精神病人的凶杀伤害行为与责任能力

精神病人的凶杀伤害行为与责任能力江苏省盐城市第四人民医院（２２４００２）缪金生，周于志有人统计，精神病人有杀人行为者占４２．１３％，伤害行为者占１３．０６％［１］．为探讨上述两种行为与精神病理现象的因果关系及责任能力问题，故将所见３８例的有关资料作一...     

论抑郁症的凶杀行为与责任能力评定

在抑郁症凶杀行为的司法鉴定中,如何判定其辨认和控制能力的受损程度,常成为司法精神病鉴定的难点;即使是某些特定的抑郁症凶杀类型,在司法精神病学界对其责任能力的评定也存在诸多争议。为此,我们对抑郁症的各种凶杀行为进行归类,并对其凶杀特征和辨认能力与控制能力进行讨论,以期提高刑事责任能力评定的一致性。     

癫痫患者发生凶杀伤害行为的特点和责任能力

通过对癫痫患者发生凶杀伤害行为的分析,发现其发生率仅次于精神分裂症,进一步分析其特点和责任能力,提出应加强对癫痫患者的治疗和管理。     

具有凶杀行为的精神疾病患者自杀行为研究

目的:探讨具有凶杀行为的精神疾病患者自杀的危险因素.方法:调查1986年至2006年具有凶杀行为的精神疾病患者院内自杀身亡3l例,采用多因素Logistic回归分析自杀行为危险因素.结果:具有凶杀行为精神疾病患者自杀男:女=3.43:1,自杀行为的发生与家族自杀史、悔恨、绝望、心理社会因素及杀害对象有关.结论:悔恨、绝望、心理社会因素等是具有凶杀行为精神疾病患者自杀的危险因素,对于有凶杀行为的精神疾病患者自杀行为应加以干预.     

精神病患者凶杀行为特征及与责任能力相关性的研究

目的探讨精神病人凶杀行为特征及与责任能力的相关性。方法用自编凶杀行为特征调查表综合司法精神病鉴定中181例重型精神病病人和47例非精神病人凶杀案例的资料,采用SPSS13.0软件统计并进行凶杀行为特征的比较和责任能力与行为特征的相关分析。结果①两组在年龄构成、性别分布、婚姻状况及性格特征方面无显著性差异(P>0.05),在受教育程度和职业分布上差异有显著性(P(0.01);两组在作案诱因和先兆、预谋、方式、对象、动机、作案后的自我保护性、责任能力多方面有显著性差异(P(0.01)。②Logistic回归分析表明作案动机、隐蔽性、保护性、作案方式、诱因、病期和对象与责任能力的评定均呈显著性相关(B0.721~28.71;P0.000~0.027)。结论精神病人的凶杀行为特征与非精神病人有明显差异,其责任能力的评定依次与动机、隐蔽性、保护性、作案方式、诱因、病期和对象密切相关。     

具有凶杀行为的精神疾病患者自杀行为研究

目的:探讨具有凶杀行为的精神疾病患者自杀的危险因素。方法:调查1986年至2006年具有凶杀行为的精神疾病患者院内自杀身亡31例,采用多因素Logistic回归分析自杀行为危险因素。结果:具有凶杀行为精神疾病患者自杀男:女=3.43∶1,自杀行为的发生与家族自杀史、悔恨、绝望、心理社会因素及杀害对象有关。结论:悔恨、绝望、心理社会因素等是具有凶杀行为精神疾病患者自杀的危险因素,对于有凶杀行为的精神疾病患者自杀行为应加以干预。     

精神疾病患者凶杀犯罪学特征

目的：探讨凶杀精神疾病患者犯罪学特征及相关因素。方法：对167例凶杀精神疾病患者和158例非凶杀精神疾病患者进行对照分析。结果：凶杀行为的发生与心理社会因素、负性生活事件、社会支持低、家庭经济状况差及未得到及时治疗、病期长等因素有关。精神疾病患者作案时常无预谋、无隐蔽性,杀害对象以亲人为主,作案后缺乏自我保护性。结论：给予精神疾病患者社会支持,及时就医,进行心理干预,减少凶杀行为的发生。     

精神疾病患者的暴力行为及其责任能力评定

精神疾病与暴力行为之间存在着较为密切的联系。精神疾病患者暴力作案的责任能力评定是司法鉴定中的常见和难点问题。本文从患者暴力行为特征、责任能力相关影响因素以及未来发展趋势等方面,结合国内外研究进展进行了综合评述,以期对精神疾病患者刑事责任能力评定的研究和实践提供理论参考。     

精神病人责任能力及其评定

责任能力评定是司法精神病学鉴定中的核心内容,本文对责任能力及其评定进行综述。     

对露阴行为的责任能力评定

对露阴行为的责任能力评定张钧贤，王士清，郑瞻培露阴行为系露阴癖的主要表现，但并非据此即能诊断为露阴癖。对露阴癖的责任能力评定尚有不同看法，而对露阴行为尚需考虑其诊断的鉴别与性质问题，不能一概按露阴癖处理，现举两例如下。案例１男，２７岁，中学文化，未婚...     

司法精神病鉴定责任能力评定20年变迁

目的　探讨２０ 年来司法精神病鉴定中责任能力评定的现状。方法　以１９８９ 年《精神疾病司法鉴定暂行规定》颁布为界,对前后１０ 年责任能力评定结果进行比较分析。结果　规定后较规定前责任能力评定总体呈趋严的趋势（ Ｐ＜ ０－０１） ;对精神分裂症、精神发育迟滞、癫痫性精神病障碍患者责任能力评定趋严（ Ｐ＜０－０１、Ｐ＜ ０－０１ 和Ｐ＜０－０１） ;对盗窃、强奸和流氓危害行为责任能力评定趋严（Ｐ＜ ０－０５） 。结论　规定后１０ 年较规定前１０ 年责任能力评定呈趋严倾向,动机论对责任能力评定的影响较深远,但尚有待进一步研究完善。     

Homicide, suicide and CSF 5-HIAA

Concentrations of 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA), and 4-hydroxy-3-methoxyphenyl glycol (HMPG) in lumbar spinal fluid were measured by mass fragmentography in 16 men convicted for criminal homicide, 22 men who had attempted suicide, and 39 healthy male control subjects. Those men who had killed a sexual partner, and those who had attempted suicide, had lower levels of the serotonin metabolite, 5-HIAA in spinal fluid than the controls. It is suggested that low levels of 5-HIAA in spinal fluid reflect a disorder of serotonin turnover, which makes the individual more prone to acts of violence in states of emotional turmoil.     

Homicide of an aggressive adolescent boy with right temporal lesion: A case report

The case is reported of a 14-year-old male who killed an 8-year-old child following an alleged insult. The subject had been known to be aggressive throughout his school career. He had suffered one nocturnal seizure at the age of 13, but he never was amnesic for any of his fights. There was a history of possible hypoxic birth trauma. Neuropsychiatric investigation revealed developmental lags in speech and other psychosocial skills and, on computer tomography, a circumscribed lesion (cystic defect) lateral to the right nucleus amygdalae.     

涉嫌暴力违法被鉴定人责任能力的多因素分析

目的探索涉嫌暴力违法被鉴定人责任能力的相关因素。方法采用回顾性研究方法,在2008～2010年的鉴定案例中筛选出符合研究条件的案例共178例进行主成分分析、相关分析和逐步回归分析,并结合相关文献进行讨论。结果责任能力与因子1(行为认知能力)、辨认能力、控制能力、医学诊断、因子2(作案行为)、因子3(负荷双方关系、危害对象、对案件性质的认识)、委托单位、送鉴原因、精神病史相关。回归分析显示,责任能力与家族史、送鉴原因、因子1高度相关,三者可解释责任能力的67.5%的变异。结论涉嫌暴力违法被鉴定人责任能力的评定存在许多影响因素,与以往研究基本相同,因此有必要制定统一的责任能力鉴定标准。     

An experimental manipulation of responsibility in children: A test of the inflated responsibility model of obsessive-compulsive disorder

The objective of this study was to investigate whether Salkovskis (1985) inflated responsibility model of obsessive-compulsive disorder (OCD) applied to children. In an experimental design, 81 children aged 9-12 years were randomly allocated to three conditions: an inflated responsibility group, a moderate responsibility group, and a reduced responsibility group. In all groups children were asked to sort sweets according to whether or not they contained nuts. At baseline the groups did not differ on children's self reported anxiety, depression, obsessive-compulsive symptoms or on inflated responsibility beliefs. The experimental manipulation successfully changed children's perceptions of responsibility. During the sorting task time taken to complete the task, checking behaviours, hesitations, and anxiety were recorded. There was a significant effect of responsibility level on the behavioural variables of time taken, hesitations and check; as perceived responsibility increased children took longer to complete the task and checked and hesitated more often. There was no between-group difference in children's self reported state anxiety. The results offer preliminary support for the link between inflated responsibility and increased checking behaviours in children and add to the small but growing literature suggesting that cognitive models of OCD may apply to children.     

The role of responsibility and fear of guilt in hypothesis-testing

Recent theories argue that both perceived responsibility and fear of guilt increase obsessive-like behaviours. We propose that hypothesis-testing might account for this effect. Both perceived responsibility and fear of guilt would influence subjects’ hypothesis-testing, by inducing a prudential style. This style implies focusing on and confirming the worst hypothesis, and reiterating the testing process. In our experiment, we manipulated the responsibility and fear of guilt of 236 normal volunteers who executed a deductive task. The results show that perceived responsibility is the main factor that influenced individuals’ hypothesis-testing. Fear of guilt has however a significant additive effect. Guilt-fearing participants preferred to carry on with the diagnostic process, even when faced with initial favourable evidence, whereas participants in the responsibility condition only did so when confronted with an unfavourable evidence. Implications for the understanding of obsessive-compulsive disorder (OCD) are discussed.     

Homicide and psychosis: criminological particularities of schizophrenics, paranoiacs and melancholic. A review of 27 expertises

INTRODUCTION: During the night of the 11 to 12 of December 2002, Mathieu X. 21 years old, convinced he was defending himself from evil human beings decapitated a nurse and an auxiliary nurse of the psychiatrist hospital. This crime, which received saturated media coverage, obviously raises questions about the dangerous and violent nature of the mentally ill, which can sometimes culminate in homicide. Firmly rooted in the collective consciousness is the popular idea that someone who kills an unknown person in the street is mentally ill. Conversely, the epidemiological data are reassuring; only 15% of such crimes are committed by the seriously mentally ill (schizophrenia, paranoia, melancholia). AIM: Typing and comparison of homicides committed by schizophrenic, paranoiac and melancholic persons. METHOD: Several murders committed by psychotic persons are presented in this article. This retrospective study shows several types of pathological murder (schizophrenia, paranoiac delirious disorder, affective disorder: melancholia and hypomania). Twenty-seven cases have been selected and analysed from 268 cases prepared over 30 years by two psychiatrists, whose diagnoses were schizophrenia, paranoia, melancholia or hypomania. RESULTS: From these 268 cases of homicide examined, 27 murderers were psychotic. Ten of these were young, single, jobless, male schizophrenics: they drank little alcohol. Most of them had a criminal history. They were paranoid schizophrenics whose hallucinatory mechanisms fed mostly persecuted, sexual and metaphysical themes. Forty percent of them were disorganised, and half of them showed negative features. They knew their victim (family, friends). Nine others were paranoiac, for the most part male, older, married, family men, without psychiatric or criminal record. Intuitions with delirious fed persecuted (77%), jealous (40%) or prejudicial themes. They murdered their wife or husband or neighbour. Alcohol consumption was often involved. Schizophrenic and paranoiac murderers often have an emotional temper. Conversely, melancholic murderers are mostly female aged around 30, married, family women, drinking little alcohol. Two-thirds of them have psychiatric records of depression, bipolar disorders and attempted suicide. Altruism is the most frequent delirious theme. Their murders are more often premeditated. They know the victim: child or partner. Suicide often follows the murder.     

Intolerance of uncertainty mediates the relationship between responsibility beliefs and compulsive checking

Both responsibility beliefs and intolerance of uncertainty have been implicated in compulsive checking behavior. Despite this, the exact relationship of these two variables with compulsive checking behavior is yet to be determined. Using a mixed sample of individuals consisting of compulsive checkers as well as non-clinical participants, we assessed the validity of a mediation model in which the relationship between responsibility beliefs and compulsive checking was mediated by intolerance of uncertainty. Although both responsibility beliefs and intolerance of uncertainty were correlated with the frequency of compulsive checking, the relationship between responsibility and checking was fully mediated by intolerance of uncertainty. Implications for the understanding of the relationship between these constructs, as well for conceptualisation of clinical checking problems are discussed.     

颅脑创伤所致精神障碍责任的评定

目的　阐明颅脑创伤所致精神障碍犯罪嫌疑人责任能力评定的原则。方法　对天津市司法精神医学鉴定委员会 1986年至 1998年间颅脑创伤所致精神障碍 3 6例犯罪嫌疑人的鉴定材料进行回顾性分析。结果　 3 6例犯罪嫌疑人中有责任能力者 10例 ,占 2 7 78% ;有限定责任能力者 9例 ,占 2 5 % ;无责任能力者 17例 ,占 47 2 %。结论　颅脑创伤所致精神障碍犯罪嫌疑人责任能力评定 ,作者提出应遵循的四条原则     

现实动机作案与责任能力的关系

目的：探索司法精神医学鉴定中现实动机作案者与责任能力之间的关系。方法：分析78例现实动机作案者的责任能力。结果：除24例无精神病外,其余54种有各种精神障碍的作案者中有31例评定为限制责任能力,23例评定为完全责任能力,无1例能完全免除责任能力。结论：动机论适合于司法精神鉴定实践,现实动机作案者,不论其精神状态如何,均不能完全免除刑事责任。