It has previously been demonstrated that decisions made by forensic experts can suffer from issues with both bias and poor reliability. The outcome of Swedish forensic psychiatric investigations can have a major impact on the courts\' choice of sanction for a mentally disordered offender. These investigations are performed by multi-professional teams of experts, where each expert is obliged to state their opinion on whether the client has a severe mental disorder (SMD) or not. In the present study, a case vignette design was used to simulate the decision-making process of forensic psychiatric investigations. Of the 73 Swedish experts working with forensic psychiatric investigations, a total of 27 (37%) participated in the study. The results showed that the Swedish experts formulated multiple diagnostic hypotheses about cases throughout the process and revised these hypotheses when presented with new information. There was substantial variation between the experts in which hypotheses were seen as most relevant. While the experts grew more certain of their opinions on SMD during the simulated investigation, there was considerable variation in their opinions both throughout and at the end of the process. Although low statistical power and the sample not being randomized limit generalizations, the results indicate no idiosyncratic patterns in the decision-making processes of Swedish experts or signs of confirmation bias. If used properly, the variation in both process and outcome could be used to safeguard and possibly increase the reliability and validity of the final decision of Swedish forensic psychiatric investigations.

At an international level, the risk assessment and management process of violent offenders follows a standard method that implies well-defined theoretical models and the use of scientifically validated tools. In Italy, this process is still highly discretionary. The aim of this study is to highlight the advantages deriving from the use of risk assessment tools within the framework of a single case study; Methods: Recidivism risk and social dangerousness of an Italian woman perpetrator of filicide were assessed through the administration of the Level of Service/Case Management Inventory (LS/CMI) instrument supported by Historical Clinical Risk-20 Version 3 (HCR-20 V3); Results: The administration of LS/CMI showed that, in this single case, the subcomponents represent a criminogenic risk/need factor are: Family/Marital, Companions, Alcohol and Drug Problem and Leisure; while constituting strengths: employment and the absence of a Pro-criminal Orientation and an Antisocial Pattern; Conclusions: Data collected through LS/CMI indicated life areas of a single case, which should be emphasised not only to assess the risk of re-offending and social dangerousness but also for a social rehabilitation programme more suited to the subject. This study demonstrates that the LS/CMI assessment tool is suitable for the Italian context.

The authors present an unusual criminal case of delusionally motivated, serial intrafamilial killings by a psychotic offender. Because the offender retained instrumental rationality and killed his victims by stealth, viz. surreptitious poisoning, the killing of his first victims went undetected. Persecutory delusions of being poisoned not uncommonly result in defensive violence, whereas in this case, religious delusions resulted in the mentally ill person killing others by poisoning them. Here, the psychotic offender killed his victims by means of poisoning based upon motivation driven by religious delusions. This case illustrates the importance of index of suspicion and appropriate investigation of mysterious deaths, and careful forensic psychiatric assessment to distinguish delusional versus extreme overvalued belief-motivated killings in addressing the insanity defense.

The worldwide public health problem of suicide, requires a multidisciplinary assessment, given its economic, cultural, social and psychological aspects. The global COVID-19 pandemic that originated from the Peoples Republic of China in the last months of 2019 has the potential to trigger mental disorders and even suicidal attemps through fear, psychosocial pressures and as a result of disruption of the customary daily life styles. In this report we discuss a case of completed suicide of a 34-year old male who had confined himself to his home, after stocking up large amounts of food, drinking water and cleaning materials in response to the COVID-19 pandemic in our country using site investigation reports, medico-legal autopsy and psychological authopsy of the deceased. It was found out that the victim was following the internet and the television daily for news on the COVID-19 outbreak in the country. One week before the event, he had left his workplace telling his colleagues that he would confine himself to his home for 15-20 days to clean up the premises. Washed banknotes and blister tablets were found in the house as well as stocked water and cooked food. The deceased had twice consulted hospitals for fear of COVID-19 infection 2 days before his demise. It was discussed that he might have the diagnosis of \"mixed anxiety and depression\". Evaluation of his experiences, discourses and behaviours within the span of 3-4 days before the act and the site investigation have suggested that he might have attempted suicide as a response to stress.

From the criminologic standpoint, as a crime committed against a psychological background of depression, homicide-suicide is a \"dual death\" whose significance transcends the specificity of the two events taken singly. Although diametrically opposite phenomena, in fact they share the same pulsions, to be found in aggressiveness, or the desire to eliminate the tensions underlying it. From this perspective, various attempts have been made to classify the homicide-suicide phenomenon, which have indicated that those who, through homicide, deprive themselves of their primary source of gratification may then decide to commit suicide as a result of this unbearable loss. Therefore, suicide post-homicide is a marker of the importance of the bond between the murderer and the victim. Indeed, some Authors have confirmed that the strong attachment between the two increases the likelihood of suicide of the former after the death of the latter; that the crime develops in a relational context featuring abuse and maltreatments; that it also stems from the fear of betrayal and the loss of an object that escapes all attempts to possess it, and that in many cases the destruction of the object through the crime is followed by the self-destruction of the criminal.

The aim of this single-case study was to investigate the responses to psychodynamic art psychotherapy from a man who had a diagnosis of antisocial personality disorder and ongoing aggressive behavior in a secure care setting. The intervention was 19 sessions of psychodynamic art psychotherapy lasting up to 1 hr per week. This study uses a single-case design with pretreatment, treatment, and posttreatment follow-up assessment of symptoms using multiple methods reported by the therapist, other staff members, and the patient. Treatment progress was assessed by (a) repeated self-report symptom measurements, (b) continuous assessment of observed aggressive behavior and risk incident reports in the hospital, (c) pre-post treatment assessment of relationship patterns and interpersonal schemas, and (d) interviews with the patient and his nurse at 9-month follow-up, retrospectively assessing the change. The patient showed a clinically significant reduction pre-post and pre-follow-up in symptoms. Behavioral observations indicated a reduction of overt aggression and risk-related incidents. Comparison of the Core Conflictual Relationship Theme pre-post treatment indicated positive changes in interpersonal schemas. This illustrative systematic single-case study highlights the potential for investigation of a novel psychotherapeutic approach that has in turn led to further developments in clinical research. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

When children report abuse, they often report that it occurred repeatedly. In most jurisdictions, children will be asked to report each instance of abuse with as many details as possible. In the current meta-analysis, we analyzed data from 31 experiments and 3099 children. When accuracy was defined as the number of correct details from the target instance (i.e., narrow definition), repeated-event children were less accurate than single-event children. However, we argue that defining accuracy as the number of reported details that were experienced across instances (i.e., broad definition) is more appropriate for repeated events. When a broad definition was applied, single- and repeated-event children were similarly accurate. Importantly, repeated-event children were less likely than single-event children to report details that had never been experienced and they were no more likely to say \"I don\'t know.\" Overall, repeated-event children were more suggestible than single-event children, but this was moderated by length of delay to recall. In analyses of recognition data, single-event children\'s sensitivity score was higher than repeated-event children\'s, with no significant difference in response bias as a function of event frequency. We discuss these results in the context of how children\'s memory for repeated events is organized. We also consider the advantage of applying a broad definition of accuracy for victims of repeated abuse and charging repeated abuse as a continuous offense rather than discrete acts. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Case formulations (CF) have been the cornerstone of effective practice in clinical psychology since the 1950s and now form one of the core competencies in clinical and forensic assessment. The use of CFs within forensic settings is becoming more relevant when working with offenders who have experienced significant trauma, suffered from personality disorder, and have displayed sexually abusive behavior. Furthermore, most North American and European jurisdictions insist that expert witnesses adopt an idiosyncratic approach to risk assessment and consider the characteristics of the individual as part of a wider formulation of the problem behavior. This article focuses specifically on CF incorporating risk assessment procedures of sexual offenders.
While empirical support for the use of risk analysis and formulation in managing offending behavior generally, and sexual offending behavior in particular, is limited, there is mounting evidence to suggest that CF can improve understanding of an individual\'s problem sexual behaviors. We argue that by integrating risk formulations into the CF provides a conceptually robust link between the etiologically development of the problem sexual behavior and effective assessment and risk management of sexual offenders. As forensic treatment programs increasingly moved toward strength-based approaches, in keeping with the Risk-Need-Responsivity principles Andrews and Bonta (2004), and the Good Lives Model Ward and Stewart (Prof Psychol Res Pract 34:353-60, 2003) of offender rehabilitation, the use of CFs in the assessment, treatment, and management of sexual offenders is indispensable. We present an etiological framework for understanding risk in an individual sexual offender by integrating a case formulation model to include the use of (static, stable, and acute) actuarial and clinical risk assessment measures as well as protective risk factors, referred to as the CAse Formulation Incorporating Risk Assessment (CAFIRA) model.

This study examined self-reports of psychopathic offenders\' childhood interactions with their parents to better understand what variables influence adult criminal psychopathy. The findings showed that childhood separations, physical abuse and indifferent parenting styles were more prominent in self-reports of incarcerated male psychopaths than with incarcerated males who were not psychopathic. To better understand the worldview of the criminal psychopath, and the trajectory of psychopathy, there is a need for more studies that examine childhood interactions with parental figures as reported by the adult criminal psychopath.
UNASSIGNED: Despite the high percentage of incarcerated psychopaths, few studies attempt to assess the past parent-child bonds of these individuals by asking them to report childhood attachments with their parents. Currently, there is limited data regarding common variables that contribute to a break in parent-child attachment and later adult criminal psychopathy. The data that presently exist concentrate on juvenile or community samples and do not explore the attachment variables that continue into adult criminal psychopathy. This paper presents the current literature regarding self-reports of childhood attachment to parents as indicated by male-incarcerated adult psychopaths compared with self-reports of childhood attachment to parents as indicated by male-incarcerated adult non-psychopaths. Variables that influence a break in attachment between the offenders and their parents and suggestions for future clinical research are provided.