Alcohol and crime
X.9 Alcohol as a causal criminogenic factor: The Scandinavian experience.
Nils Wiklund and Lars Lidberg
The link between alcohol and crime has been amply documented at least since the 19th century. This raises the question whether efforts to limit the availability of alcohol would reduce the rate of violent crimes. In this presentation we will briefly review the evidence about a connection between alcohol and violent crimes. Secondly we will mention some of the major theories to explain this connection. Thirdly, we will in some detail review the evidence from Scandinavian experiences of alcohol control measures and their effect on the rate of violent crime.
THE CONNECTION BETWEEN ALCOHOL AND VIOLENT CRIME
Wolfgang (1958) showed in his classical study on criminal homicide that alcohol was present in either the offender or the victim in 69% of the cases. It was found in both victim and offender in 48% of the cases. The exact proportion varied for race, sex, day of the week, and other variables. Goodman et al (1986) reported that alcohol was detected in the blood of 46% of homicide victims. Kuhlhorn (1984) studied 5 772 court sentences on violent crimes. He found that 82 percent of the offenders and 37 percent of the victims had consumed alcohol. The more serious the crime the more often alcohol was present in the victim. Autopsy of homicide victims (or other life crime victims) showed alcohol to be present in 61 percent of the male victims and 26 percent of the female victims.
Alcohol abuse is found particularly among criminals guilty of serious crimes of violence but Lindelius et al (1975) reported that persons with chronic alcohol abuse have a high rate of criminality but a relatively low incidence of serious crimes.
Noreik et al (1986) studied persons who underwent a forensic psychiatric investigation in Norway. They reported that only 30% of the patients could "control their use of alcohol”. Chronic alcoholism was found in 47% of the cases. Alcohol abuse increased the risk of recidivism. This confirms earlier results by Törnqvist (1966) for a Swedish forensic psychiatric population. He stressed that the alcohol factor gets its causal importance in combination with a number of other factors (p 169).
Lidberg et al (1986) showed that alcohol abuse increases the mortality risk among forensic psychiatric patients. The increased mortality risk is more related to alcohol abuse than to drug addiction.
Wiklund (1983) reported that at least 66% of fire setters are intoxicated by alcohol while they set the fires. About 50% can be characterized as chronic alcohol abusers. Virkkunen (1979) found that criminals with antisocial personalities were not as physically dependent on alcohol as criminals not so diagnosed.
Öjesjö (1983) wrote a review of alcohol and drugs in forensic psychiatry. The general rule in Sweden as in most other countries is that voluntary intoxication is no defence in a criminal charge. Perr (1976) discussed alcohol and criminal responsibility in nineteen countries (extensive reference list). He found the subject area "immensely complex".
Scandinavian adoption studies have indicated that vulnerability to alcohol abuse, criminal behaviour or both is partly influenced by an inherited genetic factor.
The Swedish adoption studies (Bohman et al 1981, Cloninger 1981) particularly studied the connection between criminality and inheritance of alcohol abuse. They distinguished between two types of alcohol abuse with different genetic and environmental causes. One type is highly heritable and for this type alcohol abuse in the adopted children is associated with extensive treatment for both alcohol abuse and criminality in the biological parents.
If vulnerability both to alcoholism and to criminal behaviour is partly inherited, one has to assume various neurophysiological factors as intervening causal variables. Altered serotonin metabolism has been shown to be a contributing factor to impulsive acting out behaviour that can be directed towards others in aggressive assaults or towards the self in the form of violent suicidal behaviour.
Lidberg et al (1984) showed that low cerebrospinal hydroxyindole-acetic acid (5-HIAA) was found in patients who had tried to commit suicide after having killed their own children. Borg et al (1985) showed that alcoholics during abstinence had subnormal levels of 5-HIAA. During intoxication 5-HIAA correlated positively with blood ethanol concentration.
Branchey et al (1984) studied the possible association between amino acid abnormalities and history of aggressive and suicidal behaviour in a population of alcoholics. They found that depressed patients with a history of aggression had the lowest Tryptophan ratio values, significantly lower than in depressed alcoholic patients with no aggression history and in patients with no history of aggression or depression. They thought this suggested "the existence of a subgroup of alcoholics with marked amino acid abnormalities at risk for manifestations of depression, suicide and aggression".
In the majority of events when alcohol is consumed there is no sign of criminal or aggressive behaviour. This clearly shows that alcohol in it self is not a sufficient causal factor for criminal behaviour to occur (with the possible exception of "pathological intoxication"). Alcohol as a causal criminogenic factor requires an additional causal variable in the form of situational factors. "Frustration" is a general term for most situational factors that in combination with alcohol can result in crime. This frustration includes provocation, disappointments, misunderstandings, threats, etc. The frustration can very well be of minor character. Kuhlhorn (1984) mentioned the case of a person who asked for a cigarette. When the other person refused he was assaulted. Kuhlhorn questioned that this can be called frustration, but formally it is a classical case of a frustrating situation; a person is prevented from a desired goal by a physical barrier. The frustrating character of the situation always interacts with the intrapsychic frustrated state of the individual (Maier 1949). Gustafson (1986) made experimental studies of alcohol, frustration and aggression. He reported that only under frustrated conditions did intoxicated subjects increase their aggression.
The modus operandi of alcohol in frustrating situations can readily be understood in terms of alcohol as a disinhibiting factor.
Alcohol as a disinhibiting factor
The nature of the relationship between alcohol and crimes of violence was discussed by Coid (1982). He listed the following possibilities:
(a) Alcoholism is directly related to violence. (b) There is an increase in violent behaviour by alcoholics in their attempts to obtain more alcohol. (c) Environmental factors in the lives of alcoholics result in violent behaviour. (d) Environmental and/or genetic factors predispose certain individuals both to violent behaviour and to alcoholism. (e) Alcoholism results in organic brain damage or other psychiatric illness that is associated with violent behaviour.
All these possibilities indicate likely contributing causal variables. The best known and the intuitively most likely hypothesis is that alcohol functions as a disinhibiting factor that diminishes the efficiency of impulse control mechanisms. According to the disinhibiting hypothesis, alcohol use is directly related to violence. Although intuitively obvious, it may be difficult to yield conclusive proofs that this factor is more important than other factors. This is particularly difficult since one must assume that environmental, genetic, neurophysiological, situational and other factors simultaneously play an important part. The disinhibiting theory is fundamental for the next level of analysis, on the macro level.
Level of alcohol consumption
The total level of consumption of alcohol can be influenced by societal control measures. An international study of alcohol control experiences was made by Mäkelä et al (1981) and Single et al (1981). Mäkelä et al (1981), made a comparative study of alcohol control methods in Finland, Ireland, the Netherlands, Poland, Switzerland, California and Ontario. They described different types of control systems, control agencies and historical developments in alcohol control. Bruun et al (1975a, b) thoroughly treated various methods for alcohol control in worldwide perspective.
Alcohol influences many different aspects of society. Here we will limit our attention to its effect on crimes of violence. If there is a direct link between the consumption of alcohol and crimes of violence it would seem possible to diminish the number of crimes of violence by means of limiting the availability of alcohol. This is in agreement with the view of alcohol as a disinhibiting factor in frustrating situations. In contrast to the genetic, and neuro-physiological factors that cannot be influenced in a systematic way, the alcohol availability factor is, in principle, easy to manipulate.
The Swedish experience
Lombroso and Ferri noted that the crime level increased in France when the new harvests of wine arrived in November each year (quoted by Collins 1981, p xv). Comparatively few studies have been made on the connection between the total level of alcohol consumption and crimes of violence.
Room (1983) wrote about the Scandinavian studies:
So far, most of the evidence in this direction for non-alcohol specific crimes
We agree with Room in his evaluation of the time series analyses.
Lenke (1976, 1982, 1986) studied total alcohol consumption levels and rates of violent crimes. Lenke (1982) argued that alcohol abuse should not be seen as an effect (together with criminal behaviour) of background environmental or biological factors. It should rather be regarded as a causal factor in relation to crimes of violence. He stressed that the statistical analyses must not be made between different countries. For instance, Denmark, with the largest per capita consumption of alcohol in Scandinavia reports the lowest rate of crimes of violence: "The fact, however, that the rates of crimes of violence rather closely follow the rates of per capita consumption of alcohol within each country in Scandinavia over time, makes it possible to give alcohol a causal role. Not, however, as the causal factor, but as a link in a causal chain." (p.356)
In Sweden there has long been an active alcohol control policy. Different control measures have led to drastic increases or decreases in the rate of alcohol consumption. As can be seen from Figs X.9.i X.9.ii, every identifiable control measure or abolition of a control measure was immediately followed by a marked change in the rate of violent crimes. Lenke's analysis starts as far back as 1854. In that year the taxes on production of vodka were drastically increased. The production of vodka decreased from 65 million litres in 1853 to 23 million litres in 1855. As can be seen from Fig X.9.i there was a simultaneous decrease in the number of homicides and the number of assaults.
The next alcohol control measure was the alcohol rationing in 1917 and 1918 due to a general food shortage during World War I.
Between 1919 and 1955 there was a general rationing of alcohol in Sweden in a conscious attempt to diminish the availability of alcohol. When the rationing system was abolished in 1955, alcohol consumption increased by about 25% in two years. The assault rate also increased by 8%.
In 1963 the availability of alcohol was suddenly limited by a strike at the Swedish state monopoly for alcoholic products.
The next change in the availability of alcohol appeared in 1965. It was made legal to sell "middle-strong" beer in general food stores (earlier this was allowed only in the State controlled liquor stores). Between 1965 and 1970 the total consumption of alcohol in Sweden rose by about 40%. The assault rate increased by more than 50% during the same period. In 1977 the law was abolished, but the total consumption of alcohol decreased by only about 10%, and the assault rate did not follow. 1978-1981 the violent crime rate remained high with diminishing alcohol consumption (Wikström 1985 p.156).
Lenke (1976, 1982) made several further analyses. He showed that the increase in violent crimes in connection with the liberalization of beer selling in Sweden was particularly marked in the younger age group, 15-19 years old. He showed that rationing of alcohol as compared with price control has a better effect on severe violent crimes. After the abolishment of the rationing system in Sweden in 1955, there was an increase in the number of homicides and deaths due to liver cirrhosis. Although the total level of alcohol consumption could soon be controlled by raised prices of alcohol, the increase in violent crimes and alcohol related deaths remained.
Lenke (1986) estimated that alcohol accounts for about 50% of violent crimes in Sweden. His data indicated that alcohol consumption in a public setting rather than in a private one increased the effect by a factor of six.
Hofer (1983) in his monograph on criminal statistics in Sweden between 1750 and 1982 agreed with Lenke about the crucial role of alcohol for crimes of violence.
Lenke (1982) argued that "alcohol policy probably is a much more effective measure against crimes of violence than traditional penal measures." When punishment was made more lenient, in the beginning of the 20th century, the rate of crimes of violence decreased. When punishment was increased in 1965, the assault rate increased. Alcohol policy measures seem to be more potent than penal measures.
The other Scandinavian countries
Lenke (1982) stressed that the total level of alcohol consumption does not explain differences between countries in the level of crimes of violence. There are other cultural factors, specific for each country, that explain differences between countries. Within each country, however, there seems to be a close relationship between the level of alcohol consumption and violent crimes.
Lenke made time-series analyses for rates of alcohol consumption and crimes of violence in Denmark, Norway and Finland from 1950 onwards. He found a strong positive correlation for all three countries. This demonstrates that the effect on violent crimes is not of short duration.
Lenke (1976) noted that for Norway and Denmark the curves for both alcohol consumption and violent crimes describe unbroken trends, both curves have risen simultaneously Even if there is a strong statistical correlation one cannot assume a causal correlation from unbroken curves, since there may be unknown background variables influencing both curves. The curves for Sweden are more compelling since they show simultaneous "jumps" up and down clearly correlated with alcohol control measures.
The curves for alcohol consumption and violent crimes in Finland, 1950-1978, are similar to the curves for the development in Sweden. In Finland also, both curves reflect changes in the alcohol control policy. (Fig. X.9.iii)
In 1969 the Finnish alcohol control laws were liberalized. "Middle-strong" beer was allowed to be sold in general food stores. During the following years there was a rapid increase in violent crimes. In 1975 prices for alcohol in Finland were raised considerably in an effort to diminish alcohol consumption. This seems to have resulted in a decrease also in violent crimes. Lenke (1986) noted that earlier studies had shown a connection between total alcohol consumption and violent crimes in Germany and France. It must be repeated, however, that cultural differences between different countries may significantly influence the precise relationship alcohol and crime in each country. For example, Bruun (1975a) reported that there is a strong correlation between rate of liver cirrhosis mortality and per capita alcohol consumption in all investigated countries with one exception, the UK, where there was a statistically significant negative correlation.
A CAUSAL RELATIONSHIP
The available evidence clearly supports the notion that there is a direct causal connection between the consumption av alcohol and crimes of violence. The time series analyses presented above show that by limiting the availability of alcohol, one can decrease the rate of violent crimes. This does not in any way exclude other causal factors. On the contrary, the alcohol factor probably is an intervening causal variable in combination with other causal variables. The theory of alcohol as a disinhibiting factor in aggression provoking situations is the best conceptualisation of alcohol as a criminogenic causal variable. Many writers, like Coid (1982) discuss alternative causal models.
It is trivial, however, to assert that a subject area is complex allowing for numerous hypothetical causal models. This is always the case in science, particularly in the behavioural sciences. In a three-variable system there are 64 possible causal models, in a four-variable system there are 4,096 and in a five-variable system more than 16 million possible causal models (Simon 1954). Simplifications are always necessary.
What is essential is that there is a causal connection between alcohol and crime. The time-series analyses clearly refute the possibility of a spurious relation between alcohol and crime (both being caused by common background variables). More important is that alcohol emerges as a highly potent causal criminogenic variable. By limiting the availability of alcohol the rate of violent crimes can be drastically reduced.
Rationing of alcohol seems to be more efficient than price control. Rationing particularly helps the heavy consumers who cannot set a limit to their consumption of alcohol. The distribution of alcohol consumption is just as important as the total level of consumption.
Collins (1981), in a detailed theoretical and methodological review of the field was generally unwilling to assert alcohol as a causal factor. Although scholarly impeccable he tended to conceal the crucial practical importance of alcohol as a criminogenic factor. The connection between alcohol and violent crimes is an applied rather than theoretical scientific problem. It may be more important to ask which are the best methods for limiting the availability of alcohol.
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 Printed in Bluglass, R. & Bowden P., Principles and practice of Forensic Psychiatry. London: Churchill Livingstone, 1990, chapter X.9, p. 941-945. Minor differences may occur in the printed version . Three figures are not included in this electronic version.
 Figures not included here; see the printed version.
 In the printed version all references are collected at the end of the handbook.
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