1. Introduction
The violent death of women for reasons of gender, typified in the Mexican penal system as femicide, is the most extreme form of violence against women and one of the most serious manifestations of discrimination against them.1 Worldwide, it is estimated that six murders of women occur every hour at the hands of men, which amounts to a total of 50,000 femicides per year, it is estimated that up to 75% of the victim and perpetrator shared an emotional bond, most of them committed by those who were their romantic partners.2
Gender-based violence has been and continues to be one of the clearest manifestations of inequality, subordination and power relations between men and women. This type of violence is based on and exercised by the subjective difference between the sexes, reflects the inequality in the power dynamics established within the binary gender system, where only the categories of man and woman exist, and generates a great impact on the lives of women.3
In Mexico in 2021, 41.8% of women aged 15 and over said they had lived through a situation of violence in their childhood.4 It is estimated that 43.9% of violence against women over 15 years of age occurs in the context of a couple and 53.1% by other aggressors.5 Femicide was typified for the first time in Mexico in 2012, since then the number of registered cases has increased, from 418 in 2012 to 1015 in 2021 and in 2022 it fell to 915 cases.6
The criminal behavior has been explored since ancient times to explain it, the case of femicide is no exception, a study measured the association between psychopathy and femicide of 97 individuals with the PCL-R scale, reported that psychopathy was an uncommon trait among perpetrators of femicidal violence.7 However, the presence of a diagnosis does not always explain a person’s behavior, so it has been proposed that a dimensional approach would explain it in a better way.8 Criminal behavior, such as mass murderers, can be analyzed from the dimensional perspective that groups into three domains of psychopathology: a) internalization (guilt, anxiety, depression, somatic symptoms), b) externalization (envy, resentment, aggression, antisocial behavior, poor self-regulation) and c) psychotic experience (hallucinations, delusions, disorganized thinking), this approach has a practical clinical use and is also useful for research, since it can be used as a general structure through which the broad spectrum of the mental functioning of serial and mass murderers can be understood. Using this dimensional model to categorize the mental functioning of perpetrators of violence may be an acceptable alternative when key data sources are limited.9
We adopted the dimensional approach mentioned above to identify the spectrum of mental functioning of subjects accused of femicide as the main objective.
2. Methods
2.1. Design and Sample
An observational, descriptive and retrospective study was conducted. Non-probabilistic sample of psychiatric-forensic files of people accused of the crime of femicide, who were evaluated in the forensic psychiatry service of the Fray Bernardino Álvarez Psychiatric Hospital, during the period between 2021 and December 2023.
2.3. Variables
Sex, age, education, occupation, marital status, previous criminal history (the most serious), personality traits, history of consumption of psychoactive substances, psychiatric diagnoses. Antecedents of the relationship: type of victim-perpetrator relationship and history of violence in the relationship. Crime: Mechanism of homicide, type of motivation, place of homicide.
The spectrum of mental functioning (internalizing, externalizing, psychotic spectrum) was identified by analyzing the data of the mental examination and pathological and non-pathological personal history recorded in the file.
2.4. Statistical analysis
Descriptive statistics, frequencies and percentages were used for qualitative variables and for quantitative variables with mean, median, minimum-maximum and standard deviation. The chi-square test and Student t-test, as appropriate, were used to contrast the cases of the psychotic and externalizing dimension.
3. Results
Eighteen files related to the crime of femicide were located, of which 10 cases correspond to consummated femicide and 8 of attempted femicide. Externalizing mental functioning is present in 77.7% of cases, followed by psychotic and internalizing, so that most of those evaluated had a behavior pattern of envy, resentment, aggression, antisocial behavior, and poor self-regulation.
94% were men (n=17) and 6% were women (n=1). Personality disorders were the most frequent diagnosis. The history of criminal conduct was in 7 cases, in three of them family violence. Table 1.
The average age of those accused of femicide was 38.6 years, median of 36.5 years. The defendants grouped in the psychotic dimension had a mean age of 44 years (standard deviation 16.3) and for the exteriorizing dimension 37.3 (standard deviation 11.3), p>0.05. Table 2.
Those accused of femicide reported higher education, being married and having employment at the time of the criminal conduct. Relationship problems and those unrelated to the couple were equally frequent. There were no statistically significant differences when comparing subjects with psychotic level of mental functioning with exteriorizing mental functioning. Table 2.
4. Discussion
Our objective was to categorize the level of mental functioning of subjects accused of femicide, we found that most of the evaluated adjusted to the externalizing dimension, that is, they had a behavior pattern of resentment, aggression, antisocial behavior and poor self-regulation and; Although a high percentage had been diagnosed with a personality disorder, the vast majority of mental disorders were not associated with a serious mental functioning condition that could impair their ability to understand the implications and consequences of their actions, their volitional capacity, or their ability to judge.
A similar study that compared femicides with homicides and perpetrators of intimate partner violence, found that femicides have more frequent histories of abuse in childhood, antisocial traits and personality instability predominate, in general femicides have a more conventional behavior pattern within society, but they had more stressors and pessimism for the immediate future.10
Suffering adverse events in childhood (ACE) or mistreatment such as abandonment, sexual, physical, psychological abuse, poverty, among others, are recognized as risk factors for mental disorders such as anxiety, depression or consumption of toxic substances, adjusting family and socioeconomic factors.11 ACEs and bullying have a cumulative effect and are associated with internalizing mental health problems (low mood, withdrawal, somatic complaints) or externalizing mental health problems (aggressive behavior, not following rules) in early adolescence.12
Alterations that manifest themselves in interpersonal and social relationships. In this sense, violence against women occurs to a greater extent in the context of the couple, a study that examined cases of femicide for 20 years in Milan, confirms this.13 However, we observe that almost half of the cases occur outside the context of the couple, so it is something that must be explored.
Several authors emphasize that the analysis of violence against women must go beyond the private sphere and recognize the threat of violence in the public or community sphere, in which women – especially young women – are at high risk of violence.14 But, it should be considered that in intimate partner violence men and women can be victims and perpetrators, a study showed that being a man increases the risk of being a victimizer only, experiences of sexual, psychological violence or adversity in childhood are associated with being a perpetrator or victim of psychological violence, but not for physical violence, but the educational level is not associated with any type of violence.15 However, we observed that almost half of the people accused of femicide had higher education, so this is a fact to be explored in the future, since social factors such as the imbalance in monetary income between the members of the couple is a relevant element in committing acts of violence.16
On the other hand, higher schooling is associated with higher income and better living conditions, but a study in Brazil found that places with a high human development index were associated with femicide, contrary to what has been reported by other authors, so that violence against women is a multifactorial phenomenon that involves individual aspects, cultural and relational.17 The data obtained in this research coincide with the results of a study that analyzed 237 sentences for femicide in which 10.5% had a criminal record, 22.4% abused alcohol or some other psychoactive substance, 19.8% had physically abused the woman before the femicide.18
5. Conclusion
The data found shows that more research is required on the association between femicidal behavior and mental functioning, above all, to understand femicidal behavior in its entirety, it is necessary to consider an approach with a gender perspective that considers the conditions of inequality and discrimination against women, the differences in power between men and women sustained by sexist reasons and prejudices about behavior femicide.
Finally, we point out that, in the practice of forensic psychiatry, the association between mental illness and criminal behavior can be dangerous, since it opens the way to opinions, processes and mechanisms that seek to justify violent and/or criminal behaviors, arguing that, being the product of an illness, the individual who suffers from it is not capable of self-regulating his behavior nor decide for himself.9
Ethical Considerations
According to Article 17 of the General Health Law on research, this work is considered risk-free. Approved by the Research and Research Ethics Committees, CI-1023 and CEI registrations, 08 February 2024.
Funding
This work did not receive any funding
Conflict of interest
We declare no conflict of interest.