Domestic Violence and Executive Dysfunction

Executive function has big implications for the design of domestic violence programs. It is important to know the subtypes of batterers because different subtypes have different needs for treatment, and different levels of intervention that are necessary to ensure safety. I’ll refer to some very recent studies that address domestic violence and executive function problems.

Research on domestic violence and cognitive problems largely centers around executive function that is known to be managed in the frontal cortex of the brain. Footballs have no frontal cortex at all, and will hit anyone. But you knew that.

One of the key aspects of executive function deficits is impulsivity. However, as with all neat categories that we are learning vast amounts of information about, impulsivity is a multidimensional construct. Neuropsychological testing does not do a lot to help us assess impulsivity, especially in our efforts to prevent violence. The best way to assess it, is to look at the person’s behavior in real-life situations. For therapists, social programs, and physicians, that means that it is folly to think that you have assessed a person suspected of domestic violence by talking to them, in so far as impulsivity is concerned. Getting collateral information (talking to family members, looking at arrest record and other background information) is essential. There is even a study that is encouraging for assessing impulsivity in clinical settings for some people.

A key question about impulsivity is how much the problem is a matter of impaired restraint, as opposed to how much the strength of the impulse is the problem. Is it the intensity of the drive to act, or is it a poor ability to exercise “free won’t” by resisting an urge (a failure of inhibitory control). Or is it both? In one study of violent offenders, time pressure reduced inhibition of errors, supporting the idea of frontal cortical deficits because the violent offenders in the test only performed poorly under time pressure conditions in which they had less ability to exercise conscious control. This suggests that inhibitory control may play a larger role. It suggests that batterers don’t need to be more emotionally aroused prior to being violent so much as that many are impaired in exercising control.

The study of suicide is an allied area, because it is a violent act and can be associated with violence against others in various ways. A recent study showed executive dyscontrol in actively suicidal people. The researchers believed that there was a state-dependent component. This is a subject for another post, but dissociation and triggers of behavior and emotion are very important here. In this study, impaired decision making was the strongest feature. Suicidal ideation without a strong impulse to act, says the article, was more likely to have rigid thinking behind it. However, both (thinkers and those at higher risk) had higher levels of aggression.

We need to look at every angle on how to improve treatment and sentencing, because the rates of recidivism are high. This is especially true for people with criminal lifestyles. Those who were prone to using weapons in violence, who engaged in other crimes, and who used drugs were very likely to batter, abuse drugs, or engage in other criminal activity over ten years following arraignment (when the study began). The first year, rates were roughly half of the full duration. This dynamic gives the impression that arrests, programs, restraining orders, and other measures are more effective than they actually are, because many studies do not look beyond a year.

References

Votruba, K.L., Rapport, L.J., Vangel, S.J., Hanks, R.A., Lequerica, A., Whitman, R.D., Langenecker, S. (2008). Impulsivity and Traumatic Brain Injury. Journal of Head Trauma Rehabilitation, 23(2), 65-73. DOI: 10.1097/01.HTR.0000314525.93381.69

CHEN, C., MUGGLETON, N., JUAN, C., TZENG, O., HUNG, D. (2008). Time pressure leads to inhibitory control deficits in impulsive violent offenders. Behavioural Brain Research, 187(2), 483-488. DOI: 10.1016/j.bbr.2007.10.011

Westheide, J., Quednow, B.B., Kuhn, K., Hoppe, C., Cooper-Mahkorn, D., Hawellek, B., Eichler, P., Maier, W., Wagner, M. (2008). Executive performance of depressed suicide attempters: the role of suicidal ideation. European Archives of Psychiatry and Clinical Neuroscience DOI: 10.1007/s00406-008-0811-1

Klein, A.R., Tobin, T. (2008). A Longitudinal Study of Arrested Batterers, 1995-2005: Career Criminals. Violence Against Women, 14(2), 136-157. DOI: 10.1177/1077801207312396