Faculty of Behavioural Sciences, Department of Clinical Neuro- and Development Psychology, Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
De Waag, Utrecht, The Netherlands.
Crim Behav Ment Health. 2024 Jun;34(3):311-338. doi: 10.1002/cbm.2334. Epub 2024 Mar 25.
Acquired brain injury (ABI) is a major health problem, often with negative effects on behaviour and mental health as well as cognition. Prevalence of ABI is exceptionally high among offenders and increases their re-offending risk. Information on risk factors for ABI and its outcomes among offenders that could guide effective treatment for them is, nevertheless, scarce and dispersed. However, there is a more substantial literature about the general population that could inform work with brain-injured offenders, especially when selecting for samples or subgroups with similar relevant characteristics, such as lower socio-economic status (SES), pre-injury lower tested intelligence score (<85) and pre-injury mental health problems.
To explore brain injury data from non-offender samples of otherwise similar socio-economic and mental health and ability characteristics to offenders then, first, to describe their untreated outcomes and, secondly, outcomes after frequently used interventions in these circumstances, noting factors associated with their effectiveness.
Three databases were systematically searched for the years 2010-2022; first, using terms for brain injury or damage and cognitive (dys)function, mental health or quality of life. Second, in a separate search, we used these terms and terms for interventions and rehabilitation. In the second review, studies were selected for clear, distinguishable data on age, sex, SES and lifestyle factors to facilitate inferences for offenders. A narrative analytical approach was adopted for both reviews.
Samples with characteristics that are typical in offender groups, including lower SES, lower pre-injury intelligence quotient (<85), prior cognitive impairments and prior mental health problems, had poorer cognitive and behavioural outcomes following ABI than those without such additional problems, together with lower treatment adherence. With respect to treatment, adequate motivation and self-awareness were associated with better cognitive and behavioural outcomes than when these were low or absent, regardless of the outcome measured.
More complex pre-injury mental health problems and social disadvantages typical of offenders are associated with poorer post-brain injury recovery. This paper adds to practical knowledge by bringing together work that follows specific outcome trajectories. Overall, succesful ABI-interventions in the general population that aim at pre-injury difficulties comparable to those seen among offenders, show that personalising injury-specific treatments and taking account of these difficulties, maximised positive outcomes.
获得性脑损伤（ABI）是一个主要的健康问题，通常会对行为、心理健康和认知产生负面影响。罪犯中的 ABI 患病率极高，增加了他们再次犯罪的风险。然而，关于罪犯中 ABI 的风险因素及其结果的信息很少且分散。然而，关于一般人群的文献更多，这些文献可以为脑损伤罪犯的治疗提供信息，尤其是在选择具有相似相关特征的样本或亚组时，例如较低的社会经济地位（SES）、受伤前较低的测试智力得分（<85）和受伤前的心理健康问题。
从社会经济和心理健康及能力特征与罪犯相似的非罪犯样本中探讨脑损伤数据，然后，首先描述他们未经治疗的结果，其次描述在这些情况下经常使用的干预措施的结果，并注意与治疗效果相关的因素。
2010 年至 2022 年，我们系统地在三个数据库中搜索了以下术语：脑损伤或损伤和认知（功能）障碍、心理健康或生活质量。其次，在单独的搜索中，我们使用了这些术语和干预措施和康复的术语。在第二次审查中，我们选择了具有明确、可区分的年龄、性别、社会经济地位和生活方式因素数据的研究，以便为罪犯提供推断。对两次审查都采用了叙述性分析方法。
具有罪犯群体典型特征的样本，包括较低的 SES、较低的受伤前智商（<85）、先前的认知障碍和先前的心理健康问题，与没有这些额外问题的样本相比，在 ABI 后认知和行为结果更差，同时治疗依从性也更低。就治疗而言，与治疗效果相比，无论测量结果如何，与低或缺乏动机和自我意识相比，适当的动机和自我意识与更好的认知和行为结果相关。
更复杂的受伤前心理健康问题和罪犯中常见的社会劣势与脑损伤后恢复较差有关。本文通过汇集遵循特定结果轨迹的工作，为实践知识增添了内容。总体而言，针对与罪犯相似的受伤前困难的一般人群的成功 ABI 干预措施表明，个性化损伤特异性治疗并考虑这些困难可以最大限度地提高积极结果。
