The patient was a 30-year-old heterosexual male with a personal history of poor school performance and an overprotective upbringing pattern. He had been in a stable relationship for several years and had a daughter. At the time of the examination, he was awaiting trial for two sexual assaults, one week apart, both of which involved the use of an intimidating instrument (knife) and the second victim had sustained injuries as a result of her resistance (dislocated shoulder). He had no previous criminal record.
Accused acts
In relation to these, he recounts the introduction into his car, under intimidation with a knife, of a stranger "whom he liked", whom he groped and kissed after convincing her not to go any further for the sake of his daughter; he left her at the door of his house, with threats of being able to locate her if she told him what had happened. After about a week, he repeated the same sequence, although this time the victim tried to run away from the car, causing injuries to herself when she was held down by the victim. Both sexual assaults coincided with a period of deterioration in the couple's relationship, and in the second one there was a clear precedent of frustration related to the non-fulfilment of the expectations of having a sexual relationship with a stranger with whom he had a telephone relationship, and towards whom the victim had feelings of incipient infatuation.
Relevant findings in the psychosexual sphere
He highlighted the existence of a low level of sexual arousal, as well as a high frequency in the practice of different sexual activities (coitus and masturbation). The expert witness presented various deviant sexual behaviours, which began with practices with little interaction with the victims (voyeurism with masturbation), gradually leading to an increase in interaction, both verbal (obscene compliments) and physical (touching without the possibility of a response from the victims), until the events with which he was charged. Habitual user of pornography and occasional prostitution.
Psychopathological findings
No significant alterations were found in axis I. Given that while he was in prison and prior to the forensic medical examination he was diagnosed with mild mental retardation by the psychologist of a non-governmental organisation, he was referred to the forensic psychologist to support the diagnostic presumption of borderline intelligence with psychometric tests, which were not valid with regard to the calculation of the intelligence quotient (IQ) due to the poor collaboration of the expert witness (he presented metasimulative behaviour according to the forensic psychological report), reaching the diagnostic conclusion of borderline intelligence on the basis of his adaptive abilities, after clinical examination and application of the Intensity of Support Scale.
With regard to Axis II, the inmate showed typical features of the borderline personality disorder construct: verbalised cognitions related to fear of abandonment by his partner, having developed crude strategies to avoid such abandonment, such as prohibiting his partner from using the car to avoid abandonment, or restricting access to family accounts; he showed feelings of low self-esteem, identifying its origin in the rejection of his partner on a sexual level, but also in the perception of actions on her part aimed at his undervaluation before other people; at the same time, he showed an unstable self-image, oscillating between feelings of high self-worth and feelings of inferiority; poor social environment, with interpersonal relationships alternating between idealisation and devaluation. High impulsivity manifested in different areas of his private life, as well as significant mood reactivity.
In addition, the inmate verbalised cognitive distortions aimed at minimising the use of violence against his partner and the victims, even blaming his partner for the alleged acts due to her sexual rejection, and the second victim for her injuries because she resisted the sexual activity by trying to flee; manifested other cognitive distortions about women and their role in society (female role related only to the care of the home and children, without active participation in the decisions derived from living together as a couple), as well as about sexuality (justification of sexual activity with her partner with the mediation of violence in the absence of the latter's persistent refusal to have sexual relations). Functional analysis of reported sexual behaviours, as well as sexual aggressions, showed a consistent association between the practice of sexual behaviours and feelings of sexual frustration and associated cognitions (feelings of low self-worth and thoughts related to abandonment).