Sexual abuse is a crime which rarely has witnesses and, therefore, proving such offences is largely based on the testimony of the victims involved when no physical evidence is available to unequivocally document it. As a result, the testimony of the victim in such cases is the only basis on which a judge should make his decisions. Studies carried out on the testimony of children have shown the difficulties which arise when the minor is both victim and witness. Research studies conducted on child abuse recall, once again, the need for reflection on the manner in which the hearing of children’s accounts should be carried out in light of their suggestibility. Questions which are suggestive in nature act to affirm more than what they ask and may lead the witness to confirm the elements of the question put forth. If the witness is a child, it is possible for an adult to insert information into the youngster’s memory, thus incorporating it into his recollection of events, or substituting the original memory with it.The aim of this study is to verify the memory capacity in school age children (ages 6 to 9 years) through involvement in play activities carried out in a classroom setting, followed by individual interviews focusing on their views of what had transpired. Several factors which are able to influence the ability to remember were analyzed: age; role performed during the play activity; whether the participants played an active role, or merely observed; and the influence of troubling factors, such as confusion or stress.The results show the complex interactions among the multiple factors investigated in this study. They highlight the importance of examining all elements which may potentially come into play when interviewing a child and to understanding his or her suitability to give testimony. The data which have emerged from our analysis confirm the assumption that children may be reliable witnesses only if they are heard utilizing correct methodology based on the use of questions which are non-suggestive, and as non-leading as possible, so as to allow the child to recount the events in a manner as free and spontaneous as possible.

This pilot study is the starting point of a potentially broad research project aimed at identifying new strategies for assessing malingering during forensic evaluations. Participants: The forensic group was comprised of 67 males who were seeking some sort of certification (e.g. adoption, child custody, driver’s license, issuance of gun permits, etc.); the non-forensic group was comprised of 62 healthy male volunteers. Method: Each participant was administered the MMPI-2. Statistical analyses were conducted on obtained scores of 48 MMPI-2 scales. In the first step, parametric statistics were adopted to identify the best combination of MMPI-2 scales that differentiated the two groups of participants. In the second step, frequency-based, non-parametric methods were used for diagnos tic purposes. Results: a model that utilized the best three predictors (“7-Pt”, “L”, and “1-Hs”) was developed and used to calculate the ForensicEvaluation Dissimulation Index (FEDI), which features satisfactory diagnostic accuracy (0.9), sensitivity (0.82), specificity (0.81), and likelihood ratio indices (LR+=4.32; LR-=0.22).

Background: L’abuso degli anziani è un problema diffuso ma sottostimato. L’entità di tale problema non è del tutto nota sia per la mancanza di segnalazioni e/o denunce sia per la difficoltà di individuare precocemente gli indicatori di un buso. Esistono molte forme di abuso sugli anziani, tra cui quelle di natura psicologica, economica, sessuale, fisica, sociale, istituzionale, ma l’abuso include anche l’incuria e l’abbandono. È chiaro, quindi, che il maltrattamento può concretizzarsi non solo con una condotta attiva, ma anche con un atteggiamento omissivo attraverso il silenzio, la sottovalutazione o l’omessa segnalazione. Saper individuare i segni caratteristici di un maltrattamento dell’anziano rappresenta un dovere da parte di ogni operatore sanitario, cruciale per l’adozione di idonee misure di difesa a tutela della vittima e di contrasto all’autore del reato. Obiettivo: Verificare il grado di percezione del fenomeno da parte degli operatori sanitari, e se essi stessi siano in grado di identificare tempestivamente i segni precoci di abuso ed adottare le azioni necessarie per la segnalazione. Materiali e metodi: Dal 1 al 30 aprile 2015, a tutti gli operatori (Medici, Medici in formazione specialistica, Infermieri, OSS e Portantini) delle Unità Operative di Medicina Interna e di Geriatria dell’Ospedale Cardarelli di Campobasso (Molise) e del Policlinico dell’Università degli Studi di Bari “Aldo Moro” (Puglia) è stato sottoposto un questionario formulato sulla scorta di altri già debitamente utilizzati e validati in altre realtà internazionali, che va ad esplorare: 1. la conoscenza da parte degli operatori del fenomeno, 2. la loro capacità di riconoscere gli eventuali segni di abuso, 3. la prevalenza del fenomeno (nel senso se abbiano mai avuto esperienza di abuso sugli anziani) 4. la conoscenza degli stessi operatori riguardo le azioni da adottare nel momento in cui si trovino di fronte ad un abuso. Risultati: La raccolta dei dati ha permesso di ottenere un totale di 98 questionari compilati su 142 somministrati (69.0%). La maggioranza dei questionari è stata compilata da soggetti di sesso femminile (75.5%), di età compresa tra 41 e 50 anni (27.6%) e con qualifica di infermiere (46.9%). La Tabella 1 descrive i dati preliminari ottenuti e la divisione per Unità Operative e per qualifica dei compilatori. La tabella 2 mostra la distribuzione per sesso e classi di età dei compilatori in base alla sede ed all’Unità Operativa di appartenenzaConclusioni: Da questi dati preliminari si evince come l’interesse per l’abuso sugli anziani, sebbene presente, non rappresenti per tutti gli operatori sanitari una priorità né un problema sentito, probabilmente in relazione alla scarsa conoscenza del fenomeno, ma soprattutto degli indicatori di abuso e delle procedure da attuare nel qual caso si venga a conoscenza di tale fenomeno. Quindi emerge forte l’esigenza di una formazione continua ed aggiornata sugli indicatori di abuso al fine di una loro più precisa individuazione nonché sulle procedure di segnalazione obbligatori alle Direzioni Sanitarie ed all’Autorità Giudiziaria.

The goal of this presentation is to describe a case of sexual abuse realized by an institutionalized patient toward a young visitor. This presentation will impact the forensic community and/or humanity by focusing on elderly sexual offenders, in order to better understand the mechanisms and factors that lead to elder sexual offenses in both family and formal care settings. Background. More commonly, older people are the victims of sexual abuse but they can be also the perpetrators. The phenomenon is complex, consisting of institutional mistreatment toward all residents or individual neglect toward a single patient. The reasons older adults commit sexual offenses, in particular against children, are still an unsolved problem in order to understand the motivations and distinguish between senile or pedophile. Such offenses can occur in the family as well as within the hospital, nursing home facility, or a residential care home for elderly. This case report describes an episode of sexual offense by an elderly institutionalized patient toward a young visitor. Case Report. A 70-year old man in a residential care home was accused of sexual abusing a 6-year old girl who was with her mother to see the grandmother. In the late afternoon, the grandmother reported to staff members that the male resident had come to her room and, promised the child some candy, and had then taken her with him to his room. Once back in her grandmother's room, the girl disclosed that the man had lowered her underwear and touched her private parts. The elderly suffered of Parkinson's disease since several years, first treated with dopamine agonists, then, for the appearance of long-term treatment syndrome and gambling, with atypical neuroleptics. By interview the child was able to mimic the abuse perpetrated, by using a doll, and by psychodiagnostic tests performed she was found to be reliable in reporting the sexual abuse. On genital examination, no injuries were observed except for some hyperemia. The analysis of the micro-traces on her underwear gave negative results for the presence of seminal fluid but it was able to detect a DNA profile consistent with that of the old-man. The man was found guilty and sentenced to 5 years in prison. A civil action was also brought against the staff of the nursing home for inadequate supervision of the resident. Discussion. The elderly are often unrecognized victims of sexual abuse but also at risk of perpetrating abuse on vulnerable targets like children or frail elderly co-residents because of many factors associated with aging. Mental illness and cognitive disturbances (related to dementia, other neurological or iatrogenic factors), as well as a range of problems in addition to physiological or pathological sex behaviors (ie, pedophilia) are just some of the several age-related factors that can lead to such offending. Recently evidence has been found linking antiparkinson therapy and disorders in the impulsive-compulsive spectrum among which gambling and hypersexuality as well as dopamine dysregulation syndrome. A distinguishing characteristic of elderly sex offenders is that the illegal activity will usually take place in a private place, such as the home of either the offender or the victim, or in a hospital or residential care home. Because of the aging of our population, elderly sexual offenders are becoming an increasing concern to clinicians and criminal justice agencies. Conclusions. It is important to have a fuller understanding of the factors leading to elder mistreatment and sexual offenses in both family and formal care settings. Caregivers have responsibilities to ensure the safety of dependent elders and to protect them from elder abuse and also to ensure they do not pose a risk to those they are living with and any visitors they may have. Moreover it is necessary to better understand the motivations and psychological factors relating to elderly sex offenders, to prevent these offenses, and

Background The case presented here took place in the deep south of Italy where, even today in some areas, people continue to hold on to beliefs in magic and superstition. Such ways of thinking have deep roots and hold important cultural significance in this part of the country. What makes this case so unusual and interesting however, is the way in which the perpetrator went about sexually abusing his daughter: • Seeking the help of sorcerers. • Sadistic practices such as injecting sperm into the victim, as well as providing her with food and drink laced with sperm. • Psychological violence. • Isolation of the victim. Method We examined the features of the violence perpetrated. An unusual web of ritualistic, mythical, subcultural, and “magical” elements were involved that went far beyond those normally associated with cases of sexual abuse. Another atypical characteristic of this case was the duration of the sexual relations between the father and daughter: 4 years. Results In cases of incest, the adult transforms a child’s dreams of seducing the parent into a nightmare in which the child is actually able to realize his or her goal. The parent should remain impassive in such situations. Whereas the child may only fantasize about sexual or incestuous behavior, adults must understand the difference between infantile phantasms by deciphering the meaning of these fantasies and not permitting them to be acted upon. Conclusions Unlike a “classic” rape, where the victim feels a sense of separateness from the rapist, the victim of sexual abuse within the family environment finds him or herself in a highly complicated relationship with the perpetrator. Even when these victims have feelings of hate toward the relative, they are unable to experience conflicting tensions and ambiguous emotions: This is particularly damaging to a child as we can see from this case.

Fatal starvation is a rare cause of death in industrialised countries. In such cases, investigation of death is never an easy task for forensic pathologists who need to couple autopsy findings with full investigation of the crime scene and family record to establish if death results from deliberate neglect, maltreatment and withholding of food. The present article describes two cases of death caused by child neglect. The first case involved a 16-month-old female who died from starvation with dehydration as a contributing factor. In the second case a 7-year-old girl died from ultimate aspiration of stomach contents that had been vomited during the child's last meal because of the fecal concretions blocking the intestinal passage. In both cases macroscopic and histological findings revealed severe chronic malnutrition; crime scene investigations confirmed stories of child maltreatment and neglect. (C) 2011 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Aim. To investigate the influence of various factors on the ability of primary school children (aged 6-9 years) to refer an event that occurred during their life. Materials and Methods. The factors analyzed were: the time since the event occurred; the role the child had in the event; the type of questions asked to elicit the account. Results. The results of this research indicate that 52.4% of 6-yearold children are able to describe the main elements of the event if they are allowed to give a free account. Asking direct questions does not improve the quality of the narrative. By contrast, in 9-year-old children the quantity of data collected is improved if direct questions are asked. A role as a participant in the event improves the quality of the child’s evidence but only in the group of children aged 9, whereas in younger children the difference is not significant. At the age of 9, the child’s resistance to leading questions is already quite good (40.7%), whereas children of 6 are much more suggestible. Conclusions. The Authors conclude this work by making some reflections on the possible use of these findings in Law Courts, and on the need for a highly specific training of experts involved in the task of collecting evidence from young children.

There are few studies of female stalkers in literature addressing different study populations. There appears to be a high incidence of mental disease among female stalkers, having an important role in inducing the harassment. We present a woman affected by a bipolar disorder had a long affair with her victim, broken off in 2007. Stalking began in January 2009 and continued for 6 months, during which time she was not taking drugs and was in a decompensated clinical phase. In July 2009, she was denounced for harassment; the authorities demanded a psychiatric examination. The woman then resumed taking the medication regularly. In December 2009, although she was in complete remission, she began stalk- ing once more. This case shows that even when there seems to be an evident relation between psychopathology and crime, it is always necessary to evaluate to what extent the mental disorder is responsible for the criminal behavior.

The use of internet is modifying our way of acting, and also our way of thinking, involving a change in one’s image, the image of the others and our relationships. However, internet is a new instrument of communication but also a tool to commit crimes. As a matter of fact crimes committed on the internet may be considered as one of the main typical psychological paradox of the relation between the mind and the advanced information technologies: the possibility that the experience of a complete control of one’s life promoted by the use of the internet (for it is characterized by accessibility, cheapness, the possibility of alter one’s identity, wholeness, interactivity and standardisation), can evolve in a progressive and complete loss of control on the virtual experience, leading to commit a real crime. The potentialities of these new mode of communication are well known, as well as the even greater number of risks for young subjects who have a not jet structured, and still in growing, personality. Cyberbulling is an example of these concrete risks. The term indicates bulling facts and troubles made through e-mails, chats, blogs, mobiles and web sites. involves minors whose identity are forming. Current study analyses distinctive characteristics of cyberbulling, compared it with traditional bullying, and highlighting similarities and differences between these.

The phenomenon of elderly sexual offenders is poorly catalogued, and especially complex. In institutions elderly people are often unrecognized victims of sexual abuse but also at great risk for doing abuse towards vulnerable victims like children. The lack of attention to an elder’s basic needs can endanger or impair not only their health or safety but also of other people living close together. In this letter for the first time we describe an episode of sexual abuse realized by an institutionalized patient toward a young visitor. This specific risk factor in Residential Care Home for Elderly may lead to a variety of negative behavioral outcomes, including the perpetration of child sexual offending. As elderly population will increase tremendously in the next years, it is necessary to better understand the motivations and psychological factors relating to elderly sex offenders, to prevent these offenses and to define standards for surveillance of resident potentially perpetrator.

After attending this presentation, attendees will more fully appreciate the importance of knowing how to recognize the various signs of elder abuse and the need to take the necessary steps both in prevention and in response. This presentation will impact the forensic science community by demonstrating that elder abuse comes in many forms, some obvious and others not so obvious. New ways to address this phenomenon must be formulated and put into practice. Background: Elder abuse is a widespread but underestimated problem. The full extent of this difficult situation is not known due to a lack of reports and/or complaints, as well as the difficulty in identifying the early warning signs of abuse. Many forms of elder abuse exist and are psychological, economic, sexual, physical, social, and institutional in nature; however, abuse also includes neglect and abandonment. It is clear that maltreatment may arise not only through active behavior, but also through omissive behavior such as silence, underestimation, and failure to report. Knowing how to identify the characteristic signs of elder abuse is the duty of every healthcare worker and is crucial in the adoption of suitable defense measures to protect the victim as well as in dealing with the offender.1,2 Objective: To establish the level of awareness of this issue by healthcare workers and to understand if they are able to promptly identify the early signs of abuse and take the necessary actions to report them. Materials and Methods: From April 1 - 30, 2015, all employees (i.e., physicians, specializing physicians in training, nurses, office support staff, social-healthcare workers, and orderlies) from the Internal Medicine Operating Unit and the Geriatrics Department at Cardelli Hospital in Campobasso (Molise) and from the Policlinico of the University of Bari “Aldo Moro” (Puglia) answered a questionnaire that was formulated by utilizing the provisions of other duly used and validated questionnaires from other international situations that are used to explore: (1) employees’ awareness of the phenomenon; (2) employees’ ability to recognize possible signs of abuse; (3) the prevalence of the phenomenon; and, (4) employees’ awareness regarding the proper actions to take when they encounter a case of abuse. Results: Data collection resulted in a total of 98 questionnaires administered to 142 respondents (69.0%). The majority of questionnaires were completed by females (75.5%) between the ages of 41 and 50 years of age (26.7%) and by qualified nurses (46.9%). Table 1 describes the preliminary data obtained and is broken down by unit and title of those who filled out the questionnaire. Table 2 shows distribution by sex and the age range of compilers according to the operating unit to which they belong. Table 1 BARI (Puglia) CAMPOBASSO (Molise) Internal Medicine Geriatrics Internal Medicine Geriatrics Title Enrolled Collected Enrolled Collected Enrolled Collected Enrolled Collected Physician 7 4 7 1 9 4 4 3 Physician in training 15 11 15 14 0 0 0 0 Nurses 12 11 12 10 20 16 15 9 OSS 4 3 4 1 3 1 3 1 Orderlies 2 2 2 2 2 1 2 1 Aides 2 1 2 2 0 0 0 0 Total 42 32 42 30 34 22 24 14 Table 2 BARI (Puglia) CAMPOBASSO (Molise) Total Internal Medicine Geriatrics Internal Medicine Geriatrics Sex (M/F) 10/22 6/24 5/17 3/11 98 Age 21-30 10 10 4 0 24 31-40 8 5 6 2 21 41-50 7 8 4 8 27 >50 7 4 8 4 23 No response 0 3 0 0 3 877 *Presenting Author Conclusions: These preliminary data show that interest in elder abuse, even when present, is neither a priority for all healthcare workers nor is it perceived as a problem by them. This is probably due to a lack of knowledge about the phenomenon, indicators of abuse, and the procedures to follow when one becomes aware of such an issue. As a result, a great need has been identified for ongoing and updated training regarding more precise indicators of abuse and the p

Objectives In forensic-psychiatric evaluations on a minor presumed victim of sexual abuse, one may come across “false positives” and “false negatives”. The aim of this study was to examine the phenomenon of false sexual abuse as revenge by one ex-partner against the other, and to offer recommendations about how to avoid this risk. Materials and Methods. The authors examined 75 technical consultations and expert testimonials in which intrafamilial sexual abuse of a minor was reported. Results. Twenty two (30%) were found to be baseless and result of conflict, revenge of one partner upon the other. Of these 22, 5 involved men who accused their ex-wives and/or live-in partners. The remaining 17 cases involved charges by women against their ex- husbands, and/or live-in partners. Conclusions. Charges of abuse represent not only an instrument of protection of one’s own children, but also a weapon of revenge against an ex-partner, putting these minors into the role of victims.

When carrying out forensic-psychiatric evaluations on a minor who is the presumed victim of sexual abuse, one may come across both “false positives” and “false negatives”. These may be the result of honest mistakes, or are intentionally false, and the result of manipulation and exploitation. False accusations may come about under certain conditions such as in particularly bitter cases of separation and divorce where one of the parents files charges against the other, and is well aware of the untruthfulness of them. In other cases, the adult reports sexual abuse that did not in fact take place, but believes in good faith that it has. Such a parent’s motives are protective in nature. Investigations carried out using inappropriate techniques may result in erroneous conclusions, thus confirming abuse that had, in fact, never taken place. The aim of this study is to examine the phenomenon of false accusations of sexual abuse as a form of revenge by one ex-partner against another, and to offer recommendations as to how to avoid falling into these traps. The authors examined Seventy-five technical consultations and expert testimonials, requested by judicial authorities, and carried out between 2003 and 2009 at the Department of Criminology of the University of Bari (Italy). These cases regarded marital unrest where intrafamilial sexual abuse of a minor was reported. Twenty-two (30%) of these reports were found to be baseless and merely a result of conflict, as well as a strategic maneuver employed by one of the partners as an act of revenge upon the other. Of these 22 baseless charges, five involved men who accused their ex-wives and/or live-in partners. The remaining 17 cases involved charges by women against their ex- husbands, and/or live-in partners. This echoes what is reported in the literature. Mothers (alienating parents) often level “Virtual accusations of abuse” against fathers (alienated parents). When, on the other hand, it is the father who is the instigator or the alienating parent, the accusations are usually aimed at the new partner of the ex-wife or ex-girlfriend. Nowadays, technical consultants who work with separated and conflicted families are increasingly involved in court cases that follow a characteristic pattern: one parent is accused of sexual abuse or serious maltreatment. This causes harm to the youngster and the accused parent is subsequently turned out, losing all contact with the child. It is important to bear in mind how Parental Alienation Syndrome (PAS) is a form of violence perpetrated on minors. A parent who alienates the other commits a form of abuse that Gardner defines as “emotional”, and may result in the permanent alienation of one loving parent, as well as psychiatric disorders. The estranged parent who forces his or her child into a situation of continual denigration and denial of the other parent can irreversibly damage fundamental psychological bonds. When parents become estranged, a serious deficit in parental care is always a risk and should seriously be considered by the courts when they make decisions regarding child custody. Charges of abuse represent not only an instrument of protection of one’s own children, but also a weapon of revenge against an ex-partner, paradoxically putting these minors into the role of victims.

After attending this presentation, attendees will better understand and appreciate the importance of the impact of incarceration on the father-child relationship and the need to create programs to address this dilemma. This presentation will impact the forensic science community by increasing awareness of the importance of both the incarcerated father and his child/children when creating a rehabilitation plan. When a father is incarcerated, his role as parent becomes “at risk” as being in detention undermines some of the fundamental aspects associated with being a parent. Going to prison alters the reciprocal nature of parent-child interactions. A father in prison cannot fully carry out his role as parent because, under such conditions, he is not able to impart a sense of attachment, trust, and security that is fundamental to the child’s development. In addition, stereotypes and prejudices may contribute to painting a picture of the incarcerated father as one who is unable to be a good parent. This could result in a life of failure and feelings of inadequacy with regard to being a father and parent. Furthermore, the absence of adequate role models, the very difficult initial adjustment period to prison life, the lack of cognitive, communicative, and relational abilities, together with the restrictive context of the prison, all make it difficult to develop and maintain adequate father-child ties that are so vital to a child’s development. Simply put, prison conditions alter both the parent-child relationship and how the subject perceives himself as a father and parent.1-3 Thus, there can be no doubt as to the importance of corrective interventions that address such negative dynamics and to the importance of support initiatives for prisoners and their families where specified locations and times for meetings between father and child can take place. These environments must be appropriate for developing and maintaining relational continuity, as well as for establishing and promoting a sense of parental responsibility in the incarcerated parent.4-6 The objectives of the study are to: (1) establish the father’s perception of his role as a parent, (2) establish the attachment styles of incarcerated fathers; and, (3) explore the relationship between the self-perceived parental role and the attachment patterns of the study subjects. Method: The directors of penitentiary administrations from two Italian regions were involved in this study. One hundred fifty male inmates were enrolled, each of whom was asked to give informed consent. Every participant was administered an articulated medical history questionnaire, in addition to two parental competence evaluation instruments. Instruments: Attachment Style Questionnaire (ASQ) and Self-Perception of Parental Role Questionnaire (SPPR).7 Final Considerations: The capacity of minors to establish multiple, deep attachments with people, even those who are not part of the immediate family circle, is well known. This is especially true when such figures demonstrate availability and readiness to respond to a child’s signals. As a result, a child’s social network takes on great importance as the child develops, particularly for children whose parents are in prison. This is linked to the correlation between successful prison re-education strategies and the ability to maintain a good relationship between the detained, his children, and his family. Reference(s): 1. Dallaire J.D. Incarcerated Mother and Father: a Comparison of Risks for Children and Families. Family Relation Blackwell Publishing, .440-453, 2007. United States. 2. Parke R.D., Clarke-Stewart K.A. Effects of Parental Incarceration on Young Children. From Prison to Home. The effects of Incarceration and Reentry on Children, Families and Communities. The Urban Institute. 2002. California. 3. Murray J., Farringhton D. Parental imprisonment. Long-lasting effect

Historically, there has been an assumption that women do not commonly perpetrate acts of sexual abuse against children (Wakefiled & Underwager, 1991). Recent interest in women offenders has brought attention to the issue, and challenges the perceptions regarding women who abuse children. The growing interest in the topic of female-perpetrated incidents of sexual victimization has produced some empirical research on the subject. A brief search of the current literature also yields a few published case studies, consisting primarily of reports on personality characteristics and developmental information from female perpetrators. Although this “provides a necessary starting point in understanding female sexual abuse perpetrators” (Wakefield & Underwager, 1991, p. 56), the findings from these data should be seen as preliminary, and may not describe the full range of women involved in the perpetration of sexual abuse (Grayston & De Luca, 1999). Women who sexually abuse minors are rare and case histories are scarce; even less is known about sexually abusive mothers. Current data suggests that females are responsible for only a small percentage of sexual offenses against children in the general population, and men remain the most common perpetrators of child sexual abuse. Unlike male offenders, however, females can often disguise sexual offending by performing normal daily activities associated with childcare (i.e. affection, bathing, and dressing). Their behavior may appear to be nothing more than excessively protective mothering. Moreover, mothers may also commit more overt and highly eroticized, seductive behaviors, even going so far as to bestow the role of "lover" upon the child. Due to the low number of cases in which women sexually abuse minors, more in-depth studies on this subject are needed. The clinical files of five women who are currently serving time in Italian prisons for the sexual abuse of minors are presented here. The cases involved varying degrees of participation in the abuse by the mothers, and ranged from active sexual engagement to allowing others to abuse their children. Records of the abuse cases and other records were utilized. In three cases women revealed an antisocial personality disorder (ASPD), while in two cases a borderline personality disorder (BPD) was diagnosed according with DSM-IV criteria. While existing studies of female child sex offenders provided a range of insight and knowledge regarding women who sexually abuse, the current literature does not adequately represent the full spectrum of female-perpetrated child victimization (Grayston & De Luca, 1999). Considerably more well documented empirical research is required to guide law enforcement and clinical professionals in their understanding of female sex offenders. In recent years, several preliminary typologies of female sex offenders have begun to emerge in an effort to more clearly specify characteristics, dynamics, and offense patterns of female sexual perpetrators. However, the current review has shown that most female sex offenders fall into several suggested typology models. Therefore, the existing typologies used to describe these women may need to be insufficient. It is recommended that more comprehensive exploration of this offender population continue in order to more appropriately understand and classify female child sex offenders.

ABUSI E VIOLENZE SUGLI ANZIANI: COSA NE PENSANO GLI OPERATORI? PRIMI RISULTATI DI UNA INDAGINE Corbi G1, Grattagliano I2, Scarabaggio L1, Catanesi R2, Sabbà C3, Fiore G3, Ferrara N4, Campobasso CP1 1 Dip. di Medicina e Scienze della Salute “V. Tiberio” , Università degli Studi del Molise 2 Sezione di Psichiatria Forense (DIMIMP), Università degli studi di Bari Aldo Moro 3 Dip. Interdisciplinare di Medicina, Università degli studi di Bari Aldo Moro 4 Dip. di Scienze Mediche e Traslazionali, Università “Federico II” di Napoli Background. L’abuso degli anziani è un problema diffuso ma sottostimato. L'entità di tale problema non è del tutto nota sia per la mancanza di segnalazioni e/o denunce sia per la difficoltà di individuare precocemente gli indicatori di un buso. Esistono molte forme di abuso sugli anziani, tra cui quelle di natura psicologica, economica, sessuale, fisica, sociale, istituzionale, ma l’abuso include anche l’incuria e l’abbandono. È chiaro, quindi, che il maltrattamento può concretizzarsi non solo con una condotta attiva, ma anche con un atteggiamento omissivo attraverso il silenzio, la sottovalutazione o l’omessa segnalazione. Saper individuare i segni caratteristici di un maltrattamento dell’anziano rappresenta un dovere da parte di ogni operatore sanitario, cruciale per l’adozione di idonee misure di difesa a tutela della vittima e di contrasto all’autore del reato. Obiettivo. Verificare il grado di percezione del fenomeno da parte degli operatori sanitari, e se essi stessi siano in grado di identificare tempestivamente i segni precoci di abuso ed adottare le azioni necessarie per la segnalazione. Materiali e metodi: Dal 1 al 30 aprile 2015, a tutti gli operatori (Medici, Medici in formazione specialistica, Infermieri, OSS e Portantini) delle Unità Operative di Medicina Interna e di Geriatria dell’Ospedale Cardarelli di Campobasso (Molise) e del Policlinico dell’Università degli Studi di Bari “Aldo Moro” (Puglia) è stato sottoposto un questionario formulato sulla scorta di altri già debitamente utilizzati e validati in altre realtà internazionali, che va ad esplorare: 1. la conoscenza da parte degli operatori del fenomeno, 2. la loro capacità di riconoscere gli eventuali segni di abuso, 3. la prevalenza del fenomeno (nel senso se abbiano mai avuto esperienza di abuso sugli anziani) 4. la conoscenza degli stessi operatori riguardo le azioni da adottare nel momento in cui si trovino di fronte ad un abuso. Risultati: La raccolta dei dati ha permesso di ottenere un totale di 98 questionari compilati su 142 somministrati (69.0%). La maggioranza dei questionari è stata compilata da soggetti di sesso femminile (75.5%), di età compresa tra 41 e 50 anni (27.6%) e con qualifica di infermiere (46.9%). La Tabella 1 descrive i dati preliminari ottenuti e la divisione per Unità Operative e per qualifica dei compilatori. La tabella 2 mostra la distribuzione per sesso e classi di età dei compilatori in base alla sede ed all’Unità Operativa di appartenenza. Tab. 1. BARI (PUGLIA) CAMPOBASSO (MOLISE) Medicina Interna Geriatria Medicina Interna Geriatria Qualifica Arruolati Raccolti Arruolati Raccolti Arruolati Raccolti Arruolati Raccolti Medici 7 4 7 1 9 4 4 3 Med. in form. 15 11 15 14 0 0 0 0 Infermieri 12 11 12 10 20 16 15 9 OSS 4 3 4 1 3 1 3 1 Portantini 2 2 2 2 2 1 2 1 Ausiliari 2 1 2 2 0 0 0 0 Totale 42 32 42 30 34 22 24 14 Tab. 2 BARI (PUGLIA) CAMPOBASSO (MOLISE) Totale Medicina Interna Geriatria Medicina Interna Geriatria Sesso (M/F) 10/22 6/24 5/17 3/11 98 Età 21-30 10 10 4 0 24 31-40 8 5 6 2 21 41-50 7 8 4 8 27 >50 7 4 8 4 23 Non risposto 0 3 0 0 3 Conclusioni. Da questi dati preliminari si evince come l’interesse per l’abuso sugli anziani, sebbene presente, non rappresenti per tutti gli operatori sanitari una priori

Il termine parricidio si riferisce all’uccisione del proprio genitore, biologico o acquisito. Questo particolare omicidio può comprendere: patricidio; matricidio; doppio particidio, uccisione di entrambi i genitori. Il parricidio è raro e rappresenta una piccola percentuale di tutti gli omicidi commessi. In Europa e Nord America la sua diffusione varia dal 2 al 4%. Il numero dei patricidi supera quello dei matricidi. In Italia, il Rapporto EURES-ANSA (2008) segnala che i particidi rappresentano meno del 3% del totale degli omicidi. I matricidi, in Italia, sono maggiori dei patricidi. Il parricidio commesso da un adolescente si differenzia da quello compiuto da un adulto. Il parricidio ha caratteristiche differenti dal matricidio. La letteratura offre diverse chiavi di lettura per questo particolare tipo di omicidio, ne evidenziamo alcune: a) porre fine con un atto disperato a situazioni di abuso e violenza intrafamiliari che durano da molto tempo. Gli adolescenti omicidi difendono sè stessi e altri membri della famigli da comportamenti tirannici e dispotici. b) presenza di disturbi psichiatrici gravi con abuso di sostanze e di alcool c) ciclo della violenza: adolescenti vittime di violenze, che diventano autori di violenze.Nel nostro studio sono stati analizzati tre casi di parricidio commessi da adolescenti.

Introduction: One of the difficulties associated with administering the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) is that it requires dichotomous responses (T/F; 0/1). The authors present this pilot study as a means of confronting this problem by proposing a new version of the test: MMPI-2-FUZZY, which allows subjects being tested to respond in a nuanced manner while following the principles of fuzzy logic. Materials and Methods: Fuzzy logic is based on assigning a degree of truth to a particular variable ranging between 0 and 1 (In our case items on the test). Computerized administration of the MMPI-2 was converted in such a way so as to allow the subject to express a level of agreement (or disagreement) for each test item on the MMPI-2 by moving a cursor along a continuous line that contains values from 100% true to 100% false. This new version of the test was preliminarily administered on a sample of 26 healthy male subjects. As an external validity criterion, the diagnostic accuracy of the MMPI-2-Fuzzy was then compared with that of the classic MMPI-2 (bivalent) by using the diagnoses of 20 male subjects with psychotic disorders upon discharge from the Psychiatric Clinic at the University of Bari (Italy), each of whom was administered the computer-based MMPI-2-Fuzzy. Results: Notwithstanding the preliminary nature of the study and the limitations associated with the small sample size, it is nonetheless possible to affirm a higher validity of the MMPI-2-Fuzzy and the two modes of administration and scoring by utilizing ROC curve (fuzzy 0 0.82; bivalent = 0.80), and the study of sensitivity, specificity and global diagnostic accuracy (fuzzy = 0.71; bivalent = 0.60) when discriminating between those who are healthy and those who are ill. Conclusions: Such promising results may indicate the need for further study regarding alternate versions of administering the MMPI-2 in both clinical and legal-medical settings.

Gli esperti in ambito forense e medico-legale stabiliscono non solo la validità di quanto riferito ma anche la credibilità di chi lo riferisce. L’intera relazione tra il soggetto e lo specialista è influenzata da elementi che alterano la genuinità della diagnosi, es.: l'assetto stesso del valutatore; la natura coatta dell'esame; il peso esistenziale ed i vantaggi legati all’esito della valutazione stessa; la necessità che i risultati vengano comunicati a terzi; la tendenza dei soggetti valutati ad amplificare la desiderabilità sociale. In questo contesto la dissimulazione, intesa come occultamento o minimizzazione di una sindrome che di fatto sussiste, rappresenta un problema nel processo diagnostico, impattando sul numero di falsi negativi. Il dissimulatore è una persona che ha ben presente una verità e poi la nega, gestendo mentalmente due affermazioni contrapposte. Nei contesti come quello medicolegale e forense, dove il bisogno di dare sostanza alle proprie valutazioni è più sentito, bisogna far fronte ai limiti della soggettività e della sola osservazione clinica. L'ausilio di strumenti psicodiagnostici è pertanto irrinunciabile ed ampiamente effettuato. Il test MMPI-2 appare il principale strumento che, ancora oggi, dimostra di possedere indici in grado di individuare atteggiamenti dissimulatori nei soggetti esaminati. Il comportamento "menzoniero" è accompagnato da elementi verbali e non verbali, segni e indizi paralinguistici meta comunicativi. Tra i comportamenti non verbali rivelatori di probabile menzogna sembra rivestire un ruolo interessante il fattore “tempo di latenza” . Gli autori, partendo dall'ipotesi che sia plausibile aspettarsi tanto nei simulatori quanto nei dissimulatori, un allungamento dei tempi di risposta (T.R.) connesso ad una maggiore "gestione mentale dell'informazione" da manipolare, hanno cercato di verificare quanto il calcolo dei T.R. applicato all’MMPI-2, rappresenti un'ulteriore fonte di informazione nell’identificare l'adozione di un atteggiamento dissimulatorio. Lo studio ha visto l'applicazione di una versione computerizzata dell'MMPI-2 costruita ad hoc capace di calcolare automaticamente i tempi di risposta, ad un campione di 59 maschi e 17 femmine suddivisi in 4 gruppi in base alla motivazione soggiacente l'accertamento medicolegale: idoneità lavorativa, genitoriale, per la patente di guida e per il porto d'armi. Il gruppo di controllo era rappresentato da volontari, clinicamente sani, non condizionati da interessi secondari nella compilazione del test, bilanciati e controllati per numerosità, età e scolarità. La validità dei T.R. è stata valutata attraverso il test statistico t di Student, confrontando i singoli gruppi sperimentali ed i rispettivi gruppi di controllo, osservandone la significatività statistica delle differenze tra le medie dei tempi a tutte le scale di controllo, cliniche, di contenuto e supplementari dell'MMPI-2 e rispetto al tempo totale di compilazione del protocollo. Le prime risultanze mostrano come la distribuzione del tempo medio di risposta si differenzi tra i soggetti sperimentali e controlli proprio in relazione a quelle scale che analizzano dei costrutti psicologici, clinici e comportamentali, inerenti gli ambiti oggetto delle valutazioni. I risultati preliminari di questo filone di ricerca appaiono incoraggianti e motivano ad un ampliamento del campione per aumentarne la significatività statistica.

The aim of this study is to provide data regarding the treatment of foreign juveniles in the Italian justice system. The authors examined the records from juvenile detention centers and primary juvenile reception centers in Italy in order to gain a better understanding of how foreign minors are treated with respect to their Italian counterparts. Statistical analysis was then carried out and the results revealed many inequalities. The authors believe that it is important to create secondary and tertiary prevention services in order to decrease the likelihood of recidivism, and to promote the minor’s integration into the social fabric of their adopted country. Foreign minors are more frequently placed in jail than their Italian counterparts. The authors conclude that only through the development of a united partnership can a welcoming network be created: one that is able to pick up on the first signs of trouble that often confront foreign minors.

This case study regards the murder of a Tunisian national residing in a small town in southern Italy who was murdered by fellow Tunisian citizen, also living in Italy. The victim was found hogtied and hanged by a cord that was suspended from an iron staff situated between two concrete electrical poles. This method of killing is known as "incaprettemento". It is an unusual type of strangulation whereby a rope is passed around the victim’s wrists, ankles, and throat causing suffocation. This results in a very slow and painful death. Typically, it is a method employed by Italian organized crime groups, but it has also been used in the execution of war crimes. This means of killing is meant to impart a particularly degrading and humiliating revenge on the victim. It may also serve as sign of intimidation and a warning to others. There is very little written about incaprettamento in the literature, but it has, nonetheless, important psychological, anthropological, and cultural implications in the field of criminology. The perpetrator underwent psychodiagnostic evaluations, and was ultimately deemed fit to stand trial.

Foreign minors often have problems integrating into Italian society. The two principal reasons for this is their young age, and their different cultural background. The aim of this study is to provide data regarding the treatment of foreign juveniles in the Italian justice system. The authors believe that it is important to create secondary and tertiary prevention services in order to decrease the likelihood of recidivism, and to promote the minor’s integration into the social fabric of their adopted country. The principal motive for which minors leave their homeland is the search for a new way of life. Persichella wrote of “advance socialization”, a term that refers to the expectations of well being that a foreigner might associate with a particular place. These mental images are often generated by the mass media, as well as by relatives and friends who have already emigrated there. These youngsters are often disappointed upon their arrival in the new country, leaving them in a state of relative deprivation, frustration, and tension, which are significant risk factors for the commission of crimes. The percentage of foreigners convicted of crimes in Italy has increased over the last decade with respect to the number of convicted Italians. This is true for all crime categories. There are many reasons for this phenomenon. Among them are the conditions in which these immigrants find themselves when they arrive in Italy (e.g. how their previous expectations measure up to the reality of their new existence; how successfully they reintegrate with their families; their ability to enter into the work force; and the influence of both Italian and foreign organized crime groups). Foreign minors are more frequently placed in jail than their Italian counterparts. This is because it is less likely that they would have access to resources that might allow them to be spared detention (e.g. having a nuclear family; a home; steady employment, etc.) In theory, these foreign juveniles are supposed to have access to detention alternatives, but in reality they must overcome serious obstacles in order to take advantage of them. Cultural mediation acts to facilitate relationships between individuals from ethnic minority groups and the associated social services that are in place to serve them. The cultural mediator aids the foreigner in understanding how to behave appropriately, and attempts to sensitize him to the customs and way of life in Italy. The cultural mediator also actively participates at various phases of institutional life, for example, in helping the minor to communicate with juvenile justice officials, and with relatives. In addition, the mediator also aids the family in navigating the Italian legal system. Some juvenile detention centers (IPMs) report a lack of resources and funding necessary to create appropriate treatment plans. They cite, for example, the under utilization of cultural mediators who are often marginalized and relegated to the singular role of interpreter. Cultural mediators are typically only available on an hourly basis, and are not considered to be an integral part of the treatment team. Short stays in IPMs are also reported to be problematic: repeated transfers make it impossible for staff to get to know the minor in order to create an individualized education program. When considering the usefulness of detention alternatives, the study and development of shareable management models that address the real needs of minors in the juvenile justice system are of fundamental importance. Facilitating the social integration process, appointment of a legal guardian when necessary, and providing qualified legal representation are high on the list of priorities. Only through the development of a united partnership can a welcoming network be created: one that is able to pick up on the first signs of trouble that often confront foreign minors.

The MMPI-2 test is one of the few psychodiagnostic instrument used in Italy which permits to identify distorted behaviours, simulation and dissimulation by means of specific scales .The aim of this research is to study the validity of the F-K dissimulation index of the MMPI-2 test and to determine its cut off values. This index permits a greater diagnostic accuracy between MMPI profiles, in which simulation an dissimulation problems are minimized or accentuated, and profiles compiled with spontaneity and in compliance with the clinical and forensic examinations . In forensic medicine field, the use of instruments that allow us to identify cases in which there are psychopathological accentuation or minimization for defensive or instrumental reasons, may represent an important contribution, in order to ascertain the validity of the results and to assess the credibility of patients’ answers, running out the risk of invalidating the whole research.

Il test MMPI-2 è uno dei pochi strumenti psicodiagnostici che consente, con scale specifiche, l’individuazione di condotte distorsive. L’obbiettivo della comunicazione è quello di presentare uno studio della validità e individuazione del cut-off dell’indice di dissimulazione F-K del MMPI-2, che consente una maggiore accuratezza diagnostica tra profili del test Minnesota compilati con atteggiamento di minimizzazione o di amplificazione di problematiche presenti (dissimulazione e simulazione) e profili compilati con atteggiamento di spontaneità e compliance con le situazioni di esame clinico e medico-legale. In ambito forense usare strumenti che consentano l’individuazione di casi in cui è presente un’accentuazione psicopatologica o una minimizzazione della stessa per motivi difensivi o strumentali, può costituire indubbiamente un significativo contributo per l’accertamento della validità dei risultati acquisiti e per stabilire la credibilità di quanto viene riportato dai soggetti esaminati, con il rischio di rendere non valide le indagini effettuate. Il Campione sperimentale è composta da 311 soggetti interessati ad apparire esenti da disturbi psichici (di cui 253 sottoposti a selezione per entrare nelle Forze Armate dall’Ufficio Selezione di Bari e 58 interessati ad ottenere/rinnovare il porto d’armi o per riottenere la patente di guida sospesa per infrazioni al Codice della strada, sottoposti a valutazione psichiatrica presso la Clinica Psichiatrica dell’Universitá di Bari). Il Campione di controllo è composto da 49 soggetti sani, volontari di pari etá, scolarizzazione e genere, genuinamente interessati ai risultati del test al solo fine della autoconoscenza. Le mediane dell’Indice F-K del gruppo di controllo sono risultate al Wilcoxon Signed Rank test significativamente differenti da quelle dei selezionandi per le Forze Armate (p < 0.0001) e da quelle dei richiedenti l’idoneita psichica al porto d’armi o alla patente di guida (p < 0.0001). Le medie dell’Indice F-K del gruppo di controllo sono risultate al t-test di Student significativamente differenti da quelle dei selezionandi per le Forze Armate (t = 6.644; p < 0.0001) e da quelle dei richiedenti l’idoneita psichica al porto d’armi o alla patente di guida (t = 4.96; p < 0.0001). La differenza media dei punteggi F-K tra il gruppo di controllo e il gruppo sperimentale dei potenziali dissimulatori e risultata di ca. 10 punti. Riassumendo, dall’analisi delle curve della Accuratezza Diagnostica globale al variare del cut-off dal nostro studio e risultato che valori dell’F-K inferiori a -10 sono affidabili indicatori di una reale condotta distorsiva in senso dissimulativo. L’accuratezza evidenziata dal Dissimulation Index (= 73%) di Gough, appare un risultato significativo che giustifica la nostra proposta di introdurre di routine all’interno di un protocollo diagnostico medico-legale l’utilizzazione del Dissimulation Index F-K di Gough quale indice numerico dell’atteggiamento distorsivo in senso dissimulativo per valori al di sotto di -10. In conclusione l’accuratezza diagnostica evidenziata dal test MMPI-2, nell’individuazione di soggetti potenzialmente dissimulatori, (indice di Gough, F-K < -10), consente di segnalare all’attenzione della comunitá scientifica e professionale dell’area medico legale e forense, l’importanza di adottare questo strumento psicodiagnostico, nel protocollo valutativo, come prezioso ausilio nella individuazione dei casi di dissimulazione di un disturbo mentale.

Essere padri detenuti rientra nella categoria di genitorialità a rischio, in quanto la condizione di detenzione fa venire meno alcuni aspetti fondamentali dell’esercizio della funzione genitoriale. L’ingresso in carcere interrompe ed altera la natura reciproca dello scambio comunicativo e interattivo genitore-figlio. Un padre detenuto non può esercitare nella pienezza fisica, spaziale e temporale il proprio ruolo di genitore, non essendo nelle condizioni di garantire la trasmissione al/la figlio/a di quel senso di attaccamento, fiducia e sicurezza fondamentale per la sua crescita. Su un ulteriore livello di analisi va considerato che stereotipi e pregiudizi possono contribuire a creare una rappresentazione culturalmente condivisa del detenuto stesso come soggetto incapace di essere un buon genitore. Ciò potrebbe determinare un vissuto di fallimento e di inadeguatezza rispetto alla percezione di sé come padre e rispetto al proprio ruolo genitoriale L’assenza, inoltre, (nella maggior parte dei casi degli individui in stato di detenzione) di modelli di riferimento adeguati, le condizioni iniziali di svantaggio, la povertà di strumenti cognitivi, comunicativi e relazionali disponibili, uniti all’esperienza di un contesto restrittivo quale il carcere, rendono difficile la costruzione e il mantenimento di un legame fra padre-figlio adeguato alle esigenze di sviluppo del minore. Quindi la condizione di detenzione altera: a) la dimensione relazionale genitore-figlio/a; b) la rappresentazione e il vissuto che il soggetto ha come di sé come padre/genitore. Non possono, pertanto, sussistere dubbi sull’importanza di interventi correttivi rispetto a tali dinamiche negative e, sull’importanza di iniziative di supporto ai soggetti detenuti ed alle loro famiglie, fra le quali vi sono ad esempio, la predisposizione di luoghi e tempi per gli incontri tra genitore detenuto e figli, adatti a recuperare e mantenere una continuità di rapporti ed a stabilire e promuovere una responsabilità genitoriale da parte del soggetto recluso. Obbiettivi della ricerca: –Verificare l’auto-percezione del ruolo paterno – Verificare lo stile di attaccamento dei padri in stato di detenzione – Esplorare la relazione tra modalità di auto-percezione del ruolo paterno e pattern di attaccamento dei partecipanti alla ricerca. Metodo: Sono state coinvolte le Direzioni delle Amministrazioni Penitenziarie di due regioni italiane: Puglia ed Emilia Romagna. Sono stati arruolati 150 detenuti di sesso maschile, a cui è stato richiesto il consenso alla ricerca ed a cui è stato somministrato un articolato questionario anamnestico e due strumenti di valutazione delle competenze genitoriali. Strumenti: ASQ- Attachment Style Questionnaire (Feeney, Noller, Hanrahan, 1994) ARP-Questionario sull’Autopercezione del Ruolo Paterno (MacPhee, Benson, Bullock, 1986). Considerazioni Finali: È nota la capacità dei minori di instaurare attaccamenti multipli profondi con persone che, pur non appartenendo alla cerchia familiare ristretta, si dimostrano disponibili e preparati a rispondere ai loro segnali. Da ciò deriva la rilevanza della rete sociale che circonda il minore nel suo processo di crescita ed, in particolare, della rete sociale dei minori che sono figli di genitori detenuti, e ciò anche alla luce dei più recenti orientamenti di politica criminale nel settore dell’esecuzione penale, che spostano sempre più le problematiche derivanti da una detenzione dal ristretto ambito carcerario allo spazio più allargato del territorio. A ciò si associa la correlazione tra il successo di strategie rieducative in carcere ed il mantenimento di una buona relazione tra detenuto figli e famiglia, dal momento che le modalità dell’esecuzione della pena investono con le proprie ripercussioni non solo il soggetto che le subisce ma, in modo altrettanto incisivo, il contesto sociale che lo circonda e la famiglia in primo luogo.

Lo stress, nel contesto della relazione paziente- caregiver è noto essere un fattore di rischio per abuso su anziani sia in setting familiari che istituzionali. Comunque, il fenomeno degli anziani responsabili di abusi sessuali è spesso misconosciuto e particolarmente com-plesso. In setting istituzionali tale popolazione è spesso vittima di abusi sessuali ma anche ad elevato rischio di divenire essa stessa responsabile di abusi nei confronti di vittime quali i bambini. Pertanto, la mancanza di attenzione alle necessità fisiologiche degli anziani può essere dannosa non solo per la salute del soggetto stesso ma anche di coloro che vivono con essi. Sulla base dei dati del Dipartimento degli Affari Interni per il periodo 2004-2010, gli anziani sono responsabili di abuso sessuale su minori per circa un quinto del totale di abusi sessuali perpetrati. Le ragioni alla base di tale comportamento sessuale ed in particolare di tali abusi nei confronti dei bambini rappresenta ancora un problema irrisolto, non essendo ancora chiaro se tale fenomeno debba essere ascritto alla “senilità” o alla “pedofilia”. Per la prima volta è descritto un caso di abuso sessuale perpetrato da un paziente istituzionalizzato nei confronti di un minore in visita. Un uomo di 70 anni residente presso una casa di riposo fu accusato di abuso sessuale nei confronti di una bambina di 6 anni recatasi in visita dalla nonna. L’uomo soffriva di morbo di Parkinson da diversi anni, ed era in trattamento con L-Dopa. Inoltre, assumeva un neurolettico atipico, la quetiapina fumarato, per il controllo di disturbi comportamentali (gambling) insorti in corso di trattamento. L’analisi delle tracce di DNA sugli abiti della bambina risultò negativa per liquido seminale ma evidenziò un profilo di DNA compatilibe con quello del paziente. L’uomo fu giudicato colpevole per abuso sessuale e condannato a 5 anni di carcere. Fu anche portata avanti un’azione legale contro lo staff della casa di riposo per inadeguata sorveglianza del paziente. Gli anziani sono spesso vittime misconosciute di abuso sessuale, ma sono anche responsabili di abusi nei confronti di soggetti più vulnerabili come bambini o anziani coresidenti. Malattie mentali e disturbi cognitivi (correlati a demenza, ad altri fattori neurologici o iatrogeni), così come una serie di problemi in aggiunta a comportamenti patologici (ad es. pedofilia) sono solo alcuni dei fattori che possono portare a tali condotte. Pertanto, se è importante comprendere a fondo i fattori che portano al maltrattamento degli anziani e agli abusi sia in ambito familiare che in setting di cura, dall’altra parte i caregiver hanno la responsabilità di assicurare la salvaguardia degli anziani non autonomi e proteggerli dagli abusi che possano subire, ma anche di assicurarsi che essi stessi non siano responsabili di abusi nei confronti delle persone con cui vivono o con cui vengano a contatto

The aim of this study was to ascertain if a relationship between weapon choice and psychopathology existed. The perpetrators (103) were evaluated at the Department of Criminology and Forensic Psychiatry of the University of Bari in southern Italy. Psychiatric examination and psycho-diagnostic tests were administered for each of the perpetrators and a database was subsequently formulated. The results showed a significant correlation between some types of mental disorder and weapon choice. A strong correlation was found between delusional disorders and the use of sharp weapons, whereas depressive disorders were more strongly associated with asphyxia. Organic disorders were found to be highly correlated with the use of blunt instruments. In cases where the homicide was the result of an impulsive reaction, the use of sharp weapons was most often observed.

Mobbing may cause the appearance of reactive mental disorders related and based to a pathogen and peculiar working environment. Usually in “Mobbing” cases we analyze the point of view of the patient, what he believes he has suffered, we listen to his reasons, we record his suffering but often it’s not possible to check and verify if this is true checking with the other party, with the Employer. Our purpose is to understand and recognize if the Mobbing situation is really in place and the quality of the Mobbing action accomplished by the employer. Our aim is to evaluate the psychological aspect that are usually examined only from the patient / “alleged victim” point of view, both clinical and forensic. The doctor has no tool to evaluate – very rarely it happens – about complains, about the mobbing environment, about downgrading of duties. For this reason, the research on data and records for years 2010-2014 provided by INAIL – Apulia Region, even if based only on official acts and documents, is in our point of view important: we have been able to have a better understanding on a complex phenomenon like the Mobbing and regarding the damage evaluation of the medical/ legal, psychological, psychiatric/forensic aspects.

Safety and well-being of health-care workers is a topic of current scientific debate. Available evidence shows that mental-health professionals are among those with the highest risk of being subject to violence in the workplace; they are also at risk of stalking, Burn-out and work-related stress. The Authors provide a comprehensive review of the scientific literature on these topics. This review showed that scarce data are available in Italy and international research may be not easily transferable to the Italian context. Collecting reliable data is crucial to orient evidence-based decisions on safety and wellbeing in Italian Mental health Department. This would allow the development of preventive measures, Risk reduction strategies, Training for professionals and recommendations for good practice. For these purposes, The authors propose the creation of regional observatories.

A homeless person may be defined as “a person in a state of tangible and intangible poverty, bearer of complex, dynamic, and multiform hardships” The study presented here was carried out in collaboration with the Italian Railway Police, from a criminological perspective, and focuses on homeless perpetrators and victims of crime. As of the writing of this article, 47 cases have been studied. Socio-demographic variables: AGE: The majority of subjects were male (72%), and 28% were female. The average age of the subjects observed was 49.8 years. The average age for males was 48.4 years, and 53.3 years for females. NATIONALITY: 74% were Italian; 26% were foreign (most of whom were Northern and Eastern Europeans) EDUCATION: 47% had five years of schooling; 19% had eight years of schooling; 6% had 13 years of schooling; and in one case, 18 years of schooling. Almost 30% of the subjects had no schooling at all. DURATION OF HOMELESSNESS: 40% were homeless for more than 5 years; 47% were homeless between 1 and 5 years; and 13% were homeless for 6 months. EVENTS LEADING TO HOMELESSNESS: Loss of employment (26%); Departure from home (20%); Immigration (10%); Divorce (10%); Home eviction (8%); Death of a family member who was the only source of income (4%); Financial failure (4%). The literature shows that divorce and poverty, as well as family and living problems predispose women to homelessness and to being victimized by crime. The literature also notes the role that mental illness and substance abuse play. Drug and alcohol use are predisposing factors for homelessness, the commission of crimes, and being the victim of crime . In addition most mental disorders diagnosed in the homeless are correlated to substance abuse , followed by mood, psychotic, and anxiety disorders ; anti-social and personality disorders ; and dual diagnosis . CRIMINAL ASPECTS OF OUR SAMPLE: Fifty-one percent of the crimes committed generally involved offences against property, or violence perpetrated against another person. This is in agreement with the literature, which reports that such crimes among the homeless are tied to the acquisition of, and selling of illegal substances . Another interesting fact taken from the literature regarding the homeless is the high percentage of crimes committed against women . This has also been confirmed by our sample. Forty-three percent of the subjects studied had no previous contact with the legal system: neither as perpetrator, nor as victim . Only 20% had been previously incarcerated. This datum differs from the literature a bit, which reports higher percentages of incarceration of homeless people with respect to our sample. The relationship between homelessness and incarceration is reported in various studies: 73% of males and 27% of females had been arrested at least one time . Gardiner & Cairns (2002) reported that 77% of male subjects in their study had been previously arrested. Moreover, being homeless increases the chances of being detained by the police after being stopped by them. And finally, physical and sexual violence constitutes another significant risk factor that may lead to homelessness . In the end, physical and sexual violence is a significant risk factor for becoming homeless.

Introduction: It seems paradoxical, but the more rational a society becomes, the more its need for spirituality grows. The phenomenon of magical religiosity is not associated with any particular social class, but may be found in all social strata of the population: People often turn in this direction at times when they are unable to face negative life events. Unscrupulous criminals, who take advantage of such weaknesses and problems of others, exploit these characteristics of fragility. The case presented here demonstrates this concept. The Case: The subject is a 53-year-old man who is legally declared as blind, and who has various previous convictions for fraud and sexual abuse on minors. He would convince people that he was a Catholic clergyman and organized masses and personal appearances in which messages from God would supposedly come through him. In addition to overseeing two religious centers where he would gather groups of the “faithful” who believed in his visions, he would also make visits to people’s homes in order to pray and perform religious rites, as well as to offer his assistance in order to help them with their various problems. The case of this “bogus priest” came to our attention following new allegations of sexually abusing five juvenile males, four of them belonging to one family (ages 10, 13, 14, and 17), and the other, their 14 year old cousin. The minors belonged to families with a multitude of problems resulting from economic hardship and relational difficulties. They had come to know the “bogus priest” during prayer meetings. When the imposter had learned of the two families’ problems, he began to make “pastoral visits” where he would offer to host the boys in his sanctuary homes during school breaks and the summer holidays. He eventually requested that custody of the boys be given over to him. He reported the families’ difficulties to social services in a manipulative way. He also stated that the boys had been sexually abused and neglected, but some of the investigations into this alleged abuse had brought his true identity to light. Judicial investigations carried out revealed that the boys had been the objects of sexual abuse at his hands over a period of time. It came out that these episodes had occurred during prayer, at confession, and when receiving spiritual guidance. The victims recounted stories of a well-planned strategy by the “bogus priest” abuser. In addition to isolating them from their families and their home environments, the “bogus priest” touched them on their genitals, asked them to perform sexual acts on each other, tried to engage in oral sex with them, masturbated them, showed them pornographic films, and asked them very intimate questions during “phony confessions”. The fake clergyman also gave the boys money in order that they not reveal what had happened. Moreover, he threatened them, saying that if they divulged what had transpired, they would be institutionalized and would lose all contact with their families. In order to prevent the parents from speaking to each other, or with social service representatives, he spoke badly to each one about the others, thereby creating a situation of isolation and conflict within the families. After being exposed, the “bogus priest” was arrested and found guilty. Conclusions: The literature, as well as clinical and rehabilitation experience on juvenile victims of sexual abuse, all demonstrate that the psychological damage to developmental processes on minors is much more severe when the abuser is a significant figure who is emotionally tied to the victim, particularly mothers and fathers. For this reason, intrafamilial sexual abuse is particularly serious and harmful to a child. We can hypothesize that a priest is perceived as a father insomuch as children have fewer instruments to separate the concept of God the father from a concrete figure who represents him. It is probable,

In the course of their work, experts in the field of forensics must evaluate not only the validity of what has been reported to them, but also the validity of who does the reporting. The entire relationship between subject and forensic science specialist is influenced by a series of elements that may alter the genuineness of a diagnosis (e.g. the examiner’s style; the rigid and constrictive nature of the exam; the repercussions of the outcomes of the exam; the need for the results to be reported to a third party; and the tendency of evaluated subjects to dissemble. Concealment of a syndrome represents a problem in the diagnostic process that results in an increase of false positives. A dissembler is a person who is well aware of the truth, but denies it by mentally managing two conflicting affirmations. In the field of legal medicine and forensics it is necessary to face up to the limits of subjectivity and clinical observations. The use of psychodiagnostic instruments, in these cases, appears to be indispensible. The MMPI-2 test is the principal instrument possessing indices that are able to root out concealing behaviors in subjects who are being examined “Lying and concealing” behaviors are accompanied by verbal and non-verbal elements, including such paralinguistic clues as body language. “The latency period” plays a particularly interesting role among the various forms of non-verbal behavior, and is often considered to be a non-verbal sign that the subject is probably lying . Beginning with the hypothesis that one can expect a longer response time by dissemblers because of their need to “manage mental information”, the goal was set to verify potential information in connection to response times on the MMPI-2 test items as an instrument that can identify concealing behaviors. This study was conducted using the computerized version of the MMPI-2, which is able to automatically calculate response times. Fifty-nine males and 17 females were enlisted and subdivided into four groups based on the reasons for which they underwent legal medical assessment: candidate for a driver’s license; suitability to carry a firearm; appropriateness for a particular job; and fitness to be a parent. These subjects were compared to a control group made up of voluntary subjects deemed to be clinically healthy and not influenced by ulterior advantages or interests regarding the completion of the test. This group was controlled for number, age, and level of education. The usefulness of response times in identifying “dissemblers” from the control gro

After attending this presentation, attendees will understand that assaults by psychiatric patients against mental health care providers is a significant occupational risk for health care staff in private and public acute psychiatric facilities and rehabilitation wards. The review of literature shows that aggressive behavior, in most cases, involves verbal aggression and that physicians and nurses reported the highest prevalence of violence. Several surveys revealed that younger patients (=25-30 years of age) with multiple diagnoses, including substance abuse, psychotic behavior, and non-compliance to treatment are at the greatest risk of violent behavior, without a great gender difference. This presentation will impact the forensic science community by emphasizing that mental health professionals can become victims of lethal assault by psychiatric patients, with minor injuries being more common (i.e., resulting in missed days of work or assignments to limited duty). Multiple or life-threatening injuries (i.e., fractures, lacerations, bruises, or a loss of consciousness) are sustained by a smaller percentage of staff members. A case of a 53-year-old female psychiatrist who was found stabbed in her office in a mental health center was reported. A 44-year-old male was charged with this fatal assault. He had been previously admitted to the hospital with suicidal ideation and confusion. A 14.5 centimeters-long kitchen knife (single cutting edge) was found in the office. The autopsy revealed 70 stab wounds: four superficial wounds of the supraclavicular and cervical areas; three abdominal wounds penetrating the liver; eight wounds of the thorax penetrating the lungs; forty-two wounds of the back (twenty-eight of which penetrated pleural cavities); six superficial wounds of the lumbar region; and seven superficial wounds of the upper arms. The same knife found in the crime scene caused all of the wounds. Death was attributed to massive hemorrhagic shock. The forensic psychiatric expert highlighted a borderline-antisocial personality disorder; the perpetrator was judged competent to stand trial and the prosecutor asked for 30 years in prison. Results from the literature review indicate that patient aggression toward mental health care professionals is common and worldwide. These incidents raised the controversial debate regarding the potential danger posed by individuals with mental illness, as psychiatrists have a 5% to 48% chance of experiencing a physical assault by a patient during their career. According to the United States Department of Justice’s National Crime Victimization Survey conducted from 1993 to 1999, the annual rate of non-fatal, job-related violent crime was 12.6 per 1,000 workers in all occupations. Among physicians, the rate was 16.2 per 1,000 and among nurses was 21.9 per 1,000; however, for psychiatrists and mental health care professionals, the rate was 68.2 per 1,000, and for mental health custodial workers the rate was 69 per 1,000.1 The most common type of aggression has minor consequences (mostly psychological as symptoms suggestive of post-traumatic stress disorder) and has usually occurred in crowded and unstructured settings without weapons, but a few cases of serious injuries or death are reported. Mental health care practitioners have to be aware that risk factors for violence are divided into two categories: static (psychiatric diagnoses of major mental illness and prior history, young adulthood, lower intelligence, history of head trauma or neurological impairment, dissociative states, history of military service, and weapons training) and dynamic (substance abuse or dependence, persecutory delusions, command hallucinations, treatment non-compliance, impulsivity, homicidality with a feasible homicidal plan, depression, hopelessness, suicidality, and access to weapons). A multidisciplinary continuing education curriculum

The development and diffusion of Information and Communication Technologies has resulted in a profound change in the way in which we learn, we relate to others and build their identity. Internet and social media are tools and contexts to improve knowledge and skills but also put themselves at risk to get involved in violent and aggressive interactions relationships as in the case of cyber bullying. The Cyberbullying refers to aggressive behavior, intentional deployed by one or more individuals, using electronic means, repetitively and continuously against a person who can not easily oppose (Smith et al., 2008). The study aims to assess the prevalence of bullying and cyberbullying and to deepen the effect of the Internet and the use of technological communication tools on the quality of relationships among adolescents. The sample is a group of 85 students aged between 10 and 13 years. The results confirm both the spread of bullying and cyber bullying that relations between these two phenomena. Moreover, it appears that only in particular conditions, technological means of communication and internet increase the risk of involvement in aggressive interactions.

This work analyses the psychological assessment in traffic psychology focusing on the Expert System Traffic (EST), a computerized psychological assessment tool of the Vienna Test System. This tool includes various neuropsychological cognitive tasks (assessing attention, memory, visuomotor ability, etc.), some personality inventories (measuring aggressiveness, emotional stability, etc.), two scales of alcol assumption and risk taking behaviour in presence of dangerous conditions. The absence of cognitive deficits, aggressive personality traits and acting behaviours prone to risk taking in dangerous situations seems to be a crucial feature of driving ability. The EST is a very high standardized procedure. Furthermore, its ability to measure a complex and multifactorial behaviour like the driving ability, makes the EST the most valid assessment of driving-specific ability in the whole context of traffic psychology.

L’autore analizza una peculiare forma di omicidio del figlio, definito in letteratura maltrattamento con esito fatale. Nella prima parte del lavoro sono descritte dall’Autore le caratteristiche criminologiche del delitto, le modalità di azione; poi viene tratteggiato il peculiare assetto sociale ed ambientale entro cui simili delitti si verificano, infine presentati i caratteristici profili di personalità degli autori. Viene quindi presentato un caso, ritenuto di particolare interesse. Si tratta di caso davvero raro perché nel mondo occidentale la morte per fame costituisce una assoluta eccezione; è particolarmente interessante sul piano psichiatrico-forense perché nell’occasione fu possibile sottoporre ad accertamento tecnico entrambi i caregivers coinvolti nella vicenda. L’eccezionalità e l’estrema crudeltà della condotta delittuosa si fronteggiano con la sostanziale “banalità” del profilo psicopatologico dei due autori. L’autore richiama la necessità di indagine cliniche allargate, tese alla comprensione del percorso di vita dell’individuo, delle soggettive chiavi di senso, le uniche che consentano di restituire comprensibilità ed intellegibilità alle condotte criminose, spogliandole così dell’antico, ma resistente, pregiudizio di follia. Il caso è splendida occasione per affrontare il tema dell’imputabilità in casi simili, laddove cioè l’estrema crudenltà della condotta lasci sospettare l’esistenza di una infermità di mente.

An estreme case of family violence on a child. Marianna is a child dead by hardships. The case, apparently far from nursing daily practice, is the occasion for reflecting how often the nursing profession witnesses situations at risk of remaining invisible unless somebody decides to take them on collecting data, reporting signals, carefully observing.

The case presented here concerns an unusual type of strangulation homicide whereby a rope is passed around the victim’s wrists, ankles, and throat resulting in suffocation by auto-asphyxia. The literature usually refers to this method as “incaprettamento” (i.e. “trussed up like a goat”), a method employed by organized crime groups such as the Italian Mafia, but also used in the execution of war crimes, or in various other cultural-anthropological contexts, This method of killing is meant to impart a particularly degrading and humiliating revenge on the victim. It also serves as sign of intimidation and a warning to others.To all appearances, the case presented here is different than those usually reported in the literature. The unusual way in which the killing took place, along with its symbolic meaning, seems to have both military and anthropological origins that reflect the culture to which the perpetrator belonged. This case study, offers the opportunity to analyze the interaction between these factors and those derived from the experience of a rigid military environment such as that of the Foreign Legion.

In ambito forense usare strumenti che consentano l’individuazione di casi in cui è presente una minimizzazione della patologia può costituire un significativo contributo per l’accertamento della validità dei risultati acquisiti e per stabilire la credibilità di quanto viene riportato dai soggetti esaminati. Il test MMPI-2 è uno dei pochi strumenti psicodiagnostici che consente l’individuazione di condotte distorsive. Il primo obiettivo di questo lavoro di ricerca è presentare gli esiti del tentativo di individuare condotte di dissimulazione tramite l'adozione di indici ricavati non da singoli item, ma dal confronto relativo a tutte le intere scale dello strumento. Un secondo obiettivo è mettere a punto un nuovo indice di dissimulazione in grado di fornire una indicazione ancora più affidabile sulla probabilità di dissimulazione da parte del valutando se confrontato con alcuni consueti indici di dissimulazione all'MMPI-2. Il Campione sperimentale è composto da 67 soggetti maschi, potenziali dissimulatori in quanto interessati a risultare sani in vista dell’ottenimento di un certificato di idoneità al lavoro, al porto d’armi, alla patente di guida o all’adozione, presso la Clinica Psichiatrica e la Sezione di Criminologia e Psichiatria forense del Policlinico di Bari, e 2 Consultori Familiari afferenti all'Azienda Sanitaria Locale di Bari. Campione di controllo: 62 soggetti maschi, volontari, clinicamente sani Per quanto riguarda i risultati preliminari: Delle 48 scale prese in considerazione, 28 hanno soddisfatto il criterio di significatività p=0,001, differenziando il gruppo sperimentale da quello di controllo. Per ridurre la ridondanza di eventuali scale altamente correlate tra loro sono state eseguite 28 regressioni multiple standard ognuna con una delle 28 scale come criterio e le altre 27 come predittori. Sono state selezionate le 20 scale che ottenevano un valore di Square Multiple Correlation minore o uguale 0.20. Queste 20 scale sono state poi inserite in un modello di analisi discriminante stepwise forward preliminare. Dall'analisi emerge che il miglior indicatore sul piano della discriminazione tra campione di controllo e sperimentale è la scala Pt, seguita da L e da Hs e da altre sei variabili. E’ stato anche calcolato un nuovo indice per la dissimulazione in ambito forense, la Forensic Evaluation Dissimulation Index. L’indice FEDI ha soddisfacenti indici di Sensibilità (0.82), Specificità (0.81), Likelihood ratio positivo (4.32) e negativo (0.22), poteri predittivi positivo (0.81) e negativo (0.82). Questo lavoro di ricerca pone le basi di un più ampio progetto di ricerca volto all’identificazione di innovative e valide strategia per l’accertamento di condotte distorsive nell’ambito di valutazioni forensi. L’analisi dei dati evidenzia un modello a tre predittori (PT, L e HS) in grado di riclassificare la quasi totalità dei partecipanti ammessi a visita (97%) e quasi il 63% dei partecipanti di controllo. Una seconda metodologia può basarsi sul superamento di un valore soglia. Il Forensic Evaluation Dissimulation Index (FEDI), presenta soddisfacenti indici di sensibilità, specificità e Likelihood Ratio e sembra di semplice utilizzazione ottenendo sempre risultati decisamente migliori rispetto ad altre scale ed indici con simili caratteristiche. L’indice FEDI oltre a presentare un alto livello di accuratezza diagnostica (0.90), risulta un indice maneggevole e spendibile in diversi ambiti.

Abstract INTRODUCTION: Gender identity disorder (GID) is a mental disorder in which gender identity is incongruent with the anatomical sex, in the absence of any clear and defined genetic or biological alteration. The diagnosis of GID as well as the assessment of patient eligibility for sex reassignment surgery (SRS) are prerequisite to the legal recognition procedure. The aim of this study was to evaluate the usefulness of the Rorschach test in differential diagnosis determination and primarily in providing information on patient eligibility for SRS, in the framework of the clinical, therapeutic and forensic psychometric and psychodiagnostic assessment, and according to the World Professional Association for Transgender Health (WPATH) criteria. MATERIALS AND METHODS: For this purpose we analysed the Rorschach test of 47 patients (33 GID and 14 GID NAS). RESULTS: Results show that GID NAS patients have greater difficulties in stress control and less adaptability, which could lead to disorganisation, impulsiveness, behavioural disorders, as well as higher levels of situational and chronic stress, with altered thought patterns and uncontrolled ideation, a higher frequency of thought disorders and disturbed relations, with lower quality and less adaptive interpersonal relationships, which are characterized by dependency and aggressive behaviours. CONCLUSIONS: This research shows that the Rorschach test cannot be used alone in the determination of the differential diagnosis between GID and GID NAS in the diagnosis and evaluation of patient eligibility for SRS, especially when comparing groups which do not shows significant differences in the prevalence of the main psychopathological disorders.

An ample volume of research evidence supports the conclusion that severe mental illness is correlated with violent behavior. While episodes of violent behavior are included in medical notes, not all episodes of violent behavior are officially reported to the police, even when they are actual crimes. We conducted a retrospective study on the already existing clinical files of four public psychiatric outpatient facilities, based in Southern Italy, in order to assess how many cases of violent behavior are actually reported and which variables are more frequently connected with the decision to report. The data shows that the episodes known to the health services, in number and seriousness, vastly outnumber the complaints actually made towards their patients.