The forensic psychologist is confrontedwith a number of difficulties and diagnosticproblems when trying to reach a conclusive expertopinion in cases of offenders with personality disorders.He can overcome these problems by applyinga model incorporating both personality variables andthe situational motivational context into his diagnosticprocedure. By taking into consideration the motivationalfactors affecting selected dimensions of theoffender's motivational processes, the forensic psychologistis able to obtain a picture of the functionalstate of the offender's personality together with itscurrent regulative and integrative functions. Themotivation of offenders manifesting the aforementioneddisorders will be much more accurate andreliable if the systemic approach to personality disorderssuggested by AndrzejJakubik is applied.
The differential diagnosis of paranoidmental dysfunction has considerable practicalsignificance for the final conclusions of the forensicpsychiatric expert opinion. The authors analysis theetiology, pathogenesis and clinical manifestationsof the three most frequent paranoid disorders (paranoidpersonality disorder, delusional reaction andparanoia) and, on this basis, they explain the basicprinciples underlying their differential diagnosis andits consequences for forensic psychiatric expertise.
The author presents the principles underlying forensic psychiatric and psychological expertise: the basic rule (to serve the court well) and the most important organisational principles – obligatoriness, insubstitutiveness (in abstracto), substitution (in concreto), autonomy and competence. Each of these principles has its counterpart in the principles binding the court organs.
alcoholrecovery clinics (35 involuntary first-time patients – group A, 24 voluntary first-time patients – group B, 29 multiple-relapse patients –group Cand 57 AA frequenters –group D). Significantbetween-group differences were found in the patients' SUIpersonality profiles in the following orderof significance: B, A, C, D. Profiles CandD differed most (rps= -0.82), suggesting thatthese two groups are direct opposites with respectto personality coherence, i.e., the factor responsiblefor adequate social functioning in everydaylife. The findings of this study also lead to themore general conclusion that the SUI may be veryhelpful in the psychological diagnosis of patients inrecovery from alcoholism.
On the basis of his review of theappropriate literature the author presents the definition,history, epidemiology, aetiology and diagnosticcriteria of dissociative disorders, also calledmultiple personality disorder. He also discusses theproblems involved in the diagnosis and forensicpsychiatric expertise of persons suffering from thisdisorder in criminal proceedings.
Personality defence mechanisms are unconscious devices which help people to cope with conflict. Conflict usually accompanies the acute or chronic reaction to stress which so often precipitates aggressive offences. The author discusses the most important directions of research on defence mechanisms. He analyses 35 cases of severe aggressive offence in which stress was the major precipitating factor and finds that, prior to the offence, the offender was most lacking in rationalisation, suppression and repression. Exposure to stress aggravates the conflict which can no longer be alleviated by means of unconscious regulation and an aggressive offence is therefore committed.
Although it is generally accepted that only certain categories of mental disease, precisely defined in the criminal code, warrant criminal insanity or severely limited sanity, many lawyers and psychiatrists are beginning to voice concern that the negative contribution of certain types of extreme personality disorder to criminal offence is insufficiently appreciated. The authors also point out that every personality should be viewed as a continuum of varying stability and that the clinical manifestations of situational decompensation of allegedly stable personality mechanisms may at times approach the borderline or even psychotic level. This implies the need to verify the existing approach of forensic psychiatry to persons suffering from personality disorders in whom particular configurations of extremely traumatic psychological and situational factors may lead to criminogenicdecompensation.
The literature on the biologicalbases of personality disorders is reviewed. The followingbiological criteria are considered: genetic factors, hormonal disorders, enzyme disorders,disorders of the serotoninergic system and CNSorganic lesions. So far, none of these criteriahas achieved sufficient diagnostic and prognosticvalidity. The authors suggest the need to developa diagnostic instrument which would link psycho-social factors to the most well-studied biological 10 concepts.
The authors discuss the cerebralmechanisms underlying development of antisocialpersonality disorder. They review the role of severaldifferent pathogenic factors such as locationof brain lesions, aetiology and neurophysiologicalsigns. The significance of neuroimaging and thesearch for neurophysiological measures of cognitivedisorder in psychopaths are discussed. Thereasons for terminological and theoretical inconsistenciesare explained and suggestions for furtherresearch are given.
Every year about 300 forensic psychiatric expert opinions are issued because of offencesinvolving soldiers. Both military and non-military experts produce these opinions. Whenthese opinions are confronted, either in day-to-daypractice or in comparative studies, experts arefound to differ significantly with respect to theirassessment of accountability and the military delinquent'scapacity for army service. The varioustypes of discrepancy of opinion are reviewed andan interpretation is suggested.
Personality disorder was diagnosedin 41 cases (39%) of women referred by the court for forensic psychiatric observation. 73% of all patients at the Department of Forensic Psychiatrywere referred because of aggressive acts, mainlymurder of family members. None of the patients inthe present study had limited accountability butsome had reactive disorders and were not examineduntil their health improved. The most frequentlydiagnosed personality disorder was emotionalinstability and the most typical motives werejealousy and revenge. Because the social consequencesare so severe, further studies of personalitydisorders in women are needed.
The problems confronting forensicpsychiatrists and the latter's role are discussed onthe basis of data gathered by the Department of Forensic Psychiatry in Utena in 1994-1998. ICD-10was used to assess typical personality features anddiagnostic categories. The contribution of the psychologistto the complex forensic psychiatric examinationis emphasised and the need to introduce thelimited accountability clause is stressed.
The results of a complex studyof aggressive behaviour in female juvenile delinquentsare presented. One hundred and eightyeight girls manifesting behaviour disorders (antisocialand delinquent) were studied. Significantmicrosocial, psychological psychopathological aggressivefactors and gender-determined factorsare signalled and the latter's connection with pathologicalaggression are discussed. The considerablesignificance of aggressive fantasies in female aggressionis noted.
In a group of predictors accountingfor 68.7% of the variance of homicide, the followingpersonality dimensions had significant effects:(1) anxiety –from negative to average in thehomicide group; (2) emotional competence-negative; (3) aggression and hostility –near averagelevel in the homicide group. Other significantpredictors were situational stress at the time of thecrime and biological functioning. The contribution(from strongest to weakest) of the different predictorscan be rank-ordered as follows: situationalstress then personality dimensions then biologicalfunctioning. Together this hierarchy predicts homicidewith a probability of almost 70%.
Diagnosis of personality disorders for the forensic psychological expert opinion is the source of much controversy, particularly in less typical cases. The author suggests a list of cognitive, affective and behavioural symptoms which may be helpful in differential diagnosis for forensic psychological purposes. Irrational behaviour and psychologically confusing motives for the crime were the criteria used to select cases for the present study.
The author presents the most importantchanges in the Polish executory penal codewhich have affected the approach to mentally handicappedpersons who have been sentenced to prison.He discusses the legal principles and grounds forpsychological and psychiatric examination of sentencedpersons and persons remanded in custody andthe functioning of the therapeutic system.