Dimensions of impulsivity related to psychopathic traits and homicidal behavior among incarcerated male youth offenders.

Despite impulsivity being included as scoring criteria within several measures of youth psychopathic traits, the relationship between psychopathic traits and dimensions of impulsivity among high-risk youth is not well-understood. Here we assessed psychopathic traits via total, factor, and facet scores from the Psychopathy Checklist: Youth Version (PCL:YV) and impulsivity through total, three-factor, and six-factor model scores from the Barratt Impulsiveness Scale (BIS-11) in incarcerated male youth offenders. Correlational analyses indicated PCL:YV total, Factor 2, Facet 3, and Facet 4 scores were significantly positively correlated with BIS-11 total scores. Additionally, psychopathy scores were significantly positively correlated with specific scores from the three-factor model of the BIS-11 (e.g. Motor and Non-Planning Impulsivity scores) and the six-factor model of the BIS-11 (e.g., Attention, Self-Control, and Cognitive Complexity Impulsivity scores). Secondary analyses suggest that participants who had previously committed homicide scored higher on lifestyle/antisocial psychopathic traits and specific dimensions of impulsivity (e.g., BIS-11 Non-Planning and Self-Control Impulsivity factor scores) compared to youth who had not previously committed homicide. Our results improve our understanding of the specific forms of impulsivity significantly correlated with youth psychopathic traits and how specific factors underlying both constructs potentially characterize youth associated with severe forms of antisocial behavior.

Predicting short-term institutional aggression in forensic patients: a multi-trait method for understanding subtypes of aggression.

Accurately predicting inpatient aggression is an important endeavor. The current study investigated inpatient aggression over a six-month time period in a sample of 152 male forensic patients. We assessed constructs of psychopathy, anger, and active symptoms of mental illness and tested their ability to predict reactive and instrumental aggression. Across all levels of analyses, anger and active symptoms of mental illness predicted reactive aggression. Traits of psychopathy, which demonstrated no relationship to reactive aggression, were a robust predictor of instrumental aggression. This study (a) reestablishes psychopathy as a clinically useful construct in predicting inpatient instrumental aggression, (b) provides some validation for the reactive/instrumental aggression paradigm in forensic inpatients, and (c) makes recommendations for integrating risk assessment results into treatment interventions.

Functional connectivity during affective mentalizing in criminal offenders with psychotic disorders: Associations with clinical symptoms.

Psychotic disorders are associated with neurobehavioral impairments in mental state attribution (mentalizing). These impairments are most severe in psychotic patients with elevated symptom levels, particularly negative and cognitive symptoms. There have been few studies of functional connectivity related to mentalizing in psychotic disorders and associations with symptoms. We conducted a functional MRI study of affective mentalizing in individuals with psychotic disorders and varying symptom levels (positive, negative, cognitive). Participants were drawn from an adjudicated inpatient forensic psychiatric population (criminal offenders). Functional MRI scans were acquired using a 32-channel ultra-fast multiband imaging sequence. Mentalizing task performance and functional connectivity were assessed in psychotic criminal offenders (n = 46) and nonpsychotic offenders (n = 41). Temporal coherent brain networks were estimated with group independent component analysis (ICA). Relative to nonpsychotic offenders, psychotic offenders showed impaired task performance and reduced activation in a component comprising the dorsomedial prefrontal cortex, superior temporal gyrus, and ventrolateral prefrontal cortex. Positive and cognitive symptoms were inversely correlated with component activity and task performance. The results are discussed with reference to potential mechanisms underlying impaired social cognition in psychotic disorders and across symptom types.

Psychopathy and behavioral correlates of victim injury in serious juvenile offenders.

The study examines delinquent behavior and psychopathy and assesses their relationship to victim injury in a population of 168 incarcerated juvenile delinquent males with lengthy histories of criminal and violent behavior. A series of multiple regressions found that 17% of the variance associated with level of victim injury was accounted for by a model that included the three-factor model of the Psychopathy Checklist: Youth Version [Forth, Kosson, and Hare, 2003], criminal versatility, and age of onset of criminal offending. Notably, anger and DSM-IV symptoms of conduct disorder were not related to level of victim injury. The results of this study support an escalation hypothesis where individuals with earlier onset to criminal behavior and greater criminal versatility escalate to more severe violence. The current results demonstrate the importance of integrating established theories of juvenile delinquency when explaining severe violence in youth.

Socio-neuro risk factors for suicidal behavior in criminal offenders with psychotic disorders.

Relative to the general population, individuals with psychotic disorders have a higher risk of suicide. Suicide risk is also elevated in criminal offenders. Thus, psychotic-disordered individuals with antisocial tendencies may form an especially high-risk group. We built upon prior risk analyses by examining whether neurobehavioral correlates of social cognition were associated with suicidal behavior in criminal offenders with psychotic disorders. We assessed empathic accuracy and brain structure in four groups: (i) incarcerated offenders with psychotic disorders and past suicide attempts, (ii) incarcerated offenders with psychotic disorders and no suicide attempts, (iii) incarcerated offenders without psychotic disorders and (iv) community non-offenders without psychotic disorders. Established suicide risk variables were examined along with empathic accuracy and gray matter in brain regions implicated in social cognition. Relative to the other groups, offenders with psychotic disorders and suicide attempts had lower empathic accuracy and smaller temporal pole volumes. Empathic accuracy and temporal pole volumes were significantly associated with suicide attempts independent of other risk variables. The results indicate that brain and behavioral correlates of social cognition may add incremental value to models of suicide risk.

Reducing violence in serious juvenile offenders using intensive treatment.

This study reports on the reduction in violent offending in a population of serious and violent juvenile offenders following an intensive institutional treatment program. The treatment group (N=101) is compared to a similar group that was assessed but not treated (N=147). All youth were sent to the program from a juvenile corrections institution where they had received the customary rehabilitation services. The results show a significant reduction in the prevalence of recidivism in the treated group after controlling for time at risk in the community and other covariates. The effects of non-random group assignment were reduced by including a propensity score analysis procedure in the outcome analysis. Untreated comparison youth appeared to be about twice as likely to commit violent offenses as were treated youth (44% vs. 23%). Similarly, treated youth had significantly lower hazard ratios for recidivism in the in the community than the comparison youth, even after accounting for the effects of non-random group assignment.

Testing factor models of the Psychopathy Checklist: Youth Version and their association with instrumental aggression.

Although there is a documented link between psychopathy and instrumental violence in adult offenders, the association between these constructs has not garnered significant attention in adolescent offenders. In this study, we evaluated the relationship between psychopathy and instrumental aggression in a sample of 122 male adolescents incarcerated in a state facility for serious and chronic offenders. We evaluated the primary (2-, 3-, and 4-factor) models of the Psychopathy Checklist: Youth Version (PCL:YV; Forth, Kosson, & Hare, 2003) and assessed their relationship to a separate 5-item measure of instrumental violence. CFA revealed good model fit for the 3- and 4-factor latent variable models of adolescent psychopathy and a single-factor model reflecting a 5-item measure of instrumental violence. Structural equation modeling results indicate that the 4-factor model accounted for 20% of the variance for instrumental violence. In contrast, the 3-factor model of the PCL:YV accounted for 8%, and the 2-factor model accounted for 5% of the variance associated with instrumental violence.