Forensic Flashcards
What is the best predictor of future violence?
History of past violence
What are some predictors of future violence?
- substance misuse
- previous expression of intent to harm others
- previous dangerous impulsive acts
- denial of previous established dangerous acts
- explosive or impulsive personality traits
- active symptoms of schizophrenia or mania
What is most likely to be associated with juvenile delinquency (law breaking activity in 10-20 year olds)?
parent criminality
Which factors are asscoiated with juvenile delinquency (law breaking activity in 10-20 year olds)?
- parent criminality
- low IQ
- Conduct disorder
- large family size
What % of children will have stopped offending by aged 19?
50%
What’s the prevalence of violence in outpatients with Schizophrenia?
5%
What’s the most common type of aggression in people with Schizophrenia?
verbal
Criminal behaviour in patients with Schizophrenia
- it increases with substace misuse
- Patients with schizophrenia usually assault a known person rather than a stranger.
- Violence is a common precipitant prior to the first admission to psychiatric ward
- Violence in patients with schizophrenia is not always a result of psychosis
-THEY DO NOT HAVE HIGHER RATES OF OFFENDING THAN THE GENERAL POPULATION
Criminal behaviour in patients with epilepsy
- There is an approximately twofold increase in the prevalence of epilepsy in prisoners compared with the general population
- the rate and type of offending by those with epilepsy are similar to the general population
- low intelligence is associated with violence in people with epilepsies
OFFENDING IS RARELY DURING THE ICTAL PHASE
Which offence is most associated with people with Asperger syndrome?
Property destruction and Fire setting
Which methods can be used to treat sex offenders?
-Cyproterone
-medroxyprogesterone
(both are contraindicated in liver disease and VTE)
-SSRIs where there are ruminations
-CBT
Which tools are useful for predicting sex offence recidivism?
- Rapid Risk Assessment for Sex Offence Recidivism (RRASOR)
- Sex Offender Risk Appraisal Guide (SORAG)
- Sexual Violence Risk-20 (SVR-20)
- Structured Anchored Clinical Judgement (SACJ)
What is the most important risk factor for violence both in general and mentally disordered populations?
Substance misuse
What is Pseudologia fantastica?
Pseudologia fantastica is one of the more extreme forms of pathological lying. This is a matrix of facts and fiction, mixed together in a way that makes the reality and fantasy almost indistinguishable. It is usually seen in forensic practice.
The duty to warn the 3rd parties in case of imminent danger is illustrated by which case?
Tarasoff’s case
Victims of womens’ violent acts are more likely to be?
Family members
What are the The Fitness to Plead / Pritchard Criteria?
Relates to the mental state of the defendant at the time of the trial. They include:
- ability to understand charges
- ability to follow proceedings
- ability to instruct counse
- ability to understand the difference between pleading guilty and not guilty
- ability to challenge a juror
What does not interfere with one’s fitness to plead?
Amnesia for the offense
What is Ganser’s syndrome?
Ganser’s syndrome is a rare dissociative disorder - often seen in people awaiting trial
What are the core features of Ganser’s syndrome?
approximate answers, clouding of consciousness, somatic conversion symptoms and hallucinations (visua pseudohallucinations)
Which of the following types of stalker is most likely to commit a homicide?
Predatory stalker
In females which age group is associated with the highest risk of committing a homicide?
30-39
Which mental illness most closely linked with murder-suicide?
Depression, especially in men
Which diagnosis is most commonly made in stalkers?
Antisocial PD
Which personality traits are more often seen in elderly sexual offenders than non offending older individuals?
Schizoid
Proportion of all homicides commited by individuals with schizophrenia?
5% (annual risk of a patient with schizophrenia committing homicide = 1 in 10,000)
Victims of female homicide perpetrators with psychosis often belong to age group?
<16
Most offenders with charge of exhibitionism belong to age group?
15-25 years
% of members of Royal College Psychiatrists who experience stalking?
22%
Proportion of those discharged from medium secure units that are convicted for violent offence within 2 years?
6%
Paedophilia
Offender usually male
50-70% have another paraphilia
1/3 adolescents
Girls twice as likely to be victims
Which group of sexual offenders are more likely to be married?
Exhibitionists
Annual risk of a HCP to be stalked?
10%
RR of psychosis in prisons compared to general population?
20
DSM requires evidence of antisocial behaviour pattern by which age in order to diagnose ASPD?
15
No of infanticides reported per year
20 (all infant homicides = 30-45 per year)
Prevalence of psychotic illness in patients with epilepsy?
3-7%
Prevalence of epilepsy in patients with schizophreniform psychosis?
0.4 - 1%
Prevalence of psychosis in prison population?
50 per 1000
5%
% of people convicted of indecent exposure have no prev record of sexual offences?
20%
Low rates of recidivism in a sexual offence are indicated by which features?
Incestual sex offence against a child
Offending behaviour of adults with LD
Adults with borderline and mild LD account for most of the offending behaviour
What are the most common mental disorders found in sex offenders?
Personality disorder
Paraphilias
Alcohol and substance misuse
PSYCHOTIC DISORDERS ARE NOT COMMON
Prevalence of ASPD?
0.6%
Is exhibitionism included in ICD10/DSM4?
It is included in both the DSM-IV and ICD-10 classification systems
What % of female prisoners have borderline personality disorder?
20% of female prisoners have borderline personality disorder.
According to English and Welsh law, at what age does a person become responsible for their actions and therefore liable to prosecution?
10 (8 in Scotland)
Which mental health problems is associated with the highest rate of homicide?
Substance misuse (contributes to 61% of homicides)
Are people with mental illness or intellectual disability more likely to be victims of violence or to be perpetrators?
People with mental illness or intellectual disability are also more likely to be victims of violence than they are to be perpetrators.
What is the peak age for male offenders in the UK?
17-18
What is the peak age for female offenders in the UK?
14
Conviction male: female
In the UK convicted males outnumber females by 5 to 1.
What is involuntary manslaughter?
the defendant never meant to kill the victim but they did by action of their behaviour (e.g. medical manslaughter).
What is voluntary manslaughter?
the defendant may have intended to kill the victim but there was a good reason (e.g. they thought they were going to be killed).
Which homicide plea can result in acquittal?
Self defence
Which punishments that can be given to children under 10 who break the law?
Local Child Curfew
The police can ban children from being in a public place between 9pm and 6am, unless accompanied by an adult. This can last for up to 90 days.
If a child breaks their curfew, they can be given a Child Safety Order.
Child Safety Order
If a child has committed an offence or broken a Local Child Curfew, they can be placed under the supervision of a youth offending team. This is called a Child Safety Order.
This lasts for up to 3 months, but in some cases it can last for up to 12 months. If a child doesn’t stick to the rules of an order, the court can consider if the child should be taken into care.
How are children who commit crimes between the ages of 10-17 treated differently from adults?
dealt with by youth courts
given different sentences
sent to special secure centres for young people, not adult prisons
In order to be found not guilty by reason of insanity a person must satisfy which rules?
McNaughten rules:
- Did not understand the quality or nature of the act
- Did not know what they were doing was wrong
- If under a delusion that prevents the true appreciation of the nature and quality of his act, he is under the same degree of responsibility as if the facts were how he imagined them to be. For example, if acted in self-defence believing life in danger then would be treated as if acting in self-defence
What is Automatism? What are the two types?
Automatism
Automatism is a defence used when the act is believed to have occurred unconsciously/involuntarily. It comes in two forms:-
Sane automatism - where the act occurs from an external cause such as a head injury.
Insane automatism - where the act occurs from an internal cause such as epilepsy, night walking etc
What are Indictable offences?
These are considered more serious and are tried in the Crown Court. Examples of Indictable offences include:
Rape or aggravated sexual assault
Murder or attempted murder
Piracy
Treason
What’s the difference between criminals and civil law?
Criminal law mostly involves the rules laid down by the state for citizens, while civil law governs the relationships and transactions between citizens.
Which court do all criminal cases go?
All criminal cases will first go to the Magistrates’ Court.
What the three main categories that criminal offences are divided into?
Criminal offences are divided into three main categories:
Summary offences - These are the least serious offences and are tried in the Magistrates’ Court.
Summary offences involve a maximum penalty of 6 months imprisonment and/or a fine of up to £5000
Triable either way offences - These can be regarded as the middle range of crimes and include a wide variety of crimes e.g. theft, assault causing actual bodily harm. These can be tried in either the Magistrates’ Court or Crown Court.
Indictable Offences - These are the more serious crimes and include murder, manslaughter and rape. All indictable offences must be tried at the Crown Court, but the first hearing is dealt with at the Magistrates’ Court. The magistrate will decide if the defendant should be given bail. The case is then transferred to the Crown Court.
What % of cases are completed at Magistrates’ courts?
95%
What % of stalking victims are assaulted?
10-33%
Which setting is persistent stalking reportedly high in?
Persistence is reportedly high in workplace stalking and among professionals pursued by ex-patients and clients.
Which proportion of stalkers re offend?
Almost half re-offend, with most returning to stalking within 12 months
What’s the risk of being stalked by a patient over a year? And over a career?
The risk of being stalked by a patient or a patients relative is between 5% and 10% in a year, and around 20% over the course of a career
Do most stalkers fit criteria for compulsory mental health treatment?
No
What’s the HCR 20?
Historical-Clinical-Risk Management-20 (HCR-20)
Used for assessing violence in inpatients and discharged patients in the community
What’s the RSVP?
Risk of Sexual Violence Protocol (RSVP)
for assessing risk of sexual violence
What’s the SARA?
Spousal Assault Risk Assessment Guide (SARA)
It can be used to help gauge risk of future violence in men arrested for spousal assault
What’s the SAM?
Stalking Assessment and Management (SAM)
Structured professional judgement tool for assessing risk of stalking behaviors
What’s the SVR20?
Sexual Violence Risk-20 (SVR-20)
Assesses risk of committing sexual violence and for targeting plans to manage that risk
What’s the RM 2000?
Risk Matrix 2000 (RM2000
consists of 3 scales
- a prediction scale for sexual offending
- a prediction scale for non-sexual violence engaged in by sex offenders
- a combination of the first two scales and predicts sexual or other violence
What’s Static-99?
Static-99
actuarial assessment instrument for use with adult male sexual offenders who are at least 18 year of age at time of release to the community
What’s VRAG?
Violence Risk Appraisal Guide (VRAG)
predicts risk of violence within a specific time frame following release in violent, mentally disordered offenders
The Hare PCL-R (Psychopathy Checklist -Revised) score is incorporated into the VRAG calculations of risk
Separation from either biological parent by age 16 (Except for death of parent)
Elementary school maladjustment score
Alcohol problems
Never married
Criminal history score for non-violent offences
Failure on prior conditional release
Age at index offence
Most serious victim injury (from the index offence)
Female victim in the index offence
Meets DSM-III criteria for any personality disorder
Meets DSM-III criteria for schizophrenia