forensic nursing

What are the Miranda Rights?

You have the right to remain silent. If you give up this right, anything you say can and will be used against you in a court of law. You have the right to have an attorney present during questioning. If you cannot afford an attorney, one will be provided for you free of charge. If you choose to answer questions, you have the right to stop answering at any time. Do you understand the rights I have just explained to you? Do you wish to answer questions? Do you want an attorney?

What is malingering?

The intentional faking of physical or psychological illness for personal gain. Not an actual disorder. Must be assessed by correctional nurses.

What is Factitious disorder?

Intentional faking of illness but the goal is to get emotional support, attention, and sympathy by assuming the sick role.

What is a misdemeanor?

A lesser crime punished by a fine and/or county jail time.

What is a felony?

A crime serious enough to be punishable by death or imprisonment in state/federal prison.

What is parole?

Release of an inmate after completing part of their sentence. They report to a parole officer during a set period.

What is probation?

A chance to remain free (or serve a short term). Given by a judge if the person can remain crime-free.

actus reus

The physical action (or omission) that makes one liable for a crime.

mens rea

The accused had the mental capacity to intend the act or foresee its consequences.

What is perjury?

Lying under oath.

What is voire dire?

When jurors are questioned to determine bias or relationships with parties, attorneys, or witnesses.

What does Pro se/pro per mean?

A person who acts as their own attorney.

What is pro bono?

An attorney who represents a client for free.

What is pro tem?

Acting in place of another officer. Temporary judge or attorney appointed as judge.

What are the types of pleas?

Guilty, not guilty, no contest, NGRI, IST (incompetent to stand trial).

What does incompetent to stand trial mean?

The person admits the crime, but the attorney claims they were mentally disturbed and lacked intent. Evidence is needed to prove incompetence.

What is Megan's Law (1996)?

Requires law enforcement to notify the public of convicted sexual offenders living in the community.

What is the Adam Walsh Child Protection and Safety Act?

Created a national sex offender registry each state must follow.

What is Amber's Law?

Federal law requiring life in prison without parole for two-time child sex offenders. Reports to Congress required for lenient judges.

What is Chelsea's Law?

2010 law increasing penalties and parole provisions for the worst child sexual offenders.

What are some laws regarding inmate rights?

8th Amendment prohibits cruel/unusual punishment; Clark Remedial Plan (CRP) improves monitoring/protection; Prison Litigation Reform Act (PLRA) reduces frivolous lawsuits; Prison Rape Elimination Act (PREA).

What is the genetic influence for criminal behavior?

Adoption studies show higher crime rates in children of biological criminal parents, especially if raised in criminal households.

What is MAOA (Monoamine oxidase A)?

Low levels linked to conduct disorder and aggression.

What is the XYY theory?

Extra Y chromosome once believed to slightly increase violence; weak theory.

What is the dopamine hypothesis?

Disturbances in dopamine system linked to reward deficiency → addiction and criminal behavior.

What can increased dopamine lead to?

Aggression, mania, OCD, psychosis.

What can decreased dopamine lead to?

ADHD, impulsivity, lack of focus, distractibility.

What is the norepinephrine hypothesis?

High levels linked to anxiety, irritability, paranoia, hyper-vigilance, aggression.

What is the serotonin hypothesis?

Low/unbalanced serotonin linked to irritability, hostility, suicidality, impulsive aggression.

What is the testosterone hypothesis?

High testosterone + low serotonin linked to violent antisocial behavior (e.g., rape). Related to dominance and aggression.

What is the role of the limbic system in crime?

Low amygdala reactivity linked to antisocial, psychopathic behavior (fearlessness, lack of empathy).

What is the role of the frontal lobes in crime?

Control maladaptive behaviors; injury leads to impulsivity, irritability, aggression, immaturity.

What is the role of cerebral hemispheres in crime?

Violent offenders often have left hemisphere deficits (language, verbal comprehension, speech).

Instinctive criminal (Havelock Ellis)

"Born criminal"; impulsive, uncontrolled predator; similar to psychopath.

Occasional criminal (Havelock Ellis)

Normally law-abiding, commits crimes due to pressure or necessity.

Habitual criminal

Crime is a way of life; petty/major crimes until caught.

Monetary offenders

Motivated by money or material needs; theft, violence for gang territory/revenge.

Neurotic offenders

Driven by unconscious conflicts; e.g., kleptomania, fire-setting.

Unconscious guilt offenders

Seek punishment; risk getting caught overlaps with neurotic offenders.

Character disorder criminals

Pathological liars, addicts, pedophiles, rapists, murderers.

Normal criminals

Most common type; repetitive petty nonviolent crimes with other criminals.

Accidental criminals

Normally law-abiding, pressured/lured into isolated crime.

Organically predisposed criminals

Brain injury/illness makes them vulnerable to criminal behavior.

Psychopathic/sociopathic criminals

Dangerous, violent repeat offenders who exploit without remorse.

Self-control theory (Gottfredson & Hirschi)

Low self-control → impulsivity, risk-taking, irresponsibility.

Crime & Human Nature (Wilson & Herrnstein)

Crime influenced by low IQ, impulsivity, family environment, schools, media, economics.

Mollification (cognitive pattern theory)

Blaming external forces: “The deck is stacked against me.”

Cutoff (cognitive pattern theory)

Blocking deterrent thoughts: “Just do it.”

Entitlement (cognitive pattern theory)

Belief one is special/deserving to commit crime.

Power orientation (cognitive pattern theory)

Need for control: “They better know not to mess with me.”

Sentimentality (cognitive pattern theory)

Offsetting crime with good deeds.

Cognitive dissonance (cognitive pattern theory)

Using shortcuts: “I’ll worry about it later.”

Criminal personality traits

Egocentricity, impulsivity, frustration, narcissism, paranoia, sadism, aggression.

Sociological theory

Crime influenced by social, cultural, political factors.

Differential Association theory

“Birds of a feather”—criminal behavior learned by association.

Strain theory

Stress → frustration → corrective action (violence/crime).

Choice theory

Criminal acts are purposeful; motives = power, justice, thrill, getting one’s way.

Social Disorganization theory

Neighborhood poverty/unemployment linked to crime.

Subcultural theories

Norms reinforce aggression, especially in deprived communities.

Economic theories

Crime to provide basic needs.

Ideological theories

Capitalism creates crime by exploiting working class and widening inequality.

DSM criteria for Antisocial Personality Disorder

Pattern of disregard for others’ rights since age 15, with 3+ traits: unlawful acts, deceitfulness, impulsivity, aggressiveness, irresponsibility, recklessness, lack of remorse.

Additional criteria

Must be at least 18, conduct disorder before 15, not during schizophrenia/mania.

Associated features

Neglectful parenting, multiple partners, arrogance, charm, manipulativeness, lying, malingering, institutionalization, substance abuse, depression, suicide risk.

Other features

Easily bored, argumentative, thrill-seeking, concrete thinking, may have Cluster B PDs, may be homeless, fail to support self, co-occur with anxiety, depression, gambling, substance abuse.

What is the PCL-R?

Psychopathy Checklist-Revised, 20 items scored 0–2, max 40.

What does a score of 30+ on PCL-R mean?

Qualifies as psychopathy.

What does a score of 22 mean?

Criminal behavior but not psychopathy.

What does a score of 5 mean?

No criminal history.

Factor 1 of PCL-R

“Aggressive narcissism”: superficial charm, grandiosity, lying, manipulative, shallow affect, lack of empathy, no responsibility.

Factor 2 of PCL-R

“Socially deviant lifestyle”: boredom, parasitic lifestyle, poor control, impulsivity, irresponsibility, delinquency, behavior problems.

Familicide

Killing all/most of one’s family.

Filicide

Killing one’s child.

Feticide

Killing a fetus.

Infanticide

Killing an infant.

Parricide

Killing one’s parent.

Matricide

Killing one’s mother.

Patricide

Killing one’s father.

Fratricide

Killing one’s brother.

Sororicide

Killing one’s sister.

Uxoricide

Husband kills wife.

Mariticide

Wife kills husband.

Multicide

Killing 2+ people.

Mass homicide

4+ victims at once in one place.

Characteristics of mass murderers

Motives = abuse, separation, job loss; middle-aged, isolated, rigid, narcissistic, paranoid, “warrior mentality.”

Characteristics of serial killers

White male 20s–40s, loner, some married, some prior records, often burglary/rape link, victims usually female, intraracial crimes, trophy collection, cannibalism, blood drinking, postmortem mutilation.

Categories of workplace violence

Criminal activity, client violence, coworker violence, domestic spillover.

Types of bullying

Individual, group, direct, indirect, relational, bias, cyber, sexting, sibling, institutional.

Stalkers

80% known to victim, most stop in 2–4 weeks; if >4 weeks, may last 6–12 months; males >30, Cluster B traits, 55% recidivism, homicide rare.

How to deal with a stalker?

Send clear message, cut contact, reduce target salience, keep records, protect self, get help.

How to enforce boundaries with criminals?

Recognize manipulation, don’t take it personally, use self-reflection, supervision, stay neutral.

Examples of boundary violations

Keeping secrets, gossiping, personal disclosure, gifts, favors.

Reasons for boundary violations

Nurse ignores infractions, unprepared, fraternization, familiarity, inmate has personal info.

What is the code of ethics?

Principles guiding professional conduct, moral duties, obligations to clients, institutions, and society.

Roles of forensic nurses

Sexual Assault Nurse Examiner (SANE).

Subspecialties of forensic nursing

Interpersonal violence, death investigation, emergency trauma, mass disaster, correctional nursing, correctional mental health, public health & safety, psychiatric forensic nursing (competency evaluation, consultant, profiler, negotiator).

Kinds of people who violate boundaries

Predators, lookers, leaders, snitches.