Pub Date : 2025-03-05DOI: 10.1016/j.ijlp.2025.102083
L. Buongiorno , F. Mele , G. Petroni , A. Margari , F. Carabellese , R. Catanesi , G. Mandarelli
Forensic psychiatry plays a critical role in legal contexts but is highly susceptible to cognitive biases that can undermine the accuracy and objectivity of evaluations. This scoping review, guided by the Arksey and O'Malley framework, aims to identify and analyze cognitive biases within forensic psychiatric practice across criminal, civil, and testimonial domains.
A comprehensive search across five databases yielded 7002 records, with 24 studies meeting the inclusion criteria. From these studies, ten distinct cognitive biases were identified, with the most frequently discussed being gender bias (29.2 %), allegiance bias (20.8 %), and confirmation bias (20.8 %), followed by hindsight, cultural, and emotional biases. Most studies focused on criminal settings, with only two addressing civil contexts.
Among the mitigation strategies reviewed, structured methodologies and the “considering the opposite” technique were the most positively evaluated and widely discussed approaches. Conversely, the self-awareness strategy was criticized for its limited effectiveness in reducing bias. Emerging tools, such as artificial intelligence, offer potential solutions but require robust ethical safeguards to prevent the perpetuation of systemic biases.
This scoping review provides a comprehensive overview of the current state of research on biases in forensic psychiatry, underscoring the need for further empirical studies to explore their prevalence, mechanisms, and effective mitigation strategies in greater depth.
{"title":"Cognitive biases in forensic psychiatry: A scoping review","authors":"L. Buongiorno , F. Mele , G. Petroni , A. Margari , F. Carabellese , R. Catanesi , G. Mandarelli","doi":"10.1016/j.ijlp.2025.102083","DOIUrl":"10.1016/j.ijlp.2025.102083","url":null,"abstract":"<div><div>Forensic psychiatry plays a critical role in legal contexts but is highly susceptible to cognitive biases that can undermine the accuracy and objectivity of evaluations. This scoping review, guided by the Arksey and O'Malley framework, aims to identify and analyze cognitive biases within forensic psychiatric practice across criminal, civil, and testimonial domains.</div><div>A comprehensive search across five databases yielded 7002 records, with 24 studies meeting the inclusion criteria. From these studies, ten distinct cognitive biases were identified, with the most frequently discussed being gender bias (29.2 %), allegiance bias (20.8 %), and confirmation bias (20.8 %), followed by hindsight, cultural, and emotional biases. Most studies focused on criminal settings, with only two addressing civil contexts.</div><div>Among the mitigation strategies reviewed, structured methodologies and the “considering the opposite” technique were the most positively evaluated and widely discussed approaches. Conversely, the self-awareness strategy was criticized for its limited effectiveness in reducing bias. Emerging tools, such as artificial intelligence, offer potential solutions but require robust ethical safeguards to prevent the perpetuation of systemic biases.</div><div>This scoping review provides a comprehensive overview of the current state of research on biases in forensic psychiatry, underscoring the need for further empirical studies to explore their prevalence, mechanisms, and effective mitigation strategies in greater depth.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102083"},"PeriodicalIF":1.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-05DOI: 10.1016/j.ijlp.2025.102088
Martina Nicole Modesti , Silvia Gubbini , Pietro De Rossi , Agostino Manzi , Giuseppe Nicolò , Barbara Adriani , Simone Pallottino , Giovanna Parmigiani , Antonio Del Casale , Cecilia Guariglia , Stefano Ferracuti
Introduction
ADHD is a neurodevelopmental disorder associated with functional, behavioral, and relational difficulties. Its onset is in childhood, before the age of 12, and it often persists into adulthood. This study investigates the link between ADHD in adulthood, psychiatric comorbidities, and the risk of criminal behavior, analyzing the impact of clinical and sociodemographic variables.
Methods
This cross-sectional study included a sample of 308 patients diagnosed with ADHD, treated at the ADHD Outpatient Clinic of SS Gonfalone Hospital in Monterotondo between 2019 and 2024. Diagnoses and comorbidities were assessed through structured interviews and standardized diagnostic tools (ASRS, DIVA-5). Information on legal status and types of crimes was collected through individual interviews. Statistical analysis was performed using t-tests, chi-square tests, and stepwise logistic regression models.
Results
In the sample, 8.1 % of patients with ADHD had committed crimes, with a male prevalence (92 %). Significant predictors of criminal behavior included male gender (OR = 1.899, p = 0.004) and alcohol use disorder (OR = 4.59, p = 0.002). Additionally, oppositional defiant disorder, ADHD diagnosis before the age of 18, and unemployment showed a potential association with risky criminal behavior. Lifetime prescription of antipsychotics (61.4 %) and antiepileptics (48.7 %) was more frequent among participants who committed crimes, while no significant differences were found in the use of atomoxetine and methylphenidate.
Conclusions
Adult ADHD, particularly in males, with combined presentation and in the presence of comorbidities such as oppositional defiant disorder and alcohol use disorder, is associated with an increased risk of criminal behavior. The findings highlight the need for personalized and multimodal interventions to mitigate these risks. Future studies should adopt longitudinal designs to explore causal dynamics and evaluate the effectiveness of therapeutic strategies in forensic contexts.
adhd是一种与功能、行为和关系困难相关的神经发育障碍。它的发病是在儿童时期，在12岁之前，并且经常持续到成年。本研究调查了成年期ADHD、精神合并症和犯罪行为风险之间的联系，分析了临床和社会人口学变量的影响。方法：本横断面研究包括2019年至2024年间在蒙特罗通多SS Gonfalone医院ADHD门诊接受治疗的308例ADHD患者样本。通过结构化访谈和标准化诊断工具（ASRS, DIVA-5）评估诊断和合并症。通过个别面谈收集了有关法律地位和罪行类型的资料。采用t检验、卡方检验和逐步logistic回归模型进行统计分析。结果8.1%的ADHD患者有过犯罪行为，其中男性占92%。犯罪行为的显著预测因子包括男性性别（OR = 1.899, p = 0.004）和酒精使用障碍（OR = 4.59, p = 0.002）。此外，18岁前的对立违抗性障碍、ADHD诊断和失业显示出与危险犯罪行为的潜在关联。终身服用抗精神病药物（61.4%）和抗癫痫药物（48.7%）的比例在犯罪参与者中更为常见，而使用阿托莫西汀和哌醋甲酯的比例无显著差异。结论：成人ADHD，特别是男性，合并表现并伴有对立违抗性障碍和酒精使用障碍等合并症，与犯罪行为风险增加有关。研究结果强调需要个性化和多模式干预措施来减轻这些风险。未来的研究应该采用纵向设计来探索因果动态和评估在法医环境下治疗策略的有效性。
{"title":"ADHD in adults and criminal behavior: The role of psychiatric comorbidities and clinical and sociodemographic factors in a clinical sample","authors":"Martina Nicole Modesti , Silvia Gubbini , Pietro De Rossi , Agostino Manzi , Giuseppe Nicolò , Barbara Adriani , Simone Pallottino , Giovanna Parmigiani , Antonio Del Casale , Cecilia Guariglia , Stefano Ferracuti","doi":"10.1016/j.ijlp.2025.102088","DOIUrl":"10.1016/j.ijlp.2025.102088","url":null,"abstract":"<div><h3>Introduction</h3><div>ADHD is a neurodevelopmental disorder associated with functional, behavioral, and relational difficulties. Its onset is in childhood, before the age of 12, and it often persists into adulthood. This study investigates the link between ADHD in adulthood, psychiatric comorbidities, and the risk of criminal behavior, analyzing the impact of clinical and sociodemographic variables.</div></div><div><h3>Methods</h3><div>This cross-sectional study included a sample of 308 patients diagnosed with ADHD, treated at the ADHD Outpatient Clinic of SS Gonfalone Hospital in Monterotondo between 2019 and 2024. Diagnoses and comorbidities were assessed through structured interviews and standardized diagnostic tools (ASRS, DIVA-5). Information on legal status and types of crimes was collected through individual interviews. Statistical analysis was performed using <em>t</em>-tests, chi-square tests, and stepwise logistic regression models.</div></div><div><h3>Results</h3><div>In the sample, 8.1 % of patients with ADHD had committed crimes, with a male prevalence (92 %). Significant predictors of criminal behavior included male gender (OR = 1.899, <em>p</em> = 0.004) and alcohol use disorder (OR = 4.59, <em>p</em> = 0.002). Additionally, oppositional defiant disorder, ADHD diagnosis before the age of 18, and unemployment showed a potential association with risky criminal behavior. Lifetime prescription of antipsychotics (61.4 %) and antiepileptics (48.7 %) was more frequent among participants who committed crimes, while no significant differences were found in the use of atomoxetine and methylphenidate.</div></div><div><h3>Conclusions</h3><div>Adult ADHD, particularly in males, with combined presentation and in the presence of comorbidities such as oppositional defiant disorder and alcohol use disorder, is associated with an increased risk of criminal behavior. The findings highlight the need for personalized and multimodal interventions to mitigate these risks. Future studies should adopt longitudinal designs to explore causal dynamics and evaluate the effectiveness of therapeutic strategies in forensic contexts.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102088"},"PeriodicalIF":1.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-03DOI: 10.1016/j.ijlp.2025.102081
Mingming Hai
International norms and domestic law-making and decision-making often underestimate the effects of psychological torture and the challenges posed by digital technologies like artificial intelligence, neurotechnology, and cybertechnology, such as cybertorture, used in interrogation techniques. This article focuses on how anti-torture legal measures, both in the international context and in their domestic implementation in China, respond to the contemporary challenges in the prevailing legal framework posed by the emergence of digital technologies and the effects of psychological torture. These challenges need to be considered from medico-legal perspectives in risk evaluation and remedies for the intertwined concept of neurorights and cybertorture and the effects of psychological torture, as well as introducing the argument that neurorights as an integral concept of human rights should be placed in the architecture of the human rights legal framework regarding cybertorture as a theoretical basis for legal reasoning in specific cases. This article aims to examine these challenges in the evolutionary interpretation of existing international conventions to combat torture by examining the changing trends in the interpretation of these instruments and the role played by soft law in them. It also examines how China, as a Convention's State party, provides judicial remedies for individual claims by psychological torture victims. It highlights that vagueness in the definition of concepts and the high threshold for the effects of psychological torture increase the risk of the victim suffering and act as a barrier to grant redress within medico-legal support. Using a mixed research method, it first analyzes two types of cause-of-action cases study regarding psychological torture of state compensation and involuntary admission procedures in Mental health Law. Quantitative analysis was also used to support the soundness of the exploratory conclusions drawn by the case study section. The empirical findings suggest that certain significant risk factors in China's law-making and judicial decision-making affect the fairness and availability of judicial remedies for individual claims.
{"title":"Effects of psychological torture and cybertorture with emerging digital technologies under anti-torture legal obligations in China: A mixed methods research in risks and remedies","authors":"Mingming Hai","doi":"10.1016/j.ijlp.2025.102081","DOIUrl":"10.1016/j.ijlp.2025.102081","url":null,"abstract":"<div><div>International norms and domestic law-making and decision-making often underestimate the effects of psychological torture and the challenges posed by digital technologies like artificial intelligence, neurotechnology, and cybertechnology, such as cybertorture, used in interrogation techniques. This article focuses on how anti-torture legal measures, both in the international context and in their domestic implementation in China, respond to the contemporary challenges in the prevailing legal framework posed by the emergence of digital technologies and the effects of psychological torture. These challenges need to be considered from medico-legal perspectives in risk evaluation and remedies for the intertwined concept of neurorights and cybertorture and the effects of psychological torture, as well as introducing the argument that neurorights as an integral concept of human rights should be placed in the architecture of the human rights legal framework regarding cybertorture as a theoretical basis for legal reasoning in specific cases. This article aims to examine these challenges in the evolutionary interpretation of existing international conventions to combat torture by examining the changing trends in the interpretation of these instruments and the role played by soft law in them. It also examines how China, as a Convention's State party, provides judicial remedies for individual claims by psychological torture victims. It highlights that vagueness in the definition of concepts and the high threshold for the effects of psychological torture increase the risk of the victim suffering and act as a barrier to grant redress within medico-legal support. Using a mixed research method, it first analyzes two types of cause-of-action cases study regarding psychological torture of state compensation and involuntary admission procedures in Mental health Law. Quantitative analysis was also used to support the soundness of the exploratory conclusions drawn by the case study section. The empirical findings suggest that certain significant risk factors in China's law-making and judicial decision-making affect the fairness and availability of judicial remedies for individual claims.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102081"},"PeriodicalIF":1.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549040","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 : 2025-02-28DOI: 10.1016/j.ijlp.2025.102087
Brendan D. Kelly
Admission without consent and treatment without consent are topics of prolonged discussion throughout the history of psychiatry. These practices raise significant issues pertaining to human rights to liberty, bodily integrity, and treatment. Balancing rights is always challenging, especially when people lack decision-making capacity owing to the impact of mental illness. In 1979, the European Court of Human Rights outlined criteria required to justify lawful admission without consent owing to mental disorder in Winterwerp v. the Netherlands. These criteria were: (a) a competent national authority needs to demonstrate the existence of a true mental disorder based on objective medical expertise; (b) the extent of the mental disorder needs to warrant compulsory confinement, and (c) continued detention needs to be validated by the persistence of the disorder. Since then, the Court has delivered multiple judgements relating to psychiatric committal and detention in various facilities, but the most significant potential addition to the Winterwerp criteria occurred in 2019, in Rooman v. Belgium. In this case, the Court stated, “that there exists a close link between the ‘lawfulness’ of the detention of persons suffering from mental disorders and the appropriateness of the treatment provided for their mental condition”. The Court stressed ‘that, irrespective of the facility in which those persons are placed, they are entitled to be provided with a suitable medical environment accompanied by real therapeutic measures’. On this basis, this paper proposes adding a fourth requirement to the Winterwerp criteria to justify lawful admission without consent owing to mental disorder: ‘(d) real therapeutic measures must be provided’. The absence of ‘real therapeutic measures’ should undermine the legal basis of admission without consent on the basis of mental disorder. This would mean that there could be no involuntary admission owing to mental disorder without treatment being appropriate and available. Such an addition to criteria for involuntary admission in national mental health legislation would protect, rather than erode, human rights, and would more accurately reflect the core purpose of psychiatry: the treatment of mental illness and the consequent alleviation of suffering.
{"title":"Updating Winterwerp with Rooman to add a requirement for ‘Real therapeutic measures’ to legal criteria for admission without consent in psychiatry","authors":"Brendan D. Kelly","doi":"10.1016/j.ijlp.2025.102087","DOIUrl":"10.1016/j.ijlp.2025.102087","url":null,"abstract":"<div><div>Admission without consent and treatment without consent are topics of prolonged discussion throughout the history of psychiatry. These practices raise significant issues pertaining to human rights to liberty, bodily integrity, and treatment. Balancing rights is always challenging, especially when people lack decision-making capacity owing to the impact of mental illness. In 1979, the European Court of Human Rights outlined criteria required to justify lawful admission without consent owing to mental disorder in <em>Winterwerp v. the Netherlands</em>. These criteria were: (a) a competent national authority needs to demonstrate the existence of a true mental disorder based on objective medical expertise; (b) the extent of the mental disorder needs to warrant compulsory confinement, and (c) continued detention needs to be validated by the persistence of the disorder. Since then, the Court has delivered multiple judgements relating to psychiatric committal and detention in various facilities, but the most significant potential addition to the <em>Winterwerp</em> criteria occurred in 2019, in <em>Rooman v. Belgium</em>. In this case, the Court stated, “that there exists a close link between the ‘lawfulness’ of the detention of persons suffering from mental disorders and the appropriateness of the treatment provided for their mental condition”. The Court stressed ‘that, irrespective of the facility in which those persons are placed, they are entitled to be provided with a suitable medical environment accompanied by real therapeutic measures’. On this basis, this paper proposes adding a fourth requirement to the <em>Winterwerp</em> criteria to justify lawful admission without consent owing to mental disorder: ‘(d) real therapeutic measures must be provided’. The absence of ‘real therapeutic measures’ should undermine the legal basis of admission without consent on the basis of mental disorder. This would mean that there could be no involuntary admission owing to mental disorder without treatment being appropriate and available. Such an addition to criteria for involuntary admission in national mental health legislation would protect, rather than erode, human rights, and would more accurately reflect the core purpose of psychiatry: the treatment of mental illness and the consequent alleviation of suffering.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102087"},"PeriodicalIF":1.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-27DOI: 10.1016/j.ijlp.2025.102086
Graziella Orrù , Giulia Melis , Giuseppe Sartori
Integrating Generative Artificial Intelligence and Large Language Models (LLMs) such as GPT-4 is transforming clinical medicine and cognitive psychology. These models exhibit remarkable capabilities in understanding and generating human-like language, which can enhance various aspects of healthcare, including clinical decision-making and psychological counseling.
LLMs, trained on vast datasets, function by predicting the next word in a sequence, endowing them with extensive knowledge and reasoning abilities. Their adaptability allows them to perform a wide range of language-related tasks, significantly contributing to advancements in cognitive psychology and psychiatry. These models demonstrate proficiency in tasks such as analogical reasoning, metaphor comprehension, and problem-solving, often achieving performance comparable to neurotypical humans. Despite their impressive capabilities, LLMs still exhibit limitations in causal reasoning and complex planning. However, their continuous improvement, exemplified by the enhanced performance of GPT-4 over its predecessors, suggests a trajectory towards overcoming these challenges. The ongoing debate about the “intelligence” of LLMs revolves around their ability to mimic human-like reasoning and understanding, a focal point of contemporary research.
This paper explores the cognitive abilities of LLMs, comparing them with human cognitive processes and examining their performance on various psychological tests. It highlights the emergent properties of LLMs, their potential to transform cognitive psychology, and the different applications of LLMs in psychiatry, highlighting the limitations, the ethical considerations, and the importance of scaling and fine-tuning these models to enhance their capabilities. We also explore the parallels between LLMs and human error patterns, underscoring the significance of using LLMs as models for human cognition.
Overall, this paper provides substantial evidence supporting the role of LLMs in reviving associationism as a viable framework for understanding human cognition while acknowledging the current limitations and the need for further research to fully realize their potential.
{"title":"Large language models and psychiatry","authors":"Graziella Orrù , Giulia Melis , Giuseppe Sartori","doi":"10.1016/j.ijlp.2025.102086","DOIUrl":"10.1016/j.ijlp.2025.102086","url":null,"abstract":"<div><div>Integrating Generative Artificial Intelligence and Large Language Models (LLMs) such as GPT-4 is transforming clinical medicine and cognitive psychology. These models exhibit remarkable capabilities in understanding and generating human-like language, which can enhance various aspects of healthcare, including clinical decision-making and psychological counseling.</div><div>LLMs, trained on vast datasets, function by predicting the next word in a sequence, endowing them with extensive knowledge and reasoning abilities. Their adaptability allows them to perform a wide range of language-related tasks, significantly contributing to advancements in cognitive psychology and psychiatry. These models demonstrate proficiency in tasks such as analogical reasoning, metaphor comprehension, and problem-solving, often achieving performance comparable to neurotypical humans. Despite their impressive capabilities, LLMs still exhibit limitations in causal reasoning and complex planning. However, their continuous improvement, exemplified by the enhanced performance of GPT-4 over its predecessors, suggests a trajectory towards overcoming these challenges. The ongoing debate about the “intelligence” of LLMs revolves around their ability to mimic human-like reasoning and understanding, a focal point of contemporary research.</div><div>This paper explores the cognitive abilities of LLMs, comparing them with human cognitive processes and examining their performance on various psychological tests. It highlights the emergent properties of LLMs, their potential to transform cognitive psychology, and the different applications of LLMs in psychiatry, highlighting the limitations, the ethical considerations, and the importance of scaling and fine-tuning these models to enhance their capabilities. We also explore the parallels between LLMs and human error patterns, underscoring the significance of using LLMs as models for human cognition.</div><div>Overall, this paper provides substantial evidence supporting the role of LLMs in reviving associationism as a viable framework for understanding human cognition while acknowledging the current limitations and the need for further research to fully realize their potential.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102086"},"PeriodicalIF":1.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143507994","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}
People with fetal alcohol spectrum disorder (FASD) can experience a range of individual, social, and systemic challenges that may increase the likelihood of life adversity, including contact with the criminal legal system (CLS). The purpose of this article was to update a 2018 systematic review of literature on this intersection of FASD and the CLS. We searched ten academic databases for studies with people with FASD involved in the CLS, as well as caregivers and service providers who support them. A total of 54 studies were identified, published between April 2017 and March 2024, which is more than double what was present in 2018. Most of this research was conducted in Canada and Australia with individuals with FASD across the lifespan. These studies indicate growth in the literature on FASD prevalence in CLS settings (n = 3), CLS-related trajectories for people with FASD (n = 15), the needs and strengths of people with FASD involved in the CLS (n = 9), FASD-informed CLS responses (n = 17), and CLS professional knowledge, attitudes, and practices related to FASD (n = 10). Despite these advancements, there remain limitations in the evidence base such as a lack of specific and rigorous intervention studies; longitudinal research on outcomes and trajectories; generalizable prevalence estimates; the unique ways in which needs, risk, and protective factors may be experienced by people with FASD; how socio-cultural factors impact people with FASD and the research conducted in this area; as well as training opportunities for professionals supporting those with FASD in the CLS. These findings are integrated with results reported in the 2018 review to identify priority areas for future research.
{"title":"An updated systematic review of the literature on fetal alcohol spectrum disorder and the criminal legal system","authors":"Katherine Flannigan , Jessica W. Pun , Pamela Buttinger , Kaitlyn McLachlan , Kathleen Holmstrom , Melissa Tremblay , Mansfield Mela , Jacqueline Pei","doi":"10.1016/j.ijlp.2025.102073","DOIUrl":"10.1016/j.ijlp.2025.102073","url":null,"abstract":"<div><div>People with fetal alcohol spectrum disorder (FASD) can experience a range of individual, social, and systemic challenges that may increase the likelihood of life adversity, including contact with the criminal legal system (CLS). The purpose of this article was to update a 2018 systematic review of literature on this intersection of FASD and the CLS. We searched ten academic databases for studies with people with FASD involved in the CLS, as well as caregivers and service providers who support them. A total of 54 studies were identified, published between April 2017 and March 2024, which is more than double what was present in 2018. Most of this research was conducted in Canada and Australia with individuals with FASD across the lifespan. These studies indicate growth in the literature on FASD prevalence in CLS settings (<em>n</em> = 3), CLS-related trajectories for people with FASD (<em>n</em> = 15), the needs and strengths of people with FASD involved in the CLS (<em>n</em> = 9), FASD-informed CLS responses (<em>n</em> = 17), and CLS professional knowledge, attitudes, and practices related to FASD (<em>n</em> = 10). Despite these advancements, there remain limitations in the evidence base such as a lack of specific and rigorous intervention studies; longitudinal research on outcomes and trajectories; generalizable prevalence estimates; the unique ways in which needs, risk, and protective factors may be experienced by people with FASD; how socio-cultural factors impact people with FASD and the research conducted in this area; as well as training opportunities for professionals supporting those with FASD in the CLS. These findings are integrated with results reported in the 2018 review to identify priority areas for future research.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"100 ","pages":"Article 102073"},"PeriodicalIF":1.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-20DOI: 10.1016/j.ijlp.2025.102072
D.A. de Waardt , C.L. Mulder , G.A.M. Widdershoven
Background
Since 2020, Dutch mental health legislation has provided scope for compulsory treatment at home (CTH). Unlike compulsory community treatment (CCT), CTH allows for the use of compulsion in a patient's home, and thus not only in hospital.
Aim
To examine several stakeholders' experiences and views regarding CTH and its implementation.
Methods
Four focus-groups were performed: one with patients, one with significant others, one with psychiatrists, and one with a mixed group of stakeholders. The transcripts were analyzed thematically.
Results
We identified three themes and 16 subthemes. The first theme concerned the potential benefits of CTH, one of which was avoiding admission to hospital. The second theme focused on preconditions for the delivery of CTH, mainly on communication between mental health workers, patients, and significant others; and the importance of a dialogue well in advance of any compulsory care. With regard to the third theme, considerations regarding the delivery of CTH, all stakeholder groups believed that CTH would be most suitable for patients who had a longer history with their treatment team: between them, they would be able to draw up a plan for compulsory care.
Conclusion
Stakeholders felt that CTH can work for patients with a longer treatment history whose home situation allows for treatment at home. They regard an advance dialogue and jointly drawing up a crisis plan as important preconditions. Overall, CTH can be regarded as an extra option for enabling an individually tailored approach.
{"title":"Stakeholder experiences with compulsory treatment at home: A focus-group study","authors":"D.A. de Waardt , C.L. Mulder , G.A.M. Widdershoven","doi":"10.1016/j.ijlp.2025.102072","DOIUrl":"10.1016/j.ijlp.2025.102072","url":null,"abstract":"<div><h3>Background</h3><div>Since 2020, Dutch mental health legislation has provided scope for compulsory treatment at home (CTH). Unlike compulsory community treatment (CCT), CTH allows for the use of compulsion in a patient's home, and thus not only in hospital.</div></div><div><h3>Aim</h3><div>To examine several stakeholders' experiences and views regarding CTH and its implementation.</div></div><div><h3>Methods</h3><div>Four focus-groups were performed: one with patients, one with significant others, one with psychiatrists, and one with a mixed group of stakeholders. The transcripts were analyzed thematically.</div></div><div><h3>Results</h3><div>We identified three themes and 16 subthemes. The first theme concerned the potential benefits of CTH, one of which was avoiding admission to hospital. The second theme focused on preconditions for the delivery of CTH, mainly on communication between mental health workers, patients, and significant others; and the importance of a dialogue well in advance of any compulsory care. With regard to the third theme, considerations regarding the delivery of CTH, all stakeholder groups believed that CTH would be most suitable for patients who had a longer history with their treatment team: between them, they would be able to draw up a plan for compulsory care.</div></div><div><h3>Conclusion</h3><div>Stakeholders felt that CTH can work for patients with a longer treatment history whose home situation allows for treatment at home. They regard an advance dialogue and jointly drawing up a crisis plan as important preconditions. Overall, CTH can be regarded as an extra option for enabling an individually tailored approach.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"100 ","pages":"Article 102072"},"PeriodicalIF":1.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-18DOI: 10.1016/j.ijlp.2025.102070
Fan Zhang , Yifang Luo , Zihuan Gao , Aihua Han
Large Language Models (LLMs) have shown impressive performance in various natural language processing tasks. However, their application in specialized domains like forensic injury appraisal remains challenging due to the lack of domain-specific knowledge and the need for accurate retrieval of relevant information. This study proposes a novel approach that combines Retrieval-Augmented Generation (RAG) with graph-based knowledge bases and deep learning to enable LLMs to conduct injury appraisals based on China’s Standards for Assessing the Extent of Bodily Injuries (SAEBI). We create a dataset of 26,199 real-world injury appraisal cases and develop a RoBERTa-CNN model for accurate classification of injury locations and severity levels. By integrating this model with a graph-based knowledge base, our RAG strategy significantly improves the performance of nine state-of-the-art LLMs in injury appraisal tasks, with accuracy gains ranging from 21 to 59 percentage points compared to traditional retrieval methods. The additional experiments on crime classification also show that our method has good transferability in different domains. Our approach showcases the potential of combining domain-specific knowledge, advanced retrieval techniques, and deep learning to enhance the performance of LLMs in specialized domains like forensic injury appraisal.
{"title":"Injury degree appraisal of large language model based on retrieval-augmented generation and deep learning","authors":"Fan Zhang , Yifang Luo , Zihuan Gao , Aihua Han","doi":"10.1016/j.ijlp.2025.102070","DOIUrl":"10.1016/j.ijlp.2025.102070","url":null,"abstract":"<div><div>Large Language Models (LLMs) have shown impressive performance in various natural language processing tasks. However, their application in specialized domains like forensic injury appraisal remains challenging due to the lack of domain-specific knowledge and the need for accurate retrieval of relevant information. This study proposes a novel approach that combines Retrieval-Augmented Generation (RAG) with graph-based knowledge bases and deep learning to enable LLMs to conduct injury appraisals based on China’s Standards for Assessing the Extent of Bodily Injuries (SAEBI). We create a dataset of 26,199 real-world injury appraisal cases and develop a RoBERTa-CNN model for accurate classification of injury locations and severity levels. By integrating this model with a graph-based knowledge base, our RAG strategy significantly improves the performance of nine state-of-the-art LLMs in injury appraisal tasks, with accuracy gains ranging from 21 to 59 percentage points compared to traditional retrieval methods. The additional experiments on crime classification also show that our method has good transferability in different domains. Our approach showcases the potential of combining domain-specific knowledge, advanced retrieval techniques, and deep learning to enhance the performance of LLMs in specialized domains like forensic injury appraisal.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"100 ","pages":"Article 102070"},"PeriodicalIF":1.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143430342","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}
In Japan, the Medical Treatment and Supervision Act (MTSA) has been in effect since 2005, and a support system has been established for those found not guilty by reason of insanity (NGRIs). Under this law, the reintegration of the subjects into society is underway. This paper summarizes the status of forensic outpatients during the seven years after its enactment. Information on forensic outpatients was obtained from 224 designated outpatient medical institutions under the law between 2005 and 2011, the period after the law's implementation. Information on demographic factors, psychiatric status, forensic background, clinical treatment history, and social service utilization was collected. Among the 690 outpatients, the most common diagnosis was F2 (Schizophrenia) (76.4 %), and the most common criminal offense was homicide/attempted homicide (28.8 %). Among the outpatients, 46.2 % developed problematic behavior during treatment, and suicidal behavior was observed in 6.0 % of the patients. Since problematic behaviors during treatment, including suicidal behavior, have been observed, it is necessary to expand support, including the development of proper relationships with patients and the early stages of treatment to promote the integration of forensic patients into society.
{"title":"Overview of forensic outpatients on the medical treatment and supervision act in Japan","authors":"Kumiko Ando , Kanako Nakazawa , Shota Matsunaga , Takayuki Okada","doi":"10.1016/j.ijlp.2025.102074","DOIUrl":"10.1016/j.ijlp.2025.102074","url":null,"abstract":"<div><div>In Japan, the Medical Treatment and Supervision Act (MTSA) has been in effect since 2005, and a support system has been established for those found not guilty by reason of insanity (NGRIs). Under this law, the reintegration of the subjects into society is underway. This paper summarizes the status of forensic outpatients during the seven years after its enactment. Information on forensic outpatients was obtained from 224 designated outpatient medical institutions under the law between 2005 and 2011, the period after the law's implementation. Information on demographic factors, psychiatric status, forensic background, clinical treatment history, and social service utilization was collected. Among the 690 outpatients, the most common diagnosis was F2 (Schizophrenia) (76.4 %), and the most common criminal offense was homicide/attempted homicide (28.8 %). Among the outpatients, 46.2 % developed problematic behavior during treatment, and suicidal behavior was observed in 6.0 % of the patients. Since problematic behaviors during treatment, including suicidal behavior, have been observed, it is necessary to expand support, including the development of proper relationships with patients and the early stages of treatment to promote the integration of forensic patients into society.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"100 ","pages":"Article 102074"},"PeriodicalIF":1.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437069","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 : 2025-02-17DOI: 10.1016/j.ijlp.2025.102082
Cristina Scarpazza , Andrea Zangrossi
The formulation of a scientific opinion on whether the individual who committed a crime should be held responsible for his/her actions or should be considered not responsible by reason of insanity is very difficult. Indeed, forensic psychopathological decision on insanity is highly prone to errors and is affected by human cognitive biases, resulting in low inter-rater reliability. In this context, artificial intelligence can be extremely useful to improve the inter-subjectivity of insanity evaluation. In this paper, we discuss the possible applications of artificial intelligence in this field as well as the challenges and pitfalls that hamper the effective implementation of AI in insanity evaluation. In particular, thus far, it is possible to apply only supervised algorithms without knowing which is the ground truth and which data should be used to train and test the algorithms. In addition, it is not known which percentage of accuracy of the algorithms is sufficient to support partial or total insanity, nor which are the boundaries between sanity and partial or total insanity. Finally, ethical aspects have not been sufficiently investigated. We conclude that these pitfalls should be resolved before AI can be safely and reliably applied in criminal trials.
{"title":"Artificial intelligence in insanity evaluation. Potential opportunities and current challenges","authors":"Cristina Scarpazza , Andrea Zangrossi","doi":"10.1016/j.ijlp.2025.102082","DOIUrl":"10.1016/j.ijlp.2025.102082","url":null,"abstract":"<div><div>The formulation of a scientific opinion on whether the individual who committed a crime should be held responsible for his/her actions or should be considered not responsible by reason of insanity is very difficult. Indeed, forensic psychopathological decision on insanity is highly prone to errors and is affected by human cognitive biases, resulting in low inter-rater reliability. In this context, artificial intelligence can be extremely useful to improve the inter-subjectivity of insanity evaluation. In this paper, we discuss the possible applications of artificial intelligence in this field as well as the challenges and pitfalls that hamper the effective implementation of AI in insanity evaluation. In particular, thus far, it is possible to apply only supervised algorithms without knowing which is the ground truth and which data should be used to train and test the algorithms. In addition, it is not known which percentage of accuracy of the algorithms is sufficient to support partial or total insanity, nor which are the boundaries between sanity and partial or total insanity. Finally, ethical aspects have not been sufficiently investigated. We conclude that these pitfalls should be resolved before AI can be safely and reliably applied in criminal trials.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"100 ","pages":"Article 102082"},"PeriodicalIF":1.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143430341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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