Iozzino Laura, Canessa Nicola, Rucci Paola, Iommi Marica, Dvorak Alexander, Heitzman Janusz, Markiewicz Inga, Picchioni Marco, Pilszyk Anna, Wancata Johannes, de Girolamo Giovanni
IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Unit of Epidemiological Psychiatry and Evaluation, via Pilastroni 4, 25125 Brescia, Italy.
Scuola Universitaria Superiore IUSS, IUSS Cognitive Neuroscience (ICoN) Center, Piazza della Vittoria 15, 27100 Pavia, Italy.
Schizophr Res Cogn. 2022 May 19;29:100257. doi: 10.1016/j.scog.2022.100257. eCollection 2022 Sep.
Studies of patients with schizophrenia and offenders with severe mental disorders decision-making performance have produced mixed findings. In addition, most earlier studies have assessed decision-making skills in offenders or people with mental disorders, separately, thus neglecting the possible additional contribution of a mental disorder on choice patterns in people who offend. This study aimed to fill this gap by comparing risk-taking in patients with schizophrenia spectrum disorders (SSD), with and without a history of serious violent offending assessing whether, and to what extent, risk-taking represents a significant predictor of group membership, controlling for their executive skills, as well as for socio-demographic and clinical characteristics. Overall, 115 patients with a primary diagnosis of SSD were recruited: 74 were forensic patients with a lifetime history of severe interpersonal violence and 41 were patients with SSD without such a history. No significant group differences were observed on psychopathological symptoms severity. Forensic generally displayed lower scores than non-forensic patients in all cognitive subtests of the Brief Assessment of Cognition in Schizophrenia (except for the "token motor" and the "digit sequencing" tasks) and on all the six dimensions of the Cambridge Gambling Task, except for "", in which forensic scored higher than non-forensic patients. "" was also positively, although weakly correlated with "poor impulse control". Identifying those facets of impaired decision-making mostly predicting offenders' behaviour among individuals with mental disorder might inform risk assessment and be targeted in treatment and rehabilitation protocols.
对精神分裂症患者和患有严重精神障碍的罪犯的决策表现进行的研究结果不一。此外，大多数早期研究分别评估了罪犯或患有精神障碍者的决策技能，从而忽略了精神障碍对犯罪者选择模式可能产生的额外影响。本研究旨在填补这一空白，通过比较有精神分裂症谱系障碍（SSD）的患者（有或无严重暴力犯罪史）的冒险行为，评估冒险行为是否以及在多大程度上是群体成员身份的重要预测因素，并控制他们的执行技能以及社会人口统计学和临床特征。总体而言，招募了115名初步诊断为SSD的患者：74名是有终身严重人际暴力史的法医患者，41名是无此类病史的SSD患者。在精神病理症状严重程度方面未观察到显著的组间差异。在精神分裂症认知简短评估的所有认知子测试中（除了“代币运动”和“数字排序”任务）以及在剑桥赌博任务的所有六个维度上，法医患者的得分普遍低于非法医患者，但在“”方面，法医患者得分高于非法医患者。“”也呈正相关，尽管与“冲动控制差”的相关性较弱。确定决策受损的那些方面，这些方面最能预测患有精神障碍的个体中的犯罪者行为，可能有助于风险评估，并成为治疗和康复方案的目标。
