Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCPsych Part B - Al-Rashid Hospital > Forensic Psychiatry 1 > Flashcards

Forensic Psychiatry 1 Flashcards

1
Q

Prevalence of violence in the mentally ill

A

4-6x higher than general population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In how many crimes is mental illness an attributable risk factor?

A

<10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which factors have greater risk of violence than MI?

A 
PD
Alcohol and drug misuse
Male
15-30 years of age
Low socioeconomic status
Past hx of violence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How many patients with schizophrenia were violent in first 20 weeks of dc?

A

9%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How many patients with depression were violent in first 20 weeks of dc?

A

19%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How many patients with bipolar were violent in first 20 weeks of dc?

A

15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How many patients with substance misuse were violent in first 20 weeks of dc?

A

29%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How many patients with PD were violent in first 20 weeks of dc?

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How many patients with schizophrenia in the community have committed a violent act in a 12 month period?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How likely are men with schizophrenia to be convicted of serious violence?

A

5 times greater than general population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Annual probability that a patient with schizophrenia will commit homicide

A

1: 3000 for men
1: 33000 for women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who did a systematic review of prison studies?

A

Fazel and Danesh 2002

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What did Fazel and Danesh’s systematic review involve?

A

62 surveys of prison studies covering 12 countries and 22,790 prisoners

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Findings of Fazel and Danesh’s systematic review?

A

In men 3.7% had psychosis, 10% had depression, 65% had a PD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How many prisoners suffer from an organic MI?

A

1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How many homicides are due to mental disorder?

A

34%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How many homicides are linked to schizophrenia?

A

5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How many homicide offenders have active sx of schizophrenia at time of offence

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Who suggested that psychosis is 10x more common in prison than the general population

A

Brugha et al 2005

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Reasons for mental disorder being more common in the criminal justice system

A

Epidemiological association
Prison psychosis
Institutional bias
Penrose Law

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is prison psychosis

A

Incarceration is a causal agent attributed to mental disorders such as psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Who suggested institutional bias?

A

Seddon 2007

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the institutional bias hypothesis re MI in prisons?

A

Prison is a method of confining undesirable elements of society such as MH patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is Penrose Law?

A

Lionel Penrose examined association between no of people in mental institutions and crime rates in Europe.

Occupancy rates in mental institutions increased with reduction in number of murders and numbers of individuals in prison and number of live births per 1000.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Rate of homicide in the UK

A

1.2/100,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How many patients convicted of homicide have some form of abnormal mental state at time of offence?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How many patients with abnormal mental state at time of offence (homicide) have psychoses?

A

66%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How many homicide offenders have schizophrenia?

A

9%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How many homicide offenders have a secondary PD diagnosis?

A

54%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How many homicide mentally disordered offenders (MDO) had contact with MH services in past year?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Annual risk of person with schizophrenia committing homicide in the UK

A

1 in 10,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Annual risk of person with schizophrenia acquiring a conviction for violence

A

1 in 150

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Victims of homicide by MDOs?

A

Acquaintances - family member usually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Who divided filicide into 6 groups?

A

D’obran 1979

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the 6 groups of filicide

A 
Battering mothers
Mentally ill mothers
Neonaticides
Retaliating women
Unwanted children
Mercy killing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is another way of dividing filicide?

A 
Altruistic
Psychotic
Accidental
Unwanted
Spousal revenge related
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is filicide?

A

Act of killing ones own child by the mother

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Describe battering mothers

A

Impulsive killing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Most common MI in filicide mothers

A

Depression
Psychotic illness
PD
Dissociative responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Most common PD in filicide mothers

A

BPD

Dependent PD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Prevalence of psychosis in filicide mothers

A

40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Prevalence of depression in filicide mothers

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Define neonaticides

A

Killing a child during first 24 hours of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Describe retaliating women

A

Aggression towards spouse displaced on to child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Describe unwanted children

A

Passive neglect or active aggression associated with unplanned pregnancies and socioeconomic hardships

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Which Act uses the term infanticide

A

Infanticide Act 1938

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Definition of infanticide under the Infanticide Act

A

When a mother causes death of her child under the age of 12 months by wilful act or omission, but at the time of the act or omission the balance of her mind was disturbed by reason of her not having fully recovered from the effect of her having given birth to the child or by reasons of effect of lactation consequent to the birth of the child.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Incidence of infant homicide in the UK

A

30-45 per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Risk factors for infanticide

A

Substance abuse

MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Define murder-suicide

A

Murder followed by suicide of perpetrator within one week of homicide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Incidence of murder-suicide

A

0.2-0.3/100,000 per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What MI is common in murder-suicides?

A

Depression 20-60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Typical clinical presentations of murder-suicides

A

Middle-aged man recently separated of facing separation from partner, depressed and access to firearms
Older male who is caregiver of spouse who is ill where there is recent onset of new illness in the male, depression and access to firearms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is Parricide?

A

Act of killing ones parents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

How many homicides and parricide?

A

2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Who is the perpetrator in most parricides?

A

Son

Aged 12-50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Motivations behind most parricides

A

Revenge for sexual abuse

Financial interest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Triggers of most parricides

A

Spontaneous act during domestic argument

Resentment, explosive anger, jealousy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Clinical risk factors of parricide

A

Sudden mood changes in background of intrafamilial conflict and repeated homicidal or suicidal threats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Prevalence of non fatal results in England and Wales

A

One million cases a year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Classifications of non-fatal assaults

A

Common assault
Aggravated assault
Battery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is common assault?

A

Intentionally/recklessly causes another person to apprehend the application of immediate unlawful force

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is aggravated assault?

A

When an individual attempts to cause serious bodily injury to another or does so purposely, knowingly or recklessly under extreme indifference to value of human life
Or attempts to cause knowingly bodily injury to another with a deadly weapon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is battery?

A

Intentionally/recklessly applying unlawful force to the body of another person

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

How many individuals convicted of non fatal violence were found to have schizophrenia?

A

9%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

How many cases of shoplifting involve MI patients?

A

3.2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Which MI is shoplifting linked to?

A

Affective disorders
Alcoholism
Drug addiction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

When is depression linked to shoplifting?

A

Middle aged woman

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

When does shoplifting peak?

A

Adolescence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is kleptomania?

A

Impulse control disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Where is Kleptomania found in ICD 10?

A

F63 - habit and impulse disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

How many shoplifters have a hx of kleptomania?

A

1-2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Gender differences in kleptomania

A

Most are women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

How many people with kleptomania also have a PD?

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Most common PD in kleptomania?

A

Paranoid

Histrionic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

How many fire setters intentionally started the fire?

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

How many psychiatric patients have a hx of fire setting behaviour

A

26%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Which psych disorders have an association with fire setting?

A 
PD
Schizophrenia - 8%
Bipolar - 11%
LD
Intoxication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Characteristics of fire settings

A 
Young adult males
Relationship difficulties
Unmarried
Poorly educated
Isolated
Unemployed/unskilled labourers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

M:F ratio of arson

A

2.1:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Primary gain of arson

A 
Relief or excitement
Delusional motive
Revenge/jealousy
Self-destruction/suicide
Recognition
Attention seeking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Secondary gain of arson

A 
Financial
Extortion
Conceal crime
Vandalism
Political protest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Who divided arson into 2 groups?

A

Faulk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is Group I arson?

A

Cases where the fire served as a means to an end e.g. revenge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What is Group II arson?

A

Cases where the fire itself was the phenomenon of interest e.g. pyromania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Describe pathological fire setters

A

Occurs on 2+ occassions
Preoccupation with fire
No excitement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Define pyromania

A

Occurs on 2+ occasions

Results in relief of tensions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What is a pyromaniac?

A

Fire-rasier who derives pathological excitement from setting fire

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

DSM IV criteria of pyromania

A

Deliberate and purposeful fire setting on more than one occasion
Affective arousal and tension prior to act
Fascination with fire and its situational context
Pleasure, gratification or relief when setting fires or witnessing aftermath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Exclusion criteria for pyromania

A

Behaviour not accounted for by CD or antisocial PD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Motive of fire setting in those <10 years

A

Curiosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Gender differences in juvenile fire setters

A

More common in females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Females who are juvenile fire setters

A

Emotional meaning regarding property and others associated with revenge and hatred - displaced aggression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Recidivism rate of arson

A

4-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Poor prognostic feature of arson?

A

Presence of mental disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Main factors of recidivism in MDOs who are arsonists

A 
Childhood firesetting
Younger age at first arson
Total number of firesetting offences
No concurrent charges other than arson
Verbalised threats to commit arson
Setting fires alone
Unmarried
Low IQ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Treatment for arson

A

Behavioural or focused on intervening in family or intrapersonal stresses that may precipitate episodes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What behavioural therapies help arsonists?

A

Aversive therapy

Positive reinforcement and stimulus satiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What is stalking?

A

Repeated intrusion involving unwanted contact and communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Behaviours associated with stalking

A 
Threats
Assaults
Ordering or cancelling goods/services on victims behalf
Sending unsolicited gifts
Initialising spurious legal action
Making complaints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

How many stalkers are men?

A

80-90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Victim profile of stalking

A

Women in reproductive years who have had a sexual relationship with the stalker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Perpetrator profile of stalker

A

Unemployed

Better educated than other criminals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Who created typologies of stalking?

A

Mullen 1999

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Name the typologies of stalking

A 
Rejected
Intimacy seekers
Incompetent suitors
Resentful
Predatory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Which type of stalking forms part of sexual offending?

A

Predatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Primary diagnosis in stalkers

A

Cluster B PD

Substance abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

In which type of stalking is delusional disorder common?

A

Stranger and star stalkers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

PTSD rates in victims of stalking

A

37-60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Factors likely to increase risk of assault in stalking

A 
Substance misuse
History of offending behaviour
Male
Making threats o violence or suicide or fantasising about assaults
Presence of narcissistic or antisocial PD
Unemployed and socially isolated
Access to victims
Sense of desperation
Hx of non-compliance to treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What was the RCPsych stalking survey?

A

2007 survey of stalking of its members

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Results of RCPsych stalking survey

A

22% of psychiatrists had been stalked
1 in 3 had experience of stalking behaviours which met legal definition of harassment
One college member becomes victim of new stalking every week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Profile of stalkers who target MH professionals

A

Male with hx of stalking
Established Axis 1 or 2 disorder
Under care of stalked clinician

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

What is clinical management of stalking based on

A

Nature of contributory mental disorder and understanding of what is sustaining the behaviour
Confronting self-deception
Instilling empathy for victim
Addressing inadequate social and interpersonal skills
Combating substance misuse

115
Q

What can stalking be prosecuted under?

A

Protection from Harassment Act 1997

116
Q

Which mental disorders are related to disinhibition?

A 
LD
PD
Schizophrenia
Alcohol use
Hypomania
117
Q

How many sex offenders have a MI?

A

<10%

118
Q

How many offences are sexual offences?

A

1%

119
Q

How many CSA offenders have victims known to them?

A

68%

120
Q

How many CSA offenders have victims who are a relative?

A

13%

121
Q

How many CSA offenders are adolescents?

A

33%

122
Q

What is characteristics of high deviancy group of CSA offenders based on?

A

STEP project commissioned by Home Office

123
Q

Characteristics of high deviancy CSA offenders?

A

Committing offences inside and outside the family
Offending against both boys and girls
Previous sexual offences
Abuse as a child

124
Q

How many paedophiles can be diagnosed with another paraphilia?

A

50-70%

125
Q

What is needed for the term incest to be used?

A

Penetration

126
Q

Rates of incest?

A

Declining

127
Q

Which type of relationship is not deemed incest in England but is in Scotland?

A

Sexual relations with step-relatives

128
Q

How many cases of incest are against children?

A

30%

129
Q

Recidivism of indecent exposure

A

Offender usually stops reoffending after conviction

20-30% reoffend

130
Q

What is indecent exposure often a result of?

A

Impulsive act associated with decreased satisfaction in life.

131
Q

When do most offenders commit indecent exposure?

A

Times of stress

More likely to be married

132
Q

What is internet based sex-offending associated with?

A

Emotional dysregulation and intimacy deficits and depressive mood states
No prior convictions

133
Q

Typologies of internet-based sex offending

A

Seeking emotional satisfaction
Intimacy deficit
Hypersexuality

134
Q

Who conducted research into dynamic risk factors in sex offenders

A

Thornton, 2002

135
Q

What are the dynamic risk factors in sex offenders

A

Sexual interests
Distorted attitudes and beliefs
Socio-affective management
Self-management

136
Q

Give examples of socio-affective management

A

Emotional regulation

Intimacy difficulties

137
Q

What is penile plethysmography

A

Allows to determine level of sexual arousal by measuring changes in penile tumescence when visual or auditory cues of deviant sexual material are presented

138
Q

Who was influential in the development of CBT for sex offenders?

A

Finkelhor

139
Q

What are the four stages of Finkelhors model for sexual offending?

A

Motivation to abuse sexually
Overcoming internal inhibitions
Overcoming external inhibitions
Overcoming resistance of victim

140
Q

Treatment strategies of sex offending

A 
Understanding offence cycle
Challenging distorted thinking
Understanding harm to victims
Fantasy modification
Social skills and anger control
Relapse prevention work
141
Q

Medicines used in sexual offending

A

Cyproterone acetate
Medroxyprogestone acetate
Buspirone

142
Q

How does Cyproterone acetate work?

A

Blocks testosterone receptors

143
Q

What are the main uses of Cyproterone acetate?

A

Reduction of sexual drive

Treatment of prostate ca in higher doses

144
Q

SEs of Cyproterone acetate?

A

Deranged LFTs
Osteoporosis
Deterioration of depressive tendency
Gynaecomastia

145
Q

When must Cyproterone acetate not be used?

A

Hx of severe depression

146
Q

What is the main anti libidinal drug used in the USA?

A

Medroxyprogesterone acetate

147
Q

How does Medroxyprogesterone acetate work?

A

Induces hepatic enzyme testosterone alpha-reductase, thus enhancing metabolic clearance of testosterone and reducing circulating testosterone levels

148
Q

What as Buspirone been found to be useful in the treatment of?

A

Transvestic fetishism

149
Q

Who did a study into male sex offenders in the USA

A

Abel et al

150
Q

Recidivism of sex offending

A

Less than 1 in 5

151
Q

Characteristics of sex offenders in Abels study

A

30% married
Most employed
40% had at least one year of college education

152
Q

Targets of sex offenders in ABels study

A

67% targeted females
12% targeted males
21% targeted both

153
Q

In how many subjects in Abels study did paraphilic tendencies start before 18 years of age?

A

> 50%

154
Q

How many sexual offenders have no previous conviction for a sexual offence?

A

75-80%

155
Q

How many child sex offenders repeated their offence against a child?

A

71%

156
Q

How many convicted sexual offenders reconvicted in 6 years?

A

10%

157
Q

Which type of offence leads to lowest reconviction for sex offenders?

A

Offence against child in own family

<10% recidivism

158
Q

Which type of sexual offence leads to highest reconviction?

A

Offence against child outside ones family.

159
Q

In which group of offenders is risk of sexual recidivism higher?

A

Homosexual and extra-familial sex offenders

160
Q

Predictors of sexual offence

A 
Sexual deviancy
Diversity in offending
Offences against male children
Phallometric evidence 
Elevated Hare Psychopathy Scale score
Reduced self-esteem and impaired victim empathy or increased anger
Victim of childhood sexual abuse
Violent sexual fantasies
Social isolation
Choice of occupational location for offending
Use of sadomasochisti/paedophilic pornography
Non-compliance with treatment
Psychological maladjustment
161
Q

What phallometric evidence is linked to increased risk of reoffending?

A

Increased response to paedophile stimuli or nonsexual violence

162
Q

How many female survivors do not tell anyone of DV?

A

31%

163
Q

Who are the most likely to be told of DV?

A

Friends
Neighbours
Relatives

164
Q

How likely are police to hear of DV?

A

20%

165
Q

How likely are medical staff to hear of DV?

A

10%

166
Q

How many cases of DV do the police come to know about?

A

17-23%

167
Q

How many cases of sexual assault do the police come to know about?

A

Less than 1 in 7

168
Q

How many women suffering DV believed telling the police would make things worse?

A

1 in 8

169
Q

How many women are affected by DV at some point in their lives?

A

25%

170
Q

Which women are at greater risk of DV?

A

<40 years of age

171
Q

Attributable risk fraction of schizophrenia in causing violence?

A

2.3%

172
Q

What is Type 1 violence in schizophrenia?

A

Organised delusional systems relating to violence
No hx of conduct problems
Commit violence after entering treatment, almost always attacking carer or acquaintance

173
Q

What type of violence is attributed to schizophrenics?

A

Type 2

174
Q

What is Type 2 violence in schizophrenia?

A

Disorganised clinical syndromes
Hx of conduct disorder
Early onset substance misuse
Diverse set of offending prior to diagnosis

175
Q

Who proposed the Threat/control override theory?

A

Link and Steuve

176
Q

What does the threat/control override theory explain?

A

Link between violence and psychosis

177
Q

Explain the threat/control override theory

A

Sx represent experiences of patients feeling that people are trying to harm them and experience their mind being dominated by forces outside themselves.

178
Q

What explains against the threat/control override theory?

A

Delusions are not associated with increased risk of violence

179
Q

How many prisoners abuse substances?

A

> 50%

180
Q

How many non-fatal assaults are associated with acute intoxication?

A

50%

181
Q

How many homicides are associated with acute intoxication?

A

66%

182
Q

How likely are schizophrenics who misuse substances to offend?

A

25times more than the general population

183
Q

Who are victims of most offenders with PD

A

Those known to them

184
Q

Who are women with PD more likely to offend against compared to women without PD

A

Children

185
Q

How many men in remand have antisocial PD

A

63%

186
Q

How many sentenced men have antisocial PD

A

49%

187
Q

How many female prisoners have antisocial PD

A

31%

188
Q

How many forensic patients have antisocial PD?

A

67%

189
Q

Risk of violence in antisocial PD

A

Tenfold increase

190
Q

How many men in remand have BPD

A

23%

191
Q

How many sentenced men have BPD

A

14%

192
Q

How many female prisoners have BPD

A

20%

193
Q

How many forensic patients have BPD

A

25-60%

194
Q

How many remanded men have paranoid PD

A

29%

195
Q

How many sentenced men have paranoid PD

A

20%

196
Q

How many female prisoners have paranoid PD

A

16%

197
Q

How many forensic patients have paranoid PD

A

18%

198
Q

Psychopathy rates in the forensic population

A

15-30%

199
Q

Psychopathy rates in the general population

A

4%

200
Q

What score indicates psychopathy in the Hare Checklist

A

25 or more

201
Q

What are the two clusters of psychopathy

A

Factor 1 - callous-unemotional

Factor 2 - antisocial

202
Q

Describe factor 1 psychopathy

A

Arrogant interpersonal style
Grandiose, glib, deceitful, lack empathy
Deficient affective experience

203
Q

What are most traits of Factor 1 psychopathy a result of?

A

Biological make-up

Heritability

204
Q

Describe Factor 2 Psychopathy

A

Impulsive
Sensation-seeking
Lack of planning
Irresponsible

205
Q

How many people with IQ <90 become delinquent?

A

20%

206
Q

What did Lyall find re LD and offending?

A

2% of 358 adults with LD had contact with police in a year

207
Q

Prevalence of aggressive behaviour amongst people with LD

A

17.6%

208
Q

Patients with intellectual disability in forensic settings

A

These patients have longest duration of stay

Most difficult to discharge because of lack of available resources

209
Q

Which offences are more common in people with LD?

A

Sex or fire-raising offences

Property offences

210
Q

What do sex offenders with LD have a greater tendency towards?

A

Victims as young male children

211
Q

What factors in sex offenders who have LD make their offences more likely compared to non-LD population?

A

Higher incidence of family psychopathology
Psychiatric illness
Social naivety
Poor ability to form normal sexual relationships
Poor impulse control
Low self-esteem

212
Q

Management of sex offenders with LD

A

SOTP

SSRI and anti-libidinals

213
Q

Reoffending rates of sex offenders with LD who are untreated

A

40-70%

214
Q

Reoffending rates of sex offenders with LD who are treated

A

20-55%

215
Q

When is risk of recidivism high in sex offenders who have LD?

A

Year following d/c

216
Q

When is depression seen as a risk factor for violence?

A

In the context of other risk factors such as substance misuse and psychosis

217
Q

What type of violence is depression a risk factor for?

A

Domestic killings

218
Q

How can depression lead to violence?

A

Can act as a disinhibitor after provocations

219
Q

How many prisoners have a form of anxiety disorder

A

10-25%

220
Q

When is dissociation seen in offenders?

A

At time of violence/arousal or in response to extreme fear which may precede violence

221
Q

What is dissociative/psychogenic amnesia associated with?

A

Violence to a known victim and with the perpetrator aroused or intoxicated with alcohol.

222
Q

Prevalence of epilepsy in prison

A

1-2%

223
Q

When is ictal violence more likely?

A

Partial and tonic clonic seizures

224
Q

Which two conditions related to epilepsy may be linked with violence?

A

Episodic dyscontrol syndrome

Explosive personality/intermittent explosive disorder

225
Q

What happens in episodic dyscontrol syndrome?

A

Lack of memory for explosive violence

226
Q

Which classification recognises intermittent explosive disorder?

A

DSM

227
Q

How can Aspergers lead to violence?

A

ToM deficit
Presence of egocentricity
Deficits in social reciprocity
All can lead to lack of awareness of impact on victims and what is wrong

228
Q

ASD and link with violence?

A

Those with ASD commit more violent offences and criminal damage than general population

229
Q

When violence occurs in sleep disturbance, which gender is it more common in?

A

Males

230
Q

Factors associated with violence during sleep disorders

A

Hx of parasomnias
Sleep deprivation
Cannabis/alcohol use

231
Q

What has been suggested for assessment of those who malinger

A

Prolonged admission for assessment
Use of SIRS/SIMS/TOMM
Polygraphs - USA only

232
Q

What is SIMS

A

Structured inventory of reported/malingering symptoms

233
Q

What is TOMM?

A

Test of malingering memory

234
Q

What is Munchausens?

A

Factitious illness where sx are created intentionally, motivated to assume sick role with absence of external incentives

235
Q

Factors associated with Mucnhausens

A

PD
Attention seeking behaviour
Masochistic tendernes
Medication seeking behaviours

236
Q

Management of Munchausens

A

Safeguarding process if by proxy
Treat any depressive disorder
Efforts to limit behaviour

237
Q

Common conditions related to Othello syndrome

A

Paranoid PD

238
Q

Risks associated with Othello

A 
Risk of partners and children
Self-harm
Substance Misuse
DV
Homicide
239
Q

What is De Clerambaults syndrome?

A

Erotomania

240
Q

Gender differences in Erotomania?

A

More common in women

241
Q

What disorder is Erotomania associated with?

A

Psychotic disorders

242
Q

Another name for Gansers syndrome?

A

Hysterical Dissociative disorder

243
Q

What happens in Gansers syndrome?

A

Approximate answers
Clouding of consciousness with disorientation
Psychogenic physical sx
Amnesic for abnormal behaviour

244
Q

Who is Gansers Syndrome common in?

A

Prisoners (esp military)

Individuals absenting themselves from navy/army

245
Q

How many men are convicted by the age of 46?

A

33%

246
Q

How many women are convicted by the age of 46?

A

9%

247
Q

How many men are responsible for 2/3 of crimes?

A

8%

248
Q

How many offenders are women?

A

1 in 5

249
Q

Peak offending age of women vs men

A

2-3 years earlier than men

250
Q

Peak age of offending in females

A

14

251
Q

Peak age of ofgending in males

A

17-18

252
Q

Sex ratio of convicted men to women

A

5:1

253
Q

How many homicide victims were young men

A

55%

254
Q

In how many homicides was both the perpetrator and victim female?

A

3%

255
Q

What is index offence for women more likely to be?

A

Romantic or domestic disputes

256
Q

How many women are in prison for non-violent offences?

A

68%

257
Q

Who are victims of womens violent acts more likely to be?

A

Family members

258
Q

How many women in prison are there due to drug offences?

A

25%

259
Q

Difference in men and women who repeat violence

A

Women have less chance of receiving a custodial sentence

260
Q

Psychiatric pleas made by women vs men who commit violence

A

Women make more pleas and receive more psychiatric disposals

261
Q

How many women in prison are estimated to be mothers?

A

50%

262
Q

Reoffending rate of men and women

A

46.6 - men

45 - women

263
Q

How much more likely are women in custody to have MI compared to the general population?

A

5x

264
Q

How many women in prison have a diagnosable MI?

A

80%

265
Q

How many women on remand suffered from psychosis?

A

1 in 5

266
Q

How many women attempted suicide during the year before custody

A

19%

3x higher than men

267
Q

How many male and female offenders have alcohol misuse

A

42% - men

31% - women

268
Q

Age of criminal responsibility in England and Wales

A

10

269
Q

Age of criminal responsibility in Scotland

A

8

270
Q

What is classed as a juvenile offender?

A

Aged 10-17

271
Q

What is classed as a young offender?

A

18-21

272
Q

What law is used when young people on conviction or remand are unmanageable at home or in foster care

A

Civil Child Care Law

273
Q

Options for convicted young offenders and those on remand

A 
Young offender institutes 
Secure training centres
Detention schools
Secure childrens homes for young offenders 12-16 years
Adolescent secure hospitals
274
Q

BME and MH care

A

More likely to be diagnosed with schizophrenia
More likely to be admitted involuntarily
More likely to be secluded and restrained
More likely to be given custodial sentence
Over-representation in criminal justice system

275
Q

Which type of crime is strongly associated with social withdrawal of the victim?

A

Sexual assault

276
Q

How many prisoners have PTSD

A

20%

277
Q

What is complex PTSD associated with?

A

Prolonged abuse as a child

278
Q

What does psychosis combined with PTSD often result in?

A

More positive sx, thus possible increase in paranoid/violent thoughts and problem behaviours

279
Q

When can the index offence be a trigger for PTSD?

A

If offence was unplanned
Offender was disinhibited
No past forensic hx

280
Q

How many patients with SMI were victims of crime in past year?

A

40%

14% - general population

281
Q

How likely are women with SMI to be victims of DV

A

4x more likely than general population

282
Q

How likely are women with SMI to be victims of sexual violence

A

4x more than general population

283
Q

How likely are women with SMI to be victims of any violence in the community

A

10x more likely than general population

MRCPsych Part B - Al-Rashid Hospital (64 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions