Lifetime risk and correlates of incarceration in a nationally representative sample of U.S. adults with non-substance-related mental illness.

PURPOSE: High rates of psychiatric disorders in correctional facilities have fueled widespread concern about the "criminalization of mental illness." While the link between incarceration, substance abuse, and antisocial-personality disorder is well established, the relationship between non-substance-related psychiatric disorders and incarceration has not been thoroughly investigated. This study examines the association of mental illness, excluding substance use disorders, with risk for incarceration in US adults. METHODS: Nationally representative data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) were used to compare the proportions of respondents with lifetime incarceration among those with no lifetime history of DSM-5 disorders, or with lifetime history of mental illness, substance use disorders, dual diagnosis, and antisocial personality/conduct disorder. Logistic regression analysis was used to examine the independent association of incarceration with mental illness alone, both in comparison to and net of associations with sociodemographic and behavioral characteristics. RESULTS: Among adults with mental illness alone, 6.7% reported past incarceration, compared to 4.8% with no history of DSM-5 disorders, and 20-40% in other DSM-5 diagnostic groups. Sociodemographic and behavioral risk factors were more strongly associated with incarceration (c-statistics = 0.74 and 0.77, respectively), than mental illness (c-statistic = 0.56). Schizophrenia or other psychoses and borderline personality disorder were independently associated with incarceration, but with effect sizes no greater than eight other sociodemographic or behavioral risk factors. CONCLUSION: A weak association of mental illness alone with incarceration was found, despite high level of public attention to "criminalization of mental illness."

A role for right ventrolateral prefrontal cortex in reasoning about indeterminate relations.

While the role of left prefrontal cortex in reasoning tasks has long been recognized, the role of right prefrontal cortex remains unclear. One patient study [Goel, V., Tierney, M., Sheesley, L., Bartolo, A., Vartanian, O., & Grafman, J. (2007). Hemispheric specialization in human prefrontal cortex for resolving certain and uncertain inferences. Cerebral Cortex, 17(10), 2245-2250] has suggested that right prefrontal cortex plays an essential role in resolving indeterminate relations. To test this hypothesis, and to identify the involvement of specific regions within right prefrontal cortex we scanned 17 normal volunteers with fMRI while they engaged in a transitive inference task involving determinate and indeterminate relations. The results show a nice crossover interaction such that, right ventrolateral prefrontal cortex (BA 47) is selectively activated by the processing of indeterminate trials with no belief-bias cues, while left lateral prefrontal cortex (BA 45) is selectively activated by the processing of indeterminate trials containing belief-bias cues. These results are not only consistent with, but also amplify, the lesion data by identifying specific regions within right and left prefrontal cortex.

The neural basis of implicit moral attitude--an IAT study using event-related fMRI.

Recent models of morality have suggested the importance of affect-based automatic moral attitudes in moral reasoning. However, previous investigations of moral reasoning have frequently relied upon explicit measures that are susceptible to voluntary control. To investigate participant's automatic moral attitudes, we used a morality Implicit Association Test (IAT). Participants rated the legality of visually depicted legal and illegal behaviors of two different intensity levels (e.g., high intensity illegal = interpersonal violence; low intensity illegal = vandalism) both when the target concept (e.g., illegal) was behaviorally paired with an associated attribute (e.g., bad; congruent condition) or an unassociated attribute (e.g., good; incongruent condition). Behaviorally, an IAT effect was shown; RTs were faster in the congruent rather than incongruent conditions. At the neural level, implicit moral attitude, as indexed by increased BOLD response as a function of stimulus intensity, was associated with increased activation in the right amygdala and the ventromedial orbitofrontal cortex. In addition, performance on incongruent trials relative to congruent trials was associated with increased activity in the right ventrolateral prefrontal cortex (BA 47), left subgenual cingulate gyrus (BA 25), bilateral premotor cortex (BA 6) and the left caudate. The functional contributions of these regions in moral reasoning are discussed.

The impact of affect and frequency on lexical decision: the role of the amygdala and inferior frontal cortex.

The current study used event-related fMRI to examine BOLD responses associated with two factors that behaviorally determine speed of lexical decision: frequency and emotion. Thirteen healthy adults performed a visual lexical decision task, discriminating between words and orthographically and phonologically legal nonwords. The study involved a 2 (Frequency: high and low) x 3 (Emotional arousal: highly negative, mildly negative, and neutral words) design with word categories matched for number of letters and concreteness. There were significant main effects for both frequency and emotion in lexical decision reaction times but no significant interaction. Negative word lexical decisions were associated with increased activation in bilateral amygdala and middle temporal cortex as well as rostral anterior and posterior cingulate cortex. Low-frequency word lexical decisions, relative to high-frequency word lexical decisions, were associated with increased bilateral activity in inferior frontal cortex. Inferior frontal cortex activation was particularly low during lexical decision for high-frequency emotional words but significant for high-frequency neutral emotional words. We suggest that this is because the semantic representation of high-frequency emotional words may receive sufficient additional augmentation via the reciprocal activation from the amygdala such that selective augmentation by inferior frontal cortex to achieve lexical decision is unnecessary.

Inhibitory attentional control in patients with frontal lobe damage.

The performance of a group of frontal lobe lesion and a group of frontal lobe dementia patients was compared with the performance of their respective matched normal control groups on two tests of inhibitory attentional control-the stop-signal reaction time task and a negative priming task. Both patient groups responded significantly slower than their respective normal control groups, but they showed only marginally significant selective impairments on the measures of inhibition. The data suggest that the specific inhibitory processes evaluated by these two tests are, in general, spared in patients with focal frontal lobe lesions or frontal lobe degeneration.