CRIMINAL PSYCHOLOGY

1. CRIMINAL PSYCHOLOGY Part Du: An Overview of Clinical Psychology and Disorders as it Applies to Criminology and Criminalistics

2. For the sake of Criminal Psychology, We will only focus on: • Adjustment Disorders • Anxiety Disorders • Mood Disorders • ADD/ADHD • Delirium, Dementia & Amnesia • Dissociative Disorders • Schizophrenia • Paraphilias, Sexual & Gender Identity Disorders • Substance Induced

3. Adjustment Disorders An abnormal or excessive reaction to an identifiable life stressor(s) The response can be associate to a single event or to multi events Describe the emotional and behavioral symptoms in response to an identifiable stressor(s) (Adjustment Disorder, 2009;American Psychiatric Association [APA],2000)

4. (Mayor Clinic Staff, 2009)

5. Simply stated • Symptoms • are excessive to what would normally be expected • significantly impairs occupational, school, or social functioning • not explained by another diagnosis/disorder • are not part of bereavement • do not last longer than six months after the stressor • Acute – Disturbance is less than six months • Chronic- Disturbance last longer than six months (APA, 2000)

6. Prevalence of Adjustment Disorder • Are common in children and adolescent • Occur equally in males and females • Occur in all cultures • Occur at all ages • Adults- Mostly depressive symptoms • Adolescent- Behavioral symptoms (i.e. acting out) (UAB Medicine, 2008)

7. What’s the difference? NORMAL STRESS Feelings that may occur in response to positive or negative situations- the body’s biological and psychological natural response Is a heightened state of readiness- allowing one to perform well under pressure ADJUSTMENT DISORDER • severe emotional reaction to a stressful event that has occurred in one’s life • when this stress response fails to switch off and reset itself after a challenging situation has passed, or if it worsens to the point of distraction, it can lead to more significant psychological problems and even worsen some medical conditions. (Hall-Flavin, 2009)

8. Causes of Adjustment Disorder LIFE STRESSOR(S) • Death of a spouse • Death • Jail term • Financial problems • Business Readjustment • Holiday Seasons • Pregnancy • Retirement • College • Disastrous events • Global/National events • Change in health status • Retirement • New responsibilities • Changes in living conditions

9. Anxiety Disorders • Anxiety is a normal reaction to stress. It helps one deal with a tense situation in the office, study harder for an exam, keep focused on an important speech. In general, it helps one cope. • When anxiety becomes an excessive, irrational dread of everyday situations, it has become a disabling disorder.  

10. Five major types of anxiety disorders: • Generalized Anxiety Disorder: GAD is an anxiety disorder characterized by chronic anxiety, exaggerated worry and tension, even when there is little or nothing to provoke it. • Obsessive-Compulsive Disorder (OCD): OCD, is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Performing so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety.

11. Five major types of anxiety disorders: • Panic Disorder: characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress • Post-Traumatic Stress Disorder (PTSD): an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.  • Social Phobia (or Social Anxiety Disorder)

12. Five major types of anxiety disorders: • Social Phobia (or Social Anxiety Disorder): an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. • Social phobia can be limited to only one type of situation (fear of speaking in formal or informal situations, or eating or drinking in front of others) • or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people.

13. Mood Disorders • Amongst the most common in children and adolescents. They include all types of depression as well as Bipolar Disorders (formerly called Manic-Depression) and are sometimes referred to as “affective disorders.” • Manic: a state of abnormally elevated or irritable mood, arousal and/or energy levels • Major depressive disorder: (also known as clinical depression, major depression, unipolar depression, or unipolar disorder)Characterized byan all encompassing Low mood accompanied by low self esteem and loss of interest in daily activities. Treatable with anti-depressants by prescription • Bipolar: defined by the presence of one or more episodes of abnormally elevated mood… also commonly experience depressive episodes, manic episodes or a mixture of both at the same time.

14. ADD and ADHD Statistics The exact cause of ADHD is UNKNOWN One of the most common neurobehavioral disorders of childhood (FamilyDoctor.org., 2009) Affects 3%-7% of all children or about 2 million American children (Centers for Disease Control and Prevention, 2005) Diagnosed approximately three times more often in boys than in girls (Centers for Disease Control and Prevention, 2005) About 30% of children diagnosed with ADHD grow out of the disorder (Klag, 1999) If one or both parents have ADHD, their children are more likely to develop the condition (WebMD, 2009)

15. Symptoms of ADD Symptoms of Inattention Often does not pay attention to details or makes careless mistakes in activities Often has trouble keeping attention on tasks or play activities Often does not seem to listen when talked to directly Often does not follow directions and fails to finish work (school, chores, office) Often has trouble organizing activities Often avoids, dislikes, or doesn’t want to do things that take mental effort for long periods of time Often loses things needed for tasks and activities Is often easily distracted Is often forgetful in daily activities

16. Symptoms of Impulsivity Often blurts out answers before questions have been finished Often has trouble waiting one’s turn Often interrupts or intrudes on others INCLUDE THESE AND YOU GET Symptoms of ADHD Symptoms of Hyperactivity Often fidgets with hands/feet or squirms in seat Often gets up from seat when expected to remain in seat Often runs about or climbs when and where it is not appropriate Often has trouble playing or enjoying leisure activities quietly Is often “on the go” or often acts as if “driven by a motor” Often talks excessively

17. Delirium A sudden, fluctuating, and usually reversible disturbance of mental function. inability to pay attention, disorientation, inability to think clearly fluctuations in the level of alertness (consciousness). Merck Manuals , 2008

18. Delirium Subtypes Hyperactive- agitated, disoriented, delusional Possible hallucinations Can be confused with schizophrenia, agitated dementia, or a psychotic disorder Hypoactive subdued, quietly confused, disoriented and apathetic Delirium may go unrecognized or be confused with depression or dementia Mixed Fluctuations between hyperactive and hypoactive subtypes Gleason, 2003

19. Delirium Symptoms Clouding of consciousness Difficulty maintaining or shifting attention Disorientation Illusions Hallucinations Fluctuating levels of consciousness Dysphasia Dysarthria Tremor Motor abnormalities Alagiakrishnan, 2009

20. Dementia Progressive chronic disorders of the brain memory loss, confusion, disorientation, personality deterioration, depression, and complete breakdown in self-care functions. Amongst other things, Alzheimer’s disease and alcoholism can lead to dementia. Stein & Cutler, 2002

21. Amnesia Loss of memory Can include the memory of personal identity due to brain injury, shock, fatigue, repression, illness or sometimes induced by anesthesia.

22. Types of Amnesia • Localized: no memory of specific events ex. Car accident • Selective: memory of only small parts of events • Generalized: encompasses person’s whole life • Systematized: memory loss of specific categories of information Ex. A specific family member

23. Causes of Amnestia Structural or chemical damage to parts of the brain Head trauma Tumors Stroke Alcoholism Long-term heavy drug use Exposure to toxin (lead, mercury, carbon monoxide, certain insecticides Encyclopedia of Mental Disorders, n.d.

24. Dissociative Disorders One of which is Formerly Known as “Multiple Personality Disorder”

25. DSM-IV-TR “ . . . Disruption in the usually integrated functions of consciousness, memory, identity, or perception.” (Frances & Ross, 2001) • 300.12 Dissociative Amnesia • 300.13 Dissociative Fugue • 300.14 Dissociative Identity Disorder (DID) • 300.6 Depersonalization Disorder • 300.15 Dissociative Disorder Not Otherwise Specified

26. Overview • All are thought to stem from traumatic experiences • Coping mechanism: disassociates from an experience or situation that is too traumatic to deal with consciously (National Alliance on Mental Illness,2009) • Prevalence of DID is .01-1% of the general population, 7% of population may have undiagnosed dissociative disorders (WebMD, 2009) • Does not occur exclusively during the course of another mental disorder and not due to direct physiological effects of a substance or general medical condition ex. Temporal lobe epilepsy

27. Diagnostic Considerations • Dissociation states may be acceptable in religious or social experiences in some cultures (Speaking in Tongues) • It should only be considered pathological if it causes significant distress or impairment (American Psychiatric Association,2000)

28. Dissociative Fugue • Sudden, unexpected travel away from home or work place with the inability to recall one’s past • Confusion about personal identity orassumption of a new identity(partial or complete) • Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

29. Dissociative Identity DisorderFormerly known as “Multiple Personality Disorder” • Presence of two or more distinct identitiesor personality states (each with its own relatively enduring pattern of perceiving, relating to, & thinking about the environment and self • At least two of these identities or personality states recurrently take control of the person’s behavior • Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness • Not due to direct physiological effects of a substance or general medical condition ex. Complex partial seizures Note: in children, not attributed to imaginary playmates or fantasy play

30. Depersonalization Disorder • Persistent or recurrent experiences of feeling detachedfrom, and as if one is an outside observer of, one’s mental processes or body ex. Feeling like one is in a dream • During the experience reality testing remains in tact • Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning • Does not occur exclusively during the course of another mental disorder and not due to direct physiological effects of a substance or general medical condition ex. Temporal lobe epilepsy

31. Dissociative Disorder NOS (NOT OTHERWISE SPECIFIED) • Disruption in consciousness, memory, identity, or perception of environment that does not meet criteria for any specific dissociative disorder • Similar to Dissociative Identity Disorder but do not meet criteria • There are not two or more personality states or amnesia for important personal information does not occur • Derealization unaccompanied by depersonalization in adults • Dissociative states due to brainwashing, thought reform, or indoctrination while captive

33. Case Studies Jason Bourne has no personal identification or money and wakes up on a park bench one morning. He is assailed by two men and is able to render them both unconscious with an amazing fighting ability that he didn’t know he had. Is it: • Depersonalization • Dissociative Fugue • Dissociative Amnesia • Dissociative Identity Disorder

34. Daniel has had a strange feeling all day that something isn’t right. He feels oddly separate from his body and the things around him don’t seem real. He feels like he is in a movie about someone else’s life. Is it: • Dissociative Fugue • Depersonalization • Dissociative Amnesia • Dissociative Identity Disorder

35. Susan found her life as a wife and mother to be very stressful. One evening she said she was going to the grocery store and didn’t return. She was missing for one week and later found three states away in a mental hospital. She was unable to identify herself to the police. Is it: • Dissociative Identity Disorder • Dissociative Amnesia • Depersonalization • Dissociative Fugue

36. Jennifer is a college student living away from home. She starts becoming concerned when people she is unfamiliar with seem to know her and call her by different names. She also has periods of time where she can not remember what happened. Is it: • Dissociative Identity Disorder • Dissociative Fugue • Dissociative Amnesia • Depersonalization

37. Schizophrenia • characterized by abnormalities in the perception or expression of reality. It most commonly manifests as • auditory hallucinations, • paranoid/bizarre delusions, or • disorganized speech & thinking w/ significant social or occupational dysfunction.

38. Schizophrenia subtypes • Paranoid type: Where delusions and hallucinations are present but thought disorder, disorganized behavior, and affective flattening are absent. • Disorganized type: Named hebephrenic schizophrenia in the ICD. Where thought disorder and flat affect are present together. () • Catatonic Type: The subject may be almost immoble or exhibit agaitated, purposeless movement. Symptoms may include a catatonic stupor (motionless) & waxy flexibility • Undifferentiated type: Psychotic symptoms are present but the criteria for paranoid, disorganized, or catatonic types have not been met. (DSM code 295.9/ICD code F20.3)Residual type: Where positive symptoms are present at a low intensity only.

39. Time to Check Your Maturity!! The following deals with disorders that are sexually related and contains some mature content. We are trusting that you will be able to approach the following content from a scientific perspective. If you do not feel you can handle this like a mature young adult, please raise your hand now. “It is better to be thought of a fool Than it is to speak and remove all doubt.”

40. Paraphilias • Sexual Arousal to objects, situations, or individuals that is not within normative stimulation. • May cause distress or serious to afflicted as well as persons associated with him/her

41. Paraphilia subtypes • Exhibitionism: the recurrent urge or behavior to expose one's genitals to an unsuspecting person or recurrent urge or behavior to perform sexual acts in a public place, or in view of unsuspecting persons. • Paedophilia: a psychological disorder in which an adult experiences a sexual preference for prepubescent children,[23] or has engaged in child sexual abuse.[24][25][26]

42. Paraphilias subtypes • Fetishism: the use of inanimate objects to gain sexual excitement. • Partialism: refers to fetishes specifically involving nonsexual parts of the body. • Frotteurism: recurrent urges of behavior of touching or rubbing against a nonconsenting person.

43. Paraphilias subtypes • Sexual Masochism: recurrent urge or behavior of wanting to be humiliated, beaten, bound or otherwise made to suffer for sexual pleasure. • Sexual Sadism: Recurrent urge to inflict pain or humiliation • Persons suffering from these conditions are seeking true unwilling pain; not the immitation of pain. • Sub note: It is a common misperception that these two would make the “perfect couple”; when actually the opposite is true. Putting two people in the same room with these conditions actually incites rage & violence

44. Paraphilias subtypes • Transvestic fetishism: arousal from "clothing associated with members of the opposite sex.” • Voyeurism: the recurrent urge or behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities, or activities which may not be sexual in nature at all.

45. Sexual Dysfunction • Sexual desire disorders or decreased libido characterized by a lack of or absence for a period of time of sexual desire, activity or of sexual fantasies. • Ranges from lack of desire for the current partner to not desiring sex at all. • Could be developed over time or present from birth. • Could be due to a physical condition such as low testosterone or estrogen; a mental dysfunction with no particular or singular source; or from a tramtic experience such as an assault.

46. Gender Identity (GID) • The formal diagnosis used by clinicians to describe persons who experience significant gender dysphoria (discontent w/ biological sex they were born with). It is a psychiatric classification & describes the attributes related to • Transsexuality (Identifying more closely with the opposite gender), • Transgender identity (Relinquishes current gender rolle for that of the opposite sex)& • Transvestism(The physical practice of cross-dressing)