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Int J Offender Ther Comp Criminol. 2018 Sep;62(12):3853-3872. doi: 10.1177/0306624X17750340. Epub 2018 Jan 1.

Associations Between Neurocognitive Characteristics, Treatment Outcome, and Dropout Among Aggressive Forensic Psychiatric Outpatients.

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1 Department of Psychiatry, Radboud University Medical Centre Nijmegen, The Netherlands.
2 Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
3 Forensic Psychiatric Centre Pompestichting, Nijmegen, The Netherlands.
4 Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands.
5 Department of Cognitive Neuroscience, Radboud University Medical Centre Nijmegen, The Netherlands.


Aggression Replacement Training (ART) is widely used to reduce aggression and is considered to be effective although there are also inconsistent results. Studies investigating the effectiveness of ART do not focus on neurocognitive characteristics. Focusing on these aspects would result in enhanced understanding of underlying mechanisms of ART. The current open uncontrolled treatment study assessed whether neurocognitive characteristics were associated with change in aggression during the social skills and anger control modules of ART among forensic psychiatric outpatients. Furthermore, differences between treatment dropouts and completers and change in these characteristics during ART were examined. A reduction of trait aggression, cognitive distortions, and social anxiety was observed. Neurocognitive characteristics were not associated with change in aggression, could not distinguish treatment completers from dropouts, and did not change after ART. It is suggested that new paradigms should be developed which take into account the social context in which these impairments appear.


aggressive behavior; forensic psychiatric patients; neurocognitive; responsivity; treatment

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