Aggression and Violent Behavior 51 (2020) 101380

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Aggression and Violent Behavior

journal homepage: www.elsevier.com/locate/aggviobeh

Executive dysfunction, violence and aggression T

a,⁎ b,c a
Ana Rita Cruz , Andreia de Castro-Rodrigues , Fernando Barbosa
a
Laboratory of Neuropsychophysiology, University of Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal
b
Instituto Superior de Psicologia Aplicada (ISPA), Universitary Institute, Rua Jardim do Tabaco, nº341149-041 Lisboa, Portugal
c
Faculty of Law, University Lusíada North (Porto), Rua Dr. Lopo de Carvalho, 4369-006 Porto, Portugal

A R T I C LE I N FO A B S T R A C T

Keywords: Executive Functions (EFs) is an umbrella expression used for several processes and subprocesses encompassing
Executive functions goal-oriented behavior and decision-making strategies. However, the extent to which impaired EFs relate to and
Impulsivity characterize different types of criminal behavior and aggressiveness is not clear. Similarly, research on the
Aggression association between EFs and psychopathy has also produced mixed findings. The failure to disaggregate between
Violence
different types of crime and antisocial individuals can impede the identification of specific neurocognitive
Crime
Psychopathy
mechanisms associated with crime. We reviewed the extent to which EFs (according to Miyake latent variable
analysis) are associated with violent and non-violent crime, impulsive and premeditated aggression as well as
psychopathic traits.
Findings, although nonconsensual, suggest a more nuanced view on the association between EFs and crime,
suggesting that different executive domains might be more compromised in violent and impulsive individuals,
and specific psychopathy facets are more associated with executive dysfunction and criminality. Studies in line
with this approach will allow offenders to benefit from intervention strategies that will address their specific
deficits, optimizing their EFs and contributing to better cognitive management in demanding and complex si-
tuations, such as criminal and violent deterrence.

1. Introduction complications), (b) general upbringing (e.g., significant exposure to

Aggressive behaviors affect social, economic, legal, and political
areas, with enormous costs associated with violence and incarceration.
From the countries in the Organization for Economic Cooperation
and Development (OECD), in 2018, Portugal occupied the middle po-
sition regarding incarceration rates with 129 inmates per 100.000 in-
habitants (OECD, 2019). Statistics from the Portuguese prison system
(2017) reported a total of 11,335 Portuguese convicted inmates (81.5%
males) by the end of 2017. In Portugal, the crimes with higher pre-
valence are property crimes (29.3%), but crimes against people come in
a close second place (26%). Even though there is a considerable impact
of criminal behaviors on society, there is no consensus regarding the
directionality of the relationship between aggressive behavior, crime,
and related variables, such as aggressive patterns or psychopathy.
Throughout history, aggressive behavior has been analyzed as a
behavioral expression, triggered in response to a perceived threat
(Tirapu-Ustárroz, García Molina, Ríos-Lago, & Ardila, 2012). There are
psychosocial explanations and intergenerational factors that may pre-
dispose the individual to later (adult) aggression and violence, such as
(a) prenatal risk factors (e.g., fetal exposure to alcohol, obstetrical
violence, socioeconomic status and cultural background), (c) being
physically and sexually abused, (d) parenting style and childhood
maltreatment (e.g., parental absence or early maternal rejection), (e)
genetic predisposition, (f) brain lesions, (g) early health risk factors, (h)
peer groups, and (i) living in a low-income neighborhood (Bergeron &
Valliant, 2001; Broomhall, 2005; Friedman, Rhee, Ross, Corley, &
Hewitt, 2018; Hancock, Tapscott, & Hoaken, 2010; Ishikawa, Raine,
Lencz, Bihrle, & Lacasse, 2001; Pennuto, 2007; Raine, 2019; Volavka,
1999). The former factors are influenced by variables such as age,
gender differences, cognitive functioning, psychopathic facets, hyper-
activity symptoms, psychopathology, social skills, attitudes, personality
traits, and intelligence (Hancock, 2014; Mol, Van Den Bos, Derks, &
Egger, 2009; Ogilvie, Stewart, Chan, & Shumd, 2011; Paschall &
Fishbein, 2002). The numerous factors related to aggression and po-
tential criminality require a multiple factor approach based on the
heterogeneity of criminal acts and human behaviors (Bergeron &
Valliant, 2001). Among those factors are the psychobiological ones, in
which executive functions (EFs) are comprised.
EFs can be defined as cognitive processes (although motivationally
affected) that integrate ideas, thoughts, movements, and actions during

⁎
Corresponding author at: Faculty of Psychology and Educational Sciences of the University of Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal.
E-mail addresses: anaritacruz@fpce.up.pt (A.R. Cruz), arodrigues@ispa.pt (A. de Castro-Rodrigues), fbarbosa@fpce.up.pt (F. Barbosa).

https://doi.org/10.1016/j.avb.2020.101380
Received 30 January 2019; Received in revised form 25 July 2019; Accepted 27 January 2020
Available online 15 February 2020
1359-1789/ © 2020 Published by Elsevier Ltd.
A.R. Cruz, et al.
complex situations that require solving problems or inhibiting in-
appropriate responses. Impairments in executive functioning are related
to self-regulation problems and regulation of socially appropriate be-
havior, and so, individuals with executive deficits are more prone to
show aggressiveness and impulsive behavior (Ogilvie et al., 2011).
Executive dysfunction can, therefore, be associated with difficulties in
attention control, impulsivity, rigidity, carelessness, planning goal-or-
iented behaviors (e.g., difficulty on setting goals), reduced capacity for
self-control, emotional lability, cognitive flexibility or adaptive orga-
nization of information (Jackson, Loxton, Harnett, Ciarrochi, & Gullo,
2014; Morgan & Lilienfeld, 2000; Ogilvie et al., 2011; Paschall &
Fishbein, 2002). When in the presence of executive dysfunction, the
individual tends to perseverate in one single strategy to solve problems
(Pino & Werlang, 2006), showing difficulties to self-regulate or monitor
the behavior in an appropriate manner (Paschall & Fishbein, 2002)
which can result in aggressive and violent actions.
Our review aims to provide an overview of the research in the field
of EFs and crime by describing the extent to which EFs are associated to
antisocial and criminal behavior, explicitly exploring whether this re-
lationship might vary according to aggressiveness or psychopathy.
2. Executive functioning, aggression, and violent criminality
Although the first references to executive functioning and ag-
gressive and violent behavior were associated with the description of
lesions and impairments in the prefrontal cortex, that is not the ob-
jective of this research. One of the aims of the current work is to revise
the role of executive functioning in antisocial behaviors, particularly in
violent criminality, from a neuropsychological perspective (Deu, 1998;
Dolan & Anderson, 2002; Hancock et al., 2010; Morgan & Lilienfeld,
2000; Ogilvie et al., 2011; Ross & Hoaken, 2011). Since these concepts
may be overlapped, it is important to distinguish them and clarify its
use in the literature.
Humans have a predetermined ability to plan and imagine future
situations and forecast the consequences of their conduct. This ability is
a direct manifestation of intact executive functioning. EFs emerge from
the association between situations that require a solution, and our ca-
pacity to plan and preview the outcome of our actions (Tirapu-Ustárroz
et al., 2012). EFs can be defined as cognitive processes (although mo-
tivationally affected) that integrate ideas, thoughts, movements, and
actions during complex situations that require solving problems or in-
hibiting inappropriate responses.
Executive functioning can be analyzed according to three domains,
namely (a) Inhibition –deliberate inhibition of a dominant or prepotent
response; (b) Shifting – defined as the ability to perform a new opera-
tion in the face of proactive interference; and, (c) Updating - char-
acterized as the ability to actively hold information in mind, replacing
old, no longer relevant information with newer, more relevant in-
formation (Miyake et al., 2000). Accordingly, EFs are responsible not
only for regulating thoughts and actions, but also for promoting an
adaptive behavior, and consequently, have a crucial role in under-
standing violent behaviors. Executive processes are responsible for
goal-directed behaviors, decision making, activation, and inhibition of
actions (Ogilvie et al., 2011). Executive deficits are associated with
antisocial behavior (ASB), such as criminality, delinquency, physical
aggression, conduct disorders, as well as psychopathy and other per-
sonality disorders (Morgan & Lilienfeld, 2000).
Aggressive behavior is a multifaceted construct, defined as overt
and intentional against another person, which may be expressed be-
haviorally in different ways (Parrott & Giancola, 2007; Volavka, 1999).
Aggression and violence, although used interchangeably, should also be
accounted as two constructs, even if they are part of the same con-
tinuum (Allen & Anderson, 2015). Aggression requires the individual's
ability to act with the intent to cause harm to a second or third party.
Violence is considered a severe form of aggression, aiming to cause
severe harm.
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Aggression and Violent Behavior 51 (2020) 101380
Evidence of the relationship between executive dysfunction and
subtypes of aggression comes from data that support significant asso-
ciations between prefrontal dysfunction, as measured by neu-
ropsychological tests, and antisocial and aggressive behavior (Brower &
Price, 2001; Paschall & Fishbein, 2002). Offenders tend to demonstrate
lower executive skills, deficits in social abilities, lack of foresight, poor
judgment, impulsivity, and immaturity. Therefore, their executive
functioning distinguishes them from non-offenders (Bergeron &
Valliant, 2001). Offenders also reveal marked deficits in their ability to
interpret social cues, empathic behavior, and problem-solving abilities
(Bergeron & Valliant, 2001). Nonetheless, according to Miyake's EFs
model (2000), instead of a general executive dysfunction, offenders
could be impaired on a single executive domain, and not necessarily on
the other domains (e.g., updating deficits appear to be more prominent
in impulsive offenders). Additionally, executive functioning deficits
seem to be more noticeable on groups of individuals with persistent and
severe behavioral problems (Barker et al., 2007; Greenfield & Valliant,
2007; Morgan & Lilienfeld, 2000; Ogilvie et al., 2011). Offenders who
show executive impairments, perform worse on executive measures,
and act more aggressively and violently (Dolan & Anderson, 2002;
Hoaken, Shaughnessy, & Pihl, 2003). Thus, it is plausible that this be-
havior pattern is due, at least partly, to behavioral disinhibition, cog-
nitive rigidity, and difficulties with generating alternative non-ag-
gressive responses (Giancola, Roth, & Parrott, 2006).
There is also evidence that recidivist inmates, regardless of offense
levels, perform worse on EFs measures, and one possible explanation is
a defective inhibition mechanism (cf. Ross & Hoaken, 2011). This may
be because first time convicted inmates were not exposed to the same
amount of risk factors, such as traumatic brain injury, persistent deviant
trajectory, substance abuse or detrimental prison impact (Ross &
Hoaken, 2011). Other explanation might be aging, since EFs are vul-
nerable to the aging process. Because of that it might be more difficult
to prevent recidivism in older individuals. For example, the speed of
processing decreases with age, increasing reaction times. Likewise,
lower IQ along with lower educational background, which often char-
acterizes offenders' samples, are associated with poor executive per-
formance (Baker & Ireland, 2007).
Baker and Ireland (2007) collected longitudinal self-report data of
physical violence and theft on a sample of men and described that
physical violence and theft show different developmental trajectories
during adolescence and early adulthood. Particularly, individuals that
committed physical violence performed worse on tasks of verbal and
executive functioning, whereas those who committed theft showed
better performance on both verbal and executive tasks. Additionally,
the developmental trajectories of offenders who committed physical
violence and theft reflected different neurocognitive functioning. Ex-
ecutive dysfunction seems to have a stronger relationship with violent
crimes, than with non-violent crimes (Ross & Hoaken, 2011). These
results suggest that those who engage in violent behaviors are more
impaired than non-violent offenders (Baker & Ireland, 2007; Barker
et al., 2007; Hancock, 2014; Miura, 2009). Therefore, across studies, it
has been found that there is a consistent and robust association between
performance on executive measures, and offensive and violent, or
simply aggressive behaviors (Baker & Ireland, 2007; Bergeron &
Valliant, 2001; Broomhall, 2005; Ogilvie et al., 2011). Hence, executive
dysfunction might be varying according to the type of offense and its
severity. Therefore, research comprising participants of forensic set-
tings started to consider them also in terms of the severity of their
aggressive acts (violent or non-violent). (Hancock, 2014; Hancock
et al., 2010).
However, other studies have compared the executive performance
of violent and non-violent offenders and reported the existence of
considerable overlap between them (Greenfield & Valliant, 2007;
Hoaken, Allaby, & Earle, 2007; Pennuto, 2007; Robertson, Taylor, &
Gunn, 1987). Hoaken et al. (2007) reported that both violent and non-
violent offenders performed poorly on EF measures compared to
A.R. Cruz, et al.
controls, and violent offenders did not perform significantly worse than
non-violent ones. Furthermore, Pennuto (2007) only found minimal
significant differences in the inhibition/divided attention task when
violent offenders were compared to non-violent offenders on measures
of EFs.
Keeping the focus on violent crimes, although some offenders have a
markedly planned and predatory criminal trajectory, the majority have
a single act of unplanned, reactive violence (Hoaken et al., 2007).
Therefore, different neurocognitive functions can contribute differently
to the type of crime committed and the pattern of aggression re-
presented. Still, it is not consensual which criteria to adopt to identify
and classify offenders, because the focus could be on their attitudes
(e.g., hostility), emotions, the impact of psychotropic substances, or the
relationship with the victim (Hancock et al., 2010). Under these cir-
cumstances, in addition to the current crime, the classification of the
offenders must also consider the history of previous convictions (e.g.,
Hoaken et al., 2007) and their aggressive patterns, namely if it is im-
pulsive or premeditated, at least.
Executive dysfunction is a risk factor for committing violent crimes,
which are characterized by higher impulsivity, tendencies to act out,
violation of social norms, and disregard for others (Bergeron & Valliant,
2001; Crowell, Kieffer, Kugeares, & Vanderploeg, 2003; Hoaken et al.,
2007). The inability to modify behavior in response to environmental
changes combined with inhibition deficits could contribute to sig-
nificant difficulties in social situations, leading to increased violent
responses. EFs determine foresight capability, planning, previewing
ability, and impulse regulation that, when impaired, constitute a risk
factor for criminality. There is a high correlation between impulsivity
and aggression among offenders' samples (e.g., impulsivity correlates
with measures of response inhibition). Additionally, individuals from
those samples also demonstrate deficits in executive memory (Dolan &
Anderson, 2002). Also, there is a high prevalence of traumatic and
acquired brain injuries in prisoners' samples, which often result in
worse executive performance by those individuals (Hancock et al.,
2010; Marsh & Martinovich, 2006; Ross & Hoaken, 2011).
As EFs coordinate higher-order control mechanisms of thought,
action, and emotion, deficits in these domains may express a biological
vulnerability for aggression (Bufkin & Luttrell, 2005; Fabian, 2010). It
is not surprising that EFs often appear to be compromised in prisoners'
samples. Inmates tend to show deficits in cognitive supervisory capacity
(Dores et al., 2014), and in the maintenance of appropriate social and
intimate relationships, fundamental in the management of daily life
activities, such as administering finances, maintaining a job or dealing
adequately with provocative interpersonal situations (Hancock et al.,
2010).
Regardless of methodological limitations, namely (a) poor specifi-
cation of EFs, (b) small sample size, (c) lack of prospective data, (d)
absence of a control group or difficulties in the selection of a compar-
ison group, (e) failure to control for confounding factors, (f) the evi-
dence that not all individuals characterized as antisocial or with con-
duct disorder show executive impairments, and (g) the possibility that
there may be EFs differences even within criminals that committed the
same type of crime (Ogilvie et al., 2011; e.g., Ross & Hoaken, 2011),
executive impairments are a plausible and well documented explana-
tion for criminal conducts.
In summary, available evidence seems enough to suggest that ex-
ecutive deficits are more common in individuals who engage in anti-
social behavior, particularly in violent criminal behavior when com-
pared to non-violent offenders. Such deficits also seems to characterize
male teenagers and young adults with persistent antisocial behavior
during their lives (Raine et al., 2005). However, more research is ne-
cessary on the executive functioning differences between violent and
non-violent offenders, as well as between violent offenders of distinct
types.
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Aggression and Violent Behavior 51 (2020) 101380
3. Impulsive and premeditated aggression
Regardless of the heterogeneity of aggressive behaviors (either
violent or non-violent), these may be primarily impulsive or pre-
meditated, each differing in their origins, as well as in their behavioral
expression and underlying physiological mechanisms (Kockler,
Stanford, Nelson, Meloy, & Sanford, 2006; e.g., Volavka, 1999). Some
aggressive acts are rapid and unplanned reactions to external or in-
ternal stimuli, which result in aggressive outbursts, without regulation;
some are directed toward acquiring power over others, oriented by
goals with previous planning, displayed by an opportunistic offense, not
requiring anger nor provocation (Cornell, 1996; Meloy, 2006).
As impulsivity and premeditation are commonly considered the two
main types of primary aggression, and since these two types of ag-
gression have a different nature and may imply distinct levels of dan-
gerousness and arousal as well as responsivity to penal interventions,
violent perpetrators can be classified as predominantly impulsive or
predominantly premeditated (Houston, Stanford, Villemarette Pittman,
Conklin, & Helfritz, 2003; Stanford et al., 2003; Volavka, 1999). There
are constraints regarding the definition of aggression patterns. Im-
pulsive and premeditated aggression differ, for example, in the level of
planning. Impulsive individuals tend to react in response to intense
emotional stimuli, fail to control their impulses and correctly analyze
contextual cues, and do not account for possible negative consequences
of their actions on themselves or others (Moeller, Barratt, Dougherty,
Schmitz, & Swann, 2001). Typically, their aggressive outbursts are
emotionally charged (Villemarette-Pittman, Stanford, & Greve, 2003),
highly spontaneous (Broomhall, 2005), uncontrolled (Raine et al.,
1998), unpredictable, and occur in response to a perceived threat or
danger (Meloy, 2006). Hence, impulsive aggression is also known as
reactive, affective, emotional, expressive, or not planned (Meloy,
2006). The aggressiveness shown is usually out of proportion regarding
the psychosocial stimuli that caused it and constituted a risk factor for
involvement in ASB (Villemarette-Pittman et al., 2003).
In fact, “impulsive individuals are at greater risk for dropping out of
school, engaging in criminal activities, and seeking out more stimu-
lating environments” (Villemarette-Pittman et al., 2003, p. 1534). Im-
pulsive offenders demonstrate poor cognitive control and flexibility,
which in turn impairs their ability to understand possible alternative
behaviors, increasing the probability of recurring actions (Broomhall,
2005; Deu, 1998). As Bergeron and Valliant (2001) explain, the “ten-
dency toward action coupled with impulsivity implies that offenders do
not think through conceivable outcomes of a given situation or consider
the ramifications of their actions” (p. 39). Under these circumstances,
their ability to plan is compromised. Additionally, their impulsivity
level may correlate with neuropsychological impairments, resulting in a
worse performance on complex, speeded tests of planning and decision
making (Deu, 1998; Pietrzak, Sprague, & Snyder, 2008; Raine et al.,
1998), along with interpersonal aggression and violent crime (Hoaken
et al., 2003).
According to some authors (e.g., Dolan & Anderson, 2002; Kockler &
Stanford, 2008), working memory may play a significant role in im-
pulsivity among all executive domains. Memory is fundamental for
searching for regularities and similarities between situations; it links
past and future, and is decisive for the course of action to follow
(Kockler & Stanford, 2008). Poor inhibitory control accounts for the
decrease in the ability to store and maintain the information, leading to
poor emotional and impulse regulation that in turn would also con-
tribute to a defective working memory functioning (Hoppenbrouwers
et al., 2013). Impulsive individuals are more prone to memory im-
pairments, lacking the ability to follow an action-oriented course to-
ward the future and take appropriate decisions based on previous ex-
periences, unable to learn from their mistakes (Bergeron & Valliant,
2001; Deu, 1998; Dolan & Anderson, 2002; Kockler & Stanford, 2008;
Syngelaki, Moore, Savage, Fairchild, & Van Goozen, 2009). On the
contrary, lower levels of impulsivity are correlated to better working
A.R. Cruz, et al.
Fig. 1. Interrelations among phenotypic constructs of psychopathy (adapted from Barbosa, unpublished work; Patrick et al., 2009).
memory (Kockler & Stanford, 2008). However, various studies (e.g.,
Hoaken et al., 2007; Meijers, Harte, Jonker, & Meynen, 2015) also re-
port that other EFs besides working memory, such as set-shifting, ap-
pear to be impaired in both violent and non-violent offenders.
On the contrary, premeditation requires impulse control, planning,
forethought, and orienting behavior toward a goal (e.g., bullying, ob-
taining money, restoring one's self-image, securing power and dom-
inance over others or controlling criminal activities), and is in-
tentionally executed (Brower & Price, 2001; Cooke, Michie, De Brito,
Hodgins, & Sparkes, 2011; Villemarette-Pittman et al., 2003). Pre-
meditated aggression is also mentioned as instrumental, proactive,
predatory, and cold-blooded (Cornell, 1996; Mathias et al., 2007;
Meloy, 2006). Instrumental aggression is goal-driven and is usually
directed toward a stranger (Cornell, 1996). It becomes clear that intact
EFs in this group of offenders is essential to correctly respond to a
problematic situation or making appropriate changes based on con-
textual and social contingencies (Giancola et al., 2006). For example,
intact ability to switch flexibly between tasks or mental sets (Miyake &
Friedman, 2012), i.e., intact cognitive and behavioral flexibility, might
be significant features that describe premeditated individuals. These
individuals seem to be more focused on their goals and are more mal-
leable and better equipped to adapt to new contextual cues or situa-
tions.
When compared to impulsive offenders, who show executive defi-
cits (Villemarette-Pittman et al., 2003), previous studies suggest that
premeditated individuals do not demonstrate EFs difficulties, at least in
activities that require planning or abstract thinking (Broomhall, 2005;
Haberle, 2011). However, more research is necessary to explore how
different types of aggression relate to different executive capabilities
since these two types of aggression have different nature and may imply
distinct levels of dangerousness, as well as distinct levels of responsivity
to penal interventions.
4. EFs and psychopathy
Commonly defined as a personality disorder, psychopathy has been
inherently associated with antisocial and criminal behaviors. Deviant
traits, such as callousness, lack of remorse, egocentricity, pathological
lying and deception, lack of empathy and concern for others, absence of
guilt, impulsiveness, and ASB are characteristics of psychopathic in-
dividuals (Glenn, Kurzban, & Raine, 2011). These individuals are often
motivated by a personal gain to manipulate, harm, and exploit others
4
Aggression and Violent Behavior 51 (2020) 101380
(Sellbom & Phillips, 2013; Viding, 2004). Psychopathic individuals are
more susceptible to adopt violent, antisocial and risk behaviors, as well
as to relapse in such behaviors (Woodworth & Porter, 2002), and are
responsible for a large number of violent crimes (Patrick, Fowles, &
Krueger, 2009; Reidy, Shelley-Tremblay, & Lilienfeld, 2011). In-
dividuals with high levels of psychopathy present a distinct profile of
offending, and their neurocognitive features indicate problems in pro-
cessing distress in others and punishment directed to oneself (Viding,
2004). Moreover, in addition to the differences between psychopathic
and non-psychopathic offenders regarding their criminal behavior,
important distinctions occur inside the former group.
Psychopathy has been recently conceptualized as a multi-
dimensional construct, thus describing a heterogeneous group (Mol
et al., 2009), with different offending patterns. According to the
triarchic model (Patrick et al., 2009), psychopathy is considered a
multivariate construct and comprises three distinct phenotypes:
meanness, boldness, and disinhibition.
Meanness comprises lack of empathy, callousness, emotional de-
tachment, active exploitativeness, excitement seeking, rebelliousness,
instrumental or predatory aggression, abuse of others, destructiveness,
and empowerment through cruelty (Patrick, 2010; Patrick et al., 2009;
Venables, Hall, & Patrick, 2014). Boldness includes the capacity to re-
main calm and concentrated in stressful situations and to recover from
those events quickly. Finally, disinhibition reflects an externalizing
component of psychopathy, related to deviant behavioral problems in
child and adult populations, and substance addictions (Patrick et al.,
2009).
Although interrelated, these phenotypes can be measured sepa-
rately, and exhibit distinct psychological and neurobiological referents
(Patrick et al., 2009), as illustrated by Figure 1.
For example, disinhibition might have a deterrent effect on an in-
dividuals ability to switch its cognitive mindset, resulting in a risk
factor for responding inappropriately in complex social interactions.
Disinhibition is more related to impulsive, violent, callous, reactive
forms of aggression, and is associated with the abnormal functioning of
the prefrontal cortex and anterior cingulate cortex, which coordinates
behavior and regulates emotional responses (Patrick, 2010). As a result,
poor executive functioning mostly maps onto the phenotype of disin-
hibition (Patrick et al., 2009). Therefore, higher disinhibition scores
might be associated with an increased individual predisposition to en-
gage in antisocial behaviors in general and aggressive behaviors in
particular, either violent or non-violent.
A.R. Cruz, et al.
However, externalizing tendencies are not synonymous of psycho-
pathy. The “diagnosis” of psychopathy would be suitable only when
paired with other phenotypic features. I.e., higher scores on these
groups might reflect different outcomes and psychopathic paths
(Patrick et al., 2009): unsuccessful psychopaths tend to score higher on
both meanness and disinhibition facets (Patrick & Drislane, 2015).
However, successful psychopaths might result from the combination of
higher scores on meanness and boldness (Venables et al., 2014; Wall,
Wygant, & Sellbom, 2015). Additionally, each phenotypic construct
integrates diverse manifestations of the psychopathic personality and
correlates with other self-report approaches of the psychopathic per-
sonality (Sellbom & Phillips, 2013). For example, disinhibition and
meanness are depicted as moderately interrelated, and the combination
of the two would result in an increased vulnerability to the criminal
psychopathy; higher scores in disinhibition may play a critical con-
tribution to an unsuccessful pattern. In turn, the occurrence of suc-
cessful psychopathy would be better explained by higher scores on
boldness and meanness, and fewer externalization features (Patrick
et al., 2009).
Psychopathy has been presented as a robust predictor of criminal
violence (Salekin, Rogers, & Sewell, 1996) and recidivism (Andrade,
2008; Mol et al., 2009; Salekin et al., 1996; Woodworth & Porter,
2002), associated with more contacts with the criminal justice system,
and more violent incidents throughout incarceration (Andrade, 2008;
Hakkanen-Nyholm & Hare, 2009). Psychopathic individuals present
higher rates of criminal and violent recidivism and are more likely to be
convicted of violent offenses than their non-psychopathic counterparts
(Andrade, 2008).
Also, the literature suggests a link between psychopathic traits,
aggression, and executive dysfunction (Blair et al., 2006; Woodworth &
Porter, 2002). Regardless, it is not consensual whether psychopathic
individuals, or which psychopathic individuals, perform poorly on
(which) measures of EF, display minimal impairments, or present def-
icits in particular EFs components, such as inhibition (cf. Bagshaw,
Gray, & Snowden, 2014; Baskin-Sommers et al., 2015; Ogilvie et al.,
2011). Neuropsychological approaches demonstrate that executive
dysfunction may be considered a marker for criminal behavior in
general, and this would explain why violent and non-violent offenders,
with or without psychopathy, might not reveal EFs differences (Barbosa
& Monteiro, 2008). Still, criminal psychopaths show interference and
inhibitory deficits in neuropsychological measures (Pham,
Vanderstukken, Philippot, & Vanderlinden, 2003). Accordingly, im-
pulsive violence was found to be significantly related to antisocial fa-
cets of psychopathy, including executive impairments, while pre-
meditated violence was significantly related to interpersonal-affective
facets of psychopathy, and conversely, these last individuals may show
better executive performance (Broomhall, 2005; Mol et al., 2009).
In recent years, studies on psychopathic features have been ex-
tended beyond individuals who repeatedly engage in antisocial or
violent acts. Current approaches consider that the psychopathic fea-
tures would account for more than a behavioral expression of aggres-
sion/violence (Patrick et al., 2009). “Successful” criminal psychopaths
seem to escape from a conviction in comparison to unsuccessful ones
(Ishikawa et al., 2001). Despite demonstrating ASB, successful criminal
psychopaths exhibit intact prefrontal functioning, including planning
abilities and adaptive behavior regulation (Mol et al., 2009) performing
better on EFs measures than unsuccessful convicted psychopaths, and
even controls (Crowell et al., 2003; Ishikawa et al., 2001).
Despite the existence of commonalities across studies with prisoners'
samples, divergent findings have been reported within these groups
(e.g., Pham et al., 2003). Such divergences are seemingly due to
methodological inconsistencies across studies (Bagshaw et al., 2014;
Baskin-Sommers et al., 2015; Dolan, 2012; Dolan & Anderson, 2002;
Ishikawa et al., 2001; Mol et al., 2009; Ogilvie et al., 2011; Pham et al.,
2003), namely:
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Aggression and Violent Behavior 51 (2020) 101380
1. differences in the definition of the concept of psychopathy (e.g., a
single broad syndrome vs. lower-level trait dimensions);
2. the tasks adopted may not be tapping the same EFs domains;
3. variations in group composition and comparison groups used (e.g.,
sampling characteristics, including the use of antisocial versus
healthy comparison groups);
4. no control of confounding variables (e.g., age, IQ, substance abuse,
comorbid psychiatric disorders, socioeconomic status);
5. measures of psychopathy used (e.g., reduced sensitivity and/or
specificity of the tests).
So far, it has discussed the inconsistencies in the relationship be-
tween psychopathy and EFs. Those could be due, as referred in point
five above, to the use of different and/or broad measures of psycho-
pathy, and even to distinct EFs assessed. Nevertheless, the association
between psychopathic facets and executive functioning could help to
explain the differences between individuals and their criminal offenses.
For example, it is expected that unsuccessful psychopaths demonstrate
lower performance on executive functions and different aggression
patterns. Notably, it is expected to find a predominant pattern of im-
pulsive aggression in the externalizing type, in comparison to a pre-
dominant pattern of premeditated aggression in the fearless type.
Existing evidence on these predictions is still scarce, demanding further
studies to test them.
Besides the links between the variables mentioned above, which are
currently being demonstrated, this revision also calls attention to the
lack of knowledge that we still have, in terms of understanding the
multiple relations between the distinct types of psychopathy, different
patterns of aggression, and the resulting criminal offenses. To deepen
this knowledge, using the EFs as a core element, is essential to develop
more adequate assessment procedures, and to better intervene with
these individuals in their particularities, in order to prevent crime and
criminal recidivism.
5. Discussion and conclusions
The variables contributing to criminality in general, and aggressive
behavior, are multi-deterministic (Bergeron & Valliant, 2001). There is
not a single approach nor any dichotomic relation between variables
that might explain aggressive behaviors (Broomhall, 2005). Therefore,
a more sophisticated approach to violent criminality should account for
numerous predisposing factors for committing a crime.
Executive functions are essential for behavior regulation, but are an
overarching and complex construct, which implies several cognitive
processes and subprocesses. Hence, addressing executive functions in
their relation with aggression features, such as impulsivity and pre-
meditation, or psychopathic traits, in offenders is essential for planning
appropriate assessment, treatment, and management strategies (Haden
& Shiva, 2008).
Offenders are commonly characterized by a pattern of executive
dysfunction in the available literature (Meijers et al., 2015; Ross &
Hoaken, 2011), even when the approach to the EFs is not replicable.
The difficulty that offenders demonstrate in tasks taping working
memory, cognitive flexibility, and inhibition of inappropriate responses
may have relevant implications in their ability to adapt to a changing
environment, and consequently influence their scholar, work, and
personal achievements throughout a lifetime (Hancock et al., 2010).
Due to such executive impairments, as rigid behavior and impulsive
outbursts, it is not surprising that offenders, at least to some degree and
regardless of their crimes, would show executive deficits (Hoaken et al.,
2007). However, heterogeneity regarding offenders' characteristics and
executive deficits makes challenging to identify a pattern of executive
impairments among different types of criminals.
Thus, although executive dysfunction may be associated with
criminality in general, it seems to show a stronger link to violent of-
fenses (cf., Hoaken et al., 2007; Ogilvie et al., 2011). It has been
A.R. Cruz, et al.
previously demonstrated that violent offenders exhibit executive dys-
function (Cooke et al., 2011; Hancock et al., 2010), mainly if the offense
is also characterized by an impulsive pattern of aggression (Broomhall,
2005). Violent offenders show deficits in identifying, pursuing, and
evaluating their progress on tasks, and consequently achieving desired
outcomes, revealing self-regulation and self-control difficulties. Speci-
fically, this class of offenders seems to have significantly impaired their
ability to monitor, code and manipulate incoming information (Miyake
et al., 2000), and to disregard no longer relevant cues, replacing it by
more recent and relevant ones (Fisk & Sharp, 2004). Aggressive in-
dividuals also demonstrate the inability to use feedback cues to regulate
their behavior and make quick decisions, which in turn increases the
likelihood of an aggressive disproportionate response to provocation
(Hoaken et al., 2003). Their inaccurate interpretation of environmental
cues is typically associated with hostility (Hoaken et al., 2007). Con-
sequently, in the presence of impairments in executive domains, the
behavior becomes deregulated and disinhibited, increasing the pro-
pensity to risk-taking behaviors. On the other hand, intact executive
functioning, and consequently better impulse control may act as a de-
terrent factor on offenders, thus leading to a potential decrease in
violent criminal activity, and consequently less incarceration and re-
cidivism rates.
Additionally, the relation between EFs, violent crime, and im-
pulsivity have been extensively examined, with studies investigating
specific executive domains in violent and non-violent criminality, and
their potential effects on impulsive aggression. However, executive
dysfunction might not adequately explain other forms of aggressive
behavior (specifically premeditated aggression). A pattern of impaired
or normal functioning of certain executive domains may constitute an
important psychobiological correlate of distinct personality structures,
namely psychopathic facets of personality, which in turn predispose
either to dominantly reactive or instrumental forms of aggression. It
appears that executive dysfunction depends differentially on diverse
manifestations of criminal and aggressive behaviors, and it is suggested
that offenders demonstrate an executive performance distinct to in-
dividuals from community samples. The previous findings highlight the
importance of more homogeneity in this field of research. Particularly,
to cover some of the identified shortcomings, studies should include
control samples, specify groups of offenders, and distinguish these ac-
cording to their aggressive pattern. Besides, authors should include
well-validated measures for both EFs and aggression and replicate the
experimental designs with different types of offenders, especially in
what concerns psychopathic traits. In order to do so it is required a new
meta-analysis based on the Ogilvie and collaborators work of 2011.
This future work should expand previous findings by addressing the
relationship between the different dimensions of aggressive and violent
behaviors with EFs.
In conclusion, the inconsistency of results between studies reveals
that a unique neuropsychological explanation for the relationship be-
tween aggression and EFs is improbable. Even though aggressive of-
fenders tend to evidence a global executive deficit, the presence of
impulsivity or other factors, such as low education, might also explain
and influence these poor EFs results. Here we tried to clarify the EFs
domains that are possibly more impaired in different types of offenders.
It is crucial to improve our understanding on the phenomenology of
executive deficits in the offenders' populations, which will help form
better diagnostic and treatment policies. Hopefully, in the future, these
individuals may benefit from intervention strategies that will address
their personality features and specific deficits, optimizing their EFs and
contributing to better cognitive control in demanding and complex si-
tuations (Strobach, Salminen, Karbach, & Schubert, 2014).
Funding
This work was supported by The Poruguese Foundation for Science
and Technology (Grant number SFRH/BD/76062/2011) awarded to the
6
Aggression and Violent Behavior 51 (2020) 101380
first author. The study was also supported by Grant SFRH/BPD/
108602/2015 from the Portuguese Foundation for Science and
Technology awarded to Andreia de Castro-Rodrigues.
Declaration of competing interest
None.
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