SHIF-UKABIF Conference June 2008 Neuropsychological Factors in Offending Behaviour

1. SHIF-UKABIF ConferenceJune 2008Neuropsychological Factors in Offending Behaviour Dr Ewan Lundie Chartered Psychologist

3. What is Offending Behaviour? “The beginning of wisdom, it has been said, is definition. Words help construct our reality, and therefore the stated meanings of words will give some indication of the concepts we employ ” (Devonshire 2008)

4. What is Offending Behaviour? The Law – the criminal standard of ‘the presence of the guilty mind’ (mens rea) direct intention: ‘to bring about the intended result’ indirect intention: ‘the foreseen result is undesired but has a virtual certainty of occuring’

5. What is Offending Behaviour? ? Offending behaviours – ‘General & Persistent Offending’, ‘Intimate Partner Violence’, ‘Sex Offending’, ‘Non-Sexual Violent Offending’, ‘Substance Misuse Related Offending’ ? Harmful behaviours – aggression, psychological control, sexual comments

6. Risk, Needs & Responsivity The ‘Risk’ Principle – target resources to the riskiest cases The ‘Needs’ Principle – prioritise criminogenic need The ‘Responsivity’ Principle – agencies and practitioners are ready, willing, and able to respond to the uniqueness of the individual (Andrews & Bonta, 2003)

7. Risk, Needs & Responsivity Best Practice in Risk Assessment Unstructured Clinical Judgment Actuarial Approach Structured Professional Judgement Practice Guidelines & Tool Evaluations: www.rmascotland.gov.uk

8. Risk, Needs & Responsivity How it Works in Practice Courts / MAPPA / ICM Good Lives Model Motivational Approaches Inclusion Agenda Programmed Interventions Desistance / Strengths

9. Risk, Needs & Responsivity Some Examples of RNR in Practice General & Persistent Offending Intimate Partner Violence Sexual Offending Non-sexual Violence Substance Misuse Related Offending

10. Review of evidence re a possible role for neuro factors? Literature review - medline / psychinfo Most references post-1995 5 of the 6 studies prior to 1982 report insufficient evidence of links 49 of the 54 studies 1982-2003 report sufficient evidence of links

11. Review of evidence ..contd. Vaccaro (1941) - TBI brings out latent psychopathic status Virkunnen et al. (1977) - criminal behaviour not a sequel of TBI Sarapata et al. (1998) - TBI rates are high and precede offending

12. Review of evidence ..contd. Lewis et al. (1986) - 15 death row inmates, selected because of imminence of execution, all had severe TBI history Volavka et al. (1992) - TBI in childhood an antecedent of violent crime, and disturbed central serotonin function in impulsive homicide & arson

13. Review of evidence ..contd. Rosenbaum et al. (1994) - TBI in spouse batterers Diaz (1995) - warns of possible abuse of TBI/crime links Reikin (1996) - case study, male, 65, enlarged cyst, killed wife Yeamains (1996) - violent adolescent females

14. Review of evidence ..contd. Simpson et al. (1999) - 477 BIRU males, 29 commit 128 sex offences in 5 year period post-injury, only 2 had pre-injury sex offence history, only 3 events alcohol-related

15. Review of evidence ..contd. Raine (1989) - High PCL-R scorers have information processing deficit with emotions and different EEG profiles Blair (2003) – neurobiological basis of psychopathy

16. Mechanisms of Action Golden (1996) - Pre-frontal cortex and temporal lobes Raine (1996) - review of imaging studies Krakowski (1997) - causal mechanisms not well understood

17. Mechanisms of Action Raine (1997) - affective aggression caused by over arousal and poor regulatory ability; instrumental aggression linked to underarousal Raine (1998) - predatory versus affective murderers; PET scans, glucose metabolism analysis Raine (1998) - Pre-frontal glucose metabolism deficits in murderers who lack psychosocial deprivation, hypotheses that brain abnormalities provide a stronger pre-disposition to violence

18. Mechanisms of Action Davidson et al. (2000) emotion regulated by a complex circuit: orbito frontal cortex, amygdala, anterior cingulate cortex; genetic & environmental factors make significant contribution; PFC gets major seretonergic projection in impulsive violent individuals;

19. Mechanisms of Action Brower (2001) - clearest links are between focal orbito-frontal injuries and impulsive aggression but still no frontal pattern that allows prediction of aggression Kefi et al. (2001) - 3 models have best empirical basis: serotonin metabolism, genetic, frontal lobes

20. Mechanisms of Action Bergvall et al. (2001) - general deficit in set-shifting & can’t alter behaviour in response to changing emotional cues Raine (2002) - social and biological factors combine to exponentially increase risk of violence [see also Miller (1992)] Blair (2003) – psychopaths can present with amygdala & orbital PFC dysfunction

21. Mechanisms of Action Berthoz et al. 2002 – orbito-frontal cortex implicated in intentional norm violation King et al. (2006) – the same circuit (including amygdala and ventromedial PFC) activated whether being compassionate or aggressive Mullin & Simpson (2007) – executive functioning deficits found in general and persistent non-ABI offenders

22. Treatment / Management Leon-Carrion (2001) - untreated childhood TBI cases have higher incidence of adult criminality Bogner et al. (2001) - pre-TBI substance misuse a relevant factor Cunic (2001) - neuro impaired S's have similar treatment response with violence reduction programme

23. Treatment / Management NIH (US) (1999) - heterogenic samples, studies have methodological flaws, but, recurring themes in effective interventions .....

24. Treatment / Management structure systematic approach individualised goal oriented learning & practice opportunities social contact relevant context

25. Treatment / Management Alderman (2003) – aggressive and violent behaviour associated with impaired executive functioning after ABI can be reduced through programmed work (structured, skills-based, problem-solving focus); Mullin & Simpson (2007) – best outcome with general and persistent non-ABI offenders in prison programme was with lowest executive ability;

26. Treatment / Management Offending Behaviour Programmes ‘What Works’ literature – CBT works (McGuire, 1995) CBT group-work reduces sex offending recidivism by 50% (Hanson et al., 2002) Accredited Programmes in UK – exist or are being developed in all key areas Linked through ICM / MAPPA / LSCMI to best practice in risk management

27. Q & A