Insanity Defense Research Articles

Exposure to descriptions of traumatic events narrows one's concept of trauma.

The concept of "trauma" was originally used by psychiatrists to describe horrific events such as rape and torture that characteristically provoke extreme emotional distress. Both colloquially and clinically, the concept of psychological trauma has broadened considerably. Although many clinical scientists have expressed concern about the broadening of the concept of trauma, it remains unclear how this concept expansion occurs. We present two experiments in which American adults (N = 276 and N = 267) sequentially classified descriptions of events (e.g., "broke a leg in a bicycle accident") as either "trauma" or "not trauma." In the first experiment, we manipulated the frequency of severe events (i.e., severe events became less and less common). In the second experiment, we manipulated the range of events (i.e., participants viewed only severe or only nonsevere events). Together, the findings suggest that an individual's frame of reference for the severity of events plays a role in narrowing or broadening the concept of trauma. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Mental Health and Recovery Needs Among Women Substance Use Disorder Treatment Clients With Stalking Victimization Experiences

This study examined mental health and recovery needs at substance use disorder (SUD) program entry and at follow-up ( n = 2064) among: (1) women with no stalking victimization; (2) women with lifetime stalking victimization experiences; and (3) women with recent stalking victimization experiences (within 12 months of program entry). Stalking can be defined as a repeated pattern of behavior that creates fear or concern for safety or extreme emotional distress in the target. Women who experienced any stalking victimization, and particularly recent stalking victimization at program entry, had more recovery needs and increased mental health symptoms. At follow-up, women with any stalking victimization experiences continued to have more recovery needs with few differences between the lifetime and recent stalking victimization groups. Stalking victimization experiences were significantly associated with depression and anxiety symptoms in the multivariate analysis. Addressing stalking victimization during SUD treatment may be important to facilitate recovery.

Criminal insanity in Bulgaria and Norway: Analysing the prospect of a common approach

This article raises the question of the prospect of a common approach to mentally ill offenders in Europe, through a comparative discussion of the criminal insanity rules and systems in Norway and Bulgaria. The underlying motivation is to fill a gap in current legal research where the insanity discourse is still to a certain extent nationally oriented. Bulgaria is to date not represented at all in the international discussion of criminal insanity. Starting out from recognizing the different history, rules, culture and welfare of Norway and Bulgaria, the authors argue that these countries have a similar practical understanding of insanity and how it is associated with mental disorders as well as common challenges in their forensic and legal systems. These insights can provide a basis for further comparative explorations concerning a possible harmonization of insanity law in Europe.

Anabolic-androgenic steroids: Considerations for forensic psychiatry, sports psychiatry, and the law

Anabolic-androgenic steroids: Considerations for forensic psychiatry, sports psychiatry, and the law

Court-Ordered forensic psychiatric evaluations for offenders with schizophrenia with homicide charges in Taiwan

Background: Homicidal offenders with schizophrenia who went through psychiatric evaluations are a small but significant group during a criminal appeal. Aim: Our aims are to explore whether the types of crime, such as homicide or not, would be related to the verdicts for the alleged offenders with schizophrenia in Taiwan. Our hypothesis was that homicide cases, rather than other alleged offenses, would be more likely to be regarded as no responsibility (legal insanity) or diminished responsibility for those defendants in the forensic psychiatric evaluation opinions or the court verdicts. Methods: A retrospective comparison of the homicide offenders with the nonhomicide offenders with schizophrenia, registered between December 2000 and November 2009, was conducted in the web-based, national, open-access court verdict databank. Results: There were 33 (3.4%) in 9691 criminal homicide offenders that had a diagnosis of schizophrenia. There were 33 in the homicide group and 22 in the nonhomicide group. Among these defendants in the homicide group, 3 (9.1%) were regarded as legal insanity, and 21 (63.6%) were regarded as diminished responsibility in comparison to the zero (0%) as legal insanity and nine (40.9%) as diminished responsibility in the nonhomicide group (P = 0.029). In addition, the group with multiple evaluations tended to receive forensic psychiatric opinions as legal insanity (N = 3; 33.3%), and the group with single evaluation tended to receive forensic psychiatric opinions as diminished responsibility (N = 16; 66.67%) (P = 0.017). The group with multiple evaluations tended to be ruled as legal insanity in the court (P = 0.001). Conclusion: Homicide cases would be more likely to be regarded as legal insanity or diminished responsibility for the defendants with schizophrenia in the forensic psychiatric evaluation opinions or the court verdicts.

The relationship of early maladaptive schemas and schema modes with violence risk in persons acquitted by reason of insanity

The legal term “insanity defense” is used to describe people who commit a crime under the influence of a mental disorder. The assessment of the violence risk posed by such individuals is complex, and in global practice, it is typically conducted by a multiprofessional team. How- ever, in Russian practice, psychological evaluation is not carried out since it is believed that psychological drivers lose their significance in the presence of a mental disorder. The article describes the results of a study on the relationship between early maladaptive schemas and schema modes with violence risk in persons acquitted by reason of insanity. Measurements were taken from 58 male patients at the St. Petersburg Psychiatric Hospital, a specialized fa- cility with intensive supervision, ranging in age from 18 to 61 years. These measurements included the level of severity of early maladaptive schemas (assessed using the Young Schema Questionnaire — Short Form Revised), the level of severity of dysfunctional schema modes (evaluated through the Schema Mode Inventory), and the level of violence risk (measured using the Historical Clinical Risk Management Scales — HCR-20 V2). The results obtained using Spearman’s rank correlation coefficient and the Benjamini — Hochberg procedure lead to the conclusion that a weak reliable relationship exists between the schema “Insufficient Self-Control” and the level of violence risk in persons acquitted by reason of insanity. Con- sequently, it is inferred that this schema can be considered a psychological driver of violence risk. The conducted research is the first of its kind in Russia.

The United Nations convention on the rights of persons with disabilities, neuroscience, and criminal legal capacity.

The United Nations Convention on the Rights of Persons with Disabilities requires states parties to 'recognize that persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life.' This mandate has sparked debate about the interpretation of legal capacity, including within the criminal context as applied to the retrogressively named 'insanity defense.' Yet, under-examined are two questions: First, what defenses should defendants with psychosocial disabilities be able to invoke during criminal prosecutions? Second, what kind of evidence is consistent with, on the one hand, determining a defendant's decision-making capacity to establish culpability and, on the other hand, the right to equal recognition before the law? Developments in neuroscience offer a unique prism to grapple with these issues. We argue that neuroscientific evidence of impaired decision-making, insofar as it presents valid and interpretable diagnostic information, can be a useful tool for influencing judicial decision-making and outcomes in criminal court. In doing so, we oppose the argument espoused by significant members of the global disability rights community that bioscientific evidence of psychosocial disability should be inadmissible to negate criminal responsibility. Such a position risks more defendants being punished harshly, sentenced to death, and placed in solitary confinement.

Criminal Insanity: Is It A Reason Enough For Criminals To Get Exempted From Liability? Or Is It Serving As The Loophole For Criminals?

Criminal Insanity: Is It A Reason Enough For Criminals To Get Exempted From Liability? Or Is It Serving As The Loophole For Criminals?

Insanity Defense in Criminal Cases in Courts in Pakistan

The insanity defense is an affirmative defense against the criminal liability of a person suffering from mental disorder. Pakistan incorporated McNaughton Rules in section 84 of Pakistan Penal Code, 1898 according to which a person cannot be held guilty of committing a crime if such a person, at the time of the commission of a crime, was suffering from such a mental disorder which rendered him/her incapable of knowing the nature of the act. This article discusses the substantial, procedural, and evidential law on the defense of insanity in Pakistan in criminal cases in light of the judgments of the superior courts. Furthermore, this article discusses the recent developments in criminal law regarding the defense of insanity in Pakistan. The findings of this research hold implications for legislatures, jurists, judges, lawyers, psychiatrists, psychologists, forensic experts, and policy makers.

Psychosis and conduct disorder in Greek forensic patients found not guilty by reason of insanity: Differences between patients with and those without a history of conduct disorder in childhood or adolescence

Much epidemiological evidence converges in identifying distinct types of individuals suffering from schizophrenia who exhibit aggressive behavior: those with and those without a history of conduct disorder (CD) in childhood or adolescence. In this study a sample of Greek forensic patients suffering from psychotic disorders was examined regarding demographic, clinical, legal and psychometric characteristics. All patients had committed a crime and were found not guilty by reason of insanity (NGRIs) in a court of law. This study aims to clarify whether history of conduct disorder leads to greater violence or shapes the index offense in some way. It also aims to examine new parameters, such as psychopathology, personality traits, substance abuse and risk assessment, not included in the relevant literature so far, and whether they are relevant and why in this specific group of patients. The sample was divided in two groups depending on the history of CD or not, and subsequently statistically significant differences were explored between the groups. The research aimed to highlight specific characteristics of both groups with the ultimate goal of making more accurate prognosis regarding risk assessment, as well as determining different needs for treatment in each group (e.g. drug abuse). Overall, 78 forensic psychiatric records of NGRI offenders were identified throughout a five-year period in the Psychiatric Hospital of Thessaloniki (January 2015 to January 2020), who were divided into two groups depending on the history of conduct disorder in childhood or adolescence (N = 30) or not (N = 48). The two groups were compared regarding hostility and aggression (with the Hostility and Direction of Hostility Questionnaire-HDHQ and the Aggression Questionnaire), personality traits (with the Zuckerman- Kuhlman Personality Questionnaire-ZKPQ), dangerousness (with the Historical, Clinical and Risk Management 20- HCR-20 scale), addiction (with the Addiction Severity Index-ASI), previous violent behavior or convictions (with a semi-structured tool), and psychopathology current and at the time of the index (with the Positive And Negative Syndrome Scale-PANSS). Comparing the two groups (with CD history vs. without CD history) we found that patients with a history of conduct disorder had significantly higher compulsory hospitalization rates up to the time of the perpetration of the offense and a significantly higher rate of illicit drug use. While they were more likely to exhibit violent behavior before the index offense, it was noted that they committed fewer crimes against life. They were younger at the index offense and they presented with more severe positive symptomatology at the time of the research and a steadily high risk assessment score. Our findings underline the importance of diagnosing CD in early life and subsequently raising awareness when this individual develops schizophrenic disorder, thus emphasizing the need for appropriately targeted interventions in each case. Our research also illustrates that forensic patients with both schizophrenia and a history of conduct disorder before the age of 15 exhibit more severe psychopathology after the index crime even after long hospitalization and treatment. Our findings illustrate that the diagnosis of CD in psychotic offenders found not guilty by reason of insanity affects their dangerousness in general, but not the severity of the crimes committed.

Criminal Responsibility (Insanity Defense)

Abstract Criminal responsibility refers to a person’s ability to understand his action, behavior at the time a crime is committed, what a person is thinking when he commits a crime or the expected result when a crime is committed. Crime is defined in terms of an act or omission (actus reus) and a mental state (mens rea). In this paper, is presented the general concept of irresponsibility and essentially reduced responsibility as a reason to be exempted from the punishment provided by the Criminal Code. Any perpetrator of a criminal offense who is capable of undertaking any action can be an active subject of a criminal offense, with the fact that regarding their sanctioning by the criminal system is concerned there are some restrictions related to age as well as dividing the perpetrators into responsible and non-responsible ones. For a person to be convicted of a crime, there must be evidence that proves his guilt, and that proves whether the perpetrator was in a regular state of mind or committed the criminal offense due to his irresponsibility. Another important element of this scientific paper is the historical aspects of how irresponsibility has been treated from the customary law to the present day, a huge focus gets also the treatment of the biological-psychological concept on one hand and the treatment of the legal concept on the other hand for this category of people. A criminal defendant who turns out to have been incapacitated at the time he committed a crime may be acquitted because of his incapacity, or he may be sentenced leniently because he was unable to understand the importance of his actions. Legally, the defendant must prove and convince the court that he was not able to understand his actions, or he is not able to distinguish right from wrong, or he must prove that he committed the act in uncontrolled impulses.

Crazy Minds in Courts

This paper demonstrates how forensic neuropsychology, especially mental disorders, is used in legal cases by providing some basic information and giving two examples, schizophrenia and dissociative identity disorder (DID), explaining both biological and legal aspects. This paper offers information on the history of forensic neuropsychology, tests needed for an insanity defense, and specialists involved. It also puts forward symptoms, etiology, neuroanatomy, pathophysiology, treatments, and some legal cases for both schizophrenia and DID. This paper also makes a connection between the biological and legal aspects of the disorders, concluding that mental disorders may help to argue for retaining rights but unlikely for getting an acquittal.

Insanity as a defence to a criminal charge

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the availability of the special verdict and common law insanity defence in cases where a person with a mental disorder faces a criminal charge.

Neurodevelopmental Disorders, Criminality, and Criminal Responsibility.

Although individuals with neurodevelopmental disorders (ND), such as intellectual disability (ID) and autism, are overrepresented in the criminal justice system, most psychiatry training is limited regarding NDs, and forensic psychiatry training tends to focus on psychotic and mood disorders. This article explores the complex interactions between NDs and criminality, including direct etiological explanations and potential mediating variables (e.g., trauma), to address common training gaps. We compare and contrast current laws relevant to assessing NDs in criminal responsibility evaluations. Not guilty by reason of insanity (NGRI) criteria vary by jurisdiction, with some specifying ID as one possible insanity defense prerequisite while most jurisdictions are nonspecific. NDs in the absence of psychosis or mania often involve impaired cognition (e.g., comprehension, reasoning, social cognition) and behavioral dysregulation. This article provides potential scenarios by which those with NDs might be competent to stand trial but qualify for one or more NGRI prongs. Suggestions for assessment methods (including for malingering) are addressed for this unique population.

Trauma and Suicide Attempts among Insanity Acquittees.

Although many studies have assessed trauma as a suicide risk factor, to the authors' knowledge this is the first study of that risk factor among forensic psychiatric populations. Using a cross-sectional self-report survey methodology, this study investigated trauma histories, adverse childhood experiences (ACEs), posttraumatic stress disorder symptoms, and lifetime suicide attempts among forensic hospital patients adjudicated not guilty by reason of insanity ( n = 107). About 45 percent reported a previous suicide attempt and 22 percent reported multiple attempts, higher than the general population. The average number of attempts was 1.05 (2.39 among those with at least one attempt). The only PTSD symptoms significantly associated with attempting suicide were negative emotions and anhedonia, both in the cognitive/mood cluster, which was the only one of the four clusters to be significantly associated with attempting suicide. Childhood physical abuse was the only trauma significantly associated with attempting suicide. Higher number of attempts was significantly associated with ACEs (emotional neglect and abuse, sexual abuse, physical neglect, and household members with substance-related problems), number of traumas, substance-related problems (especially from alcohol), arousal symptoms (excessive startle, inattention) and negative emotions. We found several statistically significant suicide risk factors, particularly ACEs. Possible explanations and implications of the results are discussed.

Neurodevelopmental Conditions and the NGRI Defense.

Guina et al. summarize the literature on neurodevelopmental conditions and crime, focusing on the use of the insanity plea for this population. There have been a small number of cases in several jurisdictions, using both cognitive and volitional prongs, generating questions about the use of the defense for people with neurodevelopmental conditions. There are theoretical scenarios in which the defense seems appropriate, such as the argument that higher order moral reasoning is contingent on a series of developmental steps, including the development of theory of mind. Other lines of argument could be based on differences in conceptual thinking, reasoning, language, memory, attention, executive functioning, emotional regulation, and impulsivity. There are multiple barriers, however, to the use of the defense, including its antiquated language, which does not reflect our current conceptualizations of mental conditions and disorders. Another barrier is associated with the implicit stigmatization of defining a different way of being as a disorder, a position at the core of the important and burgeoning neurodiversity movement. It is not clear whether neurodevelopmental conditions will become the basis for an increasing number of insanity pleas, but more information in the form of primary data and good analysis is a critical next step.

An insight into the socio-psycho contexts and modus operandi of South Africa’s worst serial killers over time

Over the years, several myths have been peddled within societies and academic circles in relation to exploring the mysterious lives of serial killers. Socio-psycho factors have been used to explain some of their criminal behaviour. Some mythologies about serial killers are that most of them are loners, abused children, and sexually motivated killers. Some researchers have also attributed mental challenges, drugs, and alcohol as possible motives for serial killers. In some instances, some serial killers have confessed to heard unknown controlling voices, urging them to kill their victims. We are not in a rational or neutral position to know whether voices, hearing by serial killers, are actually factual experiences or not. However, to enter a plea of insanity for murder is widely known with the criminal law field. This is the reason why in some cases, offenders are accessed to ascertain their fitness to stand trial. This article deals with a very serious challenging crime and highlights the safety of citizens. The article has three aims, first, to explore and debunk the secretive world of serial killers. Second, to explore the serial killer’s motives and modus operandi. Third, to highlight the dangers serial killers pose to society. Some of the findings are that serial killer does not always live a life of a loner, and some understudy of serial killers found out some of them live a family life. Several serial killers were abused as children and from dysfunctional families and social backgrounds. Most serial killers are men and there is a patriarchal domineering and controlling personality, ascribed to serial killers

Chasms of ‘Perfect Chaos’: Medico-Legal Codifications of Criminal Insanity in Colonial Bengal, 1814-1860

The 19th century in British Bengal was a formative phase for ‘modern’ judicial administration. As integral part of the colonial enterprise, the function of criminal judicature not limited to disciplining an ‘inferior’ race, but also constructing a racial profile of an essentially Indian criminal. This entailed a larger program for the legal codification in the colonies which would put the entire imperial machinery in motion. One of the primary modes of such codification was through a burgeoning medico-legislation. As colonial authorities embarked on a detailed classification crime and criminality in Bengal, they were confronted with the problem of encoding criminal insanity. In a highly racist atmosphere, the Indian insane was sure to be viewed and categorized as everything negative with Indian biology. Touted as naturally prone to violent and often criminal fits of madness, the Indians in general were seen as predisposed to mental degeneration. The problem of distinguishing madness from common criminality in Bengal seemed a problem that had to be overcome by strict adherence to medical objectivity, especially modern psychiatry, but often the involvement of medical professionals in ascertaining criminal or dangerous madness led to a struggle between jurists and medical men in staking the ultimate claim over medico-legal space. This article argues that the medical professional in colonial Bengal, instead of being auxiliary to legal apparatus, shaped and re-shaped narratives of criminal insanity which went into the formulation of medico-legal codification.

Decision-Making Within Forensic Psychiatric Investigations: The Use of Various Information Sources by Different Expert Groups to Reach Conclusions on Legal Insanity.

BackgroundWhich type of information experts use to make decisions regarding legal insanity within forensic psychiatric investigations (FPI) is relatively unknown, both in general and when considering variations due to case context. It is important to explore this area to be able to counteract the effects of various kinds of cognitive bias.MethodThe aim was to explore whether FPI expert groups differed regarding case-specific as well as general use of information types required to make decisions on severe mental disorder (SMD). Three FPI case vignettes were presented to three professional groups involved in FPIs in Sweden (n = 41): forensic psychiatrists (n = 15), psychologists (n = 15), and social workers (n = 11). The participants reported which types of information they required to reach conclusions regarding SMD in each case. They also reported which types of information they had used within general FPI praxis during the previous year and the information types’ perceived usefulness.ResultsThe expert groups differed somewhat regarding what type of information they required for the cases (e.g., results from cognitive testing), but some information was required in all cases (e.g., client’s self-report). Regarding the preliminary assessment of SMD in the three cases, minor differences were found. Within the general FPI praxis, experts reported using several information types, while the general perceived usefulness of these sources varied.DiscussionThe professional groups relied partly on a “core” of information sources, but some case-specific adaptations were found. The professional groups’ inclination to suspect SMD also varied somewhat. This indicates a need to explore the potential consequences of these similarities and differences.

Deep-seated psychological histories of COVID-19 vaccine hesitance and resistance

To design effective pro-vaccination messaging, it is important to know “where people are coming from”—the personal experiences and long-standing values, motives, lifestyles, preferences, emotional tendencies, and information-processing capacities of people who end up resistant or hesitant toward vaccination. We used prospective data from a 5-decade cohort study spanning childhood to midlife to construct comprehensive early-life psychological histories of groups who differed in their vaccine intentions in months just before COVID vaccines became available in their country. Vaccine-resistant and vaccine-hesitant participants had histories of adverse childhood experiences that foster mistrust, longstanding mental-health problems that foster misinterpretation of messaging, and early-emerging personality traits including tendencies toward extreme negative emotions, shutting down mentally under stress, nonconformism, and fatalism about health. Many vaccine-resistant and -hesitant participants had cognitive difficulties in comprehending health information. Findings held after control for socioeconomic origins. Vaccine intentions are not short-term isolated misunderstandings. They are part of a person’s style of interpreting information and making decisions that is laid down before secondary school age. Findings suggest ways to tailor vaccine messaging for hesitant and resistant groups. To prepare for future pandemics, education about viruses and vaccines before or during secondary schooling could reduce citizens’ level of uncertainty during a pandemic, and provide people with pre-existing knowledge frameworks that prevent extreme emotional distress reactions and enhance receptivity to health messages. Enhanced medical technology and economic resilience are important for pandemic preparedness, but a prepared public who understands the need to mask, social distance, and vaccinate will also be important.