Type Ii Offenders With Schizophrenia
Type II offenders with schizophrenia present no history of antisocial or aggressive behaviour prior to illness onset. Thereafter, they repeatedly engage in aggressive behaviour towards others. Such a pattern of aggressive behaviour that onsets in adulthood is very rare, as almost all persistently violent offenders have a long history of antisocial and aggressive behaviour stretching back into childhood . When a pattern of aggressive behaviour onsets in adulthood, it is usually associated with some form of brain disorder . In the sample of 248 men with schizophrenia, which we recruited from forensic and general psychiatric hospitals, we compared the offenders who did not have a childhood history of antisocial behaviour, i.e. our Types II and III, with those who did, Type I. Those without antisocial behaviour prior to illness onset, compared with those with prior CD, included similar proportions with at least one conviction for a violent crime, but, on average, they had acquired fewer convictions for violent crimes and many fewer convictions for non-violent crimes. Importantly, however, a greater proportion of patients without antisocial behaviour prior to illness onset had been convicted for a homicide when compared with patients with prior CD =3.99, p=.046). As would be expected, patients with no history of antisocial behaviour prior to illness onset were significantly older at first conviction for a violent crime than were those with prior CD.
Myth : Schizophrenia Is Untreatable
Many individuals believe that schizophrenia is untreatable because of the exaggerated ways it is portrayed in the media. Contrarily, there are several treatments used to rehabilitate those with schizophrenia and help them live healthy lives. Many take antipsychotic medications and undergo various forms of therapy, such as cognitive-behavioral therapy. Others undergo deep brain stimulation. Depending on the persons needs, the treatment staff will tailor the treatment to produce the best outcome in a successful recovery.
Why Does It Matter
The findings reported above reflect a huge amount of human suffering, on the part of the victims and their families, and on the part of the perpetrators. Schizophrenia is a devastating illness that, in most cases, limits most aspects of functioning through adult life . The evidence now shows that some of those who are stricken with this brain disorder present a propensity for engaging in aggressive behaviour towards others which leads to further negative consequences. In addition, individuals with schizophrenia are more likely than the general population to be the victims of crime , and particularly of assaults, and one of the strongest predictors of physical victimization is their own aggressive behaviour . Violent crimes committed by persons with schizophrenia matter also owing to the associated financial burden they place on society. Studying violence among persons with schizophrenia will inform the development of treatments and prevention programmes aimed at reducing such behaviours and, perhaps, further understanding of the brain mechanisms involved in aggressive behaviour.
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People With Schizophrenia Rarely Kill Strangers
By Amy Norton, Reuters Health
4 Min Read
NEW YORK – Despite some highly publicized incidents in recent years, people with schizophrenia rarely commit random homicide, research shows.
Pooling data from seven studies in four countries, researchers found that the odds of a person with schizophrenia killing a stranger were 1 in 14 million people per year.
The risk appears even lower if the disorder is being treated with antipsychotic medication, the investigators report in the Schizophrenia Bulletin.
When they looked at 42 incidents in which someone with schizophrenia killed a stranger, they found that nearly two-thirds of those offenders had never been treated with medication.
They conclude that it is exceptionally rare for someone with schizophrenia to kill a stranger — and that earlier and continued treatment of the disorder could make these events rarer still.
Schizophrenia is a brain disorder that causes people to break from reality, with symptoms such as hallucinations, paranoia and unusual thoughts and perceptions.
Most people with schizophrenia are not violent, but studies show that they are more likely than people without the disorder to commit violent crimes. This is especially true if a person with schizophrenia abuses drugs or alcohol, or had a history of violence before developing the brain disorder.
Articles On Schizophrenia Stereotypes
Schizophrenia is a serious mental disorder that affects your ability to think and act clearly. When you have schizophrenia, your brain often tells you youâre seeing things or hearing voices that arenât there. This makes it hard to tell whatâs real and what isnât. It also affects how well you think, make decisions, and manage your emotions.
Around 1% of people in the U.S. have schizophrenia. It affects men and women equally. Women tend to get schizophrenia in their 20s or 30s. Men tend to get it in their late teens to early 20s. Itâs rare in kids younger than 12. And it usually doesnât appear for the first time in adults over 40.
If you get schizophrenia, you might have:
- Delusions, or false beliefs that donât change, even when youâre given new ideas and facts
- A hard time remembering things
- Disordered thoughts
- Hallucinations, or hearing voices, seeing things, or smelling things others canât
- Lack of emotion in your face or voice
- Problems focusing
- Trouble understanding information and making decisions
Commonly, people with schizophrenia donât know they have it, which can make treatment much more challenging.
Get the real story behind some common myths.
Myth No. 3: Bad parenting is the cause. Mothers, in particular, often get blamed.
- Be less social
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Is Our Obsession With Risk Making It Worse
So what worries me is the interpretation and outcomes of these findings and their adoption into policy, legislation and clinical practice.
The real danger here is that the focus is on risk, and decisions based only on that risk at the expense of the illness itself, could even increase that risk.
The main problem is that were not actually very good at predicting violent events. This isnt because mental health professionals are rubbish but mainly because theyre so rare in the populations were looking at.
A concept that just doesnt seem to be that well understood, even among doctors, is that the predictive ability of any risk assessment depends on the rate of the event in the population were looking at. The lower the rate, the less able the assessment is to correctly predict it. If something happened frequently, it would be easier to predict.
Although the rate of violence may be slightly higher in those with schizophrenia than Jo Public the absolute rate of violence in those who suffer from schizophrenia is still very low – too low to predict with any accuracy.
Bringing Context Into Treatment
Clinicians need to consider such complexities when conducting treatment and assessments, say psychologists and others who work with patients with serious mental illness who may be at risk for violent behavior.
Each patient needs to be assessed individually to identify factors that seem causally related to acts of violence that have occurred in the past, and to focus on intervening with those factors to reduce future risk, says Appelbaum.
One basic intervention is making sure that people are following treatment protocols, says Shirley M. Glynn, PhD, a clinical and research psychologist at the Semel Institute for Neuroscience and Human Behavior at the University of California, Los Angeles.
When I hear of somebody with a serious mental illness who has acted violently or aggressively, the first thing I ask is, Where are they in terms of their treatment? she says. Often they have let treatment and medications lapse, and if you can help them get back into treatment, a lot of their behavior settles out. Findings from the CATIE Study bear this out, showing that most patients with schizophrenia who took antipsychotics as prescribed were less likely to be violent than those who did not.
What you do after people are released matters, says Dvoskin. He strongly encourages check-ins about how former inpatients or inmates are doing and whether they are following their medication regimens.
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Other Factors In Play
Researchers put different emphasis on the importance of these other factors. This might explain the wide variation in the figures for how much more likely violence is in someone with schizophrenia.
The largest study to date, conducted in Sweden, compared more than 8000 people with schizophrenia with control groups using hospital and criminal records. They found that much of the increased rate of violence in those with schizophrenia was confined to those who also abused drugs.
Controlling for other factors, those with a diagnosis of schizophrenia who did not abuse drugs were only 1.2 times more likely to have committed at least one violent offence than control subjects. But even for those with a diagnosis of schizophrenia who did abuse drugs, the comparison lessened when the researchers considered early environment and genetics – they were only 1.8 times more likely to have committed at least one violent crime than their siblings .
But a recent Australian study showed that people with schizophrenia – even without substance abuse – were twice as likely as control subjects to have a violent conviction.
Most researchers recognise that there is an increase in violent offending in those diagnosed with schizophrenia. But the studies dont tell us how much violent offending is actually caused by the mental disorder itself.
When Should You Go To The Hospital For Psychosis
If a person is showing signs of psychosis, with severely impaired thinking or disorganized speech, Finkelstein says the ER is the right place. And if someone has already been diagnosed with a psychiatric condition and is having serious issues with medications, thats a time to head to the emergency department, too.
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A Typology Of Offenders With Schizophrenia
Another reason for the inconsistent results concerning the association of psychotic symptoms and violence is that studies have compared offenders with schizophrenia to non-offenders with schizophrenia, thereby assuming that the offenders constitute a homogeneous group. The evidence, however, does not support this presumption. Among non-mentally ill offenders, findings have accumulated indicating that there are subtypes, defined by age at onset and persistence of antisocial behaviour that differ as to aetiology and response to treatment . Among offenders with schizophrenia, subtypes defined by age of onset and persistence of antisocial behaviour are also apparent. Consequently, studies that compare violent and non-violent offenders obscure features that distinguish subtypes of violent offenders with schizophrenia such that findings are difficult to interpret.
Take Action If You Think You Or Your Loved One Is In Danger
If you think your loved one is at risk of harming themselves or others and they refuse help, it is possible to have them evaluated by a psychiatrist under the Mental Health Act. This process may involve police and other first responders, and it can be a difficult and stressful process for everyone. But it can also be a necessary step if someone is in danger. You can learn more about the Mental Health Act in the info sheet Families Coping with a Crisis and you can find the Guide to the Mental Health Act at www.health.gov.bc.ca/library/publications/year/2005/MentalHealthGuide.pdf. For a more in-depth discussion of the Mental Health Act, see a video with lawyer and health law consultation Gerrit Clements.
If your loved one says that they have thoughts of ending their life, its important to take action. Call 1-800-SUICIDE at any time or message online at www.crisiscentrechat.ca between noon and 1am. If you think your loved one is in immediate danger, you can always call 911 or go to a hospital emergency room.
Where can I learn more?
- Dealing with Psychosis: A Toolkit for Moving Forward with Your Life is aimed at people experiencing schizophrenia, but it has good information on symptoms and strategies for managing the illness. There is also a chapter for support people
About the author
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‘people With Schizophrenia Aren’t All Dangerous’
Alice is a 26-year-old mum to two daughters. She’s married, she has schizophrenia and she is fed up of being portrayed as “dangerous” because of her condition.
“One of the biggest stereotypes about people like me is that we’re dangerous or violent – mostly we’re just vulnerable.”
People are often surprised when they hear about Alice’s life. That’s something that annoys her.
“Why can’t someone with schizophrenia be living in a house, driving, studying, have children, having a family life?”
When she first started to hear the voices, Alice thought she’d gained a superpower.
She was taking her GCSEs at the time.
All the characters in Alice’s head have names and personalities. You can meet them if you subscribe to our new podcast called “I Hear Voices”.
It’s Alice’s story told over 10 episodes and you can download them wherever you get your podcasts from.
“I thought I was telepathic and I had a new superpower or something.
“It’s a serious long-term condition and it’s a type of psychosis. It means it’s hard sometimes to tell what’s real and what’s not.
“I’m often very frightened, I’m in a state of fear. I feel as if the majority of people are trying to hurt me or do bad to me.
“I can also be manic and make impulsive decisions.”
These states of psychosis have put Alice in some difficult positions.
“It’s like you’re dreaming, but you’re awake,” she says.
“One of them was when I first met my husband on his 21st birthday.
Violent Criminal Offending Among Persons With Schizophrenia
There is now robust evidence demonstrating that both men and women with schizophrenia are at elevated risk when compared to the general population to be convicted of non-violent criminal offences, at higher risk to be convicted of violent criminal offences, and at even higher risk to be convicted of homicide . For example, we examined a birth cohort composed of all the 358180 persons born in Denmark from 1944 to 1947 followed until they were in their mid-forties. We excluded those who had died or emigrated before the end of the follow-up period. The official criminal records of cohort members who had been admitted to a psychiatric ward at least once with a discharge diagnosis of schizophrenia were compared with those with no psychiatric admissions. The risk of a violent crime was elevated 4.6 times among the men and 23.2 times among the women with schizophrenia when compared with those with no admissions to a psychiatric ward . Similar elevations in risk have been documented among persons with schizophrenia identified in other birth and populations cohorts . While fewer women than men, with and without schizophrenia, are convicted of crimes, schizophrenia confers a greater risk for offending among women than among men.
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People With Schizophrenia Do Not Work
Media outlets sometimes portray people with schizophrenia as separate from society, or as people who cannot do ordinary activities such as hold down a job.
The National Institute of Mental Health estimate that around 0.25% to 0.64% of people in the United States have schizophrenia or a related condition. This means that schizophrenia is relatively uncommon.
For this reason, it is possible that this myth persists because many people never know or interact with someone who has schizophrenia.
However, this does not mean that they are apart from society. People with schizophrenia who respond well to treatment are often able to enjoy independence and a job.
Maintain Your Social Network
Try to maintain your friendships or the network of people that you have in your life. These will later become important supports as your loved one recovers. Educate them and update them on your loved one’s recovery. People are sometimes afraid to ask questions about schizophrenia and this will put them at ease.
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What Not To Say To Someone With Schizophrenia
1. Dont be rude or unsupportive. Instead, be tolerant and listen to what they are saying. If they are being dangerous or inappropriate, do call for help. You dont want to be in a dangerous situation.
2. Dont bully them into doing something they dont want to do. Instead, ask them if there is someone you could call for them. A friend, parent, social worker, or therapist are all good options.
3. Dont interrupt them. Let them talk, even if they are rambling. Having someone listen is being supportive of their condition. According to Dr. Xavier Amador in his book, I Am Not Sick. I Dont Need Help!,stop arguing and start listening to your loved one in a way that leaves him feeling that his point of view is being respected.
4. Dont assume you know what they need. Instead, ask them what they would need to feel better, says the UKs Mental Health Foundation. Perhaps its a glass of water, or sitting down, or having a favorite item nearby. Help them with whatever will help soothe them.
5. Dont second guess or diagnose them. Diagnosis is for doctors. Youre there to be supportive, not give medical judgment.
6. Dont use words that make you seem like an enemy. Dont say, stop that, or Ill call the police, but instead reassure them that you are on their side and that you want to help them.
10. Dont use a strong voice. Instead use soft, gentle language, so the person knows youre to be trusted.
The Myth Hollywood Created About Schizophrenia
The bad guy is always delusional, hysterical, misplaced, or suffering from a serious mental illness.
Hollywood loves to play up mental illness and there are many television shows and movies that depict schizophrenics in a negative light. While these Hollywood creations may be entertaining, the reality is that theyre actually misinforming you about thetruth behind schizophrenia and other mental health conditions.
Schizophrenia specifically is often dramatized on screen, with the main character exhibiting violent behavior and acting out in ways that are incredibly dangerous to themselves and others.
Unfortunately, the heightened levels of aggression and impulsiveness in television and movie characters with schizophrenia only make matters worse because theyre not realistic or representative of what people with the disorder truly go through.
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