Sage Journals: Discover world-class research

Abstract

Objective: Environmental influences have been reported to play a role in the genesis of both schizophrenia and violent behaviour.

Method: We studied the central features of the family and social influences of 103 healthy non-offenders, 103 non-schizophrenic offenders, 103 schizophrenic non-offenders, and 103 schizophrenic offenders, using a semistructured instrument.

Results: Lower social class of origin, offending behaviour in the parental generation, loss of the father, a new partnership of the remaining parent, growing up in blended families, larger sibships and stays in foster homes during childhood and adolescence, promoted the development of offending behaviour in general. Schizophrenic patients were more likely to have relatives with schizophrenia, a finding which was more marked among offenders than non-offenders.

Conclusions: We were able to identify characteristic unfavourable family and social influences which were associated in schizophrenic patients with a high risk of offending behaviour. This offers the prospect of early detection of those with schizophrenia who will go on to offend.

Keywords

antisocial behaviour family structure schizophrenia socialization

Several familial and non-familial environmental factors are supposed to interact with genetic dispositions, both in the development of schizophrenia and that of antisocial behaviour [1, 2]. Florid psychotic symptomatology and comorbid substance use are generally accepted to be important determinants for the development of aggressive behaviour in patients suffering from schizophrenia [3–6]. However, little is known about the way genetic and certain social and familial factors may interact in the development of offending behaviour in these patients.

A considerable body of literature points to an association between advanced paternal age and later development of schizophrenia in offspring [7–10]. The socioeconomic status of the family of origin is also of importance, with an increased risk of schizophrenia being reported in association with parental unemployment and lower parental income [11]. The loss of one or both parents seems to be a non-specific environmental stressor increasing the vulnerability to major mental disorders in general [12–16]. Furukawa et al. concluded that childhood parental loss per se is not pathogenic for schizophrenia, but exerts influence on the expression of symptoms [17]. The potential association between schizophrenia and sibship characteristics like sibship size, birth order, birth intervals of siblings has been repeatedly investigated. However, the results of this research are divergent: while some studies found an over-representation of schizophrenia among first- or early born male children [18–21], others reported increased rates of schizophrenia among last-born children [22, 23], among younger children [24], only children [25], or among twins [26]. Recently, Pedersen et al. found children with half-siblings to be at an increased risk for schizophrenia [25]. In contrast, some studies reported no [27] or a primarily culture-dependent influence of birth order on the development of schizophrenia [28].

This is evidence for genetic influences in the different forms of antisocial and criminal behaviour [2, 29]. However, results of adoption studies indicate that the genetic burden of children of offending parents was only expressed if a child was adopted away into a dysfunctional familiar environment [30]. Countless studies on the association between social environment and later criminality reported higher rates of violent behaviour among members of lower social classes (e.g. [31, 32]). Aside from socioeconomic factors in general, family structures were also found to have an impact on the development of antisocial personality traits. Independent of study design, most studies came to similar results: later offenders are growing up more frequently in structurally incomplete families [31,33–35]. Only a few studies dealt with an association between number of siblings or birth order and criminal behaviour. Among offenders, Göppinger [31] found high rates of subjects with five or more siblings. In contrast, Kemppainen [21] reported an over-representation of only children among male offenders. In an early German study on sex offenders, 38% were first-born and about one-third were without siblings [36]. Krakowski and Czobor [37] found that violence against others was associated with having a history of foster home placement.

Aim

In schizophrenic offenders, the interactions between socioeconomic status and family structures have not been investigated until now. To examine the relevance of these factors in the development of criminal behaviour in patients with schizophrenia, we chose a four-group design encompassing healthy non-offenders, nonschizophrenic offenders, schizophrenic non-offenders, and schizophrenic offenders.

Method

Subjects

The schizophrenic offender group consisted of 103 male inmates of the Justizanstalt Göllersdorf, Austria's central high security institution for the treatment of mentally ill offenders [38]. The patients were between 18 and 62 years of age, and all had been found not guilty by reason of insanity. The severity of their index offence was classified according to Taylor [39] (for details see also Stompe et al. [5]). The 103 non-schizophrenic offenders were recruited from a large correctional institution in Vienna. Subjects with major mental disorders were excluded. The 103 schizophrenic non-offenders were drawn from the consecutive admissions to the Psychiatric University Clinic Vienna and an affiliated rehabilitation centre for patients suffering from chronic schizophrenia. Patients with a history of violence (documented in case files and by interviews of patients and collaterals) were excluded. The healthy non-offending group consisted of 103 male inmates without a history of violence and without any axis 1 diagnosis. Their social origin corresponded with that of the Austrian general population [40]. The non-schizophrenic offenders, the schizophrenic non-offenders as well as the healthy non-offenders were matched with the schizophrenic offenders for age (±2 years), the non-schizophrenic offenders additionally for the severity of the index offence.

Measures

All subjects were informed about the aims of the study and gave their written consent. The Structured Clinical Interview for DSM-III (SCID-I) [41] was administered by TS and GO-S. Family structures were investigated by use of a modified version of the Socialization Report (SOREP), a semistructured instrument originally developed for the documentation of socialization patterns in transcultural studies [28], which delivered an interrater reliability for 20 subjects (10 patients, 10 controls) ranging between kappas of 0.86 and 1.00. The SOREP contains four sections: section 1 describes the parental social status and the subjects' education and actual employment status. This section also documents the existence of offending and/or mentally ill family members. Section 2 deals with the family structure between birth and age 18, the subject's age at parental loss, the type of parental loss, and possible new partnerships of the care-giving parent (Fig. 1).

Figure 1.

Diagram of possible developments of parent relationship.

A blended family is defined as a common household comprising the subject, one natural parent, his or her new partner, and step- and/or half-sibs [42]. Section 3 of the SOREP deals with sibling structure and birth orders, and section 4 documents stays in foster homes for more than 1 year during three different periods of life (0–5 years, 6–10 years, 11–15 years of age).

Statistical analysis

Statistical analyses were conducted by means of the Statistical Package for the Social Sciences, version 12.5. Chi-square tests and one-way ANOVA + Duncan test were used to compare the socialization variables of the four samples, Non-par chi-square tests to compare the observed positions in the sib orders with the expected values. To determine the patterns of socialization differentiating between the four groups a discriminant analysis was performed including those variables showing statistically significant results (p<0.01) in univariate tests.

Results

The parental age at birth of the four groups showed no significant differences (Table 1). The socioeconomic status of the family of origin of non-schizophrenic offenders, schizophrenic non-offenders and schizophrenic offenders differed statistically significantly from that of the Austrian general population represented by our healthy nonoffending sample. Patients suffering from schizophrenia as well as offenders grew up more frequently in lower social class families. More than 11% of the offenders (with and without schizophrenia) were born by women living without partners. Parental loss due to permanent separation of the parents or death of one or both parents was found statistically significantly more often in both offender samples and – with nearly the same frequency – in the non-offending schizophrenic sample (healthy non-offenders 17.5%, non-schizophrenic offenders 39.8%, schizophrenic non-offenders 32.0%, schizophrenic offenders 45.6%, chi-square=20.5, p<0.001).

Among the schizophrenic as well as among the offending groups, the main reason for parental loss was permanent separation, mostly from the father (healthy non-offenders 13.6%, non-schizophrenic offenders 34.0%, schizophrenic non-offenders 27.2%, schizophrenic offenders 40.8%, chi-square=20.3, p<0.001). Both offender groups were also more often confronted with new partners of the remaining natural parents and especially with half- and step-sibs (blended families). Schizophrenic patients reported a parental loading with schizophrenia – in offenders twice as high as in non-offenders. High rates of offending parents were found in offending subjects with and without schizophrenia. So, the schizophrenic offender group exhibited a double familial burden, with schizophrenia as well as with criminality (Table 1).

Table 1.

Sociodemographic characteristics, family status and family burden of the parental generation of healthy non-offenders (n=103), non-schizophrenic offenders (n=103), schizophrenic non-offenders (n=103), and schizophrenic offenders (n=103) before age 18

	Healthy non-offenders	Non-schizophrenic offenders	Schizophrenic non-offenders	Schizophrenic offenders	Statistic	Significance
Age at subjects' birth
Father	31.8±8.7	28.4±8.5	29.6±9.1	31.0±8.7	F=3.3	p<0.05
Mother	28.3±8.7	25.1±6.3	25.6±8.2	26.4±6.6	F=3.1	p<0.05
Social level†
High	24 (23.3%)	2 (1.9%)	6 (5.8%)	5 (4.9%)	χ2=35.5	p<0.001
Middle	57 (55.3%)	51 (49.5%)	66 (64.1%)	38 (36.9%)	χ2=16.1	p<0.005
Low	22 (21.4%)	50 (48.5%)	31 (30.1%)	60 (58.3%)	χ2=36.7	p<0.001
Family status
Single at subjects' birth	–	11 (11.7%)	1 (0.9%)	11 (11.7%)	χ2=20.2	p<0.001
Separated	9 (8.7%)	26 (25.2%)	21 (20.4%)	28 (27.2%)	χ2=13.0	p<0.01
Widowed	9 (8.7%)	15 (14.6%)	12 (11.7%)	19 (18.4%)	χ2=4.6	ns
New partnership	5 (4.9%)	29 (28.2%)	16 (15.5%)	30 (29.1%)	χ2=26.2	p<0.001
Blended family	2 (1.9%)	29 (28.2%)	2 (1.9%)	26 (25.2%)	χ2=53.4	p<0.001
Family burden
Schizophrenia	1 (1.0%)	1 (1.0%)	11 (10.7%)	21 (20.4%)	χ2=39.5	p<0.001
Offending behaviour	–	13 (12.6%)	–	15 (14.6%)	χ2=30.3	p<0.001

†Prestige of the profession of the subjects' fathers according to Kleining and Moore [45].

Later offenders (schizophrenic and non-schizophrenic) grew up in larger sibships compared with non-offending subjects (Table 2). The healthy subjects completed secondary schooling more often than those with schizophrenia. A high rate of later schizophrenic as well as nonschizophrenic offenders spent more than 1 year in foster homes.

Table 2.

Sibship size, school certification, and stays in foster homes for more than 1 year in healthy non-offenders (n=103), non-schizophrenic offenders (n=103), schizophrenic non-offenders (n=103), and schizophrenic offenders (n=103)

	Healthy non-offenders	Non-schizophrenic offenders	Schizophrenic non-offenders	Schizophrenic offenders	Statistic	Significance
Sibship size	2.5±1.5	3.2±2.0	2.5±1.2	3.5±2.3	F=7.8	p<0.001
School finished with certification	87 (84.5%)	76 (73.8%)	53 (51.3%)	61 (59.2%)	χ2=30.5	p<0.001
Stays in foster homes
Total (age 0-15)	2 (1.9%)	27 (26.2%)	8 (7.8%)	31 (30.1%)	χ2=42.4	p<0.001
Age 0-5	–	9 (8.7%)	–	4 (3.9%)	χ2=17.4	p<0.005
Age 6-10	–	16 (15.5%)	–	13 (12.6%)	χ2=31.9	p<0.001
Age 11-15	2 (1.9%)	23 (22.3%)	8 (7.8%)	31 (30.1%)	χ2=39.5	p<0.001

Birth order was analysed by use of the Greenwood-Yule method, which compares the observed distribution of birth positions with that to be expected if all birth positions within a given sibship size would be equally represented [22, 28]. The observed and the expected distributions of birth-orders of both offender groups differed from the non-offending groups having less in the middle position and more first-borns (Table 3).

Table 3.

Birth order – excluding single children and multiple births – in healthy non-offenders (n=78), nonschizophrenic offenders (n=81), schizophrenic non-offenders (n=83), and schizophrenic offenders (n=90)

	Healthy non-offenders		Non-schizophrenic offenders		Schizophrenic non-offenders		Schizophrenic offenders
	Observed	Expected	Observed	Expected	Observed	Expected	Observed	Expected
First-born	28 (35.9%)	25.6	37 (45.7%)	21.4	32 (38.6%)	29.3	40 (44.4%)	23.3
Middle position	26 (33.3%)	26.9	24 (29.6%)	38.1	16 (19.3%)	24.4	24 (26.7%)	43.3
Last -born	24 (30.8%)	25.6	20 (24.7%)	21.4	35 (42.1%)	29.3	26 (28.9%)	23.3
p		NS		p<0.001		NS		p<0.001

Non-par chi-square test.

In a second step, those variables showing statistically significant differences in univariate statistics were entered into a discriminant analysis. Table 4 shows the within-groups correlations of each predictor variable with the canonical variable. The items blended family, stays in foster homes, lower social level of origin, and offending family members had the largest correlations with factor 1, the item schizophrenic family members had a positive, the item school finished with certification a negative correlation with factor 2. Factor 3 was correlated positively with upper social level of origin and negatively with middle social level of origin. However, the discriminative power of factor 3 is too low to differentiate between the four groups (Wilks' Lambda=0.945).

Table 4.

Structure matrix of canonical discriminant analysis

% of variance	Function 1 (63.1%)	Function 2 (27.7%)	Function 3 (9.1%)
Blended family	0.59†	0.37	0.02
Stays in foster home (total)	0.56†	0.10	0.11
Lower social level of origin	0.52†	0.00	0.19
Offending family members	0.45†	0.18	0.21
Primarily incomplete family	0.25†	0.05	−0.00
Sibship-size	0.24†	0.13	0.05
Parental loss	0.22†	0.10	0.09
School finished with certification	−0.18	−0.63†	0.37
Schizophrenic family members	0.27	0.57†	0.28
Upper social level of origin	−0.43	0.19	0.67†
Middle social level of origin	−0.25	−0.18	−0.55†

†Largest absolute correlation between each variable and any discriminant function.

Table 5 shows the means of the canonical variables by group. Function 1 clearly discriminated the offending from the nonoffending subjects, function 2 the healthy from the schizophrenic subjects.

Table 5.

Functions at group centroids (canonical discriminant analysis)

	Function 1	Function 2	Function 3
Healthy non−offenders	−0.82	0.28	0.28
Non−schizophrenic offenders	0.45	0.47	−0.23
Schizophrenic non−offenders	−0.31	−0.53	−0.22
Schizophrenic offenders	0.68	−0.22	0.12

Canonical variable means (centroids) by group.

Discussion

Family, twin and adoption studies have confirmed that in addition to genetic factors, there are important environmental determinants of both the development of schizophrenia and of violent behaviour [1, 2]. The aim of our study was to investigate which of these factors play a major role for the development of offending behaviour in patients with schizophrenia. Offenders, whether schizophrenic or non-schizophrenic, were more likely to come from the lower socioeconomic classes. Those with schizophrenia, irrespective of their offending histories, and non-schizophrenic offenders had more frequently experienced parental loss during childhood and adolescence (Table 1), usually involving the permanent separation from the father. The lack of a stable father–son relationship may – as an unspecific factor – contribute to a dysfunctional personality structure conducive to schizophrenia as well as antisocial behaviour. Being brought up with half- and/or step-sibs in a family blended or totally separated from both parents, also increases the probability of later offending behaviour in subjects both with and without schizophrenia, supporting previous claims that such disruptions in family structure predispose to criminal behaviour [30, 31,33–35].

As expected [1], parents suffering from schizophrenia were found almost exclusively in the schizophrenia cohorts (Table 1). The finding that the family burden with schizophrenia was twice as high in the schizophrenic offender group (20.4%) compared with the schizophrenic non-offender group (10.7%) can be interpreted in two ways: on could assume either that the higher genetic loading in offending patients with schizophrenia is an expression of the ‘severity’ of the illness pointing to a more direct relationship between disease and violent/ offending behaviour, or that living with a parent suffering from schizophrenia increases the probability of neglect and the exposure to general criminogenic factors. Stays in foster homes for more than 1 year – as a consequence of the loss of at least one parent or as an indicator of a problematic familial situation – exhibited a similar effect. According to the data presented in Table 2, finishing school without qualifications is associated with the later development of schizophrenia. This finding can be tentatively interpreted as the expression of uncharacteristic premorbid affective-cognitive disturbances, in some cases as a consequence of a prodromal state of schizophrenia [43].

Our results confirm those authors who found an association between larger sibships as well being a first-born child and later criminal behaviour [21, 31] (Tables 2,3) and replicate the finding [28] that birth order does not increase the vulnerability for schizophrenia. In contrast to Kemppainen [21] we could not find any differences between offenders and non-offenders concerning the number of single children (healthy non-offenders 25.2%, non-schizophrenic offenders 21.4%, schizophrenic nonoffenders 19.4%, schizophrenic offenders 12.4%, chisquare =?5.5, NS). Being the eldest son in a large sib-row may increase the pressure to become independent from the family very early. A reduction of the duration of adolescence decreases the potential to develop a mature personality [44]. The result may be a subject prone to underlie antisocial influences.

Discriminant analysis produced two canonical factors (Table 4). The first one separated offenders from nonoffenders independent of the presence of schizophrenia (Table 5). This factor primarily includes items concerning the parental family status, offending behaviour in family members and – with less statistical power – sibship size. The second factor separated patients with schizophrenia from non-schizophrenic subjects independent of offending behaviour. The central item ‘family members with schizophrenia’ represents the genetic load, while all other family items had no major significance for the development of schizophrenia.

In conclusion, we were not able to identify specific patterns of socialization characterizing schizophrenic offenders. However, our results show that certain unfavourable familial conditions, like lower social class of origin, offending behaviour in the parental generation, loss of the father, a new partnership of the remaining parent, growing up in blended families, larger sibships and stays in foster homes, all seem to promote the development of offending behaviour. The challenge is to provide more and better focused services for the early support of a high-risk group, prone to schizophrenia as well as to offending behaviour.

References

1. Tsuang

. Schizophrenia: genes and environment. Biological Psychiatry 2000; 47: 210–220.

2. Rutter

. Genetics of criminal and antisocial behaviour. Wiley, Chichester 1996.

3. Brennan

P A

Mednick

S A

Hodgins

. Major mental disorders and criminal violence in a Danish birth cohort. Archives of General Psychiatry 2000; 57: 494–500.

4. Schanda

Knecht

Schreinzer

. Homicide and major mental disorders: a 25-year study. Acta Psychiatrica Scandinavica 2004; 110: 98–107.

5. Stompe

Ortwein-Swoboda

Schanda

. Schizophrenia, delusional symptoms and violence: the threat/control-overrideconcept re-examined. Schizophrenia Bulletin 2004; 30: 31–44.

6. Wallace

Mullen

P E

Burgess

. Criminal offending in schizophrenia over a twenty-five year period marked by deinstituionalization and increasing prevalence of comorbid substance use disorder. American Journal of Psychiatry 2004; 161: 716–727.

7. Malaspina

Harlap

Fennig

. Advancing paternal age and the risk of schizophrenia. Archives of General Psychiatry 2001; 58: 361–367.

8. Dalman

Allebeck

. Paternal age and schizophrenia: further support for an association. American Journal of Psychiatry 2002; 159: 1591–1592.

9. Byrne

Agerbo

Ewald

Eaton

W W

Mortensen

P B

. Parental age and risk of schizophrenia: a case-control study. Archives of General Psychiatry 2003; 60: 673–678.

10.

10. El-Saadi

Pedersen

C B

McNeil

T F

. Paternal and maternal age as risk factors for psychosis: findings from Denmark, Sweden and Australia. Schizophrenia Research 2004; 67: 227–236.

11.

11. Byrne

Agerbo

Eaton

W W

Mortensen

P B

. Parental socioeconomic status and risk of first admission with schizophrenia – a Danish national register based study. Social Psychiatry and Psychiatric Epidemiology 2004; 39: 87–96.

12.

12. Holgard

J R

Newman

M F

. Parental loss by death in childhood as an etiological factor among schizophrenic and alcoholic patients compared with a non-patient community sample. Journal of Nervous and Mental Diseases 1963; 137: 14–28.

13.

13. Pfohl

Stangl

Tsuang

M T

. The association between early parental loss and diagnosis in the Iowa 500. Archives of General Psychiatry 1983; 40: 965–967.

14.

14. Agid

Shapira

Zislin

. Environment and vulnerability to major psychiatric illness: a case control study of early parental loss in major depression, bipolar disorder and schizophrenia. Molecular Psychiatry 1999; 4: 163–172.

15.

15. Nemeroff

C B

. The preeminent role of early untoward experience on vulnerability to major psychiatric disorders: the naturenurture controversy revised and soon be resolved. Molecular Psychiatry 1999; 4: 106–108.

16.

16. Pert

Ferriter

Saul

. Parental loss before the age of 16 years: a comparative study of patients with personality disorder and patients with schizophrenia in a high secure hospital's population. Psychology and Psychotherapy 2004; 77: 403–407.

17.

17. Furukawa

Mizukawa

Hirai

Fujihara

Kitamura

Takahashi

. Childhood parental loss and schizophrenia: evidence against pathogenic but for some pathoplastic effects. Psychiatry Research 1998; 81: 353–362.

18.

18. Barry

III Barry

Jr . Birth order, family size, and schizophrenia. Archives of General Psychiatry 1967; 17: 435–440.

19.

19. Erlenmeyer-Kimling

. The problem of birth order and schizophrenia: a negative conclusion. British Journal of Psychiatry 1969; 115: 659–678.

20.

20. Wild

C M

Shapiro

L N

Abeling

. Sampling issues in family studies of schizophrenia. Archives of General Psychiatry 1974; 30: 211–215.

21.

21. Kemppainen

. Family predictors of severe mental disorders and criminality in the Northern Finland 1966 birth cohort. Oulun Yliopisto, Oulu 2001.

22.

22. Granville-Grossman

K L

. Birth order and schizophrenia. British Journal of Psychiatry 1966; 112: 1119–1126.

23.

23. Hare

E H

Price

J S

. Birth rank and schizophrenia. Nature 1970; 228: 1223–1224.

24.

24. McDonald

O'Callaghan

Keogh

. Number of older siblings of individuals diagnosed with schizophrenia. Schizophrenia Research 2001; 47: 275–280.

25.

25. Pedersen

C B

Mortensen

P B

. Sibship characteristics during upbringing and schizophrenia risk. American Journal of Epidemiology 2004; 160: 652–660.

26.

26. Klaning

Mortensen

P B

Kyvik

K O

. Increased occurrence of schizophrenia and other psychiatric illnesses among twins. British Journal of Psychiatry 1996; 168: 688–692.

27.

27. Schooler

. Psychological Bulletin 1972; 78: 161–175, Birth order effects: not here, not now.

28.

28. Stompe

Ortwein-Swoboda

Friedmann

Chaudhry

H R

. Sibling orders of schizophrenic patients in Austria and Pakistan. Psychopathology 1999; 6: 281–291.

29.

29. Cloninger

C R

Gottesmann

I I

. Genetic and environmental interactions in antisocial behaviour. The causes of crime – new biological approaches, Mednick

S A

Moffitt

T E

Stack

S A

. Cambridge University Press, Cambridge 1987; 92–109.

30.

30. Bohman

. Predisposition to criminality. Swedish adoption studies in retrospect. Genetics of criminal and antisocial behaviour, Rutter

. Wiley, Chichester 1996; 99–109.

31.

31. Göppinger

. Der Täter in seinen sozialen Bezügen. Ergebnisse aus der Tübinger Jugendtäter – Vergleichsuntersuchung. Springer, Heidelberg 1983.

32.

32. Rantakallio

Myhrman

Koiranen

. Juvenile offenders, with special reference to sex differences. Social Psychiatry and Psychiatric Epidemiology 1995; 30: 113–120.

33.

33. Virkkunen

Eggert

Rugg

A J

Linnoila

. A prospective study of alcoholic violent offenders and fire setters. Archives of General Psychiatry 1996; 53: 523–529.

34.

34. Conseur

Rivara

F P

Barnoski

Emanuel

. Maternal and perinatal risk factors for later delinquency. Pediatrics 1997; 99: 785–790.

35.

35. Räsänen

Tihonen

Isohanni

Hodgins

Järvelin

M-R

Tiihonen

. Maternal smoking during pregnancy and risk of criminal behaviour among male offsprings in the Northern Finland 1966 birth cohort. American Journal of Psychiatry 1999; 156: 857–862.

36.

36. Fehlow

. Über die Ursachen und forensische Begutachtung von Sexualdelikten. Psychiatrie Neurologie und Medizinische Psychologie 1973; 25: 535–544.

37.

37. Krakowski

M I

Czobor

. Psychosocial risk factors associated with suicide attempts and violence among psychiatric inpatients. Psychiatric Services 2004; 55: 1414–1419.

38.

38. Schanda

Ortwein-Swoboda

Knecht

Gruber

. The situation of forensic psychiatry in Austria: setback or progress? International Journal of Law and Psychiatry . 2000; 23: 481–492.

39.

39. Taylor

P J

. Motives for offending among violent and psychotic men. British Journal of Psychiatry 1985; 147: 491–498.

40.

40. Österreichisches Statistisches Zentralamt . Sozialstatistische Daten 1990. Beiträge zu österreichischen Statistik. Österreichisches Statistisches Zentralamt, Wien 1990.

41.

41. Spitzer

R L

Williams

J BW

Gibbon

First

M B

. Structured clinical interview for DSM-III-R. American Psychiatric Press, Washington, DC 1990.

42.

42. Meulders-Klein

M-T

Théry

. Fortsetzungsfamilien. Neue familiale Lebensformen in pluridisziplinärer Betrachtung. UVK, Konstanz 1998.

43.

43. Janzarik

. Strukturdynamische Grundlagen der Psychiatrie. Enke, Stuttgart 1988.

44.

44. King

. Die Entstehung des Neuen in der Adoleszenz. Individuation, Generativität und Geschlecht in modernisierten Gesellschaften. Leske+Budrich, Opladen 2002.

45.

45. Kleining

Moore

. Soziale Selbsteinstufung (SSE). Ein Instrument zur Messung sozialer Schichten. Kölner Zeitschrift für Soziologie und Sozialpsychologie 1968; 20: 502–552.

Family and Social Influences on Offending in Men with Schizophrenia

Abstract

Keywords

Aim

Method

Subjects

Measures

Statistical analysis

Results

Discussion

References