A three-dimensional typology of delusions.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
John Junginger
Publications and source records attributed to John Junginger.
"Stereotypic" delusional offending.
Some patients with serious mental illness appear to respond violently to the same delusional content throughout the course of their illness. Anecdotal, empirical, and theoretical evidence is presented establishing the premise of "stereotypic" delusional offending. A method for measuring the similarity of two delusions separated in time also is presented. An empirical focus on stereotypic delusional offending may help identify more accurately persons at risk for violence and those at risk for becoming targets of violence. It also may provide a better understanding of successful treatment of outpatient violence and conceivably could inform the ongoing debate on involuntary outpatient commitment laws. Among the major issues of this debate in the United States are the potential benefits of a forced medication provision. One rationale for such a provision may be found in the treatment response of seriously mentally ill outpatients whose violent behavior appears inescapably tied to their persistent or recurrent delusions.
Ambulatory Care↗
Effects of serious mental illness and substance abuse on criminal offenses.
OBJECTIVE: Some believe serious mental illness has been "criminalized." Effects of serious mental illness and substance abuse on criminal offenses were studied for 113 postbooking jail diversion participants and their nondiverted counterparts. METHODS: Raters read participants' and police report descriptions of criminal offenses and participants' explanations for them. Using 5-point scales, raters independently estimated whether an offense resulted directly or indirectly from serious mental illness or substance abuse. RESULTS: Serious mental illness and substance abuse had little effect on offenses. However, substance abuse led to a sizable minority of offenses and was more likely than mental illness to cause an offense. CONCLUSIONS: Unless factors unique to serious mental illness can be specifically associated with behavior leading to incarceration, the criminalization hypothesis should be reconsidered in favor of more powerful risk factors for crime that are widespread in social settings of persons with serious mental illness.
Adult↗
Accuracy of self-reported arrests among a forensic SPMI population.
Self-reports are prone to response error even in the most structured and standardized environment, but the highly stigmatizing nature of illegal behavior and the possible cognitive problems inherent to the SPMI population increase the likelihood of such error. Using administrative data as the gold standard, the validity of self-reported arrests was examined among 85 mentally ill substance-abusing individuals with justice involvement. The overall accuracy of self-reported arrests during a three-month recall period was 84.7%. Validity was higher among individuals who at the time of the follow-up interview were either in a jail diversion program or incarcerated. Individuals with a mood disorder appeared to be somewhat less accurate in their self-reports than subjects with schizophrenia, despite the implication of cognitive distortion accompanying this latter diagnostic category. Further research on issues such as the accuracy of self-reports over longer recall periods, or the accuracy of self-reported frequency of arrest, is necessary, given the reliance on self-report methodology in outcome studies.
Adult↗
Psychotic motivation and the paradox of current research on serious mental illness and rates of violence.
Persuasive empirical support exists for a positive association between serious mental illness (SMI) and rates of violence; a great deal of support is also present for the clinical impression that psychotic symptoms sometimes motivate "symptom-consistent" violence. We propose that the issue of the motivation for violence in the SMI population can be considered independently of the issue of the association between SMI and violence rates. We review much of the current literature on the association between SMI and violence in a framework that emphasizes motivational influences unique to the SMI population. We conclude that the contribution of psychotic motivation to rates of violence in the SMI population is a major research issue. Furthermore, we believe that recognition of the independence of motivational influences and violence rates, and consideration of the impact of treatment on violence, may help explain the paradox of current research: Delusions and hallucinations may motivate violent behavior, but this psychotic motivation may not be reflected in the actual rate of violence.
Delusions↗