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Supplemental material, sj-docx-1-ijo-10.1177_0306624X221086565 for Offending Trajectories in Violent Offenders: Criminal History and Early Life Risk Factors by André Tärnhäll, Jonas Björk, Märta Wallinius, Peik Gustafsson and Björn Hofvander in International Journal of Offender Therapy and Comparative Criminology

Background: Traumatic brain injury (TBI) is a major cause of disabilities and mortality worldwide, with higher prevalence in offender populations than in the general population. Previous research has strongly advocated increased awareness of TBI in offender populations. The aim of this study was to explore the prevalence and characteristics of TBI, and to investigate associations and interactions between TBI, aggressive antisocial behaviors, general intellectual functioning, and substance use disorders (SUD) in a well-characterized group of young violent offenders. Methods: The study investigated a cohort (n = 269) of 18 to 25-year-old male violent offenders in Sweden. Data on TBI (files + self-report), aggressive antisocial behaviors (Life History of Aggression), SUD (clinical interviews), and general intellectual functioning (General Ability Index, Wechsler Adult Intelligence Scales Third Edition) were collected between 2010 and 2012. Parametric (Student's t-test) and non-parametric (Mann-Whitney U-test, Spearman's rho, χ2, Kruskal Wallis test) inferential statistics were applied and effect sizes reported. Results: TBI, both with and without loss of consciousness, was common, with 77.5% of the offenders reporting having suffered at least one TBI during their lifetime. TBI was associated with an increased occurrence of aggressive antisocial behaviors and SUD, and offenders with both TBI and SUD evidenced the largest amount of aggressive antisocial behaviors. No clinically meaningful associations were found between TBI and general intelligence. Effect sizes were in the small to medium range. Conclusions: Our study confirms an increased prevalence of TBI among young violent offenders compared to the general population, as well as associations between TBI, aggressive antisocial behaviors, and SUD. However, it provides no information on the severity of the TBI, nor on the causality of the demonstrated associations. Nevertheless, TBI, and possible related deficits, need to be considered in the assessment and treatment of young violent offenders.

One of the primary objectives in forensic psychiatry, distinguishing it from other psychiatric disciplines, is risk management. Assessments of the risk of criminal recidivism are performed on a routine basis, as a baseline for risk management for populations involved in the criminal justice system. However, the risk assessment tools available to clinical practice are limited in their ability to predict recidivism. Recently, the prospect of incorporating neuroimaging data to improve the prediction of criminal behavior has received increased attention. In this study we investigated the feasibility of including neuroimaging data in the prediction of recidivism by studying whether the inclusion of resting-state regional cerebral blood flow measurements leads to an incremental increase in predictive performance over traditional risk factors. A subsample (N = 44) from a cohort of forensic psychiatric patients who underwent single-photon emission computed tomography neuroimaging and clinical psychiatric assessment during their court-ordered forensic psychiatric investigation were included in a long-term (ten year average time at risk) follow-up. A Baseline model with eight empirically established risk factors, and an Extended model which also included resting-state regional cerebral blood flow measurements from eight brain regions were estimated using random forest classification and compared using several predictive performance metrics. Including neuroimaging data in the Extended model increased the area under the receiver operating characteristic curve (AUC) from .69 to .81, increased accuracy from .64 to .82 and increased the scaled Brier score from .08 to .25, supporting the feasibility of including neuroimaging data in the prediction of recidivism in forensic psychiatric patients. Although our results hint at potential benefits in the domain of risk assessment, several limitations and ethical challenges are discussed. Further studies with larger, carefully characterized clinical samples utilizing higher-resolution neuroimaging techniques are warranted.

The aim of this study was to characterize young dating violent offenders (DVO), and to compare them to the general population and to young offenders with violent crimes directed against other victims. We have used data from the Development of Aggressive Antisocial Behaviour Study, in all 262 young men, 18 to 25 years, convicted of violent crimes and imprisoned in the Western Region of the Swedish Prison and Probation Services. We found that young DVO offenders differed from the general population in all investigated areas; however, the group did not differ in comparisons to other young violent offenders. Our results highlight the antisocial aspects of dating violent crime being rooted in aggressive antisocial behaviour, lacking signs of any specific offender type characteristics, thus questioning the validity of crime specific treatment programs in prison for young offenders of dating violence. Resumen El presente estudio ha tenido por objetivo la caracterización de los jóvenes delincuentes violentos en sus relaciones sentimentales (“DVO” en su acrónimo inglés) y su comparación tanto con el conjunto de la población como con otros delincuentes violentos jóvenes que han cometido delitos con otro tipo de víctimas. Hemos empleado datos del estudio sobre desarrollo de conducta antisocial violenta con 262 jóvenes varones de entre 18 y 25 años de edad condenados por delitos violentos y encarcelados en la Región Oeste del Servicio de Prisiones y Libertad Vigilada de Suecia y hallado que los jóvenes delincuentes de tipo DVO se diferenciaban del resto de la población en todas las áreas objeto de estudio. Sin embargo, no mostraban discrepancias con respecto a otros delincuentes violentos jóvenes. Nuestros resul-tados destacan que los aspectos antisociales de los delitos violentos en las relaciones sentimentales tienen su base en una conducta antisocial violenta, sin indicios de vinculación con un tipo específico de delincuentes, lo cual cuestiona la validez de los programas penitenciarios para el tratamiento de delitos específicos orientados a delincuentes jóvenes condenados por violencia en las relaciones sentimentales.