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Diagnostic and Statistical Manual…cont

While in prison, O.V. was accused of sexual assault of a nurse. Dr. J concluded that pursuant to the Diagnostic and Statistical Manual, Fourth Revision (DSM-IV) of the American Psychiatric Association, O.V. suffers from three separate disorders: polysubstance dependence, antisocial personality disorder and paraphilia.

Dr. J opined that O.V. suffers from polysubstance dependence, a severe form of being addicted to multiple substances at the same time while meeting other specific criteria for the disease. Dr. J stated that O.V. is unable to control his urges to use drugs, which includes use of opiates. He set forth that O.V. is predisposed to commit all sorts of crimes and he is specifically at risk to commit further sex crimesusing cocaine offenses and he does pose a danger to the community.

Dr. J further testified that in order to be diagnosed with Axis II disorder of “Antisocial Personality Disorder,” a person must be an adult and meet at least three out of seven different symptomatic and behavioral criteria. He concluded that O.V. meets seven out of seven criteria for that disorder, which are: lack of respect for societal norms; pattern of reckless disregard for the safety of others; deceitfulness; lack of remorse and blaming others for one’s problems; irritability and impulsiveness and inability to maintain consistent employment.

Dr. J also explained that paraphilias are disorders characterized by persistent and upsetting or difficult to control urges, related to certain sexual preoccupations.

He observed:

“In this case, the condition that I am concerned the respondent has, involves a sexual preoccupation and urges related to the coercive sexual acts with nonconsenting others. Not everyone who engages in rape has a paraphilia certainly, but this respondent has some features that suggest he would meet criteria for a paraphilia, in the sense that he, himself said during, at the time of the instant offenses that he felt compelled to do what he was doing. He said that the rapes have something to do with his feelings for his mother. Most paraphilias are long-standing, chronic conditions that don’t change a whole lot throughout the life time.”
Dr. J relayed that the Static 99 is an actuarial instrument to help assess the risk of recidivism of sex offenders over a five-year period. Dr. J concluded that more than one-third of sex offenders with scores that fell within the high risk advantage recidivate within five years. He stated:

“The concern I would have is that even in a secure setting, such as prison and Kirby Psychiatric Center, the respondent continued to make threats and be involved in dangerous incidents. So I believe that he does need a secure setting to limit the risk that he might harm others.”
On cross-examination, Dr. Hicks acknowledged that O.V. is 54 years old and that the DSM-IV provides that the symptoms of antisocial personality disorder wane after a person reaches 40. He also stated that O.V. has not been on psychotropic medications and that he is not delusional. With respect to the Static 99, Dr. Hicks commented that most recommend that the actuarial instrument be used in combination with clinical assessments by skilled clinicians who are aware of forensic principles when doing risk assessment. Finally, Dr. J agreed that O.V. has his mother, who visited him in the hospital on a regular basis, and a brother as part of his support group.

To Br Cont…

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