CRM380: 8 ~ Crime and Mental Disorder

Media and Public Opinion

• Media: connection between mental disorder and violence/crime

• 60% believed that people with schizophrenia were likely to act violently towards others

  • 32% - individuals with major depression were likely to be violent towards others

• "a majority of Americans across the political spectrum favored 'increasing government spending to improve mental health screening and treatment as a strategy to prevent gun violence'"

  • The public perceptions of psychiatric patients as dangerous individuals in often rooted in the portrayal of criminals in the media

  • More than 50% of all daily news reports on mental health were depicted in a negative life

    • Infotainment -  television programming that presents information (news) in a manner intended to be entertaining

Violence and Mental Disorder

• Most crime is not committed by mentally ill

• Mentally ill individuals do not usually commit crime

  • When they do, it is often minor crimes (e.g., shoplifting, trespassing)

• Mental disorder itself is not a direct cause of crime

  • Risk factors are same for all (e.g., substance abuse)

  • Mental illness is a small factor when considering violent criminal behavior

• "Evidence is clear that the large majority of people with mental disorders do not engage in violence against others, and that most violent behavior is due to factors other than mental illness"

  • e.g., assessments of dangerousness

Studies on Mental Illness and Violence

• MacArthur Violence Risk Assessment Study

  • Higher scores on anger scale = 2x likely for violent behavior

  • Discharged psychiatric patients who did not have substance abuse were not more violent than residents of the same community

• CATIE study (schizophrenia & violence)

  • 81% = no violence

  • 15% minor violence

  • 3.6% serious violence (younger, previous record best predictors)

• Lifetime prevalence of violence among individuals with substance abuse = 35%

  • 43% with co-morbid mental illness

• Schizophrenia + substance abuse = 17 times more likely to be violent than the general population

Mental Disorders: Most Relevant for Criminal Behavior

• Most relevant diagnoses of those charged with offenses:

  • Psychotic disorders (schizophrenia - esp. paranoid)

  • Mood disorders (depression)

  • Personality disorder (ASPD)

  • PTSD

• Most common psychiatric disorder associated with risk of criminal behavior = drug/alcohol use disorders

  • Comorbidity especially important (e.g., PTSD + substance use)

Psychotic Disorders

• Characterized by:

  • Delusions

  • Hearing or seeing something that isn't there

  • A constant feeling of being watched

  • Disorganized or bizarre speech or writing

  • Inappropriate or unusual behavior

  • Strange body movements or positions

  • Feeling indifferent or numb about important situations

• Disorders Include:

  • Schizophrenia

    • Types:

      • Paranoid

      • Disorganized

      • Catatonic

      • Undifferentiated

      • Residual

    • Core characteristics:

      • Disorganized thought & cognitive functions

      • Delusions - false beliefs

      • Inappropriate or flat emotion

      • Hallucinations - auditory (most common)

    • Relation to Crime and Violence

      • Violent crime is rare

        • But 1/3 homicide offenders diagnosed with schizophrenia used excessive violence

      • Most common subtype linked to violence = Paranoid type

        • Especially concerned about Persecutory delusions - especially common in violence

          • Known as "the false conviction that others are threatening or conspiring against oneself"

  • Delusional Disorders

    • Aka "paranoid" disorders

    • Often persecutory beliefs (spied on, cheated on, followed, drugged, etc.)

      • Anger, resentment, violence can result

    • Ex. Andrea Yates case

      • Believed that killing her children was the only way to win her battle with Satan for her children's souls

Depressive Disorders

• Linked to delinquency, especially in teenage girls

• Mass murders, school shootings, workplace violence, etc. -- often linked to depression

• Relation to Violence and Crime

  • Studies: depression-violence link confounded by comorbid alcohol/drug use or sociodemographic factors

  • Swedish study: risk  of violent crime in individuals with depression = 3x higher than general population; 2x higher than sibling without depression

  • Factors that predict violence in general (e.g., antisocial behavior, substance use, anger issues) also predict violence in individuals with mental illness

    • e.g., impulsivity and mood instability (genetic, familial risk factors) could be common cause of both depression and violence

  • Depression is a risk factor not a cause

Mental Disorder and Violence

• Past mental disorder (even serious) is NOT a predictor of violence

  • As a group, mentally disorder individuals are not more likely to commit crime than those who are not

  • Prevalence of mental disorder in criminal justice is 3x higher than general population (lack of community care, homelessness, substance abuse)

• Schizophrenia (esp. persecutory delusions) is disorder most closely associated with violence and serious crime

  • Most schizophrenics do NOT commit violent crime

• Males with mental disorder and past history of violence are at increased risk of present or future violence

• Schizophrenia AND substance abuse may increase risk of violence

• Males with schizophrenia AND exhibit antisocial behavior at an early age (i.e., Early-onset offenders) often demonstrate persistence criminal offending

• Violence is associated with CURRENT and SERIOUS mental disorder

• Violence of schizophrenics is often directed at family or acquaintances