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  • 1.
    Dåderman, Anna Maria
    University West, Department of Social and Behavioural Studies, Division of Psychology and Organisation Studies.
    Finns det ett samband mellan impulsivitet och psykopati hos kriminella män?2011In: Tema: AUTISMSPEKTRUMSTÖRNINGAR, ADHD, GENETIK, ÖVRIGT / [ed] Mussie Mshgina, 2011Conference paper (Refereed)
    Abstract [sv]

    Bakgrund: Personer med psykopati beskrivs ofta som känslokalla, utan empati OCH impulsiva. MEN de kan ägna mycket energi åt att manipulera andra för att uppnå sina mål, oavsett om han eller hon är kriminell person eller ”succéfull” ledare. Detaljerade planer står i kontrast till impulsivitet. Impulsivitet kännetecknas av handlingar utan föregående planering. Viss andel av kriminellt belastade psykopater har en relativt ”normal” personlighetsprofil – liknande ”succéfull psykopat”. Poythress och Hall (2011) föreslagit revidering av det teoretiska antagandet att psykopater är impulsiva. Snowden och Gray (2011) fann inga signifikanta samband mellan PCL-R total och självskattad impulsivitet. Positiva samband fanns mellan PCL-R Facett 3 (Livsstil), 4 (Antisocial) och impulsivitet.

    Hypoteser: (1) Högre impulsivitet förväntas inte ha signifikanta samband med högre poäng i psykopati PCL-R total; (2) Högre impulsivitet förväntas ha samband med högre poäng i psykopati Facett 3 och 4.

    Metod: Studien omfattar en grupp rättspsykiatriskt undersökta män (N = 60) som rekryterats på frivillig basis vid Avdelningen för Rättspsykiatri i Stockholm (Huddinge enheten). För att mäta psykopati användes Psychopathy Checklist-revised (PCL-R). Att mäta ADHD användes ett instrument som är avsett till retrospektiva skattningar av ADHD med hjälp av journaldata. Impulsivitet mättes med hjälp av etablerade impulsivitetsskalor.

    Resultat: Det fanns inga signifikanta samband mellan PCL-R total och impulsivitet. Det fanns inte heller några signifikanta samband mellan Facett 3 resp. Facett 4 och impulsivitet. Signifikant samband fanns mellan PCL-R Facett 4 och ADHD total (r = .29, p = .023) respektive ADHD ouppmärksamhet (r = .32, p = .013).

    Fortsatt forskning: Kan ADHD vara moderator genom att ha en interaktionseffekt med impulsivitet?

  • 2.
    Dåderman, Anna Maria
    et al.
    Karolinska Institutet, Stockholm University.
    Edman, Gunnar
    Department of Psychiatry, Research and Development, Danderyd’s Hospital, Danderyd, Sweden.
    Flunitrazepam abuse and personality characteristics inmale forensic psychiatric patients2001In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 103, no 1, p. 27-42Article in journal (Refereed)
    Abstract [en]

    Sixty male non-psychotic forensic psychiatric patients, aged 16-35 years, were studied after they completed their ordinary forensic psychiatric assessment (FPA). The prevalence of flunitrazepam (FZ) abuse was investigated by using both structured and in-depth interviews with the objective of studying the relationship between the abuse and personality traits. The patient’s characteristics, DSM-IV disorders, and actual sentences were obtained by studying their files. In order to obtain measures on their personality traits, self-report inventories were administered to the patients. Eighteen out of 60 patients were FZ abusers, but only 4 of them received a diagnosis related to the FZ abuse during the ordinary FPA. In almost all cases, however, indications of the FZ abuse were found in the files. No differences in personality traits were found between the groups. The frequency of previous admissions to an FPA and actual sentences of robbery, weapons offenses, narcotic-related offenses, and other crimes, such as theft, among the FZ abusers deviated significantly from forensic non-FZ abusers. Therefore, the FZ abuse per se might be more responsible for their tendency to commit crimes characterized by danger and thrill-seeking, such as robbery, weapons offences, and theft, than personality. The most important conclusion is that assessment of FZ abuse is needed in forensic psychiatry.

  • 3.
    Dåderman, Anna Maria
    et al.
    Department of Forensic Psychiatry, Stockholm; Stockholm University, Sweden.
    Fredriksson, Björn
    Department of Forensic Psychiatry, Stockholm, Sweden.
    Kristiansson, Marianne
    Department of Forensic Psychiatry, Stockholm, Sweden.
    Nilsson, Lars-Håkan
    Department of Forensic Psychiatry, Stockholm, Sweden.
    Lidberg, Lars
    Department of Forensic Psychiatry, Stockholm, Sweden.
    Violent behavior, impulsive decision-making, and anterograde amnesia while intoxicated with Flunitrazepam and alcohol or other drugs: A case study in forensic psychiatric patients2002In: The journal of the American Academy of Psychiatry and the Law, ISSN 1093-6793, E-ISSN 1943-3662, Vol. 30, no 2, p. 238-251Article in journal (Refereed)
    Abstract [en]

    It is known that many male juvenile delinquents commit violent crimes while intoxicated with flunitrazepam (FZ), often in combination with alcohol or other drugs. We have also noted the combined abuse of FZ with, for example, alcohol in male forensic psychiatric patients. Our objective was to study violent behavior, impulsive decision making, and amnesia in male forensic psychiatric patients who were intoxicated predominantly with FZ, to increase knowledge of the abuse of FZ in vulnerable subjects. We studied five forensic psychiatric patients, all of whom were assessed in 1998. All of the subjects reported earlier reactions to FZ, including hostility and anterograde amnesia. At the time of their crimes they were all intoxicated with FZ, often in combination with alcohol or other drugs, such as amphetamine or cannabis. In contrast to their behavior based on their ordinary psychological characteristics, their crimes were extremely violent, and the subjects lacked both the ability to think clearly and to have empathy with their victims. Our observations support the view that FZ abuse can lead to serious violent behavior in subjects characterized by vulnerable personality traits, and that this effect is confounded by the concurrent use of alcohol or other drugs. It is evident that FZ causes anterograde amnesia. Previous research and the results presented herein allow us to draw the following conclusion: on the basis of the neuropsychopharmacologic properties of FZ, legal decisions, such as declaring FZ an illegal drug, are needed in countries where it is now legal.

  • 4. Dåderman, Anna Maria
    et al.
    Lidberg, Lars
    Karolinska Institutet, Department of Forensic Psychiatry, University Hospital, Huddinge, Sweden.
    Flunitrazepam (Rohypnol) abuse in combination with alcohol causes premeditated, grievous violence in male juvenile offenders1999In: The journal of the American Academy of Psychiatry and the Law, ISSN 1093-6793, E-ISSN 1943-3662, Vol. 27, no 1, p. 83-99Article in journal (Refereed)
    Abstract [en]

    This study focuses on 19 juvenile offenders who were frequently intoxicated by flunitrazepam (FZ), almost exclusively under the brand name Rohypnol. Street names for Rohypnol tablets are Rophies, Ropies, Roofies, Ropes, Roches, Rochas, Rochas Dos, Rophs, Ropers, Ribs, R-25, Roach-2s, Trip and Fall, Remember All, Mind Erasers, Forget Pills, and the Date Rape Drug. An overdose of FZ gives an increased feeling of power and self-esteem, reduces fear and insecurity, and provides the belief that everything is possible. FZ is also associated with loss of episodic memory and with impulsive violence, particularly when combined with alcohol. The subjects were taken from a subpopulation of 47 male juvenile offenders from Swedish national correctional institutions. Background information for subjects was obtained by in-depth interviewing and personality inventories including the Zuckerman Sensation-Seeking Scales, the Eysenck Personality Questionnaire, and the Karolinska Scales of Personality. Data concerning previous criminal offenses was obtained from the Swedish National Police Board. Almost all of the FZ abusers had been previously sentenced for serious violent offenses. Our data suggest that FZ abused by psychiatrically vulnerable subjects (i.e., with high scores on boredom susceptibility and verbal aggression) poses a serious hazard both to the abusers as well as the community. Our results support the finding that FZ should be classified as a Schedule I drug (i.e., a drug similar to heavy narcotics).

  • 5.
    Dåderman, Anna Maria
    et al.
    Karolinska Institutet.
    Lidberg, Lars
    Relapse in violent crime in relation to cerebrospinal fluid monoamine metabolites (5-HIAA, HVA and HMPG) in male forensic psychiatric patients convicted of murder: a 16-year follow-up2002In: Acta Psychiatrica Scandinavica Supplementum, ISSN 0065-1591, E-ISSN 1600-5473, Vol. 412, no 106, p. 71-74Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Our purpose was to investigate if low levels of cerebrospinal fluid (CSF)monoamine metabolites of 5-HIAA, HVA and HMPG predict relapse in violent crimes. METHOD: Relapse in crime and level of CSF monoamine metabolites (5-HIAA, HVA and HMPG) was studied in a group of 29 murderers. The follow-up was 16 years. RESULTS: Fourteen of the 29 murderers were convicted of crime; nine of them committed violent crimes; one was convicted of a new murder. The differences in mean CSF monoamine metabolites were lower in subjects who relapsed into any type of crime, but only the difference in mean CSF HVA was statistically significant. CONCLUSION: The risk to commit new murder is very small in males who earlier have been convicted of murder. Low levels of CSF HVA is associated with an increased risk for relapse in any type of crime.

  • 6. Lidberg, Lars
    et al.
    Dåderman, Anna Maria
    Karolinska Institutet.
    Resurser saknas ännu för psykiskt störda kriminella: Fängelserna överfulla i Litauen1999In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 96, no 11, p. 1330-1334Article in journal (Refereed)
    Abstract [sv]

    Fängelserna i Litauen är överfulla. Gulag-perioden ligger inte mer än 10 år tillbaka i tiden. Kriminaliteten har ökat. Psykiatrin lider av gamla lokaler och ter sig som hos oss på 1950-talet. Medicineringen däremot är modern.

  • 7.
    Nilsson, Thomas
    et al.
    Department of Forensic Psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Centre for Ethics, Law and Mental Health, University of Gothenburg.
    Falk, Örjan
    Department of Forensic Psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Centre for Ethics, Law and Mental Health, University of Gothenburg.
    Billstedt, Eva
    Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg.
    Kerekes, Nora
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Anckarsäter, Henrik
    Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden, Forensic psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Ragarden, House 1, SU – East Hospital, SE-416 85 Gothenburg, Sweden, Department of Forensic Psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg.
    Wallinius, Märta
    Child and Adolescent Psychiatry, Faculty of Medicine, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden, Research and Development Unit, Regional Forensic Psychiatric Clinic, Växjö, Sweden.
    Hofvander, Björn
    Child and Adolescent Psychiatry, Faculty of Medicine, Department of Clinical Sciences, Lund, Lund University.
    Aggressive Antisocial Behaviors Are Related to Character Maturity in Young Swedish Violent Offenders Independent of ADHD2016In: Frontiers in Psychiatry, ISSN 1664-0640, E-ISSN 1664-0640, Vol. 7, no NOV, p. 1-12, article id 185Article in journal (Refereed)
    Abstract [en]

    Background: Antisocial personality and psychopathic traits have constantly been found to accompany criminal and aggressive behaviors, but little attention has been given to aspects of character maturity and its relation to such behaviors. The present study investigated (1) whether level of character maturity (low, medium, and high) is associated with amount of aggressive antisocial behaviors (AABs) and psychopathic traits in young men imprisoned for violent criminality, and (2) whether such an association is independent of coexisting attention-deficit hyperactivity disorder (ADHD). Methods: Swedish males (N =  270, aged 18–25) sentenced to prison for violent and/or sexual criminality in the western region of the Swedish Prison and Probation Service underwent a thorough clinical examination during their in carceration. Data on character maturity, as measured by the character dimensions Self-Directedness and Cooperativeness of the Temperament and Character Inventory, were available for n = 148 subjects and were used to divide these offenders into three groups with low, medium, and high character maturity. These groups were then compared for variables reflecting criminal history, a DSM-IV diagnosis of ADHD, conduct disorder (CD) and substance use disorders (SUD), aggressive behaviors, and psychopathic traits. Results: Character maturity was consistently associated with less AABs and psychopathic personality traits; the group with the highest character maturity showed: (i) a later age at on set of criminality, (ii) a smaller number of prior violent criminal acts, (iii) lower prevalence of ADHD, CD, and SUD, (iv) less self-rated and expert-rated aggressive behaviors, and (v) less psychopathic traits. The association between character maturity and aggressive behaviors/psychopathic personality traits remained even when ADHD was controlled for. The only exception was sexual criminality, where the group with the highest character maturity contained the largest amount of sexual offenders. Conclusion: Higher character maturity appeared to be a protective factor among young male violent offenders, associated with less AABs, suggesting that character maturity isa promising target for treatment interventions for this group of individuals.

  • 8. Rognum, Torleiv O. L.
    et al.
    Thid, Micael
    Eriksson, A
    Death investigations systems, Nordic Countries2005In: Encyclopedia of forensic and legal medicine 1-4., Oxford, UK.: Elsevier Academic Press , 2005, p. 128-133Chapter in book (Other academic)
  • 9.
    Ståhlberg, Ola
    et al.
    National Board of Forensic Medicine, Department of Forensic Psychiatry, Gothenburg, Sweden, Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden.
    Boman, Sofia
    Swedish Prison and Probation Services, Gothenburg, Sweden.
    Robertsson, Christina
    Child and Adolescent Psychiatry, Stenungsund/Tjorn, Kungalvs Hospital, Sweden.
    Kerekes, Nora
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Anckarsäter, Henrik
    Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden, Forensic psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Ragarden, House 1, SU – East Hospital, SE-416 85 Gothenburg, Sweden.
    Nilsson, Thomas
    Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden, Forensic psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Ragarden, House 1, SU – East Hospital, SE-416 85 Gothenburg, Sweden.
    A 3-year follow-up study of Swedish youths committed to juvenile institutions: Frequent occurrence of criminality and health care use regardless of drug abuse2017In: International Journal of Law and Psychiatry, ISSN 0160-2527, E-ISSN 1873-6386, Vol. 50, p. 52-60Article in journal (Refereed)
    Abstract [en]

    This 3-year follow-up study compares background variables, extent of criminality and criminal recidivism in the form of all court convictions, the use of inpatient care, and number of early deaths in Swedish institutionalized adolescents (N = 100) with comorbid substance use disorders (SUD) and Attention-Deficit/Hyperactivity Disorder (ADHD) (n = 25) versus those with SUD but no ADHD (n = 30), and those without SUD (n = 45). In addition it aims to identify whether potential risk factors related to these groups are associated with persistence in violent criminality. Results showed almost no significant differences between the three diagnostic groups, but the SUD plus ADHD group displayed a somewhat more negative outcome with regard to criminality, and the non-SUD group stood out with very few drug related treatment episodes. However, the rate of criminal recidivism was strikingly high in all three groups, and the use of inpatient care as well as the number of untimely deaths recorded in the study population was dramatically increased compared to a age matched general population group. Finally, age at first conviction emerged as the only significant predictor of persistence in violent criminality with an AUC of .69 (CI (95%) .54–.84, p = .02). Regardless of whether SUD, with or without ADHD, is at hand or not, institutionalized adolescents describe a negative course with extensive criminality and frequent episodes of inpatient treatment, and thus requires a more effective treatment than present youth institutions seem to offer today. However, the few differences found between the three groups, do give some support that those with comorbid SUD and ADHD have the worst prognosis with regard to criminality, health, and untimely death, and as such are in need of even more extensive treatment interventions.

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