Predicting forensic inpatient violence with odor identification and neuropsychological measures of impulsivity: A preliminary study

Executive functioning in antisocial behavior: A multi-level systematic meta-analysis

Neurobiological information - including executive functioning - is increasingly relevant for forensic clinical practice, as well as for the criminal justice system. Previous meta-analyses report that antisocial populations show impaired performance on executive functioning tasks, but these meta-analyses are outdated, have limitations in their methodological approach, and are therefore in need of an update. The current multi-level meta-analysis including 133 studies (2008-2023) confirms impaired performance in executive functioning (d=.42), but studies are heterogeneous. Several moderator analyses showed that neuropsychological test used, type of executive function component, and control group characteristics moderated the overall effect. Specifically, matching psychiatric problems in the non-antisocial control group eliminated any differences in executive functioning between groups. No moderation effects were found for assessment quality, hot or cold executive functions, and various population characteristics. These results could indicate that the assessment of executive functioning in antisocial populations may be less relevant for recidivism risk assessment than thought, although this should first be assessed in prospective longitudinal studies. Executive functioning could potentially be used to identify or screen for individuals with certain treatment needs or be used as a responsivity factor, especially in disorders which are often underdiagnosed in criminal justice settings.

Neuropsychiatric correlates of olfactory identification and traumatic brain injury in a sample of impulsive violent offenders

Background

Olfactory deficits have a diverse etiology and can be detected with simple olfactory tests. Key olfactory pathways are located within the frontal and temporal lobes where they are vulnerable to damage due to head trauma. Orbitofrontal cortex (OFC) integrity is important for olfaction and aspects of behavioral regulation. We measured olfactory identification ability in a sample of impulsive violent offenders to determine its associations with history of traumatic brain injury (TBI) and a range of neuropsychiatric indices, including proxies for cognitive ability, impulsivity and social connectedness.

Methods

Male participants were drawn from the ReINVEST study, a randomized controlled trial of sertraline to reduce recidivism in violent impulsive offenders. Criteria for participation in the study included a minimum age of 18 years, a documented history of two or more violent offenses, and a score of 70 or above on the Barratt Impulsiveness Scale (BIS-11). The 16-item "Sniffin sticks" (SS) odor identification test (OI) was administered as were standardized questionnaires regarding previous TBI, additional measures to screen cognition [word reading test of the Wechsler Individuals Achievement Test (WIAT), social connectedness (the Duke Social Support Scale), and a range of other neuropsychiatric conditions or symptoms]. The sample SS scores were compared against published age-specific norms. Univariate and multivariate analyses were performed with SS score (linear regression, within those without hyposmia) or hyposmia (logistic regression) as the outcome.

Results

The mean OI scores were lower than population norms and 16% of participants were classified as hyposmic. Univariate analyses showed associations of SS score with age, WIAT score, impulsivity, TBI and TBI severity, social connectedness, childhood sexual abuse, suicidality and current use of heroin. In multivariate analyses, age, TBI severity and WIAT remained as significant independent predictors of SS score (within the normosmic range) or hyposmia (logistic regression).

Conclusion

Olfactory performance was associated with multiple behavioral phenomena in a pattern that would be consistent with this serving as a proxy for orbitofrontal functioning. As such, OI testing may have utility in further studies of offenders. In future, we will examine whether olfactory score predicts recidivism or response to the administration of sertraline, in terms of reducing recidivism.