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Handbook of Forensic Psychiatric Practice in Capital Cases


Psychiatric factors


• What is the nature of the person’s psychiatric disorder? • Does the person tend only to commit acts of violence when floridly psychotic or when suffering an episode of depression, for instance


• Are there relevant command hallucinations? • Relevance of cognitive factors that might be associated with intellectual impairment


Substance misuse


• What is the history of substance misuse • Which drugs? • Frequency and quantity of each drug used • Association of drug use with offending • During intoxication or withdrawal • Associated with offending related to funding drug habits • Are drugs used to self-medicate symptoms of mental illness? • Have there been any long-term sequelae of drug use?


Head injury


• Has there been any history of head injury? • How severe was the head injury? • Have there been any long term sequelae of head injury? • What is the relationship of head injury and the onset of violent behaviour?


Psychological factors


• Does the person hold attitudes supportive of violence? • Does the person tend to hold grudges, resentments or grievances? • Is there evidence of personality traits indicating a risk of violence? • Sadism • Lack of empathy • Affective instability • What level of insight does the person have into their own propensity for violence?


Contextual factors


• What circumstances were associated with previous violent acts? • What was the nature of their relationships at the time of violent acts? • How did the behaviour of other people contribute to acts of violence? • Who were their peers at the time of acts of violence? • Did violence occur in the context of domestic dispute? • Had the person experienced a recent loss? • What was the person’s access to weapons at the time of acts of violence?


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