Below are some links to academic research papers that we have published recently, in the area of neurodisability and criminal justice. If you’d like any more information you can get in touch with us by emailing hnk201@exeter.ac.uk.
Traumatic brain injury: Improving prevention, access to care, and clinical research
Maas, A., Menon, D., Manley, G… Kent, H… Williams, H… et. al. (2022). Traumatic brain injury: Improving prevention, access to care, and clinical research. The Lancet: Neurology, DOI: https://doi.org/10.1016/S1474-4422(22)00309-X.
Abstract:
Traumatic brain injury (TBI) has the highest incidence of all common neurological disorders, and poses a substantial public health burden. TBI is increasingly documented not only as an acute condition but also as a chronic disease with long-term consequences, including an increased risk of late-onset neurodegeneration. The first Lancet Neurology Commission on TBI, published in 2017, called for a concerted effort to tackle the global health problem posed by TBI. Since then, funding agencies have supported research both in high-income countries (HICs) and in low-income and middle-income countries (LMICs). In November 2020, the World Health Assembly, the decision-making body of WHO, passed resolution WHA73.10 for global actions on epilepsy and other neurological disorders, and WHO launched the Decade for Action on Road Safety plan in 2021. New knowledge has been generated by large observational studies, including those conducted under the umbrella of the International Traumatic Brain Injury Research (InTBIR) initiative, established as a collaboration of funding agencies in 2011. InTBIR has also provided a huge stimulus to collaborative research in TBI and has facilitated participation of global partners. The return on investment has been high, but many needs of patients with TBI remain unaddressed. This update to the 2017 Commission presents advances and discusses persisting and new challenges in prevention, clinical care, and research.
Traumatic Brain Injury: A potential cause of violent crime?
Williams, W. H., Chitsabesan, P., Fazel, S., McMillan, T., Hughes, N., Parsonage, M., & Tonks, J. (2018). Traumatic brain injury: A potential cause of violent crime? The Lancet: Psychiatry, 5 (10), 836-844.
Abstract:
Traumatic brain injury (TBI) is the biggest cause of death and disability in children and young people. TBI compromises
important neurological functions for self-regulation and social behaviour and increases risk of behavioural disorder
and psychiatric morbidity. Crime in young people is a major social issue. So-called early starters often continue for a
lifetime. A substantial majority of young offenders are reconvicted soon after release. Multiple factors play a role in
crime. We show how TBI is a risk factor for earlier, more violent, offending. TBI is linked to poor engagement in
treatment, in-custody infractions, and reconviction. Schemes to assess and manage TBI are under development. These
might improve engagement of offenders in forensic psychotherapeutic rehabilitation and reduce crime.
Poor parental supervision associated with traumatic brain injury and reactive aggression in young offenders.
Kent, H., Williams, W. H., Hinder, D., Meadham, H., Hodges, E., Agarwalla, V., Hogarth, L., & Mewse, A. J. (2021). Poor parental supervision associated with traumatic brain injury and reactive aggression in young offenders. Journal of Head Trauma Rehabilitation, 37 (2), 65-70.
Abstract:
Objective: To establish whether poor parental supervision is associated with head injury and self-reported reactive aggression (ie, aggression in response to perceived provocation or threat) in adolescents in a Young Offender’s Institute, by examining correlations between these variables. Understanding this population is important, as they are at a key pivotal age for intervention to prevent lifelong reoffending.
Methods: Ninety-six male participants aged 16 to 18 years were recruited from a UK Young Offender’s Institute. Self-report measures of remembered parenting, reactive aggression, and head injury history were administered during individual interviews.
Results: Seventy-four percent of participants reported having experienced a lifetime traumatic brain injury (TBI), and 46% of participants reported experiencing at least 1 TBI leading to a loss of consciousness (LOC). We found that poor parental supervision, length of LOC following TBI, and self-reported reactive aggression were all positively correlated.
Conclusions: Findings show that there are correlational relationships between poor parental supervision, length of LOC following lifetime TBI, and higher levels of self-reported reactive aggression. This suggests there may be pathways resulting from poor parental supervision leading to both TBI with LOC, and reactive aggression. We advocate for future research with longitudinal designs and larger samples to examine the nature of these interactions, and to establish whether poor parental supervision is a prospective risk factor for more TBIs leading to LOC, and reactive aggression. This is key to understanding whether parenting interventions could help to reduce the disabling effects of TBI in adolescents, and help to prevent contact with the law.
A pilot study of brain injury in police officers: A sources of mental health problems?
Smith, N. I. J., Gilmour, S., Prescott-Mayling, L., Hogarth, L., Corrigan, J. D., Williams, W. H. (2021). A pilot study of brain injury in police officers: A source of mental health problems? Journal of Psychiatric and Mental Health Nursing, 28 (1), 43-55.
Abstract:
Police officers have a high risk of injury through assaults, road traffic incidents and attending domestic calls, with many officers developing post-traumatic stress disorder (PTSD) as a consequence. Traumatic brain injury (TBI) is a common injury in populations involved in conflict and has been extensively linked to mental health difficulties. However, current research has not explored the frequency and sequelae of TBI in police populations, despite the elevated risk of physical and emotional trauma specific to policing. Aim To explore self-reported TBI, PTSD, post-concussion symptoms, depression and drinking to cope in a small sample of UK police, to determine the frequency of these conditions and their relationships.
Measures of TBI, mental health, and drinking alcohol to cope were administered to 54 police officers from a Midshire Police Constabulary. Mild TBI with loss of consciousness was reported by 38.9% of the sample. TBI was associated with increased post-concussion symptoms (PCS). PCS were associated with greater severity of PTSD, depression and drinking to cope.
Exploring TBI in the police could identify a major factor contributing towards ongoing mental health difficulties in a population where, based on previous research, the implications of TBI should not be overlooked, highlighting the need for further research in this area. Implications for Practice This research spans to identify the importance of routine assessment and increasing awareness within mental health services. Mental health treatments should be made amenable to a population with potential memory, planning and impulse control deficits. Further work in mental health services is needed to understand the level of ongoing issues that are due to post-concussion symptoms and those that are due to other mental health difficulties, such as PTSD, thereby educating patients on the association between TBI and emotional difficulties. A graduated return-to-work plan should be developed to enable a safe transition back to work, whilst managing any ongoing symptoms.