Forensic – 3

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19 Forensic – 3

	T	F
1.Adversarial legal systems are inquisitory in nature.
2. A power of attorney is a means whereby one person gives legal authority to another person to manage their affairs.
3. The nearest relative in mental health legislation can be an illegitimate son.
4. A medicolegal report should enhance the case of the party requesting it.
5. In civil cases, the medicolegal report should recommend the damages to be awarded.
6. Those suffering from a severe mental illness are unlikely to be fit to plead.
7. Females have a higher rate of emotional disorders than conduct disorder.
8. The heritability of antisocial behaviour is 0.6–0.8.
9. Indecent exposure may proceed to physical assault.
10. Sexual offending in learning disabilities is usually due to hypersexuality.
11. In sex offenders with learning disabilities, cyproterone acetate is the treatment of choice for males because they are unable to benefit from psychosocial interventions.
12. People with learning disabilities have higher conviction rates than the general population.
13. Recent disclosure of child sexual abuse in a family is an indication for removing the child from the family.
14. Components of treatment planning for sexually abused children include a timetable for expected change.
15. The number of previous convictions is the best indicator of risk of re-offending in paedophilia.
16. In group rape, it is likely that alcohol has been consumed.
17. A woman of 50, with no previous offences, is convicted of shoplifting. It is likely that she needed the articles she stole.
18. Patients with schizophrenia commit arson usually due to their delusions.
19. For arson there is a mandatory custodial sentence or hospital order.
20. Mental illness is uncommon in cases of homicide.
21. The term ‘abnormal homicide’ refers to homicides committed when the mental state was abnormal.
22. Patients with psychoses who kill do so because they are responding to hallucinations or delusions.
23. Homicide followed by suicide is more likely than not to be associated with a mental illness.
24. Police attending pubs at closing time reduces crime.
25. In the prison population, relatively more white people are diagnosed to have psychosis than black people.

ANSWERS

1. Adversarial legal systems are inquisitory in nature.

False: Adversarial systems are not inquisitory, but accusatory. The evidence of the prosecution is heard first, followed by the evidence of the defence. On the strength of this evidence a decision about guilt in Criminal Courts or responsibility in Civil Courts is made (Stone et al 2000, p. 24).

2. A power of attorney is a means whereby one person gives legal authority to another person to manage their affairs.

True: In making the power of attorney, the donor must have the capacity to give the power. The Enduring Power of Attorney Act, 1985, enables a power of attorney to be continued beyond the failure of the donor’s mental capacity. If the donor lacks capacity, the arrangements have to be registered with the Court of Protection.

3. The nearest relative in mental health legislation can be an illegitimate son.

True: A nearest relative means any of the following persons: (a) husband or wife (b) son or daughter (c) father or mother (d) brother or sister (e) grandparent (f) grandchild (g) uncle or aunt (h) nephew or niece. Relatives of whole blood are preferred to relatives of half blood and the elder is preferred to younger relatives. Husband or wife is defined as the person living with the patient as their husband or wife for at least 6 months. In special cases, where a person is not a relative, they can be a relative if the patient has been residing with them for a period of not less than 5 years. Preference would also be given to the relative with whom the patient ordinarily resides or is cared for. The patient’s children get priority over his/her parents as nearest relative. An illegitimate child should be treated as a legitimate child of the mother.

4. A medicolegal report should enhance the case of the party requesting it.

False: The foremost duty of the psychiatrist is to the Court and to help the Court in reaching a conclusion on the case. The report should be sufficiently detailed to be able to stand on its own to win the Court’s confidence. The report should not necessarily aim at enhancing the case of one party or another, as the status of the expert is that of an independent witness, even though he/she might be instructed by one party.

5. In civil cases, the medicolegal report should recommend the damages to be awarded.

False: While discussing the question of psychological damage, the report should comment on the mental health of the patient before the accident, the mental health immediately after the accident and the mental health at the time of the examination. The report should include the diagnosis and opinions on prognosis and the dysfunction caused by the psychiatric disorder. However, no recommendation on the damages to be ordered should be made, as this is a job for the Court.

6. Those suffering from a severe mental illness are unlikely to be fit to plead.

False: The defendant might be actively psychotic and suffering from a severe mental disorder or mental impairment and yet be fit to plead (Gunn & Taylor 1993, p. 44; Stone et al 2000, p. 55).

7. Females have a higher rate of emotional disorders than conduct disorder.

True: Girls suffer more from emotional disorders, whereas boys suffer more from conduct disorders and mixed disorders of conduct and emotion. The predisposing factors include family discord, parental psychiatric disorder, social disadvantage and inferior quality of schooling. Subsequent disturbed behaviour is also associated with chronic illness, handicap and language delay (Gelder et al 2000, pp. 1689, 1697).

8. The heritability of antisocial behaviour is 0.6–0.8.

False: 0.41–0.5 (Johnstone et al 2004, p. 701).

9. Indecent exposure may proceed to physical assault.

True: A small minority of exhibitionists escalate their offending to commit sexual assaults (Gunn & Taylor 1993, p. 547; Stone et al 2000, p. 215).

10. Sexual offending in learning disabilities is usually due to hypersexuality.

False: It is often due to poor social and relationship skills. It is much more a result of a maturational defect (Bluglass & Bowden 1990, p. 404).

11. In sex offenders with learning disabilities, cyproterone acetate is the treatment of choice for males because they are unable to benefit from psychosocial interventions.

False: Psychosocial interventions, e.g. sex education and counselling, are the treatments of choice for minor offenders. People with learning disabilities are often able to benefit from psychosocial interventions. Sex drive suppressant drugs such as cyproterone acetate can often be an adjunct to management. They may help reduce libido to a level where the individual can better control it. However, they do not substitute for psychosocial interventions (Bluglass & Bowden 1990, p. 414; Chiswick & Cope 1995, p. 74).

12. People with learning disabilities have higher conviction rates than the general population.

False: The prevalence of offending in the population with learning disabilities is low, around 1%. There is over-representation of those with borderline learning disabilities. Surveys of convicted prisoners do not show an over-representation of those with learning disabilities in the UK, but they do in other countries. For example, in Australia, 12–13% of convicted prisoners have learning disabilities (Fraser & Kerr 2003, p. 290).

13. Recent disclosure of child sexual abuse in a family is an indication for removing the child from the family.

False: Every effort is normally made to keep the child within the family. The usual practice is to remove the incest perpetrator from the family environment soon after disclosure so that the initial assessment is not hindered (Bluglass & Bowden 1990, p. 754).

14. Components of treatment planning for sexually abused children include a timetable for expected change.

False: The treatment plan in child sexual abuse includes initial evaluation, disclosure, treatment of the perpetrator, risk assessment, child protection plan, counselling for partner and treatment for the victim. A timetable for expected change is not an essential component. The legal process takes its course in parallel with the treatment.

15. The number of previous convictions is the best indicator of risk of re-offending in paedophilia.

True: The strongest predictor of sexual recidivism in paedophilia is sexual interest in children. A meta-analysis of 61 studies identified antisocial personality disorder, a high number of previous offences, younger age of offending, and being single as predictors of sex offender recidivism (Hanson & Bussiere 1998).

16. In group rape, it is likely that alcohol has been consumed.

True: Gang rapes are characterized by more alcohol and drug involvement, fewer weapons, more night attacks, less victim resistance, and more severe sexual assault outcomes compared with individual rapes. Alcohol is the drug most commonly associated with all kinds of violent and sexual crime, particularly by males. Alcohol consumption has been reported prior to offending in 50% of individual rapes.

17. A woman of 50, with no previous offences, is convicted of shoplifting. It is likely that she needed the articles she stole.

False: In most cases, the shoplifter would have no need for the articles chosen for stealing (Gelder et al 2000, p. 980; Johnstone et al 2004, p. 715; Wright et al 2005, p. 469).

18. Patients with schizophrenia commit arson usually due to their delusions.

False: The relationship between arson and psychiatric abnormality may be direct, where the patient is acting on a delusion or other psychotic phenomena, but may be indirect, reflecting stressors secondary to the illness. The history of previous fire setting and offending, understanding the precipitant to the fire setting and the subject’s own account of his fantasies and impulses are important in assessing the risk of recidivism (Johnstone et al 2004, p. 715; Stone et al 2000, p. 109).

19. For arson there is a mandatory custodial sentence or hospital order.

False: There is no mandatory sentence for arson. It depends at least in part on the severity of the crime and the risk of re-offending. However, re-offending rates are very low in those who have served custodial sentences. Arsonists with learning disabilities or mental illness might be more likely to re-offend (Gelder et al 2000, p. 2057).

20. Mental illness is uncommon in cases of homicide.

True: Figures vary for the incidence of mental illness in homicide. However, it seems to be less than 20%. Over the last 30 years, the contribution of mental disorder to homicide has decreased further. The National Confidential Inquiry found only 5% of homicides to be committed by people with schizophrenia.

Of the 1594 people convicted of homicide in England and Wales during 1996–99, 545 (34%) had a mental disorder: most had not attended psychiatric services; 85 (5%) had schizophrenia (lifetime); 164 (10%) had symptoms of mental illness at the time of the offence; 149 (9%) received a diminished responsibility verdict and 111 (7%) a hospital disposal – both were associated with severe mental illness and symptoms of psychosis. Most perpetrators with a history of mental disorder were not acutely ill or under mental health care at the time of the offence (Shaw et al 2006; Stone et al 2000, p. 130; Taylor & Gunn 1999).

21. The term ‘abnormal homicide’ refers to homicides committed when the mental state was abnormal.

False: Homicides are divided into ‘normal’ and ‘abnormal’ based on the legal outcome. Homicide is ‘normal’ if there is a conviction for murder or manslaughter. Homicide is ‘abnormal’ if there is a finding of insane murder, suicide murder, diminished responsibility or infanticide (Gelder et al 2006, p. 738).

22. Patients with psychoses who kill do so because they are responding to hallucinations or delusions.

False: Less than half of psychotic offenders describe psychotic motivation, usually delusions, for their offences. Command hallucinations are not particularly associated with murder. There is a motive in most offences.

Of the 1594 people convicted of homicide in England and Wales during 1996–99, 545 (34%) had a mental disorder. However, only 5% had psychotic symptoms and 6% had symptoms of depression at the time of the offence (Gelder et al 2000, p. 2044; Shaw et al 2006).

23. Homicide followed by suicide is more likely than not to be associated with a mental illness.

True: In the UK, homicide is followed by suicide in 10% of cases. A third to a half of all homicides in the UK are ‘abnormal’ homicides. In most cases the offender had severe depression at the time of the offence. Other causes include jealousy, paranoid disorders and intoxication (Gelder et al 2006, p. 739).

24. Police attending pubs at closing time reduces crime.

True: There is a clustering of offending behaviour at pub closing time, when people come on to the streets with high blood alcohol levels. There is a close relationship between alcohol use and criminal activity. The presence of police at pub closing time will therefore help to reduce the possibility of crime as the police can take preventive action.

25. In the prison population relatively more white people are diagnosed to have psychosis than black people.

False: There is an over-representation of black people among those who are imprisoned, among those who are diagnosed to have psychosis and among the prisoners who are diagnosed to have psychosis. The higher rates of imprisonment might be explained by higher rates of conduct disorder, adolescent-onset criminality and disadvantage within the criminal justice system (Coid et al 2002).

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