Facial affect recognition in young adult offenders: Investigating the impact of traumatic brain injury and assessing targets for intervention

Abstract

Crime and reoffending rates pose a significant societal and economic problem. Traumatic brain injury (TBI) has been associated with higher risk of criminal behaviour and reoffending risk. This project was developed to better understand this association between TBI and criminality and to assess targets for intervention. Here I assess neuropsychological profiles of adolescent and young adult offenders with history of TBI, exploring socioemotional processing as a possible mediator in this effect. Using a novel task, I investigated facial affect recognition and its relation to self-reported TBI across several offending and non-offending samples. The relationship between TBI and facial affect recognition was inconsistent across these studies. Meta-analysing the results suggested there was no clear evidence for deficit in this domain in those with higher severity TBI, in comparison to those without injury. However, the synthesised findings of these studies did suggest strong evidence for increased aggression, delinquency, alexithymia, alcohol and drug use in those with higher dosage of previous injury. Current post-concussion symptomology was a strong predictor of poorer behavioural outcomes. Furthermore, consistent with the wider literature, those recruited from offending populations demonstrated impaired facial affect recognition in comparison to aged-matched, non-offending controls. Building on this, I evaluated the application of a facial affect recognition as a therapeutic intervention for use with these populations. This included a systematic review of current applications and a feasibility study and pilot trial. The trial assessed acceptability and usability of a cognitive bias modification paradigm, for use with a sample of incarcerated violent young offenders. Overall, there are exciting prospects for implementation of strategies of this nature, responding to the need for novel prison interventions. Future high-quality research trials will help determine whether perceptual changes can translate to behavioural outcomes, particularly the alleviation of aggression and antisocial behaviour.