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When a person is scammed, does it mean they have diminished capacity to make decisions, are unduly influenced, or are incapacitated? A forensic psychiatrist may be asked to assess whether the person is fit to stand trial or needs a conservatorship (which gives another person legal authority to make decisions for them).
Drs. Nora Douglas, Renee Sorrentino, and Susan Hatters Friedman used case vignettes to illustrate their points during their presentation to the International Forensic Psychiatry Lecture Series.
Knowing how scams work and who is most susceptible to them can help mental health professionals evaluate and treat people who have been victimized.
The Scams
Fraud involves unauthorized access to financial information without the person’s consent. Scams are a type of fraud that use psychological manipulation to persuade victims to voluntarily give them money or personal information.
“Scams have become one of the most common types of crime globally, which has resulted in not only high financial tolls, but high emotional tolls as well,” Dr. Douglas said.
In 2023, more than 521,500 internet criminal complaints were filed in the United States. That’s compared with 288,300 in the United Kingdom, and 6,600 in Canada.
Common aspects of scams include unexpected contact, a sense of urgency or pressure to act quickly, too-good-to-be-true statements, upfront and untraceable payments, and spelling and grammar errors.
Scams take several forms.
- Investment scams convince people to invest based on false information. These can include pyramid schemes and cryptocurrency investments.
- Romance scams create an illusion of a romantic or close relationship to manipulate the person into sending money. This scam can evolve into sextortion.
- Grandparent scams are a type of confidence scam in which a caller pretends to be a grandchild in crisis and asks for urgent financial help.
- Phishing and spoofing scams involve unsolicited emails, texts, or phone calls that appear to be from legitimate companies. The perpetrator asks for personal or financial information or passwords.
However, scams continue to evolve and become more sophisticated as technology advances. Perpetrators can use artificial intelligence (AI) to create deepfake images of real people for sextortion. AI can also clone a person’s voice and spoof the caller ID, which are techniques used in grandparent, phishing, and spoofing scams. Perpetrators have also used cryptocurrency ATMs or kiosks and QR (quick response) codes in parking lots to steal from unsuspecting people.
Perpetrators of Scams
Unlike perpetrators of fraud, perpetrators of scams are often located far away from their potential victims, who may be persuaded to participate in their own victimization.
Researchers have found that perpetrators tend to be white males aged 35 and older, with college educations and jobs. Researchers have not found a link to psychopathic traits. The link to personality traits is unclear, and data about anxiety disorders is inconsistent. Few perpetrators have substance use or gambling problems.
The Effects
People victimized by romance scams may struggle with their anger, shock, embarrassment, shame, worry, and stress. They may also have poor self-control and suicidal thoughts. Dr. Douglas said the emotional and psychological effects of romance scams can create a “double hit” because of the loss of the relationship and the money.
Adolescents who experience sextortion often have severe psychological distress, including depression, anxiety, and stress. They may also have suicidal thoughts and injure themselves.
Susceptible Demographics
The stereotype is that victims are 65 years old and older and may have decreased cognitive function and low literacy. In the United States, people ages 70 and older reported losing more money on average than any other age group in 2024–2025. However, more people ages 30 to 49 reported losing money to fraud.
Low literacy levels, increased internet use, decreased psychological well-being, and lower self-control are also risk factors.
People who are romantics and idealize relationships are at higher risk of romance scams, Dr. Sorrentino said. While impulsivity and higher education are risk factors, there is no related risk associated with loneliness, being an extrovert, being agreeable, nor having a long-term tendency to feel anxiety, fear, sadness, and anger.
Mental health professionals are also susceptible to scams. These scams include predatory publishing and conferences, nonexistent award nominations from named colleagues, licensing board investigations, and Drug Enforcement Administration investigations.
Dr. Sorrentino said busy doctors often have no training in business, finance, or investing. At the same time, they can be overconfident and too trusting of professionals.
Scams and Forensic Psychiatry
Dr. Hatters Friedman focused on scam squads or fraud squads. These multidisciplinary squads are based in communities across the United States. Dr. Hatters Friedman is a member of the Cuyahoga County Scam Squad, which runs under consumer protection.
The group published Scam Squad Guide: Simple ways to spot, avoid and report scams to educate the community. Copies of the guide are available at libraries and seniors’ centres.
She said scam squads could provide a public health role by helping mental health professionals raise awareness, reduce stigma, and prevent victimization from scams.
For more details, watch the recording of the March 5, 2026, lecture “Grandma, Grandma, Help Me! Forensic Psychiatry and Scams.”
Written by Virginia St-Denis and approved by Drs. Susan Hatters Friedman, Renee Sorrentino, and Nora Douglas.
