Neurocognitive Deficits Underlie Adolescents´ Response to a Model

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Gender Sensitive Factors
in Girls’ Delinquency
Diana Fishbein, Ph.D.
Donna-Marie Winn, Ph.D.
Research Triangle Institute
Duke University
Transdisciplinary Behavioral
Science Program
Shari Miller-Johnson, Ph.D.
Duke University
Center for Child and Family Policy
Sanford Institute
Center for Child and Family Policy
Psychology, Social and Health
Sciences
Gayle Dakof, Ph.D.
University of Miami
Department of Epidemiology &
Public Health
Support for this presentation comes from the Office of Juvenile Justice and
Delinquency Prevention (OJJDP) and the National Institute of Mental Health
(NIMH)
Research on Girls
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Scarce: most delinquency studies focus on boys
Correlates appear to be similar
 Not clear if the risk factors affect girls
similarly
 Or risk factors may exert a similar influence
but occur disproportionately
Interpersonal and familial relationships may
more profoundly influence girls’ behavior
Even less research that accounts for ethnic
differences between sexes
Sample Characteristics
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Adjudicated and Clinical Samples
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Concentrated with high risk girls
Biases and differential referral processes
Various segments of the CJS will differ due to system
biases
Best information for designing treatment strategies
Community samples
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Indicative of general risk and protective factors
Highlights ways in which different outcomes can emerge
from similar influences
Best information for designing prevention
strategies
Gender Specificity ≠ Sensitivity
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Specific = only specific to one gender
(Menstruation)
Sensitive = present in both genders, but more
prevalent or functions differently
 Biological functions (testosterone)
 Psychological traits (depression, CD)
Need to understand normal physical and
psychosocial development of each gender
Need to account for how development affects
delinquent outcomes
Short Story!
• Biology (aspects of genetics, brain
development and function) affects
behaviors
• Chronic stress increases risk for bad
outcomes by negatively affecting brain
development
• Once stressed, the individual is more
sensitive to environmental triggers
• Early high risk behaviors are malleable
Brain Development: Prefrontal Cortex
If the prefrontal area does not develop appropriately:
• Hard time understanding social situations and social cues
•“Why I always got to wait!!”
• Sees many situations and people as out to get them or
hostile
•He dissed me!!!
• Gets mad easily
• “He meant to step on my shoe,
so I punched him!”
Frontal lobes
• Is impulsive and inattentive
• Plays video games all day,
but can’t focus in class
• Seems insensitive to consequences
• “Like I care!!”
• Heightened sensivity to reward in
spite of consequences
 Memory, planning, problem solving
• Drug abuse
Gray matter volume peaks ~ age 12
 Change with experience = plasticity
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Brain Development: Emotional
Regulation
• Limbic system is regulated by prefrontal cortex
• If the Limbic System is not adequate
communicating with the Prefrontal Cortex:
• Difficulty getting motivated
• Hard time regulating emotions
• Response to stress is
dysregulated
•Decreased sensation leads
to seeking highs (drugs)
•Poor self regulation
Causes of Disconnect between
Prefrontal Cortex and the Limbic
System
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Genetic defects
Developmental delays
Injury
Metabolic errors
Stress
Chronic stress primes the brain for
risk behaviors and drug abuse
Alters brain function, disengages coping mechanisms, and
compromises ability to execute rational choices
Increases the likelihood of
psychopathology:
depression, drug abuse &
violence
Genetic vulnerabilities affect
particular behavioral
outcomes of stress
Positive attributes of
individual or environment
is protective.
The Adolescent Brain
• Particularly vulnerable to environmental inputs,
including stress and drug effects
• Effects are longstanding
• Prefrontal cortex not fully developed until early
adulthood
• Unique stage of change in metabolism, pruning, and
increased efficiency in prefrontal function
• Emotional centers (limbic) without checks and
balances
• Greater sensitivity to rewards, less inhibition
• Seek altered states of consciousness
Fundamental Imbalance in Puberty
• Rapid physical, endocrine, and social changes
that create early affective motivations and
challenges
• Gradual, later development of affect regulation
and maturation of cognitive/self-control skills
Emotional Capacity
Pubertal drives and emotions;
sensation seeking; risk taking;
sensitivity to rewards, low self
control
Cognitive Capacity
Planning; logic; reasoning,
inhibitory control; problemsolving skills; capacity for
understanding long-term
consequences of behavior
Adolescent Girls’ Disadvantages
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Greater sensitivity to stressors, particularly familial
Greater incidence of sexual abuse, dysfunctional
familial relationships, maltreatment and other stressors
among antisocial females relative to males
Proneness to psychological and psychiatric illnesses:
e.g., depression and anxiety
Differences in development of amygdala and
hippocampus heighten stress sensitivity
Adrenal gland sensitivity negatively alters mood
Estrogen amplifies stress responses, increasing mood
disturbances
Perception of greater stress than males
Girls’ Advantages
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Larger Prefrontal Cortex  less acting out
behaviors
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Advanced language and verbal skills
More effective processing of social and
emotional cues
Female hormones protect against
neurocognitive damage from stress
“Tend and Befriend”, rather than “Fight and
Flight” due to hormonal differences
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ADHD and Conduct Disorders
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Developmental delays: Males outnumber females by a 3:1
ratio
Boys more hyperactive, girls more inattentive and less
externalizing
Presence of CD substantially compounds outcome:
severity and early onset more similar to boys
Boys more prone to both in response to stress than girls
ADHD more persistent in girls, although less severe in
community samples
Family violence is related to ADHD in girls and predicts
psychological and cognitive deficits
Programmatic Implications
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Need more research: Studies of ADHD in girls
are sorely lacking
Need greater sensitivity among professionals to
the clinical features of ADHD in girls.
Need greater clinical referrals and treatment,
even when symptoms are not externalizing
Need timely and comprehensive screening of
ADHD (and other mental health concerns) in
order to adequately address treatment needs for
delinquent girls
Basic Intelligence
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Both boys and girls with lower IQs tend to be more
delinquent
Other factors that affect the link between IQ and
delinquency
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Low Self esteem
Poor School attitudes and performance
Poor reaction of school staff towards girls (perceived)
Negative family influences
Deficits in abstract thinking interact with early pubertal
maturation to increase risk for delinquency
Programmatic Implications
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Need assessments for targeted educational and
vocational special needs programs
Need cognitive therapies with a language base
Need to better understand links between IQ and
early puberty
Cognitive and Emotional Regulatory
Deficits
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Hot and Cool Cognition
 Cool = strictly cognitive processing of abstract and
decontextualizing problems
 Hot = regulation of affect and motivation in
performing a task or solving a problem
Prefrontal-Limbic Circuitry – develops in early adulthood
Girls develop this circuitry later than boys due to female
hormones
Girls have larger and more active PFC so can suppress
externalizing behaviors but not internalizing
Sources of delays: genetics, prenatal conditions, adversity,
puberty and substance abuse
Programmatic Implications
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Programs to reduce child maltreatment
Treatment for deficits resulting from substance misuse
Parenting and family support programs to enhance
cognitive reinforcements and bonding at home
Programs to reduce maternal smoking
School preparation programs for disadvantaged girls
with cognitive and intellectual deficits
Targeted remediation services in home and school
Harm reduction approach during adolescence
Alternative activities
Early Pubertal Maturation
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Both biologically and socially challenging
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Stress profoundly influences early puberty
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Absence of biological father and familial instability
Strongly related to disruptive behavior disorders,
antisocial personality traits, and delinquency
Affiliation with older boys
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Disconnect between brain and body readiness
Early hormone release increases neural excitation
Exposure to intimate partner violence
More often sexually abused in the home
Good parenting may mitigate negative effects
Intimately interacts with psychological disorders
Programmatic Implications
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Family therapy and educational supports for
families of divorce and entry of new male
household figure
Stress reduction programs under conditions of
adversity or disadvantage
Domestic violence and child abuse prevention
programs
Psychological and cognitive supports during
early puberty for both child and caregivers
Weight control
Mental Health Issues
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Greater incidence of internalizing disorders
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Less related to delinquency than externalizing disorders
Depression and anxiety more prevalent, tho, in JJ girls
Also more CD, ODD and SA than in community
Over ¾ in JJ system with one or more disorders
Predominantly untreated
Rates of depression similar b/t sexes until puberty
Co-occurring ECF & emotional regulation deficits
Relationship with early puberty
Triggered by stress: e.g., higher rates of PTSD
Strong familial attachments may be protective
Programmatic Implications
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Comprehensive psychological assessment and
appropriate treatment, as indicated
Comprehensive psychological assessment and
appropriate treatment, as indicated
Comprehensive psychological assessment and
appropriate treatment, as indicated
Comprehensive psychological assessment and
appropriate treatment, as indicated
Remaining Research Questions
• How can we use information about girls’ brain
development and function to improve outcomes?
• How might manipulations of the environment improve
brain function and development?
• How can we use their advantages to increase resiliency
(e.g. talkative, less acting out, and read social cues better)?
• What are the critical stages of development during
which psychosocial conditions (e.g., stress) differentially
exerts its effects on girls relative to boys?
• Can understanding brain-environment interactions help
design interventions that impact at critical points in the
developmental trajectory to alter risk status for girls?
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