Non-intimate Relationships and Psychopathic Interpersonal and Affective Deficits as Risk Factors for Criminal Career: A Comparison Between Sex Offenders and Other Offenders

Sex-offenders are at risk of criminal recidivism. For the treatment to be truly effective, it must be individualized. For this purpose, an accurate assessment should focus on criminological, psychological, and psychopathological features. The present study compared sex offenders with other offenders on historical experiences (i.e., problems with violence, anti-social behaviors, problems with personal relationships, problems with substance use, traumatic experiences, and parenting style). In addition, given the association between life events and psychopathy, we explored whether the relation between life events and crime type (sexual crime vs. other types of crime) might be moderated by psychopathy traits (interpersonal and affective deficits and antisocial behavior). Eighty-eight sex offenders (76% of whom child molesters) and 102 other offenders were included. The Historical, Clinical and Risk Management - 20 item Version 3 (HCR-20V3) and Psychopathy Checklist-Revised (PCL-R) were administered. The scores of the HCR-20V3 Historical scale items were computed to assess life events. The scores of the PCL-R factors, F1 Interpersonal affective deficits and F2 Antisocial behavior, were recorded. The presence of a history of problems with non-intimate relationships was the only significant risk factor for sexual crime compared with other crimes. Interpersonal and affective deficits provided an increased likelihood of being sex offenders as compared with other offenders when problems with non-intimate relationships were possibly/partially or certainly present

The "Bestie of Satana" murders

In recent years, satanic groups have been responsible for various types and degrees of crimes. We report the case of a number of murders committed in Italy by a group of young people calling themselves the “Bestie di Satana”. Forensic psychiatric assessment of the members of a satanic sect charged with the crime revealed that all the young people had a fragile, immature personality, a very low level of education and were socially disadvantaged. The trial of the members of the “Bestie di Satana” sect was concluded with the verdict of deliberate murder, and all the members were given long jail sentences. This report should lead us to explore social and cultural responses to juvenile satanism, statistically shown to be a relatively rare phenomenon but with a high criminal potential

La gestione degli autori di reati sessuali tra psicopatologia e rischio di recidiva, prospettive trattamentali

Sex crimes provoke alarm and strong reactions from the public to a greater extent than any other type of crimes; this occurs especially when the victims are perceived to be particularly weak subjects and/or the perpetrators are affected by psychiatric disease. For these reasons, over the last few years a growing attention has been paid to abusive sex behaviors in the medical and legal fields, leading to the introduction and development of legal procedures and alternative treatments to allow comprehensive management of the different aspects of the phenomenon. This paper analyzes the relationship between mental disorders and sex crimes. Moreover, we focus on the treatment programs offered to sex offenders in some European and North American countries and, in view of the reported results, evaluate their possible introduction in Italy. Such programs are currently in force in many countries, including the United States, Scandinavia, France, Germany, Poland and the United Kingdom. They include a first phase of evaluation of the level of risk posed by the perpetrator, followed by a treatment phase, that often includes psychiatric therapy and the use of drugs. To illustrate this type of approach, we describe the U.S. and the German experiences of subject evaluation and classification, as well as the treatments administered and the benefits observed. The data available on sex offenders show a strong risk of reiteration of the crime and therefore the need for a specific management of the problem. This has convinced certain countries to adopt specific treatment strategies, even mandatory ones, that raise ethical and legal issues, especially when they involve the mandatory use of drugs. We believe these issues warrant further in-depth analysis, as well as evaluation of the role that such programs could have in Italy

Il satanismo acido. Alcune riflessioni su due recenti casi

Gli Autori si soffermano sul fenomeno del satanismo \u201cgiovanile\u201d o \u201cacido\u201d, termine con il quale si intendono di solito gruppi \u201corganizzati\u201d di giovani che celebrano riti satanisti, condividono luoghi, abbigliamento, simboli, gesti, musica e, soprattutto, sostanze stupefacenti. Spesso sotto l\u2019effetto di alcool e droghe i satanisti \u201cacidi\u201d commettono gesti dissacratori, e, talvolta, reati violenti fino ad arrivare a delitti efferati, come nei casi che qui si presentano. Si tratta di delitti commessi da gruppi che si davano una definizione di satanisti, ma che non coincidevano affatto con il fenomeno storico-culturale del satanismo, trattandosi piuttosto di giovani marginali e violenti.The authors dwell in particular on the phenomenon of "juvenile" or "acid Satanism". This term generally means "organized" groups of young people celebrating Satanic rites, having in common and sharing places, clothing, symbols, gestures, music, and most of all drugs. Often under the influence of alcohol and drugs the Acid Satanists often commit irreverent gestures, and sometimes, violent crimes or heinous crimes, as in the cases presented here. The murders were committed by groups of young people defining themself Satanists, having however no coincidence with the historical and cultural phenomenon of Satanism, being rather marginalized and violent young people

Psychopathy in sex offender: A study on a sample of apulian prisoners

Objective. To identify the possible presence and degree of psychopathy, in a sample of detained sex offender and to further evaluate the possible effect of traumatic experiences. Materials and methods. As part of a larger national project, sex offenders of Puglia were selected among the prisoners at the Bari prison and in the detached section of Altamura. Psychopathy levels were measured through PCLR. Item 8 of HCR-20 v.3 was used to evaluate history of traumatic experiences and victimization episodes. Furthermore, criminological information was collected. Results. Recruited detainees had received convictions for child sexual acts in 70% of cases. The levels of psychopathy that emerged, were in line with those found in other prisoner populations and generally in the medium-low range of PCL-R scores. Prisoners with a history of traumatic experiences had higher levels of psychopathy, as measured by the total PCL-R score and factor 1 (“interpersonal/affective”). Conclusions. The results emerged, deriving from a numerically limited sample, suggest a possible effect of early traumatic experiences in the qualitative and quantitative levels of psychopathy in sex offender

Sex offenders in jail: A mini review of treatment programs and outcomes

The debate in the scientific literature about sex offender treatment and its effectiveness remains divided and controversial. Several studies have uncovered that psychological treatment reduces the risk of recidivism in such subjects (Gallagher, et al., 1999; Hall, 1995; Hanson, et al., 2009; Hanson et al., 2002; Lösel & Schmucker, 2005; Reitzel & Carbonell, 2006; Schmucker & Lösel, 2008, 2015), whilst other studies have shown that there is insufficient evidence for this conclusion (Furby, Weinrott, & Blackshaw, 1989; Harris, Rice, & Quinsey, 1998; Kenworthy, et al., 2004; Rice & Harris, 2003). In order to clarify which treatments are applied to the sex offender population in jail, together with the associations between these treatments and reduced risk of recidivism, the present study comprised a review of the literature to determine the current state of research in this area

Excellence in forensic psychiatry services:International survey of qualities and correlates

Background Excellence is that quality that drives continuously improving outcomes for patients. Excellence must be measurable. We set out to measure excellence in forensic mental health services according to four levels of organisation and complexity (basic, standard, progressive and excellent) across seven domains: values and rights; clinical organisation; consistency; timescale; specialisation; routine outcome measures; research and development. Aims To validate the psychometric properties of a measurement scale to test which objective features of forensic services might relate to excellence: for example, university linkages, service size and integrated patient pathways across levels of therapeutic security.Method A survey instrument was devised by a modified Delphi process. Forensic leads, either clinical or academic, in 48 forensic services across 5 jurisdictions completed the questionnaire. Results Regression analysis found that the number of security levels, linked patient pathways, number of in-patient teams and joint university appointments predicted total excellence score. ConclusionsLarger services organised according to stratified therapeutic security and with strong university and research links scored higher on this measure of excellence. A weakness is that these were self-ratings. Reliability could be improved with peer review and with objective measures such as quality and quantity of research output. For the future, studies are needed of the determinants of other objective measures of better outcomes for patients, including shorter lengths of stay, reduced recidivism and readmission, and improved physical and mental health and quality of life.</p

Qualitative analysis of the capacity to consent to treatment in patients with a chronic neurodegenerative disease. Alzheimer's Disease.

Objective: Informed consent is an essential element in doctor–patient relationship. In particular, obtaining valid informed consent from patients with neurocognitive diseases is a critical issue at present. For this reason, we decided to conduct research on elderly patients with Alzheimer’s disease (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) to assess their capacity to make treatment decisions. Methods: The experimental group comprised 70 Alzheimer patients who were admitted to the Neurodegenerative Disease Unit of the University of Bari. The control group consisted of 83 elderly patients without neurocognitive disorders who were hospitalized in the Geriatric Unit at the same university. After providing written consent to participate in the research, each subject underwent the following assessments: (a) assessment of comprehension sheet, (b) Neuropsychiatric Inventory (NPI) and Global Functioning Evaluation (GFE), (c) neurological evaluation, (d) neuropsychological assessment with a full battery of tests, (d) The MacArthur Treatment Competence Study (MacArthur Competence Assessment Tool for Treatment (MacCAT-T); understanding, appreciating, reasoning and expressing a choice) and (e) a semi-structured interview administered by the patient’s caregiver. Results/conclusion: The present survey was designed to analyze possible qualitative and quantitative correlations between cognitive functioning and capacity to consent in relation to different degrees of severity of the neurodegenerative disorder. A large portion of the patients in our experimental sample did not appear to have the capacity to provide a valid consent. The authors present initial results of this study and discuss their possible implications

ADHD and illegal conduct: a survey in Juvenile Justice Services in Puglia

Obiettivo. Obiettivo del nostro studio è stato quello di individuare possibili fattori psicopatologici correlati alla messa in atto di condotte antigiuridiche da parte di minori al loro primo reato, nonché eventuali altre variabili individuali, familiari, economiche e socioculturali correlate al fenomeno indagato. Materiali e metodi. È stato condotto uno studio longitudinale su minori della Regione Puglia (Distretto della Corte di Appello di Bari e Lecce) al loro primo reato. Lo studio ha comportato l’acquisizione di una serie di informazioni anagrafiche, familiari, scolastiche, comportamentali e cliniche dei minori arruolati lungo un arco di tempo di oltre un anno e seguiti in follow-up per 18 mesi. Per le sue finalità lo studio prevedeva l’utilizzo di due scale cliniche standardizzate (Youth Self-Report e Conners Adolescent Self Report Scale). Risultati. L’indagine ha fatto emergere alcune variabili psicologiche e psicopatologiche correlate alle condotte antisociali di minori al loro primo contatto con l’Autorità Giudiziaria, nonché altre familiari, sociali e scolastiche. Conclusioni. I risultati ottenuti confermano la necessità di una prevenzione primaria e secondaria su minori a rischio, attraverso interventi multidisciplinari, precoci, selettivi