Precursors of lethal violence: a death row sample

Dehumanization Through Degendering the Death Row Inmate: A Systematic Review of the Research

Purpose: To provide an overview of how gender identity is treated in death row research. Methods: By use of a systematic review of 56 peer-reviewed journal articles that were identified as empirical, employing either qualitative or quantitative data, concepts measuring the use of gender and race identity were developed. Results: Findings were presented by the methodology employed, area of research, sample composition, and key concepts which included the use of gendered terminology in titles, abstracts, and manuscripts, as well as by the author(s)'s gender identities. Conclusion: In general, regardless of methodology or area of research, death row research does not account for the effects of gender or intersectional identities unless the sample participants or subject matter pertains to women.

Exploring the Cognitive-Communication Challenges of Adults With Histories of Traumatic Brain Injury and Criminal Justice System Involvement: A Pilot Study

INTRODUCTION

The prevalence of traumatic brain injury (TBI) in the criminal justice system (CJS) is well known. Furthermore, the impact of TBI on communication has been well documented; however, no study has explored the communication challenges of those with TBI in the CJS or considered their implications within CJS contexts. Moreover, no study has examined the possible differences in communication between those with TBI and CJS history and those with TBI but no CJS history.

PURPOSE

This cross-sectional pilot study provides a preliminary exploration of the cognitive-communication challenges in a sample of adults with histories of TBI and CJS involvement compared with a sample of adults with histories of TBI but no CJS involvement.

METHOD

Eight individuals with histories of TBI and CJS involvement were recruited through community agencies. The La Trobe Communication Questionnaire (LCQ) was administered to collect self-reported data on perceived cognitive-communication abilities, including social communication behaviors. Findings were examined and then compared with a previously studied sample of 160 individuals with TBI. Logistic regressions were calculated to determine whether response scores on the LCQ would be predictive of group membership (i.e., TBI + CJS or TBI only).

RESULTS

A range of cognitive-communication challenges were reported by both groups. A logistic regression analysis demonstrated a reasonable inference that LCQ responses may predict group membership and support the potential for statistically significant and meaningful results to justify future studies.

CONCLUSIONS

These challenges have the potential to negatively impact the success of communication interactions within the CJS and illustrate a need for speech-language pathology services for individuals with TBI in the CJS. The nature and magnitude of between-group differences merits further investigation with larger samples to explore whether any specific cognitive-communication challenge is unique to, or predictive of, CJS involvement for purposes of targeted assessment and intervention.

Aggression, Aggression-Related Psychopathologies and Their Models

Neural mechanisms of aggression and violence are often studied in the laboratory by means of animal models. A multitude of such models were developed over the last decades, which, however, were rarely if ever compared systematically from a psychopathological perspective. By overviewing the main models, I show here that the classical ones exploited the natural tendency of animals to defend their territory, to fight for social rank, to defend themselves from imminent dangers and to defend their pups. All these forms of aggression are functional and adaptive; consequently, not necessarily appropriate for modeling non-natural states, e.g., aggression-related psychopathologies. A number of more psychopathology-oriented models were also developed over the last two decades, which were based on the etiological factors of aggression-related mental disorders. When animals were exposed to such factors, their aggressiveness suffered durable changes, which were deviant in the meaning that they broke the evolutionarily conserved rules that minimize the dangers associated with aggression. Changes in aggression were associated with a series of dysfunctions that affected other domains of functioning, like with aggression-related disorders where aggression is just one of the symptoms. The comparative overview of such models suggests that while the approach still suffers from a series of deficits, they hold the important potential of extending our knowledge on aggression control over the pathological domain of this behavior.

Forgiveness, spirituality and love: thematic analysis of last statements from Death Row, Texas (2002-17)

BACKGROUND

Psychological features associated with execution are not fully understood.

AIMS

To analyse demographics of individuals executed in Texas and investigate whether there has been any change in common themes and psychological factors evident in last statements before execution between 2002 and 2017.

DESIGN

Analysis of last statements from Death Row, Texas.

METHODS

We (a) studied themes and psychological factors in last statements in Texas between August 2011 and May 2017; and (b) combined our 2011-17 data with our previous data (2002-06 and 2006-11) to present an overall analysis of last statements from 2002 to 2017.

RESULTS

Between April 2002 and May 2017 (279 executions; 240 last statements), the execution rate in Texas fell from 25 per year to 12; median time on death row increased from 108.5 months to 149.5; median age at execution increased from 38 years to 40.5; and the proportion of offences involving multiple victims rose from 28.4% to 47.1%. The most common themes in last statements were love (78%), spirituality (58%), regret (35%) and apology (35%). The most common psychological factors were identification-egression (51%), unbearable psychological pain (47%) and rejection-aggression (40%). Two themes (forgiveness, use of poetry/literature) and three psychological factors (inability to adjust, interpersonal relations, identification-egression) became less common.

CONCLUSIONS

Between 2002 and 2017, executed prisoners in Texas became fewer and older, spent longer on death row and had committed more serious offences. Themes of love and spirituality were constants, but requests for forgiveness declined.

Aggressiveness, violence, homicidality, homicide, and Lyme disease

BACKGROUND

No study has previously analyzed aggressiveness, homicide, and Lyme disease (LD).

MATERIALS AND METHODS

Retrospective LD chart reviews analyzed aggressiveness, compared 50 homicidal with 50 non-homicidal patients, and analyzed homicides.

RESULTS

Most aggression with LD was impulsive, sometimes provoked by intrusive symptoms, sensory stimulation or frustration and was invariably bizarre and senseless. About 9.6% of LD patients were homicidal with the average diagnosis delay of 9 years. Postinfection findings associated with homicidality that separated from the non-homicidal group within the 95% confidence interval included suicidality, sudden abrupt mood swings, explosive anger, paranoia, anhedonia, hypervigilance, exaggerated startle, disinhibition, nightmares, depersonalization, intrusive aggressive images, dissociative episodes, derealization, intrusive sexual images, marital/family problems, legal problems, substance abuse, depression, panic disorder, memory impairments, neuropathy, cranial nerve symptoms, and decreased libido. Seven LD homicides included predatory aggression, poor impulse control, and psychosis. Some patients have selective hyperacusis to mouth sounds, which I propose may be the result of brain dysfunction causing a disinhibition of a primitive fear of oral predation.

CONCLUSION

LD and the immune, biochemical, neurotransmitter, and the neural circuit reactions to it can cause impairments associated with violence. Many LD patients have no aggressiveness tendencies or only mild degrees of low frustration tolerance and irritability and pose no danger; however, a lesser number experience explosive anger, a lesser number experience homicidal thoughts and impulses, and much lesser number commit homicides. Since such large numbers are affected by LD, this small percent can be highly significant. Much of the violence associated with LD can be avoided with better prevention, diagnosis, and treatment of LD.

Analysis of last statements prior to execution: methods, themes and future directions

Worldwide, over 1000 people were executed in 2016 and over 3000 sentenced to death. Death row prisoners have high rates of mental illness, often combined with neurological impairment. Prolonged confinement has further negative effects on psychological function. There is a growing literature examining key themes and psychological constructs in death row prisoners immediately prior to execution. To date, this literature centres largely but not exclusively on last statements from death row in Texas, owing to ease of availability. The most common themes in last statements are love, spirituality and apology or regret. The most common psychological constructs are 'identification-egression' (e.g. attachment to a lost person or ideal, such as freedom), unbearable psychological pain and rejection-aggression. This is still a relatively new area of research and new techniques, such as computerised quantitative text analysis, are likely to complement rather than replace more traditional forms of thematic and textual analysis. For the future, it is essential that studies in this field continue to specify precisely, which last statements they use, so that overlap can be identified, and that more countries are studied (if possible). It would also be useful to expand the research frame to relate the content of last statements to additional variables relating to prisoners' offences, physical health, mental health, family structure and broader circumstances. Finally, ethical issues require continued consideration in this complex, fascinating, growing field.

History of traumatic brain injury in prison populations: A systematic review

Traumatic brain injury (TBI) can lead to cognitive, behavioural and social impairments. The relationship between criminality and a history of TBI has been addressed on several occasions.

OBJECTIVE

The objective of this review was to present an update on current knowledge concerning the existence of a history of TBI in prison populations.

METHODS

PubMed and PsycINFO databases were searched for relevant papers, using the PRISMA guidelines. We selected papers describing TBI prevalence among incarcerated individuals and some that also discussed the validity of such studies.

RESULTS

Thirty-three papers were selected. The majority of the papers were on prison populations in Australia (3/33), Europe (5/33) and the USA (22/33). The selected studies found prevalence rates of the history of TBI ranging from 9.7% and 100%, with an average of 46% (calculated on a total population of 9342). However, the level of evidence provided by the literature was poor according to the French national health authority scale. The majority of the prisoners were males with an average age of 37. In most of the papers (25/33), prevalence was evaluated using a questionnaire. The influence of TBI severity on criminality could not be analysed because of a lack of data in the majority of papers. Twelve papers mentioned that several comorbidities (mental health problems, use of alcohol…) were frequently found among prisoners with a history of TBI. Two papers established the validity of the use of questionnaires to screen for a history of TBI.

CONCLUSION

These results confirmed the high prevalence of a history of TBI in prison populations. However, they do not allow conclusions to be drawn about a possible link between criminality and TBI. Specific surveys need to be performed to study this issue. The authors suggest ways of improving the screening and healthcare made available to these patients.

Sentenced to Die: Last Statements and Dying on Death Row

Moments prior to execution, death row inmates are given time to say anything they desire. In these moments, what do inmates find most important to express? This study first examined the context of dying on death row. Conflicts over high death stigma (Silverman, 1994), just world beliefs (Lerner, 1980), system justification needs (Jost & Banaji, 1994), high death salience, lack of control, and facing their own crime were explored. Next, last statements were studied. Six themes, forgiveness, claims of innocence, silence, love/appreciation, activism and after life belief, were found. Lastly, suggestions for future research on death and dying on death row were made, with special attention paid to terror management theory (see Solomon, Greenberg, & Pyszcynski, 2004 for review) and system justification theory (see Jost, Banaji, & Nosek, 2004 for review).

Efficacy of legal judgments for defendants with traumatic brain injury

BACKGROUND

Literature has compared the frequency of aggressive behaviors of the TBI population and the non-TBI population, suggesting that the TBI population is predisposed to aggressive tendencies because the injury enables impulsivity, loss of self-control, and the inability to modify behaviors. These behavior changes have consequently, been found to lead to criminal involvement. In fact, the majority of the prison population has sustained at least one TBI in their lifetime compared to the prevalence of brain injuries in the general population. However, there is little research investigating the perceptions of criminality and guilt of these individuals.

METHODS

Two experiments were conducted that investigated the perceptions of morality, level of guilt, and appropriate sentencing of crimes committed by defendants with different severities of TBI (i.e., mild, severe, and no TBI). Participants were asked to read scenarios about crimes being committed by the defendant. Experiment 1 used a 1-between (crime), 1-within (TBI) mixed design ANOVA testing three dependent variables (morality, guilt, and sentencing). Using a more in vivo jury approach, Experiment 2 used a 3 (TBI)×2 (crime) independent groups factorial design testing the three dependent measures.

RESULTS

Overall, defendants with TBI were found less guilty of their crime, perceived as behaving morally to the crime, and receiving a milder punishment relative to the no-TBI defendants.

CONCLUSIONS

In the courtroom, the defense attorney should educate the judge and/or the jury on the effects brain injuries have on the cognition, behavior, and emotions of an individual. Thus, this education will ensure the best verdict is being reached.

Ethical and regulatory considerations in the design of traumatic brain injury clinical studies

Research is essential for improving outcomes after traumatic brain injury (TBI). However, the ubiquity, variability, and nature of TBI create many ethical issues and accompanying regulations for research. To capture the complexity and importance of designing and conducting TBI research within the framework of key ethical principles, a few highly relevant topics are highlighted. The selected topics are: (1) research conducted in emergency settings; (2) maintaining equipoise in TBI clinical trials; (3) TBI research on vulnerable populations; and (4) ethical considerations for sharing data. The topics aim to demonstrate the dynamic and multifaceted challenges of TBI research, and also to stress the value of addressing these challenges with the key ethical principles of respect, beneficence, and justice. Much has been accomplished to ensure that TBI research meets the highest ethical standards and has fair and enforceable regulations, but important challenges remain and continued efforts are needed by all members of the TBI research community.

Traumatic brain injury among Indiana state prisoners

Research on traumatic brain injury among inmates has focused on comparing the rate of traumatic brain injury among offenders to the general population, but also how best to screen for traumatic brain injury among this population. This study administered the short version of the Ohio State University Traumatic Brain Injury Identification Method to all male inmates admitted into Indiana state prisons were screened for a month (N = 831). Results indicate that 35.7% of the inmates reported experiencing a traumatic brain injury during their lifetime and that these inmates were more likely to have a psychiatric disorder and a prior period of incarceration than those without. Logistic regression analysis finds that a traumatic brain injury predicts the likelihood of prior incarceration net of age, race, education, and psychiatric disorder. This study suggests that brief instruments can be successfully implemented into prison screenings to help divert inmates into needed treatment.

Prevalence of traumatic brain injury among prisoners in South Carolina

OBJECTIVE

To determine lifetime prevalence of traumatic brain injury (TBI) in a statewide sample of prisoners.

DESIGN

Retrospective and cross-sectional cohort study.

PARTICIPANTS

Stratified random sample of prisoners scheduled to be released by release type for each gender (275 men and 267 women with completed sentences and 19 men and 15 women granted parole) and a random sample of prisoners by gender with lifetime or death sentences (26 men and 34 women). PRIMARY MEASURE: Weighted prevalence of TBI. In-person interviews ascertained history of TBI using a customized version of the Ohio State University TBI Identification Method.

RESULTS

Sixty-five percent of male releases and nonreleases, and 72% and 73% of female releases and nonreleases, reported at least 1 TBI with an alteration of consciousness. Forty-two percent of male releases and 50% of nonreleases, and 50% of female releases and 33% of nonreleases, reported at least 1 TBI with loss of consciousness. Thirty-five percent of male releases and 42% of nonreleases, and 55% of female releases and 58% of nonreleases, reported ongoing symptoms from TBI.

CONCLUSIONS

A substantial proportion of prisoners reported having experienced a TBI during their lifetime. The ongoing TBI symptoms reported by prisoners may impact their success on release.

Prevalence of traumatic brain injury in incarcerated groups compared to the general population: a meta-analysis

Traumatic brain injury can cause numerous behavioral abnormalities including aggression, violence, impulsivity, and apathy, factors that can be associated with criminal behavior and incarceration. To better characterize the association between traumatic brain injury and incarceration, we pooled reported frequencies of lifetime traumatic brain injury of any severity among incarcerated samples and compared the pooled frequency to estimates of the lifetime prevalence of traumatic brain injury in the general population. We found a significantly higher prevalence of traumatic brain injury in the incarcerated groups compared to the general population. As such, there appears to be an association between traumatic brain injury and incarceration.

Association of medically attended traumatic brain injury and in-prison behavioral infractions: a statewide longitudinal study

This study examined the association between medically attended traumatic brain injury (TBI) and in-prison behavioral infractions in a statewide population by comparing rate ratios of infractions in inmates with and without TBI over an 11.5-year period (16,299 males and 1,270 females). The in-prison behavioral infraction rate was significantly increased in males with TBI compared with no TBI for all infractions (RR = 1.32, 95% CI: 1.12, 1.55), violent infractions (RR = 1.86, 95% CI: 1.54, 2.24), and nonviolent infractions (RR = 1.19, 95% CI: 1.00, 1.41). The violent behavioral infraction rate was significantly increased in females with TBI compared with no TBI (RR = 2.44, 95% CI: 1.45, 4.12). A clearer understanding of inmates with a history of TBI and further examination of the association of TBI and behavioral infractions are needed.

Traumatic brain injury rates and sequelae: a comparison of prisoners with a matched community sample in Australia

AIM

To compare rates of past reported traumatic brain injury (TBI) in a prisoner sample with those in a control group drawn from the same location of usual residence.

METHOD

The prisoner group comprised a consecutive sample of men (n = 200) received into custody and screened by face-to-face interview. The control group comprised men (n = 200) matched for location of usual residence screened by telephone interview. Participants were asked about past TBIs and screened for drug and alcohol abuse, impulsivity and dissocial personality disorder.

RESULTS

Eighty-two per cent of prisoners and 71.5% of community participants reported at least one past TBI of any severity (i.e. with or without a loss of consciousness (LOC)) and 64.5% of prisoners and 32.2% of community participants reported at least one TBI associated with a LOC. Prisoners were more likely to report persisting side-effects of TBI and were much more likely to screen positive for impulsivity and dissocial personality disorder. Multivariate analyses found no significant association between TBI frequency or severity and custody/community group membership.

CONCLUSIONS

High reported rates of TBI in prisoner populations may reflect the excess of socio-demographic risk factors for TBI. Results of the current study do not support a role for TBI as causally related to criminal conduct.

Traumatic brain injury among Australian prisoners: Rates, recurrence and sequelae

PRIMARY OBJECTIVE

To establish the prevalence, severity, recurrence and sequelae of past traumatic brain injury (TBI) among individuals recently received into custody.

RESEARCH DESIGN

Cross-sectional random sample of men recently received into the New South Wales' (NSW) criminal justice system.

PROCEDURES

Participants were screened for a history of TBI including the injury setting, severity, treatment and sequelae of up to five separate TBI episodes.

OUTCOMES AND RESULTS

Of 200 study participants, 82% endorsed a history of at least one TBI of any severity and 65% a history of TBI with a loss of consciousness (LOC). Multiple past TBIs were common, as were ongoing sequelae. Treatment for the TBI was more common among those TBIs with a LOC compared with no LOC (66% vs. 39%).

CONCLUSIONS

Among individuals entering the criminal justice system, past TBI is common and often associated with ongoing neuropsychiatric and social sequelae. Screening for TBI at the point of reception may be warranted to better understand and treat those with ongoing neuropsychiatric sequelae arising from the TBI.

The effect of urban street gang densities on small area homicide incidence in a large metropolitan county, 1994-2002

The presence of street gangs has been hypothesized as influencing overall levels of violence in urban communities through a process of gun-drug diffusion and cross-type homicide. This effect is said to act independently of other known correlates of violence, i.e., neighborhood poverty. To test this hypothesis, we independently assessed the impact of population exposure to local street gang densities on 8-year homicide rates in small areas of Los Angeles County, California. Homicide data from the Los Angeles County Coroners Office were analyzed with original field survey data on street gang locations, while controlling for the established covariates of community homicide rates. Bivariate and multivariate regression analyses explicated strong relationships between homicide rates, gang density, race/ethnicity, and socioeconomic structure. Street gang densities alone had cumulative effects on small area homicide rates. Local gang densities, along with high school dropout rates, high unemployment rates, racial and ethnic concentration, and higher population densities, together explained 90% of the variation in local 8-year homicide rates. Several other commonly considered covariates were insignificant in the model. Urban environments with higher densities of street gangs exhibited higher overall homicide rates, independent of other community covariates of homicide. The unique nature of street gang killings and their greater potential to influence future local rates of violence suggests that more direct public health interventions are needed alongside traditional criminal justice mechanisms to combat urban violence and homicides.

Normal and abnormal aggression: human disorders and novel laboratory models

We review here aggression-related human psychopathologies and propose that human aggressiveness is mainly due to three major factors: (i) brain dysfunction affecting aggression-controlling brain centers (e.g. in certain types of brain lesions, epilepsy, Alzheimer disease, etc.); (ii) hypoarousal associated with chronically low plasma glucocorticoids, which foster violence by diminishing emotional barriers that limit such behaviors (e.g. in conduct disorder and antisocial personality disorder); (iii) hyperarousal which leads to irritability and outbursts (e.g. in depression, intermittent explosive disorder, chronic fatigue, etc.). Different disorders are associated with different types of aggressiveness; e.g. hypoarousal is often associated with instrumental aggression, whereas hyperarousal is associated with uncontrollable outbursts. Many psychological disorders have been simulated in laboratory models, which were used to assess aggressiveness. Little effort was invested, however, in assessing the abnormal dimension of such aggressiveness. We present here three models that appear especially suitable to assess abnormal aspects of rodent aggression: (i) abnormal attack targeting (head, throat, and belly) that is induced by hypoarousal in rats and models violence in hypoarousal-driven human aggression (ii) 'escalated' aggression (increased aggressive response due to frustration or instigation), which models irritability and hyperarousal-driven aggressiveness; and (iii) context-independent attacks induced by hypothalamic stimulation or genetic manipulations. These three models address different aspects of abnormal aggressiveness, and can become extremely useful in three areas: in evaluating and assessing models of human psychopathologies, in studying transgenic animals, and in developing new treatment strategies. Research based on these or similar models do not address aggressiveness in quantitative terms, but follows the development of abnormal aspects, and the possibilities of their specific treatment.

Mechanisms differentiating normal from abnormal aggression: glucocorticoids and serotonin

Psychopathology-associated human aggression types are induced by a variety of conditions, are behaviorally variable, and show a differential pharmacological responsiveness. Thus, there are several types of abnormal human aggression. This diversity was not reflected by conventional laboratory approaches that focused on the quantitative aspects of aggressive behavior. Recently, several laboratory models of abnormal aggression were proposed, which mainly model hyperarousal-driven aggressiveness (characteristic to intermittent explosive disorder, post-traumatic stress disorder, depression, chronic burnout, etc.) and hypoarousal-driven aggressiveness (characteristic mainly to antisocial personality disorder and its childhood antecedent conduct disorder). Findings obtained with these models suggest that hyperarousal-driven aggressiveness has at its roots an excessive acute glucocorticoid stress response (and probably an exaggerated response of other stress-related systems), whereas chronic hypoarousal-associated aggressiveness is due to glucocorticoid deficits that affect brain function on the long term. In hypoarousal-driven aggressiveness, serotonergic neurotransmission appears to lose its impact on aggression (which it has in normal aggression), certain prefrontal neurons are weakly activated, whereas the central amygdala (no, or weakly involved in the control of normal aggression) acquires important roles. We suggest that the specific study of abnormal aspects of aggressive behavior would lead to important developments in understanding the specific mechanisms underlying different forms of aggression, and may ultimately lead to the development of better treatment approaches.

The brain, aggression, and public policy

Investigational, conceptual, and interventional advances in the neurosciences strain consensus in research ethics, clinical ethics, legal ethics, and jurisprudence and demand innovative adaptation in public policy. I review these advances, ask how they might change a range of policies, and conclude that their implications -- particularly relating to aggression -- are likely to have been underestimated.

Brain injury and violent crime

PRIMARY OBJECTIVE

To test the hypothesis that TBI is associated with violent crime, the prevalence and characteristics of traumatic brain injury (TBI) were compared between men convicted of domestic violence and a matched comparison group.

METHODS AND PROCEDURES

Participants were 20 African American men convicted of domestic violence and 20 African American men without criminal convictions matched for age and socioeconomic status. Participants completed a questionnaire regarding health and behaviour history.

MAIN OUTCOMES AND RESULTS

More than half of the participants in both groups had sustained a TBI, although injuries in the offender group were significantly more severe. There were significantly more reports of problems with anger management in the offender group.

CONCLUSIONS

Published epidemiological data regarding TBI may underestimate the prevalence in urban populations, which may have confounded earlier studies of TBI and domestic violence. The reported prevalence in this sample of defendants suggests implications for the justice system.

Death row inmate characteristics, adjustment, and confinement: a critical review of the literature

This article reviews and summarizes research on death row inmates. The contributions and weaknesses of death row demographic data, clinical studies, and research based on institutional records are critiqued. Our analysis shows that death row inmates are overwhelmingly male and disproportionately Southern. Racial representation remains controversial. Frequently death row inmates are intellectually limited and academically deficient. Histories of significant neurological insult are common, as are developmental histories of trauma, family disruption, and substance abuse. Rates of psychological disorder among death row inmates are high, with conditions of confinement appearing to precipitate or aggravate these disorders. Contrary to expectation, the extant research indicates that the majority of death row inmates do not exhibit violence in prison even in more open institutional settings. These findings have implications for forensic mental health sentencing evaluations, competent attorney representation, provision of mental health services, racial disparity in death sentences, death row security and confinement policies, and moral culpability considerations. Future research directions on death row populations are suggested.