10.3886/ICPSR20349.v1 RTI International Neuropsychological and Emotional Deficits as Predictors of Correctional Treatment Response in Maryland, 2003-2005 Inter-university Consortium for Political and Social Research 2008 addiction aggression behavior modification behavior problems cognitive processes correctional facilities decision making emotional states evaluation human behavior inmates intervention strategies personality assessment program evaluation residential programs substance abuse treatment facilities treatment outcomes treatment programs 2008-03-31 2008-03-31 2003-03 2005-12 administrative records data, clinical data, and survey data 20349 1 The study was designed to elucidate underlying neuropsychological and emotional regulatory mechanisms in variable responses to a cognitive-behavioral therapy (CBT) program among prison inmates. This study tested the hypotheses that performance deficits in executive cognitive function (ECF) tasks and emotional responses will characterize aggressive and disruptive inmates and predict treatment response. All subjects were examined using noninvasive behavioral, psychological, ECF, and hormone tests. The data contain a total of 232 cases. Inmates volunteering to participate in the cognitive-behavioral therapy (CBT) program offered by the Maryland correctional system were recruited from three facilities using a pseudo-random selection procedure during intake into the program. Consenting inmates received an extensive baseline testing battery of several complementary dimensions of higher order neuropsychological functions as well as conditions that influence them: (1) three ECF tasks and one emotional perception task, (2) collection of salivary cortisol during an acute stress task and the Symptom Checklist 90 (SCL-90) taken beforehand, (3) a short general neuropsychological test, (4) three psychological questionnaires, (5) an historical inventory to assess prior drug use and child and family background, and (6) a treatment readiness, responsivity, and gain scale. An events inventory and a success inventory were also administered. Several additional tests were administered repeatedly throughout treatment. A record review was conducted after program completion to ascertain incidents of institutional misconduct as well as treatment performance outcomes. Variables include IQ, demographics, background information, prior drug use, early trauma, psychopathy, aggression, stressful events, success, reactions to provocation, treatment readiness, emotional perception/regulation, executive cognitive performance, cortisol measures, treatment gain, treatment responsivity, treatment completion, Maryland Offender Based State Correctional Information System (OBSCIS) data, institutional infractions, segregations, and several other computed variables. The study was designed to elucidate underlying neuropsychological and emotional regulatory mechanisms in variable responses to a cognitive-behavioral therapy (CBT) program among prison inmates. The purpose of this project was to assess (1) the role of neuropsychological and emotional deficits in behavioral problems and misconduct among inmates, (2) the usefulness of neuropsychological and emotional regulatory measures in characterizing recalcitrant and unresponsive inmates, and (3) the ability of these measures to predict treatment response in prison.

This study tested the hypotheses that performance deficits in executive cognitive function (ECF) tasks and emotional responses will characterize aggressive and disruptive inmates and predict treatment response. All subjects were examined using noninvasive behavioral, psychological, ECF, and hormone tests. Adjustments were made for age in all analyses.

The data contain a total of 232 cases. Inmates volunteering to participate in the cognitive-behavioral therapy (CBT) program (Thinking, Deciding, Changing, Communications, Relationships) offered by the Maryland correctional system were recruited from three facilities using a pseudo-random selection procedure during intake into the program. Several characteristics were exclusionary, including illiteracy, low IQ (less than 70), over age 49, and active mental illness.

Consenting inmates received an extensive baseline testing battery of several complementary dimensions of higher order neuropsychological functions as well as conditions that influence them: (1) three ECF tasks (the Cambridge Decision Making Task, the Logan Stop-Signal Task, and the Stroop Interference Task) and one emotional perception task (Emotional/Facial Expression Task), (2) collection of salivary cortisol during an acute stress task (public speaking) and the Symptom Checklist 90 (SCL-90) taken beforehand to determine present psychological state, (3) a short general neuropsychological test: the Multidimensional Aptitude Battery (MAB), (4) three psychological questionnaires: the Levenson Self-Report Psychopathy (LSRP) scale, the Reactive-Proactive Questionnaire (RPQ), and the Early Trauma Questionnaire, (5) an historical inventory: a revised version of the Addiction Severity Index (ASI) to assess prior drug use and child and family background (e.g., family dysfunction, child abuse, and family history of psychopathology), and (6) a treatment readiness, responsivity, and gain scale. An events inventory and a success inventory were also administered. Salivary cortisol samples were collected before and after administration of a stress (public speaking) as a measure of stress reactivity. The test session took about 2 to 2.5 hours to complete. The Director of Health Services in the Department of Public Safety and Correctional Services provided approval to survey their Management Information System: the Maryland Offender-Based State Correctional Information System (OBSCIS) during this study to characterize inmates in terms of their history of crimes and institutional infractions and segregations. These instruments were assessed for their ability to characterize inmates into clinically relevant subtypes (e.g., history of violence, drug abuse, impulsive or nonimpulsive aggression, psychopathy, etc.).

Several additional tests were administered repeatedly throughout treatment. After each treatment group, inmates completed the Novaco Reaction to Provocation Questionnaire (NAS), which is sensitive to change in aggressive orientations in response to treatment, and social workers completed an evaluation of each inmate participating in the research. These evaluations produced a treatment responsivity score and a gain score. One neuropsychological test, the Cambridge Decision Making Task, was readministered to assess change in executive decision making. Following baseline assessments, inmates from the three prisons received similar CBT programming. A record review was conducted after program completion to ascertain incidents of institutional misconduct as well as treatment performance outcomes.

Variables include IQ, demographics, background information, prior drug use, early trauma, psychopathy, aggression, stressful events, success, reactions to provocation, treatment readiness, emotional perception/regulation, executive cognitive performance, cortisol measures, treatment gain, treatment responsivity, treatment completion, Maryland Offender Based State Correctional Information System (OBSCIS) data, institutional infractions, segregations, and several other computed variables.

IQ variables from the Multidimensional Aptitude Battery (MAB) include verbal IQ, performance IQ, and full scale IQ. Demographic variables from the revised version of the Addiction Severity Index (ASI) (McLellan et al., 1992) include age, race, religion, marital status, weight, height, and handedness. Background variables from the ASI include prison, months in prison, years of education, occupation, hospitalizations, chronic medical problems, current medications, history of head injury/black outs, and how long for black outs. Prior drug use variables also from the ASI include history, and age started and ever used the following substances: alcohol, heroin, methadone, opiates, depressants, cocaine, stimulants, marijuana, hallucinogens, inhalants, and ecstasy. Other drug use variables in the ASI measure drug of choice, DTs, ODs, treatment, months of last voluntary abstinence, family history, and extended family history.

Variables included from the Early Trauma Inventory pertain to stressful events, physical abuse, emotional abuse, and sexual abuse. Primary and secondary scores from the Levenson Self-Report Psychopathy (LSRP) scale (Levenson et al., 1995), proactive and reactive scores from the Reactive-Proactive Questionnaire (RPQ) (Raine et al., in press), events inventory scores, and success inventory scores are also included as variables. Other variables include scores from the Reaction to Provocation Questionnaire (NAS) (Novaco, 1990) measured at four times, scores from the Treatment Readiness Scale developed by Ralph Serin (Director of Programs Research, Correctional Service of Canada), scores on the Symptom Checklist 90 (SCL-90), and scores on the Treatment Responsivity and Treatment Gain scales developed by Ralph Serin.

Additionally, performance scores from the following tasks are included: the Cambridge Decision Making Task (CDMT: Rogers et al., 1999a, and 1999b), the Logan Stop-Change Task, the Stroop Interference Task, and the Emotional/Facial Expression Task. Cortisol Assessment measures are included as variables as well as OBSCIS data such as offense data, institutional infractions, and segregations. Furthermore, several other computed variables are also included.