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Friends of the Forensic Science Club, this week we present the paper “Female Forensic Patients May Be an atypical sub-type of Females Presenting Aggressive and Antisocial Behavior” by Hodgins, S. (2022), in which the author collects information from previous literature about women that are in psychiatric forensic treatment and focuses her attention in antisocial and aggressive traits. 

In most countries, fewer women are treated in forensic psychiatric services than men, also, less are incarcerated in prisons.

Some people point out that this happens because there is less aggressive and antisocial behavior (hereinafter AAB) in women than in men; however, not all experts support this idea because studies are inconclusive.

For example, in a study where approximately 1,000 adult individuals, men and women, were analyzed, 7.5% of women and 10.5% of men presented antisocial and aggressive behaviors, which began in childhood and were maintained until adulthood. We see that the difference between both percentages is not significant.

To better understand the situation of these women and the characteristics of their mental health, the author reviews the articles already published on it.

A Dutch study produced a sample of 275 female forensic patients in their 30s. Before being admitted as patients, 54% had been convicted of a crime and 88% had previously been treated by other psychiatric services.

Three quarters of them suffered abuse in childhood, in some cases prolonged into adulthood.

The crimes for which they arrived at the forensic psychiatric center resulted in homicide (more than 50%), intentional incendies, other violent crimes, crimes against property and sexual violence.

The diagnoses they received were schizophrenia (in 32.9%), drug use disorder, depression, post-traumatic stress disorder and borderline personality disorder.

78 of the women in this study were followed for 3 years after discharge. Very few reoffended, of which only 6 were convicted of violent crimes in these 3 years immediately after discharge.

Another study, this one conducted in Ontario, Canada, analyzed all forensic psychiatry cases from 1987 to 2012, of people who were found not criminally responsible for mental disorders. 14% were women. 91% of them had previously been treated in psychiatric services and 36% had been convicted of a crime.

Furthermore, 13% of them were in a precarious situation, living on the street, and 21% were unemployed.

Therefore, all of this suggests that female forensic psychiatric patients present mental disorders that include emotional and cognitive dysfunctions and low levels of psychosocial functioning.

Among the women who present AAB, it is necessary to mention that many of them are not processed by the criminal justice system.

In a study with 96 girls and adolescents who went to a clinic seeking help for substance abuse, 44.8% of them were affected by some violent act (street fights, hitting someone, carrying weapons…). Nearly two-thirds of these girls, and 34% of those who had not been violent, were diagnosed with some kind of conduct disorder.

Comparisons of individual girls’ cases showed that those who had engaged in violent acts were four times more likely to have a drug use disorder and three times more likely to experience physical and sexual abuse. That is, they have significantly more risk factors.

The girls who participated in this study were followed for 5 years, and although they did not meet all the criteria for an antisocial personality disorder, they had more violent behavior than healthy women.

This suggests that in both adolescence and adulthood, women with prior conduct disorder tend to show higher levels of psychopathic traits, such as aggressiveness, and some antisocial conduct disorder traits.

Thus, some factors have been identified to which it is important to pay attention from childhood to prevent and treat these disorders, such as poor academic performance, the appearance of psychopathic traits…, but not aggressive and antisocial behaviors, therefore, this is something that has remained hidden from view.

It is important to note that behavioral problems and certain emotional traits in young people can predict criminality.

In addition, schizophrenia and borderline personality disorder have been linked in several studies to aggressive and antisocial behavior in women undergoing forensic psychiatric treatment.

The author proposes to pay special attention to the first years of girls, since many mental health problems have their origin in a harsh, ineffective parenting, or a problematic primary environment.

Although aggressive and antisocial behavior disorder is difficult to observe, the consequences for girls and their environment are brutal and destructive.

Thus, the author recommends focusing efforts on the prevention and treatment of those women who already suffer from these problems. For example, interventions and campaigns to prevent the use of substances, teenage pregnancy or aggressiveness in general.

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