Neuroprediction and A.I. in Forensic Psychiatry and Criminal Justice: A Neurolaw Perspective

Advances in the use of neuroimaging in combination with A.I., and specifically the use of machine learning techniques, have led to the development of brain-reading technologies which, in the nearby future, could have many applications, such as lie detection, neuromarketing or brain-computer interfaces. Some of these could, in principle, also be used in forensic psychiatry. The application of these methods in forensic psychiatry could, for instance, be helpful to increase the accuracy of risk assessment and to identify possible interventions. This technique could be referred to as ‘A.I. neuroprediction,’ and involves identifying potential neurocognitive markers for the prediction of recidivism. However, the future implications of this technique and the role of neuroscience and A.I. in violence risk assessment remain to be established. In this paper, we review and analyze the literature concerning the use of brain-reading A.I. for neuroprediction of violence and rearrest to identify possibilities and challenges in the future use of these techniques in the fields of forensic psychiatry and criminal justice, considering legal implications and ethical issues. The analysis suggests that additional research is required on A.I. neuroprediction techniques, and there is still a great need to understand how they can be implemented in risk assessment in the field of forensic psychiatry. Besides the alluring potential of A.I. neuroprediction, we argue that its use in criminal justice and forensic psychiatry should be subjected to thorough harms/benefits analyses not only when these technologies will be fully available, but also while they are being researched and developed

Neurocriminology: Implications for the Punishment, Prediction and Prevention of Criminal Behaviour

Criminal behaviour and violence are increasingly viewed as worldwide public health problems. A growing body of knowledge shows that criminal behaviour has a neurobiological basis, and this has intensified judicial interest in the potential application of neuroscience to criminal law. It also gives rise to important questions. What are the implications of such application for predicting future criminal behaviour and protecting society? Can it be used to prevent violence? And what are the implications for the way offenders are punished

Magnetic Resonance Imaging in the Legal Diganosis of Antisocial Personality Disorder

Antisocial Personality Disorder, APD, is characterized by manipulation and disregard for the emotions of others, and individuals suffering from this disorder often display behaviors that cause them to end up in the criminal justice system. The disorder prevents these individuals from learning from their mistakes, leading them to commit multiple crimes over their lifetime. Persons with APD can be diagnosed by psychiatrists and psychologists using psychological assessment tools meant to measure the attributes related to the disorder. However, the psychological tools available today are not entirely reliable or well validated and the instruments are not always useful in various situations. Neuroscientists have developed three brain theories that aim to identify the underlying mechanisms causing the symptoms of the disorder, which could lead to additional methods for diagnosis of APD in the legal setting. The first theory, called the Septo-Hippocampal theory, suggests that a dysfunction in the hippocampus causes the symptoms of APD. The second theory, the Amygdaloid theory, suggests that APD is actually caused by a dysfunction in the amygdala. The third theory, Connectivity theory, suggests that there is dysfunction in the connections between the hippocampus and amygdala that results in APD. The emergence of these theories opens the possibility of using Magnetic Resonance Imaging (MRI) or functional MRI (fMRI) technology as a diagnostic tool for APD. However, none of these theories can adequately explain the occurrence of all cases of APD, suggesting that the dysfunction could be anywhere within the brain system(s) that include the septal nuclei, hippocampus, amygdala, and/or other limbic structures. MRI and fMRI scans may prove to be useless in diagnosing this disorder

Imaging Violence in Schizophrenia: A Systematic Review and Critical Discussion of the MRI Literature

Background: Persons with schizophrenia have a small but significant increase in risk of violence, which remains after controlling for known environmental risk factors. In vivo MRI-studies may point toward the biological underpinnings of psychotic violence, and neuroimaging has increasingly been used in forensic and legal settings despite unclear relevance.Objectives: (1) To present the first systematic review, following standardized guidelines, of MRI studies of violence with schizophrenia. (2) To critically discuss the promises and pitfalls of using this literature to understand violence in schizophrenia in clinical, forensic, and legal settings.Methods: Following the PRISMA guidelines and literature searches until January 2018, we found 21 original studies that fulfilled the inclusion criteria: (1) Studies of persons with schizophrenia, (2) a history of violence or aggressive behavior, (3) the use of one or more MRI-modalities (sMRI, DTI, fMRI).Results: The most consistent findings from the structural studies were reduced volumes of the hippocampus and the frontal lobe (in particular the orbitofrontal and anterior cingulate cortex) in schizophrenia patients with a history of violence or higher aggression scores. The functional studies mainly showed differences and aggression correlates in the frontal lobe and amygdala. However, the studies were methodologically heterogeneous, with four particular areas of concern: different definitions of violence, region of interest vs. whole-brain studies, small subject samples, and group comparisons in a heterogeneous diagnostic category (schizophrenia).Conclusion: The literature reports subtle, but inconsistent group level differences in brain structure and function associated with violence and aggression with schizophrenia, in particular in areas involved in the formation of psychosis symptoms and affective regulation. Due to methodological challenges the results should be interpreted with caution. In order to come closer to the neurobiological underpinnings of violence in schizophrenia future studies could: (1) address the neurobiological differences of premeditated and reactive violence, (2) use RDoC criteria, for example, or other symptom-based systems to categorize psychosis patients, (3) increase subject cohorts and apply new data driven methods. In this perspective, MRI-studies of violence in schizophrenia have the potential to inform clinical violence prediction and legal evaluations in the future

Investigating structural and functional neural correlates in children and adolescents with antisocial behavior

Antisocial behavior is highly prevalent in young and adult populations worldwide and constitutes a major public health problem due to the huge burden on the individual as well as the significant economic burden on society. A better understanding of the underlying neurobiological mechanisms of antisocial behavior is warranted to improve current diagnostics (e.g. early detection of children at risk) and effective prevention/treatment programs. So far, neuroimaging studies have indicated neural atypicalities in youths with antisocial behavior; however, the direction and location of these brain alterations vary across studies. These ambiguities are most likely caused by the heterogeneity of the young samples with antisocial behavior studied, especially regarding sex, clinical diagnoses, and the presence of callous-unemotional traits. The central aim of this dissertation was to further the neuroscientific knowledge of antisocial behavior in children and adolescents by investigating the underlying structural and functional neurobiological characteristics, with an extra focus on possible sex differences and callous-unemotional traits. First, we examined the current neuroimaging literature, through meta-analyses, with the purpose of overcoming the heterogeneity of antisocial behavior and generating a common “overlapping” pattern of structural and functional atypicalities in youths with antisocial behavior. Secondly, the relation between callous-unemotional traits and brain structure was investigated separately for sex and independently of psychiatric comorbidities. Thirdly, this work investigated the white matter integrity within a homogenous group of girls with conduct disorder –the severe variant of antisocial behavior– in comparison to typically developing peers. This work expands our current knowledge on the structural and functional neural correlates in children and adolescents with antisocial behavior in several ways. For one, our meta-analytic results indicate a consistent pattern of gray matter reductions and hypoactivations in brain areas within the prefrontal and limbic cortex. These findings fit a recently proposed neurobiological model that connects alterations within similar brain regions with the behavioral dispositions of antisocial behavior (e.g. dysfunctions in empathy, emotional learning, and decision making). Secondly, we observed a positive relation between callous-unemotional traits and bilateral insula volume in a large international population of typically developing boys, but not in girls, independent of psychiatric disorders. This demonstrates that callous-unemotional traits have a sex-specific neurobiological basis beyond psychiatric samples. Thirdly, this work presents novel findings of white-matter integrity alterations in the body of the corpus callosum of girls with antisocial behavior, indicating possible reduced interhemispheric processing and consequent emotion processing abilities. In short, the present thesis provides original findings regarding the neurobiology of antisocial behavior in youths and emphasizes the importance of callous-unemotional traits and sex differences. Our results encourage future studies to further investigate the developmental trajectories and potential neural markers of antisocial behavior in order to enhance early detection and improve intervention programs, which could ultimately reduce antisocial behavior and delinquency in our society

Screening for autism spectrum disorders and an examination of social cognition in prisoners

Prisoners have high rates of physical and mental morbidity and of re-offending. There have been concerns that autism spectrum disorders (ASDs) may be overrepresented and under-diagnosed in this population. The aims of this study were to examine the effectiveness of an instrument which was developed to screen for ASDs in prisons and to establish whether male Scottish prisoners differ from community controls with respect to facial emotion recognition, as measured by behavioural testing, and differ on a neural basis while performing complex social judgements, as measured using functional magnetic resonance imaging (fMRI). A total of 2458 prisoners (approximately 40% of the convicted prison population) were examined using the screening tool, of whom a further 127 were interviewed in depth and were assessed for facial emotion recognition ability. FMRI was used to examine haemodynamic changes in a small sample of liberated prisoners (9) during a social judgement (approachability) versus control (gender judgments) task. The screening tool had poor sensitivity (28.6%) and specificity (75.6%) and was not effective or useful in screening for ASDs in this population. Significant deficits in negative facial emotion recognition were found in the prisoner group in comparison with age- and sex-matched community controls. Region of interest analysis of fMRI data in the bilateral amygdala revealed significantly greater activation in the left amygdala in ex-prisoners versus controls during the social judgement task. The identification of these abnormalities in facial emotion recognition and social judgement are in keeping with current literature on antisocial populations. They may offer the opportunity for development of interventions aimed at reducing re-offending in the future

Distinguishing between conduct disorder with high versus low levels of callous-unemotional traits

The aim of this thesis was to investigate differences between conduct disorder with high versus low levels of callous-unemotional traits. Differences in parenting, grey matter volume and facial emotion recognition ability were investigated using univariate and machine learning methods. In Chapter 3, youths with conduct disorder experienced more negative and less positive parenting than typically developing youths. The high callous-unemotional group also experienced less positive parenting than the low callous-unemotional group. All groups were classified with above-chance accuracy. In Chapter 4, when controlling for ADHD, youths with conduct disorder exhibited reduced grey matter volume in the insulae relative to typically developing youths. Youths with conduct disorder and high callous-unemotional traits exhibited additional reductions in the left orbitofrontal cortex. All groups were classified with above-chance accuracies. In Chapter 5, youths with conduct disorder – regardless of callous-unemotional traits – were poorer at recognising emotions than typically developing youths. Youths with conduct disorder were classified against typically developing youths at above-chance levels, but the classifier did not exceed chance when distinguishing between high and low callous-unemotional groups. Together, these findings indicate both similarities and differences in conduct disorder with high versus low levels of callous-unemotional traits, consistent with different developmental pathways to similar outcomes