Impaired neuropsychological profile in homicide offenders with schizophrenia

Engelstad, Katharina Nymo; Vaskinn, Anja; Torgalsbøen, Anne‐Kari; Mohn, Christine; Lau, Bjørn; Rund, Bjørn Rishovd

doi:10.1016/j.comppsych.2018.06.002

Cited by 17 publications

(15 citation statements)

References 38 publications

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“…Correlations were found across some neuropsychological abilities (particularly planning, visual memory and restlessness). Contrary to previous research suggesting an association between general neuropsychological difficulties and aggression (Reinharth et al , 2014; Sedgwick et al , 2017; Ahmed et al , 2018; Engelstad et al , 2018), no other cognitive abilities were found to correlate. However, there are important clinical and research aspects implicated in the associations found.…”

Section: Discussioncontrasting

confidence: 99%

“…Performance in the Immediate Recall (IR) section of the Rey Complex Figure Test (RCFT) correlating with LTS duration suggests difficulties in visual memory encoding and integration (Beebe et al , 2010). Performance on the IR may be influenced by mental planning and organisational skills used in the Copy section (Shorr et al , 1992), implying difficulties with planning and mental organisation alongside memory encoding in those most at risk of higher LTS duration, an observation in concordance with previous research (Reinharth et al , 2014; Engelstad et al , 2018). As the RCFT is made up of staggered sections, there was only a small sample who completed the IR, meaning that interpretation of these results should be done with caution, and further research into this relationship is required.…”

Section: Discussionsupporting

confidence: 84%

“…Psychotic disorders, personality disorders and developmental disorders are common diagnoses across HSPC (McCullough et al , 2020), and individuals with psychosis often present with more difficulties in neuropsychological functioning than healthy controls (Ahmed et al , 2015; O’Reilly et al , 2015; Sedgwick et al , 2017; Ahmed et al , 2018; Engelstad et al , 2018). Similar trends have also been seen in individuals with personality disorders (Mancke et al , 2015; Sedgwick et al , 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Difficulties across all neuropsychological domains are often more pronounced when individuals have a history of extreme violence (Reinharth et al , 2014; Engelstad et al , 2018). Poor executive control of violent impulses has been significantly associated with aggressive behaviours (Holley et al , 2017).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Examining the relationship between neuropsychological functioning assessed during admission to a high secure psychiatric care hospital and vulnerability to long-term segregation

McMichael

Tiley

Broyd

et al. 2020

JFP

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Purpose This paper aims to examine the relationship between neuropsychological functioning as assessed following admission to a high secure psychiatric care (HSPC) hospital and subsequent time spent in long-term segregation (LTS). Evidence from forensic populations suggests neuropsychological functioning difficulties can increase vulnerability to interpersonal violence. However, the impact of this relationship on restrictive interventions used in these settings is poorly understood. Design/methodology/approach This study quantitatively examined the neuropsychological profiles of 80 male HSPC patients as assessed during routine admission assessments, comparing data against any subsequent LTS duration during a one-year period, and a non-LTS control (n = 27). Findings Analysis found individuals who were willing and able to complete a routine neuropsychological admissions assessment spent significantly less time in LTS than those unable to complete the assessment. Performance within a test of novel problem solving (Key Search Test) was significantly worse in the LTS group than controls. Performance within a visual memory task (Immediate Recall section of the Rey Complex Figure Test) significantly correlated with LTS duration. Additional findings suggest the absence of self-reported planning difficulties as measured by a Dysexecutive Questionnaire (DEX) negatively correlated with LTS duration, while self-reported restlessness was positively correlated with LTS. Practical implications This has implications for early assessment of LTS risk and potential use of cognitive interventions to reduce the use of restrictive practices. Originality/value The results suggest some aspects of neuropsychological performance as assessed during admission to a HSPC hospital appear to be related to subsequent time spent in LTS.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Examining the relationship between neuropsychological functioning assessed during admission to a high secure psychiatric care hospital and vulnerability to long-term segregation

McMichael

Tiley

Broyd

et al. 2020

JFP

View full text Add to dashboard Cite

show abstract

“…Most studies were aimed at assessing the efficacy of some programmes to reduce violence, such as metacognitive training [28], and other psychosocial and rehabilitation interventions [29][30][31]. Other studies were aimed at investigating neurocognitive functions [32][33][34], neuropsychological impairment [35], facial emotion recognition, neurocognition, and social cognition [36][37][38][39]. Further studies were aimed to investigate patients' opinions on certain aspects of perceived stigmatization [40], insight deficits [41], working alliance and interpersonal trust in clinicians [42], and decision-making ability [43][44][45].…”

Section: Studies and Sample Characteristicsmentioning

confidence: 99%

Positive and negative syndrome scale in forensic patients with schizophrenia spectrum disorders: a systematic review and meta-analysis

et al. 2022

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Among forensic patients with schizophrenia spectrum disorders, the association between symptomatology and violence is still not entirely clear in literature, especially because symptoms shift both during the acute phase of the illness and after. The aims were to investigate the level of symptomatology in forensic patients and to evaluate if there are differences in the level of symptoms between forensic and non-forensic patients. According to PRISMA guidelines, a systematic search was performed in PubMed, Web of Science, and ProQuest, using the following key words: “forensic” AND “Positive and Negative Syndrome Scale” OR “PANSS”. A total of 27 studies were included in the systematic review, while only 23 studies in the meta-analysis. The overall sample included a total of 1702 participants, most commonly male and inpatients in forensic settings. We found that studies with an entirely male sample had significantly lower Positive PANSS ratings than studies with mixed samples. Although both forensic and non-forensic patients were affected by mild psychopathological symptoms, forensic patients presented higher ratings in all four PANSS scales. This meta-analysis shows that forensic patients reported a mild level of symptomatology, as assessed with the PANSS, and therefore might be considered as patients in partial remission. Among patients with schizophrenia, the association between symptoms and violence is very complex: many factors might be considered as key mediators and thus should be taken into account to explain this association. Further studies are needed.Trial registration all materials and data can be found on the OSF framework: https://osf.io/5ceja (date of registration: 8 September 2021)

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The contributory role of psychopathology and inhibitory control in the case of mass shooter James Holmes

Allely

2020

Aggression and Violent Behavior

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In this article, the case of Mr Holmes is discussed in detail with a particular focus on the treatment he received when he was at graduate school in the months leading up to the shooting and, primarily, the findings from the sanity evaluation carried out by Dr Metzner. In this chapter the I 3 model is applied to the case of Mr Holmes. His attack can be seen as resulting from an increase in dispositional and situational impelling factors and a decrease in inhibiting factors, based on a detailed review on available information, the instigation, impellance and inhibition factors potentially present during the lead up to the shooting (approximately five months) and present at the time of the shooting. Instigation factors included a breakup with his girlfriend and academic failure at graduate school. Impellance factors included chronic (i.e., persistent) and severe mental illness associated with psychotic features (e.g., delusions, hallucinations and disordered thinking); social anxiety disorder (and trichotillomania); chronic suicidal thinking; chronic homicidal thinking and his perceived biological shortcomings. Inhibition factors included experiencing a "loss of fear" or "overcoming fear" of the consequences of killing people; prescription medication which may have increased his inhibition (specifically, antidepressant medication, sertralinehe was eventually prescribed 150 mg of sertraline) and individuals with ASD may be 'more readier' compared to others to act on psychotic impulses. This may have been what was happening in the case of Mr Holmes why he was potentially more vulnerable to acting on his psychotic ideas and beliefs. Also, inhibition caused by his severe mental illness associated with psychotic features (later diagnosed by the four psychiatrists before the trial as either schizophrenia, schizoaffective disorder and schizotypal personality disorder).

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Impaired neuropsychological profile in homicide offenders with schizophrenia

Abstract: Our results indicate that HOS participants show clinically significant impairments in global and specific cognition.

Cited by 17 publications

References 38 publications

Examining the relationship between neuropsychological functioning assessed during admission to a high secure psychiatric care hospital and vulnerability to long-term segregation

Examining the relationship between neuropsychological functioning assessed during admission to a high secure psychiatric care hospital and vulnerability to long-term segregation

Positive and negative syndrome scale in forensic patients with schizophrenia spectrum disorders: a systematic review and meta-analysis

The contributory role of psychopathology and inhibitory control in the case of mass shooter James Holmes

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