The impact of Schizophrenia and Psychopathy to offending behaviour.
For many years people have associated mental disorders with offending behaviour and in particular, violent offending. According to Jones (2006 p, 383) evidence has been found that individuals who are mentally ill are at greater risk of arrest then the general population. He argues that in an attempt to investigate the relationship between mental disorders and offending behaviour studies have been conducted which have mainly focused on mental disorder in convicted offenders and offending rates in psychiatric populations. As a result of these studies schizophrenia and psychopathy are the two disorders that appear to be most associated with offending. This essay will attempt to describe the terms schizophrenia and psychopathy in some detail and discuss the relation each in turn has with offending behaviour.
Schizophrenia, according to Davenport (1996 p,172), is a severe mental disorder characterised with symptoms of disintegration in the thinking process, in emotional responsiveness and in contact with reality. Social relationships become impossible and cognitive functions are disturbed. Sufferers of schizophrenia may withdraw from other people and from everyday reality, often into a life of odd beliefs, or delusions, and hallucinations.The symptoms of schizophrenia can often make stable employment difficult, resulting in impoverishment and homelessness. The strange behaviour displayed by schizophrenics and the lack of social skills may lead to a loss of friends, a solitary existence and sometimes ridicule and persecution.
The German psychiatrist Emil Kraepelin (1896, cited by Gross, 2008. P.791) was the first to recognise schizophrenia as a separate mental illness. He described it as a distinct disorder which he called ‘dementia praecox’, meaning early insanity. Kraepelin believed that the symptoms were due to a form of mental deterioration that began in adolescences. However Bleuler (1911, cited by McGuire, Mason & O’Kane, 2000, p.162), a Swiss psychiatrist, disagreed with Kraepelin, he believed that the disorder did not necessarily have an early onset and the name ‘dementia praecox’ was inappropriate. Bleuler proposed his own term for the disorder, one that is still used today, schizophrenia. Schizophrenia is taken from the Greek word schizein, meaning to split, and phren, meaning the mind to describe a disorder in which the personality loses its unity.
Individuals with schizophrenia can significantly differ from one another and asKring et al (2010, p.321) explains this is because the range of symptoms in the diagnosis of schizophrenia is extensive and people may only have some of them at any given time. The symptoms of schizophrenia are divided into three categories. The first category refers to positive symptoms and these are based on Schneider’s first rank symptoms (1959, cited by Gross, 2008 p.791) which are subjective and include delusions, hallucinations and thought disturbances. Delusions are beliefs that are held contrary to reality and firmly held in spite of disconfirming evidence. Hallucinations which may be visual, these are often unpleasant and frequently include violence and destruction, but are most commonly auditory, typically as voices commenting or giving instructions. Thought disturbances are where thoughts are inserted into the mind (thought insertion), removed from the mind (thought withdrawal) or broadcast to the mind (thought broadcasting) by external forces.
The second category refers to negative symptoms that are based on Slater and Roth’s major symptoms (1969, cited by Gross, 2008, p.792). These are directly observable from the patient and include thought process disorder, disturbance of affect, psychomotor disturbance and lack of volition. Thought process disorder refers to the inability to keep to the point and becoming easily distracted. Disturbance of affect refers to affect that can be flat and expressionless or alternatively it can be inappropriate such as anger without provocation or laughter at misfortune. Psychomotor disturbance can take the form of bizarre facial grimaces, repeated gesturing or excited agitation of the body; alternatively unusual postures can be adopted and held, in a state of immobility, for long periods. Finally lack of volition refers to a lack of motivation and an absence of interest in or an inability to persist in what are usually routine activities including work, self care, social activities and affection for friends and family.
The third category according to Kring et al (2010, p.324) refer to disorganised symptoms which include disorganised speech and disorganised behaviour. Disorganised speech refers to problems in organising and maintaining a logical and coherent flow of information, whilst disorganised behaviour refers to bizarre behaviour which can take many forms, sufferers seem to lose the ability to organise behaviour in a way that conforms to usual standards, performing everyday tasks also becomes difficult.
Many studies have been conducted to examine the relationship, if any, between schizophrenia and offending behaviour, some of these studies have shown that there is a relationship between the two. For example Green (1981, cited by Jones, 2006, p. 389) conducted a survey of 58 men admitted to mental hospitals after they had killed their mothers and discovered that 75% of them were suffering from schizophrenia. Taylor (1986, p.76) conducted a survey of life sentence prisoners in London and discovered a high level of schizophrenia.
These findings are inconsistent with the work of Monahan and Steadman (1983, cited by McGuire, Mason and O’Kane, 2000, p.165) who conducted an influential review of research that was conducted prior to the early 1980. Their findings suggested that there was little if any relationship between offending behaviour and schizophrenia. They argue that many of the studies that appear to suggest a link between schizophrenia and offending behaviour have failed to take into account demographic factors such as poverty and unemployment. When these kinds of factors were considered, the apparent relationship between schizophrenia and offending behaviour, particularly violence, disappeared.
However, Mullen (2006, p.241) suggests that many of the factors that produce offending in the general population are important in producing offending in schizophrenia. These include disturbed backgrounds, poor social conditions, unemployment and substance abuse, among others. But those with schizophrenia may be more vulnerable to those influences and this in turn may increase offending behaviour.
Whilst Walsh, Buchanan & Fahy (2002, p.490) acknowledge that until the early 1980s the general opinion was that people with schizophrenia were no more likely than the general population to be violent they claim that view is now outdated. They conducted a review of the main studies that have influenced current thinking about the association between schizophrenia and offending, in particular violence, between January 1990 and December 2000. Three different approaches were examined and these included studies on violent acts in those with schizophrenia, schizophrenia in individuals who have committed violent acts and violence in those with and without schizophrenia, regardless of involvement with the mental health or criminal justice systems. They found that the majority of studies conducted over the past two decades have demonstrated a statistical association between schizophrenia and violence. Furthermore that people with schizophrenia are significantly more likely to be violent than members of the general population. Finally that the proportion of violence attributed to people suffering with schizophrenia is small.
The second mental disorder that is most associated with offending behaviour is psychopathy. Psychopathy, according to McLaughlin and Muncie (2006, p.323) is a collection of personality traits that lead to emotional or behavioural problems serious enough to require psychiatric evaluation. Psychopaths have no concern for the feelings of others and a complete disregard of any sense of social obligation. Psychopaths are characterised by lack of empathy, poor impulse control and manipulative behaviours. Kring et al (2010, p.368) argue that psychopathic people have no shame, and their seemingly positive feelings for others are merely an act. They are superficially charming and use that charm to manipulate others for personal gain and satisfaction.
Psychopathy was first recognised in the early 1800s where the term was used in Austrian psychiatry text books but as Jones (2006, p.392) explains, it was not until 1976 in his classic book The Mask of Sanity that Hervey Cleckley drew on his clinical experience to formulate diagnostic criteria for Psychopathy. Cleckley’s criteria for psychopathy focused less on behaviour as such and more on the person’s thoughts and feelings. Kring et al (2010, p.368) explain that Cleckley produced a checklist which consisted of 16 distinguishable characteristics of a psychopath, although various researchers have tried to identify the typical characteristics of a psychopath. They go on to argue that there has been widespread approval of 6 key elements described by Cleckley, they are lack of guilt or remorse, an inability to learn from experience, an inability to delay gratification, an inability to form emotional ties, the constant seeking of stimulation and a superficial charm.
The most commonly used scale that attempts to operationalise the concept of psychopathy and make assessment more reliable according to Kring et al (2010 p,270), was developed by Robert Hare in 1991 and is called the psychopathy checklist revised, known as the PCL-R test. The checklist, based on Cleckley’s criteria, is a 20 item clinical rating scale that is completed through interview and information gathered from other sources including criminal records, social worker reports and case histories. The scale divides into two linked factors, factor one includes interpersonal items, such as superficial charm, grandiose sense of self worth and pathological lying, and affective symptoms such as lack of remorse or empathy. Finally factor two measures socially deviant or anti social lifestyles, such as proneness to boredom and delinquency.
The exact relationship between psychopathy and offending behaviour according to Mclaughlin and Muncie (2006, p323) has not been completely understood but it is clear that psychopathic charachteristics are highly associated with offending. Among offenders who score highly on the PCL-R test there are also high levels of criminality and violence. Hobson and Shine (1998, p.504) findings supports this view, they found that once imprisoned, psychopaths display more violent and aggressive behaviour and are more frequently segregated from other prisoners. Furthermore, after release, the likelihood of reconviction is significantly above that for non psychopaths, particularly for violent crimes. This view is shared by Hemphill et al (1998, cited by Gross 2008, p.842) after his Meta analysis study found that psychopathic offenders were three times as likely to reoffend and four times more likely to violently reoffend within a year of release than non psychopathic offenders.
The criteria of the PCL-R test may show how psychopathic characteristics relate to offending behaviour. According to McLaughlin and Muncie (2006, p.323) the criteria of factor one for example, which includes grandiose sense of self worth and arrogance, highlights the need of psychopathic individuals to feel they are of high status, this need could be satisfied through various types of offending. Being pathological liars can also facilitate certain types of offending behaviour. Psychopaths do not feel the usually constraining emotions of guilt, remorse or empathy; as a result of these lacks of constraints the likelihood of offending behaviour in psychopathic individuals is increased.The emotional volatility of psychopathic individuals may also explain the increased violence that is evident from the studies previously mentioned. The second factor of the PCL-R which includes characteristics like proneness to boredom, impulsivity and delinquency can demonstrate why offending behaviour in psychopathic individuals is increased.
The examination of any relationship between psychopathy and offending behaviour is not helped by the unsatisfactory definition of the disorder. Jones (2006, p.393) argues that the definition is circular in that there are certain behaviours that are used to help assess the disorder, the disorder is then, in turn used to explain these behaviours. He goes on that there is already an established link between psychopathy and offending behaviour as it seems crime is incorporated into the definition of the disorder, he concludes that by the very nature of the characteristics of psychopathy, in essence, psychopathic behaviour is criminal behaviour.
On analysis of both mental disorder in convicted offenders and offending rates in the psychiatric population it is easy to establish a firm relationship between the two mental disorders described in this essay and offending behaviour. Schizophrenia is the disorder that is probably the most associated with violent offending, although the actual number does appear to be very small. There is also an established link between psychopathy and offending behaviour although, that does seem to be incorporated in the definition of the disorder.
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