Traumatic Brain Injury and Executive Functioning in an Incarcerated Sample

TRAUMATIC BRAIN INJURY AND EXECUTIVE FUNCTIONING IN AN INCARCERATED SAMPLE Abigail A. Bernett, M.A. Marquette University, 2012 Incarcerated adults in the United States represent a significant segment of the population, and traumatic brain injury (TBI) in incarcerated populations has been identified as an area of public health concern. However, not much is known about it because research investigating TBI in incarcerated populations has focused primarily on its relationship to violent behavior. The existing research suggests that a history of TBI may be related to later violent behavior, criminal activity, mental health problems, and poorer institutional and community adjustment. Further, some of the cognitive deficits found in the general population following TBI, including executive dysfunction, have also been found in incarcerated populations. The purpose of the current study was to address a gap in the research by examining the relationship between TBI and executive functioning in a sample of adults incarcerated in the Federal Prison System. The study aimed to describe the neurocognitive functioning of the sample in the domains of IQ, executive functioning, verbal memory, attention, and motor skills. Further, hypotheses based on the theory of cognitive reserve were tested regarding the relationships between TBI, executive functioning, and institution behavior. Overall, the sample demonstrated average performance across the majority of cognitive domains tested. The range of scores in all domains spanned from profound impairment to superior performance. Multivariate analysis of variance was used to look for differences in executive functioning across varying levels of TBI severity, though no significant difference was found. Regression analyses found that lower cognitive reserve was associated with lower executive functioning, though structural equation modeling did not support a relationship between executive functioning and subsequent institutional behavior. Caveats in interpreting test scores, particularly in the domain of executive functioning, are discussed, along with possible explanations for differences in cognitive functioning across incarcerated subgroups. Based on the findings of this study, it is recommended that correctional institutions increase screening and cognitive testing of individuals who present with risk factors for possible executive dysfunction (e.g., history of violent offenses, TBI) in order to better classify the inmate population. Further, individualized treatment and the incorporation of programming that specifically targets executive dysfunction are recommended.