Traumatic Brain Injury and Psychopathic Features Among Juvenile Offenders: New Evidence on Their Clinical Relevance

Background and Purpose: Psychopathic traits and a history of traumatic brain injury (TBI) are common among marginalized populations such as imprisoned individuals and can have detrimental effects on social and emotional functioning. The relationship between psychopathy and TBI warrants further investigation as many of the same brain areas are implicated in both psychopathy and mild to severe TBI. However, there is relatively little study of their relationship and whether specific psychopathic traits are more strongly associated with TBI. Based on the neurobiological view of psychopathy and the plasticity of the developing brain, there are important treatment implications for studying the co-occurrence of psychopathy and TBIs. Thus, study objectives included: 1) examine the association between the history of a TBI and psychopathic traits among juvenile offenders, 2) determine if the history of a TBI predicts the manifestation of different psychopathic factors among juvenile offenders.

Methods: A cross-sectional study of a non-probability sample of 14- to 18-year-old youth was conducted as part of the Multidimensional Youth Residential Inventory by researchers from the University of Pittsburgh. Youth were sampled from two (one male and one female) long-term residential placement facilities for juvenile offenders. The survey instrument contained demographic questions asking questions such as age, gender, racial or ethnic group, grade, and history of mental illness. The second section was comprised of assessments to measure TBI, psychopathic traits, and moral disengagement.

Results: Univariate, bivariate, and multivariate analyses were conducted. The sample consisted of 126 (55%) males and 101 (45%) females. The mean age of participants was 16.21 (SD=1.40). Approximately 22% (n=50) of participants endorsed a history of a TBI. Mean scores for the psychopathic dimensions as well as the YPI total score were as follows: grandiose manipulation dimension ( = 36.70, SD=9.62); callous unemotional dimension ( = 31.13, SD=7.40); impulsive irresponsible dimension ( = 37.20, SD=8.03); and YPI total score ( = 105.09, SD=19.75). Results of linear regression analyses showed that after controlling for gender, age, minority group membership, history of mental illness, and moral disengagement, history of a TBI significantly predicted callous unemotional (F(6, 219) = 2.332, p = .033, R² = .060) and impulsive irresponsible traits (F(6, 219) = 3.433, p = .003, R² = .086).

Conclusions and Implications: Study results show the strong, positive association between TBI and psychopathy, and elucidate the need for more research, clinical practice, and policy work examining this relationship and its potential effects further. Clinical implications suggest early intervention is needed to treat the potential long-term effects of TBIs and the development of psychopathic traits. Further neurobiological research can promote social justice by how we intervene and potentially lead to transformational changes in how psychopathy and TBIs are viewed within the criminal justice system. As the adolescent brain is prone to increased neuroplasticity, findings suggest that neuroscientific and cognitive-based interventions may be effective in the recovery of juvenile offenders. Future research should employ prospective and longitudinal designs to further track the effects of a TBI with the development of psychopathic traits.