Publications
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Bjørgen, Tale Gjertine; Reitan, Solveig Klæbo; Lydersen, Stian; Rasmussen, Kirsten & Narud, Kjersti
(2026).
Assessment of neurodevelopmental disorders (ND) and comorbid substance use disorders (SUD) in a highly violent forensic population.
Journal of Forensic Psychiatry & Psychology.
ISSN 1478-9949.
doi:
10.1080/14789949.2026.2726856.
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Bjørgen, Tale Gjertine; Reitan, Solveig Klæbo; Lydersen, Stian; Rasmussen, Kirsten; Søndenaa, Erik & Narud, Kjersti
(2024).
Assessments of neurodevelopmental functional impairments in Norwegian forensic reports on severe violent defendants.
Journal of Forensic Psychiatry & Psychology.
ISSN 1478-9949.
doi:
10.1080/14789949.2024.2444357.
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Adaptive behaviour is closely related to intellectual and neurodevelopmental functions. Impairment in these areas is associated with difficulties in education, work, and daily living. The ability to adapt to rules and laws may sometimes be affected. Therefore, impairments in adaptive functions may be relevant in the evaluation of criminal responsibility and potential special criminal sanctions, necessitating a special focus on neurodevelopmental functions and adaptive behaviours in forensic examinations. 100 Norwegian forensic reports were reviewed. Standard assessments and clinical and anamnestic descriptions of symptoms related to intellectual and neurodevelopmental conditions were recorded. Sub-criteria of neurodevelopmental diagnoses described were divided into four categories: intellectual impairment, adaptive dysfunctions, autism spectrum disorders, and attention deficit/hyperactivity disorder. The characteristics of the four categories were further explored. The description of at least one conditional category was detected in 84% of the reports, while 65% described more than two categories, and 43% described more than three categories. Symptoms from all four categories were described in 22%. Intellectual impairment symptoms were present in 57% of the reports. In only 12% of the reports a diagnosis regarding neurodevelopmental difficulties was set. The use of standardized assessments to explore neurodevelopmental functional symptoms as well as a discussion on related difficulties were limited. There is a need for more research, increased awareness, and training related to such impairments for forensic experts.
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Løvgren, Pia Jorde; Laake, Petter; Narud, Kjersti; Reitan, Solveig Klæbo & Bjørkly, Stål Kapstø
(2023).
Are symptoms assessed differently for schizophrenia and other psychoses in legal insanity evaluations of violent crimes?
BMC Psychiatry.
23(1),
p. 1–14.
doi:
10.1186/s12888-023-04992-6.
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Background: Forensic evaluations of legal insanity include the experts’ assessment of symptoms present at the mental
state examination (MSE) and the mental state at the time of offense (MSO). Delusions and hallucinations are most
important. We explored how often symptoms were recorded in written forensic reports.
Design: This exploratory, cross-sectional study included 500 reports of legal insanity written in 2009–2018 from cases
of violent crimes in Norway. The first author read all reports and coded symptoms recorded from the experts’ assessments
of the offenders. Two co-authors repeated this procedure for 50 randomly selected reports. Interrater reliability
was calculated with Gwet’s AC1.
Generalized Linear Mixed Models with Wald tests for fixed effects and Risk Ratios
as effect sizes were used for the statistical analyses.
Results: Legal insanity was the main conclusion in 23.6% of the reports; 71.2% of these were diagnosed with schizophrenia
while 22.9% had other psychotic disorders. Experts recorded few symptoms from MSO, but more from MSE,
although MSO is important for insanity. We found a significant association between delusions and hallucinations
recorded present in the MSO and legal insanity for defendants with other psychotic disorders, but no association
for defendants with schizophrenia. The differences in symptom recordings between diagnoses were significant.
Conclusion: Few symptoms were recorded from the MSO. We found no association between presence of delusions
or hallucinations and legal insanity for defendants with schizophrenia. This may indicate that a schizophrenia diagnosis
is more important to the forensic conclusion than the symptoms recorded in the MSO.
Keywords: delusions, hallucinations, forensic, insanity, bias, stigma
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Løvgren, Pia Jorde; Laake, Petter; Reitan, Solveig Merete Klæbo & Narud, Kjersti
(2022).
Use of assessment instruments in forensic evaluations of criminal responsibility in Norway.
BMC Psychiatry.
22(1),
p. 1–14.
doi:
10.1186/s12888-022-03831-4.
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Objectives
Assessment instruments are often used to enhance quality and objectivity in therapeutic and legal settings. We aimed to explore the use of instruments in Norwegian reports of forensic evaluations of criminal responsibility; specifically, whether this use was associated with diagnostic and forensic conclusions.
Methods
Our study has an exploratory cross-sectional design. We examined 500 reports filed with the Norwegian Board of Forensic Medicine in 2009–2018 regarding defendants indicted for the most serious violent crimes. The first author coded data from all reports according to a registration form developed for this study. Two co-authors then coded a random sample of 50 reports, and inter-rater reliability measures were calculated. The first author coded 41 reports for calculation of intra-rater reliability. Descriptive statistics are presented for the use of assessment instruments, and a generalized linear mixed model (GLMM) was used to estimate associations between the use of instruments and diagnostic and forensic conclusions.
Results
Instruments were used in 50.0% of reports. The Wechler’s Adult Intelligence Scale (WAIS), Historical Clinical Risk-20 (HCR-20), and the Structured Clinical Interview for DSM disorders (SCID I), were used in 15.8, 13.8, and 9.0% of reports, respectively. The use of instruments increased from 36% in 2009 to 58% in 2015; then decreased to 49% in 2018. Teams of two experts wrote 98.0% of reports, and 43.4% of these teams comprised two psychiatrists. In 20.0% of reports, the diagnostic conclusion was schizophrenia, and in 8.8% it was other psychotic disorders. A conclusion of criminal irresponsibility was given in 25.8% of reports. Instruments were more often used in reports written by teams that comprised both a psychiatrist and a psychologist, compared to reports by two psychiatrists. The use of instruments was strongly associated with both diagnostic and forensic conclusions.
Conclusion
Instruments were used in 50% of reports on forensic evaluations of criminal responsibility in Norway, and their use increased during the study period. Use of instruments was associated with diagnostic and forensic conclusions.
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Løvgren, Pia Jorde; Laake, Petter; Reitan, Solveig Merete Klæbo & Narud, Kjersti
(2020).
Assessing psychotic symptoms in forensic evaluations of criminal responsibility–a pilot study using Positive And Negative Syndrome Scale.
Journal of Forensic Psychiatry & Psychology.
ISSN 1478-9949.
31(4),
p. 490–502.
doi:
10.1080/14789949.2020.1771402.
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Description of symptoms and signs related to psychotic disorders at the time of the crime is essential in forensic evaluations of legal insanity. Knowledge of the content of forensic reports is important to improve and secure their quality. Here we report the findings of a pilot study using PANSS as an instrument to assess descriptions of psychotic symptoms in forensic psychiatric reports. Three experienced psychiatrists assessed 20 forensic reports focusing on forensic experts’ descriptions of the defendant’s mental state at the time of the observation and at the time of the alleged crime. PANSS was evaluated as a tool for examining relevant psychotic symptoms, and interrater reliability was calculated. Interrater reliability was satisfactory. It varied based on the percentage of symptoms not described in the reports and on the type of symptom. At both times more symptoms were described from the positive scale of PANSS, than from the negative and the general scale. This pilot study shows that PANSS can be used as an instrument for the structured assessment of psychotic symptoms in written forensic reports and indicates that psychotic symptoms at the time of the alleged crime are poorly described.
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Narud, Kjersti; Mykletun, Arnstein & Dahl, Alv Andreas
(2005).
Therapists' handling of patients with cluster B personality disorders in individual psychotherapy.
Comprehensive Psychiatry.
ISSN 0010-440X.
46(3),
p. 186–191.
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Narud, Kjersti; Mykletun, Arnestein & Dahl, Alv A
(2005).
A comparison of gains after treatment at a psychiatric outpatient clinic in patients with cluster A+B, or cluster C personality disorders, and non-psychotic axis I disorders.
Nordic Journal of Psychiatry.
ISSN 0803-9488.
59,
p. 331–338.
doi:
10.1080/08039480500319506.
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Narud, Kjersti; Mykletun, Arnstein & Dahl, Alv Andreas
(2005).
Quality of life in patients with personality disorders seen at an ordinary psychiatric outpatient clinic.
BMC Psychiatry.
5(1).
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Narud, Kjersti; Mykletun, Arnstein & Dahl, Alv A
(2005).
Quality of life in patients with personality disorders seen at an ordinary psychiatric outpatient clinic.
BMC Psychiatry.
5.
doi:
10.1186/1471-244X-5-10.
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Background Epidemiological studies have found reduced health-related quality of life (QoL) in patients with personality disorders (PDs), but few clinical studies have examined QoL in PDs, and none of them are from an ordinary psychiatric outpatient clinic (POC). We wanted to examine QoL in patients with PDs seen at a POC, to explore the associations of QoL with established psychiatric measures, and to evaluate QoL as an outcome measure in PD patients. Methods 72 patients with PDs at a POC filled in the MOS Short Form 36 (SF-36), and two established psychiatric self-rating measures. A national norm sample was compared on the SF-36. An independent psychiatrist diagnosed PDs and Axis-I disorders by structured interviews and rated the Global Assessment of Functioning (GAF). All measurements were repeated in the 39 PD patients that attended the 2 years follow-up examination. Results PD patients showed high co-morbidity with other PDs and Axis I mental disorders, and they scored significantly lower on all the SF-36 dimensions than age- and gender-adjusted norms. Adjustment for co-morbid Axis I disorders had some influence, however. The SF-36 mental health, vitality, and social functioning were significantly associated with the GAF and the self-rated psychiatric measures. Significant changes at follow-up were found in the psychiatric measures, but only on the mental health and role-physical of the SF-36. Conclusion Patients with PDs seen for treatment at a POC have globally poor QoL. Both physical and mental dimensions of the SF-36 are correlated with established psychiatric measures in such patients, but significant changes in these measures are only partly associated with changes in the SF-36 dimensions.
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Narud, Kjersti; Mykletun, Arnstein & Dahl, Alv A
(2003).
Experienced therapists' view on central issues in psychodynamic psychotherapy of patients with personality disorders.
Nordic Journal of Psychiatry.
ISSN 0803-9488.
57,
p. 461–467.
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Narud, Kjersti; Mykletun, Arnstein & Dahl, Alv Andreas
(2003).
Experienced therapists' opinions on central issues in psychodynamic psychotherapy of patients with personality disorders.
Nordic Journal of Psychiatry.
ISSN 0803-9488.
57(6),
p. 461–467.
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Individual psychodynamic psychotherapy is a recommended, but controversial, treatment for patients with personality disorders ( PDs). The aim of this study was to examine the relationship between demographic and professional characteristics of experienced psychotherapists and their attitudes and opinions towards aspects of this kind of psychotherapy. A questionnaire covering these issues of psychodynamic psychotherapy with patients belonging to all three DSM- IV clusters of PD was developed. A sample of 324 Norwegian psychiatrists and clinical psychologist with considerable experience in individual dynamic psychotherapy of patients with PDs filled in valid questionnaires. The therapists' age, gender, profession, postgraduate courses and degree of experience were examined as to their opinions on the following issues: alliances, aims, contraindications, needs to terminate, suicides, use of drugs, length of treatment, need for supervision and complaints to colleagues about patients' behaviour in such therapy with PD patients. Independent sample t - tests of the mean z - transformed group scores were the main statistical method applied. Therapist experience made the most significant differences as to treatment issues, while some differences also were found for age, gender and profession. The influence of postgraduate courses was negligible. Our study might have a selection bias towards therapist with strong psychodynamic orientation and particular interest in the psychotherapy of patients with PDs
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Narud, Kjersti & Dahl, Alv A
(2002).
Quality of life in personality and personality disorders.
Current Opinion in Psychiatry.
ISSN 0951-7367.
15,
p. 131–133.
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Narud, Kjersti
(2013).
How high profile offenders are dealt with by the courts, media and expert witnesses in different jurisdictions.
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Narud, Kjersti; Friestad, Christine & Dahl, Alv A
(2013).
Stalking experiences and associated factors – a controlled population-based study from Norway.
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Stalking is defined as a constellation of behaviours in which one individual inflicts on another repeated unwanted intrusions and communications.
The aim of the study is to get systematic knowledge on stalking experiences in a representative population sample of Norwegians aged 20 to 59 years. Information has been collected by a postal questionnaires covering three areas: 1) Socio-demographic data; 2) Data on health status, coping styles, hazardous alcohol use, mental distress, patterns of attachment, social avoidance, neuroticism and personality problems; and 3) Data on stalking experiences. Part 1) and 2) are filled in by both cases and controls, while Part 3) only is responded to by individuals who have stalking experiences. Based on this data, the study aims to describe:
· The prevalence of stalking and its subtypes in a representative sample of Norwegian adults aged 20 to 59 years.
· Differences between individuals exposed to stalking compared to unexposed ones concerning socio-demographic factors, global health, coping styles, hazardous alcohol use, mental distress, patterns of attachment, social avoidance, neuroticism and personality problems.
· Significant associations between the intensity of the stalking experience and global health, hazardous alcohol use, mental distress, social avoidance, personality problems adjusted for confounders.
This is a cross-sectional postal questionnaire study in which an age and gender representative sample of 5,000 Norwegians aged between 20 and 59 years of age were invited to participate. The response rate is approximately 30 %, as 1520 individuals have responded.
Data from the population study will be presented at the conference.
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Narud, Kjersti; Friestad, Christine & Dahl, Alv A
(2012).
Stalking experiences and associated factors – a controlled population-based study from Norway.
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Narud, Kjersti; Mykletun, Arnstein & Dahl, Alv Andreas
(2003).
Quality of Life in Outpatients With Personality Disorders.
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Kilden, Stine; Eidhammer, Gunnar & Narud, Kjersti
(2024).
Sikkerhetspsykiatri i Norge 2023 - En statusrapport (PDF).
Oslo universitetssykehus HF.
ISSN 9788269221831.
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Formålet med denne rapporten er å beskrive utviklingstrekk og status ved norske sikkerhetsavdelinger, særlig med hensyn til kapasitet, organisering, aktivitet, kompetanse og pasientpopulasjon. Rapporten redegjør også for utvikling og konsekvenser av strafferettslige innleggelser og rettspsykiatrisk virksomhet, og har for første gang inkludert spørsmål om behandlingstilbudet til barn, unge voksne og kvinner i sikkerhetsavdelingene.
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Published
May 8, 2019 9:17 AM
- Last modified
Oct. 19, 2020 3:03 PM
