Gabriele Rocca

Delinquency and alcohol use among adolescents in Europe: The role of cultural contexts:

This paper presents cross-cultural research using data from the Second International Self-Report Delinquency Study (ISRD-2) to evaluate the strength and characteristics of the relationship between different kinds of juvenile delinquency and alcohol use, and to investigate whether, and how, different drinking cultures may influence this relationship. The setting is a school-based survey with a self-report questionnaire in a sample of 7th, 8th and 9th grade students (comprising 12–16 year olds) from 25 European countries. After recording data on alcohol consumption among young people in different European countries, we assessed the degree to which property offences, violent offences and gang membership were associated with the use of alcohol. In addition, a multilevel analysis (MLA) was carried out to ascertain whether the association between delinquency and alcohol use was influenced by variations in drinking cultures. Different drinking patterns were observed in Mediterranean and non-Mediterranean countries. Alcohol consumption was more closely related to involvement in violent crimes than to property offences, and correlated with the frequency and seriousness of delinquent behaviour everywhere. MLA showed that gang membership increased the probability of alcohol abuse to a greater degree in non-Mediterranean countries, while involvement in delinquency proved to be associated with alcohol abuse to a similar degree in the different cultural contexts considered. With regard to cultural influences on the relationships between juvenile delinquency and alcohol use, we ascertained that cultural attitudes towards alcohol influence the delinquency–alcohol relationship at the group level rather than the individual level.

Matricide by Mentally Disordered Sons Gaining a Criminological Understanding Beyond Mental Illness—A Descriptive Study

Matricide is one of the rarest of reported murders and has always been considered one of the most abhorrent crimes. Psychiatric investigations as to why a son might murder his mother yield indications of a high rate of mental illness, primarily psychotic disorders, in perpetrators. In an attempt to gain an in-depth understanding of the role of the mother–son bond in the etiology of matricide by mentally disordered sons, this article presents a qualitative study of nine cases of matricide examined at two Italian Forensic Psychiatry Departments between 2005 and 2010 and retrospective analysis of forensic psychiatry reports on the offenders. Most matricides suffered from psychotic disorders, especially schizophrenia. Nevertheless, not all the perpetrators had psychotic symptoms at the time of the crime. A “pathologic” mother–son bond was found in all cases. However, mental illness is not the only variable related to matricide and, taken alone, is not enough to explain the crime. Several factors in the history of the mother and son need to be probed, especially how their relationship developed over the years. The peculiar dynamics of the mother–son relationship and the unique personalities and life experiences of both subjects are the real key to cases of matricide.

P-677 - Personality disorders and criminal responsibility in italy: forensic psychiatric considerations about the importance of going beyond a categorical view

In 2005 the Italian Supreme Court held that also persons suffering from “severe personality disorders” may enter a plea of NGRI. Since then, offenders with personality disorders have become a challenge for the Italian forensic psychiatric system, because criminal offenders have a high rate of personality disorders and the identification of the “severe” threshold is particularly difficult in a jurisdiction which includes the volitional prong. The aim of this study is to determine how personality disorders are viewed in relation to criminal responsibility within the Italian criminal judicial system, discussing the results in light of evidence from international literature. We conducted a retrospective study of sentences of the Italian Supreme Court between 2006 and 2010, collected via a judicial database and we reviewed the articles published in English from 2000 to 2010 with the keywords “personality disorder” and “criminal responsibility”. The results indicate that personality disorders have become very common in Italian insanity defense cases. The disorders most frequently indicated are antisocial, borderline and non otherwise specified. The majority of these are associated with another Axis I disorder, in particular with substance abuse. According to the literature, the proof of a “mental disease” is necessary, but not sufficient, to establish an “insanity defense”. In fact, in forensic psychiatry a mental disorder can be defined as “insanity” only if, in the specific case, it has caused such “psychopathological functioning” of the acting subject as to compromise his capacity for cognition and/or volition and that it was causally linked with the crime.

Suicide with "Florbert shotgun": case report.

Abstract The authors describe the case of a suicide with a shotgun charged with 9 caliber Flobert cartridge, that, if shot at a distance, generally does not cause mortal wounds. In the case in re, on the contrary, the mortal gunshot had been discharged in contact with the roof of the mouth causing not particularly destroying cranium-encephalic wounds. Consequently, there is description of the features of the entrance wound and of intracorporeal path, which can simulate distance wounds caused by handguns charged with classic small caliber cartridges.

The Working Alliance in Psychotherapy: Risk, Criticism and Perspectives in the Italian Context

This paper investigates which factors inherent to the various forms of psychotherapy are conducive to success and which are not. Particular emphasis is placed on the role of communication between the therapist and the patient, with specific regard to the outcome of treatment. The habitual practices and main problems facing healthcare professionals with regard to information and consent to psychotherapy are analysed in the context of the results of some recent studies of outcomes and processes which support the notion that the factors most frequently associated with successful psychotherapy are cooperation, proper information and a shared commitment to achieving the objectives of treatment.

Sudden death during medical thoracoscopy

Medical thoracoscopy (or pleuroscopy) is a valuable diagnostic tool in patients with pleural pathology, being minimally invasive, inexpensive and relatively easy to learn. Complications may occur, depending on the complexity of the case, and mainly include broncho-pleural fistulas, chest infections, arrhythmia, severe hemorrhage due to blood vessel injury, and air or gas embolism. Death is very rare. The present report describes the peculiar case of a 72-year-old woman affected by a pleural empyema who suddenly and unexpectedly died during medical thoracoscopy. On autopsy, three small perforations of the right lung were found, without involvement of major vessels or bronchial ramifications. After a brief overview of medical thoracoscopy and its complications, the fatality and its possible pathophysiological mechanisms are analyzed through a review of the literature.

Violent behavior and the factors associated with the decision to report it: a retrospective study

An ample volume of research evidence supports the conclusion that severe mental illness is correlated with violent behavior. While episodes of violent behavior are included in medical notes, not all episodes of violent behavior are officially reported to the police, even when they are actual crimes. We conducted a retrospective study on the already existing clinical files of four public psychiatric outpatient facilities, based in Southern Italy, in order to assess how many cases of violent behavior are actually reported and which variables are more frequently connected with the decision to report. The data shows that the episodes known to the health services, in number and seriousness, vastly outnumber the complaints actually made towards their patients.

Death by starvation. Seeking a forensic psychiatric understanding of a case of fatal child maltreatment by the parent

In the Western world, cases of fatal child neglect due to starvation are extremely rare. When they do occur, particularly at the hands of a parent, such crimes are considered to be caused by mental disorders or personality disorders with severe affective impairment. The present report describes the peculiar case of a couple with a total of four children to care for, who starved a 16-month-old female to death, while all the other children were found to be healthy. After a forensic psychiatric assessment of their criminal responsibility, the couples were both judged guilty and sentenced to 30 years in prison. After a brief overview of the scientific knowledge about filicide, the authors propose a framework that may help to understand and explain the motivations underlying this dreadful crime that shocked the nation, and emphasize the role of the forensic psychiatric investigation into cases of filicide, which may contribute to gain a greater insight into the different motivational factors underlying this phenomenon.