CHAPTER 4: CRIME AND MENTAL DISORDERS

(pp. 108 - 118 & 130 - 145)

Contents
PEOPLE WHO ARE MENTALLY – ILL. .................................................................................................................. 3
ENTERTAINMENT MEDIA. ................................................................................................................................. 3
THE USE OF MEDICATION TO TREAT MENTAL ILLNESS..................................................................................... 3
SERIOUS MENTAL ILLNESS (SMI) ....................................................................................................................... 4
MENTAL ILLNESS ............................................................................................................................................... 5
INTELLECTUAL DISABILITY ................................................................................................................................. 6
THE DSM ............................................................................................................................................................ 7
DEFINITION ........................................................................................................................................................ 8
CHARACTERISED BY ........................................................................................................................................... 8
SCHIZOPHERENIA .............................................................................................................................................. 8
AGE DEVELOPMENT .......................................................................................................................................... 8
Five characteristic symptoms ............................................................................................................................ 9
MEDICATION ..................................................................................................................................................... 9
CRIME .............................................................................................................................................................. 10
DELUSIONAL DISORDER/ PARANOID DISORDERS ........................................................................................... 10
BIPLOLAR DISORDER ....................................................................................................................................... 11
CHARACTERISED BY: ........................................................................................................................................ 11
MANIC PHASE .................................................................................................................................................. 12
CRIME .............................................................................................................................................................. 12
MAJOUR DEPRESSIVE DISORDER .................................................................................................................... 12
MAJOUR DEPRESSIVE ORDER VS BIPOLAR ...................................................................................................... 12
SYMPTOMS OF MDD ....................................................................................................................................... 13
CRIMINAL BHAVIOUR ...................................................................................................................................... 13
ANTISOCIAL PERSONALITY DISORDER ........................................................................................................... 14
DIAGNOSIS....................................................................................................................................................... 15
BEHAVIOURAL PATTERNS................................................................................................................................ 15
DSM ................................................................................................................................................................. 16
CRIME .............................................................................................................................................................. 16
INTRODUCTION ............................................................................................................................................... 17
CONDITIONS AND DEFENCES .......................................................................................................................... 17
4.2.1 POST TRAMATIC STRESS DISORDER ....................................................................................................... 17
DEFINITION ...................................................................................................................................................... 17
 INTRODUCTION
PEOPLE WHO ARE MENTALLY – ILL.

❖ BRUTAL & VIOLENT CRIMES - are not usually committed by people who are mentally-ill, and people who ar

mentally -ill do not usually commit such crimes.

❖ Crimes such as the following are committed by individuals who HAVE NO MENTAL ILLNESS in their
background:
o GUN VIOLENCE
o AGRIVATED ASSULT
o SEXUAL ASSULT

ENTERTAINMENT MEDIA.

❖ The entertainment media has been an important factor in developing a connection between mental
disorders and crime – specifically serious violent crimes.

❖ BASIC MOTIVATION FOR CRIMINALITY in a lot of crimes on entertainment media is:

o GREED
o REVANGE
o MENTAL ILLNESS

THE USE OF MEDICATION TO TREAT MENTAL ILLNESS.

❖ Drugs are effective but there are side effects such as:

o Nausea
o Loss of energy
o Inability to concentrate
o Loss of appetite
o Dizziness
❖ Medication alone is not the solution for mental illness

❖ Abnormalities in behaviour, such as those in mental disorders shouldn’t be regarded as an illness, mainly

because:

o It gives too much power to medical professionals and

o It enabled widespread use of drugs to control behaviour of people who acted differently.

SERIOUS MENTAL ILLNESS (SMI)

❖ Mental illness in general VS serious mental illness (SMI)

❖ COMMON DEFINITION OF SMI:

• A MENTAL, BEHAVIOURAL OR EMOTIONAL DISORDER, resulting in serious functional
impairment, which AFFECTS or LIMITS one or more major life activities.

❖ People with SMI- when they do commit crimes – typically they COMMIT MINOR OFFENCES rather than
brutal and violent crimes.
o They are likely to trespass, shoplift or commit simple assault rather than murdering

❖ SMI IS NOT A DIRECT CAUSE OF CRIME - and the RISK FACTORS FOR OFFENDING ARE SIMILAR IN BOTH
MENTALLY ILL AND NON-MENTALLY ILL OFFENDERS
 DEFINING MENTAL ILLNES
MENTAL ILLNESS

❖ MENTAL ILLNESS and MENTAL DISORDER are two TERMS that have become IDENTICAL

❖ Mental illness is a LESS RESTRICTIVE CONCEPT

❖ Mental illness defined:

▪ MENTAL ILLNESS A DISORDER/DISEASE OF THE MIND.

▪ Mental illness is a term used to indicate that an individual HAS PROBLEMS IN LIVING

▪ Mental illness is a disorder that interfere with a person’s ABILITY TO COPE WITH LIFE.

▪ Mental illness likely deprives a person form freedom of choice, but there are levels to this

deprivation. [Thus, even a person who has a serious disorder has some decision-making ability]

▪ Mental illness is revealed in behaviour that strays notably form what is considered normal.

❖ Serious mental illnesses have the following effects

• It deviates from normal conduct

• It severely obstructs a person’s functioning

• It has the potential to obstruct a person’s functioning

❖ The word ILLNES encourages us to look for:

• Etiology
• Symptoms
• Cures
• And to rely on the medical profession to DIAGNOSE and TREAT

❖ The term mental disorder does not imply:

• A person is sick
• A person needs to be pitied
• Nor does it imply a person is less responsibly for their actions

❖ The term CRAZY BEHAVIOUR - has been characterised as behaviour that is obviously STRANGE and
UNUSUAL and CONNOT BE LOGICALLY EXPLAINED

INTELLECTUAL DISABILITY

❖ INTELLECTUAL DISABILITY can be defined as:

• A developmental disability

• A cognitive deficiency that places limitations on a person’s cognitive capacity

• It is determined by IQ tests and a variety of performance measures.

• It CANNOT BE CURED but it can be compensated by care and training.

• It was Formally called MENTAL RETARDATION

• Although INTELLECTUAL DISABILITY cannot be cured, people who are intellectual disabled can be provided

with training and support services TO LEAD PRODUCTIVE AND INDEPENDENT LIVES

❖ People who are intellectual disabled are sometimes CHARGED WITH MAINLY MINOR OFFENCES that result
in
o Arrest
o Being detained in jail
o Serving time.

❖ However, they MAY ALSO BE CHARGED AND CONVICTED OF SERIOUS CRIMES including murder.

[DSM-V and ICD 10 – diagnostic tools]

Briefly discuss the DSM and ICD classification systems

FOUR CATEGORIES OF MENTAL DISORDERS MOST RELEVANT TO CRIME

Identify the specific mental disorders that are most likely to be associated criminal conduct

DSM- 5 (Diagnostic and Statistical Manual- American Psychiatric Association) - ICD-10 (International Classification of Diseases- World Health Organization)
 THE DSM

❖ Diagnostic and Statistical Manual of mental disorders

❖ The official guidebook or manual published by the American Psychiatric Association
❖ The DSM is used to define and diagnose specific mental disorders
❖ The concept mental illness connotes a wide rage of bizar, dramatic, harfull, unusual behavours, and the
classifications of these behaviuors have been published in the DSM
❖ Diagnoses of patients ofent appear in official records such as court documents and prison fiels and they are
also commonly seen in noncriminal maters

1.1. SPECIFIC MENTAL DISORDERS

❖ Specific mental disorders that are likely to be associated with criminal conduct but not nessesarily serious
criminal conduct
❖ it must be noted that people with these disorders are:
o Not crime prone
o Even if the individual has been diagnosed with such a disorder, that person can still be held reasonable for
criminal conduct

2. four catagories of metal disorders

o 1. The schizophrenia spectrum and other psychotic disorders

o 2. bipolar disorder
o 3. Major depression
o 4. antisocial personality disorder

▪ These 4 categories of mental disorders are the ones most closely likely to violence across the life span

SCIZOPHRENIA SPECTRUM & OTHER

PSYCHOTIC DISORDERS
 DEFINITION
❖ The mental disorder that people most often associate with "CRAZY BEHAVIOUR" since it frequently
manifests itself in highly bizarre actions

CHARACTERISED BY
❖ It is a serious mental disorder characterised by a broad range of COGNITIVE AND EMOTIONAL
DYSFUNCTIONS

SCHIZOPHERENIA
❖ A mental disorder that is complex and poorly understood

❖ It often leads to SOCIAL and ECONOMIC IMPAIRMENTS

❖ The THOUGHT and COGNITIVE FUNCTIONING becomes DISORGANIZED

➢ They fail to respond to reality [and their speech often shows this]

❖ Their thoughts become fragmented and bizarre

❖ Delusions are common

❖ These people typically demonstrate EMOTIONS such as:

➢ Inappropriate emotions
➢ Mirrors emotional flaws MAY HAPPEN EVEN IF ON MEDICATION

➢ Exhibit little if any emotional reactions

❖ Often their VOICE will be MONOTONOUS and their FACE will be IMMOBILE and EXPRESSIONLESS

❖ The person might show childlike silliness, unpredictable agitation and persecutory thoughts

AGE DEVELOPMENT
❖ This disorder normally begins EARLY IN LIFE [adolescents to mid-30’s]
 Five characteristic symptoms
❖ Delusions

o false beliefs about the world

❖ Hallucinations

o Sense or perceive things others do not.

o The most common hallucinations are AUDITORY (hear voices).

o Characteristic of schizophrenia and some forms of dementia

❖ Disorganised speech and thoughts

❖ Grossly disorganised/abnormal motor behaviour

❖ Inappropriate affect/ negative symptoms

o Such as diminished emotional expression

o Diminished expression and motivation in to engage in purposeful activities

MEDICATION

❖ The medication prescribed does include some side effects

❖ WITHOUT MEDICATION people with these disorders often experience severe breakdowns in:
o thought patterns
o emotions
o perceptions and even
o extreme social withdrawal
 CRIME
❖ There is a small proportion of crimes committed with these disorders but When they do commit crimes,
the level of violence may be higher than typical violent offender
➢ Homicide
➢ Aggravated assault

❖ Excessive violence is most common among offenders with HALLUCINATIONS + DELUSIONS

o Hallucinations alone are rare at the time of crime among homicide offenders

DELUSIONAL DISORDER/ PARANOID DISORDERS

❖ A mental disorder characterised by a system of false beliefs

❖ Is now included in the schizophrenia spectrum and other disorders section in the DSM

❖ Characterised by the presence of one or more no - bizarre delusions that persist for at least ONE MONTH

❖ The delusions are reasonably believable and not entirely far fetched

❖ Delusional disorder has no psychotic symptoms

❖ BIZARRE VS NON-BIZARRE DELUSIONS

Non bizarre delusion Bizarre delusion

Think neighbour is spying on you Think neighbour has disguised themselves as an

insect to spy on you through the window
Police have you under surveillance Aliens have you under surveillance
❖ The delusional disorder has several subtypes namely

o Erotomanic

o Jealous For the purpose of criminal behavior, types would be of concern

in relation to potential harm to others
o Persecutory

o Grandiose

o Somatic

o Mixed Persecutory type is linked

to criminal conduct
o Unspecified specifically violent criminal
conduct

BIPOLAR DISORDER
BIPLOLAR DISORDER
❖ Previously known as manic-depressive disorder

❖ It is basically a mood disorder

❖ The DSM distinguishes between bipolar 1 and bipolar 2 disorders

❖ Suicide risk among people with bipolar disorder are 15 times higher

CHARACTERISED BY:
❖ Bipolar is characterised by episodes of behaviour that alternate between a manic phase and a depressive
phase.

Manic phases include Depressive phases include

- Euphoria - Diminished interests/ pleasure in all activities

- Hyper energy - Depressed mood
- Distractibility
 MANIC PHASE
❖ In the manic phase the individual may be extremely involved in activities that have a high potential for
painful consequences, such as
o Sexual indiscretions
o Making foolish business investments

CRIME
❖ Bipolar disorder is not usually implicated in violent crimes but it may be a factor in reckless behaviour that
leads to criminal activity
o Ex. Speeding recklessly that results in the death of a person

MAJOR DEPRESSIVE DISORDER

MAJOUR DEPRESSIVE DISORDER
❖ Extreme depression

❖ Long lasting

❖ It is in the psychotic category

❖ Postpartum depression, post-partum blues, postpartum psychosis

MAJOUR DEPRESSIVE ORDER VS BIPOLAR

❖ What they have in common:
• The presence of sad, empty or irritable mood
• Cognitive and somatic changes that affect the individual’s capacity to function.
❖ What differs between them:
• Timing
• Duration
• Presumed etiology

SYMPTOMS OF MDD
❖ The symptoms of major depressive disorder include:

o Extremely depressed state that lasts for at least 2 weeks

o Generally slowing down of mental and physical activity
o Gloom Both girls and boys display
depressive symptoms
o Despair
o Feelings of worthlessness
o Perhaps regular thoughts of suicide

CRIMINAL BHAVIOUR
❖ Depression can be liked to delinquency especially in teenage girls

❖ Depression renders teenagers of both sex indifferent to their own personal safety and the consequences of
their actions
❖ They just don’t care what happen to them, this might increase the chances of them moving towards
delinquency

❖ Delinquent behaviour may lead to depression – depression does not come first

❖ Early depressive symptoms predict later delinquent behaviour

o Especially in girls

❖ Depression plays a significant role in the following incidents:

o Mass murders
An incident where a person commits
o School shootings a crime and then set up a situation
where the police are basically forced
o Workplace violence
to shoot
o Suicide by cop
❖ Depression also leads to an inordinate number of suicides that are not crime related

ANTISOCIAL PERSONALITY DISORDER

ANTISOCIAL PERSONALITY DISORDER

❖ APD – a disorder characterised by a history of continues behaviour where the rights of others are violated.

❖ Antisocial personalities lack empathy tend to be heartless, mocking and contemptuous of the feelings,
rights and suffering of others

❖ They have an impaired capacity to maintain

o Lasting relationships
o Close relationships
With family, friends or sexual partners
o Warm relationships
o Responsible relationships

❖ People with APD fail to become independent self-supporting adults, they spend most of their lives:
o In institutions
o Remain highly dependent on their families

❖ People with APD often complain of tension or depression

❖ This disorder occurs more frequently in men

❖ APD does not necessarily appear in isolation

 - A diagnosis of conduct disorder is reserved for
children or adolescents.
- Conduct disorder is a label used to identify
DIAGNOSIS children who show habitual misbehaviour

❖ To be diagnosed with APD an individual must

o Be 18 years of age
o Have a history of some symptoms of conduct disorder before age 15.

❖ Before a person can be diagnosed with APD a pervasive pattern of disregard for and violation of the rights
of others must be indicated by at least 3 of the 7 behavioural patterns

BEHAVIOURAL PATTERNS

➢ There are 7 key characteristics

❖ Failure to conform to social norms or the criminal law
o As Seen in regular performance of acts that are grounds for arrest

❖ Irritability and unusual aggressiveness

o This is indicated by repeated physical fights and assaults

❖ Consistent irresponsibility
o Reflected in a poor work history or failure to honor financial obligations

❖ Impulsivity or a failure to plan ahead

o All ages

❖ Deceitfulness
o Seen in frequent lying, use of aliases or conning for personal profit or pleasure

❖ Reckless disregard for the safety of others or self

❖ Lack of remorse or guilt for wrongdoings
o Indicated by indifference to or rationalisation of having hurt, mistreated or stolen form another

➢ Additional characterised behaviours include:

❖ Stealing
❖ Fighting
❖ Truancy
❖ Resisting authority
❖ Exhibit precocious and aggressive sexual behaviours
❖ Excessive drinking
❖ The use of illicit drugs
❖ Restlessness
❖ An inability to tolerate boredom
❖ A belief that the world is hostile
❖ Impulsive
❖ Unable to plan ahead
❖ Show deficits in executive functioning

DSM
❖ The DSM states that woman is underdiagnosed because the criteria for diagnosis focuses mainly on
aggression

❖ The DSM points out that there are genetic and physiological risks of APD
o IT IS OFTEN COMMON AMONG FIRST DEGREE BIOLOGIACL RELATIVES OF THOSE WITH THE DISORDER

CRIME
❖ A link between genes and the environment in behaviour can lead to offending
❖ APD is a common diagnosis for criminal offenders and defendants
❖ APD is offered as a diagnosis in criminal courts and in corrections
❖ In correction facilities, the rates of inmates considered with APD range between 30%-50%
❖ It is not unusual for offenders with serious mental illness to have troubling personality traits that are
consistent with APD
o They require both psychiatric and correctional treatment

4. UNIQUE DEFENSES AND CONDITIONS

INTRODUCTION
Some psychiatric diagnoses are likely to follow two decisions

1. The defendant is incompetent to stand trail

2. It is used to boost an insanity defence
❖ Some diagnosis can either
o Absolve defendants completely These conditions are not used as sperate defenses but rather to
support insanity defense.
o Or support a claim of diminished capacity/responsibility

CONDITIONS AND DEFENCES

4.2.1 POST TRAMATIC STRESS DISORDER

DEFINITION
❖ PTSD- a cluster of behavioural patterns that result from physioclogically disressing events outside the usual
range of human experience
❖ PTSD- The development of characteristic symptoms following exposure to one or more tramatic events

PTSD

❖ It was formally recognised as a distinct disorder

❖ Post Vietnam syndrome
❖ PTSD has been applied to the following circumcnases
o War veternats
o Suvivours of the holocaust Victims of human rights
o Sivivours of major disasters such as 9/11 abuse are also
o Mass shootings susceptiable to the
o Victims and survivors of symptoms liked to PTSD
▪ Rape
▪ Child abuse
▪ Spousal abuse
▪ Sexual harassment
❖ People suffering from PTSD may display:
o Different mood sates
o Negative cognition
o Dissociative symptoms This is a pattern that leads to
difficulty in develpong close,
meaningfull realtionships with
others
❖ Characteristics of PTSD
o Feelings of alienation or detatchment from social environment
❖ PTSD is viewed as an ambrella terms that applies to many people of all ages
❖ Individuals who have been diagnosed with PTSD tend to be
o Moody
o Depressed
o Difficult to be around them or to work with
❖ If adults are dignosed with PTSD they are described as
o Moving from one job to another
o Moving from one relationship to antoher
❖ If children are diagnosied with PTSD they are described as
o Having frighenting dreams
o Reconstruct the traumatic event in their play behaviour

SYMPTOMS

❖ Symptoms of PTSD include:

o Flacbacks
o Recurrent dreams or nightmares
o Painful, intrusive memories of the traumatic envet
o A diminished responsiveness
o A don’t care attitude
o Psychological numbing to the external world
o Sleep problems
o Being easily starteld
o Dificullty in consentarting or remembering
o Extrem avoidance of anthing that can be a reminder of traumatic events
❖ The start and duration of symptoms
o Symptoms may only start after some time – 6 moths to a year or even more
o The DSM states that symptoms usually begin within 3 months of the truma
o There is a possibility of delayed expression occurring months or years after
▪ Delayed expression formally called DELAYED ONSET

PTSD AS A DEFENCE

❖ PTSD has been used to support a defence in both violent and nonviolent cases
❖ Courts are willing to admit evidence of PTSD but, using it to support an insanity defence is not likely to be
successful.
❖ When the PTSD defence has been successful, it usually results in a finding of diminished responsablity
rather than complete avsulution of responsibility for the defendant

4.2.2. DISSOCIATION

❖ The DSM identifies 5 different dissociative disorders:

o Dissociative identity disorder
o Dissociative amnesia Only these 2 are discussed
❖ Dissociative disorders are characterised by a disruprion of and or discontinuity in the normal interiagtion of
o Consciousness
o Memory
o Identity
o Perception
o Body representation
o Motor control
o Behaviour

4.2.3. DISSOCIATIVE IDENTITY DISORDER

DEFINITION

❖ DID is a psychiatric syndrome characterised by the existence within a individual of tow or more distinct
personalities, any of which may be dominate at any given moment

DISSOCIATIVE IDENTITY DISORDER

❖ Formally called multiuple peesonality disorder

❖ The DMS states that DID is Characterisesed by
o (a) the presence of two or more distinct personality states or an experience of possession
o (b) and recurring episodes of amnesia
❖ The changes/transition from one personality state to another is often very sudden and it is generally
triggered by stress or some relevant envorimental stimuli
❖ People who experience DID are highly suggestible and impressionable

SYMPTOMS

❖ The symptoms of DID can be reported by the individual or the observation of others

DEFENCE

4.2.4. DISSOCIATIVE AMNESIA

DEFINITION

❖ Amnesia refers to complete or partial memory loss of an

o Event
o Series of events
o Some segments of life’s experiences
❖ Amnesia can happen due to
o Physical truma
o Neurophysiological disturbances
o Pyshiological factors

2 CATAGORIES FOR AMNESIA

❖ 1. Retrograde amnesia
o The loss of memory for past events
❖ 2. Anterograde amnesia
o The inhability to form new memories after an event that caused the amnesia

AMNESIA

❖ People with dissociative amnesia are unable to recall previously learned information or past events
❖ Amnesia can be localized or generalized
Generalized= rarest form
LOCALIZED AMNESIA

❖ The failure to recall events during a circumscribed period of time

❖ Also known as limited amnesia
❖ It is a pathological inhability to remember a specific episode or small number of episodes from the recent
past
❖ It can be caused by
o Emotional shock
o Alcohol or drug intoxication
o A blow to the head
❖ Limited amnesia is not ongoing nor does it involve extensive memory loss
❖ Memory loss is temporary and restricted to a specific event or incident

GENERALIZED AMNESIA

❖ Is a complete loss of memory

LAW_CRIME_DEFENCE

❖ The courts have not been respective to amnesia as a valid contidtion in either
o Insanity defence
o A condition that promotes incompatancy to stand trail
❖ The exeption is in the case of brain injury, when a connection can be made between the injury and the loss
of memory
 1. MENTAL DISORDERS AND VIOLANCE

MENTAL DISORDERS AND VIOLENCE

• Research: Offenders with mental disorders were no more criminally prone or violent than offenders without mental disorders

• MacArthur Research Network

• DANGEROUSNESS AND THE ASSESSMENT OF RISK (p 139)

• Weaknesses of risk assessment (Table 4-4, pp.143)

− Unstructured clinical (very subjective)

− Structured professional (speculation)

− Actuarial approach (limited focus on specific variables and groups)

• Police and the mentally disordered

- Mentally disordered inmates

Ø The Tarasoff case

- Risk factors of violence

5.1 INTRODUCTION

5.2. THW VIOLANCE OF PEROSNS WHO ARE MENTALLY DISORDERED

5.3. THE MacATHUR RESEARCH NETWORK

2. INMATES WITH MENTAL DISORDERS

 3. DANGEROUSNESS AND THE ASSESSMENT OF RISK

7.1 INTRODUCTION

7.2 CONCEPT
7.3 THREAT ASSESSMENT

7.4 THE TARASOFF CASE

7.5. VIOLANCE RISK FACTORS AND MEASURES