Taina Laajasalo

Background characteristics of mentally ill homicide offenders – a comparison of five diagnostic groups

Background characteristics of homicide offenders in relation to their diagnoses were investigated. Forensic psychiatric examination statements of 183 Finnish homicide offenders belonging to five different diagnostic categories were content-analysed for 90 dichotomous offender background variables. In several aspects alcoholics resembled offenders with no diagnosis, in that these offenders had less problematic backgrounds compared to other groups. Offenders with schizophrenia were relatively well-adjusted in childhood, however, in adolescence and adulthood, social isolation, withdrawal and other difficulties attributable to the illness of these offenders became evident. Offenders with personality disorder or drug addiction had experienced multiple difficulties in their early environments: both family and individual problems, such as parental alcohol abuse and school problems, were typical. The results suggest that offenders with different disorders differ in their background variables. These results emphasize the importance of early interventions for problem families and children at risk of antisocial behaviour and may also benefit development of effective treatments for violent offenders as well as investigations of homicide. Some methodological problems in forensic psychiatric examination based research are considered.

Psychopathic traits and offender characteristics – a nationwide consecutive sample of homicidal male adolescents

BackgroundThe aim of the study was to evaluate psychopathy-like personality traits in a nationwide consecutive sample of adolescent male homicide offenders and to compare the findings with those of a randomly sampled adult male homicide offender group. A further aim was to investigate associations between psychopathic traits and offender and offence characteristics in adolescent homicides.MethodsForensic psychiatric examination reports and crime reports of all 15 to19- year- old male Finnish offenders who had been subjected to a forensic psychiatric examination and convicted for a homicide during 1995–2004 were collected (n = 57). A random sample of 57 adult male homicide offenders was selected as a comparison group. Offence and offender characteristics were collected from the files and a file-based assessment of psychopathic traits was performed using the Hare Psychopathy Checklist-Revised (PCL-R) by trained raters.ResultsNo significant differences existed between the adolescents and adults in PCL-R total scores, factor 2 (social deviance) scores, or in facets 3 (lifestyle) and 4 (antisocial). Adults scored significantly higher on factor 1 (interpersonal/affective) and facets 1 (interpersonal) and 2 (affective). The adolescent group was divided into two subgroups according to PCL-R total scores. One in five homicidal male adolescents met criteria for psychopathic personality using a PCL-R total score of 26 or higher. These boys significantly more often had a crime history before the index homicide, more frequently used excessive violence during the index homicide, more rarely lived with both parents until 16 years of age, had more institutional or foster home placements in childhood, had more school difficulties, more often had received special education, and, more often had contact with mental health services prior to age 18 years than boys scoring low on the PCL-R. They also more often had parental criminal history as well as homicide history of parents or near relatives than the group scoring low on the PCL-R.ConclusionHomicidal boys behaved as antisocially as the homicidal adults. The adults, however, showed more both affective and interpersonal features of psychopathy. Homicidal adolescents with psychopathy-like personality character form a special subgroup among other homicidal youngsters. Recognizing their characteristics, especially in life course development, would facilitate effective prevention and intervention efforts.

Offence and offender characteristics among two groups of Finnish homicide offenders with schizophrenia: Comparison of early- and late-start offenders

Offence and offender characteristics were analysed among 109 Finnish persons with schizophrenia who were accused of a homicide between the years 1983 and 2002. Distinguishing characteristics between two groups were examined: early starters, who present antisocial behaviour before the onset of schizophrenia, were compared with late starters, who first offend after the onset of mental disorder. The results suggest that the offence characteristics of early- and late-start offenders with schizophrenia differ only modestly. However, several significant differences between the groups were found in the offender characteristics. Behaviour problems and psychiatric contacts in childhood were more common among early-start offenders with schizophrenia. The findings are discussed with regard to investigative work and the criminal justice system.

Predicting psychosis in a general adolescent psychiatric sample.

INTRODUCTION Current psychosis risk criteria have often been studied on a pre-selected population at specialized clinics. We investigated whether the Structured Interview for Prodromal Syndromes (SIPS) is a useful tool for psychosis risk screening among adolescents in general psychiatric care. METHODS 161 adolescents aged 15-18 with first admission to adolescent psychiatric services in Helsinki were interviewed with the SIPS to ascertain Clinical High-Risk (CHR) state. The participants were followed via the national hospital discharge register, patient files, and follow-up interviews. DSM-IV Axis I diagnoses were made at baseline and 12 months. Register follow-up spanned 2.8-8.9 years, and hospital care for a primary psychotic disorder and any psychiatric disorder were used as outcomes. RESULTS CHR criteria were met by 54 (33.5%) of the adolescents. Three conversions of psychosis as defined by SIPS emerged during follow-up, two of whom belonged to the CHR group. The positive predictive value of the CHR status was weak (1.9%) but its negative predictive value was 98.0%. Using the DSM-IV definition of psychosis, there were five conversions, three of which were in the CHR group. In regression analyses, hospital admissions for primary psychotic disorder were predicted by positive symptom intensity in the baseline SIPS. In addition, CHR status and SIPS positive and general symptoms predicted hospitalization for psychiatric disorder. DISCUSSION Psychosis incidence was low in our unselected sample of adolescent psychiatric patients. CHR status failed to predict SIPS or DSM-IV psychoses significantly at 12 months. However, in a longer follow-up, CHR did predict psychiatric hospitalization.

Are qualitative and quantitative sleep problems associated with delinquency when controlling for psychopathic features and parental supervision

The aim of this study was to explore the relationship between sleep, including both qualitative and quantitative aspects, and delinquent behaviour while controlling for psychopathic features of adolescents and parental supervision at bedtime. We analysed data from a nationally representative sample of 4855 Finnish adolescents (mean age 15.3 years, 51% females). Sleep problems, hours of sleep and delinquency were evaluated via self‐report. Psychopathic features were measured with the Antisocial Process Screening Device – Self‐Report. In negative binomial regressions, gender and sleep‐related variables acted as predictors for both property and violent crime after controlling for psychopathic features and parental supervision at bedtime. The results suggest that both sleep problems (at least three times per week, at least for a year) and an insufficient amount of sleep (less than 7 h) are associated with property crime and violent behaviour, and the relationship is not explained by gender, degree of parental supervision at bedtime or co‐occurring psychopathic features. These results suggest that sleep difficulties and insufficient amount of sleep are associated with delinquent behaviour in adolescents. The significance of addressing sleep‐related problems, both qualitative and quantitative, among adolescents is thus highlighted. Implications for a prevention technique of delinquent behaviour are discussed.

Homicidal behaviour among people with avoidant, dependent and obsessive–compulsive (cluster C) personality disorder

BACKGROUND Despite a growing forensic psychiatry literature, no previous study has examined in detail homicidal behaviour among offenders with cluster C personality disorders - the avoidant, dependent or obsessional personality disorders. AIMS This study aims to compare homicide offenders with cluster C personality disorders with those with other personality disorders on criminal history, offender-victim relationship and post-offence reaction variables. METHODS The sample was drawn from all Finnish homicide cases of 1996-2004 for whom a forensic psychiatric evaluation had been conducted. Data were extracted from forensic psychiatric and crime reports. RESULTS In a nationwide sample of 593 homicide offenders, 21 had at least one cluster C personality disorder. These offenders had significantly shorter criminal histories than the others. Offender-victim relationship did not differ between the groups, but confession to the crime and feelings of remorse were more common among people with cluster C disorders. In addition, compared with other personality disorder clusters, co-morbid depression was more common. CONCLUSIONS Cluster C personality disorders are rare, but not nonexistent, among homicide offenders. Observed differences in their backgrounds and post-offence behaviours indicate that they may have special needs.

Suicidality, self-harm and psychotic-like symptoms in a general adolescent psychiatric sample

We investigated the associations between clinical high‐risk for psychosis (CHR), psychotic‐like symptoms and suicidality among adolescent psychiatric patients.

Severe Sleep Problems and Psychopathic Features: A Study of FinnishAdolescents

Objective: This study investigated sleep and psychopathic features in a population-based sample of 4855 Finnish adolescents. Method: Sleep was evaluated by questions about the frequency and persistence of sleep problems and the amount of sleep on school and weekend nights. Psychopathic features were measured with Antisocial Process Screening Device-Self Report (APSD-SR). Results: Frequent and persistent sleep problems was reported by 5% of the adolescents while 3.2% of adolescents had continuous short sleep, 7 hours or less on both school and weekend nights. Higher scores on the APSD-SR measure were associated with both sleep problems and short sleep. Conclusion: We conclude that severe problems of sleep quality and quantity among adolescents may be associated with vulnerability to lack of behavioral control and prosocial behavior.

What Did the Child Tell? The Accuracy of Parents’ Reports of a Child’s Statements When Suspecting Child Sexual Abuse

Often cases of suspected child sexual abuse (CSA) come forward through children’s accounts to their parents and the parents’ subsequent reporting thereof. In this study (N = 22), randomly assigned parents listened to a mother-daughter conversation concerning suspected CSA. When freely reporting “what the child told,” participants assessed most of the information brought up by the mother as being brought up by the child. However, when asked to assess the source for each utterance, participants differentiated better. Interestingly, who they deemed brought up an event was not associated with how probable participants deemed it was that the event had occurred.

Interpersonal Relationships as Protective and Risk Factors for Psychopathy: A Follow-up Study in Adolescent Offenders

Friendships and romantic relationships may function as protective and risk factors for psychopathic traits. To better understand potential causal associations, we investigated whether within-individual changes in relationship characteristics were related to changes in psychopathic traits over time. Data were derived from ten repeated measurements of the Pathways to Desistance longitudinal study of 1354 offending adolescents (14.3% female; 40.1% Black). Analyses were adjusted for age, gender, ethnicity, self-reported offending and living facilities. Relationships of high quality were associated with lower psychopathic traits, whereas antisocial behavior and antisocial influence in relationships were related to higher psychopathic traits. Within-individual analysis indicated that time-invariant individual characteristics did not confound these associations. The findings suggest that the quality and antisocial activities of interpersonal relationships can affect positively or negatively on the levels of psychopathy.