Thursday, January 21, 2016

Cognitive Tests May Predict Aggressive Behavior in Forensic Patients

Cognitive tests may be able to help predict forensic psychiatric patients who are most prone to aggressive behaviors, according to a study published online in Psychiatry Research. Integrating such tests with instruments currently used to assess a patient’s risk of aggression could one day help to improve the ability of psychiatrists to predict these risks.

Past studies have linked aggressive behaviors in people to biases and distortions in attention, automatic association, emotion recognition, and response inhibition (the ability to refrain from socially inappropriate responses). A group of researchers in the Netherlands wanted to know whether such cognitive factors could predict the in-clinic aggressive behavior of forensic psychiatric patients.

Sixty-nine male forensic psychiatric inpatients from two settings in the Netherlands participated in a series of tests that assessed attentional bias for threat and aggression (Emotional Stroop), automatic associations (Single Target-Implicit Association Task), emotion recognition (a Graded Emotional Recognition Task), and response inhibition (Go/No-Go task). The study authors also used the Psychopathy Checklist-Revised (PCL-R) to determine the level of psychopathic traits in the study participants and scored the severity of all aggressive incidents reported in patient files within one year of the cognitive testing.

The researchers found that increased attention toward threat and aggression, difficulty recognizing sad and happy faces, and PCL-R factor 2 predicted verbal aggression; decreased response inhibition, higher PCL-R factor 2, and lower PCL-R factor 1 scores predicted physical aggression; and difficulty recognizing angry faces predicted aggression against property.

Although the authors stressed the importance of replicating the findings of their study, they noted that “cognitive tasks could have potential to complement current risk taxation instruments and facilitate and improve risk assessment in the future. Using cognitive tasks could give clinicians more insight in cognitive processes playing a role in aggressive behavior of forensic patients, which could then be targeted in treatment.”

For related information, see the Psychiatric News article “Forensic Psychiatry Topics Ripe for Teaching in a Collaborative Setting.”

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