Domestic violence as a risk factor of maternal filicide.

PURPOSE: This paper will investigate precursors to maternal filicide, focusing on domestic violence. While psychosis is often well described, less frequently explored are the connections between prior trauma, domestic violence, depression, and filicide. We will discuss reasons why a woman may not disclose domestic violence and suggest possible areas for intervention. METHODS: We present a case involving domestic violence, its impact on mental health, and eventual filicide. We then present an alternative scenario of the same case where filicide is considered, but is avoided. RESULTS: The case of the mother who experienced domestic violence and was accused and sentenced for filicide is seen in greater relief by presenting the case in an alternative scenario with effective interventions. It is clear the availability and the ability to access community supports, such as obstetric and pediatric screening, psychiatric treatment, domestic violence shelters, intimate partner violence outreach services, parenting support groups, and hospital social work case management, tragedies such as filicide can be prevented. CONCLUSION: Traumatic early childhood experiences predispose people to a stress-response system that is more prone to inactivity and impulsivity. This can cause women in domestic violence relationships to stay, limit their options for family planning, become increasingly depressed, not seek community support, and risk impulsive action of harming their child. This risk can be mitigated by building stable relationships with their medical team, treating depression, connecting with home visitation programs, and being empowered to access contraception.

Filicide in Africa: a systematic review.

BACKGROUND: Filicide, the act of a parent or parental figure killing their child, has been reported in various African countries. However, there is a lack of comprehensive reviews on the prevalence and associated factors of filicide across the African continent, which is characterized by diverse cultural beliefs and practices. This review aims to examine the prevalence and risk factors of filicide in Africa. METHODS: This review included studies on filicide in Africa, identified through searches in various databases (PubMed, Scopus, Africa Journal Online, and Google Scholar) using relevant keywords. The Mendeley reference manager was used to organize all identified articles and remove duplicate entries. A two-round screening process was conducted by two independent reviewers, with the final set of articles selected through mutual agreement. The quality of the studies was then assessed. RESULTS: Out of the 107 retrieved articles, only 15 were included in the review. These studies revealed diverse prevalence rates: 3.7% of total homicides, 1.38% of deaths from family violence, and 13.02% for autopsied children. Various potential risk factors for filicide were identified, including unwanted pregnancies, marital conflicts, family disputes and violence, low socio-economic status, mental health issues in perpetrators, and mental, physical, or neurological vulnerabilities in victims. Cultural beliefs were also recognized as contributing factors to filicide. CONCLUSION: Filicide is a complex and multi-dimensional issue influenced by various individual, familial, and societal factors. The review highlighted a high prevalence of filicide in Africa, shaped by these diverse factors.

A case-control study of filicide/infanticide in 90 mothers.

This study aims to explore the clinical and socio-demographic characteristics of 30 women who committed filicide and compare them to those of 60 postpartum women who did not commit filicide, including 30 with severe postpartum mental illness and 30 without a known history of psychiatric disorders. Clinical assessment included a face-to-face interview with the Structured Clinical Interviews for DSM-IV Axis I and Axis II Disorders. Information on socio-economic, medical, and personal factors was collected using the Clinical Interview for DSM-IV and organized in a clinical vignette and OPCRIT ratings. Consensus best-estimate diagnoses were made according to DSM-V criteria. Inference was conducted using Fisher's exact test for categorical variables and Mann-Whitney U rank test for continuous variables. Family history of violent death, psychotic symptoms (OR 8.3; CI 95% 2.26-36.13), severe insomnia (9.8; 2.28-61.75), and a schizophrenia spectrum or bipolar diathesis (4.8; 1.22-23.86) were associated with history of filicide. Rates of history of sexual abuse in childhood were higher in both the filicide and the severe postpartum mental illness groups compared to healthy controls (6.7; 1.25-70.46 and 7.8; 1.47; 80.47 respectively). Conversely, we did not observe any difference in the rates of history of sexual abuse in adulthood across groups. The lack of adequate postpartum psychiatric care was an important precipitating factor in many cases of infanticide and even late filicide. This study underscores the need for increasing awareness by health care professionals and the wider society of the complex dynamics and psychiatric risks associated with motherhood.

Filicide by mentally ill maternal perpetrators: a longitudinal, retrospective study over 30 years in a single Northern Italy psychiatric-forensic facility.

Characterization of mentally ill maternal perpetrators of filicide assigned to a single psychiatric-forensic facility, including previous access to mental health services. A cross-sectional, retrospective analysis of medical records and legal documentation of maternal filicide patients at a single psychiatric-forensic facility (1990-2021) was performed. Socio-demographic, relationship, psychopathological, and criminological characteristics were collected. Data were compared according to previous perpetrators' access to mental health services or not and access within 1 year prior to filicide or not. All 55 detainees (mean age 34.8 ± 6.2 years) were included. There were 64 victims; 15 (23%) were ≤ 1 year old and most (77%) were single victims. Some mothers had history of violence/abuse (29%), an aggressive parent (45%), and violent relationships with their intimate partner (46%) and were socially isolated (49%). Most crimes were motivated by altruism (53%). Women had attempted suicide in 39% of filicide cases. Previous psychiatric diagnoses were available for 56%; 71% had accessed services for ≤ 1 year. Patients unknown to mental health services were less likely Italian, with children below preschool age and with no history of physical abuse/violence, aggressive parent, or suicide attempts. Patients lost to mental health services (> 1 year) were less likely Italian or assuming psychopharmacological therapy, were in shorter relationships, and were mostly diagnosed with personality disorders. Female perpetrators of filicide are often unknown/lost to mental health services prior to the crime. Multifactorial historical and current characteristics aid in identifying mothers at risk. Communication of the availability of mental health services must be multi-lingual.

States of Mind with Respect to Attachment: a comparative study between women who killed their children and mothers diagnosed with post-partum depression.

INTRODUCTION: Attachment theory has been linked with the caregiving system, acting as a drive for a mother's behavior towards her offspring. The most dramatic consequence of distress following maternity is filicide. Despite this, only few studies addressed the attachment models of women who committed filicide, and very little provided comparisons with mothers diagnosed with post-partum depression. OBJECTIVE: We described the socio-demographic and psychopathological characteristics of mothers who committed filicide. Our aim was to detect differences in the attachment models between mothers who committed filicide, mothers with post-partum depression and control mothers. Participants and setting: We recruited 19 women who committed filicide (group F) along with 52 women with post-partum depression (group D), and 23 control mothers (group C). METHODS: We administered a semi-structured interview on socio-demographic aspects and psychiatric history along with the Adult Attachment Interview. We performed an ANOVA, a post-hoc analysis and a logistic regression. RESULTS: The logistic regression showed a higher prevalence of Dismissing and Disorganized attachments in women of group F compared with group C (p = 0.002, p = 0.007). Dismissing attachment was also overrepresented in group D vs group C (p = 0.012). Interestingly, women of group F showed a Preoccupied/entangled attachment to a lesser extent than those of group D, reaching a borderline significance (p = 0.056). CONCLUSIONS: Disorganized and Dismissing models of attachment are prevalent in women who committed filicide compared with mothers with post-partum depression and controls, while other models of attachment are less frequent. Therefore, attachment could be taken into consideration to define the risk for committing filicide.

Monstrous Mothering: Understanding the Causes of and Responses to Infanticide.

The deliberate killing of a child by its mother is abhorrent and is associated in the minds of many with mental illness and in particular with postnatal depression. However, at least 50% of perpetrators are neither "mad" nor "bad", and mothers who kill children are not "unhinged" by pregnancy or childbirth. We propose a different explanation: "blind rage" or "overwhelmed syndrome", whereby parents, stressed to breaking point by sleep deprivation or incessant baby crying, respond by lethally harming their child contrary to previous behaviour. The roots of this blind rage may be found in psychosocial disturbances, including the mother's own unsatisfactory experience of parenting which has caused attachment disorders. The legal framework guiding decisions to prosecute and structuring sentencing decision-making following conviction should acknowledge the exceptional stress experienced by such mothers postnatally. Health professionals including midwives and obstetricians should increase their vigilance and arrange referrals for mothers at risk of causing harm or committing infanticide.

In the Name of Love or Hatred: a Systematic Comparison Between Filicide-Suicide and Mariticide/Uxoricide-Suicide in Hong Kong.

While much of work on homicide-suicide (HS) arises out of the USA and the UK, there is a paucity of research on HS outside of the Anglo-American sphere. This paper investigates HS in Hong Kong (HK), comparing the subtypes of filicide-suicide (FS) and mariticide/uxoricide-suicide (MUS) in that context as a means of testing the generalizability of past studies. Data from the HK Special Administrative Region (HKSAR) government and the HK Police Force reports retrieved 156 cases from 2000 to 2019. In that timeframe, HS resulted in 261 deaths, with MUS being the most prevalent type of HS. Male offenders and female victims are more commonly seen. Offenders are generally older than their victims, and over half of offenders are married. FS and MUS display distinct characteristics in terms of offender and victim demographics, relationship dynamics, motives, and mode of killing. Depressed mothers tend to victimize their sons in FS as a means of saving their sons from a perceived miserable future, whereas male offenders aggress upon their female partners in MUS to alleviate their own frustrations, subsequently dying by suicide out of sorrow or a fear of consequence. MUS offenders are more hostile towards their victims and tend to kill with aggressive means, whereas FS offenders are more likely to kill with altruistic motives and with minimal force. These results match patterns of MUS and FS in the Anglo-American sphere, but with some important differences in terms of the use of guns and the presence of altruistic killing.

Childhood abuse and neglect experiences, Hostile-Helpless attachment, and reflective functioning in mentally ill filicidal mothers.

The present study represents the first empirical investigation of the mechanisms - a Hostile-Helpless (HH) attachment and reflective functioning (RF) - through which childhood abuse and neglect (CA&N) experiences may impact a mother's likelihood to commit filicide. The sample was comprised of 46 mentally ill mothers. Differences in attachment-derived risk variables between filicidal mothers (FM) and non-filicidal mothers (NFM) were also examined. FM (n = 23) reported lower RF, higher HH attachment, and a more severe history of CA&N, compared to NFM (n = 23), but did not differ on the severity of childhood experiences of loss of and/or separation from attachment figures. Bayesian analysis indicated that the mediated effect of more severe CA&N on the likelihood of committing filicide through higher HH attachment was significantly amplified by lower RF. A developmental interpretation of filicide is proposed and clinical implications for prevention and attachment-based interventions with at-risk mother-child dyads are discussed.

Murder (Infanticide) in Post-partum Depression: The Case of Akon Guode.

In 2015, 35-year-old Sudanese refugee Akon Guode had post-traumatic stress disorder and a post-partum depression when she drove her vehicle into a lake in a murder (infanticide, filicide)-suicide attempt. In 2017, Ms Guode pleaded guilty to two counts of murder, one count of attempted murder and one count of infanticide and was sentenced to 26 years' imprisonment. In August 2019, the Victorian Court of Appeal found the original sentence was "manifestly excessive". In March 2020, a majority of the High Court found that the Court of Appeal erred by taking into account that the Crown had accepted Ms Guode's plea of guilty to the charge of infanticide. The High Court quashed the sentence . In September 2020, the Court of Appeal imposed the same 18-year sentence and the same non-parole period as in August 2019. This commentary considers the application of the defences of "infanticide" and "mental impairment" and "fitness for trial" in post-partum depression and PTSD.

Repeated neonaticide: differences and similarities to single neonaticide events.

This study aims to identify differences between single and repeat perpetrators of filicide by using register-based data. The study used register-based, comprehensive, nationwide data from both Austria and Finland. The current study covers 23 perpetrators, 20 single and 3 repeat perpetrators, with a total of 28 victims. All victims had a maximum age of 24 h and all perpetrators were women. Every third victim of neonaticide was a victim of a repeat case. The repeat perpetrators were older; had a higher number of children over their lifespan, some of whom lived with them; were more likely to live within established family structures; had higher levels of education and employment; had a higher proportion of personality disorders; and were more likely to identify stress factors during pregnancy. One unexpected finding was low levels of awareness about pregnancy within the perpetrator's circle remain a risk factor, especially for repeat perpetrators. Arguably, the quality of interpersonal relationships these women have may be affected by their own mental health issues and life experience and vice versa.

Gender differences in legal outcomes of filicide in Austria and Finland.

Female offenders of filicide have been found to receive more lenient legal handling than male offenders. We aimed to discover these possible gender differences in the legal outcome of filicide cases. This was a binational register-based study covering all filicide offenders in Austria and Finland 1995-2005. We examined the legal outcomes of the crimes of all living offenders (64 mothers and 26 fathers). Mothers received a conviction of murder and life imprisonment less often than fathers. Within psychotic and personality-disordered offenders, infanticides, and offenders convicted for life, gender differences were less evident. Even though there seems to be some gender differences within the legal outcomes of filicide, ruling seemed more consistent than expected within distinct subgroups of offenders. Gender-based assumptions should not hinder equal and just handling of filicide cases.

Maternal filicide in a cohort of English Serious Case Reviews.

A national mixed-methods study of English Serious Case Reviews (SCRs) was carried out to better understand the characteristics and circumstances of maternally perpetrated filicides, to compare these with paternally perpetrated cases, and to identify learning points for mental health professionals. Published reports for all SCRs of children in England dying as a result of abuse or neglect from 2011 to 2014 were subject to qualitative analysis using a system of layered reading and inductive thematic analysis, along with descriptive and comparative quantitative analysis. There were 86 deaths directly attributable to child maltreatment within the immediate family. The mother was the suspected perpetrator in 20. Twelve of the mother perpetrators were victims of domestic violence, while 15 of the father perpetrators were known to be perpetrators of domestic violence. Those deaths resulting from impulsive violence or severe, persistent cruelty are almost exclusively perpetrated by males, while those with an apparent intent to kill the child are slightly more likely to be perpetrated by mothers. Four key themes were identified through the qualitative analysis: domestic violence, maternal mental illness, separation and maternal isolation, and the invisibility of the child. These findings highlight the important role of domestic violence and its interaction with maternal mental health. Professionals working with mothers with mental health problems need to adopt a supportive but professionally curious stance, to be alert to signs of escalating stress or worsening mental ill-health, and to provide supportive and accessible structures for at-risk families.

"Nobody came to help": interviews with women convicted of filicide in Malaysia.

Although filicide is of serious concern, it is poorly understood in Malaysia. Our interviews with health and policy professionals revealed that they attribute responsibility for filicide to women's failure to comply with social norms and religious teachings. This research sought to understand the meaning of and background to filicide from the perspectives of women who have been convicted of filicide in Malaysia. In-depth interviews were conducted in person with all eligible and consenting women convicted of filicide and incarcerated in prisons or forensic psychiatric institutions. Women's accounts were translated into English and analysed using interpretative phenomenological analysis and interpreted using narrative theory. Interviews with nine women convicted of filicide yielded evidence that others were implicated in the crime but punished less severely, if at all, and that the women had experienced lifelong gender-based violence and marginalisation with minimal access to health and social care. These findings illuminate an inadequately understood phenomenon in Malaysia and reveal why existing strategies to reduce filicide, which reflect key stakeholders' views, have had little impact. They reveal the pervasive harm of violence against women and children and its link to filicide.

["Evolution of paternal filicide-suicide in the province of Quebec"]. / Évolution dans le temps du filicide-suicide masculin au Québec.

OBJECTIVES: The purpose of this study was to specify the number of male filicide-suicide committed in the province of Quebec between 1997 and 2012, and to evaluate whether there has been an increase in the number of male filicide-suicide according to the period studied and the type of motivation to commit the crime. METHOD: The data cover all officially registered male filicides committed in the province of Quebec from 1997 to 2012, against youths under 18 years old. A total of 50 cases were divided by five years spans starting in 1997 and analyzed using the Grille d'analyse multidimensionnelle de l'homicide intrafamilial. RESULTS: The results show that among the 50 male filicides committed between 1997 and 2012, 13 of these were followed by the aggressor's suicide. Also, the likelihood of suicide committed as a result of filicide is higher among individuals who committed filicide between 2007 and 2012 and who were motivated by marital separation, compared to filicides committed between 1997 and 2001 motivated by another reason. In particular, the majority of perpetrators of filicide committed between 2007 and 2012, motivated by marital separation, committed suicide as a result of the act of committing, compared to individuals who were motivated by another reason for the same period. CONCLUSIONS: On one hand, the present study demonstrates the importance of considering self-destruction and, more specifically, the suicide of these individuals. On the other hand, our study emphasizes the importance of considering the type of motivation to commit filicide, including spousal separation, which is an element of understanding specific to male filicide-suicide.

A Typology of Familicide Perpetrators in Australia.

The murder of family members is one of the most difficult crimes to understand. This study uses Shye's action systems framework combined with multivariate data analysis to test the hypothesis that different forms of familicide will reflect the four states an action system can take, namely: Integrative, Expressive, Conservative and Adaptive. A multidimensional scaling analysis (MDS) was performed on 54 crime scene variables describing 104 cases of intra-familial homicide. The analysis revealed four distinct modes of functioning, which provided tentative support for Shye's action system. Each of the four modes had distinct associations with perpetrator characteristics. The Expressive and Integrative modes were associated with Cluster B personality traits, and criminal and substance use histories. The Adaptive mode was associated with trauma histories, mood disorders, and personality disorder traits. The Conservative theme was associated with trauma histories and psychotic disorders. Implications of findings for risk assessment and intervention are discussed.

Death of a seven-month-old child in a washing machine: a case report.

The authors present a case which brings out a unique modality of child homicide by placing the baby in a washing machine and turning it on. The murder was perpetrated by the baby's mother, who suffered from a serious depressive disorder. A postmortem RX and then a forensic autopsy were performed, followed by histologic examinations and toxicology. On the basis of the results of the autopsy, as well as the histology and the negative toxicological data, the cause of death was identified as acute asphyxia. This diagnosis was rendered in light of the absence of other causes of death, as well as the presence of typical signs of asphyxia, such as epicardial and pleural petechiae and, above all, the microscopic examinations, which pointed out a massive acute pulmonary emphysema. Regarding the cause of the asphyxia, at least two mechanisms can be identified: drowning and smothering. In addition, the histology of the brain revealed some findings that can be regarded as a consequence of the barotrauma due to the centrifugal force applied by the rotating drum of the washing machine. Another remarkable aspect is that we are dealing with a mentally-ill assailant. In fact, the baby's mother, after a psychiatric examination, was confirmed to be suffering from a mental illness-a severe depressive disorder-and so she was adjudicated not-guilty-by-reason-of-insanity. This case warrants attention because of its uniqueness and complexity and, above all, its usefulness in the understanding of the pathophysiology of this particular manner of death.

Entomotoxicology in burnt bodies: a case of maternal filicide-suicide by fire.

One of the most common methods of maternal filicide is by fire. In this case study, a 40-year-old female and her children were found completely burned in a burnt out car. All bodies showed a degree of destruction by fire consisting to a level 3 of the Crow-Glassman Scale (CGS) and early stage of insect activity. Toxicological analyses were performed on soft tissues and body fluids still available. The results were positive for diazepam and its metabolites only for children with blood concentrations consistent with therapeutic doses of benzodiazepines. Home video surveillance cameras confirmed sedation prior to death recording the mother while administering some drops of sedative drugs in a soft drink to the children just a couple of hours before setting fire to the car. Based on autopsy findings, all victims were still alive at the time of fire. The cause of death was determined as carbon monoxide poisoning and fatal thermal injuries by fire. This case study has a special focus on the entomotoxicology and the potential role of insects in death investigations of burnt bodies, supposed to be an inadequate substratum for insect colonization. It demonstrates that in burnt bodies, arthropod colonization can be quite immediate after fire is extinguished. Toxicological analyses performed on larvae actively feeding on the children's bodies were positive for diazepam and its metabolites in small amount compared with blood concentrations, whereas the larvae collected from the mother's body were totally negative. These data, according to the autopsy findings and the toxicological results from the victim's blood and tissues, supported the suspect of a non-lethal sedation prior to death, which is a common behaviour in maternal filicide.

Suicide and filicide in postpartum psychosis.

This paper reviews the frequency of suicide and filicide in a literature of over 4000, and personal series of 321, childbearing psychoses. Suicide is rare during the acute episode, but the rate is high later in the mother's life and in first degree relatives. The filicide rate is high in depressive psychoses (4.5 %), but lower in episodes without overt depression (less than 1 %), and some of these appear to be accidental, without intent to kill.

Homicide in the western family and background factors of a perpetrator.

AIMS: Familicide is a multiple-victim homicide incident in which the killer's spouse and one or more children are slain. A systematic review was conducted to reveal the background factors of western homicide perpetrators. METHODS: The systematic search was performed in the Arto, Medic, Cinahl, Medline, EBSCOhost Academic Search Premier and Social Services abstracts databases. The keywords were familicide, family homicide, familicide-suicide, filicide-suicide, extended suicide, child, murder, family, filicide and infanticide. The searches revealed 4139 references from the databases. The references were filtered and 32 peer-reviewed research articles revealed in years 2004-2014 were selected as data. The articles were analysed using inductive content analysis, by finding all possible background factors related to homicide. RESULTS: The factors were described as percentages of the range. The background factors of familicide perpetrators were categorised as follows: perpetrators who had committed homicide of a child and intimate partner and possibly committed suicide; a father had who killed a child; a mother who had killed a child; a father who had committed a filicide-suicide; and a mother who had committed a filicide-suicide. CONCLUSIONS: Psychological instability, violence and crime were found in all these categories of familicides. Perpetrators who had committed a suicide in addition to the familicide had more often been diagnosed with depression, but they sought treatment for mental health problems less often and had violence and self-destructiveness less often in their background than in other familicide categories. Social and healthcare professionals should be more sensitive to emerging family problems and be prepared for intervention.

Triple hanging in filicide-suicide: an unusual case report.

Filicide-suicide is a special category of homicide-suicide event where the victim(s) are children and the perpetrator is one of the parents or both. It is not extensively documented or adequately defined in literature. In developed countries, shooting is a common method of homicide and suicide. Uses of knives, blunt objects, strangulation, poisoning and drowning are other methods frequently employed by the perpetrator. Homicide by hanging in filicide-suicide is rarely reported in forensic literature. We present a rare case of filicide-suicide, where the mother killed both her children by hanging them one by one from a ceiling fan in the same room and later committed suicide by hanging in another room.