Clinical, Social, and Neuropsychological Dimensions of the Intersection of Addiction and Criminality.

To examine the social cognitive processes underlying the relationship of addiction and criminality, we administered the Addiction Severity Index-CF (ASI-CF) and the Iowa Gambling Task (IGT) to 35 participants (11 women) who had been released recently from jail or prison. ASI-CF revealed highest lifetime drug use for alcohol, followed by cannabis, cocaine, and heroin, with an average of 42 lifetime arrests in this ex-offender sample. The men and the women showed similar psychiatric histories marked by depression and anxiety, but the women had more lifetime problems with thinking than did the men, who had higher lifetime problems with hallucinations. On the IGT, participants showed evidence of reward-learning across the initial three blocks of 20 trials, but their performance declined over the last 40 trials, suggesting a failure to sustain gains: that is, to learn from feedback in deciding among advantageous and disadvantageous decks of cards. These deficits in motivated decision-making were moderated by current social and psychological factors, as assessed by ASI-CF. These results are discussed in regard to how disturbances in social cognitive processes may underlie the relationship of addiction and criminality.

Neuropsychology of decision making and psychopathy in high-risk ex-offenders.

OBJECTIVE: We examined the relationship of socially maladaptive behaviors with decision making and psychopathy in a sample of 26 high-risk males recently released from incarceration who were currently clients in an offender reentry service program. METHOD: The Iowa Gambling Task (IGT) and the Psychopathy Checklist Revised (PCL-R) provided measures of individual differences in decision making and psychopathy, respectively. RESULTS: The IGT and PCL-R each contributed differentially to specific socially disadvantageous outcomes, with poorer decision-making scores predicting recidivism at 3- to 6-month follow-up, and higher psychopathy linked to a retrospective measure of total lifetime incarceration. In addition, in relation to both nonrecidivist and control groups, recidivists showed a distinct pattern of IGT performance for the last 3 blocks of trials, characterized by a failure to learn from feedback and to modify their preferences to more advantageous decks of cards. In addition, the IGT and PCL-R correlated, with poorer decision making corresponding to higher ratings in psychopathy. CONCLUSIONS: The current findings may add to growing evidence of ecological validity of both decision making and psychopathy in relation to real-life outcome measures in high-risk individuals.