Civil commitment of sociopaths

I recently read an interesting discussion of the civil commitment of sex offenders in the Journal of the American Academy of Psychiatry and the Law by Shoba Sreenivasan, Ph.D. and colleagues. I had some thoughts about the article I’d like to share with you.

Many states in the United States now have laws that allow for a sexually violent predator (SVP) or a sexually dangerous person (SDP) to be committed to a mental hospital or forced into outpatient supervision once they have completed their prison sentence. In these states, mental health professionals are asked to evaluate potentially dangerous sociopaths and decide whether there is enough risk to society to warrant either inpatient or forced outpatient treatment. If an offender is deemed to be a SDP/SVP they can be committed indefinitely, only California has a specified renewable term of 2 years.

To qualify as aSVP/SDP an offender (1) has to be convicted of the offenses determined by the state to constitute a sexually violent crime; (2) to suffer from a diagnosed mental disorder; and (3) as a result of that disorder, represent a risk to public safety if released to the community.

Notice that SDP/SVP laws are designed to detect the “mentally disordered” and to differentiate them from other offenders who are presumed to be normal (?). (Is anyone who commits a sexually violent crime normal?) The intent of the SVP/SDP laws is not punishment of the offender but protection of society.

The authors of the article point out that antisocial personality disorder (sociopathy/psychopathy) can be one of the mental disorders used to justify commitment. ASPD is recognized to qualify as “a congenital or acquired condition affecting the emotional or volitional capacity that predisposes the person to the commission of criminal sexual acts to a degree constituting the person a menace to the health and safety of others.”

Granted, not every sociopath is a sex offender, and not every sociopath who commits a sexual offense is deemed to be a SVP/SDP. For example if an offender breaks into a person’s home to steal things, discovers a victim and then assaults, that is different from the offender who breaks in to look for a sexual victim and doesn’t take the jewelry.

The idea behind these laws is that the mental disorder causes the person to offend and diminishes his/her capacity to resist reoffending. In Minnesota for example, “Sexual psychopath personality” means the existence in any person of such conditions of emotional instability, or impulsiveness of behavior, or lack of customary standards of good judgment, or failure to appreciate the consequences of personal acts, or combination of any of these conditions, which render the person irresponsible for personal conduct with respect to sexual matters, if the person has evidenced, by a habitual course of misconduct in sexual matters, an utter lack of power to control the person’s sexual impulses and, as a result, is dangerous to other persons.

These laws all raise the question of the sociopath’s choice with respect to behavior. They imply that the sociopath has diminished choice and that the predatory behavior is a compulsion.

I am very much in favor of these SVP/SDP laws. I just wish we applied the same reasoning to other compulsions sociopaths have. For example. What about con artists? Don’t they evidence, “by a habitual course of misconduct in truthful matters, an utter lack of power to control the person’s lying impulses and, as a result, is dangerous to other persons.” While we recognize the terrible impact of sexual assault on victims, we tend to minimize or not recognize the psychological rape perpetrated by con artists.

Many sociopaths are “criminally versatile” in that they compulsively commit many different classes of crimes. Why can’t we recognize that sociopaths have a personality disorder that indeed makes them dangerous to other people, and subject them to more careful supervision once they are released from prison?

The states that have SVP/SDP laws are Arizona, Illinois, Wisconsin, California, Florida, Iowa, Kansas, Missouri, New Jersey, South Carolina, Texas, Virginia, Washington, Massachusetts, Minnesota, North Dakota and Tennessee.

For more discussion see:Sreenivasan, S., Weinberger, L., & Garrick, T. (2003). Expert testimony in sexually violent predator commitments: conceptualizing legal standards of “mental disorder” and “likely to reoffend”. Journal of the American Academy of Psychiatry and the Law Online, 31(4), 471-485.