Workingmemory deficits are already present in MCI patients and worsen in AD patients, suggesting that working memory should be assessed as part of neuropsychological testing.

We investigated whether forensic psychiatric inpatients can be distinguished from prisoners and healthy controls on the basis of their performance on cognitive tasks measuring cognitive flexibility (with a reversal learning task) and inhibition (with a stop signal task). Forensic psychiatric inpatients were expected to perform worse compared to prisoners. This study was based on pre-existing data from N = 241 males (119 forensic psychiatric inpatients, 57 prisoners and 65 healthy controls). We fitted logistic generalized linear models to group membership data using outcome measures from a stop signal task and a reversal learning task to examine whether deficiencies in inhibition and cognitive flexibility predict membership of the group of forensic psychiatric inpatients. Neurocognitive measures of cognitive flexibility, but not inhibition, had predictive value for group membership. This suggests that the capacity for cognitive flexibility may help differentiate between forensic subpopulations and healthy controls. Furthermore, our results highlighted substantial heterogeneity in cognitive performance in inhibition and cognitive flexibility within different offender groups. This study indicates that forensic subpopulations can be adequately differentiated based on neurocognitive measures of cognitive flexibility. In a broad sense, this study is an example of how neurocognitive approaches can contribute to refining diagnosis in forensic psychiatry.

Objective: The main aim was to investigate whether forensic psychiatric inpatients can be distinguished from prisoners and non-offender healthy controls based on their performance on neurocognitive tasks measuring behavioral inhibition and behavioral activation. Method: This study used preexisting data from 120 male forensic psychiatric inpatients, 60 male prisoners and 66 male non-offender healthy controls. A multinomial logistic regression analysis was used to study the links between our outcome measures and group membership. To this end, we used outcome measures from a Continuous Performance task, an emotional Stroop task and behavioral inhibition system and behavioral activation system (BIS/BAS) questionnaire. Results: BIS/BAS scores had discriminatory power for distinguishing forensic psychiatric inpatients from prisoners. Measures from the Continuous Performance task and the emotional Stroop task did not significantly differ between the offender groups. Conclusions: BIS/BAS are relevant concepts in the context of criminal behavior and could play a role in the development of new approaches to subtype offender populations, because they seem useful for differentiating forensic psychiatric inpatients from prisoners. For clinical practice, our results suggest that these concepts should be routinely assessed as part of neuropsychological testing in forensic psychiatric settings.