Sociodemographic, Clinical and Criminological Characteristics of Cases with a Diagnosis of Intellectual Disability Evaluated for Criminal Responsibility

Year 2021, Volume: 5 Issue: 3, 243 - 251, 22.12.2021

Abbas Atalay , Abdulkadir Yıldız

https://doi.org/10.46332/aemj.869007

Cited By: 1

Abstract

Purpose: It was aimed to determine the sociodemographic, clinical, and criminological characteristics of individuals diagnosed with intellectual disability, who underwent forensic psychiatric examinations for criminal responsibility assessment, and to examine the effects of these characteristics on their criminal behavior and criminal responsibility.

Materials and Methods: 832 Forensic Medicine Board Reports issued for criminal responsibility assessment between 2012 and 2019 were investigated retrospectively. The reports of the 69 individuals diagnosed with intellectual disability were examined. 

Results: 86.9% of the cases were male, and the mean age at the crime was 32.49±11.39. It was determined that none of them had a profession; only 30.5% of them were working in jobs that did not require complex mental functioning and adaptation skills. 26.1% of the cases were diagnosed with Borderline Intellectual Functioning, 58% with Mild Intellectual Disabilities, 15.9% with Moderate
Intellectual Disabilities. 8.6% had a comorbid neuropsychiatric disease. It was found that 37.6% of them had a previous criminal history, 74% of the cases committed violent acts, and the victims of crime significantly included family members. According to the results of the reports, it was determined that 46.4% of the cases did not have criminal responsibility, while 43.5% of them diminished
criminal responsibility and 10.1% had criminal responsibility. 

Conclusion: While evaluating whether individuals with intellectual disability have criminal responsibility, their clinical characteristics, limitations, and risk factors that predispose to crime should be considered in a holistic approach. In addition, determining risk factors is also important in terms of maintaining the continuity of social skills and functionality.

Keywords

intellectual disability, borderline intellectual functioning, criminal responsibility, crime

Ceza Sorumluluğu Değerlendirmesi Yapılan Zihinsel Yetersizlik Tanılı Olgularda Sosyodemografik, Klinik ve Kriminolojik Özellikler

Abstract

Amaç: Ceza sorumluluğu değerlendirmesi için adli psikiyatrik muayeneleri yapılan zihinsel yetersizlik tanılı bireylerin sosyodemografik, klinik ve kriminolojik özelliklerini belirleyerek bu özelliklerinin suç davranışına ve ceza sorumluluklarına etkilerini incelemek amaçlanmıştır.

Araçlar ve Yöntem: 2012-2019 yılları arasında ceza sorumluluğu değerlendirmesi yapılan olgulara düzenlenen 832 Adli Tıp Kurul Raporu retrospektif taranarak zihinsel yetersizlik tanısı konulmuş olan 69 yetişkin hastanın raporu incelenmiştir. 

Bulgular: Suç sırasındaki yaş ortalaması 32.49±11.39 olarak saptanan olguların %86.9’u erkekti. Hiçbirinin profesyonel bir meslek sahibi olmadığı, yalnızca %30.5’inin kompleks zihinsel işlev ve uyum becerisi gerektirmeyen işlerde çalıştığı saptandı. Olguların %26.1’ine Sınır Düzey Mental Kapasite, %58’ine Hafif Düzey Zihinsel Yetersizlik, %15.9’una Orta Düzey Zihinsel Yetersizlik tanısı
konuldu. %8.6’sında komorbid bir nöropsikiyatrik hastalık vardı. %37.6’sının daha önce de suç öyküsünün bulunduğu, %73.8’inin şiddet içerikli eylemlerde bulunduğu, cinsel suç mağdurlarının belirgin bir şekilde aile bireylerinden oluştuğu saptandı. Rapor sonuçlarına göre olguların %46.4’ünde ceza sorumluluğunun bulunmadığı, %43.5’inde ceza sorumluluğunun azalmış olduğu, %10.1’inde ceza sorumluluğunun bulunduğu belirlendi. 

Sonuç: Zihinsel yetersizliği bulunan bireylerin ceza sorumluluğunun olup olmadığı araştırılırken klinik özellikleri, kısıtlılıkları, suça zemin hazırlayan risk faktörleri kapsamlı bir yaklaşımla değerlendirilmelidir. Ayrıca risk faktörlerinin belirlenmesi bireyin sosyal hayata uyumu ve işlevselliğinin devamı açısından da önem arz etmektedir.

Keywords

zihinsel yetersizlik, , sınır düzey mental kapasite, ceza sorumluluğu, suç

References

• 1. Amerikan Psikiyatri Birliği: Ruhsal Bozuklukların Tanısal ve Sayımsal Elkitabı, Dördüncü baskı, Yeniden Gözden Geçirilmiş Tam Metin (DSM IV-TR), Amerikan Psikiyatri Birliği, Washington DC, 2000, Köroğlu E (çeviri ed.), Hekimler Yayın Birliği, Ankara, 2007.
• 2. Mevzuat Bilgi Sistemi. https://www.mevzuat.gov.tr/MevzuatMetin/1.5.5237-20150327.pdf. Erişim Tarihi: 02.02.2020.
• 3. Carson D, Lindsay WR, O'Brien, G, et al. Referrals into services for offenders with intellectual disabilities: Variables predicting community or secure provision. Crim Behav Mental Health. 2010;20(1):39-50.
• 4. Lindsay W, Haut F, Steptoe L. Referral patterns for offenders with intellectual disability: a 20-year study. J Forens Psychiatry Psychol. 2011; 22(4):513-517.
• 5. Fazel S, Xenitidis K, Powell J. The prevalence of intellectual disabilities among 12 000 prisoners—A systematic review. Int J Law Psychiatry. 2008;31(4):369-373.
• 6. Jones J. Persons with intellectual disabilities in the criminal justice system: Review of issues. Int J Offender Ther Comp Criminol. 2007;51(6):723-733.
• 7. Holland T, Clare IC, Mukhopadhyay T. Prevalence of criminal offending by men and women with intellectual disability and the characteristics of offenders: implications for research and service development. J Intellect Disabil Res: JIDR. 2002;46(1):6-20.
• 8. Hodgins S. Mental disorder, intellectual defıciency, and crime. Evidence from a birth cohort. Arch Gen Psychiatry. 1992;49(6):476-483.
• 9. American Association on Mental Retardation (AAMR). Mental retardation: definition, classifıcation and systems of supports. 9th ed. Washington, DC:1992.
• 10. Mannynsalo L, Putkonen H, Lindberg N, Kotilainen I. Forensic psychiatric perspectives on criminality associated with intellectual disability: a nationwide register-based study. J Intellect Disabil Res. 2009;53(3):279-288.
• 11. Ray I, Simpson AI, Jones RM, Shatokhina K, Thakur A, Mulsant BH. Clinical, Demographic, and Criminal Behavior Characteristics of Patients With Intellectual Disabilities in a Canadian Forensic Program. Front Psychiatry. 2019;10:760.
• 12. Shang QJ, Hu ZQ, Cai WX, Yu XD, Gu Y, Jiang MJ. The criminological characteristics of mental retardation. Fa yi xue za zhi. 2006;22(1):58-60.
• 13. McCarthy J, Chaplin E, Underwood L, et al. Characteristics of prisoners with neurodevelopmental disorders and difficulties. J Intellect Disabil Res. 2016;60(3):201-206.
• 14. Ray I, Simpson AI, Jones RM, Shatokhina K, Thakur A, Mulsant BH. Clinical, demographic, and criminal behavior characteristics of patients with intellectual disabilities in a Canadian forensic program. Front. psychiatry. 2019;10:760.
• 15. Chaplin E, McCarthy J, Underwood L, et al. Characteristics of prisoners with intellectual disabilities. J Intellect Disabil Res. 2017;61(12):1185-1195.
• 16. Bhandari A, van Dooren K, Eastgate G, Lennox N, Kinner SA. Comparison of social circumstances, substance use and substance related-harm in soon-to-be-released prisoners with and without intellectual disability. J Intellect Disabil Res. 2015;59(6):571-579.
• 17. Steel Z, Marnane C, Iranpour C, et al. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013. Int J Epidemiol. 2014;43(2):476-493.
• 18. Mazza, M. G, Rossetti, A, Crespi, G, Clerici, M. Prevalence of co-occurring psychiatric disorders in adults and adolescents with intellectual disability: A systematic review and meta-analysis. J Appl Res Intellect Disabil. 2020;33(2):126-138.
• 19. Vicenzutto A, Saloppé X, Ducro C, et al. Forensic inpatients with low IQ and psychiatric comorbidities: specificity and heterogeneity of psychiatric and social profiles. Int J Forensic Ment Health. 2018;17(3):272-284.
• 20. Hassiotis A, Gazizova D, Akinlonu L, Bebbington P, Meltzer H, Strydom A. Psychiatric morbidity in prisoners with intellectual disabilities: analysis of prison survey data for England and Wales. BJ Psych. Bull. 2011; 199(2):156-157.
• 21. Salvador-Carulla L, Rodriguez-Blazquez C, De Molina MR, Perez-Marin J, Velazquez R. Hidden psychiatric morbidity in a vocational programme for people with intellectual disability. J Intellect Disabil Res. 2000;44(2):147-154.
• 22. Day K. Male mentally handicapped sex offenders. BJPsych. Bull. 1994;165(5):630-639.
• 23. Lindsay WR. Research and literature on sex offenders with intellectual and developmental disabilities. J İntellect Disabil Res. 2002;46(1):74-85.
• 24. Hart C, de Vet R, Moran P, Hatch SL, Dean K. A UK population-based study of the relationship between mental disorder and victimisation. Soc Psychiatry Psychiatr Epidemiol. 2012;47(10):1581-1590. 25. Vadysinghe AN, Dassanayaka PB, Sivasubramanium M, Senasinghe DPP, Samaranayake AN, Wickramasinghe W. A study on sexual violence inflicted on individuals with intellectual developmental disorder. Disabil Health J. 2017;10(3):451-454.
• 26. Morano JP. Sexual Abuse of the Mentally Retarded Patient: Medical and Legal Analysis for the Primary Care Physician. Prim Care Companion J Clin Psychiatry. 2001;3(3):126-135.
• 27. Mevissen L, de Jongh A. PTSD and its treatment in people with intellectual disabilities. A review of the literature. Clin Psychol Rev. 2010;30(3):308-316.
• 28. Platt L, Powers L, Leotti S, et al. The role of gender in violence experienced by adults with developmental disabilities. J Interpers Violence. 2017;32(1):101-129.
• 29. Vadysinghe AN, Dassanayaka PB, Sivasubramanium M, Senasinghe DPP, Samaranayake AN, Wickramasinghe W. A study on sexual violence inflicted on individuals with intellectual developmental disorder. Disabil Health J. 2017;10(3):451-454.
• 30. Mevissen L, de Jongh A. PTSD and its treatment in people with intellectual disabilities: a review of the literature. Clin Psychol Rev. 2010;30(3):308-316.
• 31. McGilloway C, Smith D, Galvin R. Barriers faced by adults with intellectual disabilities who experience sexual assault: A systematic review and meta-synthesis. J Appl Res Intellect Disabil. 2020;33(1):51-66.
• 32. Griffiths, DM, Fedoroff, P. Persons with intellectual disabilities and problematic sexual behaviors. Psychiatr Clin North Am. 2014;37(2):195-206.
• 33. Lambrick F, Glaser W. Sex offenders with an intellectual disability. Sex Abuse. 2004;16(4):381-392.
• 34. Byrne, G. (2018). Prevalence and psychological sequelae of sexual abuse among individuals with an intellectual disability: A review of the recent literature. J Intellect Disabil. 2018;22(3):294-310.
• 35. Akpınar A, Aksoy UM. Assessing the type of offence and criminal responsibility in borderline and mild intellectual disabilities: Is there any difference? Abant Med J. 2014;3(1):7-11.
• 36. Fıstıkcı N, Canturk G, Saatcioglu O, et al. Clinical and sociodemographic characteristics of hospitalized psychiatric patients with intellectual disability. Int J Dev Disabil. 2014;60(4):243-250.
• 37. Lindsay WR, Holland AJ, Carson D, et al. Responsivity to criminogenic need in forensic intellectual disability services. J Intellect Disabil Res. 2013;57(2):172-181.
• 38. Hauser, M. J, Olson, E, & Drogin, E. Y. Psychiatric disorders in people with intellectual disability (intellectual developmental disorder): forensic aspects. Curr Opin Psychiatry. 2014;27(2):117-121.
• 39. Petrella RC. Defendants with mental retardation in the forensic services system. Conley RW, Luckasson R, Bouthilet GN, editör(s). The Criminal Justice System and mental retardation. Baltimore, MD: Paul H. Brookes Publishing; 1992:79-96.
• 40. Mosotho NL, Bambo D, Mkhombo T, et al. Demographic, clinical and forensic profiling of alleged offenders diagnosed with an intellectual disability. J Forensic Leg Med. 2020;20(4):362-376.
• 41. Asscher JJ, van der Put CE, Stams GJJ. Differences between juvenile offenders with and without intellectual disability in offense type and risk factors. Res Dev Disabil. 2012;33(6):1905-1913.
• 42. Fernell E, Gillberg C. Borderline intellectual functioning. Handb Clin Neurol. 2020;174:77-81.
• 43. Menolascino FJ, Stark JA. Handbook of mental illness in the mentally retarded. Springer Science & Business Media. 2012.
• 44. Gigi K, Werbeloff N, Goldberg S, et al. Borderline intellectual functioning is associated with poor social functioning, increased rates of psychiatric diagnosis and drug use–A cross sectional population based study. Eur Neuropsychopharmacol. 2014;24(11):1793-1797.
• 45. Hassiotis A, Ukoumunne O, Tyrer P et al. Prevalence and characteristics of patients with severe mental illness and borderline intellectual functioning. Report from the UK700 randomised controlled trial of case management. BJPsych. Bull. 1999;175(2):135-140.
• 46. Hassiotis A, Strydom A, Hall I, et al. Psychiatric morbidity and social functioning among adults with borderline intelligence living in private households. J Intellect Disabil Res. 2008;52(2):95-106.
• 47. Nouwens PJ, Lucas R, Smulders NB, Embregts PJ, van Nieuwenhuizen C. Identifying classes of persons with mild intellectual disability or borderline intellectual functioning: a latent class analysis. BMC psychiatry. 2017;17(1):1-9.