Psychopathology and Criminal Behaviors

Abstract

Forensic psychology is a branch of applied psychology in which the knowledge and skills of psychology are used in the collection, evaluation, and presentation of evidence to the judiciary. The connection between the mental state and the law has been long-standing throughout history, resulting in the emergence of forensic psychology. Plato’s work in “The Republic” explores the psychological foundations of laws from earlier eras. The Middle Ages saw ongoing discussions regarding “insanity and criminal liability” in criminal proceedings. This discussion also necessitated the examination of the relationship between psychopathology and criminal behavior. In this context, researchers have periodically examined the psychological symptoms of inmates in prisons to better understand the etiology of criminal behavior and the effects of psychopathology. This chapter is crucial in highlighting the grave impact psychopathology has on the development of criminal behavior. It is imperative to fully comprehend psychopathology to prevent criminal behavior and steer clear of labeling offenders as “individuals with psychological disorders”, which can be highly stigmatizing. The chapter provides an in-depth analysis of current research and lays out a clear roadmap for future studies.

1. Introduction

Psychopathology represents the branch of science that studies and examines psychological disorders as a word meaning. In addition to the word meaning, the term psychopathology is often used in practice with a synonym for psychological discomfort. Psychological discomfort is a specific clinical picture that progresses with a marked deterioration in the psycho-biological infrastructure of the person’s cognition, mood, and behavior. The most widely used guide in which psychological disorders are classified and explained in detail with their symptoms is the 5th version of the Diagnostic and Statistical Manual of Mental Disorders, in other words DSM5 [1]. Neurodevelopmental Disorders, Disorders Associated with Schizophrenia and Other Psychotic Disorders Within the Scope of Schizophrenia, Bipolar and Bipolar-Related Disorders, Depression Disorders, Anxiety Disorders, Disorders Associated with Obsessive-Compulsive Disorder and Obsessive-Compulsive Disorders, Dissociation Disorders, Somatic Symptom Disorders and Somatization-Related Disorders, Eating and Eating Disorders, Impulse Disorders, Sleep-Wake Disorders, Sexual Dysfunctions, Gender Complaints, Disruptive Disorders - Impulse Control and Behavior Disorders, Substance Use Disorders and Addiction Disorders, Neurocognitive Disorders, Personality Disorders, Sexual Deviation Disorders, Drug-Induced Movement Disorders and Other Side Effects of Medications and Other Conditions That May Be of Clinical Interest and Other Mental Disorders in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders are discussed in detail in this study [2].

Understanding the symptoms of mental disorders and classifying them according to their symptoms is important in terms of taking preventive measures to protect mental health and treating deteriorated mental health. However, understanding and classifying the symptoms of mental disorders is of great importance not only in the field of protection, maintenance, and improvement of deteriorated health but also in the establishment, protection, and maintenance of social order. One of the first things that come to mind when it comes to social order is norms, rules, rights-law and justice system. In this context, the coexistence of the mental health field and the rights-law and justice system in the establishment, protection, and maintenance of the social order has laid the groundwork for the emergence of forensic psychology.

Forensic psychology is a branch of applied psychology in which the knowledge and skills of psychology are used in the collection, evaluation, and presentation of evidence to the judiciary. The connection between the mental state and the law has been long-standing throughout history, resulting in the emergence of forensic psychology. Plato’s work in “The Republic explores the psychological foundations of laws from earlier eras.” The Middle Ages saw ongoing discussions regarding “insanity and criminal liability” in criminal proceedings [3]. This discussion also necessitated the examination of the relationship between psychopathology and criminal behavior. In this context, the psychological symptoms of convicts in prisons were examined from time to time, and sometimes the effects of psychopathology on the etiology of criminal behavior were tried to be understood. In this study, the effects of psychopathology on the etiology of criminal behavior will be emphasized and the importance of understanding psychopathology in the prevention of criminal behavior will be emphasized in order not to characterize criminals as “individuals with psychological disorders”, in other words, not to stigmatize them.

2. The relationship between psychopathology and criminal behavior

When examining the relationship between criminal behavior and psychopathology according to DSM-5, it should begin with neurodevelopmental disorders. Neuro-developmental disorders are characterized by developmental disabilities that lead to disruptions in individual, social, educational and occupational functions, and these disabilities appear early in life, often before the child starts school. Neuro-developmental disorders include intellectual disability, communication disorders, autism spectrum disorder, attention deficit hyperactivity disorder, specific learning disorder, motor disorders, and tic disorders. Evidence from neuroimaging studies suggests that social cognition is processed in networks involving the prefrontal cortex. Impairments in empathy are frequently observed in prefrontal cortex lesions. Therefore, it has been reported that neurodevelopmental disorders such as ADHD, autism spectrum disorders (ASD), specific learning disorders (SLD), intellectual disability may have negative effects on the development of empathy. Inability to correctly evaluate the motivation of others’ emotions and behaviors and anger control disorders are among the underlying causes of violent behavior that is on the rise in our age. Therefore, it can be said that there is a positive relationship between inability to empathize and criminal behavior [4].

Continuing with the scope of schizophrenia and other disorders that go with psychosis; Schizophrenia is a psychiatric disease characterized by delusions, hallucinations, disorganized behaviors, negative symptoms, and social dysfunction [5]. In the 10th edition of the World Health Organization’s (WHO) International Classification of Diseases (ICD), schizophrenia and its related diseases were grouped under the title of “Schizophrenia, Schizotypal and Delusional Disorders” [6]. Studies have shown that delusions, hallucinations and confusion in schizophrenia cause criminal behavior [7].

Continuing with bipolar and related disorders and depression disorders, there are studies reporting that an explosive and exuberant affect in manic disorders can make these individuals prone to violence. It has been stated that this risk is always higher with grandiosity, high self-confidence, and temper tantrums occurring in manic episodes. It has been stated that sexual harassment, fraud, and theft crimes can also be committed, especially during the mania process. It has been determined that the reasons such as narcissistic injury, the perception of humiliation of the person, or the feeling of shame can create the motivation for crime in the murders committed by people diagnosed with depression impulsively. In addition, it has been reported that post-homicide suicide is frequently observed in psychotic or severe depression [8].

Continuing with anxiety disorders; anxiety is uncertain how it will happen in the present and future; maybe it can be defined as a state of worry and uneasiness about a subjective situation that is unlikely to happen [9]. The results of the studies show that anxiety disorders are a mood state that occurs after criminal behavior rather than causing criminal behavior [7]. It is thought that the reason for this is that an individual who has committed a crime experiences intense anxiety because he will be deprived of his freedom when he is arrested, he will have to eat, drink, and sleep in the same place with people he does not know when he is arrested, and he will be referred to as an “ex-convict” in the society when his detention is over and he will not be trusted.

Continuing with obsession-compulsive disorder and related disorders, according to the psychoanalytic view, obsessions are derivatives of repressed impulses. Obsessive–compulsive personality has anal features and shows fixation features in the anal period. According to Freud, when these individuals get into conflict due to their unresolved oedipal demands that cause anxiety, they regress to the anal stage of psychosexual development to get rid of the anxiety they experience. Regression affects not only the ego but also the superego, making the superego more rigid and primitive. Basically, three defense mechanisms are used to cope with aggressive and sexual urges. These are isolation, doing-undoing, and opposition formation (reaction formation). It is the separation of the impulse from its emotional composition by isolation and keeping it at the level of consciousness only with its thought content. Doing-destroying is the removal of an action that was actually done or assumed to have been done, with the opposite action in order to prevent bad consequences. It is possible that the compulsive action is canceled by a second action and through such actions the person gets rid of the ego-threatening and frightening obsessive thoughts. The opposite reaction is the development of behavior patterns that are the exact opposite of one’s main impulses [10]. No study has been found in the literature on Obsessive–Compulsive Disorder and Criminal Behavior. This is thought to be due to the belief that the rigid superego will not allow the self to go beyond the norm. However, when faced with any stressful situation, a person can also commit a crime by disrupting what he does right or by compulsive continuation of what he does right. This can be seen clearly in crimes committed by white-collar workers. Consider a scenario where a doctor is extremely concerned about contracting an illness and refuses to touch a patient with mild allergies. Likewise, a nurse who is overly suspicious may administer extra medication to a patient due to uncertainty about whether they have taken their medication on schedule. Unfortunately, if the patient ultimately passes away due to the doctor’s failure to intervene in a timely manner and the nurse’s excessive dose of medication, the nurse would be held responsible for committing a crime.

Continuing with disorders related to trauma and triggering factors, it is a post-traumatic mental disorder that causes fear, helplessness or horror reactions in the person. The disease is characterized by re-experiencing the traumatic event, avoiding trauma-related stimuli, and hyperarousal symptoms. According to the researche, trauma victims exhibit excessively angry behaviors and tend to use alcohol and drugs in order to cope with the guilt and hyperarousal they feel because they cannot prevent the traumatic event from happening again [11]. This extreme anger behavior will increase the tendency to exhibit criminal behavior by committing violence against other people and by committing acts such as being involved in crime when the consciousness is clouded due to the drug effect of the alcohol and substance used.

Continuing with dissociative disorders, it can be defined as a mental illness that includes problems related to memory, identity, emotion, perception, behavior and sense of self, and whose symptoms can potentially impair all areas of mental functionality [12]. Three common symptoms of this disorder are amnesia, fugue, and multiple personality. In multiple personalities, different personalities and identities are experienced in the same person. As if the other personality did not exist at that time, the personality in which he or she lives at that moment dominates his attitudes and behaviors. When the patient transitions to a second identity, the real personality is often not remembered. The real personality is not aware of the other. The transition from one personality to another is often sudden. Each personality has different characteristics. When they are subjected to a two-person psychological test, they give completely different results [13]. In these sudden personality transitions, the tendency of the person to not be able to recognize and make sense of where he is and the people he is with increases, and in this case, the tendency to exhibit criminal behavior increases.

Continuing with somatic symptom disorders and related disorders, somatic symptom disorder occurs when a person feels excessive and exaggerated anxiety about physical symptoms [14]. As mentioned before, the relationship between anxiety disorders and crime-related behaviors, results of studies show that anxiety disorders are a mood state that occurs after criminal behavior rather than causing criminal behavior [7]. It is thought that the reason for this is that an individual who has committed a crime experiences intense anxiety because he will be deprived of his freedom when he is arrested, he will have to eat, drink, and sleep in the same place with people he does not know when he is arrested, and he will be referred to as an “ex-convict” in the society when his detention is over and he will not be trusted.

Continuing with nutrition and eating disorders; eating disorders are psychiatric disorders in which there are deteriorations in eating attitudes and behaviors, behaviors toward weight control are revealed, and psychosocial and physical functions are impaired [15]. Since eating disorders are a disorder characterized by behaviors aimed at controlling one’s own weight, its relationship with criminal behaviors is thought to be limited to the suicide dimension.

Continuing with the expulsion disorders; excretion disorders are disorders that are common in childhood and negatively affect the life of the child and the family, associated with the lack of bladder or bowel control expected according to the child’s age and developmental status [16]. As it can be understood from the definition of expulsion disorders, it is thought that there is no direct relationship with criminal behaviors.

Continuing with sleep–wake disorders; According to the International Classification of Sleep Disorders, sleep disorders are basically divided into two as “dyssomnia” and “parasomnia.” Dyssomnia is defined as sleep initiation or continuation disorders with changes in the amount, quality and timing of sleep. Parasomnia, on the other hand, is used to express changes and deterioration in behavioral and physiological areas during sleep, concurrent with the sleep period [17]. When the defenses in criminal cases are examined, many examples of sleep disorders, especially parasomnias, are used as defense in criminal cases. In particular, there were many cases where sleepwalking convinced the jury in American courts that the accused was innocent [18]. This suggests that sleepwalking seen in parasomnia leads to criminal behaviors.

Continuing with sexual dysfunctions, gender complaints, and sexual perversion disorders; Physiological responses to sexual stimuli in humans are divided into four stages as arousal, plateau, orgasm, and resolution. Sexual dysfunctions are the absence of response or overstimulation in any of these stages. Sexual dysfunctions are generally divided into three as paraphilias, sexual identity disorders, and sexual dysfunctions [19]. Depending on the type of disorder acts such as violations of sexual autonomy and sexually aggressive behaviors toward children, violations of privacy and inviolability of home, and attacking the body of the deceased after the death of the deceased were observed in the acts committed by the perpetrators with these disorders [20]. It is also understood from the use of the word perpetrator that the behaviors are also criminal acts.

Disruptive disorders – Continuing with impulse control and conduct disorders; Impulse control disorders are characterized by the repetitive inability of the person to perform actions that may be clearly harmful to himself or to others, while destructive behavior disorders are characterized by behavioral problems such as aggression and breaking the rules [21]. According to the DSM-5, there are two forms of the disorder with childhood-onset and adolescence-onset. In the childhood onset, physical violence and difficulty in peer relationships predominate, and the symptoms of the disorder begin before the age of 10. Another disorder, such as attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (COD), often accompanies the clinical picture. In the adolescence-onset type, the findings related to the disorder are absent before the age of 10, and the disorder in violent behavior and peer relationships is relatively mild [22]. The dimension of this disorder, which is characterized by physical violence and disorder in peer relationships, is closely related to criminal behavior, especially in terms of violent behavior.

Continuing with substance-related disorders and addiction disorders; substance addiction, which is called substance use disorder together with DSM-V, is defined as a brain disease characterized by the desire to take substances continuously or periodically and some behavioral disorders in order to feel the pleasurable effects of the substance or to avoid the discomfort caused by its absence [23]. While there are many factors that lead individuals to commit crimes, drug addiction can also be among the reasons that lead individuals to commit crimes. The individual may become a victim of crime by causing a change in the situation and behavior of individuals. When the literature is reviewed, the relationship between illegal substance use and crimes of violence, aggression and theft is mentioned. Apart from violence, aggression and theft committed under the influence of drugs, crimes such as traffic accidents, media courier, and sexual assault can also be committed. In addition, due to wrong decisions when people are under the influence of substance use; behavioral disorders, provocation and aggression, fraud, drug addicts can be involved in crimes such as armed and unarmed attacks, blackmail and threats, murder in order to obtain the substance they use, may cause traffic accidents, sexual abuse, work in a way that can harm oneself and others. They may cause accidents and commit crimes such as substance use during imprisonment [24].

Continuing with personality disorders, it is very difficult to define a personality disorder. It can be said that personality disorders are the area that causes the most diagnostic discussion in psychiatry. It is known that people who are excluded from mental disorders and who show long-term adjustment disorders are common in every society. What distinguishes personality disorders from personality structure is the severity of the traits. In order for the diagnosis of personality disorder to be made, significant disorders must be present for a relatively long period of time without changing the individual’s ability to adapt to society, to keep a regular job, and to ensure continuity in relationships. These behavioral patterns, which are embedded in the self, are maintained without showing flexibility for the purpose of adaptation and cause significant impairment in the society and work life [25]. There are many subtypes of personality disorders. Individuals who have difficulty in adapting to social norms and who constantly repeat behaviors that are considered criminal by social norms are diagnosed with antisocial personality disorder (APD). Individuals with this diagnosis are those who cannot take the necessary responsibility in family and social life, act impulsively, and often display aggressive behaviors [26]. In addition to APD, although intense anger and impulsive behaviors are evident in borderline personality disorder, the presence of transient paranoid thoughts or severe dissociative symptoms under intense stress are features that increase the risk of being involved in crime. In addition, it is known that paranoid, passive – aggressive personality disorders and narcissistic behaviors increase the risk of committing violent crimes in adolescents and young adults. Multiple personality disorder causes sexual dysfunctions in individuals; it is said that sadomasochism, pedophilia, zoophilia, exhibitionism, and erotic asphyxia can be seen in both homosexual and heterosexuals [8].

3. Conclusion

As a result, it is understood that many of the mental illnesses in DSM-5 cause criminal behavior, while others are associated with criminal behavior even if they do not cause criminal behavior. However, the above-mentioned information should be used to strengthen preventive mental health services, rather than labeling offenders as “mentally ill”. For example, it is stated in the literature that individuals with neurodevelopmental disorders have difficulty in empathizing and tend to commit crimes because they have a tendency to act impulsively. During therapy with these individuals, “What did he say, what did I understand?” It is possible to prevent them from committing crimes by doing exercises or doing impulse control work so that they can empathize. In order to prevent schizophrenia from committing crimes, it can be shown that the sound heard or the image seen does not actually exist by recording a phone call while working with auditory hallucinations to show that their hallucinations are not real in therapy, or by video recording with a camera when working with visual hallucinations. In bipolar disorder, on the other hand, when the individual is in a manic period, it can be prevented from committing a crime by strengthening social support resources and ensuring that he is under the supervision of his family or close circle. In order to prevent criminal behavior in sleep–wake disorders, simple measures such as locking the bedroom door can be taken to prevent crime, especially for sleep-walkers. In sexual dysfunctions, in order to prevent delinquency, hormonal therapy can be applied to individuals with sexual dysfunction or daily activities can be planned to transfer their energies outside of sexuality. In order to prevent children with impulse control and conduct disorder from committing crimes, it is important to provide early therapy support and to raise awareness of their families. In personality disorders, in order to prevent delinquency, antisocial personality disorder can be prevented by applying the right treatment method when childhood conduct disorder is observed in order to prevent the development of antisocial personality disorder. In addition, people with borderline personality disorder can be prevented from committing crimes by conducting impulse control studies during therapy.