1,721,048 research outputs found
Personality disorders and criminal responsibility in Italy: forensic psychiatric considerations about the importance of going beyond a categorical view
No full textIn 2005 the Italian Supreme Court held that also persons suffering from “severe personality disorders” may enter a plea of non-responsibility if, at the time of an alleged crime, they were under such severe stress that they decompensated into a mental state during which they were unable to appreciate the nature, quality and
consequences of their behavior or to conform their conduct to the requirements of the law.
Since then, offenders with personality disorders have become a challenge for the Italian forensic psychiatric system, because criminal offenders have a high rate of personality disorders and the identification of the “severe” threshold is particularly hard in a jurisdiction which includes the volitional prong.
The aim of this study is to determine how personality disorders are viewed in relation to criminal responsibility within the Italian criminal system, discussing the results in the light of the evidences from the international literature.
We conducted a retrospective study of sentences of the Italian Supreme Court from January 1, 2006, to December 31, 2010, collected via a judicial database and we reviewed the articles published in English from 2000 to 2010 with the keywords “personality disorder”, “criminal responsibility”, “insanity defense”, “volitional/cognitive capacities”.
The results of the sentences study indicate that personality disorders have become very frequent in Italian insanity defense cases. The most frequently occurring are antisocial, borderline and non otherwise specified. The majority of these were associated with another Axis I disorder, in particular with substance abuse.
According to the literature, the proof of a “mental disease” is necessary, but not sufficient, to establish an “insanity defense”, because from a forensic psychiatric standpoint the necessary conditions whereby a mental disorder can take on the meaning of “insanity” should be that it has caused, in the specific case, such “psychopathological functioning” of the acting subject as to compromise his capacity for cognition and/or volition and that it was causally linked with the crime
Fondamenti di Psicopatologia Forense. Problemi di metodo e prospettive di sviluppo delle consulenze psicologiche e psichiatriche in ambito giudiziario
No full textHomicide committed by psychiatric patients: Psychiatrists’ liability in Italian law cases
No full textInterest in psychiatrists' professional liability in Italy has increased in recent years because of the number of medical malpractice claims. Professional liability for failure to prevent violent behaviour by psychiatric patients is particularly debated. This study describes three Italian cases in which health professionals - physicians and nurses - were found guilty of manslaughter for murders committed by psychiatric patients. Examination of the cases focuses on claims of malpractice, patients' characteristics, the circumstances of the homicide and the reasons for the court's judgment. In particular, the predictability of violent behaviour and the concept of causal links are examined in detail. The cases provide an opportunity for a study of comparative jurisprudence. The topics discussed are relevant not only to practicing psychiatrists but also to experts assessing medical liability in cases of criminal acts committed by psychiatric patients
I programmi di trattamento psicosociale dei disturbi della condotta in età evolutiva al vaglio della ricerca valutativa
No full textDespite the increasing scientific interest in evidence-based interventions for conduct problems in young people, there remains a wide gap between the knowledge gained through empirical research and clinical practice. The aims of the present study were to identify empirically supported psychosocial intervention programs for young people with conduct problems and to evaluate the underpinnings, techniques and outcomes of these treatments. We analyzed reviews and meta-analyses published between 1982 and 2011 concerning psychosocial intervention programs for children aged 3 to 12 years with conduct problems. According to the literature reviewed, parent training should be considered the first-line approach to dealing with young children, whereas cognitive-behavioral approaches have a greater effect on older youths. Family interventions have shown greater efficacy in older youths, whereas multi-component and multimodal treatment approaches have yielded moderate effects in both childhood and adolescence. Some limitations were found, especially regarding the evaluation of effects. Nevertheless, the literature analysis indicated that psychosocial interventions for minors with conduct problems are widely studied and can be considered a useful part of treatment planning for youths who display problems of adaptation. To date, no single program has emerged as the best. However, it emerges that the choice of intervention should be age-specific and should take into account developmental differences in cognitive, behavioral, affective and communicative abilities
Tra nosografia e clinica: la valutazione medico-legale del c.d. lutto complicato
No full textL’interesse della Medicina Legale per le conseguenze psicopatologiche correlate con un lutto familiare nasce e si sviluppa sulla spinta della sentenza della Corte Costituzionale n. 372 del 1994, che ha ritenuto risarcibile il danno alla salute psichica subìto da un prossimo congiunto a seguito della morte di un familiare vittima di fatto illecito altrui, allorquando possa essere provato che la patologia psichica sia causalmente riconducibile all’evento e rappresenti un’alterazione di carattere irreversibile.
Affrontare il tema del lutto in una cornice di tipo medico-legale, dunque, implica la soluzione di diverse questioni che riguardano sia la natura fisiologica o patologica delle conseguenze della “sindrome da lutto”, sia il ruolo delle eventuali preesistenze, sia la dimensione del pregiudizio invalidante.
Sebbene sia universalmente accettato che l’elaborazione del lutto possa fallire o complicarsi dando luogo a problematiche psicopatologiche, la fase diagnostico-prognostica risulta sempre molto delicata e particolarmente complessa. La ricerca clinica da tempo evidenzia come le manifestazioni del cd. lutto complicato non coincidano tout court con le categorie diagnostiche attualmente presenti nei più diffusi sistemi nosografici internazionali (DSM IV-TR, ICD-10), tanto da suggerire l’introduzione di un’entità clinica autonoma e definita. In realtà, molti Autori ritengono che sia possibile individuare e descrivere in modo specifico la presenza di disturbi psicopatologici derivanti da una elaborazione ritardata o complicata del lutto. L’utilizzo degli strumenti diagnostici proposti dalla ricerca clinica può rendere anche l’indagine medicolegale facilmente controllabile e ripetibile, e cioè basata su evidenze scientifiche.
Tali indagini richiedono certamente un accurato e complesso esame comparativo tra la condizione clinica presente al momento dell’accertamento e quella preesistente all’evento, con l’obiettivo di escludere eventuali preesistenze e di differenziare l’aggravamento dalla co-morbidità, il peggioramento dalla recrudescenza.
Sul piano, infine, della concreta quantificazione del danno, è necessario partire da una valutazione percentualistica basata sugli inquadramenti nosografici offerti dalle più condivise classificazioni medicolegali, ma occorre procedere lungo un secondo livello di indagine, c.d. “funzionale”, nel quale l’esperto è tenuto a cercare di personalizzare il dato numerico sulla base dei riflessi disfunzionali psico-socio-esistenziali indotti dallo stess
Il comportamento violento tra biologia ed ambiente: La criminologia verso un "nuovo" approccio biosociale?
No full textIn recent years there has been a renewed interest in studying the relationship between biology and crime, with particular reference to aggression and violence. This "return" to the biological interpretations of antisocial conduct took rise from the growing body of research seeking to identify the genetic basis, biochemical and morphological characteristics of human behavior, both normal and pathological. After a brief reminder of the main evolutionary stages of biological theories in criminology, we have examined the recent interpretations of the mechanisms underlying the development of violent behavior, so as to provide a comprehensive review of current scientific knowledge. Finally, we have analyzed an emerging topic in behavioral biology, epigenetics, a sort of "social genetics" which studies the changes induced by the environment on gene expression, rather than the gene structure. © Pensa MultiMedia Editore
La psichiatria forense e il “vizio di mente”: criticità attuali e prospettive metodologiche
No full textIn the last decades the concept of « infirmity » has been much debated in connection
with rules 88 and 89 of the Italian criminal code, fueled by the lack of a
single shared interpretation of such expression, which essentially originates from
the difficult relationship between law and psychiatry: the first one regards psychiatry
as a stable and rational foundation for decision-making, the second one attempts
to combine the uncertainties of its clinic dimensions with the needs of legal
certainty.
This discussion has led to unavoidable side effects involving the cooperation
between scientific knowledge and the judge, who has gradually found himself torn
between different orientations, with inevitable differences of interpretation and application
of the law. In particular, following the epistemological-methodological
evolution that has characterized the history of modern psychiatry, the jurisprudence
has showed a sort of dichotomy about the the concept of infirmity.
This development has undergone a major review by the United Sections of
the Supreme Criminal Court, n. 9163/2005 which not only clarified the conflict
about the interpretation of « infirmity », but also gave an opportunity to develop
a systematic review of criminal responsibility.
The Authors analyze, in particular, how this development has influenced forensic
psychiatry as to provide pragmatic criteria for a methodology usable in practice
by the experts in this difficult field of investigation
Behavioral neurobiology in forensic psychiatry: problems and prospects
No full textBackground
In recent decades, considerable progress has been made in the study of the biological bases of violent behavior, so much so as to rekindle a heated debate on the notions of “free will” and “criminal responsibility”. These questions gained renewed prominence in Italy after the sentence of a criminal Court that decided to admit a “diminished responsibility defense” because the offender was found to be carrier of a few genetic variants that were thought to be associated with a predisposition to violence.
Case report
An adult female was charged with the murder of her sister. The first forensic psychiatric report excluded the presence of a mental disorder, so she was assessed responsible. A second forensic psychiatric evaluation took place, including: (1) psychometric assessment (MMPI-2 & PPI-R); (2) neuropsychological examination; (3) morphometric analysis with VBM and (4) genetic analysis of DNA aimed at identifying genetic polymorphisms associated with violence. The final report picked out the presence of a multiple personality disorder and of abnormalities in brain-imaging scans and in five genes that have been linked to violent behavior. The Court ruled a sentence of “diminished responsibility” arguing that the defendant's genes “would make her particularly reactive and vulnerable to aggressiveness in stressful situations”.
Discussion
A growing number of researches have investigated the relationship between biogenetics and violent behavior. In particular, recent studies have combined behavioral genetics and functional brain imaging with the rationale that specific polymorphisms may lead to brain changes which, in turn, may increase vulnerability to various forms of violent behavior. A critical next step in testing this ‘‘from genes to brain to violent behavior’’ hypothesis is to identify the role of the environment (epigenetics).
Conclusion
The use of neuroscience and behavioral genetics is increasingly considered potentially useful in providing objective data on the assessment of a defendant’s criminal competence. From a forensic psychiatric standpoint, nonetheless, it must be remembered that the necessary conditions whereby a mental disorder can take on the meaning of “insanity” should be that it has caused, in the specific case, such mental impairment as to compromise the capacity for cognition and/or volition and that it was causally linked with the crime
Un passo avanti e mezzo indietro della Cassazione civile sul diverso "binario" nell'accertamento del nesso causale fra diritto civile e diritto penale.
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