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CASC > Forensics > Flashcards

Forensics Flashcards

1
Q

How much more common is violence in mentally ill compared with gen pop

A

4-6x

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2
Q

How many crimes can be attributed to mental illness

A

<10%

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3
Q

Risks of conviction for serious violence by men with SCZ compared to gen pop

A

5x risk of being convicted of serious violence

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4
Q

Annual risk of patient with SCZ committing homicide

A

Men - 1:3000

Women - 1:33,000

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5
Q

Prevalence of psychosis in male prisoners

A

3.7%

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6
Q

Prevalence of depression in male prisoners

A

10%

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7
Q

Prevalence of PD in male prisoners

A

65%

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8
Q

How much more common is psychosis in prison compared to gen pop?

A

10x more

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9
Q

Rate of homicide in the UK

A

1.2 in 100,000

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10
Q

% of individuals convicted of homicide who have mental illness

A

9% have SCZ
12% have other psychotic disorder
54% have secondary PD diagnosis
10% had contact with MH services in last year

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11
Q

Annual risk of person with SCZ committing homicide

A

1 in 10,000

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12
Q

What is filicide

A

Mother killing ones own child

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13
Q

Common mental illnesses in filicide

A

Depression - 25%
Psychosis - 40%
PD - EUPD and dependent
Dissociative response

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14
Q

Types of filicide

A

Battering mothers - impulsive (loss of temper)
Mentally ill mother
Neonaticides - within first 24 hours of life
Retaliating women - aggression towards spouse displaced on to child
Unwanted children - passive neglect or active aggression associated with unplanned pregnancies and socioeconomic hardship
Mercy killing

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15
Q

Definition of infanticide under Infanticide Act 1938

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 the effect of lactation consequent on the birth of the child’.

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16
Q

Incidence of infant homicide in UK

A

30-45 per year

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17
Q

Incidence of murder-suicide

A

0.2-0.3 per 100,00 per year

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18
Q

Most common mental illness in murder-suicide

A

Depression - 20-60%

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19
Q

What is parricide

A

Killing ones parents

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20
Q

How many homicides are parricides

A

2%

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21
Q

What is common assault?

A

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

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22
Q

What is aggravated assault?

A

when the individual attempts to cause serious bodily injury to another
or causes such injury purposely, knowingly, or recklessly under circumstances
manifesting extreme indifference to the value of human life; or attempts to cause or
purposely or knowingly causes bodily injury to another with a deadly weapon.

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23
Q

When is battery?

A

if he/she intentionally/recklessly applies unlawful force to the body of another
person. (A battery is committed when the threatened force actually results in contact with
the other and that contact was caused either intentionally or recklessly.)

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24
Q

How many individuals convicted of non-fatal violence have SCZ

A

9%

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25
Q

What mental illnesses are linked with shoplifting

A

Affective disorders
Alcoholism and drug addiction
Depression in middle-aged women

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26
Q

What is kleptomania

A

Impulse control disorder

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27
Q

How many shoplifters have kleptomania

A

1-2%

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28
Q

How many fire setters intentionally start the fire i.e. arson

A

1 in 4

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29
Q

What mental illnesses occur in patients with fire setting behaviour

A

8% SCZ
11% Bipolar
Alcohol misuse is common
LD

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30
Q

M:F ratio of arson

A

2.5:1

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31
Q

What is pyromania

A

Arson occurs on 2+ occasions and results in relief of tension
Pyromaniacs are fire-
raisers who derive a pathological excitement from setting the fire, attending the scene,

busying themselves with it, or having called out the fire brigade in the first instance.

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32
Q

DSM IV criteria of pyromania

A

Deliberate and purposeful fire setting on more than one occasion;
Affective arousal and tension prior to the act; Fascination with, and attraction to, fire and its
situational context; Pleasure, gratification or relief when setting fires or witnessing or
involvement in their aftermath; The exclusion of other causes (see above); The fire-setting is
not ‘better accounted for’ by conduct disorder, or antisocial personality disorder.

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33
Q

What are juvenile fire setters

A

Younger than 10
Make up >50% of arrests
Motive is often curiosity
More common in females

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34
Q

Risk factors of recidivism in arson

A

childhood firesetting problems,
younger age at first firesetting and arson, total number of firesetting offences, no concurrent
charges other than arson, verbalized threats to commit arson, setting fires alone, unmarried
and low IQ.

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35
Q

Treatment for arson

A

largely behavioural or focused on intervening in the family or
intrapersonal stresses that may precipitate episodes of fire setting. Behavioural treatments like
aversive therapy have helped fire setters. Other treatment methods
rely on positive reinforcement with threats of punishment and stimulus satiation.

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36
Q

M:F ratio of stalking

A

8-9:1

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37
Q

Types of stalkers

A

• The rejected who pursues ex-intimates, either in the hope of reconciliation or for
vengeance.
• Intimacy seekers who stalk someone they believe they love and they think they will
reciprocate
• Incompetent suitors, who inappropriately intrude someone, usually seeking a date or brief
sexual encounter
• The resentful who pursue victims to exact revenge for actual or perceived injury.
• The predatory whose stalking forms a part of sexual offending.

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38
Q

Primary diagnoses in stalkers

A

PD - Cluster B in ex-intimate stalkers
Substance abuse
Delusional disorders - erotomania followed by jealousy and persecution
SCZ
Affective and organic psychosis in stranger and star stalkers

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39
Q

Risk factors of assault in stalking

A
  • Substance misuse
  • History of offending behaviour
  • Male gender
  • Making threats of violence or suicide or fantasising about assaults
  • Presence of PD (Narcissistic or antisocial)
  • Unemployed and socially isolated
  • Access to victims
  • Sense of desperation (crisis periods)
  • History of non-compliance to treatment
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40
Q

Treatment of stalking

A

• The nature of the contributory mental disorder and an understanding of what is sustaining
the behaviour
• Confronting self-deception, which minimise or justify the behaviour
• Instilling empathy for the victims plight
• Addressing inadequate or inappropriate social and interpersonal skills
• Combating substance misuse.

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41
Q

How many sex offenders have Mental illness?

A

<10%

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42
Q

Common mental illnesses in sex offenders

A 
LD
PD
SCZ
Alcohol use
Hypomania
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43
Q

How many offences are sex offences?

A

1%

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44
Q

How many victims of paedophiles are a relative?

A

13%

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45
Q

How many victims of paedophiles are known to them

A

68%

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46
Q

M:F ratio of paedophiles

A

9:1

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47
Q

How many sex offenders are adolescents

A

33%

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48
Q

Characteristics of high deviancy group of sex offenders

A

individuals committing
offences outside and inside the family; individuals offending against both boys and girls;
high deviants were twice as likely to have committed previous sexual offences; more likely
to have been abused as a child.

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49
Q

How many paedophiles have another paraphilia?

A

70%

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50
Q

How much more likely are paedophiles to engage in physical contact with a child than voyeurestic or exhibitionistic activities

A

2.5x more likely

51
Q

How much incest is against children

A

30%

52
Q

Causes of indecent exposure

A

Exhibitionism
Alcohol and drug use
Rarely dementia or hypomania
Impulsive during time of stress

53
Q

Re-offending rate of indecent exposure

A

20-30%

54
Q

Common causes of in

A

If reoffending results in conviction

Angry, aggressive exhibitionist (erect when offending)

55
Q

What is internet based sex-offending associated with

A

Emotional dysregulation
Intimacy deficits
Depression
Hypersexuality

56
Q

Psychological characteristics to consider when assessing sex offender

A
  • Sexual interests (including sexual preoccupation, as well as sexual preference for children)
  • Distorted attitudes and beliefs (cognitive distortions, and beliefs supportive of rape)
  • Socio-affective management (for instance, emotional regulation and intimacy difficulties)
  • Self-management (for instance, poor problem-solving abilities, lifestyle impulsiveness).
57
Q

Treatment of CBT

A

Understanding the offence cycle, Challenging distorted
thinking, Understanding the harm done to victims, Fantasy modification, Social skills and
anger control and Relapse prevention work

58
Q

When is pharmacotherapy considered for sex offenders

A

If contributing mental illness, then to treat the illness

59
Q

Medications used in sex offenders

A

Cyproterone acetate - blocks testosterone receptors
Medroxyprogesterone acetate - induces hepatic enzyme testosterone alpha-reductase, thus enhancing clearance of testosterone

60
Q

Impact of cyproterone acetate

A

Reduces sexual drive

61
Q

SEs of cyproterone acetate

A

Deranged LFTs
Osteoporosis
Gynaecomastia
Deterioration of depressive tendency

62
Q

Recidivism rate of sex offenders

A

less than 1 in 5

63
Q

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

A

75-80%

64
Q

How many convicted sex offenders are reconvicted after 6 years?

A

<10%

65
Q

Prognostic factors for reduced risk of recidivism in sex offenders

A

Index offence against child in own family

66
Q

Risk factors for further sex offences in convicted sex offendres

A

Index offence against child outside ones family, particularly boys
Multiple paraphilias
Index offence against stranger
Homosexual and extra-familiar sex offenders

67
Q

Predictors of a sexual offence

A

• Sexual deviancy: Higher number of sex offences, especially more than one type of
sexual offence, and previous criminal history.
• Diversity in offending, including violent and general crimes;
• Offences against male children carries more reoffending risk than offences against girls;
there is a lower risk of recidivism if the primary offence is an incest
• Phallometric evidence of response to paedophile stimuli and/or nonsexual violence
• Elevated score on Hare Psychopathy Scale (Rice et al., 1990)
• At time of index offence, reduced self-esteem, impaired victim empathy (high risk) or
increased anger
• Being a victim of childhood sexual abuse,
• Presence of violent sexual fantasies
• Longstanding social isolation (present in some sexual murderers)
• Choice of occupational location to facilitate access to potential victims
• Use of sadomasochistic or paedophilic pornography
• Non-compliance or failure to complete treatment. This is often associated with dissocial
traits.
• Often more deviant sexual practices are seen as relatively younger victims.
• Psychological maladjustment, including substance use or abuse, antisocial attitudes and
personality disorders

68
Q

How many women will be victims of DV at some point in their life

A

1 in 4

69
Q

Women most at risk of DV?

A

<40 years

70
Q

How many violent attacks are the result of DV?

A

44%

71
Q

How many prison inmates misuse substances

A

> 50% (2% gen pop)

72
Q

How many prison inmates misuse alcohol

A

> 40% (4% gen pop)

73
Q

How many non-fatal assaults and murders are associated with acute intoxication

A

50% non-fatal

66% murders

74
Q

Risk of violent offending in patients with SCZ who misuse substances

A

25x increase compared to gen pop

3.6 risk ratio in those with SCZ without substance use

75
Q

Prevalence of antisocial PD in prisons

A

63% remanded men
49% sentenced men
31% female prisoners

76
Q

Risk of violence in those with antisocial PD

A

10x more than gen pop

77
Q

EUPD PD in prisoners

A

23% of remanded men
14% sentenced men
20% female prisoners

78
Q

Narcissistic PD in prisoners

A

8% remanded men
7% sentenced men
6% female prisoners

79
Q

Paranoid PD in prisoners

A

29% remanded men
20% sentenced men
16% female prisoners

80
Q

Common offending in those with LD

A

Sex or fire-raising offences

Property offences most common

81
Q

Risk of sex offending in LD

A

2x more than non-LD

82
Q

Management of sex offending in LD

A

Group SOTP

Pharmacotherapy - SSRI, antilibidinal

83
Q

Potential causes of sex offending in LD

A

high incidence of family psychopathology, psychiatric illness, social naivety, poor ability to
form normal sexual and personal relationships, poor impulse control and low self-esteem.

84
Q

Re-offending rate of offenders with LD not treated vs treated

A

Not treated - 40-70% (similar to non-LD populations)

Treated - 20-55%

85
Q

When is depression a risk factor for violence

A

In context of other risk factors like substance use or psychosis
Domestic killings
Mercy killings

86
Q

How many prisoners have anxiety disorders

A

10-15%

87
Q

Prevalence of epilepsy in prison

A

1-2%

1% in gen pop

88
Q

Sx of gansers syndrome

A

approximate answers, clouding of consciousness with disorientation,
psychogenic physical symptoms – analgesia & hyperaesthesia and pseudohallucinations
amnesia for abnormal behaviour

89
Q

Which group is gansers commonly seen in

A

prisoners - esp military prisoners

individuals absenting themselves from army or navy

90
Q

How many offenders are women

A

1 in 5

91
Q

Peak age of offending

A

14 in girls

17-18 in boys

92
Q

M:F ratio of convictions

A

5:1

93
Q

Risk of SMI in women in custody compared to gen pop

A

5x more likely

94
Q

How many women in prison have a diagnosable MI

A

80%

95
Q

How many female offenders have alcohol misuse problems

A

31% (vs 42% in men)

96
Q

What is a juvenile offender

A

Aged 10-17

97
Q

What is a young offender

A

18-21

98
Q

How many prisoners have {TDS

A

20%

99
Q

s35 of MHA?

A

Remanded for report on mental state for 28 days, renewable up to 12 weeks total

100
Q

s36 of MHA?

A

Remanded for treatment for 28 days, renewable up to 12 weeks total - crown court only

101
Q

s38 of MHA

A

Following conviction, interim hospital order

102
Q

Aim of guardianship order under s37 MHA

A

Ensure offender receives care and protection; guardian also has power to require offender to live at specific place or attend specific place for treatment at specific time

103
Q

How long does guardianship order last

A

6 months; can renew for another 6 months twice then yearly

104
Q

How many prisoners have mental illness

A

> 90%
in 37% of sentenced male
prisoners, 63% of men on remand, 57% of sentenced women prisoners and 76% of women
remand prisoners.

105
Q

Suicide rate in prison compared to gen pop

A

8x higher

106
Q

Which prisoners are at most risk of suicide

A

First 6 months of imprisonment
Life prisoner
Remand and young offenders
History of substance use and violent offences

107
Q

Pritchard criteria for fitness to plead

A
  • Understanding the charge/charges
  • Deciding whether to plead guilty / not
  • Exercising the right to challenge jurors
  • Instructing solicitors and counsel
  • Following the course of proceedings or
  • Giving evidence in his/her own defence
108
Q

TO what level does unfitness to plead need to be proven if raised by prosecution?

A

Beyond reasonable doubt

109
Q

McNaughten 1843 rules for insanity defence

A
  1. A defect of reason (impaired, not mere failure to exercise)
  2. Due to a disease of mind (not externally caused)
  3. Leading to loss of appreciation of nature and quality of an act (the offence; physical nature
    not moral).
  4. So the accused did not realise what he was doing was wrong (either legally or morally).
110
Q

Burden of proof for McNaughten insanity defence

A

Defence

111
Q

What is needed for diminished responsibility defence

A

Defending counsel must demonstrate absence of mens rea

112
Q

What is automatism

A

Automatism is a plea by a defendant that his actions were not under the control of his
conscious mind, i.e. that his bodily movements were unwilled and involuntary. Although
generally pleaded as a ‘defence’ a successful plea of automatism will negate the conduct
element of the actus reus of any offence with which the defendant is charged.

113
Q

What is automatism simpliciter/sane automatism

A

is a complete ‘defence’ as the defendant is deemed not to be in any way to blame for what
happened. Hypoglycemia (isolated), night terror and dissociative states can be classed as
‘sane’ automatisms. Here the cause is often ‘external’.

114
Q

What is insane automatism

A

likely to recur (‘internal’) and the counsel can plead not guilty by
reason of insanity (insanity defence). Night walking, epilepsy, hypoglycemia due to a
recurring condition are classed as ‘insane’ automatisms.

115
Q

What is culpable homicide

A

Outcome of diminished responsibility argument
Lack of specific intent to kill
Can be involuntary - death unintended but occurs as a result of assault or negligence
Voluntary - death from intentional reckless act but because of provocation or diminished

116
Q

What is involuntary intoxication as a defence

A

intoxication refers to someone
unwittingly taking a ‘spiked’ drink or automatism occurring as a side-effect to medical treatment.
This constitutes a valid defence. But voluntary self-induced intoxication is not a defence. Apart
from being ‘spiked’, involuntary intoxication may also include taking a drug prescribed by a
medical practitioner, using a substance that is not dangerous but in a reckless manner, using a
substance as a result of an irresistible impulse to take it (due to a dependent state). All of these
can be used as mitigating factors to reduce sentencing or acquittal.

117
Q

What mitigating factors can reduce culpability of defendant

A
  • Being provoked
  • Age or vulnerability
  • Mental disorder or LD
  • Involuntary intoxication
  • Showing remorse
  • Having a limited role in the offence
118
Q

Criteria for fitness to give evidence

A
  • Understanding the question
  • Applying their mind to answering them
  • Conveying the answers intelligibly to the jury
119
Q

Types of false confession

A

Voluntary
Coerced-compliant
Coerced-internalised

120
Q

Factors influencing false confessions

A

(1) Situational factors – effects of custody/isolation – e.g.
process of police interrogation (2) Individual factors – include mental disorder, incapacity etc.

121
Q

What is a professional witness in court

A

Comment on clinical state, where they had some involvement

122
Q

What is an expert witness in court

A

Write reports to court regarding mental disorder or specific issue

123
Q

Types of expert witnesses

A

Advisory
Actuarial
Clinical
Experimental (evidence)

CASC (16 decks)

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