P. 2: Filicide

Homicidal-suicidal fathers

common motive was extended suicide, highest risk of separation from wife, least educated, intoxicated more often than any other group, oldest (~43 years), victims least likely to be infants, incidents of domestic violence, and shooting most commom method for killing

What is neonaticide?

homicide of newborn w/in first 24hrs - almost always committed by mothers

Anonymous delivery

implemented in France (1793, 1941), in Luxembourg (1993), Italy (1997), Austria (2001)

What is infanticide

killing a child (< 1 yr)

Single sober parents

least often intoxicated at time of crime & less likely to act on impulse, had prior dealings with authority on matters concerning their children, psychotic motives second most frequent, no infant victims, ~37 years, 69% were mothers in this group

Prosocial, psychotic parents

majority married, highly educated as group, motive was psychotic, almost no record of previous family violence or dealings with authorities, most not working at time of crime, 73% were mothers, ~33 years old

Violent-impulsive parents

more fathers than mothers, have criminal record, responsible for earlier cases of domestic violence, exhibited conduct disorder features as a child, less likely to be working at time of crime, filicide being an 'accident' as cause of death of battering, mean age ~28 years

DSM-IV

refers to postpartum disorders for a limited number of diagnoses that begin within the first 4 weeks after birth.

ICD-10

refers to postpartum disorders only if the disorders have onset within the first 6 weeks after birth and do not meet criteria for disorders classified elsewhere

Infanticidal mothers

youngest at ~27 years old, had youngest victims (22/28 were neonaticides), almost no previous dealings with authorities, motive was to get rid of unwanted child, crime not impulsive, no psychotic or extended suicide motivation, suffocation most common method for killing

Anonymous delivery law

(effective in some European countries) allows women to give birth in a hospital anonymously and free of charge if she gives up her child for adoption

What can cause filicide in the absence of psychopathology?

- Altruism (relieving the child of real or imaginary suffering, usually involving a suicide attempt by the parent) - Unwanted child (seen as burden) - Accident or child maltreatment - Spousal revenge

What is the process of neonaticide?

- Conceal thier pregnancy--> deliver without medical assistance,--> kill the victim--> hide the body. Tanaka et al., 2016)

How can we prevent filicide?

- Improved awareness by health care professionals and childbearing women must be promoted - Monitoring for the emergence of symptoms after childbirth should be performed by the physician and the patient's family. - Screening to identify cases for early intervention is another important goal. - Fathers with a history of substance misuse, violence or affective disorder and mothers who were teenagers at the birth of their child, or with affective disorder may be appropriate targets for intervention - Providing sex education and birth control - EPDS can be used as an effective screen for postpartum depression. (?)

Baby Blues

- NOT THE SAME AS POSTPARTUM DISORDERS common; they peak on days 4-5 postpartum and consist of a mild mood disturbance that typically does not require treatment - Women who developed postpartum depression had significantly lower oestradiol levels. - Women with a history of postpartum depression are sensitive to the mood-destabilizing effects of withdrawal from gonadal steroids at birth.

Examples of characteristics in maternal filicide:

- Psychosis more common among filicidal mothers than fathers - most mothers were considered not responsible for their actions due to insanity - Neonaticides are almost always committed by mothers and infanticides in 73% of cases - All mothers experienced stress caused by maternal discord and violence of spouse - causes of death: drowning, strangulation/ smothering, or banging them against a hard object

What is the importance of gaining more knowledge on female offenders?

- Raising numbers worldwide - Intergenerational transfer *Children of violent/ antisocial mothers: high risk of multiple problems (criminal, mental health, addiction, risk-taking behavior) - Recognition of victims of female offending

What was the Dutch Multicenter Project? What did research conclude?

- Tested gender issues in forensic psychiatry - Method: tested men and women in 5 different dutch forensic settings on multiple research topics; - Conclusions: Female forensic psychiatric patients: highly traumatized group with complex psychopathology - relevant gender differences: trauma history; mental health needs; criminal history - differences subgroups women (e.g., offense type, psychopathology) - High mortality rate (18%) - Risk assessment: low predictive accuracy for violence - Treatment is not an easy task; acknowledgment gender- specific aspects

What does risk assessment look like for female offenders?

- There are significant gender differences in the expression of violence/ pathways and violence risk factors - mental health professionals of both genders underestimate the risk violence in women - most tools developed are catered toward males

*What are psychopathologies related to filicide?

- almost half had a history of mental health problems, more common in maternal than paternal perpetrators (Flynn, 2013) - Most common diagnosis is affective disorders; EX) mood disorders, bipolar, & depression - Personality disorders - Psychosis is not as common

postpartum psychosis

- differ from other psychotic episodes because of alterations in cognition and confusion. -Differences: increased manic symptoms, absence of schizophrenic symptoms, and marked confusion in the puerperal group. - Cognitive disorganization was common in postpartum psychosis, which might be due to sleep deprivation. Acute-onset postpartum psychosis is usually bipolar disorder. - Serious postpartum disorders have a rapid onset and progression of symptoms.

Are their differences between filicidal mothers and fathers?

- higher proportion of fathers than mothers were convicted of filicide - Filicide is one of the few crimes that women commit as often as men - Mothers were more likely than fathers to have symptoms of mental illness at the time of the offense, specifically depressive symptoms - Filicidal fathers are typically older at the time of the crime and victims older than those of filicial mothers

What are examples of biological factors that could lead to filicide

- hormone levels - sleep deprevation

Examples of characteristics in paternal filicide:

- more likely to be perpetrators than mothers(?) - use violent methods of killing - have previous convictions for violent offenses - perpetuate multiple killings - have a history of substance misuse/dependence - frequently had personality disorder - higher proportion of fathers than mothers were convicted of filicide - Men were more likely than women to be imprisoned for the same offense - Be intoxicated at time of offense and commit suicide (homicidal- suicidal fathers) - about 20% found to have psychosis

Safe haven laws

- the US allow for an anonymous surrender of unwanted newborns at places like hospitals and fire stations

What are examples of developmental stressors that could to lead to filicide?

- the death of their own mothers or incest - lack of social or marital support - economic difficulties, family stress - young age - immaturity, and unrealistic expectations of motherhood

What can cause neonaticide in the absence of psychopathology?

- unmarried, had somewhat older maternal mean ages, infrequently had prenatal care, and experienced denial or concealment of their pregnancy - young, poor, single women who lived with their parents (fearful of repercussions), lacked prenatal care, were free of major psychiatric disorders, and had unwanted pregnancies - nonexistent or inadequate relationships with the neonate's father. - shame - fear of rejection - abandonment by significant others - the social stigmas associated with an illegitimate birth

What are examples of social stressors that could to lead to filicide?

- young, poor - previous convictions for violence - history of substance misuse

What are the most important differences from male offenders?

1) Higher prevalence (sexual) trauma 2) psychopathology: more complex, comorbidity 3) More interesting behavior 4) longer treatment history

What are the 5 classifications of filicide (Putkonen)

1. Homicidal-suicidal fathers 2. Violent-impulsive parents 3. Single sober parents 4. Prosocial, psychotic parents 5. Infanticidal mothers

What is gender responsive treatment?

Aim: identifying specific treatment needs and developing treatment guidelines for women in (gender- mixed) forensic mental health care Method: Literature--> Survey-->interviews--> Expert meetings--> pilot study Results: Treatment program--> Trauma treatment; parenting skills, empowerment, role of social and intimate relationships; psych-education

What is the Female Additional Manual (FAM)?

Examines risk violence in women who have demonstrated prior violent behavior

Flynn, 2013

Flynn et al. (2013)'s study aimed to provide a detail up-to-date description of the demographic and forensic characteristics of filicide perpetrators, as well as measure the prevalence of mental illness among filicide perpetrators, and investigate the prevalence of mental illness by gender of the perpetrator

Friedman 2009 Study: Neonaticide: Phenomenology and considerations for prevention

Friedman, H.S. and Resnick P.J. (2009)'s systematic literature review identifies characteristics of maternal neonaticide offenders in industrialized/developed countries. By reviewing PubMED Medline searches using the terms neonaticide and infanticide, they found that maternal neonaticide perpetrators were often single, first time parents, young (mean age 23), poorly educated, no premorbid mental illness, lower socio-economic status, lacked prenatal care, and denied/concealced their pregnancies.

Kauppi et al., 2010 Study: Maternal and paternal filicides: a retrospective review of filicides in Finland.

Kauppi et al. (2010)'s retrospective study illustrates the differences between maternal and paternal filicides in Finland over a 25-year period. By analyzing a sample of 200 filicides, they found that 59% were committed by mothers, mean age of victims was significantly lower for maternal victims. Furthermore, filicidal mothers showed mental distress; psychosis and psychotic depression were diagnosed in 51% of maternal perpetrators, and 76% were deemed insane. Paternal perpetrators were jealous of their mates, had a personality disorder (67%), abused alcohol (45%), or were violent towards their mates. During childhood, most perpetrators had endured emotional abuse from parents/guardians.

(Klier) Is the introduction of anonymous delivery associated with reducing high neonaticide rates in Austria? A retrospective study:

Klier et al. (2012)'s retrospective study aims to evaluate the effect of anonymous delivery laws on the frequency of neonaticide by completing a census of police-reported neonaticides of Austria (1991-2009). In addition, it aims to compare rates of neonaticide with those in countries where there is a police register for neonaticides but no anonymous delivery or safe haven laws (Finland and Sweden). Results show that Austria reported 7.2/100 000 neonaticides/birth prior to law, and 3.1/100 000 after the passing of the law. As to Finland and Sweden, neonaticide rates were lower than Austrian before and after implementation of Austrian law.

What is the nature of violence by women compared to men?

Less visible: more domestic, less serious physical injuries Less than 10% of the prison and forensic mental health care house women Different expression: more reactive and relational; less sexual and instrumental Different motives: emotional, relational, jealously

Why do neonaticide happen?

Neonaticides occurred when an illegitimate child was not wanted, out of shame, fear of rejection, social stigmas, etc.

(Tanaka et al., 2016)

Tanaka et al. (2016)'s systematic review of scientific literature aimed to identify population-based studies reporting the incidence of neonaticide in different countries; from 485 abstracts, 12 studies were selected. The study shows the effectiveness of preventive measures, such as anonymous free delivery, in reducing the incidence of neonaticide, though effects may be short-term. Despite social and institutional changes, neonaticide persists even in the most socially advanced, liberal, and prosperous societies in the world.

What is filicide?

The act of killing one's child (0-18 yr).

Post Partum Disorders

The majority of disorders that begin in the postpartum period are mood disorders (major or minor depression, mania, schizoaffective mania, schizoaffective depression, schizophrenia, unspecified functional psychosis, and personality disorders or other illnesses) (Wisner, 2007)

Baby hatches

accessible incubators situated outside of the hospitals, where the incubator signals the staff on call when a baby is placed inside - used in Austria, Germany, Switzerland, Czech Republic, Hungary, Italy, Poland, Japan, Philippines, Pakistan, and South Africa - Cons of baby hatches: they do not provide support to the mother during her pregnancy and placement of the child at baby hatch; baby could be placed without mother's consent, or baby might be the result of rape or incest, making further investigation impossible