Thèse--Montpellier. / "Bibliographie": p. 121-126.

Many aspects of capital punishment have been debated extensively, such as its legality and cruelty. One such aspect is the role a defendant's mental functioning should play in the proceedings. In recent years the Supreme Court has barred the mentally retarded and juveniles from the death penalty due to their cognitive limitations and problems with behavioral control (Slobogin, 2003). This reasoning has prompted many in the fields of mental health and law to advocate for a similar bar for offenders with severe mental illness since their impairments create similar problems in judgment and behavioral control. The Supreme Court cited public consensus as its grounds in banning the mentally retarded and juveniles from sentences of death; however, public consensus on mentally ill capital offenders is not quite as clear. Few attempts have gauged public opinion on sentencing severely mentally ill offenders to death, and the little research that does exist has produced conflicting results. While polls show that Americans oppose the death penalty for the severely mental ill (Gallup, 2008), the literature shows that jurors are more likely to sentence these defendants to death (Charlotte School of Law [CSL], 2006). Second to the issue of barring the severely mentally ill from the death penalty is the issue of what mental health factors would be considered severe enough to qualify for a bar. There has been no previous research to gauge public opinion on these issues. Surveys were constructed to gauge opinion on the issue and were mailed randomly to 1,640 people throughout the United States. A total of 202 surveys were returned completed. Support was found for a bar from the death penalty for the mentally ill. However, the mental health factors that should comprise a bar received varied support and were less clear in determining which should comprise a bar. When given alternatives to a death sentence, participants overwhelmingly chose some type of life sentence. Public opinion appears to be an important aspect in the imposition of capital punishment upon the mentally ill.

Background: It is now well established that there are core cognitive impairments associated with a diagnosis of schizophrenia. In parallel with our increased understanding of these core deficits, our awareness that mentally ill offenders (MIOs) are at additional risk of cognitive impairment due to an increased rate of traumatic brain injury and substance abuse has also grown. Absent from the literature is evidence of whether these cognitive impairments change over longer periods of time in MIO’s and whether these changes, or baseline abilities, impact an individual’s risk of violence. Furthermore, the negative impact head injury has on an individuals’ cognitive, behavioural and psychological functioning is well documented. These changes can lead to an increased likelihood of violence and crime, yet there is currently a scarcity of knowledge regarding the prevalence of head injury within mentally ill offenders in Scotland and its association with risk-related outcomes. Aims: The aims of the present thesis were to; (a) Examine the course of cognition in N=49 mentally ill offenders who underwent neuropsychological assessment while in the State Hospital, Scotland in 2004-5, and assess whether baseline or change in cognition predicts violent incidents or risk at follow-up, and; (b) Examine the cross-sectional association between head injury, substance abuse and risk-related outcomes of all individuals within the forensic network in Scotland for whom data could be extracted (N=428). Hypotheses: (a) We hypothesized that processing speed, verbal comprehension, working memory, delayed verbal memory, delayed non-verbal memory, impulsivity, inattention and problem-solving would decline over a 10-year period, and that deficits in impulsivity, emotion recognition, working memory and delayed memory would predict patients’ risk-related outcomes in a sample of mentally ill offenders. (b) It was also hypothesized that the presence of head injury and/or substance abuse within patients would predict worse risk-related outcomes, namely: quantity of violent offences, risk of harm to self, risk of harm to others and severity of violent offences. Analysis: We conducted a series of repeated measures MANOVAs, MANCOVAs and hierarchical linear regressions in SPSS Statistics to test our hypotheses. Individuals with a primary or secondary diagnosis of a learning disability were excluded. Results: (a) Our results propose that cognitive abilities significantly change over time (F(1.51, 30.1) = 5.98, p = .011), but direction of change is ability dependent. We found that impulsivity (Effect Size (ES) = .253), inattention (ES = .233), working memory (ES = .288) and auditory delayed memory (ES= .268) worsen over time. Measures of impulsivity and working memory significantly predicted some, but not all, risk-related outcomes, however these effects became diluted once additional variables with shared variance were added into the predictive models. We did not find that traumatic brain injury, substance misuse or alcohol misuse significantly mediated change in cognition over time. (b) In the national cohort study, results suggested that head injury had a significant effect on HCR total scores, F(1,259) = 6.679, p = .010 (partial eta square = .025), violence during admission (χ2 = 5.545, p = .022) and violent offences at a .1 p-value only, F(1,259) = 3.495, p = .063 (partial eta square = .013). Drug misuse only had a significant impact on total violent offences, F(1,259) = 8.933, p = .003 (partial eta square = .033) and nothing else. Furthermore, the interaction between alcohol misuse and schizophrenia also only had impact on total violent offences, F(1, 259) = 7.516, p = .007 (partial eta square = .028). Head injury was not significantly associated with either historical or current self-harm, however alcohol misuse, drug misuse and schizophrenia were. Conclusions: Our results highlight the unstable nature of cognition in mentally ill offenders and the impact that head injury has on violence-related outcomes, over and above substance misuse and a diagnosis of schizophrenia. This has potentially renovating implications for clinical practice regarding risk management, assessment, and treatment planning.

OBJECTIVES: (1) Describe the population of mentally ill offenders over whom Ontario Review Board (ORB) held jurisdiction. (2) Assess the influences of psychopathology and criminal factors on criminal career. METHOD: This study was a retrospective case series design that reviewed all offenders who were court ordered for psychiatric evaluation at Mental Health Services Site of Providence Care in Kingston, Ontario from 1993 to 2007 (N=347). Eighty five subjects were found not criminally responsible on the account of mental disorder and were included in statistical analysis (n=85). Bivariate associations between five key variables and two outcome variables, seriousness of crime and recidivism, were examined. Logistic regressions were conducted to test the role of the predictor variables on the outcome variables. RESULTS: Age and change in principal psychiatric diagnosis over time were shown to be associated with seriousness of crime. Timing of psychiatric onset, early signs of deviance and change in diagnosis were shown to be associated with recidivism. On the whole, study population did not markedly vary in their distribution of variables by the outcome variables. Regression model included timing of psychiatric onset; psychiatric history; existence of criminal associate; child abuse history; and early signs of deviance. Recidivism was shown to be predicted by early signs of deviance (OR=8.154, p<0.05). Existence of criminal associates was shown to have substantial values of odds ratio at marginal significance (OR=7.577, p=0.13). CONCLUSION: Seriousness of crime is a complex factor that could not be sufficiently predicted by any one or combinations of study variables. Recidivism is better predicted by criminality factors than psychopathology. In the future, an exploratory analysis that more broadly examines the psychopathology and criminal factors in Canadian forensic population is needed. Findings from this study have important clinical and legal implications. / Thesis (Master, Neuroscience Studies) -- Queen's University, 2011-08-10 10:35:13.036

This study examined the use of language in the development and implementation of mental health policy. It focused on the current discourse of mental health reform in Ontario as it related to individuals with a mental illness and who are in conflict with the law. Using a qualitative design, informed by critical inquiry and a postmodern perspective, the researcher explored administrative perceptions of the accomplishments and challenges faced at different levels of the mental health and criminal justices systems in Ontario. The participants' understandings of the provincial mental health reform policy, Making it Happen, and the extent they felt that their organizations and related policies were able to create positive change in the lives of service users were also examined. While the language of mental health policy encompasses an empowerment, community integration approach to providing services, findings indicated that a biomedical-model, public safety discourse appear to inform both policy and practice. A number of questions and apparent inconsistencies in the manner in which the mental health and criminal justice systems deal with the needs of this population were also identified. This thesis concludes with recommendations for future research.

Typescript (photocopy) / Thesis (Ph. D.)--University of Hawaii at Manoa, 1980. / Bibliography: leaves 173-177. / Microfiche. / vi, 177 leaves, bound 28 cm

Thesis (M.A.)--University of North Carolina Wilmington, 2008. / Title from PDF title page (October 20, 2008) Includes bibliographical references (p. 32-34)

Thesis (doctoral)--Universität, Basel, 2008. / Includes bibliographical references (p. 587-642).

Thesis (D.N. Sc.)--Catholic University of America. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 79-88).

Thesis (M.D)--University of Hong Kong, 1999. / Includes bibliographical references (leaves 80-124).