Crime & Mental Disorders Flashcards
What does the tautological argument suggest?
That mentally ill people are dangerous, and people who commit violent/ sensational crimes are mentally ill.
According to the DSM, a mental disorder is characterized by…?
- Dysfunction of some internal process within the
person. - Negative consequences for the individual.
(pain, distress, disability.)
What are the three major changes in the recent DSM versions?
- Focus on the behavioural indicators of the
mental disorder. - Reclassification of neurosis.
- Expansions of subcategories of psychosis.
What is included in the reclassification of neurosis in the recent DSM versions?
- anxiety disorders, somatoform disorders,
dissociative disorders.
What is the difference between mental illness and mental disorder?
- Mental illness is usually centred around a medical
model indicating there is a cure or treatment. - Mental disorder is a clinical syndrome.
What is included in the expansion of subcategories of psychosis?
- schizophrenia, major affective disorders
What is schizophrenia? (DSM)
- Persistent, chronic, serious mental disorder
affecting a variety of aspects of behaviour,
thinking and emotion. - At least two positive symptoms:
- Delusions, hallucinations, disorganized
speech, disorganized behaviour. - Negative symptoms:
- Inappropriate affect, alogia, avoliation.
What is alogia?
Poverty of thinking.
Ex: Lack of [quality] speech.
What is avolition?
Inability to initiate and persist in goal directed activities. Such as school or work.
What are positive symptoms?
Things that are added to their normal functioning. Ex: Hallucinations.
What are negative symptoms?
Things that are taken away from their normal functioning. Ex: Inappropriate affect.
What are the subtypes of schizophrenia?
Disorganized, catatonic, paranoid, undifferentiated, residual.
What is schizophreniform disorder? (DSM)
Diagnosed when the symptom criteria for schizophrenia are met, but the duration is too short and social and occupational functioning may not be impaired.
What is catatonic behaviour?
Lots of sitting, sleeping, laying. Lack of responsiveness.
Which type of schizophrenia actually has a correlation to violence/crime?
Paranoid Schizophrenia
What is residual schizophrenia?
Where the individual may have experienced it before, but may not be right now.
What is schizoaffective disorder?
Diagnosed when the symptom criteria for schizophrenia are met and during the same continuous period there is a major depressive, manic or mixed episode.
What are delusional disorders characterized by?
- Nonbizarre delusions of at least 1 month’s
duration. - Symptom criteria for schizophrenia cannot be met
- Hallucinations can be present, but not prominent.
(if they are related to the delusion.) - Psychosocial functioning may not be impaired.
What are olfactory hallucinations?
Smelling something that isn’t really there.
What are tactile hallucinations?
Having physical contact with something that isn’t there.
What are the subtypes of delusional disorders?
Erotomanic, gandiose, jealous, persecutory, somatic, mixed, unspecified.
What is erotomanic delusional disorder?
Belief of being loved from afar. (Usually being loved by a famous person)
What is jealous delusional disorder?
Ex: Delusion of being cheated on.
What is persecutory delusional disorder?
Delusions that their goals are being deterred by other people.
What is major depressive disorder?
- Chronically persistent and pervasive emotional
depression. - Goes beyond normal grief or sadness to be
characterized by an essential feature of loss of
interest/pleasure in life activities. - Weight loss/gain, insomnia/hypersomnia,
psychomotor agitation, feelings of worthlessness.
What is bipolar disorder? (Manic-depression)
- Characterized by dramatic “mood swings” or
episodes of mania & hypomania.
What is the difference between mania and hypomania?
Hypomania is similar to mania but distinguished by the absence of psychotic symptoms and less impact of functioning.
What is mania?
A state of elation, irritation, motivational or euphoric feelings.
What is Antisocial Personality Disorder?
A pervasive pattern of disregard for the violation of the rights of others occurring since 18 years of age by three (or more) of the symptom criteria.
What are common features of anti social personality disorder?
- Failure to conform to social norms
- Deceitfulness (lying, use of aliases)
- Impulsivity or failure to plan ahead
- Irritability and aggressiveness
- Consistent irresponsibility
- Lack of remorse
- Individual is at least 18 years old
- Evidence of conduct disorder with onset before
the age of 15.
Make Chart of Mental disorders and violence.
List by arboledo-florez, et al. (1996.)
What does it mean if you are unfit to stand trial?
On account of mental disorder, the accused is unable to understand the nature and/or consequences of the proceeding or unable to instruct their counsel at any stage of the court proceedings.
When would a warrant of committal/disposition of detention be issued?
If the accused would be found unfit. They would be committed to a secure psychiatric facility until such a time as they become fit.
The mandate of the psychiatric facility is only to make the person ___ ___ _____?
Fit for trial.
What percentage of the US accused are sent for fitness assessments?
2%-8%
Out of the 2%-8% that go through fitness assessments, what percentage is found unfit? (In the USA and Canada)
- 20% - USA
- 11% - CANADA
What are the correlates of people who are unfit to stand trail found by Bartol are?
- Limited social/occupational skills
- History of prior criminal charges/hospitalizations
- Unmarried, minority status, poorly educated
What is the Fitness Interview Test (FIT)?
- Semi structured interview that takes 30 minutes
What is the criteria that is evaluated in the FIT?
a) Understanding the nature or object of the
proceedings
b) Understand the possible consequences of the
proceedings
c) Ability to communicate with counsel
What can happen if you are found NCRMD?
- Absolutely discharged
- Conditionally discharged
- Detained
What are the conditions assessed to determine NCRMD?
- Actus reus (they weren’t totally in control)
- Mens Rea (they did not know it was wrong)
What is the McNaghten rule?
To be presumed to be insane, has to be establish that at the time of committing the act, they were in such a disease of the mind that they didn’t know what they were doing, or, if they did- they didn’t know it was wrong.
What are the issues of the McNaghten rule? (2)
1) “Disease of the mind” is vague
2) Knowing it is wrong (“wrong” is a broad
meaning)
Why is PTSD still a controversial diagnosis?
Due to concerns over the validity of assessment since it depends largely on self-report.
What is dissociative identity disorder?
The suffering from alternation of two or more distinct personality states with impaired recall among personality states of important information.
Why is dissociative identity disorder possibly “iatrogenic?”
Iatrogenic - exists because clinicians believe in it.
- The clinician unintentionally believed so strongly
in the condition that they actively seek and
interpret various behaviours as symptoms of the
disorder.
What is retrograde amnesia?
Difficulty in recalling past memories
What is anterograde amnesia?
Difficulty in creating new memories
What is limited amnesia?
Refers to a pathological inability to remember a specific episode, a small number of episodes due to a blow to the head, substance intoxication or emotional shock. Effects are temporary.
What percentage of persons convicted of homicide claim they cannot remember the crime? Due to what?
30%-65%. Usually because of alcoholic intoxication.
What is important to assess “dangerousness” by clinicians?
Responsibility of mental health professionals to breach confidentiality in order to warn third parties of risk for violence from their client.
Why is it difficult to accurately understand the base rates of violence?
Clinicians generally over predict due to fear of legal ramifications.
How do you predict if there will be future violent acts?
To understand how and why people chose to act violently in the past, and to determine whether these or other factors might lead the person to make similar choices.
What are the features of an unstructured assessment?
- No constraints on evaluation. Any information
can be considered. - No constraints on decisions. Information can be
weighted and combined in any manner. Also, the
results can be communicated in any manner.
What are the limitations of unstructured assessments?
- No systematic empirical support
- Decisions are broad
- Relies of charismatic authority
What are the features of risk scales?
- Designed to predict violence
- High-fidelity
- Imposed rigid structure
What are the limitations of the risk scales?
- Requires professional judgements (how to
interpret scores) - Justification of use requires induction
- Results may be easily misinterpreted
In the violence risk scale (VRS) what is a static variable?
- Current age, sex, convictions, family upbringing
In the violence risk scale (VRS) what is a dynamic risk factor?
- Violent lifestyle, attitudes, peers, interpersonal
aggression, weapon use, mental disorder, etc.
What is the guide for risk assessments?
- Use many sources of information
- Standardized and structured
- More accurate and informative
- Assess both static and dynamic risk factors
A risk assessment instrument should be…? (2)
- Appropriate for the question at hand and the
target population. - Sample a wide range of major risk variables of the
population in question. - One size does not fit all.
