Crimes by people with schizophrenia in Korea: comparison with the general population.

BACKGROUND: This study was performed to describe the prevalence of crimes committed by persons with schizophrenia using population-based data and to compare the crime prevalence of persons with schizophrenia and the general population. METHODS: The number of crimes was obtained from the Korean National Policy Agency (KNPA) crime statistics (2012-2016), which provide the number of crimes in terms of the criminal's mental status and mental health conditions. For the number of persons with schizophrenia, estimates were used which had been calculated from the inpatient and outpatient claims from the National Health Insurance Service. The crime prevalence in persons with schizophrenia was calculated according to the types of crimes, and a comparison with the general population was conducted. RESULTS: The overall crime prevalence of persons with schizophrenia was 72.7 to 90.3 per 10,000 from 2012 through 2016, which was about one fifth that of the general population. While the crime rates of the persons with schizophrenia were lower than the general population in most types of crimes including violence, intellectual crimes, and theft, the prevalence of murder, arson, and drug-related crimes in persons with schizophrenia was about five times, six times, and two times that of the general population respectively. CONCLUSION: The higher prevalence of serious offences among persons with schizophrenia suggests the need for closer and more appropriate care for the population, which would be achieved through effective continuity of institutional and community care.

Fire-setting performed in adolescence or early adulthood predicts schizophrenia: a register-based follow-up study of pre-trial offenders.

BACKGROUND: Aggressive and disruptive behaviours often precede the onset of serious mental illnesses. Fire-setting is a type of crime that is associated with psychotic disorders. AIM: The aim of this prospective follow-up study was to investigate if fire-setting performed in adolescence or early adulthood was associated with future diagnoses of schizophrenia or schizoaffective disorder. METHODS: The consecutive sample consisted of 111 Finnish 15-25-year old males with fire-setting crimes, decreed to a pre-trial forensic psychiatric examination in 1973-1998, and showing no past nor current psychosis at the time of examination. For each firesetter, four age-, gender-, and place of birth-matched controls were randomly selected from the Central Population Register. The subjects were followed until the death of the individual, until they moved abroad, or until the end of 2012. RESULTS: Fourteen firesetters (12.6%) and five controls (1.1%) were diagnosed with either schizophrenia or schizoaffective disorder later in life, corresponding to a hazard ratio of 12.5. The delay between the fire-setting offense and the future diagnosis was on average nearly 10 years. CONCLUSIONS: Young male offenders undergoing a forensic psychiatric examination because of fire-setting crimes had a significant propensity for schizophrenia and schizoaffective disorder. Accurate assessments should be made both during imprisonment and later in life to detect possible psychotic signs in these individuals.

Predicting non-familial major physical violent crime perpetration in the US Army from administrative data.

BACKGROUND: Although interventions exist to reduce violent crime, optimal implementation requires accurate targeting. We report the results of an attempt to develop an actuarial model using machine learning methods to predict future violent crimes among US Army soldiers. METHOD: A consolidated administrative database for all 975 057 soldiers in the US Army in 2004-2009 was created in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Of these soldiers, 5771 committed a first founded major physical violent crime (murder-manslaughter, kidnapping, aggravated arson, aggravated assault, robbery) over that time period. Temporally prior administrative records measuring socio-demographic, Army career, criminal justice, medical/pharmacy, and contextual variables were used to build an actuarial model for these crimes separately among men and women using machine learning methods (cross-validated stepwise regression, random forests, penalized regressions). The model was then validated in an independent 2011-2013 sample. RESULTS: Key predictors were indicators of disadvantaged social/socioeconomic status, early career stage, prior crime, and mental disorder treatment. Area under the receiver-operating characteristic curve was 0.80-0.82 in 2004-2009 and 0.77 in the 2011-2013 validation sample. Of all administratively recorded crimes, 36.2-33.1% (male-female) were committed by the 5% of soldiers having the highest predicted risk in 2004-2009 and an even higher proportion (50.5%) in the 2011-2013 validation sample. CONCLUSIONS: Although these results suggest that the models could be used to target soldiers at high risk of violent crime perpetration for preventive interventions, final implementation decisions would require further validation and weighing of predicted effectiveness against intervention costs and competing risks.

The effect of temperature on arson incidence in Toronto, Ontario, Canada.

Studies of crime and weather have largely excluded arson from empirical and theoretical consideration, yet weather could influence arson frequency over short time frames, influencing the motivation and activity of potential arsonists, as well as the physical possibility of fire ignition. This study aims to understand the role of weather on urban arson in order to determine its role in explaining short-term variations in arson frequency. We use data reported to the Ontario Fire Marshall's office of arson events in the City of Toronto between 1996 and 2007 to estimate the effect of temperature, precipitation, wind conditions and air pressure on arson events while controlling for the effects of holidays, weekends and other calendar-related events. We find that temperature has an independent association with daily arson frequency, as do precipitation and air pressure. In this study area, cold weather has a larger influence on arson frequency than hot weather. There is also some evidence that extremely hot and cold temperatures may be associated with lower day-time arson frequency, while night-time arson seems to have a simpler positive linear association with temperature.

[Arson and pyromania, update 2015]. / Incendiaires et pyromanes.

While the fire constitutes a threat and provokes avoidance by the entire animal world, its control as lighting and maintenance is inseparable from the history of humankind. For 1% of the population that use is turned to harm, repeatedly and without objective reason, responding to the historical definition of pyromania. The profile of arsonists does not appear to be different from that of the general criminal population: alcohol abuse, nicotine, marijuana and antisocial personality do not make fire setters a special case. However positive fire experience lived in childhood, emotional avoidance and expertise in fire settings' control seems to be specific, as recidivism risk below that of the general criminal population.

Offending behaviours of child and adolescent firesetters over a 10-year follow-up.

BACKGROUND: To assess the postintervention arson recidivism and other offending rates of a group of 182 firesetting children and adolescents referred to the New Zealand Fire Awareness and Intervention Program (FAIP) over a follow-up period of 10 years. To investigate predictors of offending behaviour as well as variables associated with previous involvement in firesetting behaviour and offending severity. METHOD: Data collected at the time of the FAIP intervention was provided by the New Zealand Fire Service and the offence histories of the sample were accessed from the New Zealand Police database (NIA). Data were analyzed using both descriptive and inferential statistics. RESULTS: Although the arson recidivism rate was low (2%), rates of general offending were high, with 59% of the sample having committed an offence during the follow-up period. Fifteen percent of the sample was classified as severe offenders, 40% as moderate and 4% as minor. Of offenders, 12.6% had been imprisoned during the follow-up period. Offending was predicted by experience of abuse and a previous firesetting behaviour at the time of the FAIP intervention. Living with both parents at the time of intervention decreased the probability of an individual engaging in future offending behaviour. The presence of family stress and a diagnosis of Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder (ADD/ADHD) were associated with previous firesetting behaviour. In addition, involvement with family violence (as a perpetrator, complainant or victim) was associated with more severe offending behaviour. CONCLUSIONS: In light of existing research, the findings of this study indicate that many firesetters are at risk for future offending and that identification of high-risk individuals is therefore an important consideration for any organization involved with firesetters. To minimize this risk, there is a need for a collaborative, multiagency approach to firesetting behaviour involving comprehensive risk assessment and appropriate referral for at-risk individuals.

Mental illness and psychiatric treatment amongst firesetters, other offenders and the general community.

OBJECTIVE: Firesetting is often reported to be associated with psychopathology, but frequently these conclusions are based on studies reliant on selective forensic psychiatric samples without the use of comparison groups. The aim of the study was to examine the rates of mental illness, substance use disorders, personality pathology and psychiatric service usage in a population of convicted firesetters compared with other offenders and community controls. METHOD: Using a data-linkage design, the study examined the psychiatric histories and usage of public mental health services by 1328 arsonists convicted between 2000 and 2009 in Victoria, Australia. These were compared with 1328 matched community controls and 421 non-firesetting offenders. RESULTS: Firesetters were significantly more likely to have been registered with psychiatric services (37%) compared with other offenders (29.3%) and community controls (8.7%). The firesetters were also more likely to have utilised a diverse range of public mental health services. Firesetters attracted psychiatric diagnoses more often than community controls and other offenders, particularly affective, substance use, and personality disorders. CONCLUSIONS: This study confirms that there is a link between firesetting and psychopathology, suggesting that there is a role for the psychiatric screening of known firesetters, and a need to consider psychopathology in formulating the risk for further firesetting.

Adult Externalizing and Suicidal Behavior in Children Who Set Fires: Analysis of a 40 Year Birth Cohort Study.

OBJECTIVE: Firesetting in children is thought to be an indicator of severe conduct problems in young people. However, no research has examined whether childhood firesetting is also associated with increased risk of externalizing and suicidal behaviors in adulthood. METHOD: Data were obtained from a longitudinal study (n = 1265). Childhood firesetting/conduct problems (7-10 years) were derived from an assessment of antisocial behavior. Externalizing/suicidal behavior was derived from the Composite International Diagnostic Interview and the Self-Report Delinquency Inventory. Generalized estimating equation (GEE) models estimated associations between childhood firesetting and adult substance use disorders, criminal offending, and suicidal ideation, adjusting for childhood conduct problems and other confounding factors. Associations between childhood and adult firesetting (age 18-40 years) were examined using cross-tabulation (χ2). RESULTS: Five percent of children reported firesetting (7-10 years). Childhood firesetting appeared to increase the risk of adult firesetting; however, in most cases adult firesetting was not associated with childhood firesetting (χ2 (1) = 4.15, p = .0417). Childhood firesetting was a risk marker for adult externalizing/suicidal behavior; however, the effect was relatively weak (IRR = 1.51; 95% CI: 1.11-2.05). Children with conduct problems who also engaged in firesetting were found to be at substantially higher risk of later externalizing/suicidal behavior (IRR = 2.84; 95% CI: 1.24-6.49). CONCLUSION: This study found that childhood firesetting is a risk marker for adult externalizing/suicidal behavior, not an independent risk factor. It may be more useful for clinicians to focus on child conduct problems generally, rather than focussing on firesetting behavior.

Intervention for Firesetting Offenders: A Case Study.

There is little research on treatment for firesetting, especially for those who were incarcerated for their offenses. Of the treatment programs that do exist, there are limitations to feasibly implementing these in correctional settings. We propose a short-term (eight-session) program, Intervention for Firesetting Offenses (INFO), based on techniques that have been empirically supported for this population, including psychoeducation, motivational interviewing, cognitive behavioral therapy-based strategies, and relapse prevention. We provide a description of INFO using the case study of Mr. A, a man who was incarcerated for an arson offense. Overall, INFO was feasibly and effectively implemented, as the individual improved his understanding of firesetting in general and his own motivations and risk factors for engaging in firesetting and developed a relapse prevention plan to avoid future offending behaviors.

Gender differences in firesetting: results from the national epidemiologic survey on alcohol and related conditions (NESARC).

This study presents gender differences in sociodemographics and in psychiatric correlates of firesetting in the United States. Data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a representative sample of U.S. adults. Face-to-face interviews of more than 43,000 adults were conducted in the 2001-2002 period. This study focused on the 407 subjects with a lifetime history of firesetting. The prevalence of lifetime firesetting in the U.S. was 1.7% in men and 0.4% in women. Firesetting was significantly associated with a wide range of antisocial behaviors that differed by gender. Multivariate logistic regression analyses indicated associations in both genders with psychiatric and addictive disorders. Men with a lifetime history of firesetting were significantly more likely than men without such history to have lifetime generalized anxiety disorder as well as a diagnosis of conduct disorder, antisocial personality disorder, alcohol or cannabis use disorder, and obsessive-compulsive personality disorder. Women with a lifetime history of firesetting were significantly more likely than women without such history to have lifetime alcohol or cannabis use disorder, conduct disorder, and antisocial or obsessive compulsive personality disorder, as well as psychotic disorder, bipolar disorder or schizoid personality disorder. Women with a lifetime history of firesetting were significantly more likely than men with such history to have a lifetime diagnosis of alcohol abuse and antisocial personality disorder as well as a diagnosis of schizoid personality disorder. Our findings indicate that firesetting in women could represent a behavioral manifestation of a broader spectrum than firesetting in men.

A young woman with visual hallucinations, delusions of persecution and a history of performing arson with possible three-generation Fahr disease.

OBJECTIVE: Fahr disease (FD) is a rare neurological and psychiatric disorder. The disease is classified by intracranial calcification of the basal ganglia with the globus pallidus region being particularly affected. We examined a young woman with visual hallucinations, delusions of persecution and a history of performing arson with possible third-generation FD. METHOD: Case report of third-generation FD. RESULTS: A 23-year-old woman was arrested for two arsons: i) The patient exhibited progressive psychotic symptoms, including visual hallucinations, delusion of injury, irritability, lability of mood, mental retardation and visual disorders and ii) Computed tomography (CT) imaging demonstrated bilateral calcifications of the basal ganglia (globus pallidus) in the patient, her mother and her grandmother. CONCLUSION: We found a family with a three-generation history of FD who exhibited calcification in the brain and mental retardation. Compared to her mother, the patient described here displayed anticipation of disease onset.

Prevalence and correlates of fire-setting in the United States: results from the National Epidemiological Survey on Alcohol and Related Conditions.

Fire-setting is a serious and costly form of antisocial behavior. Our objective in this study was to examine the prevalence and correlates of intentional fire-setting behavior in the United States. Data were derived from a nationally representative sample of US residents 18 years and older. Structured psychiatric interviews (N = 43,093) were completed by trained lay interviewers between 2001 and 2002. Fire-setting as well as mood, anxiety, substance use, and personality disorders of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition were assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) version. The prevalence of lifetime fire-setting in the US population was 1.0%. Respondents who were men, white, 18 to 35 years old, born in the United States, and living in the western region of the United States had significantly higher rates of fire-setting than their counterparts. Fire-setting was significantly associated with a wide range of antisocial behaviors. Multivariate logistic regression analyses identified strong associations between lifetime alcohol and marijuana use disorders, conduct disorder, antisocial and obsessive-compulsive personality disorders, and family history of antisocial behavior. Intentional illicit fire-setting behavior is associated with a broad array of antisocial behaviors and psychiatric comorbidities. Given the substantial personal and social costs related to arson, prevention and treatment interventions targeting fire-setters potentially could save lives and property.

Epidemiology of firesetting in adolescents: mental health and substance use correlates.

OBJECTIVE: Despite high rates of firesetting among community adolescents, little is known about its correlates. This study identifies the mental health and substance use correlates of four firesetting levels in an epidemiological sample of adolescents. METHODS: Three thousand, nine hundred and sixty-five (3,965) students in grades 7 to 12 were surveyed. Multinomial analyses were used to compare non-firesetters; desisters (lifetime, but no past-year firesetting); low frequency firesetters (once or twice in the past 12 months); and high frequency firesetters (3 + times) on measures of mental health and substance use. RESULTS: Twenty-seven percent of youth reported firesetting during the past year. Of these, 13.7% reported one or two episodes, and 13.5% reported 3 or more episodes. Firesetting was more prevalent among males and among those in high school. Youth who began firesetting before age 10 were more likely to report frequent firesetting during the past year. Compared to non-firesetters, the firesetting groups had elevated risk profiles. Desisters and low frequency firesetters were more likely to report psychological distress, binge drinking, frequent cannabis use, and sensation seeking. Low frequency firesetters also reported higher rates of delinquent behavior, suicidal intent, and low parental monitoring than non-firesetters. High frequency firesetters reported elevated risk ratios for all of these risk indicators plus other illicit drug use. The cumulative number of risk indicators was positively associated with firesetting severity. CONCLUSIONS: Firesetting is associated with psychopathology and substance use during adolescence. Findings highlight the need for programs to address the mental health and substance use problems that co-occur with firesetting.

The organization of the psychiatric service and criminality committed by the mentally ill.

INTRODUCTION: Over the past 40 years, a marked deinstitutionalisation in favour of social and community psychiatry has taken place in many countries. During this same period of time, there has been an increase in the number of mentally ill criminals. The purpose of this study is to analyse the correlations between the reorganization of the psychiatric treatment system, the growing number of forensic patients and the increase in serious crime, homicide, arson and violence associated with the mentally ill. MATERIALS AND METHODS: Using registers and other data sources, we estimated the annual positive or negative growth rate of consumed psychiatric beds and in social and community psychiatry (explanatory variables) and in prevalence and incidence of forensic patients, homicide, arson and violence (response variables) from 1980 to 1997 for each of the Danish counties. We analysed the immediate effect of the changing treatment structure by relating response variables to explanatory variables. The long-term effect was analysed in the form of between county analysis with both single and multiple regressions. RESULTS: Bed closure had no immediate effect on either the number of forensic patients or serious criminality. The between county analysis shows, however, that over time the (negative) growth rate in number of consumed beds is significantly correlated with the (positive) growth rates for forensic patients, homicide and arson. Social and community psychiatry have little effect, if any. DISCUSSION: The study is based on historical data, but the results are still valid. We have used two sets of data firstly the number of forensic patients and, secondly the reported number of crimes associated with the mentally ill. The uniformity of the results leads us to consider them for certain: That the decreasing effort invested in inpatient treatment is causing an increase in the crime rate among the mentally ill. CONCLUSION: Many forensic patients suffer from schizophrenia. These patients are not only offenders, but also the victims of an inadequate treatment system. Modern inpatient treatment facilities should be established.

Mentally Disordered Firesetters: An Examination of Risk Factors.

OBJECTIVE: In this study, we examined the risk-related characteristics of mentally disordered patients who had either been (1) involved in a firesetting incident or (2) involved in a nonfiresetting comparison incident while under the care of the National Health Service (NHS). METHOD: A total of 132 participants were recruited from an NHS Care Group in England (66 mentally disordered firesetters, 66 mentally disordered comparisons). Logistic regression was used to model the ability of static, dynamic, and incident-related factors in predicting whether a patient had set a fire (including gender-sensitive subanalyses), whether a patient firesetter was male or female, and a one-time or repeat firesetter. RESULTS: We identified a cluster of variables that predicted firesetting status. We also identified key factors that predicted female patient firesetters relative to female patient controls who engaged in other undesirable behaviors and male patient firesetters. A cluster of variables predictive of repeat versus one-time firesetting also emerged. CONCLUSIONS: Findings are discussed in relation to further development of risk-related firesetting theory.

The link between maltreatment and juvenile firesetting: correlates and underlying mechanisms.

OBJECTIVE: Despite the widely held belief that abuse is a risk factor for childhood firesetting, the role of maltreatment in firesetting is largely unexplored. This study reports on a sample of children and adolescents referred to a brief assessment and intervention program for juvenile firesetters. Firesetting histories of maltreated youth were compared to a group of firesetting youth with no maltreatment history. METHODS: Participants included 205 children and youth aged 4-17 years and their caregivers. Assessments were completed with a standardized protocol. Forty-eight percent of the sample had a history of maltreatment as reported by caregivers; 26% of the sample had experienced more than one type of maltreatment. RESULTS: When compared to the non-maltreated group, children with histories of maltreatment demonstrated more frequent fire involvement, more versatility regarding ignition sources and targets, and a greater likelihood of an immediate family stressor as a motive for firesetting (all p<.05). Maltreated children were more likely to become involved with fire out of anger (p=.001), and there was also a trend towards higher rates of recidivism (p=.07). Children's externalizing behavior partially mediated the influence of maltreatment on specific fire-related outcomes of children (OR=1.10; 95% CI=1.04-1.17; p=.001). CONCLUSIONS: Within a juvenile firesetting population, the presence of maltreatment is a risk factor for a more severe course of firesetting. The findings also suggest that the link between maltreatment and firesetting is operating partially through heightened emotional and behavioral difficulties. PRACTICE IMPLICATIONS: This study demonstrates that maltreatment is a risk factor that contributes to a more severe course of juvenile fire involvement, and that the link between maltreatment and firesetting operates largely through heightened behavioral and emotional difficulties. These findings highlight the need for mental health clinicians to (a) be aware that these two serious clinical issues frequently co-occur, (b) screen for fire-related behaviors and maltreatment during general assessments, and (c) consider maltreatment status when thinking about the risk of firesetting.

Pervasive developmental disorders and criminal behaviour: a case control study.

The prevalence and pattern of criminal behaviour in a population of 313 former child psychiatric in-patients with pervasive developmental disorders were studied. The patients were divided into three subgroups and compared with 933 matched controls from the general population. Age at follow-up was between 25 years and 59 years. An account of convictions in the nationwide Danish Register of Criminality was used as a measure of criminal behaviour. Among 113 cases with childhood autism, .9% had been convicted. In atypical autism (n=86) and Asperger's syndrome (n=114) the percentages were 8.1% and 18.4%, respectively. The corresponding rate of convictions in the comparison groups was 18.9%, 14.7%, and 19.6% respectively. Particular attention is given to arson in Asperger's syndrome (p= .0009).

Fire interest and antisociality as risk factors in the severity and persistence of juvenile firesetting.

OBJECTIVE: In the DSM-IV-TR, firesetting is included as a criterion for the diagnoses of conduct disorder and pyromania. The link between firesetting and antisocial behavior is well established in the empirical literature. Although theoretical models of firesetting often include fire interest as a putative risk factor, there is little research on the role of fire interest in firesetting or on the construct of pyromania. METHOD: The present study evaluated a sample of children and adolescents referred to an outpatient specialty program for juvenile firesetters with firesetting as the primary presenting problem. By assessing fire interest and antisocial behavior concurrently, the contribution of fire interest to firesetting after controlling for the role of conduct problems was evaluated. RESULTS: Results revealed that fire interest and antisocial behavior were significantly and positively correlated. Moreover, variations in fire interest added to the prediction of firesetting severity at assessment and firesetting recidivism at 18-month follow-up above and beyond what was predicted by antisociality alone. CONCLUSIONS: These findings have implications for an empirically derived taxonomy of pathological firesetting.

Arson: a growing inferno.

In a series of 34 arsonists, our survey compares the changing trends in arson to an earlier study carried out ten years ago in the same region in the UK by Rix (1994). The survey is based on pre-trial court reports done by the second author only. Fire-setting offending was predominantly seen in the young male (18-32). Fire-setting started as early as age seven and was seen as late as 63 years of age. More than half of the subjects received some form of family support. At least one third had an ICD-10 (WHO, 1992) diagnosable mental disorder and more than half were diagnosed with a psychiatric disorder during the time of reporting. A third of the subjects had a personality disorder diagnosis prior to reporting and another third had disordered personality traits established during the time of reporting. More than half had a psychological motive. Eleven per cent started a fire for excitement with only one for revenge. A third of the subjects were first time arsonists. Sixty-five per cent of arson involved building damage and all the 34 subjects were under the influence of alcohol prior to and during the act of arson. Additionally, there was cannabis use in nearly half of the subjects. Opioids and poly substance abuse were seen in a third of subjects. With the extent of financial and social burden along with risks, attention should be focused on accessing these individuals early to preventing recidivism. More research needs to be undertaken to identify the psychological motives behind fire-setting and to look into the drugs and alcohol problems amongst the younger age groups.

Female Fire-Setters: Gender-Associated Psychological and Psychopathological Features.

OBJECTIVE: Female fire-setters are reported to commit nearly one-third of deliberately set fires, yet there are limited studies examining the characteristics that distinguish them from suitable comparison groups. The aim of this study is to compare incarcerated female fire-setters with incarcerated male fire-setters and female offender controls on psychopathological and psychological features that could be targeted via therapeutic interventions. METHOD: We recruited 65 female fire-setters, 128 male fire-setters, and 63 female offenders from the prison estate. Participants completed a battery of validated tools assessing psychiatric traits and psychological characteristics (i.e., inappropriate fire interest, emotion/self-regulation, social competence, self-concept, offense-supportive attitudes, and boredom proneness) highlighted in the existing literature. RESULTS: Major depression and an internal locus of control distinguished female fire-setters from male fire-setters. Alcohol dependence, serious/problematic fire interest, and more effective anger regulation distinguished female fire-setters from the female offender control group. CONCLUSIONS: This is the first study to examine differences between female fire-setters, male fire-setters, and female control offenders on both psychopathological features and psychological traits. These findings highlight the gender-specific and offense-specific needs of female fire-setters that clinicians need to consider when implementing programs that ensure client responsivity.