1,720,974 research outputs found
Is disulfiram (Antabus (R)) indicated in the treatment of offenders with alcohol use disorders?
No full textBackground Research studies and clinical experience provided us with valuable information about the efficacy of disulfiram. Although supervised disulfiram treatment has been shown to improve outcome in court-referred patients too it is obviously rarely used in German forensic hospitals. Method Two cases illustrated the application of disulfiram to constitute an adjunct to treatment of forensic inpatients. Results Disulfiram can be used as an adjunct for maintenance of abstinence when the relapse risk is due to insufficient impulse control. Discussion The decision to use disulfiram to assure sobriety for high risk groups, e.g. criminal offenders is discussed
Recidivism after Final Rejection of a Subsequent Order of Preventive Detention
No full textFollowing the decisions of the European Council on Human Rights since 2009 and the German Federal Constitutional Court of 2011, the regulation of preventive detention in Germany had to be reregulated. Though they were based on a thin amount of data, the discussions about the dangerousness of the detainees were controversial and emotional. In 2011, we published results of a study on recidivism after (legally not ordered) subsequent preventive detention (S 66b German StGB). In the meantime, both the number of cases studied and the observation period covered has been expanded. The evaluation of the Federal Registry of Excerpts (Bundeszentralregister; BZR) from those offenders considered highly dangerous, but due to the jurisprudence of the Federal Supreme Court, not placed under subsequent preventive detention (nachtragliche Sicherungsverwahrung: nSV; S 66b German StGB) now detects an average period of 6.5 years (time at risk phi 78 months). Within this period, 28% were convicted of a serious offense relapse, 37% were convicted of a non-serious offense, and 34% were not reconvicted
Recidivism after Final Rejection of a Subsequent Order of Preventive Detention
No full textFollowing the decisions of the European Council on Human Rights since 2009 and the German Federal Constitutional Court of 2011, the regulation of preventive detention in Germany had to be reregulated. Though they were based on a thin amount of data, the discussions about the dangerousness of the detainees were controversial and emotional. In 2011, we published results of a study on recidivism after (legally not ordered) subsequent preventive detention (S 66b German StGB). In the meantime, both the number of cases studied and the observation period covered has been expanded. The evaluation of the Federal Registry of Excerpts (Bundeszentralregister; BZR) from those offenders considered highly dangerous, but due to the jurisprudence of the Federal Supreme Court, not placed under subsequent preventive detention (nachtragliche Sicherungsverwahrung: nSV; S 66b German StGB) now detects an average period of 6.5 years (time at risk phi 78 months). Within this period, 28% were convicted of a serious offense relapse, 37% were convicted of a non-serious offense, and 34% were not reconvicted
Neurobiological research on pedophilia - results and their consequences for the assessment of pedophilic offenders
No full textThe difficulty with the assessment of pedophilic offenders is in the valid assessment of a pedophilic interest. The current methods lack of validity and reliability. In the last decade the amount of neurobiological investigations in pedophilia accelerates, however, the results are very heterogeneous. Relevant results for the assessment of pedophilia do not exist yet. In addition a verification of the validity and reliability of the used designs is absent. It is the challenge of the neurobiological forensic research to examine carefully the potential in assessing pedophilic offenders
Forensic assessment Are biological facts useful?
No full textPrognoses in forensic psychiatry are demanded and delivered on a daily basis. Given the multitude of different causes, it is not surprising that prognostic questions also widely differ. To predict the likelihood of criminal re-offences, risk checklists are used; biological parameters are rarely considered. This text outlines exemplary (neuro-)biological investigations and methods and their relevance to the diagnosis and treatment of psychiatric disturbances. Their possible relevance with regard to forensic psychiatric prognoses is also discussed. It is suggested that biological facts must be investigated as additional predictors
Forensic assessment Are biological facts useful?
No full textPrognoses in forensic psychiatry are demanded and delivered on a daily basis. Given the multitude of different causes, it is not surprising that prognostic questions also widely differ. To predict the likelihood of criminal re-offences, risk checklists are used; biological parameters are rarely considered. This text outlines exemplary (neuro-)biological investigations and methods and their relevance to the diagnosis and treatment of psychiatric disturbances. Their possible relevance with regard to forensic psychiatric prognoses is also discussed. It is suggested that biological facts must be investigated as additional predictors
Recidivism and Characteristics of Highly Dangerous Offenders Being Released from Retrospectively Imposed Preventive Detention: An Empirical Study
No full textThis study examines the recidivism of offenders who are considered to be highly dangerous but who, as a result of a decision of the German Federal High Court, have not been in preventive detention because it was imposed retrospectively (Group II preventive detention cases; 66b StGB). Taking into consideration the restrictions imposed by the study, the data were evaluated regarding their usefulness for predicting the likelihood of reoffending. The results of this study suggest that it could be useful to describe criteria for the not very severe reoffending group. Copyright (c) 2013 John Wiley & Sons, Ltd
Legal Probation after Psychiatric Assessments for Additional Preventative Detention
No full textSince its introduction in 2004, the additional preventative detention ("nachtragliche Sicherungsverwahrung") in Germany has been discussed controversially and emotionally. There are few empirical data about additional preventative detention. We report initial results of a country wide study of the legal probation and danger prognoses of individuals considered to be too dangerous for society but who have served their time in prison. We analyzed expert testimonies from 25 judicial decisions which did not result in additional preventative detention-due to a recent change in the law. It was found that two years after release from prison 28 % of the individuals had committed a serious offense and 38 % had committed a minor offense. About 40 % of the former candidates for additional preventative detention did not reoffend in that time
The Role of Testosterone in Sexuality and Paraphilia—A Neurobiological Approach. Part II: Testosterone and Paraphilia
No full textABSTRACT
Introduction
Antiandrogen therapy has been used for 30 years to treat paraphilic patients and sexual offenders. Yet the therapeutic success of antiandrogens is uncertain. Furthermore, there is still a lack of comprehensive knowledge about the effects of androgen-lowering therapy in paraphilic patients.
Aim
We discuss endocrinological, neurobiological, and therapeutic aspects of paraphilia with the aim of integrating these on the basis of the current neurobiological and clinical knowledge on testosterone that was set out in Part I of this review.
Methods
Our review of the human literature comprises the current knowledge about the neurobiology of paraphilia and the known endocrinological, pathophysiological, and genetic aspects of this disorder. The role of testosterone is discussed. A survey of antiandrogen therapy and its outcome in paraphilic patients and sex offenders is provided.
Results
Although not all data are consistent, current imaging research suggests that structural and functional changes in pedophilia appear for the most part in brain regions also involved in sexual functions. Not exclusively testosterone but also some other endocrinological and neurochemical parameters could be disturbed in pedophilic patients and child molesters; these include changes in hypothalamic–pituitary function, prolactin levels, and dopaminergic or serotonergic functions. There appears to be a sex-steroid-related genetic influence on antisocial traits, externalizing behavior, and sexual behavior. Most of the studies in which antiandrogen therapy in paraphilic patients and sex offenders have been examined were case reports, or observational or open-label studies, and many did not include adequate control groups. Only a few placebo-controlled double-blind studies have been published with inconsistent results concerning treatment effects. Outcome measures differ between the studies and do not seem ideally suited to their purpose.
Conclusions
On the basis of the current knowledge about testosterone and its effects on brain and behavior as described in Part I, and of available results on the relationship between testosterone and paraphilia as well as antiandrogen therapy, we present from a neurobiological perspective an extended scientific proposal for design features to investigate the effects of antiandrogen treatment in large clinical trials.
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