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PubMed1992

Rapists' behaviour: a three aspect model as a basis for analysis and the identification of serial crime.

In this paper it is proposed that the behaviour of an offender during a sexual assault can be considered as consisting of three main groupings or 'aspects'. These have been termed 'Modus Operandi', 'Sexual and Personal Gratification' and 'Attitude and Intimacy'. Although an oversimplification, such a model facilitates a preliminary description of the offender which can be of direct assistance to an investigating officer. Various factors affect the consistency and variability of behaviour and the model has formed a basis for the development of a concept as to which behaviours might be the more useful for identifying linked offences. This more systematic approach to the investigative and intelligence processes is reliant on a victim's statement containing very detailed information about the offender's actions, together with a record of as much of his speech as can be recollected. The material required is described using the model and the text is illustrated with case examples. Instances are quoted of the possible inferences and their relevance to the investigation of sexual offences.

Criminal Psychology↗
PubMed1992

Nurses as patient assault victims: an update, synthesis, and recommendations.

The literature documenting the incidence and reactions of nursing staff who have been assaulted by patients is increasing. Before 1980 very little work was done in the area. What did appear generally indicated that patient violence against staff was infrequent, and on the rare occasion when it did occur the staff member was usually in some way responsible. Current research shows that assault is a serious risk factor for nurses. The incidence of assault is high and vastly underreported. Staff members experience short- and long-term emotional, social, biophysiological, and cognitive reactions to being assaulted. Interventions to help the staff victim in the recovery process are increasingly used.

Adaptation, Psychological↗
PubMed2006

Individual difference factors in risky driving: the roles of anger/hostility, conscientiousness, and sensation-seeking.

Motor vehicle crashes claim the lives of more Americans than any other cause of injury. One factor long recognized as relevant to predicting dangerous driver behavior is the driver's personality. This study examines the independent and combined roles of three personality traits--sensation-seeking, conscientiousness, and anger/hostility--in predicting risky driving behavior. Seventy-three participants completed personality and driving history questionnaires, and also engaged in a virtual environment (VE) task designed to assess risk-taking driving behavior. Each facet of personality was correlated to risky driving behavior in independent univariate analyses. In multivariate analyses, sensation-seeking emerged as the best predictor of self-reported driving violations. Anger/hostility and the interactive effect of anger/hostility by sensation-seeking also emerged in a multivariate analysis predicting one measure of self-reported driving violations. No personality trait predicted risky driving in the VE in multivariate analyses. Results are discussed with respect to previous work in the field, challenges involved in measuring the constructs of interest, and implications to prevention.

Accidents, Traffic↗
PubMed2006

Impact of Georgia's Teenage and Adult Driver Responsibility Act.

STUDY OBJECTIVE: In 1997, the Georgia General Assembly enacted the Teenage and Adult Drivers Responsibility Act (TADRA), a comprehensive legislative package that attempted to reduce fatal crashes of teenaged drivers by introducing graduated driver's licensing, "zero tolerance" of underage impaired drivers, and automatic license revocation for speeding greater than 25 miles per hour over the posted limit and other dangerous driving behaviors. To determine whether TADRA reduced teen driving fatalities, we examine fatal crash rates involving various age groups before versus after the law was enacted. METHODS: Data from the Fatal Accident Reporting System were used to calculate annualized fatal crash rates of various age groups of drivers during an 11-year interval 5 1/2 years before TADRA was enacted and 5 1/2 years afterwards. To identify potential historical effects, Georgia's experience was compared to that of Alabama, South Carolina, and Tennessee, states that did not adopt equally comprehensive legislation during the study period. RESULTS: During the preenactment period, 317 Georgia drivers aged 16 were involved in a fatal crash (57/100,000 person-years) compared to 230 in the postenactment period (36/100,000 person-years; risk ratio [RR] 0.63; 95% confidence interval 0.53 to 0.75). Speed-related fatal crashes were cut by 42%, and alcohol-related fatal crashes decreased nearly 60%, without displacing fatal crashes to older age groups. These reductions greatly exceeded those noted in 2 of 3 comparison states and the nation overall. CONCLUSION: TADRA markedly reduced fatal crash rates among 16-year-old Georgia drivers. Fatal crashes were not displaced to older age groups.

Accidents, Traffic↗
PubMed2005

The internet and children: advantages and disadvantages.

This article examines how the Internet has entered children's lives and notes some of its potential positive and negative influences on children. Although the Internet's effects on a given child vary based on each child's characteristics and how the child uses the Internet, adults still must have a fundamental understanding of these general potentials. An awareness of the hazards inherent to children's Internet use is essential for all who work with children so they can apply preventive measures and help keep children safe. Whether a child uses the Internet and how a child uses the Internet significantly impact the Internet's influence on him or her. A child's personality and developmental needs also inevitably modify the Internet's influence on him or her.

Achievement↗
PubMed2005

Recurrent dreams: Recurring threat simulations?

Zadra, Desjardins, and Marcotte (2006) have made a valuable contribution to the empirical testing of the Threat Simulation Theory (TST) (Revonsuo, 2000a) in recurrent dreams. For the most part, their results are in accordance with the theory, while some findings seem to conflict with the predictions of TST. In our commentary, we consider some alternative ways to interpret the results, and we conclude that many prominent features of most recurrent dreams seem to be manifestations of a threat simulation function, leading to repeated rehearsal of threat perception and avoidance, but a minority of recurrent dreams seem to have origins unrelated to threat simulation.

Adaptation, Physiological↗
PubMedDate not supplied

Factors influencing the stability of psychiatric diagnoses in the emergency setting: review of 934 consecutively inpatient admissions.

OBJECTIVE: This study aimed to examine the stability of psychiatric emergency diagnoses and factors influencing diagnostic concordance. METHODS: The concordance between psychiatric emergency and inpatient diagnoses was calculated using kappa coefficient. The groups with and without psychiatric diagnostic stability were compared to determine factors influencing diagnostic stability. RESULTS: Agreement between psychiatric emergency and inpatient diagnoses was fair (range of kappa=.48-.56) for bipolar, schizophrenia, schizoaffective and depressive disorders. Results indicated that patients with stable diagnoses between psychiatric emergency and inpatient settings are likely to arrive on legal holds and that patients without concurring diagnoses are likely to have a higher medical burden. CONCLUSION: Further studies exploring ways to improve diagnostic stability in psychiatric emergency setting are warranted.

Academic Medical Centers↗
PubMedDate not supplied

Applications for release by Australians in Victoria found not guilty of offences of violence by reason of mental impairment.

Much research in relation to mental illness and the law has concentrated upon when accused persons are entitled to avail themselves of the defence of not guilty by reason of insanity or mental impairment. However, the decision as to when persons found not guilty by such pleas should be released step by step back into the community involves difficult analyses of the risk of recidivism by persons who have committed serious acts of violence whilst mentally ill. This article analyses some 70 cases heard by the Supreme Court of Victoria in Australia since the jurisdiction to make such decisions has been transferred from the executive arm of government to the judiciary. The jurisprudence generated by the Victorian Supreme Court constitutes Australia's most developed law in relation to prediction of dangerousness. This article evaluates the different and subtle dynamics that have influenced the judges in an increasingly sophisticated way to grapple with the phenomenon of mental illness in deciding when persons who have already killed can safely be released from involuntary detention status within the confines of a forensic psychiatric institution back into the general community.

Australia↗
PubMed2006

Putting community risk in perspective: a look at correlations, causes and controls.

Much research, but not all, appears to show that persons with severe mental illness are more dangerous and violent than others; but it is misleading and feeds the stigma cannon. This paper critically reviews reported correlations between severe mental illness and violence, examines their statistical confounds, highlights studies which seek causal mechanisms explaining the associations, points to what those causal mechanisms tell us about controlling risk in the community, and reviews legal attempts to control community risk in light of those causal mechanisms.

Alcoholism↗
PubMed2006

Psychiatric assessment after every six years of the TBS order in the Netherlands.

Protecting the public from dangerous mentally ill offenders is an important issue in may countries. The UK, Scotland and Germany for example are looking for new ways to deal with this issue and some have looked at the Dutch system of first sending the offender to prison for a number of years and then for treatment to a secure clinical facility. Dutch law uses the term TBS: detention at the government's pleasure. Legal rights of the patient under the TBS-order are protected by regular evaluations to help the court determine if the patient still poses a danger to society. These evaluations take place every two years, at the end of each extension period. Every six years an extra assessment by independent experts is obligatory. In this same period other types of assessment occur too, such as for transferral to a long-stay unit. A complicated succession of experts may visit the patient, asking the same questions and using the same files, distracting his or her attention and motivation from the treatment process. This system is threatened by the qualitative and quantitative scarcity of properly qualified experts. Measures have been taken to counteract these difficulties, but will they suffice?

Commitment of Persons with Psychiatric Disorders↗
PubMed2006

Fitness to be sentenced: a historical, comparative and practical review.

A Canadian judicial decision recently held that a person convicted of a criminal offence who suffered a substantial deterioration in mental condition since the trial could be found unfit to be sentenced. The court based its conclusion on both historical arguments and the Canadian Charter of Rights and Freedoms. There are compelling justifications for recognizing this concept. The paper looks at the history of fitness and how the sentencing phase became disconnected from claims of unfitness in the late 19th century. It then considers theoretical justifications based on fairness, viewing sentencing as a moral discourse, and the effect of the Canadian Charter of Rights and Freedoms. Because of the number of practical questions that need to be addressed before implementing a concept of unfitness at the sentencing stage, the paper looks at some common law jurisdictions for guidance: Australia, New Zealand, and the American states of New York, Illinois, Connecticut, and Ohio. From these comparisons comes the idea of a "provisional cap". That is, the recognition of unfitness at the sentencing stage should be followed by a form of sentencing that takes into account the gravity of the offence, the prosecutor's position, any relevant aggravating or mitigating factors that can be adduced, and then results in a "provisional" sentence, whether custodial or community-based, which stays in effect until the offender becomes fit. The paper ends with a model that incorporates this approach while providing both that offenders will be confined, if necessary, in hospitals and not prisons, and also that the dispositions will be reviewed annually to ensure that the least restrictive and least onerous sanctions are imposed.

Canada↗
PubMed2006

Contacts with public services, with special reference to mental health care, preceding a serious crime: a retrospective study of 268 subjects of forensic psychiatric investigations.

Between July 1995 and June 1996, 533 subjects underwent forensic psychiatric investigation I Sweden. Odd case numbers (n = 268) were included in the study. Of these 268 people, 50% had been in contact with psychiatric services during the six-month period preceding the crime leading to forensic psychiatric assessment. Contacts with psychiatric services during the six-month period preceding the crime were significantly more common in three categories of individuals than others. These were: women, individuals who were diagnosed as having a psychotic disorder during the forensic psychiatric investigation, and individuals found to suffer from a serious mental disorder as defined in the legislation. Subjects who were found not to suffer from a serious mental disorder and were thus not eligible for special sanctions on medicolegal grounds had significantly less psychiatric contacts before the crime, as did subjects under 20 years of age. However, these two groups still had considerably more psychiatric contacts than the general population. The present results suggest that the patient category studied requires special monitoring and case management in general psychiatry in Sweden. To this end, we call for closer studies of high-risk individuals, particularly of previously violent offenders and potentially violent offenders, and closer studies of their psychiatric contacts. This will provide a basis for the development of adequate programs and guidelines for effective care and treatment within the psychiatric sector.

Adult↗
PubMed2006

Balancing autonomy and risk: a failure of nerve in England and Wales?

Specialised mental health legislation typically provides for the hospitalisation and treatment of those with mental disorders in the absence of their consent. The article examines the possible justifications for the existence of these special powers and argues that two of the most common justifications, the protection of the patient and the protection of others, do discriminate against those with a mental, as opposed to a physical, disorder. The relationship between mental health and mental capacity, or guardianship, legislation is then considered and possible ways forward are discussed with particular reference to the current reform debate in England and Wales.

Commitment of Persons with Psychiatric Disorders↗
PubMed2006

Attitude to personality disorder among prison officers working in a dangerous and severe personality disorder unit.

BACKGROUND: It is well established that staff attitudes to personality disordered patients are commonly negative, characterised by pessimism and rejection. A recent study in forensic psychiatric hospitals has described the psychological and social factors underlying positive attitudes, and suggested that staff with more positive attitudes perform better and are less stressed. AIM: To assess whether it is possible to predict which staff will adjust positively to working with personality disordered people. More specifically to confirm links between attitude to personality disorder and: job performance; perception of managers; personal well-being; burnout; and interaction rates with inmates. METHODS: The opening of a new Dangerous and Severe Personality Disorder unit within a UK prison allowed a longitudinal study of prison officers to be performed, in which a number of measures, including the Attitude to Personality Disorder Questionnaire (APDQ), were collected at three fixed points (at baseline, eight and sixteen months after the opening of the unit). RESULTS: Attitude to Personality Disorder varied over the course of the study, and changes in attitude were linked to events experienced by individual officers. More positive attitude to personality disorder was associated with improved general health and job performance, decreased burnout, and favourable perception of managers. CONCLUSIONS: Attitude to Personality Disorder has important outcomes, and is responsive to the psychosocial environment. Its measurement is not useful for staff selection, because of low stability over lengthy time periods. The APDQ has been demonstrated to be valid measure of attitude to PD, and potentially useful for outcome studies, or benchmarking between units.

Absenteeism↗
PubMed2006

Civil commitment in Turkey: reflections on a bill drafted by psychiatrists.

Involuntary hospitalization of the mentally ill has been an issue that still remains outside the judicial system in Turkey. Despite the new Turkish Civil Code, which includes several articles relevant to involuntary psychiatric hospital admissions, there still appears to be a need for a comprehensive mental health law to address specific issues concerning civil commitment of the mentally ill. As a result of the lack of specific statutory regulation, an insufficient number of psychiatric hospital beds and limited appreciation of the safety risks involved in untreated mental illness, involuntary hospitalization remains an underutilized option by psychiatrists and the courts alike. In response to its concerned members, the Psychiatric Association of Turkey has appointed a task force to draft a proposed mental health law, entitled the "Psychiatric Patients' Bill of Rights." Although the draft suggests a model with emphasis on the right to psychiatric treatment, it also recommends close judicial oversight to prevent potential abuses of discretion by the system. However, this might present logistic problems in a country with already overburdened courts. Authors discuss the highlights of the draft within the context of Turkey's current cultural, social and judicial structure, and compare it to similar laws of other countries.

Advisory Committees↗
PubMed2006

Life imprisonment: recent issues in national and international law.

This article notes that, because understandings of what life imprisonment means are often ambiguous, the life sentence is sometimes perceived to be relatively uncontroversial. Life imprisonment without the prospect of parole for children under the age of 18 years is the most extreme form of this sentence that can be imposed. However, in the United States of America even such sentences have only recently become the subject of public debate. In contrast, in a small but growing number of jurisdictions all life sentences are regarded as constitutionally suspect and contrary to human rights, whilst in the majority of jurisdictions the imposition of life imprisonment is strictly limited. The article traces recent developments in the imposition and implementation of life imprisonment that have evoked some controversy. It pays particular attention to attempts that have been made in practice to ensure that life imprisonment produces punishment that is proportionate to the crime. It points out, however, that a renewed focus on combating dangerous offenders through indeterminate preventive sentences has blunted even this modest safeguard. It warns that this tendency increases the risk of life imprisonment being an unfairly harsh penalty.

Adolescent↗