Brain Injury & Crime Flashcards
1
Q
Criminated Behaviour
A
- ROSS & FABIANO (1985); “offenders cope poorly w/life via ‘cognitive deficit’ exhibition”; 1/4 UK inmates between 15-24y
- IE. lack of impulse control; poor emotion control/problem solving; rigid/inflexible thinking; lack of consequence recognition; inability to shift perspectives via empathy/theory of mind)
2
Q
CB: Anti-Social Behaviour
A
- predicted by:
1. LOW SELF CONTROL
2. HYPERACTIVITY
3. SENSATION SEEKING
3
Q
CB: Judicial Bias
A
- other than “criminal” behaviour, status offences (ie. begging/loitering/sexual exploitation/homeless curfew break) show justice system process as exacerbated by poverty
- causes lack of legal assistance/ID documentation access to impoverished
4
Q
CB: Young Re-offending
A
- FARRINGTON et al (2006); extremely high, particularly when vulnerable; prolific offenders usually “early starters”; later commit 77% of crime; 71.9% re-conviction chance within less than a year
- could be explained via MATURATION
5
Q
CB-YR: Maturation
A
- LENROOT & GIEDD (2006); grey/white matter subcomponents undergo dynamic adolescent changes
- axonal pruning = first 2 years post birth; synaptic pruning = adolescence
- wave peaks of pruning show complexity of underlying emotional/cognitive function changes
- neurochemical changes affect dopinergic systems
6
Q
CB-YR: Maturation (Teenagers)
A
- morphological changes affect mesolimbic structures; ie. nucleus accumbens maturity = heightened reward sensitivity/act for reward; dorsolateral prefrontal cortex can hardly keep up; axonal systems rewired (ie. circuitry impulse/judgement control)
- social brain also evolves; re-salience of sensory stimuli to sexual motivation/copulatory behaviour via phylogenetically programmed recreational procreation (aka. romance) = x4 more likely to engage in risks w/other teens/”crush” present
- so adult reasoning + heightened reward demand = poor consequence consideration/low capacity of buffering immediate influences = RISKY DECISION MAKING
7
Q
Traumatic Brain Injury
A
- injury/violence 2 leading death causes in 10-24y
- TBI (ie. falls/assaults) largest cause of death/disability in children/young adults WORLDWIDE
- 12% adults MAY have TBI
- 5-5-5 = under 5y in poorest 5% areas x5 more likely to be injured to TBI point
- highest annual occurrence in USA/Canada region; highest severity/burden of TBIs in South-East Asian/Western Pacific region
8
Q
TBI: Paediatric
A
- road accidents; most common (39%); unspecified causes (25%); falls (25%)
- infant/child mortality related in low income countries
- males x1.8 times more likely than females
- 7.3/100 deaths in pTBI cases; 1/4 experienced normal function reduction on discharge
- pTBI more likely in formative years in LICs than teen
9
Q
TBI: Mild/Moderate-Severe
A
- 30min loss of consciousness
- external mechanical force w/rotational sheer force insults brain (ie. blow to the head aka. crash stop on pillow, assault, fall)
- frontal/temporal lobes most common injury sites
- MILD ONLY: requires more “dosage” (ie. repeated injury); problems more likely
10
Q
TBI: Paediatric Personality Change
A
- M-STBI = 20%; MTBI = 80%
- 4/10 occurrence chance (though often delayed)
- affects:
COGNITION (attention/memory/sociability/execution)
BEHAVIOUR (dis-inhibition/anger)
MOOD (depression/anxiety) - injury = impulsivity/poor social skills/externalising behaviour = disrupted prosocial life role/increased risk of crime involvement
11
Q
TBI: The Social Brain
A
- RYAN et al (2013); TBI involves anterior brain region pathology linked w/social cognition
- diffuse axonal injury (DAI) disrupts white matter formation/connectivity between “social-brain” network (ie. superior temporal sulcus/fusiform gyrus/temporal pole/medial prefrontal cortex/orbitofrontal cortex/amygdala/temporoparietal junction/inferior parietal cortex)
12
Q
TBI: Mental Health/Conduct Disorders Post Injury
A
- increased risk of: elevated psychological distress/attempted suicide/counsel seeking/prescribed psych medication/victimisation via (cyber) bullying/threat w/weapon/violent and nonviolent misconduct behaviour
13
Q
CB-TBI: Risk of Crime Post Injury
A
LICHTENSTEIN et al (2011); epilepsy + TBI w/violent crime (ie. assault/homicide) associations; huge 44k+ sample
- TBI = 8.8% committed violent offence post diagnosis; statsig increase when compared w/controls; attenuated when compared w/unaffected siblings
14
Q
CB-TBI: Paediatric Risk of Crime Post Injury
A
- MCKINLAY et al (2010); longitudinal birth cohort (1265) in urban New Zealand; hospitalised/non-hospitalised/no injury groups; 15-21y; self-reported crimes
- TBI statsig more likely to get arrested w/evidence of school problems/teenage expulsion within 2 years
- WILLIAMS & CORDEN et al (2010); 65% TBI history in UK youth offender; +3 TBI = more violence; related directly w/offence count too
- CHITSABESAN et al (2015); 93 male 15-18y UK offenders; 83% = TBI; 44% w/ ongoing symptoms; CHAT session revealed high ADHD/self-harm/suicide risk/care experience
15
Q
CB-TBI: Lack of Support
A
- KENT et al; poor parental supervision associated w/TBI reactive aggression in young offenders; parental interventions could reduce disabling effects of TBI in adolescents/contact w/law
16
Q
CB-TBI: Neurodevelopmental Disorders in Detained Adolescents
A
- BORSCHMANN et al (2020); young offender (YO) characteristics associated w/ amplification by pre-existing issues (ie. ADHD/ASD/Foetal Alcohol Spectrum Disorder (FASD)/intellectual disability/TBI)
- inattention/hyperactivity (12% YO; 2% NON) = ADHD/TBI
- speech/hearing/language impairment affecting academics (65% YO; 5% NON) = TBI/FASD/ADHD/ASD
- reduced height/weight/head/face or memory/cognition/mortor skill deficits (21% YO; 5% NON) = ASD/TBI
- IQ/adaptive functioning deficit (32%YO; 4% NON) = FASD/TBI/ASD
- disruption to normal brain functionality (50% YO; 15% NON) = TBI
- TBI by far most common factor
17
Q
CB-TBI: Female Offenders
A
- 65% show signs of brain injury; of these, 62% via domestic violence; 33% sustained prior to first offence
- vulnerable via abuse history/problematic substance misuse; TBI history must be included in justice policy to bring attention to interventions reducing mental health morbidity
- dose-response between TBI rate/loss of consciousness/deficit skill count
- female TBI offenders misjudge social situations/struggle in groups/heightened suicide risk
18
Q
CB-TBI: Female TBI Traits
A
- CUSIMAO et al; emotionally/physically traumatised foster kids w/TBI; behaviour involves:
DANGEROUS COPING MECHANISMS (49%); ie. drugs/alcohol
EMOTIONAL TRAUMA NORMALISATION (81%); ie. rape/sexual assault
ADVERSE EXPERIENCE NORMALISATION (66%); ie. not having parents
19
Q
CB-TBI: Reduced Vulnerability
A
- kids most likely to experience TBI are least likely to receive support; problems are grown INTO, not out of
- importance of parental/carer support and preventative interagency working (ie. education/health/social justice/policing)
- improved inclusion necessary to reduce exclusion; kids must be worked with to deflect/divert experiences
- kids at risk of system entry must be found for via welfare law, where TBI is accounted for in regards to system entry; maturity must also be remembered; if in system, adopt trauma informed approach/programme
20
Q
CB-TBI: Young TBI Offender Upon Arrest
A
- HUGHES et al (2019)
- disorientated/stressed/overwhelmed/misunderstanding rights/falsely impulsive confessions/language difficulty w/questions/inappropriate body language/”rudeness”
- misinterpretation of attitude affects judge’s ruling
- police trained to recognise TBI signs via screening tools; new application of gatekeeping role
21
Q
CB-TBI: Police Awareness
A
- most severe TBI associated w/complex social needs linked w/ongoing symptoms
- BISI useful screening tool for police; increases awareness and confidence when working w/neurodivergent spectrum
- further support for TBI young offenders/police could reduce impulsive behaviour/improve rehabilitative outcomes/ensure proper assessment/necessary diagnosis
22
Q
CB-TBI: “Secure…”
A
STAFF w/appropriate intervention skills.
EMOTIONALLY resilient staff.
CARE FOR STAFF via supervision/support.
UNDERSTANDING establishment wide for child development/attachment/trauma/key theories.
REFLECTIVE SYSTEM of staff aware of trauma at all levels
EVERY INTERACTION MATTERS as the whole system must approach.
23
Q
CB-TBI: “Secure Stairs” Development
A
- behaviour = symptom; skewed development = cause
- development must be addressed to get rid of root issue; team formulation as powerful strategy for shifting cultures to psychosocial models/understanding of individual stories
24
Q
CB-TBI: “… Stairs”
A
SCOPING; situation assessed w/clarity around child’s life narrative.
TARGETS; staff, child and “home” agree on goals within establishment.
ACTIVATORS; children have psycho/bio/social developmentally informed multi-factorial formulation clarifying issues.
INTERVENTIONS; specialist/core; formulation/risk assessment driven; tailored to child’s risks/needs/content/intensity/timing.
REVIEW/REVISE; IRL outcome/goals monitored by home/establishment according to frequency/severity of behaviour; regular multi-disciplinary reviews.
SUSTAIN; sustainability planning from outset; maintenance of goals upon release and transition.
25
CB-TBI: Key Takeaways
- sometimes young offenders don't have TBI, but MOST DO; not specialist population, THE population
- staff must have qualities/qualifications/skills/support to work in a meaningful way to provide rehabilitation
- multi-agency working is vital for properly integrated judicial systems
- judicial TBI/neurodivergence screening is possible:
PRE-CUSTODY (DEFLECT)
CUSTODY (DIVERT)
SENTENCING (COMMUNITY ORDERS)
EXIT (SOCIAL RE-ENTRY)
