Evaluate the claim "we can predict who will become a criminal"
Sharonhy
Workshop4-PsychopathyMentalDisordersanddrugs.pptxCriminal Behaviour CRM203
Workshop 4: Psychopathy & Mental Disorder
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Matters arising
MCQ upcoming (more details in future weeks)
Remember to have good internet connection
There is enough time, but it is time limited
Read around the topics (don’t just rely on workshop notes!)
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Workshop Overview
Part 1:
What is Psychopathy?
How to measure psychopathy?
Practical implications
Part 2:
Define the concept of mental disorder or mental illness.
Provide an overview of the DSM-V and the diagnoses that are most relevant to criminal behaviour.
Define and review issues relating to competency to stand trial.
Discuss the prevalence of mental illness in incarcerated populations.
Define risk assessment and identify various tests
Network Analysis of Drugs/trafficking
Rather than me reciting B&B / drug names
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B& B = bartol and bartol - the core textbook. This works as a reminder of what the core textbook is (link back to MCQ!) and it also points out that this course is NOT just a repetition of the textbook. We get to underline why coming to workshops is important, and why it’s more than reading a book etc
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PSYCHOPATHY
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A confusion of terms…
Primary Psychopaths
Secondary Psychopaths
Dyssocial Psychopaths
Sociopath
Anti-social Personality Disorder (APD)
Dyssocial Personality – ICD10
Life Course Persistent - LCP
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Sociopathy Vs Psychopathy
"The psychopath is callous, yet charming. He or she will con and manipulate others with charisma and intimidation and can effectively mimic feelings to present as "normal" to society. The psychopath is organized in their criminal thinking and behavior, and can maintain good emotional and physical control, displaying little to no emotional or autonomic arousal, even under situations that most would find threatening or horrifying. The psychopath is keenly aware that what he or she is doing is wrong, but does not care.
"Conversely, the sociopath is less organized in his or her demeanor; he or she might be nervous, easily agitated, and quick to display anger. A sociopath is more likely to spontaneously act out in inappropriate ways without thinking through the consequences. Compared to the psychopath, the sociopath will not be able to move through society committing callous crimes as easily, as they can form attachments and often have 'normal temperaments.' . . .“
Kelly McAleer, Psy.D
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Sociopathy Vs Psychopathy
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Psychopaths in the workplace
5 Phase model
Entry – charm and social skills to obtain employment; hard to spot; helpful, even benevolent
Assessment – weigh up your usefulness: pawn (easily influenced) or patron (protect against attacks)
Manipulation – create ‘psychopathic fiction’ – positive info about self, misinformation about others, pawns or patrons used
Confrontation – character assassination to maintain agenda
Ascension – patron discarded and power claimed by psychopath
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Female Psychopaths…
May be more violent to close intimates
Use manipulation, flirtation, or coercion instead of physical aggression to achieve control
More likely to have been a victim of sexual abuse
BUT
Equally likely to use drugs and alcohol
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Are you a psychopath?
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This is the Trolley problem. If you want, you can find videos of this – there are some nice ones, or just guide them through it. Even if they already know it, you can discuss and debate the morals of it etc.
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The proposition
There are some individuals “who demonstrate a discernible cluster of psychological, interpersonal and neurological features that distinguish him or her from the general population” (Bartol &Bartol)
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DSM V
The requirement of six out of seven trait facets with a resulting broader representation of psychopathic personality traits (e.g., callousness, manipulativeness) provides for a more severe presentation of Antisocial PD that is more reflective of what has always been the target construct for this disorder (e.g., Hare, 1996)
However, constraining the DSM-5 conceptualizations to pre-defined conceptual theories of psychopathy likely does not take full advantage of this emerging model in providing psychopathy-relevant trait information.
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DSM V
Psychopathy scholars continue to debate a variety of important issues, including (but not limited to) optimal factor structures (e.g., Cooke et al., 2006; Hare & Neumann, 2008), whether antisocial/criminal behavior should be part of the construct (e.g., Skeem & Cooke, 2010; Hare & Neumann, 2010), and the role of fearless-dominance/boldness in psychopathy (e.g., Lilienfeld et al., 2012; Miller & Lynam, 2012).
Moreover, scholars also continue to ponder which elements need to be present to constitute psychopathy (or “primary” psychopathy), including whether affective-interpersonal traits (e.g., callousness, deceitfulness, social potency) are sufficient in isolation (Lilienfeld, 1994; Poythress & Hall, 2011) in light of that not all individuals high on psychopathy are impulsive (cf. Hicks et al., 2004; Poythress & Hall, 2011).
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Clinical Description
Various historical descriptors based around concepts such as moral insanity, sexual depravity or problems with affect
Today we base it on developments from Cleckley’s The Mask of Sanity
Which Hare (1970) has formalised into the Psychopathy Check List. This has been revised and is now referred to as the PCL-R.
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Before we begin…
Do you all know what factor analysis is?
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This is important for students to know, because it will underpin our understanding of psychopathy. We need to know that it is a statistical approach, and as such there are issues within it.
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PCL-R Factor 1
Glibness, superficial charm, sociable, outgoing, easy to get on with
Grandiose sense of self worth
Need for stimulation/excitement, prone to boredom
Pathological lying
Cunning, manipulative interpersonal skills, often based on charm
Lack of remorse or guilt
Shallow affect
Lack of empathy; callous; unable to love: selfish; egocentric; non-altruistic; non-empathic except as a means of manipulation. "The psychopath's inability to feel genuine, meaningful affection for another is absolute“
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PCL-R Factor 2
Parasitic life style
Poor behavioural controls
Promiscuous sexual relations
Early behaviour problems
Lack of realistic, long term goals
Impulsivity
Irresponsibility
Failure to accept responsibility, no insight
Many short term-marital relationships
Juvenile delinquency
Revocation of conditional release
Criminal versatility
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PCL-R
PCL-R is scored on a 0 (not present) 1(inconsistently present), 2 (consistently present)
Cut off scores vary between 21 to 33
It does have utility as a predictor but it is not the best predictor
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Factor Analysis
Two Factor
Factor 1 – the empathy factor (emotional make up and responses)
Factor 2 – the impulsivity factor (the antisocial traits). This is the better predictor of recidivism.
Three Factor
Adds the grandiose factor
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Factor Analysis II
Four Factors
Interpersonal – lying, manipulative
Impulsive
Affective – empathy and grandiosity
Antisocial – poor regulation, criminality
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Factor Analysis II
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Additional Attributes
These are sometimes included in descriptions
Appears intelligent; often well informed; willing to give views on almost anything (Cleckley suggested above average)
Absence of psychotic symptoms
Absence of anxiety
Egocentric
Cool, calm & collected. Able to withstand severe stress
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The issues of treatment
Cleckley in particular started the thesis that psychopathy was not treatable
The belief that psychopaths do not benefit from treatment is firmly entrenched with some and entirely rejected by others
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The issues of treatment
Firstly this assumes the existence of psychopathy
Secondly it blames the person for the lack of effective treatment – the treatment worked, it’s a pity the patient died!
Thirdly, here is what we know: the PCL-R identifies high risk individuals; these individual are the most entrenched individuals (start earlier etc); entrenched behaviour is the most difficult to shift; entrenched behaviour requires considerable doses of treatment; treatment programs have historically targeted the wrong needs; treatment programs are not sufficiently funded;
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The issues of treatment
There are many treatment programmes that have demonstrated effectiveness for high risk offenders but they do not measure psychopathy and do not treat psychopathy
These programs focus on criminogenic needs
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OPTIONAL IF YOU WANT TO USE THIS
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Biological explanation
A variety of biological indicators have been found in psychopaths
There are now a variety of biological explanations
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Hemispheric Dysfunction
Hemispheric dysfunction theory suggests left hemisphere is dysfunctional in that it does not provide sufficient control over impulsivity ie poor self regulation.
Some suggestion of right hemisphere dysfunction – emotions not felt as strongly.
Note these are consistent with the two major dimensions: poor impulse control and indifference to others.
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Executive Function Problems
There is evidence that high risk offenders have executive control problems
Executive control lies in the pre-frontal cortex and is responsible for organising, planning and inhibition – for consequential thinking
This evidence points to pre-frontal lobe damage or dysfunction as a potential explanation for psychopathy
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Amygdala Dysfunction
As already noted, the amygdala is critical in emotional processing
There is evidence that damage or dysfunction is seen in psychopaths
This would explain the lack of emotional responding and would be consistent with the lack of empathy dimension
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ANS Under Arousal
Electrical conductance of skin of psychopaths is lower than normals
Suggests under-activity of sympathetic or over-activity of parasympathetic nervous system
Implication: ANS does not respond to external threat and/or ANS filters information to CNS
Thus they tend to have lower levels of anxiety
Autonomic Nervous System
(regulates the internal organs without conscious recognition or effort)
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ANS Under Arousal
Anxiety might be important for avoiding bad behaviour because
Bad behaviour leads to punishment which results in anxiety and with pairing bad behaviour leads to anxiety which we avoid. It could explain the non-learning.
We avoid bad behaviour because it makes us look bad. Looking bad causes us anxiety. Thus we like to do good to avoid the anxiety/feeling guilty. That is altruistic behaviour avoids anxiety. It could explain the callous trait.
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ANS Under Arousal
ANS under arousal also explains the impulsivity/sensation seeking activities of psychopaths. That is, they are under-aroused and seek out arousal.
Here’s an observation: many high risk violent offenders describe themselves as “pretty laid back, really”. Why?
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Environmental Factors
There is little doubt that environmental factors impact on criminality
Poor parenting evidence is very robust
There are two explanations for the biological evidence
Poor parenting causes the evidence (but this does not explain the genetic evidence)
It is a double edged sword: people who have these conditions are poor parents and they pass them onto their children
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Classification Issues
Psychopathy is a very powerful negative label, particularly in the UK and North America. It is less significant in Australia.
It describes a cluster of attributes which are considered (by some) to be a class. The very first question is whether or not the label has meaning.
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Issues with Classification
Problem of labelling. Labels focus our attention on the attributes in common not in distinction. Sometimes, as in psychological classifications, there are greater differences than there are similarities.
But are labels necessary for communication, prediction and decision making; especially true for CJS.
Does this label add to our understanding?
There are few prototypical cases. Most only have some of the attributes of the class. They are more defined by the heterogeneity than their homogeneity.
There is considerable variation in psychopathic traits from outright villains to heroes
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Issues with Classification
Furthermore, some characteristics of psychopathy are also characteristics of other personality disorders. This makes differential classification/diagnosis very problematic.
Dichotomous versus continuous distinction.
Difference in kind or difference in degree?
Classification systems require reliable criteria, consistency of usage and theoretical relevance to explanation and prediction
Hare has attempted to produce a reliable criterion – based on his test! PCL-R is a reliable and valid predictor in some circumstances of recidivism but not the best.
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Issues with Classification
The argument goes: high risk offenders are psychopaths. The PCL-R identifies high risk offenders; therefore the PCL-R identifies psychopaths; therefore psychopaths exist!!
Risk – again, one of the identification variables is high risk of re-offending. High recidivism is an indication of psychopathy. This is circular since high risk offending is merely high risk offending.
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Issues with Classification
Label confusion – term has been changed from sociopath to psychopath to ASPD or APD and there have been changing criteria.
Varying degrees of moral overtones - now has strongly pejorative connotations “intra-species predator”
Aetiological confusion – causation is unclear (almost totally)
Are we dealing with just one condition?
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Psychopathy- in sum
Is it a moral judgement or a clinical diagnosis? (does it vary depending on context?)
Is it a useful ‘diagnosis’
Is it more harmful than helpful?
If we cannot agree on a definition, how can we agree on causes, or outcomes?
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Mental Disorders (and drugs)
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Lecture Overview
Define the concept of mental disorder or mental illness.
Provide an overview of the DSM-V and the diagnoses that are most relevant to criminal behaviour.
Define and review issues relating to competency to stand trial.
Discuss the prevalence of mental illness in incarcerated populations.
Define risk assessment and identify various tests
Network Analysis of Drugs/trafficking
Rather than me reciting B&B / drug names
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NOTE: make it clear that I am not suggesting the use of drugs (for clinical reasons) is related to criminal reasons. I am just trying to give students something ‘new’ to think about. A new method, and a relation to criminology.
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Identification issue
Deviation from a statistical norm (statistical abnormality) – IQ, MMPI
Deviation from a cultural norm (cultural or value concept of abnormality).
Maladjustment - the person does not meet the demands placed upon him/her. (A distress concept - could be normal both culturally and statistically).
Disordered - a system thrown into confusion, disarray
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Bartol & Bartol definition
A disorder of the mind that is judged by experts to interfere substantially with a person’s ability to cope with life on a daily basis (page 238)
The judgment is by experts – this is a clinical versus forensic distinction
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Problems of identification
A disorder not an illness
Cannot be objectively seen – there are no micro-organisms, lesions or broken bones, furthermore it is likely that there are many “causes” for the same disorder ie diagnosis does not produce aetiology, treatment or prognosis
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Problems of identification
Is inferred – it is a subjective evaluation (even if it is dressed in objectivity) of another’s behaviour generally with the aim to control
(note historically it wasn’t even behaviourally based)
Radical criminology & anti-psychiatry have argued that both criminal law and psychiatry are part of the same mechanism of control of deviance.
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Diagnosis
Diagnostic and Statistical Manual – DSM-V of American Psychiatric Association
World Health Organisation International Classification of Diseases ICD–10 Chapter V
DSM used in America, ICD-10 used in Europe
Both used in Australia
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Crime and Mental Disorder
Strong views in society that mental disorder is related to crime probably based on media portrayal and fear
Mentally ill persons act outside normal rules & this might “logically” run to legal rules
We believe that some acts are so abhorrent that they could only be done by a person who was insane (although the evil line is gaining momentum).
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Crime and Mental Disorder
Are there any categories of mental disorder that are relevant to crime?
Relevance means:
Increasing risk or causally linked
Criminal responsibility
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Diagnoses relevant to crime
Schizophrenia
Paranoid disorders
Mood disorders
Personality disorders – especially APD or Dissocial Personality Disorder (ICD-10)
Intellectual disability
Substance abuse
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Schizoprenia
Severely disturbed – thoughts, feelings or perceptions
Positive categories – excess or distortions (delusions or hallucinations)
Negative categories – losses of normal function (emotional & cognitive flattening resulting disorganised speech and behaviour and inappropriate affect)
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Delusions
Persecution beliefs common: being tormented, followed, tricked, spied on, or being made fun of.
Some people believe that certain gestures, comments, passages from books, newspapers or movies (and so on) are directed specifically at them.
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Hallucinations
Perceptual disturbances
Auditory most common
Command hallucinations critical
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Paranoid Schizophrenia
Delusions or hallucinations only and no signs of disorganisation or flattening of emotions
Specific themes often of persecution
Higher risk of committing a violent offence and/or of hurting themselves
Risk is significantly increased in a background of anti-social behaviour especially violence
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NOTE: these have been changed in the latest DSM-V.
I recently worked a case with a “paranoid schizophrenic” – might be worth asking students to find/research some cases, and talk about the offender, their behaviour and process etc. Set it as ‘after workshop work’ if you want
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Paranoid Disorders
Delusional disorders with paranoid theme
Differential diagnosis problematic but needs to be present for 1 month as opposed to 6 months and is more generally suspicious as opposed to clearly delusional
Increased risk especially in presence of anti-social history
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Mood Disorders
The DSM-V identifies a variety of mood disorders
Bipolar which is a combination of mania and/or depression
Depressive disorders
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Mood Disorders: Depression
Depression: includes hopelessness, increased irritability (especially children)
Loss of interest or pleasure – don’t care any more
Risk is elevated in juveniles and those who think others are better off dead
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Mood Disorders: Mania
Abnormally and persistently elevated, expansive, or irritable mood (which may alternate)
Poor judgment often leads to activities that are likely to have painful consequences
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Mood Disorders: Mixed
Some people have both a Manic Episode and a Major Depressive Episode occurring daily. This is frequently referred to a manic depressive psychosis or bipolar mood disorder.
The swings can occur at very short notice
This condition seems to be related to serious violence which may also involve self harm– ie homicide, especially of loved ones
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Personality Disorders
Anti-social personality
Borderline personality disorder – extreme emotionality & impulsivity
Narcissistic personality disorder – extreme sense of entitlement
ICD-10 different terms
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Anxiety Disorders
Appears very similar to heart attack
Fear of dying, lose control, have a heart attack or go crazy & the need to flee
Not common, probably under-represented in offenders, but
Anxiety does occur when in prison
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Intellectual Disability
Normal prevalence rate is around 2%
Rates in prisons as high as 10%
Over-represented in violent offences & a risk factor if sexually offending
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Substance Abuse
Will deal with this material later, but it is evident that substance abuse and crime have a link.
Note and this is a very important note, no causality is being inferred!!!!
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Mental disorder and criminal law
Fitness to plea
Not guilty on grounds of insanity
Intersection between criminal justice system and mental health system
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Mental unfitness to stand trial
Criminal Law (Mentally Impaired Accused) Act
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S9 unable to understand
nature of the charge;
requirement to plead to the charge or the effect of a plea;
purpose of a trial;
the right to challenge jurors;
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S9 unable to understand
follow the course of the trial;
understand the substantial effect of evidence presented by the prosecution in the trial; or
unable to properly defend the charge
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Insanity
Criminal code S 27 Insanity
(1)… not criminally responsible … if at the time of doing the act … (had) a state of mental impairment as to deprive him of capacity to understand what he is doing, or … to control … to know that he ought not to do the act … .
(2) … being delusional is not automatic insanity
Essentially based on McNaughton rule
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Bartol & Bartol
Two Criteria
Irrationality: Person was not in control of his or her mental processes at the time of the offense
Compulsion: Person was not in control of his or her behavior at the time of the offense
And not knowing right from wrong
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Insanity defence
Insanity defence generally used very conservatively, diminished responsibility preferred tactic (indeterminacy versus mitigation)
Insanity can lead to indefinite detention in prison or hospital
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Mentally Impaired Accused
People who have found unfit or insane
Detained in
Detention centre – juvenile
Prison
Approved hospital
Declared place
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Other
Prisoners with serious mental illness (schizophrenia) in acute phase – may be serviced by State Forensic Mental Health Services (SFMHS)
Parolees with serious mental illness may be serviced by SFMHS
Mental Health Act part 3 – Involuntary Patients
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Mental illness & offenders link
What are the strategies?
Longitudinal studies – follow a cohort
Examine mental illness in offenders/prisoners
Examine criminality in mental patients
Longitudinal studies are expensive and rare
Definitions of disorder always a problem (APD, substance abuse etc)
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Risk Assessment
Statistical versus clinical judgement
Aim is to identify level of risk
Some instruments identify risk factors (HCR 20)
Some instruments identify level of risk only (LSI-R)
Some instruments identify risk for specific offences (VRAG, SORAG, STATIC 99)
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Summary
Mental disorder alone is not a predictor
Heterogeneity in mental disorder category
Mental disorder (schizophrenia, intellectual disability) increases risk for risky people
Mental disorder basis for some offenders
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Key Issues
Care/treatment for seriously disordered or protection from serious offenders
What do we do with seriously disordered serious offenders?
Should a person be sentenced on proportionality or on responsibility?
Can diminished responsibility be used to give a person a lower sentence and a higher sentence?
Has de-institutionalisation impacted on CJS?
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What does this mean?
The law is dichotomous but disorder is continuous – it results in a discontinuous system especially once sentenced. Disorder can be treated or transient for other reasons but a criminal act is not.
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Drugs and networks
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Case Study: Jeffrey MacDonald
Aka: Green Beret Killer
Accused (and prosecuted) of killing his entire family
Wife, 2 children
Why?
Speculation his diet pills were a factor: Eskatrol Spansule (15mg Dextroamphetamine) (“Speed”) and 7.5mg Prochlorperazine (Compazine) to counteract the excitability of the speed
Taking 3-5 pills daily for 3-4 weeks prior
Would that be enough to lead to ‘chronic amphetamine psychosis’
Would that explain the murders?
Symptoms of cessation? ‘extreme fatigue and mental depression’
Why are we so quick to conclude “stimulants cause homicide” – we wouldn’t say “heroin causes burglaries”
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This is a very interesting case, if students want to learn more, they can read my recent publication:
Matrix Forecasting and Behaviour Sequence Analysis: Part of the Timeline Toolkit for Criminal Investigation
https://link.springer.com/article/10.1007/s11896-020-09367-1
I’ll upload the pdf
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Drug trafficking and networks: CSA
A. Search customer: walk to spot lone with white male, 30-49 years of age
B. Solicit customer: say type of drug(s) for sale when face-to-face
1. Agree on terms: agree to provide 1 gram of cocaine for $50
2. Make exchange: fulfill agreement
C. Arrange place/time: tell customer to walk together to nearby place ASAP
Start
Steps A, B, C are facilitating steps
Steps 1, 2 are necessary steps
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If students want to know more about CSA, they can read my school shooter paper, or my recent ‘Timeline Toolkit’ paper (I’ll upload both)
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Drug trafficking and networks: CSA
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Drug trafficking and networks: CSA
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Drug trafficking and networks: SNA
What is (social) Network Analysis
Network Analysis: interpreting the relationship between ‘nodes’ (individuals, factors, ‘points of interest’)
Relationships: connections between nodes
Connections: (influence, interaction, supply)
Node
(entity, person,
system group)
Tie / Link
(relationship/
connection between
2 nodes)
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What is (social) Network Analysis
Drug trafficking and networks: SNA
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What is (social) Network Analysis
Drug trafficking and networks: SNA
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Drug trafficking and networks: SNA
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What is (social) Network Analysis
Drug trafficking and networks: SNA
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What is (social) Network Analysis
Drug trafficking and networks: SNA
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In sum
How can these methods help us ‘work’ a cold case?
Understanding a script?
Networks of connections?
Can they be combined?
Why do we think that drugs cause crime?
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