Bully on the Brain
But the findings from the USC study raise legal and ethical questions about whether some violent offenders are completely responsible for their actions, and whether they can or should be treated with specific interventions that could curb impulsive behaviors and dampen their aggressive tendencies so that they no longer present a threat to society at large.
"I don't think anyone would argue that you can treat extreme antisocial behavior by locking people away, but then how would we treat them, and is it possible to prevent such behaviors from occurring in the first place?" asks M. Marsel Mesulam, MD, in an interview with WebMD seeking objective analysis. Mesulam is professor of psychiatry and behavioral sciences at Northwestern University Medical School in Chicago.
"The exciting part would be if this could be a marker to identify children who are at increased risk for this troublesome adult outcome, and if it would have sufficient accuracy to pick up children who are at risk for this condition, because that's a prerequisite for any targeted intervention program," agrees David R. Offord, MD, director of the Centre for Studies of Children at Risk at McMaster University in Hamilton, Ontario.
If the causes of the underlying problem can be identified, it could allow doctors to design therapies such as drugs or surgery to treat the specific brain defect, combined with other strategies such as psychiatric treatment and behavioral therapy. Such therapies would be likely to be more effective in children, whose brains are more adaptable to change than those of adults, says researcher Adrian Raine, DPhil, professor of psychology at the USC, in an interview with WebMD.
"We have to try to discover what the causes of the prefrontal damage are, and that's what we can't answer at the moment," Raine says. "The deficit could occur from environmental factors, such as birth complications, which could traumatize the brain. We did research a few years ago showing that birth complications predispose to violent offending in adulthood. Perhaps if we gave under-served mothers better prenatal and postnatal health care, we might be in a better position to do something about reducing one of the sources of prefrontal damage."