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How are diagnostic systems used to classify mental abnormality?
- Instruments are aimed to help diagnosis
- Overt symptoms such as behaviours are judged to indicate if something is wrong internally which should be diagnosed, classified and treated
- It is assumed that mental illness can stem from multiple factors in the brain
- The two most commonly used systems are the international classification of diseases, injuries and causes of death and the diagnostic statistical manual of mental disorders
What is the DSM-5?
- Diagnostic statistical manual of mental disorders volume 5
- Provides criteria to define and classify various mental disorders, this criteria must be met in order for a diagnosis to be met
- Provides treatment recommendations
- Criticised by the British psychological society in a 2011 report
- Disorders classified as 'not otherwise specified' are a huge proportion (30%)
- Diagnostic categories don't predict response to medications or other interventions where more specific formulations might (Moncrieff, 2007)
- Top down method is ineffective, should start with experiences and work up
- Statistical analysis of problems from community samples show that they don't map onto past or current (Mirowsky & Ross, 2003)
Give an example of guidance for diagnosing a mental health problem from the DSM-V
- 'A pervasive pattern of disregard for and the violation of the rights of others'
- Must be 18
- Must have 3 from the following:
- Conduct disorder before 15
- Irritability and aggressiveness
- Disregard for the rights of others
- Reckless disregard for the safety of others
- Impulsive, irresponsible behaviour
- Lack of remorse
- Low tolerance for frustration and boredom
- BPS (2011) argues that the classification as this as an illness detracts from the social factors that help to cause it
What is the mad vs bad debate?
- Some theories suggest that crime is abnormal, an indication of some psychological disorder, and that criminality is a sickness that can be cured
- Others theorise that offending is executed in the same way, and for some of the same reasons as other everyday activities, and that crime is normal
- The general consensus is that most crime is normal and that some is indicative of disorder
How prevalent is mental disorder in prison populations?
- People with mental disorders are over-represented
- 16% of prisoners reported a mental condition or had spent at least 1 night in a mental hospital (US bureau of justice, 1999)
- Steadman et al (2009) used a structured criminal interview and found that 14.5% of males and 31% of females in prison suffered from serious mental illness
- Could be caused by prison
What is schizophrenia?
- A group of disorders characterised by disturbances of perception, thought, affect and action (Palmer, 2013)
- Attributed to an interaction between genes and environment
- Around 1% of the population have it
- Onset usually occurs from mid teens to middle age
Is schizophrenia more common amongst prisoners?
- Yes- Fazel & Danesh (2002)
- Examined psychiatric surveys of prison populations from 12 mainly western countries (over 60 surveys and over 22,500 reports)
- Around 4% had psychotic illness, mainly schizophrenia
- Prisoners were found to be 2-4 x more likely to have schizophrenia
Is Schizophrenia correlated with violence?
- Yes -Fazel et al (2009)
- Meta analysis of risk of violence for people with schizophrenia as opposed to risk for general population
- Measured using self reports of criminal convictions for violence
- A diagnosis of schizophrenia was reliably associated with an increased risk of violence amongst men and women
Why do more schizophrenics offend?
- The relationship between schizophrenia and crime could be causal, correlational or consequential (Palmer, 2013)
- Causal: people respond to delusions criminally
- Correlational: factors that are thought to be associated with schizophrenia are also implicated in criminal behaviour such as living in a dysfunctional family. Sudden life events should prompt both outcomes
- Consequential: committing a crime is stressful and traumatic, this could increase the likelihood of exhibiting schizophrenic symptoms
What is the difference between psychopathy and sociopathy?
- Psychopathy: characterised by a chronic disturbance to the self, others and their environment causing distress and harm to others and a failure to complete their social obligations' APA (2000)
- Charming, manipulative, impulsive, vain and arrogant, unable to feel and understand emotions
- Sociopathy: share many characteristics with psychopaths but lack the superficial charm due to a lack of socialisation
How is psychopathy diagnosed?
- Harder to detect that other mental disorders due to the lack of physical symptoms
- Interaction of genetic and environmental factors
- Complete the Hare (2003) checklist using interviews and case files
- Out of 40, 30+ indicates psychopathy
Are psychopaths more criminal?
- Yes - Hare (2003), the general population is around 1% psychopathic and the prison population is 10-30%
- Yes- Porter & Woodworth (2006), psychopaths commit disproportionate amounts of violent crime
- Yes- Moffitt (1993), psychopaths are typically life-course persistent offenders
- Yes- Porter & Porter (2007), homicides committed by psychopaths are generally more savage and premeditated
Why are psychopaths more likely to offend?
- Hart (1998)
- Exhibit cognitive biases that make offending more likely to occur (such as hostile attribution bias)
- Lack guilt that would otherwise deter people from crime
- More impulsive