Pub Date : 1999-09-01DOI: 10.1080/09585189908403694
C. Claus, L. Lidberg
Abstract This paper proposes a syndrome model for systematic understanding of serial murder. The five components of the model are: omnipotence, sadistic fantasies, ritualized performance, dehumanization, and symbiotic merger. The purpose of the model is to facilitate risk assessment, crime prevention and treatment planning. The serial killer acts as if deprived of his entire existence. Thus, a psychotherapy process must focus on distinct settings to achieve its object as a source of information about primitive psychic mechanisms.
{"title":"Serial murder as a Schahriar syndrome","authors":"C. Claus, L. Lidberg","doi":"10.1080/09585189908403694","DOIUrl":"https://doi.org/10.1080/09585189908403694","url":null,"abstract":"Abstract This paper proposes a syndrome model for systematic understanding of serial murder. The five components of the model are: omnipotence, sadistic fantasies, ritualized performance, dehumanization, and symbiotic merger. The purpose of the model is to facilitate risk assessment, crime prevention and treatment planning. The serial killer acts as if deprived of his entire existence. Thus, a psychotherapy process must focus on distinct settings to achieve its object as a source of information about primitive psychic mechanisms.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84593586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403680
M. Dolan, R. Gibb, P. Coorey
Abstract Although mental health review tribunals were introduced to safeguard the rights of patients detained under the Mental Health Act 1983, increasing concern has been expressed over delays, costs and ultimate efficacy. This study attempted to examine Special Hospital patients' perspectives on the functioning of tribunals. The findings indicate that although patients in this group frequently exercise their rights of application the majority have a very limited understanding of the powers of tribunals. The vast majority of applications were made without consultation with the responsible medical officer (RMO) and in only 6% of cases had a positive RMO recommendation. The latter cases tended to be those which were most successful. Given the costs of aborted tribunal applications and unsuccessful hearings, consideration should be given to greater liaison between legal and medical representatives of patients when considering application for a tribunal hearing, and greater education of patients to improve t...
{"title":"Mental heath review tribunals: A survey of special hospital patients' opinions","authors":"M. Dolan, R. Gibb, P. Coorey","doi":"10.1080/09585189908403680","DOIUrl":"https://doi.org/10.1080/09585189908403680","url":null,"abstract":"Abstract Although mental health review tribunals were introduced to safeguard the rights of patients detained under the Mental Health Act 1983, increasing concern has been expressed over delays, costs and ultimate efficacy. This study attempted to examine Special Hospital patients' perspectives on the functioning of tribunals. The findings indicate that although patients in this group frequently exercise their rights of application the majority have a very limited understanding of the powers of tribunals. The vast majority of applications were made without consultation with the responsible medical officer (RMO) and in only 6% of cases had a positive RMO recommendation. The latter cases tended to be those which were most successful. Given the costs of aborted tribunal applications and unsuccessful hearings, consideration should be given to greater liaison between legal and medical representatives of patients when considering application for a tribunal hearing, and greater education of patients to improve t...","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/09585189908403680","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72535197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403692
P. Santtila, Petri Alkiora, Magnus Ekholm, P. Niemi
Abstract This article describes a case of a post-office robbery in which two validated false confessions were made. A young man, Mr S, made a detailed confession to the actual robbery whereas his partner, Ms A, confessed to having been present when Mr S and his accomplice left to carry out the robbery as well as to hearing Mr S confess to the robbery. Both of these confessions later turned out to be false. Mr S's confession had the hallmarks of a coerced-internalized false confession, compared with Ms A's, which was more likely a coerced-compliant false confession. The individual and situational factors that probably contributed to these false confessions are described. Mr S had high suggestibility, low memory ability, and high anxiety. Ms A did not have these vulnerabilities. Both had been drinking alcohol and using drugs for an extended period of time, thus resulting in relative lack of memory for the day of the robbery as well as withdrawal symptoms while incarcerated which may have contributed to the ...
{"title":"False confession to robbery: The roles of suggestibility, anxiety, memory disturbance and withdrawal symptoms","authors":"P. Santtila, Petri Alkiora, Magnus Ekholm, P. Niemi","doi":"10.1080/09585189908403692","DOIUrl":"https://doi.org/10.1080/09585189908403692","url":null,"abstract":"Abstract This article describes a case of a post-office robbery in which two validated false confessions were made. A young man, Mr S, made a detailed confession to the actual robbery whereas his partner, Ms A, confessed to having been present when Mr S and his accomplice left to carry out the robbery as well as to hearing Mr S confess to the robbery. Both of these confessions later turned out to be false. Mr S's confession had the hallmarks of a coerced-internalized false confession, compared with Ms A's, which was more likely a coerced-compliant false confession. The individual and situational factors that probably contributed to these false confessions are described. Mr S had high suggestibility, low memory ability, and high anxiety. Ms A did not have these vulnerabilities. Both had been drinking alcohol and using drugs for an extended period of time, thus resulting in relative lack of memory for the day of the robbery as well as withdrawal symptoms while incarcerated which may have contributed to the ...","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77018068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403679
G. Gudjonsson, S. Rabe-Hesketh, Claire Wilson
All violent incident forms completed between 1980 and 1996 on the regional secure unit at the Bethlem Royal Hospital were analysed. During the 17-year period 280 patients were admitted and of those 165 (59%) were involved in one or more violent incidents. There were 2,180 incidents. Two thirds (66%) of incidents were recorded between 1983 and 1986. The incidents peaked at mealtimes, at medication times, and at 2100 hours, the time when day-staff leave and night-staff arrive. A statistical model was developed to analyse the relationship between legal section, diagnosis, age, gender and ethnic differences, and the rate of incidents. The rate of incidents was significantly related to the age of the patients, the time period when the patients were on the unit, and the legal section they were detained under.
{"title":"Violent incidents on a medium secure unit over a 17-year period","authors":"G. Gudjonsson, S. Rabe-Hesketh, Claire Wilson","doi":"10.1080/09585189908403679","DOIUrl":"https://doi.org/10.1080/09585189908403679","url":null,"abstract":"All violent incident forms completed between 1980 and 1996 on the regional secure unit at the Bethlem Royal Hospital were analysed. During the 17-year period 280 patients were admitted and of those 165 (59%) were involved in one or more violent incidents. There were 2,180 incidents. Two thirds (66%) of incidents were recorded between 1983 and 1986. The incidents peaked at mealtimes, at medication times, and at 2100 hours, the time when day-staff leave and night-staff arrive. A statistical model was developed to analyse the relationship between legal section, diagnosis, age, gender and ethnic differences, and the rate of incidents. The rate of incidents was significantly related to the age of the patients, the time period when the patients were on the unit, and the legal section they were detained under.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73407422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403688
Piotr Pierzchniak MRCPsych, MRCPsych Frank Farnham BSc, Nikki de Taranto MRCPsych, CQSlU Deborah Bull MSc, CPsychol Harpreet Gill MSc, Paul Bester MRCPsych, Cub MSc Ffphm Alison McCallum Mb, Md Mrcp MRCPsych Harry Kennedy BSc
The mental health service needs of all North London patients in medium (N = 97) and maximum security (N = 79) were assessed. Patients and key nurses were interviewed using validated measures and, for patients in maximum security, the respective responsible medical officers (RMOs) also completed a standard enquiry form. Multi-disciplinary panels from the catchment areas then rated immediate and future needs for security and treatment. Unlike previous studies, we found only 25% of patients ready for an immediate move to lower security and a greater disparity between those thought ready for discharge by their Special Hospital RMO and those thought ready for discharge by the local panels. We identified a particular unmet need for long-term, 24-hour, nurse-staffed accommodation, rather than long-term medium security.
{"title":"Assessing the needs of patients in secure settings: A multi-disciplinary approach","authors":"Piotr Pierzchniak MRCPsych, MRCPsych Frank Farnham BSc, Nikki de Taranto MRCPsych, CQSlU Deborah Bull MSc, CPsychol Harpreet Gill MSc, Paul Bester MRCPsych, Cub MSc Ffphm Alison McCallum Mb, Md Mrcp MRCPsych Harry Kennedy BSc","doi":"10.1080/09585189908403688","DOIUrl":"https://doi.org/10.1080/09585189908403688","url":null,"abstract":"The mental health service needs of all North London patients in medium (N = 97) and maximum security (N = 79) were assessed. Patients and key nurses were interviewed using validated measures and, for patients in maximum security, the respective responsible medical officers (RMOs) also completed a standard enquiry form. Multi-disciplinary panels from the catchment areas then rated immediate and future needs for security and treatment. Unlike previous studies, we found only 25% of patients ready for an immediate move to lower security and a greater disparity between those thought ready for discharge by their Special Hospital RMO and those thought ready for discharge by the local panels. We identified a particular unmet need for long-term, 24-hour, nurse-staffed accommodation, rather than long-term medium security.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85852214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403681
J. Fuller, J. Cowan
The changing fortunes of clinical approaches to risk assessment in the forensic and mental health fields are reviewed. A prospective study of medium-term clinical risk forecasting in a forensic setting is described, using receiver operating characteristics (ROC) to evaluate the judgements of the multi-disciplinary teams. The accuracy of consensus predictions of patient-related risks was found to be comparable with actuarially based studies over similar time-scales, although some low base-rate events eluded prediction. The study reasserts a role for clinical judgement in risk assessment, but recognizes that evaluation of risk assessment activity in care settings is methodologically confounded by subsequent risk management interventions. Studies of how clinicians proceed from the former process to the latter may prove a more fruitful direction for future research in forensic settings.
{"title":"Risk assessment in a multi-disciplinary forensic setting: Clinical judgement revisited","authors":"J. Fuller, J. Cowan","doi":"10.1080/09585189908403681","DOIUrl":"https://doi.org/10.1080/09585189908403681","url":null,"abstract":"The changing fortunes of clinical approaches to risk assessment in the forensic and mental health fields are reviewed. A prospective study of medium-term clinical risk forecasting in a forensic setting is described, using receiver operating characteristics (ROC) to evaluate the judgements of the multi-disciplinary teams. The accuracy of consensus predictions of patient-related risks was found to be comparable with actuarially based studies over similar time-scales, although some low base-rate events eluded prediction. The study reasserts a role for clinical judgement in risk assessment, but recognizes that evaluation of risk assessment activity in care settings is methodologically confounded by subsequent risk management interventions. Studies of how clinicians proceed from the former process to the latter may prove a more fruitful direction for future research in forensic settings.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76480177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403684
S. Riordan
In an attempt to assess the overall frequency and impact of indecent exposure on women's lives and also to elicit women's fear of sexual crime in general, 72 women were questioned. Of the subjects, 35 (48.6%) had been the victim of indecent exposure, 13 (37.1%) of these on two or more occasions. The women agree that indecent exposers are dangerous and cause great distress. Furthermore, women perceive the offence to be trivialized by the police, and by men in general. Indecent exposure greatly impinges on women's spatial and social freedom and serves to reinforce their fears of sexual crime.
{"title":"Indecent exposure: The impact upon the victim's fear of sexual crime","authors":"S. Riordan","doi":"10.1080/09585189908403684","DOIUrl":"https://doi.org/10.1080/09585189908403684","url":null,"abstract":"In an attempt to assess the overall frequency and impact of indecent exposure on women's lives and also to elicit women's fear of sexual crime in general, 72 women were questioned. Of the subjects, 35 (48.6%) had been the victim of indecent exposure, 13 (37.1%) of these on two or more occasions. The women agree that indecent exposers are dangerous and cause great distress. Furthermore, women perceive the offence to be trivialized by the police, and by men in general. Indecent exposure greatly impinges on women's spatial and social freedom and serves to reinforce their fears of sexual crime.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88819217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403687
J. McKenna, J. Shaw, Kathleen Porceddu, A. Ganley, Katherine Skaife, S. Davenport
A sample of patients with schizophrenia detained in a high-security hospital, but thought no longer to require conditions of maximum security, was compared with patients in a high-dependency rehabilitation unit and a district rehabilitation service, by using several of the instruments from the TAPS studies (Team for Assessment of Psychiatric Services) and the REHAB scale. The high-dependency rehabilitation patients were found to be significantly more disabled than the maximum-security patients on a variety of parameters. Implications for service provision are discussed.
{"title":"‘Long-stay medium secure’ patients in Special Hospital","authors":"J. McKenna, J. Shaw, Kathleen Porceddu, A. Ganley, Katherine Skaife, S. Davenport","doi":"10.1080/09585189908403687","DOIUrl":"https://doi.org/10.1080/09585189908403687","url":null,"abstract":"A sample of patients with schizophrenia detained in a high-security hospital, but thought no longer to require conditions of maximum security, was compared with patients in a high-dependency rehabilitation unit and a district rehabilitation service, by using several of the instruments from the TAPS studies (Team for Assessment of Psychiatric Services) and the REHAB scale. The high-dependency rehabilitation patients were found to be significantly more disabled than the maximum-security patients on a variety of parameters. Implications for service provision are discussed.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87597122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403690
L. Thomson
Abstract This paper reviews the recent literature in forensic psychiatry on clinical management. It examines the association between mental disorder and crime/violence, and considers specific conditions and problematic behaviours. Risk assessment and management techniques are reviewed, including those systems designed to maximize care and minimize risk.
{"title":"Clinical management in forensic psychiatry","authors":"L. Thomson","doi":"10.1080/09585189908403690","DOIUrl":"https://doi.org/10.1080/09585189908403690","url":null,"abstract":"Abstract This paper reviews the recent literature in forensic psychiatry on clinical management. It examines the association between mental disorder and crime/violence, and considers specific conditions and problematic behaviours. Risk assessment and management techniques are reviewed, including those systems designed to maximize care and minimize risk.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85283770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403689
K. Wheat
{"title":"Liability for failure to diagnose dyslexia","authors":"K. Wheat","doi":"10.1080/09585189908403689","DOIUrl":"https://doi.org/10.1080/09585189908403689","url":null,"abstract":"","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82010408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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