Clinical Forensic Psychology Introductory Perspectives on

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Carlo Garofalo · Jelle J. Sijtsema
Editors

Clinical Forensic
Psychology
Introductory Perspectives
on Offending
Editors
Carlo Garofalo Jelle J. Sijtsema
Department of Developmental Department of Developmental
Psychology Psychology
Tilburg University Tilburg University
Tilburg, The Netherlands Tilburg, The Netherlands

ISBN 978-3-030-80881-5 ISBN 978-3-030-80882-2 (eBook)

https://doi.org/10.1007/978-3-030-80882-2

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To Lasse and Melissa
Foreword

The study of antisocial behavior encompasses a host of explanatory variables

spanning multiple units of analysis. Invariably, our understanding of conduct
problems and the individuals who perpetrate them connects to psychological
phenomena, and, when considering those with severe behavioral impairments,
touches on clinical forensic psychology. However, many students of crime have at
best a smattering of knowledge about clinical forensic psychology. For instance,
there is general understanding of ADHD, but little awareness of its subtypes.
Many have general awareness of concepts such as psychosis and psychopathy,
but their features are commonly juxtaposed. There is universal awareness of per-
sonality, but limited recognition of its structural foundation and the multiple,
varied conditions of personality disorder. For many students and even criminolo-
gists alike, understanding of clinical forensic psychology is vague and imprecise.
This book changes that.
Carlo Garofalo and Jelle J. Sijtsema’s Clinical Forensic Psychology: Introduc-
tory Perspectives on Offending is a signal work containing contributions from
experts spanning Australia, Canada, Netherlands, New Zealand, Sweden, United
Kingdom, and the United States. This is one of the book’s important selling
points: Readers receive content directly from some of the leading experts in the
world, which gives the content a richness and scholarly freshness that one does
not often see in an introductory text. The focus on foundational theoretical con-
cepts also provides the reader with the scholarly content for understanding “the
story” behind conduct problems and does so by showcasing the works of sea-
soned scholars as well as newer scholars who are well versed in the forensic
psychology tradition.
Clinical Forensic Psychology: Introductory Perspectives on Offending is orga-
nized into four parts. Part I covers theoretical and clinical models that underpin

vii
viii Foreword

deviant behavior. Models include prevention, psychophysiology, emotion, moral

development, personality, empathy, narrative roles, attachment theory, and peer
effects. A unique asset is the chapters are transdisciplinary and invoke biologi-
cal, cognitive, experimental, individual differences, and interpersonal perspectives
rather than relying on traditional disciplinary approaches that ignore other con-
tent. Part I also shows the compelling explanatory power of specific content areas
that when considered cumulatively reveal the multifaceted etiology of conduct
problems. This allows the reader to ascertain the intrapersonal and interpersonal
mechanisms that engender antisocial behavior.
Part II explores psychopathology and deviant behavior specifically how spe-
cific forms of psychopathology drive the propensity to have conduct problems.
Again, several important content areas are provided including Antisocial Person-
ality Disorder, Borderline Personality Disorder, Narcissistic Personality Disorder,
schizophrenia, psychopathy, ADHD, substance use disorders, and intellectual dis-
abilities. An engaging feature of the chapters is the use of a case report of a
person whose symptoms instantiate a particular condition. An important takeaway
from Part II is that although (with the exception of psychopathy and Antisocial
Personality Disorder) many with these conditions do not engage in antisocial
conduct, the condition itself does confer a significant likelihood of engaging in
criminal acts. Moreover, the chapters show the nuance of psychopathology and
its association with offending. For instance, readers will see that cluster B per-
sonality disorders are risk factors for offending but other personality disorders
such as those that are characterized as eccentric (cluster A) and fear (cluster C)
are not. Thus, simply saying someone has a personality disorder or mental illness
tells us nothing about its specific and, in turn, its reach across decision-making
and life domains.
Part III examines offending behaviors from a typological approach span-
ning aggression, juvenile offenders, adult firesetters, adult male sexual offenders,
homicide offenders, and domestic violence offenders spanning those who perpe-
trate intimate partner violence and child maltreatment. Part III really shows the
reader how the theoretical and conceptual material from the prior two parts man-
ifests in different offending types and, very importantly, how antisocial behavior
can be understood as a distribution ranging from very low (i.e., non-offending) to
very high (i.e., pathological offenders). Consistent with broad social science mod-
els that convey the heterogeneity of antisocial behavior (e.g., DeLisi & Piquero,
2011; Loeber & Farrington, 1998; Moffitt, 1993), the many faces of antisocial
conduct (e.g., proactive vs. reactive, direct vs. relational, intermittent vs. chronic,
sexual vs. non-sexual, adult vs. youth perpetrated, specialized vs. versatile) are
revealed.
Foreword ix

Part IV spans risk assessment and treatment and includes chapters on violence
risk assessment, personality assessment in forensic settings, common psychologi-
cal treatment used to address criminal behavior, the Good Lives Model, Forensic
Schema Therapy, and ethical issues in forensic psychology. Part IV is the prag-
matic, policy part of the book, which shows the successes and the limitations
of interventions to reduce conduct problems among various populations as well
as the challenges of assessment in clinical and criminal justice system settings.
Although devoted to risk assessment and treatment, it also shows how content
areas from the first three parts of the book manifest in the mental health and
judicial spheres. For instance, the chapter on the insanity defense highlights the
salience of psychotic disorders where recognition of right from wrong, and thus
the ability to form criminal intent, is central to whether an accused person can
be prosecuted. This is a very different scenario from other constructs and con-
ditions (e.g., aggression, psychopathy, callous-unemotional traits, and Antisocial
Personality Disorder) where criminal responsibility is not an issue.
Although an introductory text, Clinical Forensic Psychology: Introductory Per-
spectives on Offending encourages even the expert reader to think more deeply
about these topics. For instance, although several diagnostic entities are examined
in-depth, the chapters also do a good job of showing the diversity or hetero-
geneity that exists within presumably discrete diagnostic conditions. To illustrate,
although psychopathy encapsulates a coherent set of symptoms spanning affect,
conduct, and interpersonal skills, there is also remarkable diversity among psy-
chopathic offenders. Some are glib, showy, and engaging, others are brutally
straightforward and socially indifferent. Some exhibit a range of psychiatric con-
ditions that bear on mood and affect, others appear devoid of psychological
distress. Some have lifelong contacts with the justice system, others avoid arrest
but their personality functioning wreaks havoc on relationships, school, and work
functioning. In the words of the editors, the various conditions herein are not
monolithic entities.
Finally, the reason Clinical Forensic Psychology: Introductory Perspectives on
Offending is such an outstanding work is owed to the brilliance of its editors.
Carlo Garofalo and Jelle J. Sijtsema are versatile scholars with outstanding con-
tributions in many content areas spanning psychopathy, emotion and emotional
regulation, aggression, peer and social network effects on antisocial conduct, sub-
stance abuse, youth delinquency, normal and dark personality features, ADHD,
risk assessment, sexual offending, and externalizing psychopathology. They could
have written masterly on all the topics covered herein, but employed their editorial
acumen to secure a global roster of experts to provide introductory perspectives
x Foreword

on offending. In doing so, they have done clinical forensic psychology, crimi-
nology, and the social sciences an important favor. As knowledge continues to
build outside the traditional criminological sphere, it is incumbent on students of
antisocial and criminal activity to reach out of their wheelhouse and engage the
broader literature that bears relevance to their own work.

Matt DeLisi
Ames, IA, USA
Alex R. Piquero
Miami, FL, USA

References
DeLisi, M., & Piquero, A. R. (2011). New frontiers in criminal careers research, 2000–2011:
A state-of-the-art review. Journal of Criminal Justice, 39(4), 289–301.
Loeber, R., & Farrington, D. P. (Eds.). (1998). Serious and violent juvenile offenders: Risk
factors and successful interventions. Sage.
Moffitt, T. E. (1993). Adolescence-limited and life-course-persistent antisocial behavior: A
developmental taxonomy. Psychological Review, 100(4), 674–701.
Preface

Before you lies the textbook “Clinical Forensic Psychology: Introductory Per-
spectives on Offending”. The idea for this book arose from a need to have a
book that could be used to teach graduate and undergraduate courses in Foren-
sic Psychology programs with an emphasis on mental health. Given the strong
interest of many students in pursuing a clinical career, we wanted to have a book
that would provide students with an introduction to Clinical Forensic Psychology
in an easy to understand manner, while also offering an up-to-date overview of
the various facets of this field at a level that could be useful to expert practition-
ers and scholars alike. Most available forensic psychology textbooks typically
include a handful of chapters on “mental health” with important, yet selective
and concise, reference to the psychosocial correlates of crime and offending. We
thus took the task upon us to compile a book that would provide readers with a
comprehensive context of the psychological and social factors that may explain
offending, giving each construct of interest the space needed to be addressed
thoroughly. Moreover, the book should offer knowledge about the links between
mental disorders and offending, as well as the current state of affairs regarding
offender assessment and treatment. The need for such a textbook is high, given
that more and more universities around the world currently offer courses, majors,
or (clinical) master programs in Forensic Psychology.
Because this book is written first and foremost for undergraduate and graduate
students with no prior knowledge about Clinical Forensic Psychology, the book
starts by introducing the reader to general theoretical explanations of antisocial
behavior, before moving on to more specific topics within Clinical Forensic Psy-
chology, such as the link between specific mental health issues and antisocial
behavior, assessment, and ethical issues. At the same time, the book has also
much to offer to practitioners, scientists, and people who are interested in this

xi
xii Preface

field of study, either approaching it for the first time (e.g., coming from a purely
clinical background, or from a purely forensic/criminological background) or as
seasoned experts looking for an updated collection of the mainstream topics of
relevance for research and practice in this field. Each chapter is written by experts
in their respective fields, provides clear definitions of the relevant psychological
constructs and related biosocial correlates that are discussed, and offers ample
examples from the literature and practice. Each chapter can thus also be read on
its own. Moreover, when appropriate, many chapters provide additional (clini-
cal) case material to illustrate relevant topics and help bridging the gap between
theory and practice.

What is Clinical Forensic Psychology?

Clinical Forensic Psychology is a field within Clinical Psychology that centers

on the study, assessment, and treatment of mental health issues in relation to
offending in its broadest sense, hence bridging mental health and criminal jus-
tice systems. In so doing, it is valuable for mental health science and practice
to understand those individual characteristics that pose a risk for criminal jus-
tice involvement, and it is valuable for the criminal justice system to appreciate
the individual needs and risk factors that can inform trial and post-trial decision-
making, including treatment and rehabilitation efforts. This field overlaps with
the discipline of forensic psychiatry in some jurisdictions, which shares the same
target of interest (mental health in relation to offending). Yet, Clinical Forensic
Psychology integrates a medical (diagnostic) perspective with an emphasis on
the dimensional nature of psychological phenomena, their interaction with the
environment, and the explanatory mechanisms linking them with offending. At
the same time, Clinical Forensic Psychology intersects with those areas of crim-
inology and forensic sciences that appreciate the relevance of individual-level
correlates of crime and offending, but addresses them from a purely clinical psy-
chological angle rather than from sociological or legal ones. As such, this field
offers itself with a multitude of potential connections with neighboring fields,
whose integration is necessary to obtain a full appreciation of the multifarious
explanations of offending.
In many countries, there is acknowledgment that mental health issues may in
part explain offending behaviors and thus warrant treatment to reduce the risk of
reoffending. Assessment is an important part of treatment and admission to foren-
sic mental health care. It not only serves as an index for the level of risk, but may
also provide guidance to the nature and intensity of treatment. More importantly,
Preface xiii

(risk) assessment is conducted to assist in decision-making regarding (temporal)

leave and release from mental health care and/ or incarceration. Although mental
health issues in essence reside within the individual, they always interact with
the environment. In a very real sense, from a clinical forensic psychology point
of view, offending is a product of the interaction between mental health issues
and the environment. At the same time, there is much misconception about the
direct links between mental health issues and offending, and often the risk of
(re)offending is best predicted by considering multiple factors related to histori-
cal factors, personal(ity) factors, social factors, and compliance to treatment, as
well as their inter-relations. Therefore, it is important for clinical forensic psy-
chologists to also understand the developmental and situational perspectives of
offending. While this book takes a psychological approach to understanding and
explaining offending, this choice was one of scope given the clinical focus, which
by no means implies that individual-level correlates of crime operate in isolation
from the environment. In fact, each chapter also sheds light on the role of psy-
chological constructs and mental health issues in specific contexts. Whether it
pertains to the legal context in which child sex offending is defined, the role
of peers in motivating antisocial behavior, or the role of attachment styles to
caregivers early in life, each context interacts with and may shape individual
characteristics that could either enhance or decrease the risk of offending.

Roadmap of the Book

The chapters are bundled in four distinct sections that are preceded by a gen-
eral introductory chapter that describes the history of forensic psychology. This
chapter provides insight into the development of Clinical Forensic Psychology
and presents a brief introduction of many topics that are discussed in more detail
in the following chapters.
Part one focuses on psychological perspectives that may explain deviant
behavior and provides a solid understanding of how psychological factors come
into play when explaining offending. In this section, readers learn more about the
developmental, physiological, emotional, cognitive, and social underpinnings of
offending. This is accomplished from a perspective that goes beyond traditional
classifications of mental disorders and accounts for the natural variation of inter-
individual differences in each of these domains, which in turn may explain why
some individuals are more prone to offending than others. Specifically, Chap-
ters 2 to 7 provide more information about the role of psychological constructs
xiv Preface

on offending, whereas the remaining chapters in this section focus on the role of
context.
Part two zooms in on the link between mental health issues and offending, by
discussing a wide range of psychopathological problems that are often observed
in offenders. The first few chapters (11–13) cover personality disorders that are
most prevalent in Clinical Forensic Psychology. The other chapters (14–18) dis-
cuss the wide prevalence of these psychological disorders in offender populations,
but also debunk the myths that often surround the association between mental dis-
orders and offending. Being integrated among the other sections of the book, this
part does not mean to suggest a simplistic correspondence between discrete men-
tal health conditions and offending. Rather, it offers an updated starting point
on the most common forms of psychopathology that are related to an increased
risk for offending and whose assessment may aid (clinical) decision-making and
communication among practitioners. Such an emphasis on traditional diagnostic
syndromes is also fruitful as it allows to draw from the rich streams of literature
that have accumulated over the years on each of them, and of which the chapters’
authors are prominent representatives. As noted across chapters, and in continuity
with the previous section of the book, readers will appreciate the inevitable inter-
connection across mental health conditions addressed in each chapter, as well
as interconnections that each has with the psychosocial factors discussed in part
one.
Part three moves away from a disorder-focused approach and covers a range
of behaviors and offender groups that are relevant in forensic contexts. This
approach is common in correctional and forensic mental health and offers a first
efficient way to allocate resources and guide subsequent personalized decision-
making. The topics discussed include a focus on juvenile offenders, and other
offender groups defined by specific types of offenses, each with their own set of
explanatory perspectives, risk factors, and clinical and legal approaches. Although
the book does not cover an exhaustive discussion of all offenses and offender
groups, it includes a focus on aggressive behavior, which is at the core of many
offending behaviors.
Finally, part four covers the more practical or applied aspect of Clinical
Forensic Psychology by discussing risk assessment and offender treatment. This
section is a must-read for students in Clinical Forensic Psychology programs,
as it discusses the basics of risk assessment and common treatment approaches.
In addition, this section offers the latest insights into the assessment of antiso-
cial personality characteristics broadly defined, as well as information about the
novel Forensic Schema Therapy treatment approach. This section concludes with
Preface xv

reflections on the ethical issues that clinicians and scientists face in forensic psy-
chology practice. As such, it provides a go-to resource for experts in need of
updating their knowledge and practice skills.
In closing, with this textbook, we hope to attend to the needs of students,
practitioners, and scientists who want to engage with the field of Clinical Forensic
Psychology, either to develop or strengthen the clinical skills to work in forensic
settings, or to complement forensic expertise with a greater attention to the needs
and risks of individuals who come into contact with the criminal justice system.

Tilburg, The Netherlands Jelle J. Sijtsema

Carlo Garofalo
Acknowledgments

We thank our patient wives, at times impatient babies, and problematic cats. We
are grateful to Dr. Matt DeLisi and Dr. Alex Piquero, as well as to two anony-
mous reviewers, who supported the initiative of this book from the beginning.
In addition, we are grateful to the publisher, and in particular Josie Taylor and
Liam Inscoe—Jones for their confidence and continued support throughout this
endeavor. And last but not least, we want to extend our gratitude to all the con-
tributors in this book. Without them, this book would not have been possible and
we are happy that they stood by us, despite all the challenges that came with the
COVID-19 pandemic.

xvii
Contents

1 History of Forensic Psychology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Jacqueline B. Helfgott and Joslyn K. Wallenborn

Part I Underpinnings of Deviant Behavior

2 Antisocial Behavior Prevention: Toward a Developmental
Biopsychosocial Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
René Carbonneau and Richard E. Tremblay
3 Cardiovascular Psychophysiology and Antisocial Behavior . . . . . . . 49
Presley McGarry and Jill Portnoy
4 Moral-Cognitive Delay and Distortions . . . . . . . . . . . . . . . . . . . . . . . . . 67
John C. Gibbs
5 Emotion and Emotion Regulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Carlo Garofalo
6 Basic Personality and Deviant Behavior . . . . . . . . . . . . . . . . . . . . . . . . 109
Donald R. Lynam and Joshua D. Miller
7 Callous-Unemotional Traits and Empathy . . . . . . . . . . . . . . . . . . . . . . 127
Sophie Alshukri, Kerry Lewis, and Luna C. Muñoz Centifanti
8 Narratives Roles of Criminal Actions . . . . . . . . . . . . . . . . . . . . . . . . . . 143
David Canter and Donna Youngs
9 Attachment Theory and Offending . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Gwen Adshead and Estelle Moore
10 Influences of Peer Relationships and Romantic Partners
on Antisocial Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Jelle J. Sijtsema
xix
xx Contents

Part II Psychopathology and Deviant Behavior

11 Antisocial Personality Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Jessica Yakeley
12 Borderline Personality Disorder Among Justice-Involved
Populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
Madison D. Smith, Rachelle H. Kromash, Shania L. Siebert,
Genevieve J. Allison, and Kelly E. Moore
13 Narcissistic Personality Disorder and Deviant Behavior . . . . . . . . . . 241
Tiffany D. Russell, Samantha M. Holdren, and Elsa Ronningstam
14 Schizophrenia Spectrum, Other Psychotic Disorders
and Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Zhaorong Song, Rhiannon Corcoran, and Steven M. Gillespie
15 Psychopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Matt DeLisi
16 Attention-Deficit/Hyperactivity Disorder (ADHD)
and Offending . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
Susan Young and Kelly Cocallis
17 Substance Use, Abuse, and Disorder Within Forensic
Psychiatry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321
Malin Hildebrand Karlén
18 Offenders with Intellectual and Developmental Disabilities . . . . . . . 339
John L. Taylor

Part III Offending Behaviors

19 Forms and Functions of Aggression . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357
Morsal Khouwaga Yusoufzai and Jill Lobbestael
20 Juvenile Offenders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377
Michael G. Vaughn, Leslie J. Sattler, and Katherine J. Holzer
21 Adult Perpetrated Firesetting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397
Nichola Tyler and Magali-Fleur Barnoux
22 Adult Male Contact Sexual Offenders: Challenges
in Classification and Theoretical Perspectives . . . . . . . . . . . . . . . . . . . 415
Mirthe G. C. Noteborn
Contents xxi

23 Homicide and Mental Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 445

Pauline G. M. Aarten and Marieke C. A. Liem
24 Domestic Violence: Intimate Partner Violence, Child
maltreatment, and Co-Occurrence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 461
Sara R. Nichols and Amy M. Smith Slep

Part IV Risk Assessment and Treatment

25 Violence Risk Assessment: Research and Practice . . . . . . . . . . . . . . . 479
Corine de Ruiter and Martin Hildebrand
26 Using the MMPI-3 in Forensic Psychological Assessments . . . . . . . . 515
Martin Sellbom, Dustin B. Wygant, Anthony M. Tarescavage,
and Yossef S. Ben-Porath
27 The Good Lives Model: A Strength-Based Approach
to Rehabilitating Offenders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 539
Mary Barnao
28 Culpability and Accountability: The Insanity Defense . . . . . . . . . . . 555
Gerben Meynen and Johannes Bijlsma
29 Common Psychological Treatments Used to Address Criminal
Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 567
Michael Daffern, Nina Papalia, Emily Stevenson,
and Stuart Thomas
30 Forensic Schema Therapy and SafePath: Individual-
and Milieu-Therapy Approaches for Complex Personality
Disorders and Externalizing Behavior Problems . . . . . . . . . . . . . . . . 587
David P. Bernstein, Marjolein F. van Wijk-Herbrink,
and Truus Kersten
31 Ethical Issues in Forensic Psychology . . . . . . . . . . . . . . . . . . . . . . . . . . 609
Estelle Moore and Gwen Adshead

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 627