This study surveyed 199 forensic clinicians about the practices that they use in assessing violence risk in juvenile and adult offenders. Results indicated that the use of risk assessment and psychopathy tools was common. Although clinicians reported more routine use of psychopathy measures in adult risk assessments compared with juvenile risks assessments, 79% of clinicians reported using psychopathy measures at least once in a while in juvenile risk assessments. Extremely few clinicians, however, believe that juveniles should be labeled or referred to as psychopaths. Juvenile risk reports were more likely than adult reports to routinely discuss treatment and protective factors, and provide recommendations to reevaluate risk. The implications of these findings are discussed.

Identification of factors that predict recurrent antisocial behavior is integral to the social sciences, criminal justice procedures, and the effective treatment of high-risk individuals. Here we show that error-related brain activity elicited during performance of an inhibitory task prospectively predicted subsequent rearrest among adult offenders within 4 y of release (N = 96). The odds that an offender with relatively low anterior cingulate activity would be rearrested were approximately double that of an offender with high activity in this region, holding constant other observed risk factors. These results suggest a potential neurocognitive biomarker for persistent antisocial behavior.R isk assessment is a major component of criminal justice and treatment decisions. One crucial application of such predictions is the ability to identify, manage, and remediate antisocial behavior. Decisions that rely on antisocial risk prediction pervade the justice system, beginning with recommendations for bail, jail, and probation to sentencing, civil commitment, parole decisions, diversion, and treatment program assignments, to name a few. Initial attempts to predict future antisocial behavior based purely on clinicians' opinions have been shown to be highly inaccurate (1). Subsequent research that used evidence-based static (e.g., age, sex, criminal history) and dynamic (e.g., impulsivity, drug use, social support) risk factors have led to significant improvements in predicting future antisocial behavior (2-4).One of the strongest and most widely studied risk factors for recidivism is impulsivity, or behavioral disinhibition, the persistent lack of restraint and consideration of consequences (3). Risk assessments, personality tests, and neuropsychological measures have been used to assess impulsivity and have demonstrated the ability to predict future antisocial behavior. However, these latter measures serve only as proxies for direct measurement of the brain's inhibitory and cognitive control systems. Indeed, neuroscientists have suggested that endophenotypes carry the potential to characterize underlying traits and abnormalities independently of behavioral phenotypes (5). This stance has been supported by recent functional MRI (fMRI) studies that have, for instance, accurately predicted choices in a motor-decision task (6), substance abuse relapse (7-10), and consumer purchases (i.e., neuromarketing) (11). These results raise the possibility that more direct measures of brain activity associated with impulse control may lend incremental utility to the prediction of future antisocial behavior.The brain regions associated with impulse control have been well characterized. Consistent among these regions is the anterior cingulate cortex (ACC), a limbic region associated with error processing, conflict monitoring, response selection, and avoidance learning (12-16). Neurobiological models suggest that the ACC is central to an error-monitoring circuit wherein it relays error information from the basal ganglia and inferior fron...

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Several authors have expressed concern regarding the use of youth psychopathy assessments in determinations of risk for general and violent offending. The Psychopathy Checklist: Youth Version (PCL:YV) was completed with 182 male adolescent offenders in this prospective study (average 14.5 month follow-up) of general and violent recidivism. Both a two-factor and three-factor model of the PCL:YV significantly predicted general and violent recidivism at a predictive accuracy ranging from 68 to 63%. However, regression analyses indicated these associations were explained primarily by behavioral psychopathic symptoms, rather than interpersonal or affective traits. Implications for the use of psychopathy assessments for risk during adolescence are discussed.

Etiological models of life-course persistent offending often emphasize behavioral explanations. Suggestions that persistent offenders have psychopathy ignore the distinct non-behavioral features of the psychopathy disorder. Using a three-factor model of the PCL-YV and cluster analysis with 259 incarcerated adolescents, we identified four distinct juvenile subtypes on the basis of affective, interpersonal, and behavioral dimensions. Prospective and retrospective comparisons of antisocial behavior patterns found the cluster comprising all three psychopathy dimensions to be the most chronic and severe. Impulsive features alone were strongly associated with severe antisocial behaviors retrospectively, but not prospectively. Findings rebut the proposal that disruptive behavioral and impulsive symptoms can identify \u22fledgling psychopaths.\u22 Assessments that disregard callous-unemotional traits will likely result in high false positive rates among serious adolescent offenders. Implications for developmental models of chronic offending are discussed in light of the need for further follow-up into adulthood