragic have been extremely violent.
There is a notable lack of moral development and inability to feel empathy for others.
There are many exacerbating conditions, including pathological jealousy, addiction to pornography, alcohol abuse, hatred of women, resentment of authority, dishonesty, and a calculating mind.
It is my opinion to a reasonable degree of psychological certainty that he remains seriously dangerous and at risk for future incidents of violent and sexually violent behavior
But I cannot say what specific form of behavior, how severe, with what frequency, or within what time period.
A. Research shows people who demonstrate a fundamental deficit in forming empathy for another are resistant to treatment.
B. Research shows neurologically based differences between people who show significant psychopathy and those who do not.
C. Escalating patterns of sadistic sexual behavior are associated with enduring patterns of sadistic sexual behavior and violence in general.
D. Some “mitigators” such as childhood abuse also predict greater likelihood of recidivism.
E. Voluntary admissions that signify significant guilt (when other motivation not present, such as plea bargain), may indicate development of conscience, which can be used to facilitate rehabilitation. That is not evident in this case.
F. Personality structure and ego strength suggest greater potential for rehabilitation.
G. Lack of substance abuse may reduce recidivism.
H. Lack of victim access may reduce recidivism.
I. There are many individual and situational factors that cannot be predicted.