Specific risk factors of arsonists in a forensic psychiatric hospital.

Arsonists are often treated in forensic settings. However, high recidivism rates indicate that treatment is not yet optimal for these offenders. The aim of this case series study is to identify arsonist specific dynamic risk factors that can be targeted during treatment. For this study, we used patient files of and interviews with all patients that were currently housed at a forensic psychiatric hospital in the Netherlands (14 arsonists, 59 non-arsonists). To delineate differences in risk factors between arsonists and non-arsonists, scores on the risk assessment instrument the Historical Clinical Future-30 (HKT-30; completed for 11 arsonists and 35 non-arsonists), an instrument similar to the Historical Clinical Risk Management-20 (HCR-20), were compared. The groups did not differ on demographic factors and psychopathology. Concerning dynamic risk factors, arsonists had significantly poorer social and relational skills and were more hostile. Although this study needs replication, these findings suggest that the treatment of people involved in firesetting should particularly target these risk factors.

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.

The Pictorial Fire Stroop: a measure of processing bias for fire-related stimuli.

Fire interest is a risk factor for firesetting. This study tested whether a fire-specific emotional Stroop task can effectively measure an information-processing bias for fire-related stimuli. Clinic-referred and nonreferred adolescents (aged 13-16 years) completed a pictorial "Fire Stroop," as well as a self-report fire interest questionnaire and several control tasks. Results showed (a) comparatively greater fire-specific attentional bias among referred adolescent firesetters, (b) a negative relationship between Fire Stroop attentional bias and self-reported fire interest, and (c) positive correspondence between Fire Stroop attentional bias and self-reported firesetting frequency. These findings suggest that instruments that measure an automatic bias for fire-specific stimuli may usefully supplement self-report measures in the assessment and understanding of firesetting behavior.

["Pyromania" and arson. A psychiatric and criminologic data analysis]. / "Pyromanie" und Brandstiftung. Eine psychiatrische und kriminologische Datenanalyse.

We analyzed psychiatric and criminological data from 103 arsonists. The following criticisms of the definition of pyromania according to DSM-III-R and IDC-10 seem appropriate. First, the categoric exclusion of aggressive motives does not seem very promising, since approximately one fourth of arsonists whose firesetting is based on motives quoted in DSM-III-R may also have an aggressive motive. Second, ICD-10 gives being drunk and alcoholism as a criterion for the exclusion of pyromania. This seems untenable, since the behavior classed as pyromania is largely a product of alcohol misuse. Repeated firesetting, resulting from being fascinated by fire etc., may be less a disturbance of impulse control but rather the manifestation of a psychoinfantilism, which, supported by alcohol abuse, extends into older age. The mean age of such arsonists is slightly above 20 years. The tendency for relapses after imprisonment seems to be low; this tendency probably decreases spontaneously in older age. The mean age of arsonists with aggressive motives is a little below 30 years, those setting fire with suicidal motives have a mean age of 35, deluded arsonists have a mean age of 40 years. Concrete sexual motives are relatively rare. Approximately 50% of arsonists have a purely aggressive motive. Retaliation is a rare cause, however, since most of them do not even know the victims. One third of these persons set the fire in their own homes. Most arsonists show a personality disorder, with insecurity and narcissism predominating. Data on firesetting are to be treated with caution, since two thirds of all cases are newer resolved; one fourth of cases concern minors, and in Central Europe arsonists with rational motives are hardly ever referred to psychiatrists.

[Young arsonists, psychopathology and follow-up aspects]. / Les jeunes incendiaires, psychopathologie et aspects évolutifs.

Relatively infrequent (2% of offences in France) the arson behavior (1989, 11,149 acts with an elucidation of 35%) is highly diffused as recent events have shown (forest fire, shops, cars in suburbs). A population of 30 young firesetters, under 25 years shows a great frequency of social parental failure with weak intellectual and scholar levels, but with less obvious pathologic states. Since 1981, the non referring to a criminal court show that this delinquency is linked with other offences. Educational care and psychotherapeutic sid allow a possible evolution to avoid backsliding.

Inpatient psychiatric treatment of a young recidivist firesetter.

The inpatient psychiatric treatment and 1-year follow-up of a recidivist child firesetter with multiple clinical and behavioral problems is described. This case was unique due to the child's young age and both the severity and frequency of firesetting. The focus of therapy was on teaching fire safety skills and concepts to alter the child's interest in and involvement with fire. Other elements of the therapy targeted associated antisocial behavior and depression. At 1-year follow-up, the child had not engaged in additional firesetting. This case highlights the need to provide a comprehensive assessment of firesetting, understand its relationship to psychopathology, and offer specialized interventions.

A community-based program for juvenile firesetters.

In 1981 the Dallas Fire Department began a new program for juvenile firesetters. Based on an interview graphing technique that helps the juvenile firesetter to correlate triggering events with feelings leading to aggressive firesetting behavior, the program is staffed by fire department personnel who are trained by psychiatric faculty of the University of Texas Southwestern Medical School at Dallas. Comparisons with the city's previous program demonstrate the new program's effectiveness in preventing the recurrence of firesetting behavior as well as its cost-efficiency. Similar programs have been successfully adopted in Houston and Fort Worth.

Children who set fires: some background and behavioral characteristics.

Background and behavior of 90 children identified as fire-setters in a population of 544 referred for residential treatment is presented. None exhibited fire-setting behavior while in residential treatment, but questions are raised about alternative treatments achieving the same result. A current bibliography is provided.

Home vs hospital care of children with behavior disorders. A controlled investigation.

A controlled investigation was conducted to assess and compare the treatment outcomes of community and hospital care for children with behavior disorders. Findings showed that (1) community care was effective with regard to behavioral control, and (2) both treatments were comparable concerning educational achievement, parent role function, family adjustment, and parent satisfaction with treatment. It was noted that many severely disturbed children who are in dire socioeconomic predicaments can be maintained in the community with special care and intervention.

[Possibilities of cognitive and functional behavior analysis and the resulting therapeutic interventions in a mentally retarded pyromaniac]. / Möglichkeiten kognitiver und funktionaler Verhaltensanalyse und sich daraus ableitender Therapieansätze für geistig behinderten Brandstifter.

Apart from general educational and treatment practices there is practically no attempt in providing specific rehabilitation programs for the mentally retarded adult firesetter. After a brief review of cognitive-behavior modification approaches in self-control training, the authors report on a method which has proved to be effective in cognitive and behavior analysis under threatening penalty conditions in a case of mental retardation with a history of repeated firesetting. The treatment goals are derived from the functional behavioral and cognitive analysis of the problem situation, the developmental analysis including attitudes and attributions, the motivational and self-control analysis and the analysis of social conditions. Fire-setting is defined as an operant behavior under discriminative stimulus control. An individual treatment program relevant to the different therapeutic targets is established. The proceedings are described by the authors.

Juvenile firesetters: do the agencies help?

In an attempt to find out what was being done for juvenile firesetters in their metropolitan community the authors reviewed the records of the local fire marshal, juvenile court, and psychiatric clinic. They found that the various agencies involved with 69 juveniles over a 3-year period were unable to coordinate their efforts and were largely unsuccessful in controlling the firesetting. Because the families of firesetters seem to have many other social problems, the authors recommend early inpatient assessment and possible referral to foster homes or residential treatment settings for juvenile firesetters.