The Maltreatment : Aggression Link among Prosecuted Males : What about Psychopathy?

Criminal offenders constitute a high-risk sample regarding experiences of childhood maltreatment and engagement in severe aggression. Moreover, psychopathic traits are more common in samples of offenders than non-offenders. Although research has underlined the relationship between childhood maltreatment and adult aggression, the influence of psychopathy on this link is still unclear. We examined the dynamics of maltreatment, aggression, and psychopathy in a mixed sample of 239 male violent, sexual, and other offenders using latent factor structural equation modeling. We found a consistent positive association of maltreatment with aggression. Psychopathy did not mediate this relation. Maltreatment was not associated with psychopathy, although psychopathy had a positive effect on aggressive behavior. These dynamics appeared similar for violent, sexual, and other offenders. However, latent variables were constructed somewhat differently depending on the offender status. For instance, sexual abuse appeared to be of specific importance in sexual offenders. Violent offenders showed high rates of psychopathy compared to sexual and other offenders. The current findings may inspire future research to focus more closely on the different subtypes of psychopathy when examining its role in the prediction of aggression based on childhood maltreatment. Moreover, childhood maltreatment must not be neglected in treatment and prevention approaches aimed at reducing the risk of aggressive behavior

The Suitability of the Childhood Trauma Questionnaire in Criminal Offender Samples

Adverse childhood experiences (ACEs) are common in community samples and are associated with various dysfunctional physical, psychological, and behavioral consequences. In this regard, criminal offenders are at specific risk, considering their elevated ACE rates compared with community samples and the associations of ACEs with criminal behaviors. However, assessing ACEs in offender samples by self-reports has been criticized with regard to their validity and reliability. We examined the suitability of ACE-self-reports using the Childhood Trauma Questionnaire (CTQ) in a sample of 231 male offenders involved in the German criminal justice system by comparing self-reported to externally rated ACEs to externally rated ACEs based on the information from the offenders’ criminal and health-related files and on interviews conducted by forensically trained psychological/psychiatric experts. The accordance between self-ratings and expert ratings was examined considering mean differences, correlations, inter-rater agreement measures, and regression analyses. Offenders themselves reported a higher ACE burden than the one that was rated externally, but there was a strong relationship between CTQ self-assessments and external assessments. However, associations were stronger in offenders seen for risk assessment than in those evaluated for criminal responsibility. Overall, the CTQ seems suitable for use in forensic samples. However, reporting bias in self-reports of ACEs should be expected. Therefore, the combination of self-assessments and external assessments seems appropriate

The role of stress coping strategies for life impairments in ADHD

Attention-deficit/hyperactivity disorder (ADHD) is commonly accompanied by functional impairments within personal, professional, and social context as well as further psychological distress. The role of perceived stress has been examined in this regard, although little is known about the influence of stress coping strategies. We examined the dynamics between ADHD symptomatology, stress coping strategies, and life impairments in a sample of 230 clinical and non-clinical adult individuals. ADHD was associated with low probability of choosing adaptive but high probability of implementing maladaptive stress coping strategies as well as with increased life impairments. Adaptive stress coping showed little effects beyond the associations between ADHD and life impairments, whereas some maladaptive coping strategies increased current life impairments over and above the effects of ADHD and further psychological distress. The present findings emphasize the need of professional support in adults with ADHD and the necessity to include stress coping strategies in respective treatment approaches aimed at reducing life impairments

Mental Health in Young Detainees Predicts Perpetration of and Desistance From Serious, Violent and Chronic Offending

Mental health problems are common among young offenders but their role in predicting criminal recidivism is still not clear. Early identification and treatment of young offenders at risk of serious, violent, and chronic (SVC) offending is of major importance to increase their chances to develop into a healthy and non-criminal future and protect society from further crime. In the present study, we assessed mental health among 106 young offenders while incarcerated and analyzed their criminal careers up to 15 years after release. We found high rates of mental health issues, especially externalizing problems, but also concerning illegal substance and alcohol use patterns as well as personality disorders. Rule-breaking behavior and internalizing problems were negatively related to incarceration time until study assessment, but withdrawal and internalizing problems were positively associated with remaining time to release. Whereas, SVC status before assessment and after release were not statistically dependent, mental health issues predicted perpetration of and desistance from SVC offending after release. Alarming alcohol use appeared to be of specific importance in this regard. Findings indicate that young offenders at risk of future SVC offending may benefit from mental health treatment with specific focus on problematic alcohol consumption to prevent ongoing crime perpetration

ADHD symptom profiles, intermittent explosive disorder, adverse childhood experiences, and internalizing/externalizing problems in young offenders

Attention-deficit/hyperactivity disorder (ADHD) and co-existing psychiatric/psychological impairments as well as adverse childhood experiences (ACEs) are common among young offenders. Research on their associations is of major importance for early intervention and crime prevention. Intermittent explosive disorder (IED) warrants specific consideration in this regard. To gain sophisticated insights into the occurrence and associations of ADHD, IED, ACEs, and further psychiatric/psychological impairments in young (male and female) offenders, we used latent profile analysis (LPA) to empirically derive subtypes among 156 young offenders who were at an early stage of crime development based on their self-reported ADHD symptoms, and combined those with the presence of IED. We found four distinct ADHD subtypes that differed rather quantitatively than qualitatively (very low, low, moderate, and severe symptomatology). Additional IED, ACEs, and further internalizing and externalizing problems were found most frequently in the severe ADHD subtype. Furthermore, females were over-represented in the severe ADHD subtype. Finally, ACEs predicted high ADHD symptomatology with co-existing IED, but not without IED. Because ACEs were positively associated with the occurrence of ADHD/IED and ADHD is one important risk factor for on-going criminal behaviors, our findings highlight the need for early identification of ACEs and ADHD/IED in young offenders to identify those adolescents who are at increased risk for long-lasting criminal careers. Furthermore, they contribute to the debate about how to best conceptualize ADHD regarding further emotional and behavioral disturbances

A new rating scale for adult ADHD based on the Symptom Checklist 90 (SCL-90-R)

Attention deficit hyperactivity disorder (ADHD) in adults is increasingly recognized as a clinically important syndrome. The aim of this study was to evaluate the psychometric performance of a new scale for adult ADHD based on the widely used Symptom Checklist 90 Revised (SCL-90-R). Scale performance was assessed in a clinical study including 100 ADHD patients and 65 opiate-dependent patient controls, and in the Zurich study, an epidemiological age cohort followed over 30 years of adult life. Assessments included a ROC analysis of sensitivity and specificity, internal consistency, test-retest reliability, external validity and measurement invariance over nine testing occasions. The new scale showed a sensitivity and specificity of 75 and 54%, respectively, internal consistency over 0.8 (McDonald's omega, Cronbach's alpha), one-year test-retest reliabilities over 0.7, statistically significant and substantial correlations with two other validated self-rating scales of adult ADHD (R = 0.5 and 0.66, respectively), and an acceptable degree of longitudinal stability (i.e., measurement invariance). The proposed scale must be further evaluated, but these preliminary results indicate it could be a useful rating instrument for adult ADHD in situations where SCL-90-R data, but no specific ADHD assessment, are available, such as in retrospective data analysis or in prospective studies with limited methodical resources

Alexithymia, emotion processing and social anxiety in adults with ADHD

<p>Abstract</p> <p>Objective</p> <p>Given sparse research on the issue, this study sought to shed light upon the interactions of alexithymia, emotion processing, and social anxiety in adults with attention-deficit hyperactivity disorder (ADHD).</p> <p>Subjects and methods</p> <p>73 German adults with ADHD according to DSM-IV diagnostic criteria participated. We used the Toronto Alexithymia Scale (TAS-20) to assess alexithymia, the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) to assess different features of social anxiety, and we applied the German 'Experience of Emotions Scale' (SEE) to measure emotion processing.</p> <p>Results</p> <p>40% of the sample were found to meet the DSM-IV criteria of social anxiety disorder, and about 22% were highly alexithymic according to a TAS-20 total score ≥ 61; however, the mean TAS-20 total score of 50.94 ± 9.3 was not much higher than in community samples. Alexithymic traits emerged to be closely linked to emotion processing problems, particularly 'difficulty accepting own emotions', and to social anxiety features.</p> <p>Discussion/conclusion</p> <p>Our findings suggest interactions of alexithymia, emotion processing dysfunction, and social anxiety in adults with ADHD, which may entail the therapeutic implication to thoroughly instruct these patients to identify, accept, communicate, and regulate their emotions to aid reducing interaction anxiety.</p

Prefrontal and anterior cingulate cortex abnormalities in Tourette Syndrome: evidence from voxel-based morphometry and magnetization transfer imaging

<p>Abstract</p> <p>Background</p> <p>Pathophysiological evidence suggests an involvement of fronto-striatal circuits in Tourette syndrome (TS). To identify TS related abnormalities in gray and white matter we used optimized voxel-based morphometry (VBM) and magnetization transfer imaging (MTI) which are more sensitive to tissue alterations than conventional MRI and provide a quantitative measure of macrostructural integrity.</p> <p>Methods</p> <p>Volumetric high-resolution anatomical T1-weighted MRI and MTI were acquired in 19 adult, unmedicated male TS patients without co-morbidities and 20 age- and sex-matched controls on a 1.5 Tesla neuro-optimized GE scanner. Images were pre-processed and analyzed using an optimized version of VBM in SPM2.</p> <p>Results</p> <p>Using VBM, TS patients showed significant decreases in gray matter volumes in prefrontal areas, the anterior cingulate gyrus, sensorimotor areas, left caudate nucleus and left postcentral gyrus. Decreases in white matter volumes were detected in the right inferior frontal gyrus, the left superior frontal gyrus and the anterior corpus callosum. Increases were found in the left middle frontal gyrus and left sensorimotor areas. In MTI, white matter reductions were seen in the right medial frontal gyrus, the inferior frontal gyrus bilaterally and the right cingulate gyrus. Tic severity was negatively correlated with orbitofrontal structures, the right cingulate gyrus and parts of the parietal-temporal-occipital association cortex bilaterally.</p> <p>Conclusion</p> <p>Our MRI <it>in vivo </it>neuropathological findings using two sensitive and unbiased techniques support the hypothesis that alterations in frontostriatal circuitries underlie TS pathology. We suggest that anomalous frontal lobe association and projection fiber bundles cause disinhibition of the cingulate gyrus and abnormal basal ganglia function.</p