crim 103

• Psychopathy


  • Glibness and superficiality (super charming)
  • Grandiose sense of self-worth (high self-esteem)
  • High need for stimulation
  • Pathological lying
  • Cunning/manipulative
  • Lack of remorse
  • Shallow affect (don't show many emotions or fake)
  • Lack of empathy
  • Parasitic lifestyle (uses people to get what they want)
  • Poor behavioural controls
  • Promiscuous sexual behaviour
  • Early behaviour problems
  • Lack of realistic long-term goals
  • Impulsivity
  • Irresponsibility
  • Failure to accept responsibility for actions
  • Many short-term marital relationships
  • Juvenile delinquency
  • Revocation of conditional release
  • Criminal versatility (different kind of crimes)
• Antisocial Personality Disorder (APD)


  Failure to conform to norms, aggressive, irresponsible, impulsive, deceitful, reckless disregard, lack of remorse
• "A pervasive pattern of disregard for, and violation of, the rights of others"(DSM-V)
• Difference between Psychopathy and APD


  • Definition of APD narrower than psychopathy, restricts definitions to behavioural indicators - psychopathy also includes emotional, neurological and cognitive aspects
  • APD is diagnosable mental disorder in the DSM-V; Psychopathy is not
  • APD always includes criminal behaviour; not all psychopaths are criminal
• Types of Psychopaths


  • Primary - innate at birth
  • Secondary - results from severe emotional problems
  • Dyssocial - adopted based on peer culture
• The PCL-R (psychopathy checklist)


  • Assesses affective, interpersonal, behavioural, and social deviance
  • Includes self-reports, observations, reports from collateral sources
  • Rating of 0-2 on each trait
• Categorical vs. Dimensional Approach

  • Categorical Approach: Psychological traits or disorders are seen as distinct categories, where individuals either belong to one category (e.g., have the disorder) or another (e.g., do not have the disorder). Yes or no approach
  • Dimensional Approach: Psychological traits or disorders are viewed as existing on a continuum or spectrum, with variations in severity or intensity being assessed rather than strict categories. Like a sliding scale
• Categorical model: PCL-R cutoff of 30 = psychopath, but this is arbitrary
• Dimensional Model: Everyone has some psychopathic characteristics to a greater or lesser degree
• Core Factors of Psychopathy: The Two Factor Position


  • Factor 1: Interpersonal/emotional components - Shallow affect, remorseless, manipulates others, associates with planned predatory violence, predicts psychology in general
  • Factor 2: Socially deviant - Impulsive, stimulation-seeking, lacks goals, associates with impulsive violence, predicts general and violent recidivism
• The Four Factor Position

  • Factor 1: Interpersonal - Arrogant and deceptive ex. lying and glibness
  • Factor 2: Lifestyle - Ex. impulsive, parasitic, stimulation-seeking , lack of goals
  • Factor 3: Affective - Ex. Lack of remorse, failure to accept responsibility
  • Factor 4; Antisocial behaviour - Ex. poor behavioural controls, criminal versatility
• Psychopathy is strongly linked to crime
• Criminal psychopaths believed responsible for disproportionate amount of crime on society; are most violent and persistent types of offenders
• Psychopaths are 5x more likely for violent recidivism, and 80% of psychopathic sex offenders recidivated
• Causes of Psychopathy


  • Environmental factors - Social Factors may play a role in someone biologically predisposed (ex. Parenting, early abuse, peer rejection)
  • Neuropsychology: Central Nervous System Differences - Left hemisphere deficiency in language processing skills, Right hemisphere deficiency in emotions
  • Frontal Neuropsychological Studies - Psychopaths may have defects in frontal lobe processing
  • Amygdala may be partly responsible for frontal lobe deficiencies
  • Sensation seeking and Optimal Arousal of the Cerebral Cortex - Psychopathic behaviour is an extreme form of sensation seeking
  • Peripheral Nervous System Differences - Psychopaths SNS does not react sufficiently to stress, and that PSNS acts extra quickly
• Tentative Conclusions about Psychopaths

  • Psychopaths are automatically and cortically under-aroused
  • Lack necessary emotional responses and are deficient in avoidance learning
  • If emotional arousal can be induced they can learn to avoid aversive situations
  • With adequate incentives they can learn to avoid aversive consequences
• Arguments against treating Psychopaths


  • Nothing works
  • Psychopathy should be untreatable
  • No research has shown it can be treated
  • More harm than good - General harm - increased recidivism?, Harm to other patients, Use to show good behaviour, Harm to staff
• Directions for treatment of Psychopaths

  • Reasonable expectations
  • Target behaviours for change
  • Motivation
  • Encourage meaningful treatment participation
  • Maintenance
  • Monitor to ensure that changes remain stable
• Schizophrenia


  • Mental illness that impairs perception and expression of reality
  • Ongoing for at least 6 months; serious impact on functioning
  • Positive symptoms: delusions, hallucinations, disorganized speech, catatonic behaviour/grossly disorganized
  • Negative symptoms: affective flattening, alogia, avolition
• Delusion


  A false belief that involves misinterpretation of perceptions or experiences, based on incorrect inference about external reality, firmly sustained despite what most others believe and incontrovertible proof to contrary
• Hallucination


  A perception, in the absence of stimulus, that is believed to be genuine, can involve any of the 5 senses
• Disorganized speech


  Derailment - jumping topics, Tangentiality - answering questions in an unrelated way, Incoherence - speech that is incomprehensible
• Grossly disorganized behaviour/ catatonia


  Childlike or silly, Unpredictable agitation, Inappropriate sexual, Catatonic motor behaviours
• Schizophrenia facts: Prevalence 0.3-0.7%, Age of onset (F late), M:F ratio is close to 1:1, Onset typically slow and gradual, Prognosis, Genetic predictors - 1st degree have 10x greater risk, Enviro predictors - winter birth; urban-born, prenatal virus or famine
• Delusional disorder


  Delusions that last at least 1 month : without other symptoms of schizophrenia, Other than impact of delusions, no marked impairment in psychosocial functioning, Subtypes: eromantic, grandiose, jealous, mixed
• Mood disorder


  Characterized by episodes of various duration
• Depressive episode


  2 week period in which individual experiences, nearly every day: depressed, loss of interest, insomnia, loss of energy, guilt/unworthyness, recurrent thoughts of death or suicide
• Manic episode


  Abnormally & persistently elevated, expansive or irritable mood for 1+ week with 3+ of: Inflated self-esteem/grandiosity, Decreased need for sleep, Talkative, Flight of ideas, Distractibility, Increased goal-directed activities, Increased sec drive and socialbility, Psychomotor agitation, Excessive involvement in pleasurable activities w/ high potential for painful consequences
• Hypomanic episode


  Abnormally and persistently elevated, expansive, or irritable mood for 4+ days, No marked decrease in functioning; activities usually organized (not bizarre), Also 3+: Inflated self-esteem
• Major depressive disorder

  5+ symptoms listed for major depressive episode (no history of manic or hypomanic episodes), Prevalence: 7%; females have 1.5 to 3x higher rate, Peak age of onset in 20's, High mortality rate; ~15% die by suicide
• Bipolar disorders


  Recurrent episodes of significant disturbance in mood, Occur on spectrum ranging from debilitating depression to unbridled
• Bipolar 1 disorder


  Characterized by 1+ manic episodes, Often have hypomanic or depressive episodes, M:F is 1:1 (mean age onset = 18 years), Family history = 10x greater risk, Suicide risk 15x higher
• Bipolar 2 disorder


  1+ major depressive episode and 1+ hypomanic episodes, Is not milder form bipolar 1, prevalence : 0.8%, Average age of onset mid-20s, Genetic risk, High suicide risk; ⅓
• Other mental disorders that may be related to crime

  • Post-traumatic stress disorder
  • Intermittent explosive disorder (anger disorder)
  • Kleptomania (impulse to steal)
  • Pyromania (impulse to start fires)
  • Dissociative identity disorder (aka multiple personality disorder)
• Personality disorders


  Enduring pattern of inner experience and behaviour that deviated markedly from cultural expectations, inflexible , begins in adolescence, stable overtime, Involves changes in 2 of: cognition, impulse control
• Personality disorder subtypes


  • Cluster A: odd and eccentric
  • Cluster B: dramatic, emotional, erratic
  • Cluster C: anxious or fearful
• Fitness to stand trial

  CJ system has a presumption of 'fitness', Issue maybe raised by court, accused, or prosecutor, Court may order a fitness assessment, Acute psychosis is common
• Mental Health Act & Certification


  Provincial legislation designates criteria for involuntary admission and treatment
• Bipolar II disorder


  Not a milder form of bipolar I disorder
• Prevalence of bipolar II disorder: 0.8%