Background
In
Japan, the legislation directing treatment of offenders with psychiatric
disorders was enacted in 2005. Neuropsychological impairment is highly related
to functional outcomes in patients with psychiatric disorders, and several
studies have suggested an association between neuropsychological impairment and
violent behaviors. However, there have been no studies of neuropsychological
impairment in forensic patients covered by the Japanese legislation. This study
is designed to examine the neuropsychological characteristics of forensic
patients in comparison to healthy controls and to assess the relationship between
neuropsychological impairment and violence risk.
Methods
Seventy-one
forensic patients with psychiatric disorders and 54 healthy controls (matched
by age, gender, and education) were enrolled. The CogState Battery (CSB)
consisting of eight cognitive domains, the Iowa Gambling Task (IGT) to test
emotion-based decision making, and psychological measures of violence risk
including psychopathy were used.
Results
Forensic
patients exhibited poorer performances on all CSB subtests and the IGT than
controls. For each group, partial correlational analyses indicated that poor
IGT performance was related to psychopathy, especially antisocial behavior. In
forensic patients, the CSB composite score was associated with risk factors for
future violent behavior, including stress and noncompliance with remediation
attempts.
Conclusion
Forensic patients with psychiatric disorders exhibit a
wide range of neuropsychological impairments, and these findings suggest that
neuropsychological impairment may increase the risk of violent behavior.
Therefore, the treatment of neuropsychological impairment in forensic patients
with psychiatric disorders is necessary to improve functional outcomes as well
as to prevent violence.
Below: Magnitude of impairment in forensic patients relative to healthy controls on each CSB measure
Below: Magnitude of impairment in forensic patients relative to healthy controls on each CSB measure
Below: The IGT net scores for the 5 blocks for forensic patients and healthy controls
Full article at: http://goo.gl/TpZu9X
By:
Hirofumi Nishinaka, Kenji Hashimoto
Division of Clinical
Neuroscience, Center for Forensic Mental Health, Chiba University, Chiba, Japan
Jun Nakane
National Hospital Organization
Shimofusa Psychiatric Medical Center, Chiba, Japan
Takako Nagata, Mayu Omori, Naotsugu Hirabayashi
Department of Psychiatry,
National Center of Neurology and Psychiatry, Tokyo, Japan
Atsushi Imai, Noriomi Kuroki, Noriko Sakikawa, Osamu Kuroda
Department of Psychiatry, Tokyo
Metropolitan Matsuzawa Hospital, Tokyo, Japan
Yoshito Igarashi
Division of Law and Psychiatry,
Center for Forensic Mental Health, Chiba University, Chiba, Japan
More at: https://twitter.com/hiv insight
No comments:
Post a Comment