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Cognitive–affective factors underlying disinhibitory disorders and legal implications

Nature Reviews Psychology volume 1, pages 145–160 (2022)Cite this article

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Abstract

Disinhibited behaviours such as aggression, criminality and substance misuse are ubiquitous. In the USA, a violent crime occurs every 25 s, a non-violent crime every 4.1 s, an incidence of domestic violence every 3 s and substance misuse every 2.4 s. These behaviours are widespread, but more commonly exhibited by individuals with specific psychological problems, namely disorders characterized by disinhibition. Although individuals with disinhibitory disorders display similar behaviours, the underlying cognitive–affective factors are distinct and must be taken into account when developing scientifically informed interventions. In this Review, we provide a summary of key cognitive–affective factors associated with four disinhibitory disorders: substance use disorders, borderline personality disorder, antisocial personality disorder and psychopathy. We focus on these four disorders given their phenotypic overlap and because individuals with these disorders disproportionately find themselves ensnared in the legal system. We discuss the implications of integrating an understanding of cognitive–affective functioning for more successful interactions between individuals with these disorders and the police, courts and correctional facilities. To protect all members of society, we must consider how psychological science can have a greater role at various stages of legal intervention.

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Fig. 1: Characteristics of disinhibitory disorders.
Fig. 2: Cognitive–affective factors that give rise to disinhibitory disorders.
Fig. 3: Pattern of performance related to cognitive–affective factors across disinhibitory disorders.

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Acknowledgements

A.B.-S. thanks the Russell Sage Foundation for providing space to think through the topics covered in this Review.

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Authors and Affiliations

  1. Department of Psychology, Yale University, New Haven, CT, USA

    Arielle Baskin-Sommers, Sonia Ruiz, Brianna Sarcos & Cortney Simmons

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A.B-S. researched data for the Review. A.B-S. and C.S contributed substantially to discussion of the content. All authors contributed to writing the Review, and reviewed and/or edited the manuscript before submission.

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Glossary

Hierarchical Taxonomy of Psychopathology (HiTOP)

A newer classification system focused on grouping signs, symptoms, and maladaptive traits and behaviours into broad spectra of psychopathology rather than discrete categorical diagnoses.

Amygdala

A region of the brain important for emotion processing and detecting salient information.

Ventromedial prefrontal cortex

A brain region in the prefrontal cortex that is involved in processing risk, emotional responding and the cognitive processing of morality.

Fronto-limbic circuitry

Neural circuitry that connects the frontal lobe with subcortical regions, such as the amygdala, and regulates mood, cognition and behaviour.

Hippocampus

A brain structure embedded in the temporal lobe that has a major role in learning and memory.

Mesocorticolimbic circuitry

Neural circuitry that extends from regions deep within the brain to the prefrontal cortex to transport dopamine (a neurotransmitter) and supports reward learning.

Orbitofrontal cortex

A brain region in the prefrontal cortex that has a role in representing the affective values of reinforcers in decision-making, executive function and learning.

Startle response

The magnitude of muscle twitch measured by placing sensors on the orbicularis oculi muscle under the eye.

Electroencephalography

A non-invasive electrical monitoring method to record electrical activity on the scalp through a cap and sensors placed on the head and face.

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Baskin-Sommers, A., Ruiz, S., Sarcos, B. et al. Cognitive–affective factors underlying disinhibitory disorders and legal implications. Nat Rev Psychol 1, 145–160 (2022). https://doi.org/10.1038/s44159-022-00020-8

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