Rechtliche Rahmenbedingungen und Behandlungspraxis bei persönlichkeitsgestörten Straftätern in den Niederlanden

Zusammenfassung   Die Behandlung pers?nlichkeitsgest?rter Straft?ter, die in den Niederlanden haupts?chlich dem Ma?regelvollzug obliegt, steht durch die Forderung von Politik und ?ffentlichkeit nach maximaler Sicherheit der Allgemeinheit momentan unter st?ndigem Druck. Gleichzeitig finden im Ma?regelvollzug Entwicklungen statt, die gew?hrleisten sollen, dass der Sektor seine prim?re Aufgabe, die Gesellschaft vor rückfallgef?hrdeten Straft?tern zu schützen, besser erfüllen kann. Dabei wird ebenfalls versucht, den unterschiedlichen Sicherungs- und Behandlungsbedürfnissen der verschiedenen Patientengruppen durch ein differenziertes, wissenschaftlich fundiertes Behandlungsangebot gerecht zu werden. In diesem Beitrag werden die Errungenschaften in der Behandlung psychisch gest?rter Straft?ter beschrieben und es wird erl?utert, inwieweit die Panikmache von Politik und Medien die gemachten Fortschritte zu untergraben droht.      

Multimodale Psychotherapie der dissozialen Persönlichkeitsstörung: aktuelle Konzepte in der Straftäterbehandlung

The frequent equalization of antisocial personality disorder with habitual criminality has led to the fact that therapeutic pessimism still pervades and many psychotherapists are reluctant to treat patients with antisocial personality disorder because of widespread belief that such patients are frequently untreatable. There is increasing evidence, however, that antisocial personality disorders can absolutely be successfully treated. Meta-analyzes have shown that successful treatment programs are modularized and thus highly structured thematically according to therapy priorities. Furthermore, therapy optimism of therapists could be repeatedly demonstrated as an additional factor, which at the same time implies significant positive effects on a favorable therapist-patient relationship. In this article the most important research results from recent studies are summarized and discussed. Treatment planning in detail is then discussed, based on thorough assessment of the individual’s personality characteristics to determine prognosis, risk management, and appropriate treatment.     

Die Kriminalprognose bei persönlichkeitsgestörten Straftätern

Many studies have shown that there is an elevated prevalence of personality disorders in criminal offenders in addition to the statistically higher probability of becoming repeat offenders. This article highlights the method of Applied Criminology which explains how this method can help to detect the relevance of personality disorders when applied to an individual case. In a second part of this article the personality disorders are examined and also how this method facilitates the risk assessment process by allowing case managers to highlight the aspects that are prevalent to predict future criminal behavior.     

Die Kriminalprognose bei persönlichkeitsgestörten Straftätern

Many studies have shown that there is an elevated prevalence of personality disorders in criminal offenders in addition to the statistically higher probability of becoming repeat offenders. This article highlights in part I the method of Applied Criminology which explains how this method can help to detect the relevance of personality disorders when applied to an individual case. In this second part the personality disorders are examined and also how this method facilitates the risk assessment process.     

Rechtliche Gesichtspunkte zur Rückfallprognose und Vollstreckung bei älteren Straftätern

As our society ages, the number of offenders who are older than 60 when they are up to release from prison or forensic hospital also increases steadily. Instruments of prognosis (e.g. HCR-20, PCL, SVR, Static-99, Dittmann-List) currently in use are not validated for this group, which means that forensic-psychiatric and -psychological experts have to rely on casuistry with all it’s methodical problems for their reports on whether or not there is a risk for relapse (which are obligatory by German law). Therefore the Courts of Execution Matters (in Germany dealing with conditional discharge; same question for any kind of Parole Board in other countries) have to apply standards as provided by the law and the jurisdiction up to the Constitutional Court to a much higher degree than they have to do regarding the much better researched group of younger offenders. In doing so, the focus has to be much more on the special circumstances of senior citizen in general and specifically on the aged offender’s life. There is a urgent need to intensify research on this group of offenders.     

Qualifizierung und Qualitätskontrolle in der forensischen Psychiatrie – die aktuelle Situation in der Schweiz

The practice of civil expert opinions in Switzerland is in a period of upheaval due to fundamental alterations regarding the legal foundations which were implemented on 1 January 2013. The new civil code displaces the authority to order measures which restrict people’s liberty based on an endangerment to themselves or third parties from a lay institution to a newly created expert committee. Moreover, patient’s rights are greatly enhanced. The subsequent consequences for expert opinion activities are not yet appraisable. The development in the practice of insurance legal expert opinion is influenced by new legal measures which aim at reducing the growing number of new disability retirements most notably due to psychiatric disorders. In contrast to the civil area there are already clearly defined standards for the insurance legal area which were established by the Swiss Society of Psychiatry and Psychotherapy in 2012. The legal foundations as well as the practice of expert opinions in the context of the Swiss civil and insurance law are comparable with the German situation but there are still some important differences related to the content and terminology. This paper outlines the current situation and recent developments in Switzerland as well as pointing out differences in comparison to Germany.     

Umgang mit gefährlichen Straftätern in England und Wales

Forensic psychiatric institutions exist in all western European countries. Their organisation depends on a number of factors including the legal framework and societal attitudes towards mentally disordered offenders. This article describes and critically comments on the forensic psychiatric system in England and Wales, its legal framework and approaches to dealing with dangerous offenders. England and Wales have a long forensic psychiatric tradition with the first high security hospital, Broadmoor hospital, having been established in 1863. Evidence-based treatment approaches in forensic hospitals as well as in prisons, training of forensic psychiatrists and research in the field of forensic psychiatry have gained international recognition. However, there are some worrying aspects in the system of forensic psychiatric care and the criminal justice system more generally, in particular the high and still increasing number of prisoners in comparison with other European countries, the low age of criminal responsibility, long sentences, increasing length of stay in forensic care and the increasingly risk averse culture. A number of differences to the German system can be found; one such difference relates to the role of criminal responsibility which is irrelevant for decisions regarding commitment in England and Wales. Only the mental state and need for treatment at the time of trial (or later assessment in prison) determine whether an offender is admitted to psychiatric care or receives a prison sentence. A number of new initiatives have been launched in recent years resulting in an increasing number of individuals being detained in forensic psychiatric and criminal justice institutions, in particular the initiative for the detention and treatment of individuals with so-called dangerous and severe personality disorders, the sexual offenders register and the new sentence of indeterminate imprisonment for public protection. These initiatives have been the subject of a number of complaints to the European Court of Human Rights. Nevertheless, the trend towards a more and more risk averse culture continues.     

Guter Eindruck und Persönlichkeitsfragebogen

Ohne ZusammenfassungDie vorliegende Arbeit stellt einen Auszug aus einer Semesterarbeit über Probleme des guten Eindrucks dar, die auf Anregung von Prof. Dr. E. Rausch von H. Gregor im Sommer 1960 dunchgeführt wurde.     

Psychodynamische Psychotherapie bei antisozialen und psychopathischen Störungen der Persönlichkeit

Important theoretical basic principles of the psychodynamic treatment of patients with antisocial and psychopathic personality disorders are presented. Focusing on delinquency and general orientation to the structural level of the personality organization should be integrated. Indications of treatment difficulties, countertransference problems and technical principles are given. Skepticism of the treatment is poorly evidence-based and forensic psychotherapy of these patient groups should be intensified.     

Die Vielfalt der Persönlichkeit—Gefährdung der Einheit der Person?

Uniformity against manifold faces of a personality are manifest presentations of a supposed underlying person (subjectum) as its synthetic-cohesive potential. The association-psychology of the 19th century brought forward the concept of dissociation, which allows to interpret a broad spectrum of phenomena between adaptive functioning (salutary) and maladaptive, dysfunctional phenomena of psychopathology: it opens a dimensional perspective which includes dissociative identity disorder, dissociative trance disorder, borderline-pathologies and the most severe forms of ego/self-dissociation, -fragmentation in schizophrenic disorders.     

Jugendliche Sexualstraftäter: Spezialfälle der Prognoseerstellung?

This study compared a sample of 273 juvenile (aged 14 to under 18), 178 adolescent (aged 18 to under 21) and 273 adult (older than 20 years) male sex offenders modus operandi (or MO, the way in which they committed their offenses), frequency of recidivism and predicted recidivism via the static-99. In terms of the frequencies of the MO aspects we found that juveniles and adolescents differed significantly from adult sexual offenders. However, concerning the frequency of sexual violent behaviors, adolescents committed more severe offenses in contrast to the two other groups. The comparison of recidivism rates indicated that adolescent sexual offenders were significantly less likely to commit a new sexual offense, but were considerably more likely to commit a non-sexual violent offense compared to adult sexual offenders. For juvenile offenders, only few static-99 variables were predictive of future recidivism in comparison to the other groups, suggesting that the static-99 may only have a restricted utility in juvenile offenders. Further, juvenile offenders risk levels were found to fall primarily within the medium risk group making individual differentiation of potential risk difficult. It is suggested that additional predictors, which help to differentiate young sexual offenders must be investigated.     

Psychische Störungen und Psychotherapie in der spätmodernen Gesellschaft

The development into a globalized network capitalism has brought enduring change to everyday experiences of humans and affected their self-images and concepts of normality. The new capitalism offered us a specific disturbance panorama which, however, in the language game of clinical diagnostics cannot be named and classified in its social framework. Here is a gap in professional reflection. Psychotherapy needs social diagnostics and for its part can contribute to it. Moreover, it is necessary for psychotherapy to develop its therapeutic technical operating level by a critical alertness for the structural conditions of human life and human suffering.