A Systematic Review and Meta-Analysis of Decision-Making in Offender Populations with Mental Disorder

Abstract

Decision-making has many different definitions and is measured in varied ways using neuropsychological tasks. Offenders with mental disorder habitually make disadvantageous decisions, but no study has systematically appraised the literature. This review aimed to clarify the field by bringing together different neuropsychological measures of decision-making, and using meta-analysis and systematic review to explore the performance of offenders with mental disorders on neuropsychological tasks of decision-making. A structured search of PubMed, Embase, PsycINFO, Medline, Cinahl was conducted with additional hand searching and grey literature consulted. Controlled studies of decision-making in offenders with evidence of any mental disorder, including a validated measure of decision-making were included. Total score on each relevant decision-making task was collated. Twenty-three studies met inclusion criteria ( n = 1820), and 10 studies (with 15 experiments) were entered into the meta-analysis ( n = 841). All studies included in the meta-analysis used the Iowa Gambling Task (IGT) to measure decision-making. Systematic review findings from individual studies showed violent offenders made poorer decisions than matched offender groups or controls. An omnibus meta-analysis was computed to examine performance on IGT in offenders with mental disorder compared with controls. Additionally, two sub-group meta-analyses were computed for studies involving offenders with personality disorder and psychopathy, and recidivists who were convicted of Driving While Intoxicated (DWI). Individual studies not included in the meta-analysis partially supported the view that offenders make poorer decisions. However, the meta-analyses showed no significant differences in performance on IGT between the offender groups and controls. Further research is required to ascertain whether offenders with mental disorder have difficulty in making advantageous decisions. An analysis of cause and effect and various directions for future work are recommended to help understand the underpinning of these findings. Trial Registration: CRD42018088402 . Electronic supplementary material The online version of this article (10.1007/s11065-018-09397-x) contains supplementary material, which is available to authorized users.

Decision-making and risk-taking in forensic and non-forensic patients with schizophrenia spectrum disorders: A multicenter European study

“…Some of the inconsistencies found in previous studies might reflect intrinsic differences in the specific demands posed on cognitive processing by different decision-making tasks. In this respect, it is noteworthy that the few studies reporting greater risk-taking in offenders have generally used the Iowa Gambling Task ( Jones et al, 2019 ), which requires the coordinated activity of both reasoning and affective processes generally subsumed under the notions of “hot” and “cool” executive functions ( Dunn et al, 2006 ). The latter includes processes characterized by their inherently cognitive nature such as working memory, response inhibition or planning, typically associated with abstract and decontextualized problems and with the engagement of the fronto-parietal executive brain networks ( De Brito et al, 2013 ).…”

“…Importantly, most earlier studies have assessed decision-making skills in offenders (see Jones et al, 2019 ) and people with mental disorders (e.g., Hiser and Koenigs, 2018 ) separately, thus neglecting the possible additional contribution of a mental disorder on choice patterns in people who offend. We thus aimed to fill this gap by comparing risk-taking in patients with schizophrenia spectrum disorders (SSD), with and without a history of serious violent offending.…”

The neurocognitive profiles of justice involved people with foetal alcohol spectrum disorder: A systematic review

“…Neurocognitive deficits are commonly reported among the general population of justice‐involved individuals, particularly in areas of executive function (Morgan & Lilienfeld, 2000; Ogilvie et al., 2011), decision‐making (Jones et al., 2019), intellectual functioning and attention (Harker, 2014; LaDuke et al., 2017). Similarly, high rates of non‐credible responding, as judged by Performance Validity Tests (PVTs), have been reported in this population (Ardolf et al., 2007).…”

The role of inhibition capacities in the Iowa gambling test performance in young tattooed women

“…As a simulation of real-life decision-making, the IGT involves weighing expected, but uncertain, rewards and penalties (for review [40]). Diminished performance on the IGT expresses the participant’s failing to learn from punishment cues, and ability to improve their decisions in the face of changing contingencies [40]. The IGT is a favored measure available to gauge risky decisions [22].…”