The term “psychological autopsy” is exactly what it sounds like: a psychological profile to determine the mental state of someone who is already deceased. There are many reasons why a psychological profile may be conducted, with the most common one being to determine the cause or nature of death, whether it be by natural causes, suicide, homicide, or an accident.
In this article, Team YLCC explores the concept of a psychological autopsy in a from a comprehensive perspective. Read on!
A rather large amount of information must be collected in order to perform a psychological autopsy. Some of this information is personal information (any history of drug/alcohol abuse, known stresses, lifestyle, relationships, etc), biographical information (birth date, occupation, marital or relationship status), any secondary information (criminal record, family history), and information gathered by interviewing family members of the deceased. Once this information is gathered, forensic psychologists can begin to piece together the psychological autopsy.
This investigatory tool is not used as often as one might think, but it is still considered an important tool at an investigative team’s disposal, especially when combined with the other tools available to them. One reason why it may not be more commonly used is the question regarding its reliability and validity. There have also been questions as to the uniformity of the way investigators are trained in using this technique.
Psychological autopsies are mostly performed most often on suicide bombers. This type of investigation is conducted to help get inside the minds of suicide bombers, and therefore, attempt to understand why they sacrifice their own lives in order to also take the lives of others. Investigators have been able to gather a significant amount of information on this particular population of people, both from family members of the bombers, and the would-be bombers themselves who happen to be apprehended before they have the chance to carry out their attacks.
APPLICATIONS OF A PSYCHOLOGICAL AUTOPSY
The process of a Psychological Autopsy enjoys utility in a variety of situations, including the following:
- Assisting medical examiners with “equivocal” deaths
- Research on suicide
- Insurance claims
- Criminal cases
- Estate issues and contested wills
- Malpractice claims
- Worker’s compensation cases
- Product liability cases
- Efforts by organizations to prevent suicide
- Promoting understanding and grieving among surviving family members.
PAs have been shown to have a significant impact on medical examiners’ determinations in equivocal cases. The PA has also been used for several decades to collect valuable research data about suicide that ultimately inform prevention efforts. The vast majority of these studies suggest that a mental disorder is present in a preponderance of suicides. The first generation of research to use the PA found that more than 90% of individuals who completed suicide suffered from mental disorders, mostly mood disorders and substance use disorders. The second generation of PA research has employed case-control designs, resulting in better estimations of the role of various risk factors for suicide.
The PA can be a very helpful tool to assist medical examiners and homicide investigators in approaching “equivocal deaths.” An equivocal death may be one in which the manner of death is questionable, or the circumstances surrounding the death are otherwise unclear. The following are typical equivocal death scenarios:
- Drug-related deaths
- Autoerotic asphyxia
- Self-induced asphyxia (e.g., the “choking game”)
- Drownings
- Vehicular deaths
- “Russian roulette”
- “Suicide by cop”
- Staged death scenes.
The PA method has also been used in a forensic context in both criminal and civil courts. While courts have admitted testimony based on psychological autopsies in many civil cases, criminal courts have been more hesitant. In criminal cases, the PA may be used to establish whether a decedent was likely to have committed suicide, or whether the death should be viewed as a homicide. In some criminal cases, most notably Jackson v. State, the PA has been used to help analyse whether an abusive relationship played a role in a suicide. In the criminal case U.S. v. St. Jean, the PA was used by the prosecution to assist in determining whether or not a suspected homicide victim had been a likely candidate for suicide.
In civil cases, the PA has been used to help determine whether benefits are owed to the decedent’s beneficiaries. These cases often involve life insurance payments, because many policies hold that a suicide precludes benefits. However, some policies permit payment if it can be proved that the decedent’s death was an “insane suicide.” Insane suicide is a legal term that was defined by the U.S. Supreme Court in the case of Mutual Life Insurance Company v. Terry. The Court held that a suicide was “sane” when the insured decedent “being in the possession of his ordinary reasoning faculties, from anger, pride, jealousy, or a desire to escape from the ills of life, intentionally takes his own life.”
METHODOLOGY OF PSYCHOLOGICAL AUTOPSY
The PA method involves collecting and analysing all relevant information on the deceased. All applicable records are reviewed, including medical records, psychiatric records, police records, and autopsy findings. A visual inspection of the death scene via photographs is necessary, and a visit to the scene will occasionally be required. A thorough review of the decedent’s writings in the form of diaries, journals, e-mails, and internet correspondence is vital. In addition to reviewing records, structured interviews with family members, relatives, and/or friends are necessary. Thus, a PA synthesizes data from multiple informants and records. When performed in a comprehensive manner, the method may take anywhere from 20–50 hours or longer to complete. The overriding principle is that the greater the amount of relevant data analysed, the more accurate the investigator’s conclusions are likely to be.
Suicide risk factors vary among different populations. The investigator should consider any special nuances of the deceased, such as age group,32 mental health diagnosis, gender and other factors that may allow for a more precise consideration of risk factors associated with that group. This requires that those who conduct PAs stay up to date with the evolving psychiatric and suicidology literature, which is steadily becoming more detailed about risk factors in distinct diagnostic categories such as depression and bipolar disorder as well as in individuals who are not receiving mental healthcare services. Some decedents may have displayed unique, individualized behaviours suggestive of increased or decreased suicide risk that will be known only to close social contacts or treating mental health professionals. Thus, it is important to learn as much as possible about the decedent’s individualized risk factors and patterns of reactions to past stress.
The importance of collateral interviews as part of the PA method cannot be overstated. Careful interviews with the decedent’s family members and other relevant social contacts distinguish a proper PA from a mere analysis of demographic data and police reports. Most experts recommend a structured or semi-structured approach to collateral interviews. At least one study has developed a semi-structured interview for the PA that has demonstrated interrater reliability. For research purposes, there has been a trend toward using modified instruments such as the Structured Clinical Interview for DSM-IV Disorders (SCID), as well as a life events calendar method, which helps identify and quantify the burden of events that may be associated with suicide. Collateral interviews often reveal critical and/or determinative information about the decedent that cannot be obtained elsewhere. Recent theories about suicide have stressed that psychiatric illness alone is not enough to fully explain an individual suicide. Rather, a stress-diathesis model has been proposed, in which the risk for suicidal acts is determined by the interplay of biopsychosocial factors and situational variables. According to this model, a diathesis may be reflected in an individual’s tendency to have maladaptive responses to stressors, such as acting impulsively. Such information is most likely to be obtained via collateral interviews.
WHAT ARE THE GOALS OF A PSYCHOLOGICAL AUTOPSY?
The goals of the PA include obtaining an in-depth understanding of the decedent’s personality, behavior patterns, and possible motives for suicide. The investigator strives to obtain an objective analysis of factors that increased and decreased the decedent’s risk of suicide. In certain cases, an experienced investigator can use the method to help sort out degree of risk and intent and to identify causal factors at the time of death. Ultimately, this should allow for a well-informed assessment of whether or not the deceased was a likely candidate for suicide. The following are some of the key goals of the PA:
- Identify behaviour patterns—reactions to stress, adaptability, changes in habits or routine
- Establish presence or absence of mental illness
- Identify possible precipitants
- Determine presence or absence of motives
- Determine presence or absence of suicidal intent
- Determine suicide risk factors—both mitigating and aggravating
- Perform a post-mortem suicide risk assessment
- Establish whether or not the deceased was a likely candidate for suicide.
Psychological Autopsy is an important tool in Forensic Science that empowers investigative teams to solve an unsolvable crime that lacks motive. Despite the absence of a proper standard set of guidelines for it, investigating officers and police officials should undergo training and orientation programs related to criminal psychology and human psychology. This will probably help them interpret all the pieces of evidence better which can eventually help them to resolve the suicidal and equivocal deaths.
YLCC would like to thank Riya Singh for her valuable insights in this article.
