Background and Aims: The prevalence of acquired brain injury (ABI) in offender populations appears much higher than in the general population, being estimated at 50% compared to 12%, respectively. Taking into account ABI-related cognitive and social impairments or behavioral changes in forensic treatments might be relevant and may improve treatment outcomes. The aim of the current review is to summarize and integrate the literature on psychological interventions or treatments for consequences of ABI in the forensic setting. Reviewing this literature could provide crucial information for improving treatment options for offenders with ABI, which may contribute to reducing recidivism.Methods: The PubMed/MEDLINE, PsychInfo, CINAHL, COCHRANE, and Web of Science databases were searched for studies in adult offenders with ABI that evaluated the effect of psychological interventions with a focus on ABI-related impairments and recidivism.Results: This review identified four intervention studies that met the inclusion criteria. These included an adult population (≥18-year-old) in a forensic setting (given the focus of the current review on treatment, defined here as an environment in which offenders are treated while being incarcerated or as outpatients), non-pharmacological treatments and were published in English or Dutch between 2005 and 2020. All studies reported some positive effects of the intervention on interpersonal behavior, cognition and recidivism. The aspects of the interventions that seemed most beneficial included personalized treatment and re-entry plans, support for the individual and their environment and psychoeducation about the effects of ABI.Discussion: Although positive effects were reported in the studies reviewed, all studies had methodological limitations in terms of sample size, study design and outcome measures which affects the strength of the evidence. This limits strong conclusions and generalizability to the entire offender population.Conclusion: Despite high prevalence of ABI in offender populations, interventions in forensic settings seldom address the effect of ABI. The few studies that did take ABI into account reported positive effects, but those results should be interpreted with caution. Future studies are warranted, since this does seem an important venue to improve treatment, which could eventually contribute to reducing recidivism.

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BackgroundPublic health-inspired programs for Countering Violent Extremism (CVE) have developed internationally in a relatively short period of time. Research into these programs is scarce. There is a need for information that helps drive public health interventions.ObjectivesTo present data on the occurrence of psychiatric disorders, self-sufficiency problems and adverse childhood experiences (ACE) in a population suspected of violent extremism.MethodsA cross-sectional study, with data from screening reports for 34 adult subjects included in a multi-agency case-based approach on violent extremism in Amsterdam, the Netherlands. Subjects were screened in the period between December 2015 to May 2021. Screening reports, which included the Screener for Intelligence and Learning Disabilities (SCIL) and the Dutch version of the Self-sufficiency Matrix (SSM-D), were used to gather information on the main outcome measures.ResultsMajor psychiatric disease categories were found to be mood and anxiety disorders and mild intellectual disability (each 29.4%), substance related disorders (35.3%), personality disorders (41.2%), and psychotic disorders (14.7%). Complex self-sufficiency problems, measured by the number of people who had self-sufficiency problems in 4+ domains and the number of people who had similar self-sufficiency problems as homeless people in Amsterdam, were found in 35.3 and 32.4% of the client sample. The most prevalent ACE were emotional neglect (47.1%), household mental illness (44.1%), and loss of a parent (38.2%), 35.3% had been exposed to 4+ ACE. An association was found between NACE and self-sufficiency problems on two domains, namely “Mental Health” (rho = 0.51, p = 0.002) and “Law and order” (rho = 0.42, p = 0.013).ConclusionsAn accumulation of social and psychiatric problems in people suspected of violent extremism underlines the importance of professionals in health and social care being actively involved in developing CVE approaches.

Despite the recognized importance of mild to borderline intellectual disability (MBID) among offender populations, there is insufficient understanding of its prevalence and associations with other social-psychiatric problems. Therefore this study investigated MBID prevalence and its relation with psychopathology and self-sufficiency problems (SSPs) in important lifedomains among young adult violent repeat offenders (N ¼ 432) enrolled in a focused deterrence program in Amsterdam. Offenders participated voluntarily in a social psychiatric screening which included the Screener for Intellectual Disability and Learning Disorders (SCIL) to assess MBID, the Dutch version of the self-sufficiency matrix (SSM-D) to assess SSPs, and an assessment of the presence of psychiatric disorders according to DSM methodology. Results showed an MBID prevalence of 51.1%. Nearly all offenders presented with at least one psychiatric disorder (95.0%) and SSPs in multiple life-domains. Among MBID offenders, symptoms of mood-and anxiety disorders, substance dependency and higher variety in SSPs were more frequently observed than among non MBID offenders. These results indicate the importance of adapting communication and treatment programs to increase their responsivity to MBID offenders. Self-sufficiency problems, that may reflect shortcomings in adaptive functioning specifically among MBID offenders, can be considered criminogenic needs and should be targeted accordingly to reduce recidivism.