Zur Gefährlichkeit ehemaliger Patienten des Maßregelvollzugs (§ 63 StGB)

Background

The prediction of dangerousness in mentally ill offenders – and here mainly the issue of safety – is still of primary interest for forensic experts and also the public. The effectiveness of treatment and therefore of the whole German forensic system is generally measured by recidivism rates of this clientele.

Methods

The Essen prospective Multi-Centre Prognosis Study began in 1997, and 23 forensic hospitals in Germany took part. Data of 321 subjects were collected with a follow-up of up to 10 years (mean 7.5 years). This article presents topical recidivism rates.

Results

Currently the general recidivism rate is 31.5% and for severe reoffences 10.3% which is relatively low in comparison to other recent studies.

Conclusions

The rate of general recidivism of forensic patients in Germany has been reduced in the last years while the rate of severe reoffence was constant. In order to reduce the number of reoffences further studies should analyze the forensic aftercare.     

Patienten mit einer wahnhaften Depression in der Maßregel nach § 63 StGB

Delinquency of depressed patients numerically plays a minor role in criminal or civil law. Compared with the high prevalence of affective disorders in the general population, the frequency of patients in forensic psychiatric hospitals with the respective disorder as a main diagnosis is low. The spectrum of possible crimes committed by depressed subjects essentially comprises disease-characteristic offences, amongst which cases of extended suicide or attempted suicide are the foremost and most tragic offences. Based on 2 case reports notions of extended suicide as well as questions of forensic assessment are discussed.     

Höchstrichterliche Anforderungen an die Unterbringung in einem psychiatrischen Krankenhaus nach der Neufassung von § 63 StGB

Through the amendments to §63 of the Penal Code (StGB) from 1 August 2016 the legislature has defined more precisely and tightened up the prerequisites for commitment to a psychiatric hospital. Since then the Federal Court of Justice judicature has specified the new requirements for the prerequisites for a prognosis of dangerousness in many verdicts. These amendments are presented using examples. In addition, this article gives a summary of typical sources of error in commitment decisions according to §63 of the Penal Code from the perspective of the Federal Court of Justice.     

Über Mentalisierung, Affektregulierung und die Entwicklung des Selbst

The author presents an overview of the work by the London research group around Peter Fonagy. This work combines two currently prominent research areas within developmental psychology—the theory of mind research and the attachment research—with psychoanalysis, and it outlines the stepwise acquisitation of the mentalization ability within a comprehensively planned design. The ability to understand oneself and others as entities with mental-emotional states and to deal meaningfully with one’s own inner life and that of others is seen as dependent on attachment experiences. The architecture of the theory is being reconstructed in six steps: After elucidating the mentalization concept (I), the affect-mirroring model (II) and the playing-with-reality-theory (III) are presented. Both segments of the theory constitute the central theoretical core and lead to a particular understanding of the features of the interactive and symbolic affect regulation which is presented in part IV. Particular aspects of the development of the self are then considered (V), and finally the implications of the presented issues with respect to the conceptualisation of such clinical phenomena as the projective identification. The author sees the original aspects of this approach in the fact that Fonagy et al. choose to write an interaction history as opposed to a maturation history favored by many cognitive psychologists in the era of the human genome project. The red thread pervading the discussion of divergent topics is the importance of interpersonal interaction to the development of thinking and emotional processes. The structure of (early) interpersonal relationships is considered as constitutive for normal and pathological variations of the ability to perceive oneself and others as thinking and feeling beings.     

Zur Bedeutung des Wahns für die Beurteilung der Schuldfähigkeit nach den §§ 20 und 21 StGB

For the assessment of criminal responsibility of offenders with symptoms of delusion it first has to be examined if one of the four basic elements of §§ 20, 21 of the German Penal Code is fulfilled. For this purpose a careful diagnosis of the type and intensity of the delusion and the underlying psychiatric disease is necessary. If a basic element is fulfilled the effect of the delusion on the ability of the offender to perceive the wrongful character of the act and to control behavior have to be discussed. For this the model of the anthropological cross developed by Winfried Brugger can be helpful.     

Die Sachverständigenexpertise im Spannungsfeld zwischen Justiz und Psychiatrie am Beispiel des Hangbegriffes des § 66 StGB (Sicherungsverwahrung)

Using the example of psychiatric expert opinions in trials leading to preventive detention, we analysed how far the corresponding orders by the courts were suited to guide the psychiatric experts and restrict them to their area of expertise. Furthermore we concentrated on the question, what reasons were given for preventive detention on both psychiatric and judicial side and how psychiatric arguments were adopted by the judges. Our results show clearly, that placing an order with the psychiatric expert as well as adopting the psychiatric arguments for preventive detention occur mainly in a stereotypic way. Psychiatric and judicial arguments for preventive detention refer both to previous delinquency. Aspects concerning the offenders personality appear to be secondary, although they play a major role in the decision for preventive detention. The article shows the controversy associated with forensic-psychiatric expertise in the courtroom and the need for communication and clarification between psychiatry and law.     

Zur Differenzierung zwischen unsicheren und aggressiven Teilnehmern beim Gruppentraining Sozialer Kompetenzen (GSK) im Straf- und Maßregelvollzug

The cognitive-behavioural group training for social competence “GSK” [16] has proven to also be effective in the penal system [28]. The present study examines if a targeted differentiating assessment prior to the intervention and a thereon based homogeneous group composition with regard to insecure and aggressive behaviour patterns can enhance the effectiveness of the “GSK” in the penal system and in a forensic hospital unit. Altogether 48 male delinquents across both settings were therefore divided into a “homogeneous insecure” group, a “homogeneous aggressive” group and a “heterogeneous” group. Pre-post-comparisons show that the intervention is effective for all three groups and also in both settings, the penal system and the forensic hospital unit. The “homogeneous aggressive” group revealed the strongest intervention effects.     

Transparenz und Fairness in der Therapie von Sexualstraftätern in Haft und Maßregelvollzug

It makes sense to treat sexual offenders in prison. Treatment can be successful even if coerced. However, particular difficulties arise due to the great power disparity between therapist and patient and the latter’s remoteness from normal living conditions. This report will describe the current status of treatment techniques/approaches for sexual offenders in prison (with particular regard to social therapy) and special forensic hospitals as viewed by an external reviewer judging the process, methods and success of treatment for preventing relapse and estimating criminal prognosis. We mention standards for a respectful and positive approach towards the patient client. With regard to the Good Lives Model, it is supportive to develop positive resources in the perpetrator. This also requires a heightened readiness from therapist and team for transparency (instead of confidentiality) towards the perpetrator as to the assessment of progress and status of therapy. We criticize tendencies for a confrontative, if not humiliating approach, which undermines the self-esteem of the client and exploits the power disparity between therapist and perpetrator.     

Kritische Anmerkungen zur Einweisung von Jugendlichen und Heranwachsenden in den Maßregelvollzug

In this paper the preconditions for placing adolescents and young adults in forensic psychiatric institutions are analyzed. According to the law such placements are only justifiable in exceptional cases. Even from a psychiatric point of view it is difficult to delineate a severe and most notably lasting mental disorder at a young age and distinguish it from a lack of maturity, although only the first would justify an indefinite placement in an institution. Nevertheless both broadly pathologizing certain behaviors and loosely interpreting preconditions for placements in institutions encourage commitment to institutions.     

Erfolg und Mißerfolg im Leistungswetteifer des imbezillen Kindes

Zusammenfassung Vergleicht man imbezille Kinder, die nicht bildungsfähig sind, aufgrund ihres Intelligenzalters (nicht ihres Lebensalters!) mit geistig normalen Kindern, so ist bei einer denkbar einfachen Wetteifertätigkeit der gleiche Entwicklungsverlauf leistungsmotivierten Erlebens und Verhaltens zu beobachten.Sobald die kognitive Struktur des Früher -oder Späterfertigwerdens erfaßt werden kann — was spätestens von einem Intelligenzalter von 3;6 Jahren ab der Fall ist —, wetteifern erstens imbezille wie normale Kinder, zeigen sie zweitens charakteristischen Erfolgs- und Mißerfolgsausdruck mit seinen alterstypischen Veränderungen, sowie drittens einen entwicklungstypischen Wandel a) in den Versuchen zur Bewältigung von Mißerfolg und leistungsthematischen Konflikten und b) in zunehmender Konflikthaftigkeit und realistischerer Beurteilung bei der Vorhersage des eigenen Erfolges. Lediglich in der Ausdauer beim Wetteifern sind die nach Lebensalter älteren Schwachsinnigen den geistig Normalen überlegen, was mit gewissen Voraussagen Lewins übereinstimmt.Die Befunde unterstreichen, daß nicht ein affektiver oder ein körperlich-biologischer, sondern der kognitive Entwicklungsstand entscheidend ist für die Genese der Leistungsmotivation und deren Entwicklungsverlauf. Befunde und Schlußfolgerungen anderer Autoren, die die Fähigkeit des Imbezillen zum Erleben von Erfolg und Mißerfolg in Frage stellen, werden diskutiert.     

Drogenabhängige Patienten im Maßregelvollzug gemäß § 64 StGB: Verbesserung der Quote erfolgreicher Behandlung durch suchtspezifische Medikation?

In Germany, addicted offenders can be sentenced to compulsory addiction treatment in forensic mental hospital departments (Art. 64 of the penal code). A presupposition to such a sentence is a fair chance of successful treatment and rehabilitation. Commonly, an expert witness is asked by the court to assess this point in the trial. To date, the treatment in forensic mental hospitals aims at total abstinence from any kind of drugs. But in at least half of the cases, a fair chance of successful treatment is no longer seen after a period of therapy. In most cases, these patients are returned to prison. The paper pleads that in offenders addicted to illegal drugs, a drug specific medication – in particular methadone maintenance treatment or naltrexone medication – might be a useful option. The rate of “treatment failure” might be reduced slightly by using this option with some of the patients.     

Anfänge und Entwicklung der Leistungsmotivation: (I.) im Wetteifer des Kleinkindes

Ohne Zusammenfassung     

Anfänge und Entwicklung der Leistungsmotivation: (II.) in der Zielsetzung des Kleinkindes

Ohne ZusammenfassungDiese Arbeit ist Herrn Prof. Dr. Wolfgang Metzger zum 65. Geburtstag gewidmet.     

In den Bogenmaßen des Seins. Zum Transzendentalen bei Husserl und Deleuze

Although both Husserl and Deleuze declare themselves to be committed to the idea of transcendental philosophy, it is not clear how a constructive discussion between these two approaches to the transcendental question might begin. In this paper, the basis for such a productive confrontation will be sought in the concept of multiplicity as developed by nineteenth century mathematics. This concept serves as a crucial operational concept both in Husserl and in Deleuze. The following critical analysis clarifies the idea and the task of phenomenology as a philosophy of pure immanence whose fundamental metaphysical dimension can thus be no other than time.