Essentials

Question 1

What is normal behaviour?

Answer 1

o Cultural/social/ethical: differences in cultural and social norms. Cultural and social norms also involve ethical perspectives of a society.
o Statistical model: the majority of us fall within the middle of the bell curve. There are extreme cases (low and high). Low and high extremes are depending on which variables or concepts you are interested in.
o Medical model: psychiatry is a subdiscipline of medicine. The DSM fully ignores comorbidity (a key concept: comorbidity is having multiple psychological/psychiatric disorders at the same time. This is not an exception but the rule, trauma is rampant). The DSM describes every disorder as being discrete, and sees them as perfectly isolated disorders.

Question 2

What is Psychopathy?

Answer 2

o Psychopathy is a personality disorder characterised by a combination of affective, interpersonal, lifestyle, and antisocial features. It is considered a neurodevelopmental disorder resulting from a complex interplay of genetic and environmental risk factors.

Question 3

What are the key features of psychopathy?

Answer 3

o Key Features of Psychopathy:
 Affective: Individuals with psychopathy lack empathy, guilt, or remorse, are callous, and have shallow or deficient affect
 Interpersonal: They tend to be grandiose, arrogant, deceitful, and manipulative
 Lifestyle: They often engage in impulsive and irresponsible behaviours
 Antisocial: Individuals with psychopathy often engage in instrumental, planned acts of antisocial behaviour and aggression from an early age

Question 4

What are the Developmental Aspects of Psychopathy?

Answer 4

 While it is inappropriate to diagnose children with psychopathy, many adults with psychopathy exhibited callous and antisocial behaviours during their childhood (Conduct Disorder)
 A subgroup of antisocial children and young people may be at risk of developing psychopathy in adulthood
 Callous-unemotional (CU) traits in children, such as a lack of guilt and empathy, are considered a core affective component of psychopathy

Question 5

What is Prevelance of Psychopathy?

Answer 5

1% of general population
Higher among incarcerated individuals 15-30%

Question 6

What is the relation between psychopathy and neurocognitive disruptions?

Answer 6

 Psychopathy is associated with disruptions in emotional responsiveness, reinforcement-based decision-making, and attention
 Individuals with psychopathy show reduced emotional responsiveness, especially for fear and empathy
 They have difficulty in reinforcement-based decision-making tasks and show reduced neural responses to reward and punishment
 Attention-based models suggest they over-focus on certain features of a stimulus (e.g. reward), while ignoring others (e.g. punishment)

Question 7

What are the brain abnormalities associated with psychopathy?

Answer 7

 Structural abnormalities have been observed in cortical and subcortical regions, including the prefrontal cortex, insula, amygdala, and striatum
 Psychopathy is associated with reduced grey matter volume in several brain regions and atypical white matter microstructure’
 Studies have found differences in brain responses to emotional stimuli, with reduced activity in the amygdala and other areas during emotional tasks

Question 8

How is Psychopathy assesed?

Answer 8

 The most widely used tool for assessing psychopathy is the Hare Psychopathy Checklist-Revised (PCL-R). It evaluates interpersonal, affective, lifestyle, and antisocial traits
 The PCL-R is a dimensional measure with a categorical cut-off score that is commonly used for diagnosis
 Other measures such as self-report questionnaires, like the Triarchic Psychopathy Measure (TriPM), are used to assess psychopathic traits, but self-report measures should not be used alone for diagnosis

Question 9

What is the comorbidity of psychopathy?

Answer 9

 Psychopathy commonly co-occurs with other cluster B personality disorders, particularly ASPD, narcissistic personality disorder and borderline personality disorder
 Other comorbid conditions include substance use disorders and attention-deficit/hyperactivity disorder (ADHD)
 Internalizing disorders tend to have a weak association with psychopathy, although the relationship differs for various facets of psychopathy

Question 10

What are the consequences of psychopathy?

Answer 10

 Psychopathy is associated with various negative outcomes, including legal problems, social and family impairments, educational and employment problems, and mental and physical health problems
 Individuals with psychopathy may experience a reduced quality of life, and are more prone to violence, substance abuse and relationship issues
 The societal and economic effects of psychopathy are substantial

Question 11

What is Prevention and Treatment of psychopathy

Answer 11

 Early interventions for at-risk children and young people are important for the prevention of psychopathy in adulthood
 Parent management training is a recommended approach for addressing antisocial behaviour in children
 There is currently no effective treatment for adults with psychopathy, but preliminary interventions that target neurocognitive disturbances have shown promising results

Question 12

What is Conduct Disorder?

Answer 12

 Conduct disorder (CD) is a psychiatric disorder that typically emerges in childhood or adolescence and is characterized by severe antisocial and aggressive behaviour. It involves a repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms or rules are violated

Question 13

What are the key characteristics and diagnostic features of conduct disorder?

Answer 13

o Key Characteristics and Diagnostic Features:
 Violations of Rights: CD involves behaviours that violate the rights of others, such as physical aggression towards people or animals, theft, property damage, and rule violations
 Persistent Pattern: These behaviors are not isolated incidents but form a repetitive and persistent pattern
 DSM-5 Criteria: The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) requires the presence of at least three of 15 criteria within the past 12 months, with at least one criterion present in the past 6 months. These criteria are grouped into categories including aggression to people and animals, destruction of property, deceitfulness

Question 14

What are the subtypes of conduct disorder?

Answer 14

 Age of Onset: CD can be subtyped based on the age at onset of symptoms:
* Childhood-onset type: At least one symptom is present before 10 years of age
* Adolescent-onset type: All symptoms emerge after 10 years of age
* Unspecified onset: When the age at onset of CD is unknown or there is insufficient information to determine it

 Limited Prosocial Emotions (LPE)
* Both DSM-5 and the International Classification of Diseases 11th edition (ICD-11) include a specifier for CD with additional symptoms, referred to as LPE in DSM-5. This specifier applies to children who meet the criteria for CD and also show two or more of the following over an extended period of time and across multiple relationships:
o Lack of remorse or guilt
o Callousness or lack of empathy
o A lack of concern about educational or occupational performance
o Shallow emotions
o Indifference to punischment

• Severity
  o The DSM-5 includes specifiers for mild, moderate, and severe manifestations of CD, based on the number of symptoms present and the degree of harm caused to others.

Question 15

What is the prevelance of CD

Answer 15

• CD affects approximately 3% of school-aged children and is more prevalent in males than females

Question 16

What is the comorbidity of CD?

Answer 16

• ODD Oppositional Defiant Disorder (ODD): Children with CD have a 15-fold higher risk of meeting criteria for ODD
• ADHD Children with CD have a 10-fold higher risk of ADHD
• Substance Misuse CD is frequently associated with substance misuse, especially in adolescence
• Internalizing Disorder : CD frequently co-occurs with major depressive disorder, particularly in girls, and with anxiety disorders

Question 17

What are the risk factors of CD?

Answer 17

• Environmental factors
  o approximately 50% of the variance in CD is attributable to environmental influences
• Genetic factors
  o Twin studies suggest that 40-50% of the variance in CD is attributable to genetic factors

Question 18

Neurocognitive and Brain Mechanisms involved in CD?

Answer 18

• Neurocognitive deficits: Individuals with CD show deficits in facial and vocal emotion recognition, affective empathy, decision-making, and reinforcement learning. They also show biases in decision-making, being more influenced by potential rewards and less influenced by punishment
• Brain regions: Functional MRI (fMRI) studies show lower activity in brain networks involved in emotion processing (amygdala, anterior insula, anterior cingulate cortex), reward processing, and decision making in people with CD. Structural abnormalities have also been found in brain regions including the amygdala, insula, orbitofrontal cortex, and striatum. Studies have also reported atypical white matter microstructure and connectivity in individuals with CD

Question 19

What is the treatment of CD?

Answer 19

• Psychosocial intervention targets parents or primary caregivers and the child or adolescent’s home context. These include parent management training (PMT), family therapy, and multisystemic therapy.
• Medication
• Individualised approach

Question 20

What is the outcome and prognisis of CD?

Answer 20

• Negative Outcomes: CD is associated with a range of negative outcomes, including criminal behaviour, substance use, lower educational attainment, and mental health problems
• Continuity: CD is a strong risk factor for antisocial personality disorder in adulthood, although most children with CD do not develop this disorder
• Early Intervention: Early interventions are crucial to prevent the long-term negative consequences associated with CD

Question 21

What is White and Gray matter?

Answer 21

Question 22

What are neurodevelopmental disorders and when can they occur?

Answer 22

Neurodevelopmental disorders can occur when the development of the nervous system doesn’t follow the usual pattern (abnormal neurodevelopment), affecting the brain’s structure, function, and connectivity. These deviations lead to problems in behavior, cognition, and emotion. Neurodevelopmental disorders are driven by genetic and environmental interactions, with specific interactions per developmental stage. Environment typically ignites genetic risk.

Question 23

What is the neuro-bio-psychosocial jigsaw?

Answer 23

Question 24

Is there an antisocial brain?

Answer 24

You could say there is an antisocial brain, but it is difficult to treat, to change, to alter, it seems kind of not evolved yet. But we also know that there is a large group of antisocial people who tend to become normalized at the behavioral level, they might still have psychopathic tendencies but the behavior becomes normalized. There is such a thing as an antisocial brain, because we also have a depressed brain, an autistic brain, an anxious brain, etc. But there are ethical issues regarding labeling an individual as having an antisocial brain. Ethics should be respected. Heavy injuries can also alter someone’s brain, often towards a more antisocial brain. It could be acquired and it could be a neurodevelopmental thing.

Question 25

What are the two main factors concerning neurodevelopmental disorders?

Answer 25

• Gene x Environment Interactions

Question 26

What are the 3 gene x environment interactions in youth?

Answer 26

o Bio-Psycho-Social Risk CD/Psychopathy in Youth

 Passive Gene-Environment Correlation:
* Occurs when children inherit genetic factors from parents that shape their environment.
* Example: Inherited genes may increase the risk of psychopathology and also contribute to parents creating an environment conducive to negative behaviors.

 Active Gene-Environment Correlation:
* Involves children actively influencing or seeking out specific environments based on their genetic predispositions.
* Example: A child with genetic tendencies for delinquency might actively choose to associate with antisocial peers or engage in stimulating/dangerous situations.

 Evocative Gene-Environment Correlation:
* Arises when a child’s inherited genetic traits lead to specific behaviors that evoke negative responses from their environment.
* Example: Genetic predispositions, such as insensitivity to authority, may provoke negative reactions from parents, teachers, and others, worsening the overall situation.

Question 27

What is the pathway from Gene to Behaviour?

Answer 27

● Genetic Influence on Neuronal Formation:
○ Genes, through protein coding, actively contribute to the intricate process of forming neurons.
● Neuronal Organization and Behavioral Impact:
○ The complex structure of the brain involves single neurons organizing into populations, ultimately forming tightly coupled systems.
○ In instances of normal genetics, optimal behavioral patterns emerge. However, disruptions in this process can lead to system dysfunctions, significantly impacting behavior.
● Specifics of Genes in Neuron Formation:
○ Specific genes are dedicated to coding the intricate details necessary for the formation of neurons, a fundamental building block of the brain.
● Formation Principle and System Characteristics:
○ The formation principle of “neurons that fire together, wire together” highlights the interconnected nature of neuronal populations.
○ Systems within the brain exhibit characteristics of being tightly coupled, with connections established both structurally and functionally.
● Behavioral Drive and Dysregulations:
○ Systems, including prominent ones like the reward system, actively propel and influence behavioral responses.
○ Dysregulations within these intricate systems can result in clinical situations, manifesting as psychopathology or conduct disorders.

Question 28

What is the amygdala centered model?

Answer 28

o Neurocognitive Model Antisociality: Amygdala-Centered Model
 The amygdala takes in a central position, the amygdala (salience detector) is one of the first brain regions to light up, which makes the amygdala quite relevant. This model is able to explain the majority of behavior we see in youngsters. In the case of a severely antisocial individual:
* Amygdala hyporesponsive (below average) to negative stimuli (for example not being able to decode someone’s fearful expression and therefore not being able to maybe have the realization you are doing something wrong/should not go through with your plans)
* Suboptimal Amygdala-Frontostriatal (frontal cortex, striatal regions which are mainly involved in behavior and reward systems) coupling → it is not communicating well, which leads to;
* Deficient affective processing
* Biased attention/poor associative learning (they are not fully insensitive, but processing punishment differently, which does lead to some insensitivity to punishment. But punishment should happen immediately after the bad behavior, but often in practicality with for example court cases the time between the offense and punishment is too long)
* Precludes learning from mistakes/negative outcomes
* Promotes persistent antisocial/maladaptive behavior

Question 29

What is the neurocognitive model of antisociality?

Answer 29

o New Detective Team: Dr. Kent Kiehl has a different way of looking at why some people behave really badly. He uses a model called the “Paralimbic System Dysfunction.”
o Beyond Amygdala: This model doesn’t just focus on the amygdala (our brain’s detective). It looks at more parts of the brain and how they work together.
o Brain’s Special Operations: Dr. Kiehl thinks that the brains of these people have a few areas that work a bit differently. It’s like having alternative operations in their brain.
o Making Up for Missing Skills: Imagine these people are missing some natural abilities, like understanding when someone is sad by looking at their face. Because they lack these skills, their brains use other parts to make up for it.
o Special Brain Scanner: Dr. Kiehl even uses a mobile MRI scanner to study the most severe cases. It’s like a special brain camera that helps him see what’s going on inside their heads.
o Brain’s Compensatory Moves: The different brain areas in these troublemakers work together to help them get by in a complicated social world. Even though they might not feel emotions the way others do, their brains find ways to understand what others are feeling. It’s kind of like a workaround—they don’t feel it, but they know how to use emotions to their advantage.

Question 30

What is the Amygdala?

Answer 30

o The amygdala is like your brain’s emotional alarm system.
 It’s responsible for:
* Detecting danger: When you see something scary (like a snake!), your amygdala helps you feel fear and react quickly.
* Processing emotions: It helps you understand and experience a wide range of feelings, like happiness, sadness, and anger.
* Creating emotional memories: It connects your emotions to your memories, so you remember things that made you feel strongly.

o In simple terms, the amygdala helps you:
 Stay safe: By recognizing threats and triggering your “fight-or-flight” response.
 Understand and express your feelings: By processing emotions and connecting them to your experiences.
 Learn from your emotions: By linking your feelings to memories, helping you avoid or seek out similar situations in the future.

o Think of it this way: If your brain was a house, the amygdala would be the security system, always on the lookout for trouble and sounding the alarm when needed.

Question 31

What is the role of the Amygdala in Antisociality?

Answer 31

o Current understanding
o Smaller in size
o Hyporesponsive to negative affective stimuli
o Deprived of regulatory corticolimbic interactions

Question 32

• What is the Evolution Amygdaloid Complex

Answer 32

o Larger BLA (Basal Lateral Amygdala) vs. CMA (CentroMedial Amygdala) in Mammals
o Particularly Humans and Primates
o Complex Socioemotional Functions
 The more cognitively evolved an animal becomes, the larger the basal lateral amygdala is. Tightly connected to the neocortex. Some animals do not have neocortex, but humans do have them → this allows us for more complex socioemotional functions.
 If the amygdala is not functioning well, the moral compass is blocked/imbalanced/upset.

Question 33

• What is the problem with group examinations?

Answer 33

o Classic Approach Oversimplifies (Fig A): Comparing big groups with and without a condition overlooks variations.
o Complex Clinical Reality (Fig B): Clinical settings reveal diverse subgroups within cases, making it more intricate.
o Spectrum, Not Separation (Fig C): Conditions exist on a scale; it’s not a clear-cut distinction between having it or not.
o Diverse and Varied Cases (Fig D): Cases differ significantly, like pieces of a puzzle that don’t perfectly fit.
o Issues and challenges
 Test Accuracy Challenges: Tests may struggle to reliably identify or rule out the condition.
 Small Effect Size: Effects observed may be subtle, and replicating results can be challenging.
o Predictive Limitations: This method may fall short in predicting diagnosis, progression, and treatment response accurately.

Question 34

What can empathy be? (Characteristics)

Answer 34

o Myopic
 (short-sighted)
 Empathy makes you focus on something that is nearby, that is close to you, that looks like you, it is not necessarily wrong but it makes you nearsighted.

o Selective
 We think people that look like us are better than others; it defines, to some extent, how we relate to other people. For example, we have less empathy for homeless people, for refugees on a small boat, but we do not generally empathize a lot with this, but a picture of a refugee boy dead on a beach did impact us greatly (it is only one person).

o Fleeting
 Farmers’ protests at the same time as hundreds of refugees dying, what do we care about? The farmers’ protests. ‘Empathy makes us make bad decisions’

o Destructive
 Would you ever have torture if humans would not be empathic? Only humans perform actual ‘torture’.

Question 35

What is the Matrouschka Russian Doll model?

Answer 35

o The ‘Russian doll’ model of empathy suggests that empathy is built in layers, with a simple, automatic mechanism at its core and more complex cognitive processes as outer layers.
o Core Mechanism (PAM): At the heart of empathy is the Perception-Action Mechanism (PAM). When you see someone experiencing an emotion, your brain automatically activates similar neural and bodily responses. This means you might experience changes in your heart rate, facial expression, or body posture that match the other person’s state. This automatic mirroring allows you to “feel into” the other person’s feelings. This core process is often involuntary and very rapid, not relying on conscious thought.

Emotional Contagion: This is the automatic matching of another’s emotional state, driven by PAM. It’s like catching a yawn – it’s an involuntary reaction to another’s expression of emotion.

Cognitive Empathy: This is a more complex form of empathy that builds upon the emotional core. It involves not just feeling the other’s emotion, but also understanding the reasons for it. It includes assessing the other person’s situation, behaviour and needs. Cognitive empathy allows for tailored help

Perspective Taking: This higher level of empathy also includes the ability to adopt another’s perspective. This involves understanding that other people may have different viewpoints and that those views are valid to them.

The model suggests that higher levels of empathy, such as cognitive empathy and perspective-taking, cannot exist without the basic emotional responses driven by PAM. The ‘Russian doll’ model proposes that if the inner layers of empathy are deficient, then the outer layers will also be affected. For example, autism may reflect deficiencies in these outer layers, but such deficiencies go back to issues with inner layers.

Question 36

What are the multifaceted aspects of empathy?

Answer 36

Empathy is a multifaceted construct, consisting of a lot of aspects that have generally built up through evolution and became more complex along the way

 Emotional contagion/automatic contagion; the feeling of what someone else is feeling, automatically taking over the responses of the emotional response of somebody else, empathy for pain (for example one baby cries and the rest starts crying too), mice and rats also have this visible response to others and who might help another rat to avoid the pain

 Personal distress; we can also take over the stress response of somebody else (happens a lot in interactions between parents and children, couples, etc.), this can lead to a form of empathy which is not actually empathy anymore but personal distress (you get so distressed by someone else’s stressful situations that you can no longer help this person because you are so overwhelmed with your own feelings now) it is self-oriented, it is not about the person who experienced the stress in the first place anymore, you no longer respond to the needs of the other person but only your own needs

 Concern; focus on the other, which makes behavior really empathic, you have to be able to distinct between yourself and others

 ‘Through empathy, we are able to put ourselves in other people’s shoes and connect with how they might be feeling about their problem, circumstance, or situation’

 Mentalizing; for example reading someone’s expression/eyes → cognitive empathy, the aspects of empathy where you are trying to understand what somebody else is feeling/thinking, that is a different part of empathy, you use other parts of the brain (especially the prefrontal cortex; ventromedial prefrontal cortex)

 Multifaceted; you need an integration of all these forms of empathy to really be able to help somebody else, because if you do not have cognitive empathy you will do something that does not help, you will only help yourself

 Great (?); we need all sorts of empathy, not just one, more than just the affective/motivation empathy (because you might respond in the wrong way)

Question 37

What are the effects of testosterone?

Answer 37

o Testosterone facilitates aggression by
 Being more dominant
 Worse emotional responsiveness (to angry faces)
 Reduced fear and empathic responding

o Testosterone can bias the output of the amygdala, it affects connectivity of the amygdala with other regions. Connectivity in the brain is an important part of where violent behavior comes from. Balance between testosterone and cortisol; testosterone does not do this alone, there is a theory that testosterone works together with cortisol (relevant when it comes to emotional reactiveness and aggression), cortisol is activated when there is stress, the output of the stress system. It might be that people who use violence have lower levels of cortisol but higher levels of testosterone (hormonal profile).

o Prefrontal-limbic activation affects aggressive behavior
 Refers to the brain regions that influence emotions and decision-making.
 Influences how we behave aggressively.
 Connected to how we handle emotions and show empathy.
 Testosterone’s Role:
* Hormone testosterone plays a part in regulating these behaviors.
 Interactions with Other Hormones:
* Works together with cortisol and serotonin, other hormones that influence stress and mood.
 Impact on Moral Behavior:
* Affects moral behavior through changes in empathy.
* Can potentially lead to violent actions.
 Neural Circuitry:
* Empathy, aggression and morality rely on overlapping neural circuitry, which is biased by endocrine systems.
* These pathways are influenced by the body’s hormonal systems.
 

Question 38

What is the BioPsychoSocial model?

Answer 38

o Biology:
 Physical health considerations.
 Genetic vulnerabilities.
 Effects of drugs or substances.

o Psychological:
 Coping skills assessment.
 Social skills evaluation.
 Family relationships examination.
 Evaluation of self-esteem and mental health.

o Social:
 Assessment of peer relationships.
 Consideration of family circumstances.
 Examination of family relationships.

Question 39

How does brain development work?

Answer 39

• Brain Development
  o Continues into adulthood.
  o Prefrontal cortex (front brain) undergoes development into the 20s and 25s, controlling behavior.
  o Development rates vary among individuals, akin to variations in speech or walking abilities at ages 1-3.

Question 40

How do the different areas of the brain develop?

Answer 40

• Differential Development of Brain Areas
  o Social Emotional System (Amygdala):
   Fully develops around ages 16-20.
   Concentrated emotional activity during adolescence.
   Adolescents are highly engaged in emotions, peer relations, and social perception.

o Cognitive Control System:
 Still in the process of development.
 Active emotional control system vs. developing cognitive control system.
 Risk-taking behavior in young adults and adolescents due to the imbalance; desire for high-risk activities without full control.

Question 41

How does reward sensitivity differ between different ages?

Answer 41

o Adolescents show higher sensitivity to larger rewards, more willing to work for significant incentives

Question 42

What is the role of TBI in Delinquent behaviour?

Answer 42

o Traumatic brain injury (TBI) is a significant factor in the context of juvenile delinquency, with a notable prevalence among young offenders. Here’s a breakdown of its role:
o High Prevalence: A substantial percentage of juvenile delinquents have experienced TBI, with figures reaching 30%. This is even higher among adult detainees, at 55%, indicating a possible link between TBI and criminal behaviour.
o Impact on Treatment: TBI can contribute to unsuccessful treatment outcomes for juvenile offenders.
o Cognitive Function Problems: TBI is associated with problems in cognitive functions. Such cognitive impairments can impact a juvenile’s ability to learn from their mistakes and make sound judgements, potentially increasing the risk of reoffending.
o Delinquent Behaviour: TBI is directly linked to delinquent behaviour. This could be due to the cognitive and emotional changes that result from brain injury.
o Assessment for TBI: Given the impact of TBI, the sources indicate a need to assess for it. Neuropsychological and neurological assessments, sometimes including MRI scans, can help identify the presence of a TBI.
o TBI and other Neurobiological Factors: The sources suggest a broader need to understand neurobiological factors, including brain injuries, and how they affect behaviour. This involves understanding how these factors can contribute to delinquency.
o Connection to Impulsivity: The sources suggest that TBI can impact a person’s ability to regulate impulses. One study found a correlation between white matter integrity and impulsivity. TBI may damage the white matter of the brain and lead to problems with impulsivity, which is associated with delinquent behavior.
o Forensic Relevance: The legal system is beginning to acknowledge the potential implications of neurobiological factors such as TBI. Neuropsychological evaluations help assess the impact of brain injury and other factors on criminal behavior, helping to determine criminal responsibility and the need for specific treatment.
o In summary, TBI represents a significant neurobiological factor that contributes to delinquent behaviour in juveniles by affecting cognitive function, emotional regulation, and impulsivity. Understanding the impact of TBI is crucial for effective intervention, treatment, and legal decision making.

Question 43

How does neurology in the dutch pro justitia reports work’?

Answer 43

• Neuroloket en Neuropoli
  o
  o The terms “Neuroloket” and “Neuropoli” refer to specific services related to neurological assessment in the context of forensic evaluations.
  o Neuroloket is a neuro office, where consultation is provided by a clinical neuropsychologist and a neurologist. This suggests that it serves as an initial point of contact for individuals who may require further neurological assessment within a forensic setting.
  o Neuropoli offers ambulatory assessment, conducted by a clinical neuropsychologist (KNP) and a neurologist. This suggests a more in-depth, mobile assessment.
  o Clinical Assessment is also provided, which may involve a day admission to the Pieter Baan Center (PBC). These clinical assessments are conducted by a neurologist and a KNP, and may include an MRI scan and neuropsychological tests.
  o These services are important in the context of forensic assessments, because they allow for the evaluation of neurobiological factors, such as traumatic brain injury (TBI), that may be related to delinquent behaviour. The assessments conducted by the Neuroloket and Neuropoli can provide insight into the presence of conditions like TBI, tumors, neurodegenerative diseases, epilepsy, severe addiction, and trauma, all of which may influence behaviour. These assessments could be crucial in determining the relationship between mental health and criminal activity, as well as the need for treatment and can inform judicial decisions.
  o In summary, Neuroloket and Neuropoli are part of a framework for providing specialist neurological and neuropsychological assessments within the forensic system, with a focus on identifying and understanding how brain-related factors may contribute to delinquent behaviour.

Question 44

What was the NWA research at the NIFP about?

Answer 44

o The NWA research grant focuses on understanding the complex relationship between delayed development and delinquent behaviour, using a biopsychosocial model. The research aims to address gaps in knowledge about neurobiological factors that influence delinquent behaviour, and how these factors interact with psychological and social factors. The goal is to improve sentencing and treatment for young offenders.
o Here’s how the research works:
o Focus on Delayed Development: The research treats delayed development as a biopsychosocial construct, acknowledging the interplay of biological, psychological, and social factors in understanding delinquent behaviour. This suggests that the research will consider a wide range of influences, including brain development, mental health, and environmental factors.
o Developmental Profiles: The research aims to create profiles of development related to desistance from delinquent behaviour. This means identifying patterns and trajectories in how developmental factors influence whether individuals stop engaging in criminal behaviour. For instance, the research might track how specific developmental delays correlate with continued delinquent behaviour.
o Decision Support Tools: The research aims to create decision support tools that can help legal professionals make informed decisions regarding sentencing and treatment for young offenders. These tools might use the identified developmental profiles to predict the likelihood of reoffending, and advise on the best course of treatment.
o Assessment of Delayed Development: The research aims to develop reliable methods for assessing delayed development. This suggests that the research will work to standardise the process of evaluating developmental delays that could be influencing criminal behaviour.
o Lack of Knowledge: The research acknowledges a lack of knowledge about specific neurobiological factors that influence delinquent behavior, how these factors change over time, and how neurobiological, psychological and social factors combine. This indicates that the research will address these unknowns by studying them in detail.
o Dashboard: The research includes a ‘dashboard’, which is likely a tool to visualise the results of the research. This may assist researchers and other professionals to interpret the complex interplay of factors being studied.
o Interdisciplinary Approach: The research incorporates a biopsychosocial approach which indicates that it will bring together knowledge from different fields including neuroscience, psychology, and sociology. This is to understand the causes and solutions to delinquent behaviour in young people.
o In summary, the NWA research aims to advance the understanding of the causes of delinquent behaviour by studying the interplay of biological, psychological and social factors. The research is designed to translate the findings into practical tools and knowledge that can improve outcomes for young offenders in the legal system.

Question 45

What is the reproducability crisis?

Answer 45

o The “reproducibility crisis” in neuroscience and psychology, particularly in the study of conditions like conduct disorder and psychopathy, refers to the difficulty in replicating research findings, hindering the ability to draw firm conclusions. This is due to several interconnected factors:
 Heterogeneity of Clinical Populations: Traditional studies often assume a homogeneous group of individuals with a condition, but in reality, there are diverse subgroups with different underlying issues. This can mean that findings from one study may not apply to all individuals with a given condition
 Methodological limitations
* Small Sample Sizes: Many studies have small sample sizes, reducing the statistical power to detect real effects and increasing the risk of false positives. This can result in findings that are difficult to replicate.
* Variability in methods: There is substantial variability in task parameters, comparison groups, and fMRI data analysis, making it difficult to compare and synthesise findings across studies
* Lack of Psychometric Validation: Measures used may not be reliable or sensitive enough to capture individual differences accurately
 Overemphasis on group averages, overlooking individual variations and specificities
 Lack of Research Harmonisation: A lack of consistency in data collection and analysis methods across studies hinders the ability to combine data and find robust, replicable findings
 Limited Team scicence
 Consequences
* Issues with Sensitivity, Specificity and validity
* Small and hard to replicate effects
* Inability to predict

Question 46

What is individual level interference?

Answer 46

o Moving to individual-level inferences: Focusing on individual differences instead of group-level averages

o Individual-level inferences, in the context of the sources, refer to a shift in research focus from group-based analyses to examining data and drawing conclusions about individuals within a population, rather than about the population as a whole

Question 47

What is ENIGMA and the relevance of BIG DATA and AI

Answer 47

o Big data and associated analytical techniques, such as artificial intelligence (AI) and machine learning (ML), are seen as crucial for addressing the reproducibility crisis in the study of conditions like conduct disorder and psychopathy by enabling a move towards individual-level inferences. The sources indicate several ways in which big data can help:
o Moving Beyond Group Averages: Traditional research often relies on group-level analyses, overlooking the heterogeneity within clinical populations. Big data facilitates a shift towards individual-level inferences, allowing researchers to analyse data at the level of the individual and recognise the unique patterns of symptoms, biology, and environmental influences that affect each person.
o Handling Complex Datasets: Big data techniques can process the vast, complex datasets needed to understand conditions like psychopathy, which involve interactions between genetics, brain structure and function, and environmental factors. This includes the ability to analyse multimodal, high-dimensional data.
o Advanced Analytical Techniques: AI and ML algorithms can be used to identify subtle patterns and make predictions based on large amounts of data. These advanced techniques can uncover relationships and patterns that might be missed by traditional statistical methods, helping researchers move beyond simple correlations and identify more complex interactions.
o Improving Predictive Power: Big data and AI can improve the ability to predict individual diagnosis, prognosis, and treatment response. By integrating data from various sources, including brain imaging, genetics, and behaviour, these models can potentially offer more accurate, personalised predictions.
o Enhancing Generalisability and Validation: AI prioritises generalisability and validation, which are critical for addressing the reproducibility crisis. By training algorithms on large datasets, researchers aim to develop models that can be reliably applied to new, unseen data.
o Data-Driven Personalised Solutions: Big data and AI facilitate the development of data-driven personalised solutions. This includes tailoring interventions to the specific needs of an individual and enabling more effective diagnosis and treatment.
o Identifying Subgroups: Big data can help identify more narrowly defined clinical subgroups with specific environmental and neurobiological vulnerabilities. This level of granularity is essential for developing targeted treatments.
o Collaborative Research: The use of big data also supports collaborative efforts through large-scale initiatives such as the Enhancing Neuro Imaging and Genetics through Meta Analysis (ENIGMA) consortium, which pools data across many different research groups. This approach, referred to as “team science,” combines expertise from various disciplines, leading to more comprehensive and robust findings.
o However, it is important to note that big data and AI are not a “silver bullet” and have limitations. There are many ethical issues to be considered, and strict replication and validation are still warranted. Also, the sources note that access to large amounts of high quality data and the methods to analyse it are still being developed.
o In summary, big data, AI, and ML are seen as crucial for advancing research and helping overcome the reproducibility crisis in the study of psychopathy and conduct disorder. By enabling the analysis of complex, multimodal datasets, facilitating individual-level inferences, and encouraging collaborative research efforts, these approaches have the potential to significantly improve the understanding, diagnosis, and treatment of these conditions.

Question 48

How do durkheim and martison differ on crime?

Answer 48

o Durkheim: Research all over the world; incarceration rates, types of factors that are in a society → What are the countries with the highest crime rates in the world? (e.g. the US). Why do certain types of societies have lower crime rates?

o Martison: Regarding people that commit crimes, there is only one thing you can do, you have to take care of the safety of our society and lock those people up.

Question 49

What is biofeedback treatment?

Answer 49

 Walking around with a watch that measures your heart rate, skin, and has an app on your phone. If the heart rate goes up the phone will send you a message asking what is going on. In treatment you can use this data to talk about the situation.

Question 50

What is the VR treatment?

Answer 50

 Training people for hypothetical situations. What can you do? Talking about it and reflecting on it. Reflecting is difficult for some people so through virtual reality it becomes easier.

Question 51

What is Group Theory?

Answer 51

 According to research, not so effective, when young criminal people are together they can also influence each other negatively.