Criminal Responsibility in Amphetamine Psychosis

Abstract: Historical changes in forensic psychiatric evaluation on criminal responsibility and proceedings in psychopathological findings of amphetamine psychosis are reviewed at first. The classification of amphetamine related mental disorders are proposed in 6 types. Among them, the clinical characteristics and psychopathological features of "Anxiety-situational reaction type" (Fukushima) are described. According to some reasonable grounds, offenders diagnosed as anxiety-situational reaction type should be evaluated as diminished responsibility in place of irresponsibility. Finally, two cases of murder committed under the influence of amphetamine, are reported in detail.     

Amphetamine Psychosis in Tokyo–Its Clinical Features and Social Problems

Abstract: Japan is presently experiencing a second epidemic of amphetamine abuse, with methamphetamine abusers committing an increasing number of murders and injuries to ordinary citizens. As a result of the author's study of some 60 cases of amphetamine psychosis, the basic symptomatology of the disease was determined to be a paranoid hallucinatory state. Moreover, according to the contents of the paranoid hallucinatory state and the courses of the disease, amphetamine psychotics were divided into two types–the acute and the chronic. Though the former delusions were vivid, realistic and concrete, the latter were generalized, systematized and grandiose. Regarding the course of the disease, the former were episodic and the latter required longer treatments. Thus as the outline of the social background of these addicts had been made clear, it has been emphasized that the authorities must decide to solve this as a social problem.     

限定刑事责任能力评定量表在情感性精神障碍案例中的运用

目的探讨《精神病人限定刑事责任能力评定量表》在情感性精神障碍案例中的运用。方法多中心收集被评定为限定刑事责任能力的鉴定案例,对其中的情感性精神障碍人完成量表评定,同时要求鉴定专家将限定刑事责任能力按辨认与控制能力受损的程度进行三级划分。结果小部分组、部分组、大部分组量表评定总分的平均分依次升高且存在显著性差异,分别为22.07±2.59、25.93±6.12、29.61±4.50;量表共15个条目与评定分显著相关,相关系数从0.289至0.703不等;因子分析得到7个因子,能解释74.958%变异。结论精神病人限定刑事责任能力评定量表内部构建合理,在情感性精神障碍者责任能力限定评定中,能有效反映再分三级之间差异。     

Psychopathy and Criminal Responsibility

This article considers whether psychopaths should be held criminally responsible. After describing the positive law of criminal responsibility in general and as it applies to psychopaths, it suggests that psychopaths lack moral rationality and that severe psychopaths should be excused from crimes that violate the moral rights of others. Alternative forms of social control for dangerous psychopaths, such as involuntary civil commitment, are considered, and the potential legal implications of future scientific understanding of psychopathy are addressed.     

Psychopathic and Neuropathic Pathways to Homicide: Examination of Harris and Rice's Two-Path Model of Criminal Violence in Homicide

The present research examined a two-path model of homicide defined by psychopathic and neuropathic pathways. Twenty-six forensic psychiatric inpatients found not guilty due to reason of insanity of homicide or attempted homicides were assessed. A large number of variables derived from standardized neuropsychological psychometric assessment, actuarial and structured risk assessment tools and structured interviews were analysed. Qualitative comparative analysis (QCA) and the Answer Tree program showed that independence of the two pathways was observed from a nomothetic analysis with individual variations understood by the complex variable relationships at an idiographic level.     

Children's Responsibility for Criminal Conduct: The Principle of Doli Incapax under Contemporary Australian Law

In RP v The Queen [2016] HCA 53, the High Court of Australia heard an appeal on the issue of whether a child who had engaged in sexual intercourse with his younger brother had been proved to have an understanding that his conduct at the relevant time had been seriously wrong. The Court considered the contemporary operation of the presumption that a child between the ages of 10 and 14 is doli incapax and thus not criminally responsible and considered the forms of conduct which might be sufficient to establish that the presumption is rebutted. In so doing, it affirmed the contemporary relevance of the presumption and gave important guidance as to the evidence which has the potential to lead to a proper conclusion that the presumption has been rebutted.     

Psychosis pathways converge via D2high dopamine receptors

The objective of this review is to identify a target or biomarker of altered neurochemical sensitivity that is common to the many animal models of human psychoses associated with street drugs, brain injury, steroid use, birth injury, and gene alterations. Psychosis in humans can be caused by amphetamine, phencyclidine, steroids, ethanol, and brain lesions such as hippocampal, cortical, and entorhinal lesions. Strikingly, all of these drugs and lesions in rats lead to dopamine supersensitivity and increase the high-affinity states of dopamine D2 receptors, or D2High, by 200-400% in striata. Similar supersensitivity and D2High elevations occur in rats born by Caesarian section and in rats treated with corticosterone or antipsychotics such as reserpine, risperidone, haloperidol, olanzapine, quetiapine, and clozapine, with the latter two inducing elevated D2High states less than that caused by haloperidol or olanzapine. Mice born with gene knockouts of some possible schizophrenia susceptibility genes are dopamine supersensitive, and their striata reveal markedly elevated D2High states; suchgenes include dopamine-beta-hydroxylase, dopamine D4 receptors, G protein receptor kinase 6, tyrosine hydroxylase, catechol-O-methyltransferase, the trace amine-1 receptor, regulator of G protein signaling RGS9, and the RIIbeta form of cAMP-dependent protein kinase (PKA). Striata from mice that are not dopamine supersensitive did not reveal elevated D2High states; these include mice with knockouts of adenosine A2A receptors, glycogen synthase kinase GSK3beta, metabotropic glutamate receptor 5, dopamine D1 or D3 receptors, histamine H1, H2, or H3 receptors, and rats treated with ketanserin or aD1 antagonist. The evidence suggests that there are multiple pathways that convergetoelevate the D2High state in brain regions and that this elevation may elicit psychosis. This proposition is supported by the dopamine supersensitivity that is a common feature of schizophrenia and that also occurs in many types of genetically altered, drug-altered, and lesion-altered animals. Dopamine supersensitivity, in turn, correlates with D2High states. The finding that all antipsychotics, traditional and recent ones, act on D2High dopamine receptors further supports the proposition.     

The Role of Impulse Control Disorders in Assessing Criminal Responsibility: Medico-Legal Perspectives from South Africa

The role of impulse control disorders on criminal responsibility is currently a controversial issue. With the advent of the DSM-5 various questions arise which specifically relate to the nature and impact of impulse control disorders on criminal responsibility. Further anomalies, in addition, relate to the differences between the classification of impulse control disorders in the DSM-IV-TR as opposed to the recent DSM-5. To date the issue of impulse control disorders has only been addressed in limited criminal case law in South Africa and indicates that courts generally view these disorders as mitigating factors during the sentencing procedure. The focus of this contribution will be to revisit the diagnostic framework for impulse control disorders with specific reference to the criteria provided for in the DSM-5 in order to assess its applicability to a finding of diminished criminal responsibility as provided for in section 78(7) the Criminal Procedure Act 51 of 1977, and whether it could in certain circumscribed circumstances fulfil the criteria for the defence of pathological criminal incapacity, or more commonly known as the insanity defence. The vital and essential role of the mental health expert within such context will be illustrated.     

The Role of Untreated Psychosis in Neurodegeneration: A Review of Hypothesized Mechanisms of Neurotoxicity in First-Episode Psychosis

For over 20 years, studies have tried to measure the association between the duration of untreated psychosis (DUP) and changes in brain morphology. A hypothesis that untreated psychosis is neurotoxic has been postulated, but the mechanisms of that toxicity have not been described. We re-analyzed papers collected for a systematic review to extract data on the hypotheses that have been generated on the potential mechanisms by which DUP could impact brain morphology in first-episode psychosis. Dopaminergic hyperactivity, prolonged hypothalamic–pituitary–adrenal activation, and persistent activity of catecholamines have been hypothesized as mechanisms to explain these associations. However, the question remains as to whether the observed structural changes are permanent or may be reversed via antipsychotic treatment.     

‘My Brain Made Me Do It?’ Reflections on the Role of Neuroscience in Assessing Criminal Responsibility – A South African Medico-legal Perspective

Recently the role of neuroscience in assessing criminal responsibility has become an issue of academic and practical debate. The question that arises is the role that neurological or brain disorders can play in assessing criminal responsibility. Within the context of South African criminal law, the question arises as to whether these disorders will meet the threshold requirements for the defence of pathological criminal incapacity. Various medico-legal issues arise when assessing the role of neurological disorders in relation to criminal responsibility. In this contribution, the reflections are provided pertaining to the role of neuroscientific evidence in explaining criminal responsibility within the context of selected areas of application. Evidentiary aspects pertaining to the presentation of neuroscientific evidence are further canvassed as well as the role of neuroscientific evidence advanced in support of mitigation of punishment.     

Asperger's Disorder,Criminal Responsibility and Criminal Culpability

In the seminal 2002 case of Atkins v. Virginia, the United States Supreme Court held that executing the mentally retarded violates the Eighth Amendment's ban on cruel and unusual punishment. The Court did not set forth guidelines for defining mentally retarded and instead left it to the states to define the issue individually. State definitions for mental retardation or intellectual disability were examined, including documentation of procedures for Atkins claims. Results indicated significant differences between states in definitions and procedures. Not all states had a statutory ban on executing the mentally retarded, and while most states subscribed to a three-pronged definition modeled after clinical psychiatric definitions, most failed to operationalize the prongs. Additionally, states differed on the burden of proof required to show mental retardation, which party bears that burden, the timing of the showing, who makes the determination of mental retardation, and the standard used to review the determination. In addition to documenting definitions of mental retardation and criminal procedures for Atkins claims in states with the death penalty, this study sought to identify an ideal definition for intellectual disability in capital cases. While aspirational, a single definition would better satisfy the mandate of the Atkins decision by providing consistent protection to criminal defendants across states.     

Criminal responsibility assessment in Switzerland: changes and continuity

BACKGROUND: The factors that experts use to assess criminal responsibility are not very well known. Changes in the importance attributed to certain diagnoses are occasionally mentioned in the literature. The aim of this study is to identify the existence and the nature of such modifications. METHOD: We compared the socio-demographic, criminological and psychiatric characteristics of two samples of psychiatric assessments carried out in Geneva, Switzerland in 1973-74 (N = 75) and 1997-98 (N = 94). RESULTS: The two groups of subjects described by the experts' reports appear to be quite different in several characteristics. However, the rate at which experts conclude their reports in favour of diminished responsibility was not found to be significantly different. The logistic regression shows that the diagnosis of personality disorder is the only variable that influenced the experts differently for the 1997-98 period compared to the 1973-74 period. CONCLUSION: In Geneva, psychiatric experts still continue to ascribe diminished responsibility to offenders suffering from psychosis or depression. However, the population that undergoes psychiatric assessments nowadays has changed considerably.     

Multicenter Study of Brain Volume Abnormalities in Children and Adolescent-Onset Psychosis

The goal of the study is to determine the extent of structural brain abnormalities in a multicenter sample of children and adolescents with a recent-onset first episode of psychosis (FEP), compared with a sample of healthy controls. Total brain and lobar volumes and those of gray matter (GM), white matter, and cerebrospinal fluid (CSF) were measured in 92 patients with a FEP and in 94 controls, matched for age, gender, and years of education. Male patients (n = 64) showed several significant differences when compared with controls (n = 61). GM volume in male patients was reduced in the whole brain and in frontal and parietal lobes compared with controls. Total CSF volume and frontal, temporal, and right parietal CSF volumes were also increased in male patients. Within patients, those with a further diagnosis of “schizophrenia” or “other psychosis” showed a pattern similar to the group of all patients relative to controls. However, bipolar patients showed fewer differences relative to controls. In female patients, only the schizophrenia group showed differences relative to controls, in frontal CSF. GM deficit in male patients with a first episode correlated with negative symptoms. Our study suggests that at least part of the GM deficit in children and adolescent-onset schizophrenia and in other psychosis occurs before onset of the first positive symptoms and that, contrary to what has been shown in children-onset schizophrenia, frontal GM deficits are probably present from the first appearance of positive symptoms in children and adolescents.     

Amphetamine withdrawal produces region-specific and time-dependent changes in connexin36 expression in rat brain

Repeated amphetamine treatment produces a long-lasting augmentation of locomotor behavior in rats, a phenomenon known as behavioral sensitization. This process is thought to be a correlate of the addictive process in humans, and it is believed that there are drug-induced neuroadaptations that underlie these behavioral changes. One mechanism by which amphetamine can alter brain function is by affecting direct intercellular communication between neurons via gap junctions. The purpose of the present study was to examine the effect of an amphetamine treatment regimen known to produce changes in dye coupling between neurons, a functional correlate of gap junction function, on the expression of the neuronal gap junction-forming protein, connexin36. Here we report that withdrawal from an extended amphetamine regimen produces region-specific and time-dependent changes in connexin36 expression in rat nucleus accumbens and prefrontal cortex, brain regions known play roles in sensitization and addiction. This is, to our knowledge, the first demonstration of pharmacological manipulation of connexin36 in vivo.     

Impaired Performance on the Reading the Mind in the Eyes Test in First-Episode Psychosis and Clinical High Risk for Psychosis

ObjectiveAlthough previous studies have reported impaired performance in the reading the mind in the eyes test (RMET), which measures complex emotion recognition abilities, in patients with schizophrenia, reports regarding individuals at clinical high risk (CHR) for psychosis have been inconsistent, mainly due to the interacting confounding effects of general cognitive abilities and age. We compared RMET performances across first-episode psychosis (FEP) patients, CHR individuals, and healthy controls (HCs) while controlling for the effects of both general cognitive abilities and age. MethodsA total of 25 FEP, 41 CHR, and 44 HC subjects matched for age participated in this study. RMET performance scores were compared across the groups using analysis of variance with sex and intelligence quotient as covariates. Exploratory Pearson’s correlation analyses were performed to reveal the potential relationships of RMET scores with clinical symptom severity in the FEP and CHR groups. ResultsRMET performance scores were significantly lower among FEP and CHR participants than among HCs. FEP patients and CHR subjects showed comparable RMET performance scores. RMET scores were negatively correlated with Positive and Negative Syndrome Scale (PANSS) positive symptom subscale scores in the FEP patients. No significant correlation was identified between RMET scores and other clinical scale scores. ConclusionImpaired RMET performance is present from the risk stage of psychosis, which might be related to positive symptom severity in early psychosis. Longitudinal studies are necessary to confirm the stability of complex emotion recognition impairments and their relationship with social functioning in early psychosis patients.