Study Finds Two Types of Crime-Linked Brain Disorder: “Several studies have linked a form of mental illness called organic

brain syndrome with an increased likelihood of committing crimes, but the results of new research

suggest that the association between crime and the mental illness is not as straightforward as some

experts have thought.

Male criminals with organic brain syndrome display different patterns of criminal behavior

depending on how old they are when first arrested, researchers report.” I’ve long been interested in the relationship between neurobehavioral disorders and violent and criminal behavior, and this is not a surprising finding to me. Ethologists feel there are essentially two patterns of animal violence. Predatory violence is self-interested, purposeful, self-protective, and without physiological signs of arousal. Affective violence, with arousal, is reactive and often undirected. Essentially, this represents the cataclysmic activation of the so-called “fight or flight response.”

Some neuropsychiatrists, like myself, are convinced that the human analogy holds up. The predators are the sociopaths. They are canny about being caught and not picking on someone their own size, are remorseless and their preying on others is for self-gain. Affective violence with intense arousal, on the other hand, is often reactive and impulsive. The pureyor of this type of violence is not motivated by self-interest; the violence is not instrumental and often not very focused. Moreover, the perpetrator may not exercise the judgment to protect themself against the consequences of their actions (either physical injury or social/legal consequences). They are often overcome by remorse after their ‘storm-like’ eruption of violence, as if it had been ego-alien to their usual sense of themselves. The compelling picture is one of a defect in normal inhibitory function — often abetted by the use of disinhibiting substances (e.g. the diagnostic entity of ‘pathological intoxication’, the ‘violent drunk’ to the extreme) — and loss of control.

Evidence in both animal and human studies suggests different neural circuitry controls each type of aggressive behavior, and that sociopaths often have normal-looking and -functioning brains when studied neuropsychologically. I think that what the current study calls “early starters” have what we call a sociopathic or antisocial personality organization which allows them to violate the rights of others with impunity and without compunction. The “late starters” represent those whose organic brain condition has damaged their inhibitory neural circuitry (usually but not always associated with the frontal lobe), loosening their impulse control. Why, then, in this study, is organic brain damage found in the “early”, sociopathic type of criminals too? Probably because a career of antisocial behavior often involves brain-damaging substance abuse (one of the diagnostic criteria for antisocial personality disorder) and other causes of personal injury as consequences, rather than causes. In fact, the current study demonstrated that the “early starters” were more likely to abuse drugs.

The conclusions of the study are also consistent with my way of thinking about this: ‘The findings may have important implications for the treatment of criminal behavior, (the study’s author) noted.

“The antisocial behavior of late starters can be thought of as the result of a disease and may be

responsive to medication or behavioral training programs.”

In contrast, she said, the antisocial behavior of early starters is often long-lasting and stable and

may be extremely difficult to modify.’

And how about the prediction and prevention of violence that may be associated with a neurobehavioral disorder? “The ability of psychiatrists to predict which patients may become violent is no longer science fiction, some experts say. Conducting interviews

that focus on certain factors in a person’s history and using new measurement tools allow psychiatrists to make reasonably accurate short-term

predictions about violence risk.” Psychiatric News It’s important to clarify, however, that short-term risk prediction is imprecise and clinicians cannot be held to a standard, IMHO, of liability for failing to have a crystal ball. The talk reported on here is, to my way of thinking, merely commonsense with prudent clinical practice thrown in for good measure. The greatest risk factor in violence prediction is, of course, a history of previous violence. Other factors to assess include ‘criminal history, possession of a gun, history of

multiple psychiatric admissions, the presence of violence fantasies, and sexually aggressive behavior or fantasies about

such behavior,… a first criminal

arrest occurring at a young age; being a male under age 40; a history of cruelty to animals, firesetting, or reckless driving;

viewing oneself as a “victim”; being very resentful of authority; and a lack of compassion and empathy for others.’ Commonsense, no? With a little bit of circularity thrown in — defining a person as violence-prone if they have evidence of a condition one of whose defining factors is violence…