Lecture 4 – Schizophrenia and Crime
DSM-5 Diagnosis;
- Two or more of the following present for a significant portion of time during a one-
month period:
- Delusions
- Hallucinations
- Disorganised speech
- Grossly disorganized or catatonic behaviour
- Negative symptoms
- Level of functioning is affected by symptoms
- Signs of disturbance persist for at least six months, with symptoms present for at
least one month
- Other illnesses and affective disorders must be ruled out
- If there is a history of autism spectrum disorder or communication disorder of
childhood onset, the delusions/hallucinations must be prominent
ICD-11 Diagnosis;
- Schizophrenia is characterised by disturbances in multiple mental modalities,
including thinking (e.g., delusions, disorganisation in the form of thought),
perception (e.g., hallucinations), self-experience (e.g., the experience that one's
feelings, impulses, thoughts, or behaviour are under the control of an external
force), cognition (e.g., impaired attention, verbal memory, and social cognition),
volition (e.g., loss of motivation), affect (e.g., blunted emotional expression), and
behaviour (e.g., behaviour that appears bizarre or purposeless, unpredictable or
inappropriate emotional responses that interfere with the organisation of
behaviour). Psychomotor disturbances, including catatonia, may be present.
Persistent delusions, persistent hallucinations, thought disorder, and experiences of
influence, passivity, or control are considered core symptoms. Symptoms must have
persisted for at least one month in order for a diagnosis of schizophrenia to be
assigned. The symptoms are not a manifestation of another health condition (e.g., a
brain tumour) and are not due to the effect of a substance or medication on the
central nervous system (e.g., corticosteroids), including withdrawal (e.g., alcohol
withdrawal).
, Symptoms;
Links to Violence & Crime;
A (brief) History of Schizophrenia & Crime;
- Historically, schizophrenia associated with violence, then academics rejected the
notion claiming no more dangerous than anyone else (Hiday, 1995)
- Mixed bag in terms of evidence:
- E.g. 5% of offenders in a sample of 1594 had schizophrenia (Eronen et al., 1996) but
others found no association (Monahan & Steadman, 1983)
- 1980’s onwards studies were higher quality, and population-based
- They suggested a modest association between violence & schizophrenia:
- Swanson et al., (1990)
- data from 10059 participants in
the US
- Used structured interviews to est.
diagnosis and self-report data to
assess violence in past 12 months
- Those with schizophrenia were
more likely to report violence than
participants with no MHP
- After Swanson a lot of studies
were inconsistent or had messy
designs
- Then meta-analyses started taking
off…
DSM-5 Diagnosis;
- Two or more of the following present for a significant portion of time during a one-
month period:
- Delusions
- Hallucinations
- Disorganised speech
- Grossly disorganized or catatonic behaviour
- Negative symptoms
- Level of functioning is affected by symptoms
- Signs of disturbance persist for at least six months, with symptoms present for at
least one month
- Other illnesses and affective disorders must be ruled out
- If there is a history of autism spectrum disorder or communication disorder of
childhood onset, the delusions/hallucinations must be prominent
ICD-11 Diagnosis;
- Schizophrenia is characterised by disturbances in multiple mental modalities,
including thinking (e.g., delusions, disorganisation in the form of thought),
perception (e.g., hallucinations), self-experience (e.g., the experience that one's
feelings, impulses, thoughts, or behaviour are under the control of an external
force), cognition (e.g., impaired attention, verbal memory, and social cognition),
volition (e.g., loss of motivation), affect (e.g., blunted emotional expression), and
behaviour (e.g., behaviour that appears bizarre or purposeless, unpredictable or
inappropriate emotional responses that interfere with the organisation of
behaviour). Psychomotor disturbances, including catatonia, may be present.
Persistent delusions, persistent hallucinations, thought disorder, and experiences of
influence, passivity, or control are considered core symptoms. Symptoms must have
persisted for at least one month in order for a diagnosis of schizophrenia to be
assigned. The symptoms are not a manifestation of another health condition (e.g., a
brain tumour) and are not due to the effect of a substance or medication on the
central nervous system (e.g., corticosteroids), including withdrawal (e.g., alcohol
withdrawal).
, Symptoms;
Links to Violence & Crime;
A (brief) History of Schizophrenia & Crime;
- Historically, schizophrenia associated with violence, then academics rejected the
notion claiming no more dangerous than anyone else (Hiday, 1995)
- Mixed bag in terms of evidence:
- E.g. 5% of offenders in a sample of 1594 had schizophrenia (Eronen et al., 1996) but
others found no association (Monahan & Steadman, 1983)
- 1980’s onwards studies were higher quality, and population-based
- They suggested a modest association between violence & schizophrenia:
- Swanson et al., (1990)
- data from 10059 participants in
the US
- Used structured interviews to est.
diagnosis and self-report data to
assess violence in past 12 months
- Those with schizophrenia were
more likely to report violence than
participants with no MHP
- After Swanson a lot of studies
were inconsistent or had messy
designs
- Then meta-analyses started taking
off…
