This study examines the utility of the MMPI-2 in predicting responsibility in pre-trial forensic patients, using a post hoc sample of 94 offenders from Sterkfontein Psychiatric Hospital in Gauteng. Firstly, the overall characteristics of the pre-trial forensic patients are discussed, following an analysis of demographic, clinical, criminal and MMPI-2 pre-trial data, as well as an overview of the Megargee typological classification of offenders. The sample is classified into Criminally Responsible (CR), Diminished Criminal Responsibility (DCR) and Not Criminally Responsible (NCR), and the CR and DCR groups are collapsed (CR/DCR) for many of the analyses when comparing them to the NCR group. Secondly, the variance of variables with responsibility is discussed, after examining one-way ANOVA’s of demographic, clinical, criminal and MMPI-2 variables, as well as an overview of high point pairs. Thirdly, discriminant analyses were conducted of demographic, clinical and MMPI-2 variables. When comparing the collapsed CR/DCR group to the NCR group, psychiatric diagnosis, presence of psychosis, the MMPI-2 Pa and Es scales, as well as race and substance abuse each had unique predictive power and created a substantial discriminative equation (F (6,70) = 45.732, p <0.0005) with a successful prediction rate of 96%. Using only MMPI-2 variables to predict responsibility showed significant unique contributions for the Pa, Es, MAC-R and Mf scales, with the BIZ scale not quite significant, and a fairly significant overall discriminant equation (F (5,73) = 6.474, p < 0.0005), with an overall successful prediction rate of 82%, with the MMPI-2 variables adding an additional 3% to the predictive power of the demographic and clinical variables. Similarly, when examining the more complex 3 group responsibility classification of CR, DCR and NCR, it was found that the demographic, clinical and MMPI-2 variables of psychiatric diagnosis, psychosis, race, substance abuse, and the Pa, Es and Ma scales all had significant contributions to a powerful discriminant analysis (F (14, 136) = 19.758, p < 0.0005) that was capable of correctly reclassifying almost 95% of the sample, and the MMPI-2 variables providing an increase in predictive power of 8%. Differences in responsible and not responsible pre-trial forensic patients are discussed, as well as the role of the MMPI-2 in assessing these differences, and the fact that it is highly likely that it adds more to the forensic assessment of responsibility than a 3% (CR/DCR versus NCR) or 8% (CR versus DCR versus NCR) increase in predictive power. Limitations of the study are discussed, together with recommendations for future research with the MMPI-2 for assessment of criminal responsibility. The suggestion is made that the MMPI-2 can become a valuable tool in South African forensic settings, not only in the assessment of responsibility and malingering, but also in the placement, management, follow-up and treatment of offenders, to maximize the limited resources in South Africa allocated for the rehabilitation of offenders, and minimize the risk of recidivism or rehospitalization.

Thesis (M. Medicine (Psychiatry)) -- University of Limpopo, 2022 / BACKGROUND: The challenge of sexual offence crimes against women and children is notably increasing worldwide with an accompanying impact on the mental and physical well-being of the victims and society, in general. Despite the impact, sexual offenders remain a complex group, not well studied in forensic psychiatry settings globally. Previous studies identify psychosocial factors and mental illness associated with sexual offending. Adequate care, treatment and rehabilitation of sexual offenders are crucial to reduce the impact of sexual offence and re-offending. AIMS: To determine the demographic variations, clinical factors, and observation outcomes in terms of diagnosis, fitness to stand trial, and criminal responsibility among the alleged sexual offenders referred to Thabamoopo Hospital. OBJECTIVES: To determine the prevalence of mental disorders among alleged sexual offenders, to determine the number of offenders fit or unfit to stand trial and who are criminal or not criminally responsible, to determine factors associated with vulnerability to sexual offending behaviour. METHOD: This study is based on a review of clinical records and files and psychiatrists' observation reports of all alleged sexual offenders referred by the courts for forensic psychiatric observation between the period January 2015 to December 2018 at Thabamoopo Hospital. RESULTS: The sample consists of 94 participants, only one female; all were black Africans. The majority were in middle adulthood, unemployed, of a lower level of education and not married. All participants had been charged with rape. A large number of the alleged sexual offenders were diagnosed with mental conditions. The most common diagnoses were Intellectual disability disorders, psychotic disorders and substance-related disorders. More than half of the sample was fit to stand trial and criminally responsible. CONCLUSION: More than half of the participants charged with rape were found fit to stand trial and to be criminally responsible. A significant number were diagnosed with mental illness. The outcomes of being unfit to stand trial and not being criminally responsible were common among mentally ill sexual offenders. The results signify that this group of offenders needs adequate psychiatric care, treatment and rehabilitation in order to reduce sexual offending and re-offending due to the impact of mental illness.