Shelton - Relationships - Between - Frontal - PDF

INFORMATION TO USERS
This manuscript has been reproduced from the microfilm master. UMI
films the text directly from the original or copy submitted. Thus, some
thesis and dissertation copies are in typewriter face, while others may be
from any type o f computer printer.
The q u a lity of this reproduction is dependent upon the quality of the

copy submitted. Broken or indistinct print, colored or poor quality
illustrations and photographs, print bleedthrough, substandard margins,
and improper alignment can adversely afreet reproduction.
In the unlikely event that the author did not send UME a complete
manuscript and there are missing pages, these will be noted. Also, if
unauthorized copyright material had to be removed, a note will indicate
the deletion.
Oversize materials (e.g., maps, drawings, charts) are reproduced by

sectioning the original, beginning at the upper left-hand comer and
continuing from left to right in equal sections with small overlaps. Each
original is also photographed in one exposure and is included in reduced
form at the back o f the book.
Photographs included in the original manuscript have been reproduced

xerographically in this copy. Higher quality 6” x 9” black and white
photographic prints are available for any photographs or illustrations
appearing in this copy for an additional charge. Contact UMI directly to
order.
UMI
A Bell & Howell Information Company
300 North Zeeb Road, Ann Arbor MI 48106-1346 USA
313/761-4700 800/521-0600
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
RELATIONSHIPS BETWEEN FRONTAL LOBE FUNCTIONING, PSYCHOPATHY,
AND AGGRESSION IN A SAMPLE OF MALE JUVENILE DELINQUENTS
A DISSERTATION
SUBMITTED TO THE FACULTY
OF
THE DEPARTMENT OF PSYCHOLOGY
BY
ROBERT R. SHELTON
IN PARTIAL FULFILLMENT OF THE
REQUIREMENTS FOR THE DEGREE
OF
DOCTOR OF PSYCHOLOGY
LOUISVILLE, KENTUCKY May, 1999
es J. Cooksey,
APPROVED:
Marilyn Wagner, Ph.D.
irry Lewis, Ph.D. ^
DEPARTMENT CHAIR:
Thomas Titus, Ph.D.
UMI Number: 9916544
Copyright 1998 by
Shelton, Robert Ray
All rights reserved.
UMI Microform 9916544

Copyright 1999, by UMI Company. All rights reserved.
This microform edition is protected against unauthorized

copying under Title 17, United States Code.
UMI
300 North Zeeb Road
Ann Arbor, MI 48103
Copyright 1999, Robert Ray Shelton
ABSTRACT
Past research with adult criminals and juvenile delinquents has indicated links between
neurological functioning and antisocial behavior in general and aggression in particular.
Psychopathy is a construct that has a long history of examination in adult populations and in
recent years has been applied to children and adolescents. There has been research in adult
populations on the relationship of psychopathy and frontal lobe functioning, however, this
research has been inconsistent in its results and has been rarely applied to adolescents.
Research with adults has documented consistently a link between psychopathy and aggression
with psychopathic individuals committing more crimes and more violent crimes.
This project sought to examine the relationships of psychopathy, aggression, and frontal
lobe functioning in a sample of male juvenile delinquents. It was hypothesized that higher levels
of psychopathy would be positively correlated with higher levels of aggression and lower levels
of frontal lobe functioning, and that higher levels of aggression would be positively correlated
with lower levels of frontal lobe functioning. The researcher recruited 40 male delinquents who
were residing in four residential facilities. After consents were obtained from the juvenile and his
legal guardian, the following measures were given during an individual session: the Psychopathy
Checklist - Youth Version (PCL-YV), the Aggression Questionnaire (AQ), WISC-III Mazes,
Controlled Oral Word Association (COWA), Design Fluency, and the Complex Figure Test
(CFT). The CFT was utilized as a measure of posterior functioning. The juvenile's counselor
completed the Overt Aggression Scale (OAS), and a Legal History Scale was completed by the
researcher after reviewing the chart.
O f those correlations relevant to the hypothesis of relationships between psychopathy,
aggression, and frontal lobe functioning, the Psychopathy Checklist • Youth Version was
significantly correlated with the Free Novel condition of Design Fluency (c= .31, j i < .05) and
with the Fixed Novel condition of Design Fluency (c= .34, p.< .05). The Overt Aggression Scale
was significantly correlated with the Free Novel condition of Design Fluency (c = -.42, e < .05).
After this initial analysis, the data were re-analyzed with the effects of Age held constant in order
to control for the effects of maturation on measures of performance. With Age controlled, the
PCL-YV was no longer significalty correlated with either the Free Novel or Fixed Novel
Conditions of Design Fluency. The OAS was found to still be significantly and negatively
correlated with the Free Novel condition of Design Fluency (c= -.37, g < .05).
The hypothesized relationship between aggression and frontal lobe functioning did
receive some support. While a positive relationship between frontal lobe functioning as
measured by Design Fluency and psychopathy was suggested to exist in this sample, these
results did not support the hypothesized relations between psychopathy and frontal lobe
functioning and between psychopathy and aggression. The results are discussed in relation to
previous findings of abnormal lateralization in psychopaths and their ineffective processing of
affective information.
TABLE OF CONTENTS
ACKNOWLEDGEMENTS iv
LIST OF TABLES v
CHAPTER
I. GENERAL PRESENTATION OF THE PROBLEM 1
II. LITERATURE REVIEW 10
III. METHOD 32
IV. RESULTS 36
V. DISCUSSION 42
REFERENCES 55
APPENDICES
A. AGGRESSION QUESTIONNAIRE 66
B. OVERT AGGRESSION SCALE 68
C. LEGAL HISTORY SCALE 70
D. INFORMED CONSENTS 71
E. DEPARTMENT OF JUVENILE JUSTICE
RESEARCH AGREEMENT 73
ii
ACKNOWLEDGEMENTS
This project was possible only through the support and encouragement of my wife,
Suzanne Quick Shelton, and my children, McKenzie Laurel Shelton and Madison Caroline
Shelton. I am grateful for the assistance of the Department of Juvenile Justice, especially the
staff and residents of Cardinal Treatment Center, Rice-Audobon Youth Development Center,
Johnson-Breckinridge Youth Development Center, and Central Kentucky Youth Development
Center. I would also like to thank the members of my dissertation committee for their guidance.
iv
TABLE 1 DESCRIPTIVE STATISTICS OF MEASURES OF PSYCHOPATHY.
AGGRESSION, AND FRONTAL LOBE FUNCTIONING
TABLE 2 PERCENTAGE OF SAMPLE OBTAINING CLINICALLY SIGNIFICANT
SCORES ON SELECTED MEASURES
TABLE 3 CORRELATION COEFFICIENTS OF VARIABLES RELATED
TO PSYCHOPATHY, AGGRESSION, AND FRONTAL
LOBE FUNCTIONING
TABLE 4 CORRELATION COEFFICIENTS OF VARIABLES RELATED
TO PSYCHOPATHY, AGGRESSION, AND FRONTAL
LOBE FUNCTIONING CONTROLLING FOR THE EFFECTS OF AGE
Frontal Lobes, Psychopathy, and Aggression 1
CHAPTER I
GENERAL PRESENTATION OF THE PROBLEM
On the morning of Tuesday, December 2,1997, a 14 year old boy entered Heath High
School in Paducah, Kentucky carrying a .22 caliber handgun with spare ammunition, two rifles
and two shotguns. At about 7:40 a.m. an informal prayer meeting of about 35 students ended in
the school lobby. The 14 year old calmly inserted earplugs, drew the pistol from his backpack,
and opened fire. Three teen-age girls died and four other students received medical attention for
injuries. The student who fired into the crowd received charges for murder, attempted murder,
and burglary.
While this is a sensational example, juvenile violence and aggression is a nationally
recognized problem. The Office of Juvenile Justice and Delinquency Prevention reported that
assaults, robberies, rapes, and homicides committed by juveniles increased by 93% between
1985 and 1994 (Snyder and Sickmund, 1995). The Kentucky Department of Juvenile Justice, in
its recommended treatment protocol, made the identification and control of serious and chronic
juvenile offenders a priority. Aggressive and violent juveniles fit in this category. The
identification of such juveniles can be aided, serious acts of aggression and violence possibly
avoided, and appropriate treatment or detention decisions facilitated if correlates that predict
aggression and violence are better understood (Rice, 1997).
In the quest to understand the origins and associated characteristics of human
aggression and violence, a number of factors have been examined, including family
environment (Bischof, Stith, & Whitney, 1995; Huesmann, Eron, Lefkowitz, & Walder, 1984),
evolutionary considerations (Ebl-Eibesfeldt, 1977; Figueredo & McCloskey, 1993), and
sociological factors (c.f., Andrews & Bonta,1994). A factor receiving increasing attention for
violent and aggressive adults is the relationship of neuropsychological functioning with violence
and aggression (e.g., Bryant, et al, 1984; Langevin, 1987; Nestor, 1992). A second factor that
has received attention primarily in adult populations is the relationship of violence and
aggression with personality variables, in particular a cluster of personality and behavioral
characteristics labeled "psychopathic" after the work of Cleckley (1976).
Summary of Related Research and Theory
An area of the brain that has generated interest due to possible links to antisocial
behavior are the frontal lobes. The frontal lobes are involved in the "executive control" and
regulation of behavior (Volavka, Martell, & Convit, et al, 1992). Normal functions of the frontal
lobes include sustaining attention and concentration, abstract reasoning and concept formation,
goal formulation, planning and anticipation of consequences, initiation of purposeful motor
behavior, self-monitoring, self awareness, and inhibition of unsuccessful or impulsive actions,
with subsequent shift to more adaptive behaviors (Moffitt, 1990). Damage to the prefirontal areas
can separate action from knowledge; impair the abilities to handle sequential behaviors,
establish or change a set, maintain a set in the face of interference, monitor personal behavior;
and can produce attitudes of unconcern, unawareness, and apathy (Mattson & Levin, 1990;
Stuss & Benson, 1984). Interestingly, a type of personality change that can result from damage
to the frontal lobes is referred to as "pseudo-psychopathic" (Mattson & Levin, 1990; Stuss &
Benson, 1984). This personality change possesses characteristics of a puerile, jocular attitude,
sexually disinhibited humor, and a high degree of self-indulgence with a corresponding lack of
concern for others.
Much of the adolescent literature on neuropsychological functioning and violence or
aggression deals with the broad and typically court-determined construct of "delinquency."
While some of these studies do not examine neuropsychological functioning and aggression
specifically, they are relevant due to the fact that aggressive acts are a major subset of
delinquency. Furthermore, the impulsivity and disinhibition related to delinquent acts are
consistent with the impulsivity and disinhibition found in much aggression and violence.
Pontius and Ruttiger (1976) conceived of the developing ability to generate increasingly
complex narratives as a sign of frontal lobe maturation. They examined stories from 132
Australian school children (ages 9 - 1 6 ) (Pontius and Ruttiger, 1976). The children were divided
Reproduced with permission o f the copyright owner. Further reproduction prohibited without permission.
into three groups: "normal" as judged by their teachers; "delinquent” if known to have committed
indictable acts; and those with "emotional problems” which included "highly aggressive behavior,
disturbed family situation or neurotic behavior." After a blind analysis of the stories, a downward
trend in story complexity was found from the "normals” to those with emotional problems
followed by the delinquents. The authors concluded that the findings supported the theory of a
maturational lag of the frontal lobe system in delinquents.
One hundred seventy-seven boys were followed from ages 6 to 12 and identified as
physically aggressive through four assessments of aggression during those years (Sequin, et ai,
1995). These subjects were given cognitive neuropsychological tests (e.g., dichaptic
lateralization, digit span, nonspatial conditional association, paired associates, etc.). The results
indicated that tests of executive functioning were most clearly associated with physically
aggressive behavior. With social factors (e.g., low socio-economic status and family adversity)
controlled, stable aggressive boys (those aggressive at three of four aggression assessments)
had problems in executive functions. Social factors were found to be related significantly to
verbal learning only; impairments in cognitive executive functions were associated with physical
aggression. This latter point has been found to be true also in previous studies of adult
antisocial behaviors and delinquent behavior (Sequin, et al, 1995).
In New Zealand as part of a longitudinal study 1,139 children at the age of 13 were given
3 subtests of the Wechsler Intelligence Scale for Children-Revised, the Grooved Pegboand,
Mazes, Rey Auditory Verbal Learning Test, Rey-Osterreith Complex Figure Test, Trail-Making
Test, and the Wisconsin Card Sort Test (Moffitt, Lynam, & Silva, 1994). The Self-Reported
Early Delinquency Instrument was given to them at ages 13 and 15; while at age 18, information
court convictions, police contacts and self-reported delinquency was collected. Poorer
neuropsychological functioning at age 13 was associated with a greater likelihood of having
committed crime at age 18. Verbal and verbal memory factors were most related to
delinquency (Moffitt, Lynam, & Silva, 1994).
Voorhees (1981) examined neuropsychological differences between 28 juveniles with
"extensive histories) of criminal behavior (robbery, assault, prostitution)" (p. 59) from a juvenile
facility and 13 control subjects with no criminal history who were performing adequately
educationally. Both groups were mixed male and female with an overall mean age of 15.5. The
groups were compared using the Bender-Gestalt visual motor test and Luria's
Neuropsychological Investigation. Significant differences, with the delinquent group performing
more poorly, were found on Motor Functions, Visual Functions, Impressive-Expressive Speech,
Reading and Writing, Arithmetic Skills, Mnestic Processes, Intellectual Processes, and on the
Bender-Gestalt Test. There was not a significant difference on Tactile Functions. The author
interpreted these results as suggesting that the delinquents' performance levels were less
affected when sustained attention, symbolic manipulations, and complex abstract abilities were
not involved. These are functions typically associated with the frontal lobes.
From the preceding literature review, it appears that there are neuropsychological and
neurological correlates of aggression and violence in adolescents. These correlates are
strongest in regard to some type of frontal lobe dysfunction. This is logical since frontal lobe
functions relevant to aggression include judgment, planning, the capacity to filter out irrelevant
stimuli, and inhibition of behavioral and emotional responses. The temporal lobes in general and
the limbic system in particular have also been found to have some relation to aggression and
violence. It appears that some authors consider the connection more compelling and more
definite than other researchers. As Volavka, Martell, and Convit (1992) noted, many studies
have small sample sizes, a lack of reliable and valid measures of frontal lobe functions,
confounded research designs, and few have control groups. There is a need for the global
concepts of aggression and violence to be better defined; many studies have settled for a court's
judgment that an individual is guilty of a particular crime. Due to lack of standardization in
charging and convicting juveniles, this approach can result in considerable sampling bias.
Psychopathy is conceived of as a cluster of personality and behavioral characteristics
after the work of Cleckley (1976). Psychopathic individuals are risk-taking sensation seekers
who are frequently involved in criminal activities and who are described as grandiose,
egocentric, manipulative, forceful and cold-hearted. They typically demonstrate shallow
emotions, have difficulty maintaining close relationships, and lack empathy, anxiety, and
remorse. In addition, the psychopathic personality has been viewed as having a high degree of
impulsiveness and minimal tolerance for sameness (Quay, 1965). Antisocial Personality
Disorder and the related child and adolescent diagnosis Conduct Disorder (American Psychiatric
Association, 1994) bear much in common with psychopathy but stress behavior whereas the
construct of psychopathy also emphasizes qualities of interpersonal relating (e.g., callousness)
which do not come under the diagnostic criteria found in DSM-IV. The diagnosis of psychopathy
received impetus from the work of Hare (1985) and his associates in their development of an
instrument designed to detect psychopathy. The most recent incarnation of this instrument
designed for use with adults is the Hare Psychopathy Checklist - Revised (Hare, 1991). Adult,
male psychopaths spend more time in prison than non-psychopathic criminals between the ages
of 16 and 40 (Hare, McPherson, & Forth, 1988). Adult male offenders who were rated as more
highly psychopathic by the Psychopathy Checklist-Revised committed more crimes and more
violent crimes and experienced more violent recidivism than less psychopathic or non-
psychopathic offenders (Serin & Amos, 1995, c.f., Quinsey, 1995). Thus, it appears that
psychopaths form a subset of the population that commit more crimes and more violent crimes
than other criminals.
Some research has sought to extend the concept of psychopathy into use with
adolescents and children. Utilizing criteria developed by Quay (1965), Shostak and McIntyre
(1978) found limited support in three male populations for the pathological stimulus seeking
Quay (1965) described. A group of juvenile offenders (mean age -1 5 years, 2 months) made up
one of the three populations. Bernstein (1981) also utilized Quay's (1965) criteria with 40
delinquent and 40 nondelinquent youth. The delinquent sample had committed at least two
criminal acts and were institutionalized at the time of the study. Bernstein (1981) found that
psychopathy was predictive of developmentally immature responses. In another study
adolescent psychopaths were found to have greater responsivity to rewards in a learning task
than non-psychopathic adolescents (Scerbo, et al, 1990). This study utilized 40 male adolescent
juvenile offenders who were residents in a home for juvenile offenders. Information on their
offenses or histories of violence was not provided. Psychopathy was assessed in this study
utilizing the Revised Behavior Problem Checklist to assess the presence of criteria for Antisocial
Personality Disorder and Conduct Disorder, a self-report psychopathy scale developed from the
Psychopathy Checklist, and an impulsivity scale.
The work of Hare (1985) has provided direction for the assessment of psychopathy in
children and adolescents. Harpur and Hare (1994) using the Psychopathy Checklist - Revised
found that the affective-interpersonal aspects of psychopathy (i.e., egocentricity,
manipulativeness, callousness, and lack of empathy, guilt, or remorse) remained stable across 5
samples of male prison inmates with ages ranging from 16 to 70. This suggests that
psychopathy is a stable construct with applicability to adolescents.
In research analogous to that with adults, factor analysis of a measure of psychopathy in
children identified two dimensions of behavior, one associated with impulsivity and conduct
problems (l/CP) and the other associated with the traditional interpersonal and affective aspects
of psychopathy (callous/unemotional; CU) (Frick, et al, 1994). The former dimension was highly
correlated with traditional measures of conduct problems while the latter was independent of
conduct problems, suggesting that the two dimensions interact in a fashion similar to that of adult
psychopaths and giving support to the extension of the psychopathy construct to children.
Utilizing the Psychopathy Checklist -Revised (PCL-R), Myers, et al (1995) assessed 30
adolescent inpatients for psychopathy, delinquent behaviors, DSM-III-R Axis I disorders, and
personality disorders. Significant relationships were found between elevated PCL-R
psychopathy scores and delinquent behaviors, conduct disorder, and narcissistic personality
disorder. The authors interpreted the results as supporting the use of the PCL-R as a measure of
psychopathy in adolescents.
A version of the Psychopathy Checklist modified for use with adolescents and several
other measures were given to a sample of 75 male adolescents incarcerated in a maximum-
security detention center (Forth, Hart, & Hare, 1990). The base rate for psychopathy in this
juvenile sample was 36%. Scores on the modified PCL were significantly correlated with number
of Conduct Disorder symptoms, number of previous violent offenses, number of institutional
charges for violent or aggressive behavior, and the number of charges or convictions for violent
offenses after release. The authors noted that the distribution of scores, base rate for
psychopathy and the psychometric properties of the PCL were all similar to those obtained from
adult male offenders. A modified version of the Psychopathy Checklist-Revised for use with
adolescent populations - the Psychopathy Checklist - Youth Version - is currently under
development (Forth, Kossen, & Hare, in press).
In examining the construct of psychopathy, examiners have considered many factors,
including neuropsychological functioning. Much of this research has taken place with adults and
has been characterized by differing definitions of the construct of psychopathy, although this has
been standardized in recent research thanks to Hare's work (1985). Twenty adult male patients at
a VA hospital identified as psychopathic (defined by a "self-report behavioral checklist" adapted
from the Research Diagnostic Criteria for Antisocial Personality Disorder and the Socialization
scale from the California Psychological Inventory (So-scale), also those with "overwhelming
history" of Antisocial Personality Disorder), were compared with 23 patients who scored below
the cutoffs on the classification scales and with 18 college students. The measures used for
comparison were the Wisconsin Card Sort Test (WCST), the Stroop Color-Word Interference
Test, the Sequential Matching Memory Test (SMMT), an anagram task, spontaneous reversal of
the Necker Cube, and the Activity Preference Questionnaire (physical and social anxiety). As
predicted, and consistent with research with frontal lobe patients, the psychopathic group made
significantly more errors on the WCST, the SMMT, and more Necker Cube reversals
(Gorenstein, 1982).
Research on frontal lobe functioning and psychopathy has not found consistent results.
In a replication of Gorenstein's (1982) study: 81 male inpatients in a VA hospital Alcohol
Dependence Treatment Program were rated psychopathic if they met the Research Diagnostic
Criteria for APD and scored at or below the mean for prison inmates on the Socialization scale.
Groups were formed according to high or low alcoholism, and nonpsychopathic or psychopathic,
resulting in a 2 x 2 design. All were given the Mazes subtest of the WISC-R, the Sequential
Matching Memory Test, the Necker Cube, the Interference Memory Task, and the Wisconsin
Card Sort Test. Performance was found to be poorer in groups who were high in alcoholism, low
in psychopathy, older and less intelligent. The authors found no support for Gorenstein's (1982)
hypothesis that psychopaths display cognitive deficits akin to those exhibited by frontal lobe
patients (Hoffman, Hall, & Bartsch, 1987).
Thirty psychopathic inmates and 30 non-psychopathic inmates (psychopathy diagnosed
based on the Psychopathy Checklist) were given tests specific to different brain locales:
orbitofrontal-ventromedial measures: a visual “go/no-go" discrimination task, the Porteus Maze
Test, and an index of anosmia - the Modular Smell Identification Test; frontodorsolateral
measure: the Wisconsin Card Sort Test; posterorolandic measures: correct pairings on a mental
rotation task, and Similarities from the Ottawa Wechsler Intelligence Scale. Psychopaths were
found to be significantly impaired on measures of ventral frontal functioning; they exhibited more
errors of commission on the go/no-go task; performed more poorly on the qualitative score of the
Porteus Mazes; and were more incapacitated on the olfactory identification task. However, the
psychopaths performed similarly to the nonpsychopaths on the other neuropsychological tasks,
all consistent with the authors' hypotheses of a specific orbitofrontal and/or frontal ventromedial
dysfunction in psychopathy (Lapierre, Braum, & Hodgins, 1995).
From the preceding review, it is apparent that a consensus does not yet exist in regard to
the relationship of psychopathy and neuropsychological functioning. Evidence has been given
for contributions of the frontal lobes in the behaviors conceptualized as psychopathic. Other
studies have provided evidence that counters the role of frontal lobe functioning in psychopathy.
Purpose and Hypotheses
The purpose of this dissertation was to examine and clarify the relationships between
frontal lobe functioning, aggression, and psychopathy in a population of male juvenile
delinquents. From the preceding literature review, it is apparent that most research on frontal
lobe functioning and psychopathy has taken place with adult populations and not with an
adolescent population. In addition, investigation of neuropsychological functioning and
aggression in adolescents has typically been general in nature and has not examined functioning
associated with a specific area of the brain. Typically, studies have relied on the judicial
system's definition of an adolescent as a "juvenile delinquent" to create groups, thereby
admitting substantial selection bias into the process. Finally, the investigation of the construct of
psychopathy in an adolescent population is still in its early stages, although the creation of an
instrument to detect psychopathy has aided greatly in the establishment of this construct.
The significance of this dissertation lies in two points: that psychopathy is a new
construct applied to adolescents requiting further validation and that the relationship of frontal
lobe functioning to psychopathy and aggression in adolescents has received little attention as an
area of focus for research.
It was hypothesized that there would be a negative correlation between scores on
measures of frontal lobe functioning and scores on measures of aggression and psychopathy
(that is, juvenile delinquents who demonstrate more deficits associated with frontal lobe
functioning would also demonstrate more aggression and psychopathy). It was also
hypothesized that there would be no relationship between scores of psychopathy and scores on a
measure of posterior brain functioning. It was further hypothesized that there would be a positive
correlation between scores on measures of aggression and scores on a measure of psychopathy,
implying that juvenile delinquents who demonstrate higher degrees of psychopathy also
demonstrate more aggression.
CHAPTER II
LITERATURE REVIEW
Understanding the relationships between neuropsychological functioning, aggression,
and psychopathy is important in clarifying the brain-behavior relationship and also in settings of
applied psychology. Attempts have been made to use neurological findings to support a not
guilty by reason of insanity defense. In this regards, Ciccone (1992) noted that "less than 0.1%
of felonies are dealt with by an insanity defense. 80% of successful insanity defenses are
agreed to by the prosecution. When contested, juries find the defendant not guilty by reason of
insanity in less than 5% of cases.” (p. 610) Thus, it would seem that an insanity defense based
on neurological findings is neither popular nor successful if questioned.
Ciccone (1992) described the McNaughton Test, which is still used in many jurisdictions
in considering not guilty by reason of insanity pleas. In 1843, Daniel McNaughton shot and killed
the secretary to the British prime minister. He was found not guilty by reason of insanity. In the
ensuing public outcry, 15 high judges convened and devised the McNaughton Test. For a
finding of insanity "it must be clearly proved that, at the time of committing the act, the party
accused was laboring under such a defect of reason, from disease of the mind, as not to know
the nature and quality of the act he was doing; or if he did know it that he did not know he was
doing wrong."
Restak (1993) discussed three criteria that must be met for courts to consider brain
damage as a mitigating factor in determining responsibility in acts of criminal violence: "Does
brain damage exist and is it responsible for a deficit? Second, is that deficit a contributing cause
of the defendant's action? Third, can it be said convincingly that, absent the deficit and the
resulting behavior, the crime would not have taken place?" (p. 869). Restak (1993) indicated
that the current state of the art is such that the best a neurologist as an expert witness can offer
is that brain damage might have been one factor at play in a violent act. From the foregoing, it
may be seen that there are very practical reasons for understanding the relationship of
neuropsychological functioning, aggression, and psychopathy. In addition, consistent findings
may be useful in shaping new interventions to be used with violent offenders.
Neuropsychological Correlates of Juvenile Delinquency and/or Aggression
Hurwitz, et al (1972) found that 15 delinquent boys (ages 14.5 to 15.5 years, selected by
their adjudication by the courts as juvenile delinquents) performed significantly more poorly than
a sample of 15 "normal" boys (ages 14.5 to 15.5 years, selected with the help of a school
guidance counselor) on rhythmical tasks of the Lincoln-Oseretsky Test of Motor Development.
In a second study, Hurwitz, et al (1972) compared 13 boys (mean age 11 yr. 4 mo.) living in a
state training school for juvenile offenders with 13 "normal" boys (mean age 11 yr. 4 mo.) whose
selection was not indicated. The two samples were compared on a finger tapping task, a
repetitive naming task, the Stroop Color-Word Interference Test, the Beery-Buktenica Visual-
motor Integration Test, the Graham-Kendall Memory-for-Designs, the Children's Embedded-
figures Test, and the Standard Raven Progressive Matrices. The two groups differed
significantly on the tapping task, the repetitive naming task, and the Stroop Color-Word
Interference Test. The researchers suggested that the findings implied that the delinquents were
deficient in their abilities to sequence sensorimotor events and interpret symbolic stimuli.
Fitzhugh (1973) examined 19 court-referred juveniles "excluding truancy, runaway, and
curfew violations" (p. 494), comparing them to 10 "emotionally disturbed" non-court referrals
(comparable mean age for both groups; approximately 17 years old). The delinquent group
performed significantly less well on the Speech Perception Test, Tactual Performance Location,
and on Finger Tapping of the right hand, and on Wechsler-Bellevue subtests Information,
Comprehension, Arithmetic, Vocabulary, Picture Completion, and Block Design.
Forty violent male delinquent adolescents were compared to 40 nonviolent delinquents
(mean age for both groups was 14.6 years) in a residential facility (Spellacy, 1977). Professional
staff classified delinquents as violent who demonstrated attempts to injure others or property
within the facility. Both groups were given the Minnesota Multiphasic Personality Inventory,
Similarities, Vocabulary, Coding, and Block Design subtests from the Wechsler Intelligence
Scale for Children, Word Fluency, Sentence Repetition, Digit Repetition-Forward and Reversed,
the Token Test, Tonal Memory Test, Consonant Perception Test, an experimental dichotic
listening test, the Visual Retention Test, Embedded Figures Test, the Porteus mazes, and simple
reaction time. Twelve statistically significant differences were found with the nonviolent group
performing better on Similarities, Vocabulary, Block Design, estimated Verbal IQ, estimated
Performance IQ, estimated Full Scale IQ, the Visual Retention Test, the Embedded Figures
Test, W ISC Mazes, Sentence Repetition, and the Token Test. Interestingly, the violent group
recalled more words in the dichotic listening task.
Forty-nine aggressive boys (ages 6 years 5 months - 8 years 1 month) were compared to
a non-aggressive group from the same age range, school, and census tract (Camp, 1977).
Aggression was determined based on scores on the School Behavior Checklist. The boys were
compared on measures of verbal ability, types of self-guiding speech, nonverbal intelligence,
reading achievement, impulsivity, ability to inhibit responses, and response modulation following
overt and covert commands. Eighty-eight percent of participants were correctly classified in
discriminant function analysis. Vocabulary, immature and irrelevant private speech, fast reaction
times, baseline speed of finger tapping, inhibition errors, and speed of responding during covert
commands for slowing all scored highly in their contribution to classification as aggressive. The
author interpreted these findings as consistent with the hypotheses that young aggressive boys
fail to utilize verbal mediational activities in situations where it would be useful (Camp, 1977).
Seven adolescent males with histories of multiple assaultive incidents were compared
with 8 adolescent males with diagnoses of behavior disorders and with few or no assaultive
incidents and with 6 adolescent males with diagnoses of organic brain syndrome (Krynicki,
1978). All participants were patients in a psychiatric hospital. The participants were compared
on a standard clinical EEG, and on a variety of neuropsychological measures designed to assess
motor and perceptual-motor functions, sensory functions, and memory and cognitive functions.
It was hypothesized that the repetitively assaultive adolescents would be more similar to the
organic patients than to the nonassaultive patients. The results indicated that the nonassaultive
group could be distinguished from both the assaultive and the organic groups on the basis of
EEG abnormality, degree of establishment of hand dominance, perseveration errors in a visual-
motor task, and verbal short term memory. The assaultive and organic groups were found to be
indistinguishable from one another. The author interpreted the results as supporting a
hypothesis of a relation of severe aggression and left hemisphere dysfunction. Significant EEG
abnormalities of the frontal lobes were also found (Krynicki, 1978).
Lewis, et al (1979) examined 97 boys (ages not given) incarcerated in a correctional
school. These boys were rated from nonviolent to violent based on their past behaviors and
offenses. The investigators gave the boys a diagnostic evaluation consisting of a psychiatric
assessment, a neurological assessment, and psychoeducational testing (Wechsler Intelligence
Scale for Children-Revised, the Bender-Gestalt Test, and the Rorschach Test). Only 8 of the
boys were considered by ail the investigators to be nonviolent. Compared with the violent boys,
the nonviolent group had significantly fewer members with psychomotor epileptic
symptomatology and fewer members with a discrepancy between right and left palm strikes of
greater than 10%. The investigators also grouped the participants according to being more or
less violent and compared these groups. These comparisons yielded the findings that the more
violent boys exhibited or gave histories of paranoid symptomatology, were more likely to be
loose, rambling, and illogical during interviewing, more frequently had one or more signs of
minor neurological impairment, performed significantly more poorly on WISC-R Arithmetic, and
exhibited a greater reading grade discrepancy. The more violent group was also significantly
more likely to have been physically abused or to have witnessed extreme violence (Lewis, et al,
1979). A multiple regression analysis to determine what variables best predicted group
membership found that paranoid symptomatology and minor neurological signs accounted for
40% of the total variance (Lewis, et al, 1979). This study suggests a relationship between
neurological factors and violence, however, it possesses a number of methodological problems
that make its usefulness questionable. The participants were poorly described, a one
dimensional measure of violence was used, and a number of non-standardized assessment
procedures were utilized.
Surwillo (1980) investigated the relationship between EEGs and childhood aggression.
In examining 6 "severely aggressive boys" (ages 8.7 - 13.6 years), he found that interval
histograms of the boys’ EEGs were more similar to the histograms of much younger boys, based
on an equation which predicts the age of a participant from his or her EEG histogram. Surwillo
(1980) interpreted these results as supporting a maturational-retardation hypothesis of
aggressive behavior.
Spreen (1981) reported a follow-up study of 203 adolescents and young adults who had
been seen for neuropsychological testing and counseling because of learning problems between
the ages of 8 and 12. These participants were followed up between 4 and 12 years later. At the
time of the original assessment, the participants were identified as belonging to one of three
groups: those with definite neurological signs of brain damage, those with neurological signs of
possible brain dysfunction, and learning disabled children without any indications of brain
dysfunction. Participants and one or both parents were interviewed separately and questioned
about a number of areas, including a series of questions about delinquency, described as
"general questions.. . followed by questions about details of the incidents and penalties imposed
in chronological order." A control group of 52 adolescents without learning problems was
randomly selected from area schools and matched with the experimental groups. Spreen (1981)
found no significant differences between the 4 groups on the question of whether or not they had
come to the attention of the police, or on the type of first or subsequent offenses. The only
significant difference found was in the type of penalties incurred, with the learning handicapped
participants having received somewhat more penalties and more severe penalties than the other
groups. Spreen (1981) interpreted these results as giving little support to the hypothesis that
organicity or neurological impairment is a precursor or partial cause of delinquency. Noteworthy
in this study is that Spreen (1981) relied entirely upon the reports of the participants and their
parents for information on police contact, offenses, and penalties. Accessing official records
could have produced more reliable information. In addition, it has been recognized that self-
reports and official records both underestimate the actual incidence of delinquent activities
(Henggeler, Smith, & Schoenwald, 1994).
Ninety-nine adolescents (male = 64, female = 35, average age 14.8 years) admitted to a
residential facility for persistent delinquents were examined using the Halstead-Reitan Battery
plus 12 other neuropsychological tests (Yeudall, Fromm-Auch, & Davies, 1982). The majority
(81.3%) of the delinquents had committed nonviolent crimes. A comparison group of 47
adolescents (male = 29, female = 18) with no previous history of neurological or psychiatric
disorders from regular classrooms was also assessed. Eighty-four percent of the delinquent
group's neuropsychological test profiles were abnormal compared to 11% of the nondelinquent
group with a pattern of nondominant greater than dominant hemisphere dysfunction and anterior
greater than posterior dysfunction (Yeudall, et al, 1982). Discriminant function analysis conrectly
identified 76% of the delinquents and 90% of the nondelinquents with a higher cognitive
functions variable and a motor strength and dexterity variable accounting for most of the
variance (26.5% total). The authors concluded that a neurological deficit could be present in
some juvenile delinquents, especially persistent delinquents. The authors observed that these
deficits could cause delinquents to have difficulties in planning and perceiving consequences
(Yeudall, et al, 1982).
Fifty-four delinquent youths, newly committed to state's custody (average age 15.1
years) were compared to 51 nondelinquent adolescents (average age 14.3 years) recruited by
random mailings (Kamiski, et al, 1982). There were several demographic differences between
the groups: the delinquents were approximately 9 months older than the comparison group, the
rate of single-parent families was three times that in the delinquent than in the comparison
group, and the delinquents' parents tended to be younger, less educated, and of lower
occupational status. The two groups were compared with a neurodevelopmental examination
designed to assess six areas: neuromaturation, gross motor function, temporal-sequential
organization, visual processing, and auditory-language functions (Kamiski, et al, 1982). The
delinquent adolescents were found to be more likely to exhibit neurodevelopmental delays and
were also more likely to exhibit multiple delays. With socioeconomic variables controlled,
significant differences were found on fine motor functions and auditory-language functions
(Kamiski, et al, 1982). The authors suggested that these neurodevelopmental delays make the
delinquent group more likely to face experiences that place them at high risk for developing
delinquent lifestyles. Several problems exist with this study, including the fact that gender of the
groups was not reported, there was no indication of the nature of the delinquents' criminal acts
(e.g., nonviolent versus violent), and there was no report of how the authors determined that the
comparison group was indeed nondelinquent.
Sixty-five male juveniles detained in a low security facility were compared to two
comparison samples: 48 with predominately lower middle class characteristics and 48 with
predominately upper middle class demographic characteristics (Wolff, Waber, Bauermeister,
Cohen, & Ferber, 1982). Comparisons were made on an extended pediatric neurological
examination for neuropathological "soft signs" (minor neuropathological signs, e.g., clumsiness,
tremors, sagging, etc.) and a comprehensive neuropsychological assessment in the areas of
non-verbal intelligence, language functions, attention, perceptual and motor functioning, and
spatial abilities. Delinquents scored lower than both control groups on non-verbal intelligence.
The delinquent group showed overall impairment on all language measures relative to both
comparison groups. However, the delinquent group did not differ from the comparison groups on
measures that did not involve linguistic processing. The delinquent group also exhibited more
neurological soft signs. A stepwise regression for the neurological and neuropsychological
variables on an index of severity of delinquency indicated that the neuropsychological measures
accounted for 45.4% of the variance of the severity index, with language measures accounting
for most of this variance (Wolff, et al, 1982).
Seventy-three court referred males with an average age of 15 were given
comprehensive neuropsychiatric evaluations (Tarter, et al, 1983). The participants were divided
into three groups based on their offense; a nonviolent group with predominantly property crimes
(n = 28), a violent group who had caused personal injury of a nonsexual nature (n - 31), and
those whose offense was sexual in nature (n = 14). None of the participants exhibited abnormal
EEGs, signs or symptoms of a neurological disturbance, or psychotic symptoms. Adolescents
with histories of brain trauma or who demonstrated EEG or neurological abnormalities were
excluded from the study. Participants were given a battery of tests including the Wechsler
Intelligence Scale for Children-Revised or the Wechsler Adult Intelligence Scale, selected
subtests from the Detroit Test of Learning Aptitude, the Peabody Individual Achievement Test,
and the Pittsburgh Initial Neuropsychological Test System. Group comparisons revealed only
one statistically significant difference out of 47 variables evaluated. Each dependent variable
was then correlated with ratings of the participants' most violent offense; only 6 of 41 correlations
were significant at the .05 level or better. These six variables accounted for little of the
performance variance, however. The authors interpreted their results as not supporting previous
findings of a strong association between neurological functioning and delinquency (Tarter, et al,
1983). Several methodological problems exist with this study, including the exclusion of those
adolescents demonstrating abnormal EEGs, neurological functioning, or with histories of head
trauma. The authors did not indicate how many such adolescents were excluded or the nature or
number of their offenses. It is possible that their sample did not reflect the true nature of the
population of juvenile delinquents. Also, reliance on criminal offense history alone is a uni
dimensional portrayal of violence and aggression and does not necessarily capture an
individual's full range of experience.
Seventy-one (40 male, 31 female, average age 16.2 years) incarcerated delinquents
were examined using the Physical and Neurological Examination for Soft Signs (PANESS), the
Wide Range Achievement Test, Wechsler Intelligence Scale for Children-Revised or the
Wechsler Adult Intelligence Scale, a structured psychiatric evaluation, and the Luria-Nebraska
Neuropsychological Battery (McManus, Brickman, Alessi, & Grapentine, 1985). History of
violence was assessed based on number of violent offenses and violent assaults within
institutions. Gross neurological dysfunction was found to be uncommon in this sample of
delinquents. Significant relationships were not found between neurological soft signs and any of
the measures of delinquency or in-program violence (McManus, et al, 1985). However, the
authors did not examine the relationships between the neuropsychological and intellectual
measures and delinquency and violence.
Lewis, et al (1985) examined nine male subjects who had been clinically evaluated as
adolescents and were later arrested for murder in their late teens or twenties. These subjects
were compared with 24 incarcerated delinquents who did not go on to commit violent offenses.
Data available for review included comprehensive psychiatric and neurological evaluations,
information on the families, including degree of violence and any abuse that occurred. At the
time of their adolescent examinations, the nine subjects who murdered differed from the
comparison group on the presence of psychotic symptoms (100% vs. 50%) and major
neurological impairment (88% vs. 27%). The authors speculated that a constellation of factors
including psychosis, neurological impairment, abuse, and violence in the home tend to
predispose an individual to an increased likelihood of extremely violent acts and may be useful
in identifying those young people at high risk for violence (Lewis, et al, 1985).
Lewis, et al (1988) examined 14 individuals sentenced to death fora capital offense
committed before they were 18 years old. At the time of the examinations, the subjects ranged
in age from 17 years 10 months to 29 years 2 months. The examinations consisted of detailed
neurological histories, a structured psychiatric interview, EEGs, WAIS-R, Rorschach Inkblot Test,
House-Tree-Person Test, Halstead-Reitan, Woodcock-Johnson Psycho-Educational Battery, and
tests of written and spoken language. Eight subjects were found to have histories of CNS
trauma, 9 exhibited serious neurological abnormalities, 7 were psychotic, all but 2 had Full-Scale
IQs below 90, only 3 were performing at grade level, 12 had been physically abused, and 5 had
been sexually abused (Lewis, et al, 1988). The authors speculated that all of these factors were
relevant to mitigation of the murders.
Pontius (1972) speculated that some forms of delinquency are associated with an
inability to shift from one principle of action to another when appropriate, a deficit she indicated
is characteristic of frontal lobe dysfunction. This deficit is problematic for a subset of juvenile
delinquents when they are involved in a criminal action and events do not go as anticipated (e.g.,
a homeowner enters during a burglary) and the juvenile is unable to alter his or her actions to
accommodate this change (e.g., the juvenile continues towards the goal of burglary and may
injure the homeowner as an obstacle in his or her way without having had the intention of doing
this. Pontius (1972) further theorized that this deficit is related to a maturationa! lag of the frontal
lobes.
In a review of the literature on cerebral dysfunctions and juvenile delinquency,
Buikhuisen (1987) concluded that evidence was ample for associations to frontal lobe, temporal
lobe, and nondominant hemisphere dysfunction. Buikhuisen (1987) speculated that frontal lobe
deficits would be more often found in impulsive and poorly planned illegal activities. This is due
to the lack of self-control, emotional outbursts, and social insensitivity often found in frontal
dysfunction (Buikhuisen, 1987).
Gorenstein (1990) reviewed the neuropsychology of juvenile delinquency and concluded
that the behavior of juvenile delinquents parallels the behavior of both humans and animals who
have sustained damage to a system made up of the prefrontal cortex, the septal area, and the
hippocampus. These parallels are found in avoidance of incidental punishment, reduction of fear
and anxiety in anticipation of aversive events, a deficiency in maintaining an internal
representation of future events, a heightened responsiveness to rewards, and increased
stimulation seeking (Gorenstein, 1990). Gorenstein and Newman (1980) theorized that deficits
in these areas would bring about a general disinhibition in behavior, the prototype for which
would be criminal psychopathy.
Moffitt (1990) reviewed research on the neuropsychology of juvenile delinquency and
concluded that there have been consistent findings of neuropsychological deficits, especially in
verbal and self-control ("executive") functions. Considering the link between neurological
functioning and violence, Moffitt (1990) concluded that past research supported more strongly
deficits in adults than in juveniles. Moffitt (1990) speculated that this was due to the fact that
juveniles have not had as much time to commit repeated acts of violence. Moffitt (1990)
criticized many of the studies reviewed due to subject selection bias, lack of comparable control
groups, poor standards of data collection and data analysis, and failure to address the specificity
of the obtained neuropsychological deficits to antisocial behavior.
In a review of the literature on neuropsychological correlates of violence and aggression,
Golden, Jackson, Peterson-Rohne, and Gontovsky (1996) concluded that neither intellectual loss
nor learning disabilities predispose children to delinquency, but that when signs of frontal
disorders are present, there is a higher likelihood of violent behavior. Golden, et al, (1996) also
concluded that there may exist a subgroup of antisocial personality disorder with prefrontal
dysfunction. These individuals are more impulsive, unable to support themselves through
socially acceptable means, and are drawn into criminal behavior through their own lack of control
as well as the leading of others. These individuals also overreact to stress and are frequently
involved in confrontations (Golden, et al, 1996).
Several consistent findings come out of this review of the literature of the relationship
between neuropsychological functioning and juvenile delinquency. There is ample evidence that
juvenile delinquents typically perform more poorly on neuropsychological measures than normal
controls. Some studies have found global deficits, others nondominant hemisphere deficits, and
still others have localized the deficits, typically to the frontal or temporal lobes. There appears to
be support for the possibility that there is a subgroup of juvenile delinquents with deficits on
measures of frontal lobe functioning and characterized by a distinctive pattern of behavior
associated with such deficits. This behavior pattern includes a high degree of impulsivity, a lack
of control, and a tendency to overreact to stress with frequent involvement in confrontations.
This subgroup typically has not been examined for their interactional characteristics, such as
empathy, which would be related to the presence or absence of psychopathic features, or for the
nature of their criminal acts. It is possible that those juveniles with neuropsychological deficits
are those who demonstrate more psychopathic features. Many of the studies reviewed above
have been criticized for using measures of questionable validity, lack of adequate control groups,
subject selection bias, and poor standards of data analysis.
Neuropsychological and Neurological Correlates of Aggression and Violence in Adults
Pontius and Yudowitz (1980) hypothesized that some criminal actions are related to a
maturational lag in the frontal lobe system, reflected in an inability to appropriately switch the
principle of action during an ongoing activity when circumstances call for such a switch. The
authors investigated their hypothesis by employing the Narratives Test (in which the participants
described their criminal offense and their ability to switch the principle of action during the
criminal act was assessed) and the Trial-Making Test Part B. Participants were 30 male inmates
(average age 22.8 years) serving prison sentences of not more than 2 years. The authors found
that errors on the Trail-Making Test Part B were associated with difficulty in switching the
principle of action in 36% of the clinical sample. They interpreted this as supportive of their
hypothesis of the association of a maturational lag of the frontal lobe system with some criminal
actions (Pontius &Yudowitz 1980).
Seventy-two adult males without past or present psychiatric or substance abuse related
problems and without reported head injuries or learning disabilities completed the Self-Ordered
Pointing Task (SOP) and the Conditional Association Task (CAT), both of which are designed to
be measures of frontal lobe functions, and an abbreviated Wechsler Adult Intelligence Scale-
Revised (WAIS-R) (Giancola & Zeichner, 1994). Aggression was measured with a task in which
subjects apparently received and thought they could give electric shocks from and to a
competitor. Aggression was significantly related to performance on the CAT but not the SOP.
This was noted to be puzzling since the SOP is intended to measure organization, planning, and
monitoring response sequences, which have previously been noted to be related to aggression
(Giancola & Zeichner, 1994).
Eighteen adult males who had killed and faced murder or manslaughter charges were
compared to 21 men with nonhomicidal violence charges and also compared to 16 men with
nonviolent nonsex charges (Langevin, et al, 1987). Measures used included the Halstead-
Reitan, Luria-Nebraska, WAIS-R, personality and substance abuse measures, CT scans, and
EEGs. The Reitan Impairment Index showed a trend to significance for the killers and assaulters
compared to controls. No significant group differences were found in CT scan or EEG results.
The results indicated that the temporal lobes were not implicated in brain pathology of the violent
group, as the researchers had expected. More significant group differences existed on the
substance abuse measures. Killers and assaulters used alcohol more frequently and more of
them experienced dysphoric effects (e.g., paranoia, feelings of inferiority) than the controls.
These results were interpreted to suggest an interaction of neuropsychological functioning,
substance abuse, and personality functioning in the etiology of violent behavior (Langevin, et al,
1987).
Fifty-five violent adult inmates (violent defined as having committed assaultive crimes
against persons) were compared to 55 nonviolent inmates (property-related crimes) on the Luria-
Nebraska Neuropsychological Battery-Form 1 (Bryant, et al, 1984). Sixty were also given the
Wide Range Achievement Test and the Arithmetic, Vocabulary, Block Design, and Picture
Arrangement subtests from the Wechsler Adult Intelligence Scale. The violent group
demonstrated more neuropsychological deficits than the nonviolent group on tasks requiring
complex integration of information from visual, auditory, and somesthetic systems; creating,
planning, organizing, and executing goal directed behaviors; and on tasks requiring sustained
attention and concentration. The authors cautiously interpreted their findings as indicating a link
between anterior brain dysfunction and violence (Bryant, et al, 1984).
Fourteen adult male cocaine addicts diagnosed with antisocial personality disorder and
identified as either "high violent" or "low violent" were compared on the Wisconsin Card Sorting
Test. The low violence group made significantly more perseverative errors than the high
violence group, which was somewhat at odds with other research showing frontal lobe
dysfunction for more violent groups (Rosse, Miller, & Deutsch, 1993). This interpretation
operates on the assumption that the Wisconsin Card Sorting Test is a valid measure of frontal
lobe functions.
Forty adult male inpatients at a maximum security psychiatric facility were examined
using the WAIS-R, Trail-making Test Part B, and the Wide Range Achievement Test-Revised
(WRAT-R) (Nestor, 1992). Twenty-two were placed in a younger group and 18 in an older
group, with charges such as murder, assault with intent to murder, and rape. In the younger
group higher rates of both a learning disability (spelling and oral reading) and history of childhood
conduct disorder were found; in the older group there existed a higher rate of psychosis. The
results were interpreted as consistent with earlier studies that suggested that a
neurodevelopmental disorder in conjunction with childhood conduct disorder is associated with
an early onset of violence. No other evidence was demonstrated of a relationship between poor
scores on other neuropsychological tasks and violence, but the study did not directly assess the
relationship between frontal lobe involvement and violence (Nestor, 1992).
Thirty adults awaiting trial or sentencing for murder or going through an appeal process
were given neurological examinations (Blake, Pincus, & Buckner, 1995). These examinations
revealed "frontal "dysfunction in 20 (64.5%), some evidence of temporal lobe abnormalities in 9
(29%), EEG abnormalities in 8 of 20, MRI or CT abnormalities in 9 of 19, and abnormalities (not
identified) in all subjects tested. The authors commented that, "most impressive was the high
frequency of frontal signs or, more generally, cortical or subcortical signs in this population" (p.
1644). The authors also made the point that the frontal lobes exercise an inhibitory effect upon
other cortical areas and may serve to filter out' irrelevant information, which allows a person to
not be dependent on environmental stimuli. The authors suggested that severe abuse, brain
dysfunction, and paranoia are three factors which may have a causative role in violence for this
population. The high rate of alcohol use at the time the violent act was also noted (Blake,
Pincus, & Buckner, 1995). This suggestion is similar to Pincus' (1993) theory that three factors
interact and have more than an additive effect on the etiology of violence: brain damage,
paranoia, and abuse. Pincus (1993) also suggested that further disinhibition of behavior through
intoxication can result in impulsive, violent outbursts.
Pontius (1989) discussed the possibility of limbic system dysfunctioning in terms of the
"limbic psychotic trigger reaction,” in which homicide is prompted by a specific, individualized
external stimulus, which brings about a brief, very active reliving of past (moderately stressful),
frequently repeated situations. The homicidal episode is brief and out of character with the
individual showing a flat affect and first time hallucinations, and experiencing no loss of
consciousness, which allows full recall, at times with suicide attempts. Homicide during a fugue
state with echopraxia in temporal lobe epilepsy is also described. Both situations are
acknowledged to be rare (Pontius, 1989).
In a pilot study on the relationship of hemispheric dysfunction and aggression, 41
hospitalized adult males were studied for abnormal lateralization. Lateralization was determined
with the Finger Oscillation Test from the Halstead-Reitan. Those with severely abnormal
lateralization engaged in more frequent and more severe acts of physical aggression, more
severe (but not more frequent) acts of verbal aggression, and required more severe nursing
interventions. When seizure history, alcohol abuse, and drug abuse, were all statistically
controlled for, no relationship remained between abnormal lateralization and aggressive
behavior, thus the authors concluded that there appears to be no causal link between
lateralization and aggression (Hillbrand, et al, 1994).
Twenty-eight patients meeting the criteria for personality disorders characterized by
impulsivity (Borderline Personality Disorder and Antisocial Personality Disorder), and 28 healthy
control subjects were compared on neurological examinations (Stein, et al, 1993). The patients
had significantly more neurological soft signs (described as "nonlocalizing neurological
phenomena that occur in the absence of evidence of gross neurological disease,” p. 258, e.g.,
involuntary movements, apraxias, problems performing rapid alternating movements, etc.) for
the left side than controls. Patients with a history of aggression, however, had significantly more
right-sided neurological soft signs than those without a history of aggression. Increased
neurological soft signs were also associated with poor performance on the Wisconsin Card
Sorting Test (Stein, et al, 1993).
In a review of the literature, a number of factors were implicated in their relation to
violence (Volavka, Martell, & Convit, 1992). These included the importance of childhood
victimization, both for socialization, possible brain injury, and genetic predisposition; head
injuries; and seizures. The authors noted that, "virtually no crimes are directly attributable to an
ictal or postictal confusional state." (p. 239). Alcohol consumption was noted to be related to
violent crime, and a possible interaction described between acute alcohol effects and underlying
brain dysfunction. The relationship of other drug abuse to violence remains uncertain.
According to the authors, neuropsychological tests show more impairment /abnormality in violent
than nonviolent groups. There is equivocal evidence on intellectual impairment; some studies
show differences (lower IQ’s for violent offenders) others do not. The authors noted that it is
possible that intelligence modulates the relationship between personality disorders and violence
(Volavka, Martell, & Convit, 1992). There are possible links of violence with temporal lobe
dysfunction, but the contribution of these mechanisms is considered to be small. Other studies
suggest that frontal lobe dysfunction may have a role in violent behavior, however, the authors
noted that such studies have small sample sizes, a lack of reliable and valid measures of frontal
lobe functions, no control groups, and confounded research designs. Still other studies indicate
that certain violent offenders may exhibit dysfunctions of the dominant hemisphere, and some
studies suggest that serotonergic transmission (causing a reduced level of serotonin) is impaired
in certain violent offenders. Such an impairment could result in a reduction of impulse control
(Volavka, Martell, & Convit, 1992).
Miller (1994) reviewed syndromes of aggression following brain injury. Episodic
dyscontrol syndrome is "intermittent attacks of violence attributed to an efectrophysiological
disturbance in the brain" (p. 91). This can occur without a prior history of brain injury, but usually
it is associated with damage to the medial portion of the temporal lobes which contain limbic
system structures important for regulating emotion and motivation. Impairment to areas of the
frontal lobes that inhibit or regulate behavior and emotional responses can lead to lessened
control over sudden shifts of mood. A final consideration is premorbid aggression and
antisocial'ity. Miller (1994) noted that, "Deficits in 'executive contror...may characterize the
thought and behavior of those individuals most likely to incur a traumatic brain injury in the first
place, and be a predisposing factor in incurring a traumatic injury." (p. 95) This impulsive
population is most likely to suffer brain damage which would serve to further disinhibit their
behavior. "One particular problem with many of these patients is a tendency to endorse their
impairment and use it as an excuse for continuing and even escalating previous patterns of
antisocial behavior 'I cant control myself - I'm brain-damaged'" (Miller, 1994, p. 100).
Mills and Raine (1994) reviewed 20 brain imaging studies using CT, MRI, rCBF, and
PET techniques in the study of violent and sexual offending. These authors suggested two
alternative hypotheses to account for the most prevalent findings: frontal lobe dysfunction may
be associated with violent offending while temporal lobe dysfunction may be associated with
sexual offending, and fronto-temporal dysfunction may be associated with violent sexual
offending; or, anterior brain dysfunction may be a general predisposing factor towards offending,
regardless of the location of the dysfunction (whether frontal or temporal), with the type of
offending (violent, sexual, or violent and sexual) determined more by non-biological factors (Mills
& Raine, 1994).
In another series of studies, individuals guilty of arson and impulsive homicide were
found to have low levels of serotonergic activity in combination with a disturbance of glucose
metabolism (Linnoila, et al, 1994/1983; Virkkunen, Nuptial, Goodwill, & Linnoila, 1994/1987;
Virkkunen, DeJong, Bartko, Goodwin, & Linnoila, 1994/1989). The researchers found that
impulsive acts are even more likely when these individuals are under the influence of alcohol or
drugs. These biochemical deficiencies were also found to be highly accurate in predicting
recidivism, with an 84.2% hit rate.
This survey of the literature on neuropsychological correlates of aggression and violence
in adults indicates that more aggressive or violent adults possess more neuropsychological or
neurological deficits. These deficits are found typically in the frontal or temporal regions of the
brain or in the nondominant hemisphere. Most of these studies reflect that the more violent
individuals have difficulties in verbal or linguistic abilities. Methodological problems these
studies often possess included small sample sizes, a lack of reliable and valid measures of
neuropsychological functions and of violence or aggression, no control groups, and confounded
research designs. Since psychopathic adults commit more crimes and more violent or
aggressive crimes, it is logical to hypothesize that such psychopathic individuals demonstrate
neuropsychological deficits consistent with those found in this review of the literature.
Psychopathy in Adolescents and Children
As noted in Chapter 1, psychopathy is conceived of as a cluster of personality and
behavioral characteristics after the work of Cldckiey (1976). Psychopathic individuals are risk-
taking sensation seekers who are frequently involved in criminal activities and who are described
as grandiose, egocentric, manipulative, forceful and cold-hearted. They typically demonstrate
shallow emotions, have difficulty maintaining close relationships, and lack empathy, anxiety, and
remorse. Researchers are gradually extending the concept of psychopathy into work with
children and adolescents.
O'Brien and Frick (1996) examined response to reward and punishment in a learning
task with children (ages 6 -1 3 ) identified as having severe conduct problems with no anxiety
disorder, nonanxious children with attention-deficit hyperactivity disorder, and children in a
normal control group. Psychopathy was identified using six items from the Psychopathy
Screening Device (Frick & Hare, in press), an instrument designed for use with children and
analogous to the Psychopathy Checklist-Revised. Nonanxious psychopathic children
demonstrated a reward-dominant learning style, indicating that they continued previously
rewarded responses even when the response began earning punishment.
Christian, et al (1997) utilized the Psychopathy Screening Device (Frick & Hare, in press)
with 120 clinic-referred children between the ages of 6 and 13 and identified a unique sub-group
that scored highly on the callous/unemotional subscale of the PSD. This interpersonal and
affective dimension is the sin qua non of psychopathic individuals. This sub-group had a higher
number and variety of conduct problems, a greater history of police contacts, and more parental
history of antisocial personality disorder. The authors interpreted their findings as offering further
support for the extension of the psychopathy construct into work with children. The construct of
psychopathy has also been suggested as one means of identifying children who are at risk for
developing into chronic offenders (Lynam, 1996).
Lynam (1997) utilized a measure of psychopathy based on the Hare Psychopathy
Checklist and derived from items on the Childhood Behavior Checklist and a simplified version
of the California Q-set. The responses on these measures of parents of 430 boys ranging in age
from 12 to 13 appeared to validate the construct of psychopathy in this age group of children.
Boys rated high in psychopathy committed more types of crimes as well as more serious crimes.
These boys were also rated as stable, seriously delinquent boys based on measures of
delinquency two years apart. These boys also scored higher on measures of impulsivity than
less psychopathic boys. These boys also scored low on measures of self and teacher reported
psychopathology (except for conduct disorder and oppositional defiant disorder). Lynam (1997)
noted that these findings are consistent with research with adult psychopaths, providing further
evidence for the validity of the psychopathy construct in children.
Based on these studies and those cited in Chapter 1 on psychopathy and children and
adolescents, it appears that psychopathy can be a valid and useful concept when applied to
children and adolescents. A unique sub-group of children and adolescents can be identified who
possess characteristics similar to psychopathic adults. If the findings with adults hold true for
children and adolescents, researchers would expect to find that psychopathic children and
adolescents are involved in more delinquent activities and more aggressive or violent delinquent
activities, are more likely to become recidivists after arrest and incarceration, and are more
aggressive while incarcerated. As yet no research has been published on the relationship
between neuropsychological functioning and psychopathy in children or adolescents, one of the
chief areas of interest of the current study.
Psvchopathv and Neuropsychological Functioning in Adults
Nineteen psychopathic and 15 normal inpatients in a VA chemical dependency program
were compared on a variety of measures (Sutker & Allain, 1987). Psychopathy was defined as
a Minnesota Multiphasic Personality Inventory profile with Pd or Pd/Ma scales having T scores
greater than 70 and no other elevations above 70, a score of 32 or above on the Socialization
Scale, a diagnosis of Antisocial Personality Disorder, and no evidence of brain trauma or current
illness. The neuropsychological measures used were the WAIS-R, the Wisconsin Card Sort Test,
Porteus Mazes, and the Visual-Verbal Test. No significant differences between the two groups
were found on any measure. The authors interpreted the results as suggesting that analogies
between psychopathy and frontal lobe deficits are premature and possibly unfounded (Sutker &
Allain, 1987).
Two samples of adult male inmates (N = 90 and 167) were defined psychopathic by
Psychopathy Check List-Revised scores and divided into high, medium, and low psychopathy
groups (Hart, Forth, & Hare, 1990). In sample 1 were 22,41, and 27 members of the high,
medium, and low groups respectively; in sample 2 were 32, 95, and 40 in each. The groups in
sample one were compared on the Trail-Making Test, the Visual Retention Test, the Auditory
Verbal Learning Test, and the Visual Organization Test. Groups in sample 2 were compared on
the Trail-making Test, the Controlled Word Association Test, the Vocabulary and Block Design
subtests from the WAIS-R, and the Reading subtest from the Wide Range Achievement Test - 2.
Beck Depression Inventory scores, scores from the Trait form of the State-Trait Anxiety
Inventory, and a rating of substance abuse were collected on both samples. No significant
differences on any neuropsychological measures between any of the groups were found in either
sample. The authors interpreted the results as providing no support for traditional brain-damage
explanations of psychopathy (Hart, Forth, & Hare, 1990).
Forty-six adult prison inmates were divided into low, medium, and high psychopathy
groups by use of a 22 item psychopathy checklist, DSM-III diagnosis for Antisocial Personality
Disorder (APD), and the So-scale. All were given the Necker Cube, WCST, and a sequential
matching memory task. No differences between the groups were found, whether using the
psychopathy checklist, APD diagnosis, or So-scale score to differentiate groups (Hare, 1984).
Miller (1987) reviewed neuropsychological studies of the aggressive psychopath and
concluded that these studies have reflected characteristic deficits in psychopaths including
deficits in skills requiring verbal mediation, conceptual integration, and the abilities to anticipate
consequences and to use feedback from behavior to modify response patterns. Miller (1987)
theorized that the disinhibited psychopath suffers from a neurodevelopmental maturational
deficit that causes difficulties in using inner speech to modulate attention, affect, thought, and
behavior. Both the frontal lobes and the left hemisphere (if nondominant) are implicated in these
difficulties: the frontal lobes for their impact on recursive evaluation and planning and behavior
and the left hemisphere for its language system which provides a means of articulating to
oneself thoughts, feelings and goals.
Research on the link between neuropsychological functioning and adult psychopathy has
provided ambivalent results. While much research has failed to show any differences in
neuropsychological functioning between groups of inmates rated low, medium, and high in
psychopathy, other research has found such differences.
Integrative Summary
From the foregoing literature review, it is apparent that both adolescents and adults who
are aggressive and violent typically perform more poorly on neuropsychological measures than
normal controls or more poorly compared to the normative sample of such measures. Some
studies have found global deficits, others nondominant hemisphere deficits, and still others have
localized the deficits, typically to the frontal or temporal lobes. Many of these studies have been
criticized for using measures of questionable validity, lack of adequate control groups, subject
selection bias, poor standards of data analysis, small sample sizes, and confounded research
designs. These problems make interpretation of some of the studies difficult.
Adult psychopathic criminals commit more crimes than less psychopathic or
nonpsychopathic criminals (Hare, McPherson, & Forth, 1988). Adult psychopaths also are more
likely to act aggressively and commit violent crimes (Serin & Amos, 1995). Adult psychopaths
are more likely to be violent recidivists after their releases from incarceration (Quinsey, 1995).
Research on the link between neuropsychological functioning and psychopathy in adults
has provided ambivalent results. While much research has failed to show any differences in
neuropsychological functioning between groups of inmates rated low, medium, and high in
psychopathy, other research has found such differences. If criminals with various types of
neurological deficits are more aggressive and violent than those without, it is logical that some
type of connection exists between neurological functioning and psychopathy, as it has been
found that psychopathic criminals are more aggressive and violent than nonpsychopathic.
Possibly as neuropsychological/neurological research becomes even more sophisticated, the
links will be better understood.
Psychopathy can be a valid and useful concept when applied to children and
adolescents. A unique sub-group of children and adolescents can be identified who possess
characteristics similar to psychopathic adults. Researchers have found that psychopathic
children and adolescents are involved in more delinquent activities and more aggressive or
violent delinquent activities, are more likely to become recidivists after arrest and incarceration,
and are more aggressive while incarcerated. As yet no research has been published on the
relationship between neuropsychological functioning and psychopathy in children or adolescents.
CHAPTER III
METHOD
Participants
Participants were 40 juvenile males in residential programs administered by the
Kentucky Department of Juvenile Justice who were present or newly admitted during a six month
period. Participants were recruited from minimum (two facilities, 27 participants), medium (one
facility, 8 participants), and maximum security (one facility, 5 participants) residential facilities in
Louisville, KY. Participants were recruited by announcements and descriptions of the project
during their regular group counseling sessions. The participants were informed in general terms
of the purpose and nature of the research (i.e., examining juveniles and aggression) and those
interested were asked to sign a consent form. Once consent was obtained from the juveniles,
letters describing the research and requesting parental consent were sent to the participants'
parents or legal guardians. The juveniles participated only when parental consent had been
obtained. The project was described to a total of 161 juveniles, out of which juvenile and
parental consents were obtained for 40. Average age of the participants was 16.12 years. The
sample included 29 Caucasians, 10 African Americans, and 1 Hispanic American. Of the 40
participants, 30 had been adjudicated as juveniles and 10 had been adjudicated as adults due to
the circumstances of their offense. Participants had been adjudicated for the following offenses:
Terroristic Threatening (3), Property Crimes (10), Drug related crimes (2), Assault (8), Probation
Violations (2), Sexual Offenses (5), Armed Robbery (8), and Murder/Homicide (2).
Instruments
Wechsler Intelligence Scale for Children - III Mazes (Wechsler, 1991) - seven
increasingly complex mazes that are timed. Patients with frontal lobe lesions have been found
to perform poorly on such a task (Lezak, 1995). Mazes 4 through 11 were utilized. Raw scores
from Mazes 4 through 11 were utilized in the data analysis.
Design Fluency (Jones-Gotman & Milner, 1977) - consists of two trials: in the first, the
participant is asked to "invent drawings" that neither represent actual objects nor namable
Frontal Loises, Psychopathy, and Aggression 33
abstract forms and that are not only scribbles. In the second trial, the participant is told to make
drawings using only four lines, straight or curved. The number of novel designs produced in
each condition minus any perseverative responses was utilized as the score for this measure.
This procedure has been found to be sensitive to the presence of frontal lobe lesions. Design
Fluency has also demonstrated age-related deficits theoretically related to frontal lobe
deterioration (Daigneautt, Braun, & Whitaker, 1992, Lezak, 1995).
Controlled Oral Word Association (COWA) (Perret, 1974, Spreen & Strauss, 1991) - the
participant is asked to say as many words as he or she can think of beginning with a given letter
of the alphabet, excluding proper nouns, numbers, and the same word with a different suffix.
The letters "F," "A," and "S" were utilized for this project. There are three one minute trials of
this test. COWA has been found to be sensitive to the presence of frontal lobe lesions (Benton,
1968, Lezak, 1995). The score utilized was the total number of acceptable words produced in all
three trials.
Rey-Osterrieth Complex Figure Test (Spreen & Strauss, 1991, Lezak, 1995) -
participants were shown a complex figure to copy, then asked to draw it from memory after a
delay of 30 minutes. The administration and scoring procedures described by Spreen and
Strauss (1991) were followed.
The Aggression Questionnaire - a 29 item questionnaire that taps into four aspects of
aggression: physical aggression, verbal aggression, anger, and hostility (Buss & Perry, 1992; see
Appendix A). These four aspects were confirmed through factor analysis. The overall internal
consistency evaluated by the alpha coefficient was .89. Overall test-retest reliability was .80.
Construct validity was demonstrated by correlations between the Aggression Questionnaire and
peer observations of aggression, sociability, and shyness (Buss & Perry, 1992).
The Overt Aggression Scale - a 4 item measure adapted from a study conducted of
aggressive psychiatric patients (Yudofsky, Silver, Jackson, Endicott, & Williams, 1986; see
Appendix B). The scale considers verbal aggression, and physical aggression against self,
objects, and other people.
Legal History Scale • a single item, 5 point Likert scale that rated the juvenile's legal
history from ”1 - no legal charges for aggressive or assaultive behaviors (such as Terroristic
Threatening, Assault, Armed Robbery, etc.)" to "5 - legal charges for violent crimes (such as
Assault, Rape, Homicide, etc.)." (See Appendix C.)
The Psychopathy Checklist - Youth Version (PCL-YV) is a 20 item scale which has been
used with adolescents for research purposes (see Appendix D). Information to score items is
gathered in a semi-structured interview. Since the PCL-YV is still in the early stages of
development, significant research with this instrument has yet to be performed. However, its
design was purposefully similar to the Revised Psychopathy Checklist utilized with adult
populations. It is also highly similar to the Psychopathy Screening Device (Frick, et al, 1994)
designed for use with younger children. Both the PCL and the PSD have been found to be
possess adequate construct validity. Factor analysis of both have consistently identified two
dimensions of psychopathy, one associated with impulsivity and conduct problems and the other
associated with the traditional interpersonal and affective aspects of psychopathy (Frick, et al,
1994; Hare, et al, 1990). Internal consistency for the PCL-R assessed by Cronbach's coefficient
alpha ranged from .85 to .89 (Hare, et al, 1990).
Procedure
After a juvenile expressed interest in participating in the study, he was given a statement
of informed consent to sign (see Appendix E). A letter describing the study and an informed
consent form was sent to his parents or legal guardian (see Appendix E). When the consent was
returned to the researcher, the researcher arranged a time to meet with the juvenile at the facility
where he was a resident. The following measures were given to the juvenile in this order
(instructions were consistent with those published in the primary references noted above.):
Rey-Osterrieth Complex Figure Test (copy trial)
Controlled Oral Word Association (COWA)
Design Fluency
Mazes subtest from Wechsler Intelligence Scale for Children - III
The Aggression Questionnaire
Rey-Osterrieth Complex Figure Test (Delayed recall trial)
Psychopathy Checklist - Youth Version
The above measures took two hours or less for the juvenile to complete. The juvenile’s
chart was then reviewed by the researcher to obtain demographic information and information to
complete the Psychopathy Checklist - Youth Version. The Legal History Scale was completed
based on the review of the juvenile’s legal history. After the administration of the measures, the
Overt Aggression Scale was given to the juvenile's counselor to complete.
Frontal Loises, Psychopathy, and Aggression 36
CHAPTER IV
RESULTS
Descriptive statistics for the participants on variables relevant to psychopathy,
aggression, and frontal lobe functioning are presented in Table 1. The Overt Aggression Scale
(OAS) was completed and returned by the participants' facility counselors. Thirty-two of these
scales were returned for a return rate of 80%. Thus, any statistics involving the OAS were
computed using 32 cases.
Table 1
Descriptive Statistics of Measures of Psychopathy, Aggression, and Frontal Lobe Functioning
Mean (sd)
Age 16.20 1.13
Age at 1st Offense 13.27 2.02
PCL-YV 21.75 6.86
Aggression Questionnaire 92.25 17.67
Legal History 3.20 1.09
Overt Aggression Scale 3.87 2.68
Mazes (Raw scores) 15.20 4.31
Free Novel -Design Fluency 19.02 9.77
Fix Novel - Design Fluency 12.25 6.85
COWA 23.85 9.30
CFT-Copy 28.77 6.22
CFT-Recall 18.10 9.53
In order to give these mean scores context, they will be described in terms of scores
obtained by normative samples. Samples for which sufficient data was available (i.e., sample
size, standard deviations) were compared using z-scores. The Psychopathy Checidist - Youth
Version (PCL-YV) mean score of 21.75 (SD = 6.86) for the juvenile sample in the current study
falls within the range of mean scores from 20.1 to 23.95 obtained on the Psychopathy Checklist
Revised by 5 samples of adult male prison inmates (total n = 925) and 3 samples of male
forensic psychiatric patients (total n = 356) (Hare, Harpur, Hakstian, Forth, Hart, & Newman,
1990). By way of contrast, a sample of 75 young male offenders incarcerated in a maximum
security facility rated on an 18 item version of the Psychopathy Checklist obtained a mean score
of 26.2 (SD = 7.5) (scores prorated to a 20 item PCL, Forth, Hart, & Hare, 1990). Nine
participants (22.5%) in the current study obtained scores of 30 or above on the PCL-YV, the
cutoff score suggested for a diagnosis of psychopathy (Forth, Kossen, & Hare, in press).
A sample of 612 male college students, ages ranging from 18 to 20 years, obtained a
mean score of 77.8 (SD = 16.5) on the Aggression Questionnaire (Buss & Perry, 1992). In
comparison, the present sample of male juveniles obtained a significantly higher mean score of
92.25 (SD = 17.67) on the Aggression Questionnaire (z(5.03) = 0).
In their original study of design fluency after focal cortical lesions, Jones-Gotman and
Milner (1977) utilized a normal control group (n = 34, M age = 28.3,24 males and 10 females)
that obtained a mean number of Free Novel drawings of 16.2 and a mean number of Fixed
Novel Drawings of 19.7. The sample of juveniles in the present study compared favorably with a
mean number of 19.02 Free Novel drawing and 12.25 Fixed Novel drawings.
Following accepted clinical practice, Lezak (1995) recommended considering scores on
neuropsychological measures of two standard deviations below the mean of a normative sample
as being indicative of defective performance, and scores one standard deviation below the mean
as reflecting a trend towards defective performance. Following this standard, 75% (30/40) of the
current sample obtained scores on the Copy condition of the Complex Figure Test at least one
standard deviation below the mean of a normative sample (Spreen & Strauss, 1991; see Table
2). On the Recall condition of the Complex Figure test, 35% (14/40) of the current sample
obtained scores at least one standard deviation below the mean of a normative sample (Spreen
& Strauss, 1991; see Table 2). On the COWA, 87.5% (35/40) of the participants in the current
sample obtained scores at least two deviations below the mean of a normative sample (Spreen
& Strauss, 1991; see Table 2). Twenty-five percent (10/40) of the current sample obtained
scores at least two deviations below a normative sample's mean on WISC-III Mazes (Wechsler,
1991). Thus, the majority of the sample obtained scores tending towards deficiency on two of
the neuropsychological measures (Complex Figure Test Copy condition and COWA).
Table 2
Percentage of Sample Obtaining Clinically Significant Scores on Selected Measures
Complex Figure Test Copy Condition (Spreen & Strauss, 1991)
1 standard deviation below the mean: 5 cases = 12.5% of sample
2 standard deviations below the mean: 25 cases = 62.5% of sample
Total: 75% at least 1 sd below mean
Complex Figure Test Recall Condition (Spreen & Strauss, 1991)
Total: 35% at least 1 sd below the mean
Controlled Oral Word Association (Spreen & Strauss, 1991)
2 standard deviations below the mean: 30 cases = 75% of sample
Total: 87.5% at least 1 sd below the mean
Mazes (Wechsler, 1991)
Total: 25% at least 1 sd below the mean
To summarize the comparisons to available normative data; the present sample
obtained a Psychopathy Checklist - Youth Version mean score similar to psychopathy scores in
an adult sample, and an Aggression Questionnaire mean score significantly higher than a college
sample, The majority (at least 75%) of the sample obtained scores tending towards deficiency
on 2 of 6 neuropsychological measures (COWA and CFT-Copy).
Pearson correlation coeffecients were determined and are presented in Table 3. The
number of correlations calculated makes Type I errors more likely, however, significance was
liberally set at the .05 level in order to allow emerging trends to be evident.
The hypothesis of a relationship between aggression and frontal lobe functioning did
receive support (see Table 3). The Overt Aggression Scale was significantly and negatively
correlated with the Free Novel condition of Design Fluency (c= -.42, g < .05).
The hypothesis of a relationship between psychopathy and frontal lobe functioning in
which Psychopathy Checklist - Youth Version would have been significantly negatively correlated
with the measures of frontal lobe functioning (WISC-lil Mazes, Design Fluency Free and Fixed
Novel conditions, and Controlled Oral Word Association) did not receive support (see Table 3).
The Psychopathy Checklist - Youth Version was not negatively correlated with any of the
measures of frontal lobe functioning and in fact was significantly and positively correlated with
the Free Novel condition of Design Fluency (c =.31, g < .05) and with the Fixed Novel condition
of Design Fluency (c =.34, g < .05). The hypothesis of no relation between scores on the
Psychopathy Checklist - Youth Version and the Complex Figure Test was supported (see Table
3).
The hypothesis of a relationship between the psychopathy measure and the measures of
aggression did not receive support. The Psychopathy Checklist - Youth Version was not
significantly correlated with any of the measures of aggression (see Table 3).
Table 3
Correlation Coefficients of Variables Related to Psychopathy, Aggression, and
Frontal Lobe Functioning
Age Age 1st PCU AQ Legal Hx OAS Mazes FreeNov FixNov COWA CFTCopy CFT-Re.
(n»321
Age .46“ .15 -.34* .00 -.26 .39* .29 .40“ .50“ .51“ -.03
Aoe 1st .02 -.22 .17 .03 .20 .12 .19 .30 .30 -.02
PCU .06 .25 -.08 .12 .31* .34* .19 .16 .10
Ad .04 .36* -.26 -.27 -.29 -.09 -24 -.02
Leaal History -.07 .03 .10 .06 .15 -.01 .11
OASfn=32> -.19 -.42* -.29 -.18 .02 .09
Mazes -.18 .03 .22 .59“ .52“
FreeNov .77“ .43” .07 -.19
FixNov .43” 38* .10
COWA .42” .14
CFT-Coov .58“
* g < .05, **g < .01
(Age = age at time of study, Age 1st = age at first offense, PCL = Psychopathy Checklist - Youth
Version, AQ = Aggression Questionnaire, Legal Hx = Legal History Scale, OAS = Overt
Aggression Scale, FreeNov = Free Novel Condition of Design Fluency, FixNov = Fixed Novel
Condition of Design Fluency, COWA = Controlled Oral Word Association, CFT-Copy = Complex
Figure Test - Copy Condition, CFT-Re = Complex Figure Test - Recall Condition.)
The significant correlations of Age with 5 variables of interest, implied that Age, or
maturation, could have significant effects on a number of the variables, especially measures of
performance such as Design Fluency. Thus, correlation coefficients were again obtained
controlling for the effects of Age (see Table 4).
Controlling for the effects of Age, the hypothesis of a relationship between frontal lobe
functioning and aggression continued to receive support. The Overt Aggression Scale continued
to be significantly and negatively correlated with the Free Novel condition of Design Fluency (c =
•37, p. < .05).
With the effects of Age controlled, the hypothesis of a negative relationship between
measures of frontal lobe functioning and the Psychopathy Checklist-Youth Version received no
support. The positive and significant correlation between the PCL-YV and both conditions of
Design Fluency dropped below the designated level of significance (Free Novel: £= .28, g = .08;
Fixed Novel: £= .31, p = .057).
Of note is that several additonal significant correlations dropped below the designated
level of significance with the effects of Age controlled. Significant and positive correlations were
no longer obtained for the OAS with the AQ (c= .30, p = .096). Several intercorrelations of
neuropsychological measures dropped below the designated level of significance (CFT-Copy
with Fixed Novel: e= .22, p = .17; CFT-Copy with COWA: £= .22, p = .17; and Fixed Novel with
COWA: £= .29, b = .07). Interestingly, with the effects of Age controlled, the Free Novel
condition of Design Fluency was found to be significantly and negatively correlated with Mazes
(C= .33, p < .05).
Table 4
Correlation Coeffecients of Variables Related to Psychopathy, Aggression, and
Frontal Lobe Functioning Controlling for the Effects of Age
AQ Legal Hx OAS Mazes FreeNov FixNov COWA CFTCopy CFT-Re.

(n=32)
PCL .12 .25 -.04 .07 .28 .31 .13 .10 .11
AQ .04 .30 -.15 -.19 -.17 .09 -.08 -.03
Legal History .02 .04 .10 .07 .17 -.01 .11
OAS (n=32) -.11 -.37* -.21 -.07 .18 .09
Mazes -.33* -.15 .04 .49** .58**
FreeNov .74** .34* -.09 -.19
FixNov .29 .22 .12
COWA .22 .18
CFT-Copy .69**
* p < .05, * * p < .01
(PCL = Psychopathy Checklist - Youth Version, AQ = Aggression Questionnaire, Legal Hx =
Legal History Scale, OAS = Overt Aggression Scale, FreeNov = Free Novel Condition of Design
Fluency, FixNov = Fixed Novel Condition of Design Fluency, COWA = Controlled Oral Word
Association, CFT-Copy = Complex Figure Test - Copy Condition, CFT-Re = Complex Figure
Test - Recall Condition.)
CHAPTER V
DISCUSSION
The hypothesis that aggression would be related to frontal lobe functioning received
some support from these results. As predicted, the Overt Aggression Scale was significantly and
negatively correlated with the Free Novel condition of Design Fluency (c= -.39, g < .05). The
relationship between between the OAS and the Free Novel conditon of Design Fluency also
continued after controlling for the effects of Age (c= =.37, q.< .05). This indicated that
participants who were rated by their counselors as being more aggressive in the facility produced
fewer novel drawings. Jones-Gotman and Milner (1977) found reduced scores on the Free
Novel condition of Design Fluency in patients having left central and right fronto-central lesions.
Thus, the reduced scores of the more aggressive members of the present sample could be
related to deficits in frontal lobe functioning. This is consistent with previous research on
aggression and neuropsychological functioning in both juvenile and adult populations (Golden, et
al, 1996; Miller, 1987; Moffitt, 1990). Design Fluency is theorized to involve such skills as the
regulation of behavior by plans and strategies and one's own responses, and the planning and
elaboration of strategies (Daigneault, Braun, & Whitaker, 1992). A deficit in such skills implies
difficulties in the regulation of one's own behavior and a tendency to a haphazard, reactive style
of relating to the environment. Adolescents with such difficulties who are already vulnerable due
to other factors (e.g., exposure to familial violence) lack the resources to generate alternative
plans of action when confronted with frustrating situations. Such adolescents could also
experience failure in traditional settings where planning and strategizing are valued and
expected (i.e., schools). Both these situations could set the stage for aggressive acting out. An
alternative explanation is that these reduced scores reflect the manner in which aggressive
participants approached an ambiguous task and thus are indicative of a cognitive style rather
than an organic deficit. Previous research (Davis & Boster, 1992; Guerra & Slaby, 1990) has
indicated that aggressive adolescents tend to respond aggressively to ambiguous stimuli. The
poor performance on the Free Novel condition could reflect confusion in the face of uncertainty
on the part of the more aggressive participants.
The hypothesis that higher levels of psychopathy as measured by the Psychopathy
Check List - Youth Version (PCL-YV) would be associated with lower levels of frontal lobe
functioning as measured by W ISC-III Mazes, COWA, and Design Fluency found little support
based on the results from this study. This may be considered a fairly robust finding, as the
author's bias was in the direction of such a relationship. Unexpectedly, scores on the PCL-YV
were significantly and positively correlated with the production of novel designs in both
conditions of Design Fluency, the opposite direction of that predicted (Free Novel: £= .31, g <
.05; Fixed Novel: £= .34, g < .05). With the effects of Age controlled, these relationships
dropped below the level of significance set for this study (Free Novel: £ = .28, g = .08; Fixed
Novel: £ = .31, a = 057). This indicates that the relationship between PCL-YV scores and
performance on Design Fluency is moderated to some degree by the effects of age. It is
possible that a larger sample would have more definitively established the presence or absence
of a relationship. These findings appear suggestive but not conclusive. Thus, the following
discussion is necessary speculative.
Daigneault, Braun, & Whitaker (1992) theorized that abilities measured by Design
Fluency included the regulation of behavior by plans and strategies and one's own responses,
and the planning and elaboration of strategies. While at first glance these abilities seem foreign
to criminal psychopaths, it is possible that psychopaths are more able to read and manipulate the
social environment when not required to utilize verbal abilities. A tendency to interact with the
social environment using nonverbal skills may make it harder for psychopaths to empathize with
other people and allow them to manipulate and exploit others more readily.
The better performance on Design Fluency by more psychopathic participants may also
have reflected the abnormal lateralization of functioning found by other researchers (Hart &
Forth, 1984; Hare & McPherson, 1984; Raine, O'Brien, Smiley, Scerbo, & Chan, 1990). In
general, the left hemisphere of the brain has a greater role in language than does the right
hemisphere, and the right hemisphere has a greater role in visual-spatial abilities than does the
left hemisphere (Kolb & Whishaw, 1990; Lezak, 1995). Thus, in the present study, COWA
generally assessed functions that are more specific to the left frontal lobes, and Design Fluency
assessed functions that are somewhat more specific to the right frontal lobes. Compared to
normative samples, the juveniles in this study performed within normal limits on Design Fluency
and had deficient performances on COWA, which is suggestive of hemispheric differences.
Jones-Gotman and Milner (1977) localized the production of Design Fluency drawings to the
right frontal lobes based on poor performance on this measure of patients having lesions in this
area.
A consistent theme of psychopathy research has been the dissociation between
psychopaths' verbal abilities and their difficulty in regulating their behavior and in appreciating
the affective experiences of others. Psychopaths' linguistic abilities have been found to have
reduced lateralization (Hart & Forth, 1984; Hare & McPherson, 1984; Raine, O'Brien, Smiley,
Scerbo, & Chan, 1990), indicating that psychopaths do not process language primarily in the left
hemisphere of the brain, but in both hemispheres. While the significance of these findings are
still being debated, it is possible that this abnormal lateralization is related to a more basic
problem; that is, poor integration between affective components and cognitive and behavioral
components (Hare, Williamson, & Harpur, 1986). A study of event-related potentials related to
language in psychopaths found that psychopaths showed less behavioral and electrocortical
differentiation between affective and neutral words than did nonpsychopaths (Williamson,
Harpur, & Hare, 1991). The researchers concluded that the psychopaths did not make
appropriate use of the affective components of language (Williamson, Harpur, & Hare, 1991). A
preliminary brain imaging study using single photon emission computerized tomography
indicated that psychopaths showed patterns of relative cerebral blood flow during the processing
of emotional words that differed from that of control groups (Intrator, Hare, Stritzke, Brichtswein,
Dorfman, Harpur, Bernstein, Handlesman, Schaefer, Keilp, Rosen, & Machac, 1997). The
authors concluded that "brain processes associated with lexical processing are not the same in
psychopaths as in normal individuals, and that psychopaths do not differentiate between neutral
and affective words in the same way that others do” (Intrator, et al, 1997, p. 102). This
anomalous processing of affective language could be at the root of the emotional detachment
and interpersonal barrenness that is fundamental to the construct of psychopathy. Psychopaths
may be unable to appreciate the experiences of others due to relative deficits in the processing
of affective language which causes an inability to maintain a coherent internal dialogue
transposing the experiences of others into their own narrative. This is consistent with the
hypothesis that differences in performance on neuropsychological measures that psychopaths
sometimes exhibit are not related to neurological deficits, but related instead to functional and/or
structural differences in the brains of psychopaths and normal individuals (Hare, Williamson, &
Harpur, 1986). Cleckley (1976) referred to the "semantic aphasia” of psychopaths, in which they
possess the ability to use affective language appropriately, but lack the true feeling behind the
words. One possibility is that these differences represent an evolutionary adaptation that has
been successful for the small subgroup of psychopaths that may have been historically present
in the larger population (c.f. Mealey, 1995). From this point of view, the ability to use,
manipulate, and exploit others without consideration of their feelings or consequences to them
may have been evolutionarily adaptive. This also could acount for the lack of amenability to
treatment noted in psychopaths (Rice, Ham's, & Cormier, 1992).
What other explanations are possible for the lack of the predicted patterns of correlations
between scores on the PCL-YV and the measures of aggression with scores on the
neuropsychological measures? One possible explanation is found in considering the pattern of
correlations between the neuropsychological measures. This raises the question of whether
anterior and posterior functions were adequately assessed. The Complex Figure Test was
chosen in order to assess posterior functioning, however, the copy condition of the Complex
Figure Test was significantly correlated with several of the measures chosen to assess frontal
lobe functioning; Mazes (c = .57, p < .01), the Fixed Novel condition of Design Fluency (c= .41, p
< .05), and COWA (e = .50, p < .01). Mazes was also significantly positively correlated with the
Complex Figure Test recall condition (c = .52, p < .01). This pattern of correlations between the
putative posterior and anterior measures suggests that the abilities assessed by these measures
are not as localized as hypothesized. It is possible that the organizational demands of the
Complex Figure Test required more of the higher cognitive processes usually considered to be
the domain of the frontal lobes. The only neuropsychological measure not correlated with the
Complex Figure Test was the Free Novel condition of Design Fluency. However, it is not
possible to conclude that this means the Free Novel condition was actually assessing frontal lobe
functioning. Thus, it is possible that the neuropsychological measures used to test the
hypotheses of relationships between frontal lobe functioning and psychopathy and aggression
were measuring neuropsychological functining in general rather than frontal lobe functioning
specifically. This alternative explanation loses some of its force when the partial correlations are
considered. With the effects of Age controlled, the Copy condition of the Complex Figure Test
no longer correlated significantly with either the Fixed Novel condition of Design Fluency (c = .23,
p = .17) or COWA (c = -22, p = .17). Thus, it appeared that controlling for the effects of age
upon these performance measures allowed their independent nature to become more apparent,
it is likely that these measures did assess functions independent of those assessed by the
Complex Figure Test. Based on prior research and theory, these functions may be specified as
typically located in the frontal lobes.
The hypothesis that psychopathy as measured by the PCL-YV would be associated with
higher levels of aggression or violence as measured by the Aggression Questionnaire, the Legal
History Scale, and the Overt Aggression Scale also received no support. These results give rise
to the question of whether the Psychopathy Checklist in its Youth Version is appropriate for use
with adolescents. However, previous research with young male offenders (Forth, Hart, & Hare,
1990; N = 75, M age = 16.3) found a positive correlation between PCL scores and number of
previous violent offenses and number of institutional charges for violent or aggressive behavior.
Research with adults has consistently found that those offenders scoring highest on the PCL are
the most aggressive in facilities, commit more crimes and more violent crimes, and are most
likely to be violent recidivists (Hare, McPherson, & Forth, 1988; Serin & Amos, 1995). Bearing
this research in mind, it may be that the current results are anomalous and may have resulted
from methodological problems with this study. Since no strict exclusionary criteria were utilized,
the composition of this sample may have influenced the reliability of some of the measures
used. In addition, differences in instrumentation among these studies could have led to the
conflicting results. For example, some researchers of psychopathy in adult correctional
populations have used length of time in prison, the number of convictions per year of violent and
nonviolent offenses, and the number of institutional charges for violent behavior as indicators of
the extent and seriousness of criminal activity and violence (Forth, Hart, & Hare, 1990; Hare,
McPherson, & Forth, 1988). Of the measures used in the present study, the Aggression
Questionnaire is a self-report measure of one's own aggressive tendencies and actions. One
would expect that psychopaths would report more aggressive tendencies and actions. However,
it is possible that a desire for social acceptability was at work and more aggressive participants
attempted to appear less aggressive. This seems a reasonable assumption since some of these
participants would have been in the situation of anticipating future appearances before parole
boards, privilege review committees, etc. The more psychopathic and more aggressive
participants probably would have found little incentive to be honest about their aggression. The
lack of relationship of PCL-YV scores and scores on the Legal History Scale is also
understandable since the Legal History Scale is a simple measure of a single situation:
participants' most violent crime. What is not captured with this measure is whether this past
crime was singular in the participant's experience or rather one crime of many. A non-
psychopathic participant with one violent crime would have rated high on this scale, whereas a
psychopathic participant with numerous less violent crimes would have rated lower. In
retrospect, a better measure would have combined severity of past offenses with the number of
such offenses. Consistent with the literature, scores on such a measure would be expected to be
positively correlated with scores of psychopathy.
There also has been recent research (Kosson, Steuerwald, Forth, & Kirkhart, 1997)
focused on providing a measure to supplement the PCL-R in order to minimize subjectivity in
scoring the interpersonal aspects of psychopathy. Kosson, et al (1997) recommended rating as
more psychopathic those individuals who demonstrate the callous, grandiose, insensitive aspects
of psychopathy during the actual interview. As the PCL-R (Hare, 1991) and its iterations now
stand, such behavior during the interview is not given such emphasis. Such work has the
promise of reducing heterogeneity in those identified as psychopathic by the PCL-R. Similar
research has been conducted in the context of improving the predictive validity of risk
assessments (Menzies & Webster, 1995). In initial research of this type, interview behavior
(specifically participant agreeability and the interviewer's rating of the tension level during the
interview) was found to be a weak predictor of future violence (Menzies & Webster, 1995). This
type of research bears examination in the context of applying the psychopathy construct to
adolescents as a means of identifying problematic juveniles and predicting their future behavior
and potential response to intervention.
A finding that was not predicted but that is related to the interests of this study was that
Age was significantly and negatively correlated with the Aggression Questionnaire (c= -.37, p. <
.05). This indicates that in this sample of juvenile delinquents, the younger participants reported
higher levels of aggression. This could be related to a self-perceived lack of impulse control in
relatively immature adolescents. Pontius (1972) and Pontius and Ruttiger (1976) related such
impulsivity to developmental lags in the maturation of the frontal lobe system. These lags result
in difficulty in "switching from one principle of action or value to a higher one when
circumstances change during an on-going activity" (Pontius, 1972, p. 291). An example of how
such a lag could affect aggression and/or delinquent behavior is a homeowner interrupting a
juvenile in the act of burglarizing the homeowner's residence. A juvenile not possessing such a
developmental lag would be capable of stopping his or her actions and switching to a different
action - for example, flight, surrender, or negotiation. A juvenile with such a developmental lag
would have difficulty making such a switch and could conceivably do violence to the homeowner
in order to return quickly to the original principle of action - the burglary. Luria and Homskaya
(1964) provide some evidence supportive of this theory. They emphasize that only after ages 3
1/2 to 4 are children able to perform complex series of actions governed by verbal instructions or
complex internal intentions. Children prior to the age of 18 to 24 months have difficulty
interrupting ongoing behavior. Yakolev and Lecours (1966) reported a steady increase in the
myelination of the association cortex (frontal lobes) well into puberty. Any interruption in this
process could result in a lag such as Pontius (1972) described. Surwillo (1980) found that
aggressive boys were more likely than nonaggressive boys to have immature EEGs. While this
does not localize any developmental lag in the frontal lobes, the evidence of overall immaturity
in brain function does lend some support to Pontius' (1972) theory. In the present study, the
positive correlations of Age of participant with Mazes (c = .39, p < .05), the Fixed Novel condition
of Design Fluency (c = .40, p < .01), Controlled Oral Word Association (c= .50, p < .01), and the
Complex Figure Test-copy condition (c = .51 p < .01) may reflect the effects of maturation on
such performance measures, indicating that the younger the participant, the poorer the
performance on these measures. What is unknown is whether this constitutes a specific lag
compared to normal male adolescents. The fact that overall this sample had defective
performances on 2 of 6 neuropsychological measures lends some support to Pontius' (1972)
theory. It is likely that there are multiple etiologies of aggression, each of which overlap and
each of which may have subtle differences in expression. Adult aggression may be related to
levels of psychopathy, brain dysfunction, mental illness (specifically paranoia), and alcohol or
drug abuse (Blake, Pincus, & Buckner, 1995; Pincus, 1993). Some adolescent aggression may
be related to these variables, and other expressions of adolescent aggression may also be
related to specific developmental lags in brain functioning, lags which are overcome as the
adolescent matures into adulthood.
In reference to other research samples, this sample of juvenile delinquents reported
themselves to be significantly more aggressive than a sample of college age males. This
sample also had a similar degree and range of psychopathy compared to samples of adult male
prison inmates and male forensic patients. Overall, this sample of male juvenile delinquents
were found to be impaired on 2 of 6 measures of neuropsychological functioning (Controlled Oral
Word Association and Complex Figure Test - Copy), consistent with other research in this area
(e.g., Moffitt, Lynam, & Silva, 1994; Sequin, et al, 1995; Voorhees, 1981). What is not known
from this sample is whether or not this depressed neuropsychological functioning is related to
overall deficiencies in intellectual functioning. What such a finding suggests is the possible
reciprocal nature between deficient cognitive functioning and social achievement and
acceptance. It is possible that many juvenile delinquents were unable to succeed in mainstream
settings due to such deficiencies and experienced failure and rejection and eventually "drifted"
into delinquent activities.
Participants in this study had been adjudicated for a number of crimes, ranging in
severity from Terroristic Threatening (3) and Property Crimes (10) to Armed Robbery (8) and
Murder/Homicide (2). The Office of Juvenile Justice and Delinquency Prevention reported that
24% of all juveniles in public long-term institutions in 1992 had been committed for a violent
crime, while 76% of all juveniles in such institutions had been committed for a non-violent crime
(Snyder & Sickmund, 1995). The present study's sample has a similar breakdown with 27% of
the juveniles convicted of a violent crime and 73% convicted of a nonviolent crime.
There are several limitations of the present study which must be addressed. The
researcher developed the research proposal and administered and scored all of the measures.
This process made experimenter bias more likely than some type of blind methodology.
However, this may actually have made the results more robust as the researcher did not expect
the results that were obtained. Several potentially confounding variables were not assessed and
thus not controlled for. These variables include intellectual functioning, psychopathology, head
trauma, and substance abuse. All of these variables have relationships to psychopathy,
aggression, and neuropsychological functioning that have been addressed by other researchers
but were considered outside the scope of the present study. It is possible that not controlling for
one or more of these factors confounded the ability of the measures used to accurately assess
the constructs they were intended to measure.
The size of the current sample (40) is smaller than that originally proposed (100).
Problems in recruitment, obtaining parental consent, and a smaller population to sample than
expected limited the size of the sample.
Despite facilities with similar capacities for juveniles, the majority (67%) of volunteers for
this project came from the two minimum security facilities, with only 32% of the participants
coming from the medium and maximum security facilities. The proportion of those volunteering
to those recruited was significantly different with residents of the minimum security facilities
more likely to volunteer for participation than the residents of the medium or maximum security
facilities (minimum security = 27/86; medium/maximum = 13/75; z(2.47) = .0068). It is possible
that a self-selection bias was at work and that those who volunteered differed in some way from
those who did not. Typically, residents of the medium and maximum security facilities tend to be
juveniles who are more aggressive or have committed more violent crimes.
While the study of psychopathy in adolescents and children is still in its early stages, it is
possible to describe tentative implications for intervention. Suggestions have been made in this
study that psychopathy may have evolutionary origins and a primarily organic etiology. Should
such distant causes result in a hopeless view? Not necessarily. By way of analogy, humans
have developed intellectual functioning in advance of other animals due to its adaptive function,
resulting in brain structures substantially different from our nearest evolutionary relatives, the
primates. Even with this evolutionary and organic basis, though, an individual human's
intellectual endowment is impacted substantially by early social and physical experiences such
as stimulating environments and nutrition.
Thus, first and most importantly, any intervention into psychopathy must be early,
preferably before adolescence. Several researchers have broken ground on work to identify
psychopathy in children (Christian, et al, 1997; Frick & Hare, in press; Lynam, 1997; O'Brien &
Frick, 1996). Policy changes need to take place in which prevention takes priority over
retribution or punishment (Tate, Reppucci, & Mulvey, 1995). Any programmatic interventions
would have to be careful not to label children as "psychopathic,” due to the negative associations
with this term. One possibility is to develop a program to work with pre-teen children who have
been referred due to aggression. Loeber (1982) has noted that childhood aggression and other
antisocial behavior is predictive of adult aggression and even arrest as an adult. Researchers in
another study (Huesmann, Eron, Lefkowitz, & Walden, 1984) examined aggression as a
personality trait over a 22 year span and found that aggression at age 8 correlated with criminal
offending, the seriousness of criminal offenses, and aggression in 30 year olds. Since
aggression is characteristic of psychopathic individuals, this should cast a wide net with which to
capture children with psychopathic tendencies, as well as other children who are aggressive for
different reasons. Since the primary deficit in psychopaths is in interpersonal relating and
appears to be related to verbal processing of affective stimuli, a focus on this area would be
important for these children. Internalizing control over anger, impulsive behavior, and
aggression is also important, however, it is likely that for these children the interpersonal
component, with its lack of feeling for others, will be primary. Teaching these children to
recognize affective states in others and then talking oneself through an appropriate response
would be helpful. This would be similar to established treatment approaches taken with
aggressive boys in which the emphasis is on teaching the aggressive boys to verbally mediate
their own behavior (e.g., Camp, 1977; Goldstein, Glick, Reiner, Zimmerman, & Coultry, 1986).
Such interventions with antisocial children in general have been shown to have weak treatment
effects (Kazdin, 1987), however, it is possible that targeting antisocial children with psychopathic
tendencies with interventions designed to address their specific deficits could bring about more
change. Broad-based interventions such as Multisystemic Therapy (MST) have shown some
success in reducing the antisocial behavior of youthful offenders (Henggeler, Melton, & Smith,
1992). MST utilizes child-focused, family-centered interventions and seeks to solve multiple
problems across the numerous contexts in which antisocial children exist. Utilizing MST with
pre-teen children and combining it with interventions such as those mentioned above could have
an impact. With such a group as psychopathic children, even a little success could go a long
way towards ameliorating the personal and social effects of psychopathy in adulthood.
In conclusion, this study provided some support for a relationship between frontal lobe
functioning and aggression. Future research could investigate what distinguishes the aggressive
acts of psychopaths from the aggressive acts of individuals with diminished frontal lobe
functioning. It may be that there are two somewhat overlapping groups in the criminal
population; aggressive criminals who are psychopathic and aggressive criminals who have
deficits in brain functioning, particularly in frontal lobe functioning. The present study provided
unexpected support for a relationship between frontal lobe functioning and psychopathy in that a
positive relationship was obtained where a negative relationship was predicted. This relationship
dropped below the established level of significance when the effects of Age were controlled. As
noted, this positive relationship may be a reflection of the abnormal lateralization of functioning
in psychopathic persons that other researchers have observed. Future studies on psychopathy
and brain functioning may profitably focus on how psychopaths process information related to
the affective states of other people. Studying the impact on interpersonal relationships of such
information processing could yield valuable insights into the nature of the fundamental
characteristic of psychopathy: impoverished relationships characterized by exploitation and lack
of empathy. Unexpectedly, this study provided no support for the relationship of psychopathy
and aggression in this population. In light of the consistent history of such a relationship in adult
populations, future research could revisit this issue using more ecologically valid measures of
aggression in order to provide more information on the validity of the construct of psychopathy
for use with adolescents. Longitudinal research on psychopathy could provide valuable insights
into the development of this personality and behavioral trait. Such research could address the
questions of whether children identified as psychopathic actually develop into adult psychopaths
as well as what protective factors may keep this from happening.
Overall, psychopathy appears to be a useful concept in application to adolescents. It
offers the possibility of identifying a subgroup of antisocial juveniles that may be responsible for
most delinquent activities and that may be relatively treatment resistant Ongoing research into
the various components of psychopathy, such as the anomalous processing of affective
information and interpersonal relating, offers the potential for more specific interventions that
may have some impact on this group at an early age.
REFERENCES
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental
disorders (4th ed.). Washington, DC: Author.
Andrews, D. A., & Bonta, J. (1994). The psychology of criminal conduct. Anderson
Publishing Co.: Cincinnati, OH.
Benton, A. L. (1968). Differential behavioral effects in frontal lobe disease.
Neuroosvcholooia. 6. 53-60.
Bernstein, R. M. (1981). The relationship between dimensions of delinquency and the
developments of self and peer perception. Adolescence. 36. 543-556.
Bischof, G. P., Stith, S. M., & Whitney, M. L. (1995). Family environments of
adolescent sex offenders and other juvenile delinquents. Adolescence. 3 0 .157-170.
Blake, P. Y.; Pincus, J. H.; & Buckner, C. (1995). Neurologic abnormalities in
murderers. Neurology. 4 5 .1641-1647.
Bryant, E. T., Scott, M. L„ Golden, C. J. &Tori, C. D. (1984). Neuropsychological
deficits, learning disability, and violent behavior. Journal of Consulting and Clinical Psychology.
52. 323-324.
Buikhuisen, W. (1987). Cerebral dysfunctions and persistent juvenile delinquency. In
S. A. Mednick, T. E. Moffitt, & S. A. Stack (Eds.), The causes of crime: New biological
approaches fpp. 168-1841. Cambridge: Cambridge University Press.
Buss, A. H., & Perry, M. (1992). The Aggression Questionnaire. Journal of Personality
and Social Psychology. 63. 452-459.
Camp, B. W. (1977). Verbal mediation in young aggressive boys. Journal of Abnormal
Psychology. 86. 145-153.
Christian, R. E. Frick, P. J., Hill, N. L., Tyler, L , & Frazer, D. R. (1997). Psychopathy
and conduct problems in children: II. Implications for subtyping children with conduct problems.
Journal of the American Academy of Child and Adolescent Psychiatry. 3 6 .233-241.
Ciccone, J. R. (1992). Murder, insanity, and medical expert witnesses. Archives of
Neurology. 49. 608-911.
Cleckley, H. (1976). The mask of sanity (4th ed.). St. Louis: Mosby.
Cornell, D. G., Roberts, M., & Oram, G. (1997). The Rey-Osterrieth Complex Figure
Test as a neuropsychological measure in criminal offenders. Archives of Clinical
Neuropsychology. 12. 47-56.
Oaigneauft, S., Braun, C. M. J., & Whitaker, H. A. (1992). Early effects of normal aging
on perseverative and non-perseverative prefrontal measures. Developmental Neuropsychology.
fi, 99-114.
Davis, D. L. & Boster, L. H. (1992). Cognitive-behavioral-expressive interventions with
aggressive and resistant youths. Child Welfare. 71. 557-573.
Eibl-Eibesfeldt, I. (1977). Evolution of destructive aggression. Aggressive Behavior. 3.
127-144.
Figueredo, A. J., & McCloskey, L. A. (1993). Sex, money, and paternity: The
evolutionary psychology of domestic violence. Ethology and Sociobiology. 14. 353-379.
Fitzhugh, K. B. (1973). Some neuropsychological features of delinquent subjects.
Perceptual and Motor Skills. 3 6 .494.
Forth, A. E., Hart, S. D., & Hare, R. D. (1990). Assessment of psychopathy in male
youth offenders. Psychological Assessment: A Journal of Consulting and Clinical Psychology.
2.342-344.
Forth, A., Kossen, D. & Hare, R. D. (in press). The Hare Psychopathy Checklist: Youth
Version. Toronto: Multi-Health Systems.
Frick, P. J., & Hare, R. D. On press). The psychopathy screening device. Toronto:
Multi-Health Systems.
Frick, P. J., O'Brien, B. S., Wootton, J. M., & McBumett, K. (1994). Psychopathy and
conduct problems in children. Journal of Abnormal Psychology. 103.700-707.
Giancola, P. R.; & Zeichner, A. (1994). Neuropsychological performance on tasks of
frontal-lobe functioning and aggressive behavior in men. Journal of Abnormal Psychology. 103.
832-835.
Golden, C. J., Jackson, M. L., Peterson-Rohne, A., & Gontovsky, S. T. (1996).
Neuropsychological correlates of violence and aggression: A review of the clinical literature.
Aggression and Violent Behavior. 1. 3-25.
Goldstein, A. P., Glick, B., Reiner, S., Zimmerman, D., & Couitry, T. (1986). Aggression
replacement training. Champaign, IL: Research Press.
Gorenstein, E. E. (1982). Frontal lobe functions in psychopaths. Journal of Abnormal
Gorenstein, E. E. (1990). Neuropsychology of juvenile delinquency. Forensic Reports.
15-48.
Gorenstein, E. E„ & Newman, J. P. (1980). Disinhibitory psychopathology: A new
perspective and a model for research. Psychological Review. 87. 301-315.
Guerra, N. G. 7 Slaby, R. G. (1990). Cognitive mediators of aggression in adolescent
offenders: 2. Intervention. Developmental Psychology. 26. 269-277.
Hare, R.D. (1984). Performance of psychopaths on cognitive tasks related to frontal
lobe function. Journal of Abnormal Psychology. 9 3 .133-140.
Hare, R. D. (1985). Comparison of procedures for the assessment of psychopathy.
Journal of Consulting and Clinical Psychology. 53. 7-16.
Hare, R. D. (1991). Manual for the Revised Psychopathy Checklist. Toronto: Multi-
Health Systems.
Hare, R. D. & Forth, A. E. (1985). Psychopathy and lateral preference. Joumai of
Abnormal Psychology. 94. 541 -546.
Hare, R. D. & McPherson, L. M. (1984). Psychopathy and perceptual asymmetry during
verbal dichotic listening. Joumai of Abnormal Psychology. 9 3 .141-149.
Hare, R. D.t McPherson, L. M., & Forth, A. E. (1988). Male psychopaths and their
criminal careers. Joumai of Consulting and Clinical Psychology. 5 6 .710-714.
Hare, R. D., Harpur, T. J., Hakstian, A. R., Forth, A. E., Hart, S. D., & Newman, J. P.
(1990). The Revised Psychopathy Checklist: Reliability and factor structure. Psychological
Assessment: A Joumai of Consulting and Clinical Psychology. 2 .338-441.
Harpur, T. J., & Hare, R. D. (1994). Assessment of psychopathy as a function of age.
Joumai of Abnormal Psychology. 103. 604-609.
Hart, S. D., Forth, A. E., & Hare, R. D. (1990), Performance of criminal psychopaths on
selected neuropsychological tests. Joumai of Abnormal Psychology. 9 9 .374-379.
Hare, R.D., Williamson, S. E., & Harpur, T. J. (1986). Psychopathy and language. In T.
E. Moffitt & S. A. Mednick (Eds.), Biological contributions to crime causation, (pp. 68-92).
Dordrecht: Martinus Nijhoff Publishers.
Henggler, S. W., Smith, B. H., & Schoenwald, S. K. (1994). Key theoretical and
methodological issues in conducting treatment research in the juvenile justice system. Joumai
of Clinical Child Psychology. 2 3 .143-150.
Hilfbrand, M.; Langlan, D.; Nelson, C. W .; Clark, J. E.; & Dion, S. M. (1994). Cerebral
lateralization and aggression. Joumai of Offender Rehabilitation. 2 1 .81-90.
Hoffman, J. J., Hall, R. W ., & Bartsch, T. W . (1987). On the relative importance of
"psychopathic" personality and alcoholism on neuropsychological measures of frontal lobe
dysfunction. Joumai of Abnormal Psychology. 9 6 .158-160.
Huesmann, L. R., Eron, L. D., Lefkowitz, M. M„ & Walder, L. O. (1984). Stability of
aggression over time and generations. Developmental Psychology. 2 0 .1120-1134,
Hurwitz, I., Bibace, R. M. A., Wolff, P. H„ & Rowbotham, B. M. (1972).
Neuropsychological function of normal boys, delinquent boys, and boys with learning problems.
Perceptual and Motor Skills. 35. 387-394.
Intrator, J., Hare, R., Stritzke, P., Brichstwein, K., Dorfman, D., Harpur, T., Bernstein, D.,
Handelsman, L., Schaefer, C., Keilp, J., Rosen, J., & Machac, J. (1997). A brain imaging
(single photon emission computerized tomography) study of semantic and affective processing in
psychopaths. Biological Psychiatry. 42. 96-103.
Jones-Gotman, M., & Milner, B. (1977). Design fluency: The invention of nonsense
drawings after focal cortical lesions. Neuropsvcholooia. 1 5 .653-674.
Kamiski, W. M., Levine, M. D., Clarke, S., Palfrey, J. S., & Meltzer, L J. (1982). A
study of neurodevelopmental findings in early adolescent delinquents, Joumai of Adolescent
Health Care. 3 . 151-159.
Kazdin, A. E. (1987). Treatment of antisocial behavior in children: Current status and
future directions. Psychological Bulletin. 1 0 2 .187-203.
Kolb, B., & Whishaw, I.Q. (1990). Fundamentals of human neuropsychology. W.H.
Freeman and Company: NY.
Kosson, D. S., Steuerwald, B. L., Forth A. E., & Kirkhart, K. J. (1997). A new method
for assessing the interpersonal behavior of psychopathic individuals: Preliminary validation
studies. Psychological Assessment. 9. 89-101.
Krynicki, V. E. (1978). Cerebral dysfunction in repetitively assaultive adolescents. The
Joumai of Nervous and Mental Disease. 166. 59-67.
Langevin, R.; Ben-Aron, M; Wortzman, G.; Dickey, R.; & Handy, L (1987). Brain
damage, diagnosis, and substance among violent offenders. Behavioral Sciences and the Law.
5.77-94.
Lapierre, D., Braum, C. M. J., & Hodgins, S. (1995). Ventral frontal deficits in
psychopathy: Neuropsychological test findings. Neuropsychologia. 3 3 .139-151.
Lewis, D. O., Shanok, S. S., Pincus, J. H., & Glaser, G. H. (1979). Violent juvenile
delinquents: Psychiatric, neurological, psychological, and abuse factors. Joumai of the
American Academy of Child Psychiatry. 2. 307-319.
Lewis, D. O., Moy, E., Jackson, L. D., Aaronson, R., Restifo, N, Serra, S., & Simos, A.
(1985). Biopsychosocial characteristics of children who later murder A prospective study.
American Joumai of Psychiatry. 1 4 2 .1161-1167.
Lewis, D. O., Pincus, J. H., Bard, B., Richardson, E., Prechep, L., S., Feldman, M., &
Yeager, C. (1988). Neuropsychiatric, psychoeducational, and family characteristics of 14
juveniles condemned to death in the United States. American Joumai of Psychiatry. 145. 584-
589.
Lezak, M. D. (1995). Neuropsychological assessment. New York: Oxford University
Press.
Linnoila, M., Virkkunen, M., Stein, M., Nuptial, A., Rim, R., & Goodwin, F. K. (1994).
Low cerebrospinal fluid 5-hydroxyindoleacetic acid concentration differentiates impulsive from
nonimpulsive violent behavior. In R. D. Masters & M. T. McGuire (Eds.), The neurotransmitter
revolution: Serotonin, social behavior, and the law, (pp. 62-68). Carbondale, IL: Southern
Illinois University Press. (Reprinted from Life Sciences. 33. pp. 2609-2614,1983).
Luria, A. R., & Homskaya, E. D. (1964). Disturbance in the regulative role of speech
with frontal lobe lesions. In J.M. Warren & K. Akert (Eds.), The frontal granular cortex and
behavior, (pp. 353-371). New York: McGraw-Hill.
Lynam, D. R. (1996). Early identification of chronic offenders: Who is the fledgling
psychopath? Psychological Bulletin. 120. 209-234.
Lynam, D. R. (1997). Pursuing the psychopath: Capturing the psychopath in a
nomological net. Joumai of Abnormal Psychology. 106.425-438.
McManus, M., Brickman, A., Alessi, N. E., & Grapentine, W . L (1985). Neurological
dysfunction in serious delinquents. Joumai of the American Academy of Child Psychiatry. 24.
481-486.
Mattson, A. J., & Levin, H. S. (1990). Frontal lobe dysfunction following closed head
injury: A review of the literature. The Joumai of Nervous and Mental Disease. 178.282-291.
Mealey, L. (1995). The sociobiology of sociopathy: An integrated evolutionary model.
Behavioral and Brain Sciences. 18. 523-599.
Menzies, R., & Webster, C. D. (1995). Construction and validation of risk assessments
in a six-year follow up of forensic patients: A tridimensional analysis. Joumai of Consulting and
Clinical Psychology. 63,766-778.
Miller, L (1987). Neuropsychology of the aggressive psychopath: An integrative
review. Aggressive Behavior. 1 3 .119-140.
Miller, L. (1994). Traumatic brain injury and aggression. Joumai of Offender
Rehabilitation.,21.91-103.
Mills, S., & Raine, A. (1994). Neuroimaging and aggression. Joumai of Offender
Rehabilitation. 21. 145-158.
Moffitt, T. E., Lynam, D. R., & Silva, P. A. (1994). Neuropsychological tests predicting
persistent male delinquency. Criminology. 3 2 .277-288.
Moffitt, T. E. (1990). The neuropsychology of juvenile delinquency: A critical review.
In M. Tonry & N. Mom's (Eds.). Crime and justice: A review of research (12th ed., pp. 99-169).
Chicago: University of Chicago Press.
Myers, W. C., Burket, R. C., & Ham's, H. E. (1995). Adolescent psychopathy in relation
to delinquent behaviors, conduct disorder, and personality disorders. Joumai of Forensic
Sciences. 40. 436-440.
Nestor, P. G. (1992). Neuropsychological and clinical correlates of murder and other
forms of extreme violence in a forensic psychiatric population. The Joumai of Nervous and
Mental Disease. 180. 418-423.
O’Brien, B. S., & Frick, P. J. (1996). Reward dominance: Associations with anxiety,
conduct problems, and psychopathy in children. Joumai of Abnormal Child Psychology. 24. 223-
239.
Perret, E. (1974). The left frontal lobe of man and the suppression of habitual
responses in verbal categorical behaviour. Neuropsychologia. 12. 323-330.
Pincus, J. H. (1993). Neurologist's role in understanding violence. Archives of
Neurology. 5Q. 867-869.
Pontius, A. A. (1972). Neurological aspects in some type of delinquncy, especially
among juveniles: Toward a neurological model of ethical action. Adolescence. 7 .289-308.
Pontius, A. A. (1989). Subtypes of limbic system dysfunction evoking homicide in limbic
(?) psychotic trigger reaction and temporal lobe epilepsy - evolutionary constraints.
Psychological Reports. 65. 659-671.
Pontius, A. A., & Ruttiger, K. F. (1976). Frontal lobe system maturational lag in juvenile
delinquents shown in narratives test. Adolescence. 11. 509-518.
Pontius, A. A., & Yudowitz, LL.B. (1980). Frontal lobe system dysfunction in some
criminal actions as shown in the Narratives TesL The Joumai of Nervous and Mental Disease,
168,111-117.
Quay, H. C. (1965). Psychopathic personality as pathological sensation seeking.
American Joumai of Psychiatry. 1 2 2 .180-183.
Quinsey, V. L. (1995). The prediction and explanation of criminal violence.
International Joumai of Law and Psychiatry. 1 8 .117-127.
Raine, A., O'Brien, M., Smiley, N., Scerbo, A., & Chan, C. (1990). Reduced
lateralization in verbal dichotic listening in adolescent psychopaths. Joumai of Abnormal
Restak, R. (1993). The neurological defense of violent crime: 'Insanity defense’
retooled. Archives of Neurology. 50. 869-871.
Rice, M. E. (1997). Violent offender research and implications for the criminal justice
system. American Psychologist. 52. 414-423.
Rice, M. E., Ham's, G. T., & Cormier, C. A. (1992). An evaluation of a maximum
security therapeutic community for psychopaths and other mentally disordered offenders. Lfflat
and Human Behavior. 16. 399-412.
Rosse, R. B.; Miller, M. W.; & Deutsch, S. I. (1993). Violent antisocial behavior and
Wisconsin Card Sorting Test performance in cocaine addicts. American Joumai of Psychiatry.
150.170-171.
Scerbo, A.; Raine, A.; O'Brien, M.; Chan, C.; Rhee, C.; & Smiley, N. (1990). Reward
dominance and passive avoidance learning in adolescent psychopaths. Joumai of Abnormal
Child Psychology. 1 8 .451-463.
Serin, R. C.; & Amos, N. L. (1995). The role of psychopathy in the assessment of
dangerousness. International Joumai of Law and Psychiatry. 1 8 .231-238.
Sequin, J. R.; Pihl, R. O.; Harden, P. W.; Tremblay, R. E.; & Boulerice, B. (1995).
Cognitive and neuropsychological characteristics of physically aggressive boys. Joumai of
Abnormal Psychology. 104. 616-624.
Shostak, D. A.; & McIntyre, C. W. (1978). Stimulus-seeking behavior in three
delinquent personality types. Joumai of Consulting and Clinical Psychology. 4 6 .582.
Snyder. H. N., & Sickmund, M. (1995). Juvenile offenders and victims: A national
report. Washington, DC: Office of Juvenile Justice and Delinquency Prevention.
Spellacy, F. (1977). Neuropsychological differences between violent and nonviolent
adolescents. Joumai of Clinical Psychology. 33. 966-969.
Spreen, O. (1981). The relationship between learning disability, neurological
impairment, and delinquency: Results of a follow-up study. The Joumai of Nervous and Mental
Disease. 169. 791-799.
Spreen, O., & Strauss, E. (1991). A compendium of neuropsychological tests:
Administration, norms, and commentary. New York: Oxford University Press.
Stein, D. J.; Hollander, E.; Cohen, L.; Frenkil, M.; Saoud, J. B.; DeCaria, C.; Aronowitz,
B.; Levin, A.; Liebowitz, M. R.; & Cohen, L. (1993). Neuropsychiatric impairment in impulsive
personality disorders. Psychiatry Research. 4 8 .257-266.
Stuss, D. T., & Benson, D. F. (1984). Neuropsychological studies of the frontal lobes.
Psychological Bulletin. 95. 3-28.
Sutker, P. B., & Allain, A. N. (1987). Cognitive abstraction, shifting, and control:
Clinical sample comparisons of psychopaths and nonpsychopaths. Joumai of Abnormal
Psychology. 9 6 .73-75.
Surwillo, W . W . (1980). The electroencephalogram and childhood aggression.
Aggressive Behavior. 6. 9-18.
Tarter, R. E., Hegedus, A. M., Alterman, A. I., & Katz-Garris, L (1983). Cognitive
capacities of juvenile violent, nonviolent, and sexual offenders. The Joumai of Nervous and
Mental Disease. 171. 564-567.
Tate, D. C., Reppucci, N. D., & Mulvey, E. P. Violent juvenile delinquents: Treatment
effectiveness and implications for future action. American Psychologist. 50. 777-781.
Virkkunen, M.; Nuptial, A.; Goodwill, F. K.; & Lineal, M. (1994). Cerebrospinal fluid
monoamine metabolite levels in male arsonists.ln R. D. Masters & M. T. McGuire (Eds.), The
neurotransmitter revolution: Serotonin, social behavior, and the law, (pp. 62-68). Carbondale,
IL: Southern Illinois University Press. (Reprinted from Archives of General Psychiatry. 44. pp.
241-247,1987)
Virkkunen, M.; DeJong, J.; Bartko, J.; Goodwin, F. K.; & Linnoila, M. (1994).
Relationship of psychobiological variables to recidivism in violent offenders and impulsive
firesetters: A follow-up study. In R. 0. Masters & M. T. McGuire (Eds.), The neurotransmitter
revolution: Serotonin, social behavior, and the law, (pp. 62-68). Carbondale, IL: Southern
Illinois University Press. Reprinted from Archives of General Psychiatry. 46. pp. 600-603,1989).
Volavka, J.; Martell, D.; & Convit, A. (1992). Psychobiology of the violent offender.
Joumai of Forensic Sciences. 37. 237-251.
Voorhees, J. (1981). Neuropsychological differences between juvenile delinquents and
functional adolescents: A preliminary study. Adolescence. 3 6 .57-66.
Wechsler, D. (1991). Wechsler Intelligence Scale for Children (3rd ed.L San Antonio,
TX: The Psychological Corporation.
Williamson, S., Harpur, T. J., & Hare, R. D. (1991). Abnormal processing of affective
words by psychopaths. Psychophysiology, 28,260-273.
Wolff, P.H., Waber, D., Bauermeister, M., Cohen, C., & Ferber, R. (1982). The
neuropsychological status of adolescent delinquent boys. Journal of Child and Psychiatry and
Yakovlev, P. I., & Lecours, A. R. (1967). The myelogenetic cycles of regional
maturation of the brain. In A. Minkowski (Ed.), Regional development of the brain in early life.
(pp3-70). Oxford: Blackwell.
Yeudall, L. T., Fromm-Auch, D, & Davies, P. (1982). Neuropsychological impairment of
persistent delinquency. The Journal of Nervous and Mental Disease. 170. 257-265.
Yudofsky, S. C., Silver, J. M., Jackson, W ., Endicott, J., & Williams, D. (1986). The
Overt Aggression Scale for the objective rating of verbal and physical aggression. American
Journal of Psvchiatrv. 143. 35-39.
APPENDIX A
The Aggression Questionnaire
For the following items please rate how true each is of you. Using the following rating scale
record your answer in the space to the left of each item.
1 = Extremely uncharacteristic of me
2 = Somewhat uncharacteristic of me
3 = Only slightly characteristic of me
4 = Somewhat characteristic of me
5 = Extremely characteristic of me
1. Once in a while I cant control the urge to strike another person.
2. I tell my friends openly when I disagree with them.
3. I flare up quickly but get over it quickly.
4. I am sometimes eaten up with jealousy
5. Given enough reason, I may hit another person.
6. I often find myself disagreeing with people.
7. When frustrated, I let my irritation show.
8. At times I feel I have gotten a raw deal out of life.
9. If somebody hits me, I hit back.
10. When people annoy me, I may tell them what I think of them.
11. I sometimes feel like a powder keg ready to explode.
12. Other people always seem to get the breaks.
13. I get into fights a little more than the average person.
14. I cant help getting into arguments when people disagree with me.
15. Some of my friends think I'm a hothead.
16. I wonder why sometimes I feel so bitter about things.
17. If I have to resort to violence to protect my rights, I will.
18. My friends say that I'm somewhat argumentative.
19. Sometimes I fly off the handle for no good reason.
20. I know that "friends" talk about me behind my back.
21. There are people who pushed me so far that we came to blows.
22. I have trouble controlling my temper.
23. I am suspicious of overly friendly strangers.
24. I can think of no good reason for ever hitting a person.
25. I sometimes feel that people are laughing at me behind my back.
26. I have threatened people I know.
27. When people are especially nice, I wonder what they want.
28. I have become so mad that I have broken things.
29. I am an even-tempered person.
APPENDIX B
The Overt Aggression Scale
(Check all that typically apply for this adolescent while in your program.)
1. Verbal Aggression
Makes loud noises, shouts angrily.
Yells mild personal insults, for example, "You’re stupid!"
Curses viciously, uses foul language in anger, makes moderate threats to others or
self.
Makes clear threats of violence toward others or self (Tm going to kill you") or
requests help to control self.
2. Physical Aggression Against Objects
Slams door, scatters clothing, makes a mess.
Throws objects down, kicks furniture without breaking it, marks the wall.
Breaks objects, smashes windows.
Sets fires, throws objects dangerously.
3. Physical Aggression Against Self
Picks or scratches skin, hits self, pulls hair (with no or minor injury only).
Bangs head, hits fist into objects, throws self onto floor or into objects (hurts self
without serious injury).
Small cuts or bruises, minor bums.
mutilates self, causes deep cuts, bites that bleed, internal injury, fracture, loss of
consciousness, loss of teeth.
4. Physical Aggression Against Other People
Makes threatening gestures, swings at people, grabs at clothes.
Strikes, kicks, pushes, pulls hair (without injury to them).
Attacks others, causing mild-moderate physical injury (bruises, sprains, welts).
with permission o f the copyright owner. Further reproduction prohibited without permission.
Attacks others, causing severe physical injury (broken bones, deep lacerations,
interna! injury).
APPENDIX C
Legal History Scale
1. No legal charges for aggressive or assaultive behaviors.
2. Has received legal charge(s) for non-physical aggressive behavior such as
Terroristic Threatening.
3. Has received legal charge(s) for physically aggressive behaviors such as Assault 3rd or
4th.
4. Has received legal charge(s) for physically aggressive behaviors such as Assault 1st or
2nd or Armed Robbery.
5. Has received legal charge(s) for physically aggressive behaviors such as Murder 1st or
2nd, Rape, or Kidnapping.
APPENDIX D
Informed Consents
This research project looks at the relationships of scores on questionnaires about
aggression and personality, and how well you do on some skill tests such as memory, drawing,
and language. This research is designed to help people understand aggression better. Total
time for this will be two hours or less. Your counselor will be given a questionnaires about
aggression you've shown in this program and about any history of substance abuse you have.
The researcher will also look through your chart to get additional information on your history.
The researcher will contact your legal guardian to get his or her consent for your participation
before you actually take part. This project is required to earn a Doctor of Psychology degree at
Spalding University in Louisville, KY. The researcher has a Master of Arts degree in
Clinical/Community Psychology and is a Certified Psychological Associate in the Commonwealth
of Kentucky. In addition, this research project has been approved by DJJ.
You could experience embarrassment if you feel you dont do as well as you would like.
If staff at your facility got information on how you did, there could be an impact on you are
treated. However, your confidentiality will be assured by identifying information being left out,
and anonymity will be assured by the use of a numerical coding system to identify participants.
Results will not be associated with any individual resident. You may understand yourself and
your actions better as a result of participation in this research. In addition, this research may
help the juvenile justice system give even better treatment to juveniles.
Participation in this research is voluntary, and you may end your participation at any time
without any kind of penalty. Signing this form means you are willing to participate and that your
questions have been answered to your satisfaction. If you have any more questions or if other
concerns come up, you can contact the researcher (Robert Shelton) at work at (502) 425-2571.
Participant________________________________________________Date__________________
Researcher________________________________________________ Date_________________
Dear (Parent);
Your son,______________ , has shown interest in taking part in a project I am doing to
earn a Doctor of Psychology degree at Spalding University in Louisville, KY. Enclosed with this
letter is a copy of the consent form he signed. This project has been approved by the Kentucky
Department of Juvenile Justice.
This research project looks at aggression and personality and skills such as memory,
drawing, and language. I will interview your son about some of his history and past actions and
he will complete a questionnaire on his aggression and he will do four short skills tests. Your
son's counselor will be given questionnaires about his aggression and his legal history. I will
also look through your son's chart to get additional information.
There is a slight chance your son could feel embarrassed if he doesn't do as well as he
would like. If staff at the facility somehow got information on how he did, there could be an
impact on how he is treated. However, his confidentiality will be kept by all identifying
information being left out and code numbers and not names will be used. Individual results will
not be given to the facility. Your son may understand himself and his actions better as a result of
taking part. This research may also help the juvenile justice system give even better treatment
to juveniles.
Participation is voluntary and your son or you may end his participation at any time
without any kind of penalty. If you wish to end your son's participation at any time, simply call
me at the number given below. Signing this form means you are willing for your son to
participate and that all your questions have been answered to your satisfaction. If you have
questions or if other concerns come up, you can contact me (Robert Shelton) at work at (502)
425-2172.
Please return this form in the enclosed, self-addressed, stamped envelope. Thank you.
Parent/Legal Guardian__________________________________Date_________
Researcher__________________________________________ Date_________
with permission o f the copyright owner. Further reproduction prohibited without permission.
APPENDIX E
Department of Juvenile Justice
Research Agreement
I agree to abide by ail Department policies which govern the conduct of research.
I fully realize that the use and dissemination of research findings which may identify
juveniles or staff of the Department requires a signed statement of consent by each identified
staff or juvenile and their legal guardian.
I agree to permit a staff member assigned by the administrator to monitor the research
project while in progress.
I agree to submit a proposal including the anticipated use and dissemination of the
research findings for approval prior to the start of research.
I agree to submit all research findings to the Department's research staff upon
completion of the research.
I agree that no research findings will be used in any proceeding against the Department
of Juvenile Justice.
Researcher Date
Witness Date
IMAGE EVALUATION
TEST TARGET (Q A -3 )
1.0 l£ Vi
y * mu2.2
|0 6 “* " =
2.0
l.l
1.8
1.25 1.4 1.6
150mm
IIWIGE .Inc
1653 East Main Street
Rochester. NY 14609 USA
Phone: 716/482-0300
Fax: 716/288-5989
0 1993. Applied Image, Inc., All Rights Reserved

Shelton - Relationships - Between - Frontal - PDF

Загружено:

Сведения о документе

Оригинальное название

Авторское право

Доступные форматы

Поделиться этим документом

Поделиться или встроить документ

Параметры публикации

Этот документ был вам полезен?

Это неприемлемый материал?

Авторское право:

Доступные форматы

Shelton - Relationships - Between - Frontal - PDF

Загружено:

Авторское право:

Доступные форматы

INFORMATION TO USERS

The q u a lity of this reproduction is dependent upon the quality of the

Oversize materials (e.g., maps, drawings, charts) are reproduced by

Photographs included in the original manuscript have been reproduced

AND AGGRESSION IN A SAMPLE OF MALE JUVENILE DELINQUENTS

SUBMITTED TO THE FACULTY

THE DEPARTMENT OF PSYCHOLOGY

IN PARTIAL FULFILLMENT OF THE

REQUIREMENTS FOR THE DEGREE

LOUISVILLE, KENTUCKY May, 1999

Marilyn Wagner, Ph.D.

irry Lewis, Ph.D. ^

Thomas Titus, Ph.D.

All rights reserved.

UMI Microform 9916544

This microform edition is protected against unauthorized

neurological functioning and antisocial behavior in general and aggression in particular.

researcher after reviewing the chart.

O f those correlations relevant to the hypothesis of relationships between psychopathy,

previous findings of abnormal lateralization in psychopaths and their ineffective processing of

I. GENERAL PRESENTATION OF THE PROBLEM 1

II. LITERATURE REVIEW 10

B. OVERT AGGRESSION SCALE 68

C. LEGAL HISTORY SCALE 70

E. DEPARTMENT OF JUVENILE JUSTICE

Johnson-Breckinridge Youth Development Center, and Central Kentucky Youth Development

AGGRESSION, AND FRONTAL LOBE FUNCTIONING

TABLE 2 PERCENTAGE OF SAMPLE OBTAINING CLINICALLY SIGNIFICANT

SCORES ON SELECTED MEASURES

TABLE 3 CORRELATION COEFFICIENTS OF VARIABLES RELATED

TO PSYCHOPATHY, AGGRESSION, AND FRONTAL

TABLE 4 CORRELATION COEFFICIENTS OF VARIABLES RELATED

TO PSYCHOPATHY, AGGRESSION, AND FRONTAL

LOBE FUNCTIONING CONTROLLING FOR THE EFFECTS OF AGE

GENERAL PRESENTATION OF THE PROBLEM

While this is a sensational example, juvenile violence and aggression is a nationally

aggression and violence are better understood (Rice, 1997).

In the quest to understand the origins and associated characteristics of human

evolutionary considerations (Ebl-Eibesfeldt, 1977; Figueredo & McCloskey, 1993), and

aggression with personality variables, in particular a cluster of personality and behavioral

characteristics labeled "psychopathic" after the work of Cleckley (1976).

Summary of Related Research and Theory

goal formulation, planning and anticipation of consequences, initiation of purposeful motor

behavior, self-monitoring, self awareness, and inhibition of unsuccessful or impulsive actions,

concern for others.

Much of the adolescent literature on neuropsychological functioning and violence or

maturational lag of the frontal lobe system in delinquents.

antisocial behaviors and delinquent behavior (Sequin, et al, 1995).

neuropsychological functioning at age 13 was associated with a greater likelihood of having

delinquency (Moffitt, Lynam, & Silva, 1994).

Voorhees (1981) examined neuropsychological differences between 28 juveniles with

Neuropsychological Investigation. Significant differences, with the delinquent group performing

neurological correlates of aggression and violence in adolescents. These correlates are

judgment that an individual is guilty of a particular crime. Due to lack of standardization in

Psychopathy is conceived of as a cluster of personality and behavioral characteristics

egocentric, manipulative, forceful and cold-hearted. They typically demonstrate shallow

construct of psychopathy also emphasizes qualities of interpersonal relating (e.g., callousness)

than other criminals.

psychopathy was predictive of developmentally immature responses. In another study

Psychopathy Checklist, and an impulsivity scale.

found that the affective-interpersonal aspects of psychopathy (i.e., egocentricity,

psychopathy is a stable construct with applicability to adolescents.

In research analogous to that with adults, factor analysis of a measure of psychopathy in