Gaps in Crisis Mental Health: Suicide and Homicide-Suicide

Gaps in crises of mental health emerge from poor distinction between the qualities of people who suicide and those who murder and then kill themselves. The role, if any, that substance use has in such lethal violence is an example of such a lack of distinction. 

In this study, a sample of medical examiner investigative and toxicology reports from Los Angeles and Orange counties in California were available for analysis for 432 suicide cases and 193 homicide-suicide cases. This informed clearer toxicological and pharmacological distinction of suicide from homicide-suicide. 

• Blood alcohol levels were higher in persons committing suicide than in homicide-suicide perpetrators (p=.004). 
• Homicide-suicide perpetrators had almost twice the level of stimulants in their system than people who suicide (p=.022) but did not have comparatively elevated levels of drugs or alcohol. 

Predictors of suicide included the following: 

• substance abuse history, 
• high number of drugs in system, 
• death inside a house, 
• and legal impairment by alcohol. 

Predictors of homicide-suicide included 

• gunshot as the cause of death, 
• female gender, 
• domestic conflict, 
• children living in the home, 
• and prior arrest for substance abuse.

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By: Carretta CM1, Burgess AW2, Welner M3.

• 1School of Nursing, Rutgers The State University of New Jersey, Newark, NJ
• 2William F. Connell School of Nursing, Boston College, Chestnut Hill, MA.
• 3The Forensic Panel, New York, NY.

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A Burning Question: Does Arson Increase When Local House Prices Decline?

We construct panel data on house prices and the determined cause of 4.8 million individual fires in the United States between 1986 and 2010 to test whether decreases in local housing market prices coincided with increases in arson. Since some insured homeowners may attempt to disguise the actual cause of fire as accidental, we also examine how decreases in local house prices are associated with changes in the total number of fires and the probability of determined causes of accidental fires. For the sample period, our results suggest that declines in local house prices coincided with increases in arson, the total number of fires, and the probability that fires were determined to occur due to arson and misuse. We provide further support for the existence of such an effect with empirical evidence that the relation between declines in house prices and arson is stronger in states that allow mortgage lender recourse.

Via:  http://goo.gl/QB8FJP Read full (PDF) article at: http://ow.ly/d/3Mdw

By:  Michael D. Eriksen is an Assistant Professor of Finance, Rawls College of Business, Texas Tech University, Lubbock, TX 79409. James M. Carson is the Daniel P. Amos Distinguished Professor of Insurance, Department of Insurance, Legal Studies, and Real Estate, Terry College of Business, University of Georgia, Athens, GA 30602

Personality Disorders and Violence: What Is The Link?

Despite a well-documented association between personality disorders (PDs) and violence, the relationship between them is complicated by the high comorbidity of mental disorders, the heterogeneity of violence (particularly in regard to its motivation), and differing views regarding the way PDs are conceptualised and measured. In particular, it remains unclear whether there is a causal relationship between PDs and violence, and what the psychological mechanisms might be that mediate such a relationship. Here, a perspective on PD and violence is offered that views the relationship between them through the lenses of the Five Factor Model of personality and a quadripartite typology of violence. Evidence is reviewed suggesting that emotion dysregulation/impulsiveness, psychopathy, and delusional ideation conjointly contribute to the increased risk of violence shown by people with PD, and do so by contributing to a broad severity dimension of personality dysfunction. This view is consistent with the abandonment of personality disorder categories in the forthcoming eleventh edition of the International Classification of Diseases (ICD-11), where severity of personality disorder is defined in terms of the degree of harm to self and others.

Below: The quadripartite (2×2) violence typology. The intersection of impulsiveness (vs. control/premeditation) and affect (positive vs. negative) yields 4 distinct types of violence characterised by motives of excitement seeking and greed (both associated with positive affect) and revenge and self-defence (both associated with negative affect)

Below:  A schematic overview of the suggested relationship between personality disorder (PD) and violence. General psychopathology (p) is subsumed by 3 factors, Externalizing, Internalizing and Thought Disorder but, as reported in [7], p is associated most strongly with Thought Disorder (indicated by a heavy arrow in the figure). Externalizing subsumes traits associated with both psychopathy and emotional impulsiveness, both of which contribute to severe PD and increase the risk for violence, particularly appetitive violence. Thought Disorder is shown as contributing independently to the risk of violence, and particularly of aversive violence. Also shown are contextual factors such as alcohol use that operate as proximal causal risk factors for violence in concert with distal personality factors

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By:  Richard Howard

Institute of Mental Health, University of Nottingham Innovation Park, Jubilee Campus, Triumph Road, Nottingham, NG7 2TU UK

Biggest Probelms with Police Body Cameras

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Clarifying the Link Between Childhood Abuse History and Psychopathic Traits in Adult Criminal Offenders

Childhood abuse is a risk factor for the development of externalizing characteristics and disorders, including antisocial personality disorder and psychopathy. However, the precise relationships between particular types of childhood maltreatment and subsequent antisocial and psychopathic traits remain unclear. 

Using a large sample of incarcerated adult male criminal offenders (n = 183), the current study confirmed that:

• severity of overall childhood maltreatment was linked to severity of both psychopathy and antisocial personality disorder in adulthood. 
• Moreover, this relationship was particularly strong for physical abuse and the antisocial facet of psychopathy. 
• Sexual abuse history was uniquely related to juvenile conduct disorder severity, rather than adult psychopathy or antisocial behaviors. 
• Additionally, there was a significantly stronger relationship between childhood maltreatment and juvenile conduct disorder than between childhood maltreatment and ASPD or psychopathy. 

These findings bolster and clarify the link between childhood maltreatment and antisocial behavior later in life. 

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By:  Dargis M, Newman J, Koenigs M.

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The Rikers Island Hot Spotters: Defining the Needs of the Most Frequently Incarcerated

We used "hot spotting" to characterize the persons most frequently admitted to the New York City jail system in 2013.

We used our Correctional Health Services electronic health record to identify 800 patients admitted in 2013 who returned most since November 2008. We compared them to a randomly selected control group of 800 others admitted in 2013, by using descriptive statistics and cross-tabulations, including data through December 2014.

The frequently incarcerated individuals had a median of 21 incarcerations (median duration 11 days), representing 18 713 admissions and $129 million in custody and health costs versus $38 million for the controls. The frequently incarcerated were: 

• significantly older (42 vs 35 years), 
• and more likely to have serious mental illness (19% vs 8.5%) 
• and homelessness (51.5% vs 14.7%) in their record. 
• Significant substance use was highly prevalent (96.9% vs 55.6%). 
• Most top criminal charges (88.7%) for the frequently incarcerated were misdemeanors; assault charges were less common (2.8% vs 10.4%). 

Frequently incarcerated persons have chronic mental health and substance use problems, their charges are generally minor, and incarceration is costly. Tailored supportive housing is likely to be less costly and improve outcomes.

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By: MacDonald R1, Kaba F1, Rosner Z1, Vise A1, Weiss D1, Brittner M1, Skerker M1, Dickey N1, Venters H1.

• 1All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY.

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Crime and Punishment in Darwin

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