The legal significance of clinical formulations of firesetting behavior.
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The authors report on a population of psychiatric patients who were studied over a 6.75 year period to determine the occurrences of firesetting behavior noted in their psychiatric inpatient records. Two groups of 50 patients each were drawn from an earlier study and were matched by sex, age, and diagnoses. One group of patients had prior firesetting behavior; the other did not. Firesetting behavior was found not only in patients originally identified as having previously engaged in this behavior, but also in those with no documented history of this act prior to the period of the study. Patients having firesetting behavior in their past psychiatric record set more actual fires. Total number of episodes of firesetting behavior, however, was not significantly different between the two groups. Results are discussed in terms of the communicative function of firesetting and the dilemma of clinical prediction.
Hospital records of all patients under age 65 years old on the census of Worcester State Hospital (WSH) on October 25, 1988 (n = 279) were reviewed for indications of firesetting behaviors during the individuals' adult lifetime. The prevalence of firesetting behaviors was found to be 27.2%. The prevalence of firesetting episodes, a subset of firesetting behaviors, was found to be 17.6%. A stepwise discriminant function analysis was used to determine whether any factors significantly differentiated the members of the firesetting behavior group from the remainder of the population. This analysis revealed that the number of WSH admissions, the number of admissions to other inpatient facilities, and a history of injurious behavior to self are significant positive predictors of membership in the firesetting behaviors group. The results of the WSH analysis are very similar to those found at Northampton State Hospital in 1983. These high prevalence rates have implication for treatment, education, record keeping, and liability.
After a historical introduction and some short remarks on criminal arson, this review of the literature since 1955 mainly focuses on pathological firesetting. It deals with all important aspects of the psychiatry of firesetting: arson by persons referred to psychiatric examination, by the mentally ill, and by psychiatric inpatients, the relationship between arson and sexuality, psychoanalytical contributions, arson by children and juveniles, therapy and prevention of firesetting behaviour. Female arsonists, recidivism, and suicide by burning are considered separately.
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In the writings of the Japanese novelist, Yukio Mishima, primal scene experiences and derivative expressions of them recur persistently. The element of fire figures prominently in connection with the wish to wreak vengeance on the persons originally observed in the act of intercourse. As a destructive, attention-compelling spectacle, fire is a particularly suitable vehicle for this purpose. In Mishima's works, revenge takes the form of retaliation in kind: parental figures, or their surrogates, are put into the position of having to observe the child, or substitutes for him, in the act of sexual infidelity. These observations as well as clinical reports in the literature suggest some insights into fantasies of pyromania. They also make possible certain speculations concerning Misima's turbulent life and dramatic suicide.
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A case of a 12 1/2-year-old female fire-setter is presented. The symptom was the result of long term developmental problems precipitated by the onset of puberty. Psychoanalytically oriented individual psychotherapy combined with marital and family therapy were the modes of treatment. The continuous struggle to establish a therapeutic alliance with an early adolescent is discussed. A patient whose main mechanisms of defense are repression, suppression, denial, and projection presents a challenge for the therapist.
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We report on 3 boys with fire setting, photoparoxysmal responses to intermittent photic stimulation, and temporal lobe electroencephalographic abnormalities. Fire setting resolved and behavior improved with administration of anticonvulsants.