Neurocognitive disorders in sentenced male offenders: implications for rehabilitation

Motor difficulties in young people who offend

BACKGROUND

Research suggests that motor difficulties may be closely associated with severe emotional and behavioural problems in children. However, there is limited research on the role of motor function in young adults who offend.

AIMS

To assess motor skills, balance, and primary reflex persistence in young people who offend, and to examine the relative association of different motor factors with self-reported levels of aggression.

METHODS

We recruited three groups of males (14-18 years); young people serving custodial sentences (n = 33) in a youth justice centre, and an IQ-matched comparison group (n = 36) and an average-IQ comparison group (n = 38) of non-offenders. All completed a standardised test of motor skills, clinical assessment protocols for balance and primary reflex persistence, and a standardised self-report behavioural rating scale.

RESULTS

The youth justice group showed significantly lower abilities in some motor skills and balance and significantly higher levels of primary reflex persistence and aggression than both comparison groups. In a multiple regression model, only manual dexterity (p = .032) and primary reflex persistence (p = .002) were significant predictors of aggression.

CONCLUSIONS

A broad range of motor difficulties are likely to occur in young people who offend. We discuss the implications of motor difficulties for approaches to rehabilitation of persistent offenders.

External locus of control and cognitive ability independently distinguish men in prison from community living non-offending men

BACKGROUND

The ability to cope with failure and subsequent feedback is crucial for prisoner rehabilitation. Impaired executive function in prisoners, high trait aggression and external locus of control can undermine the capacity to react to feedback in socially adaptive ways.

AIM

To investigate the relationships between aggression, locus of control, and attribution in an experimental task involving feedback about failure and success.

METHODS

Two groups were compared: 1. Imprisoned men, 2. Community living men without a history of incarceration. Aggression, locus of control and reasoning ability were assessed by means of psychometric instruments. An experimental task building on cognitive ability and providing performance-related feedback was carried out. Attributions of failure and success were measured using an ad hoc rating scale.

RESULTS

Prisoners reported higher levels of aggression and generalised externality, but poorer reasoning ability than the comparison group. Aggression was associated with external locus of control. In the experimental task, the community group showed higher success rates; higher scores on the task were correlated with less external attribution of own performance. Higher external locus of control and lower reasoning ability were independently associated with being a prisoner in a logistic regression model.

CONCLUSIONS AND IMPLICATIONS

Men in prison were characterised by greater social and fatalistic externality paired with lower reasoning ability than never incarcerated community men. In-prison rehabilitation strategies should pay early attention to improving reasoning ability and enabling men to recognise likely overuse of externally attributing their difficulties to fate, then helping them to become more realistic in their attributions and make use of realistic feedback.

Cognitive dysfunction in older prisoners in Germany: a cross-sectional pilot study

Purpose

The purpose of this study is to collect the first empirical data on the cognitive state of elderly prisoners in Germany and to examine associations between cognitive function and sociodemographic, clinical and incarceration characteristics.

Design/methodology/approach

All prisoners aged 60 years and older of five prisons in North Rhine-Westphalia, Germany, were asked to participate. The cognitive screening instruments mini-mental state examination (MMSE) and the DemTect were used to assess global cognition. Executive functions were tested with the trail making test and the frontal-assessment-battery. The Patient Health Questionnaire (PHQ-9) was used to assess participants’ affective state.

Findings

The sample of this study consisted of 58 prisoners with a mean age of 65.52 years (standard deviation = 6.03); 82.8% are male. Using the MMSE with age- and education-corrected z-scores, 36.9% of the prisoners showed marginal or impaired global cognition scores. Using the DemTect, 41.4% of the prisoners were classified as being cognitively impaired. Up to 40% of the prisoners showed deficits in executive functioning and around 60% of the prisoners showed depressive symptoms. The correlation analysis revealed significant associations between cognitive scores and age (rho = –0.335, p = 0.014), education (rho = 0.309, p = 0.020), sentence duration (rho = 0.409, p = 0.007) and duration of current incarceration (rho = 0.302, p = 0.043). The DemTect total score was significantly associated with the PHQ-9 (rho = –0.335, p = 0.016).

Practical implications

A large group of the prisoners showed a higher prevalence of cognitive dysfunction than that observed in same-age people who are not incarcerated. Taken together, there is an urgent need for an adequate management of older cognitively impaired prisoners including routine cognitive testing and guidelines-oriented treatment of cognitive symptoms.

Originality/value

This study has several strengths. To the best of the authors’ knowledge, this is the first study examining the cognitive and affective state in a German prison population. The authors considered female and male prisoners, as well as different prison settings, representing a realistic prison sample. The authors used several neuropsychological instruments to get a more detailed insight into the older prisoners’ cognitive status while trying to consider the economy of time and possible attention deficits to prevent dropouts during testing.

Cognitive functioning and aggressive antisocial behaviors in young violent offenders

Studies have shown that offenders have impaired cognitive abilities yet it is unclear if cognitive dysfunction per se contributes to aggressive antisocial behaviors. Our aims were to (1) determine associations between cognitive functioning and different forms of aggressive antisocial behaviors, (2) describe prevalence of, and covariates to, uneven intellectual profiles, and (3) investigate associations between cognitive functioning and age at onset of aggressive antisocial behaviors. A cohort (n = 269) of 18-25 years old male violent offenders were assessed for general intellectual functioning with the Wechsler Adult Intelligence Scales-third edition, and for executive functions with the Cambridge Neuropsychological Test Automated Battery. Only one measure of cognitive functioning - slower reaction times in a response inhibition test - was significantly correlated with higher occurrence of aggressive, but not exclusively antisocial, behaviors. Furthermore, offenders with even intellectual profiles showed more aggressive antisocial behaviors than offenders with uneven intellectual profiles. Finally, increased errors in tests of cognitive flexibility and slower reaction times in a response inhibition test were associated with a younger age at onset of general, but not exclusively violent, criminality. Overall, effect sizes were small. The findings emphasize the need of research investigating how cognitive functioning in offenders affects susceptibility to treatment interventions.

Do High-risk Prisoners Entering Treatment Have Clinically Impaired Cognitive Impulse Control?

Moffitt's (1993) developmental theory suggests that offenders on the life-course persistent (LCP) trajectory inherit or acquire neuropsychological deficits that compromise impulse control, and ultimately contribute to criminality. Empirical tests of this notion with adult LCP offenders are rare; the expected degree of impairment and which mechanisms are unclear. This research adopted a neurocognitive framework that proposes three cognitive mechanisms of impulse control: decision-making, perceptual control, and motor impulse control. Participants were 77 adult males, predominantly LCP prisoners completed five assessment tasks during pre-treatment assessment. Overall, proportions of impairment were unexpectedly low within and across cognitive impulse control domains. The highest proportions of impairment were observed on tasks requiring cognitive flexibility and sustained attention, and only cognitive flexibility uniquely predicted estimated pre-treatment violence risk. Results suggest the need to disaggregate cognitive from personality and behavioural variants of impulsivity and to further investigate how impaired cognitive flexibility affects progress during and following treatment.