S-40-01

Psychotherapy of cruel sadism: A family systemic approach

N. M. Turchenko. Rostov State Medical Universit, Rostov on Don, Russia

Objective: To study and develop the role and place of psychotherapy in cruel sadism integrated treatment within the systemic integrated approach concept.

Methods: Studied was the structure of the family system, peculiarities of its functioning and development, as well as communication patterns and upbringing peculiarities in 57 serial sexual aggressors, with an application of a family systemic integrative concept.

Results: Practically all the 57 cruel sadists have shown various dysfunctional communication patterns, structural violations associated with vague or rigid boundaries of both the family system and its subsystems. Each family revealed discrepancy between the development of matrimonial and parental subsystems and, on the other hand, the family system age and its actual needs. 11 out of the 57 studied families ended in a divorce when the children were 3 to 14 years old. In 7 families there was the father's or mother's death, including 1 murder of the father and 2 cases of the mother's suicide. Emotional relations in 14 families were characterized as lacking emotional devotion, in 14 cases there was emotional attachment to the mother, and in 4 cases to the father (a symbiont dependence type). In most families there was communication with ‘double bind’ elements. In 50% of the families the relations between the parents were characterized as a dominant mother - peripheral weak-willed father. One-fifth of the examined persons long lived beyond the family: in children's homes, boarding schools. However even those who lived in their families experienced emotional disallowance, cruel treatment. The above-said families were characterized by an inclusive anomalous impact: in 84.6% of cases cruelty was combined with emotional disallowance, in 73.1% it was emotional disallowance. Revealed were problem conflict relations with equals in age as early as in school years. 21% were included in the peers’ groups, while the rest were disallowed or isolated.

Conclusion: Cruel sadists developed in the family systems characterized by gross violation of the structure, development and functions of both the whole system and its subsystems. Under such conditions, assimilated were pathologic communication patterns, which were then transferred to the out-family relations. Inclusion in holiatry of psychotherapy based on a systemic integrative approach permits to raise therapy effectiveness and prevent possible criminal consequences.

S-40-02

Animal cruelty and psychiatric disorders

R. Gleyzer, A. R. Felthous. Washington State University, Tacoma, WA, USA.

Objective: Animal cruelty in childhood, though generally viewed as abnormal or deviant, for years was not considered symptomatic of any particular psychiatric disorder. Though currently used as a diagnostic criterion for conduct disorder, research establishing the diagnostic significance of this behavior is essentially nonexistent. Presenters will discuss results of the original study designed to test the hypothesis that a history of substantial animal cruelty is associated with a diagnosis of antisocial personality disorder (APD). Associations with other disorders commonly diagnosed in a population of criminal defendants will be reviewed.

Methods: Forty-eight subjects, criminal defendants who had histories of substantial animal cruelty, were matched with subjects without this history. Data were systematically obtained from the files using four specifically designed data retrieval outlines.

Results: Study demonstrated significant association of animal cruelty during childhood with APD, antisocial personality traits, and polysubstance abuse. Mental retardation, psychotic disorders, and alcohol abuse showed no such association.

Conclusion: Implications of the study results and significance of findings will be reviewed in the light of existing literature.

S-40-03

Animal cruelty: A prodrome of antisocial and aggressive behavior or not?

A. Felthous, R. Gleyzer. Southern’ Illinois University, Chester, USA

Objective: Animal cruelty in childhood is a criterion of conduct disorder and antisocial personality disorder (DSM IV-TR, 2000). Animal cruelty is also often considered to be a manifestation of abnormal aggression that may be associated with violence against people at a later age (Kellert and Felthous, 1985). Yet studies examining these possible associations appear to have resulted in contradictory results, presumably due to inconsistencies across studies in definitions of animal cruelty, definitions of aggression and antisocial conditions, methods of data collection, and thoroughness of interviews to identify and characterize animal cruelty (Felthous and Kellert, 1987). This updated review examines relevant research reports published since the review by Felthous and Kellert in 1987.

Methods: Studies were organized into two groups: Those of subjects initially identified as cruel to animals and those that classified subjects as aggressive or antisocial but also addressed whether they were cruel to animals.

Results: Firm conclusions must await replication studies that apply the same definitions and methods.

Conclusion: Nonetheless, results of this review support an association between substantial animal cruelty (severe and recurrent) in childhood and more enduring antisocial and

aggressive conduct.

S-40-04

Cruel criminal sadism: Origination and development

A. Bukhanovsky. Rostov State Medical Universit Psychiatry, Rostov-on-Don, Russia

Objective: To describe the peculiarities of the origin, clinical picture and development of dangerous cruel criminal sadism (CCS) in serial sexual killers.

Methods: Clinically examined were 58 serial sexual

aggressors, including 39 killers, each having committed 2 to 56 attacks.

Results: Non-fatal cerebral, sexual and personal predisposition has been revealed. The condition for CCS psychogenesis,

appearing in accordance with the mechanisms of reactive

imprinting (34.3%) or operant teaching (65.7%), is psychosocial desadaptation due to numerous chronic intra- and interpersonal conflicts and frustrations. The CCS clinical picture, which corresponds to the dependent behaviour symptoms (non-chemical dependence), includes the psychophysical dependence syndrome, pathosexual tolerance growth, personality impoverishment and sexuality impoverishment. The repeatedly actualized obsessive- compulsive drive to cruel sexual violence is responsible for the multi-episodic (serial) nature of crimes. Tolerance rise leads to a higher cruelty degree, blood-thirstiness, danger. Impoverishment of both the personality and sexuality leads to aggravated social desadaptation and broken partnership and family ties. CCS development takes place in stages and includes pre- and clinical stages, as well as pre- and criminal periods. The major manifestations of the pre-clinical stage are alternating specific recollections, dreams, cruel treatment of animals.

Conclusion: CCS is a dangerous criminogenic variant of the dependent behaviour disease (non-chemical dependence). The peculiarities of its development permit to organize early detection of those belonging to high risk and patients, carry out primary, secondary and tertiary prophylaxis of the disease itself and its dangerous criminal consequences.

S-40-05

Brain of serial killers

O. Bukhanovskaya. Rostov State Medical Universit, Rostov on Don, Russia

Objective: A study of brain structures in cruel serial killers (SKs)

Methods: Brain, skull and craniovertebral area MRI of 27 SKs and two control groups (n: 60).

Results: SKs have shown a hundred per cent presence of anomalous pathological MRI symptoms. The most significant of these are: expanded subarachnoidal spaces (p<0.01) - symmetrical, partially combined, of frontal and temporal parts; inadequate differentiation between the grey and white matters occurring three times more often in frontal and temporal parts; expanded lateral (58.3%) and the third (TV) ventricles. In other 1/5 of the patients there was a TV slit-like constriction disclosed in none of the control group cases. The brain deep structures showed: a significant number of pathological signs (75.0% against 12.0% of the control group, p<001). All of them are of dysontogenetic character and belong to either the transparent partition or callous body. Among pathological MRI symptoms of skull bones and cranio-vertebral zone positive are aeriferous sinus anomalies, basic bone, cranial fossae and clivo-axial angle. The basic group also showed other dysontogenetic anomalies of the cranio-vertebral zone. In aggregate, they acquire the character of an important symptom as they are manifested in 29.2% against 4.0% in the control group.

Conclusion: SKs show a number of symptoms manifested as a cerebral predisposition of the appearance and development of sadistic multi-episodic sexual aggression. These are of an inborn, dysontogenetic origin and make two hierarchic levels of morpho- fucntional lesion: cortical and sub-cortical parts, of predominantly frontal and temporal localization; limbic system, predominantly septal region and callous body.