The Anatomy of Violence (48 page)

What accounted for the dramatic change? To begin to answer, we have to look back at what was fueling Danny’s antisocial behavior, which started as early as toddlerhood and exploded during adolescence. “I was really bored in school,” Danny would say after his treatment was completed, “but all the crimes were really exciting to me. I liked the action, getting away from the cops. I just thought it was so cool.”
²

The thirst for
stimulation-seeking is clear. We documented in
chapter 4
how children who are chronically under-aroused seek out stimulation to jack their physiological arousal levels back to normal. We know from longitudinal research that schoolchildren with excessive resting slow-wave
EEGs are much more likely to become adult criminal offenders.
³
That’s exactly what Danny demonstrated in his first clinical evaluation session—excessive
delta and theta activity, chronic cortical under-arousal. We also discussed how poor prefrontal functioning predisposes
an individual to impulsive homicide. We saw how when the home environment is loving and devoid of deprivation, yet the child is still antisocial, we should expect biology to be the culprit in crime—the social-push hypothesis.

We see in Danny’s case an example of how biology is not destiny. The psychophysiological, brain-based predispositions to crime and violence are not immutable. Importantly, Danny himself—albeit with the aid of electronic biofeedback and social support—instituted his own metamorphosis. It’s more a case of mind over matter. He had agency in his rehabilitation—and that may have been a critical component in his redemption.

Of course there is no easy solution to crime and violence, and Danny is just a case study. Yet what I want to give you in this chapter is a hopeful message. Rather than giving up when faced with biology-based offending, we can use a set of biosocial keys to unlock the cause of crime—and set free those who are trapped by their biology at an early age.

Before embarking on what may work to help kids like Danny, let’s summarize what I have been arguing so far, using a theoretical framework to give a context to treatment efforts. You can see it visually in
Figure 9.1
.

This
biosocial model emphasizes the role of genes and the environment in shaping the factors that predispose someone to childhood aggression and adult violence. A key assumption is that
joint
assessment of social and biological risk factors will yield innovative new insights into understanding the development of antisocial behavior.

The right-hand side of the figure outlines the main components of the model. Starting at the top, we have both genes and environment as the causal foundations of later violence. Social risk factors, on the right, have been the understandable focus of social scientists for three-quarters of a century. Biological risk factors, on the left, reflect neurocriminology, the new and more challenging field of enquiry.

Genes and environment are the building blocks for the biological and social risk factors in the next lower step in the model. Yet you’ll also see arrows linking genetics with social factors as well as with biological risk factors. Genes can shape social risk factors for violence such as low
social class and parental divorce.
⁴
Similarly, social risk factors like environmental stress can impair brain functioning, while living in a risky
neighborhood can increase the chance of head injury.

Figure 9.1
   
Biosocial model of violence

Biological and social risk factors then give rise to brain risk factors that are played out at three levels: cognition (e.g., attention deficits), emotion (e.g., lack of conscience), and
motor (e.g., disinhibition) processes. This brain dysregulation can then do one of two things. It can move on to directly give rise to
conduct disorder and violence, or it can join forces with social influences to form a biosocial interaction that brings on the teenage thunderstorms of emotion. This biosocial pathway is what I tried to emphasize in the previous chapter, and consequently I place it here as the heart of the model of the anatomy of violence.

Yet there is one piece missing. It is this juncture in our journey—what you see in the dynamic center part of the model—that we will now focus on. The lightning bolts represent striking out the biosocial pathway to adult violence. So what are the biosocial interventions that can block the development of conduct disorder and violence?

One approach to stopping
violence—one that we see all too often today—is to wait until the child is already kicking down the doors and becoming unmanageable. Unfortunately, by then it’s often too late to effectively correct course. Why not intervene early in life to prevent future violence?

That’s what
David Olds did in a landmark study that won him the Stockholm Prize—criminology’s equivalent to the Nobel Prize. You’ll recall that mothers who smoke
during
pregnancy have offspring who are three times more likely to become adult violent offenders.
⁵
Birth complications are another risk factor.
⁶
We also discussed how poor nutrition during pregnancy doubles the rate of
antisocial personality disorder in adulthood.
⁷
We’ve noted the importance of early maternal care during the critical
prenatal and postnatal periods of brain development.
⁸
Alcohol during pregnancy is also associated with later adult crime and violence.
⁹
These are the biosocial influences that David tackled.

His sample consisted of 400 low-social-class pregnant women who were entered into a randomized controlled trial. The
intervention group had nine home visits from nurse practitioners during pregnancy, with a further twenty-three follow-up visits in the first two years of the child’s life—a critical time window in child development. The nurses gave advice and counseling to the mothers on reducing smoking and alcohol use, improving their nutrition, and meeting the social, emotional, and physical needs of their infant. The control group received standard levels of prenatal and postnatal care. Follow-ups were made on the offspring for fifteen years.

The results were dramatic. Compared with controls, the children whose mothers had nurse visitations showed a 52.8 percent reduction in arrests and a 63 percent reduction in convictions. They also showed a 56.2 percent reduction in alcohol use and a 40 percent reduction in smoking. Truancy and destruction of property were reduced by 91.3 percent. These effects were even stronger in mothers who were unmarried and particularly impoverished.
¹⁰

Why was this early intervention so effective? Clues come from other effects of the program. The babies of mothers visited by nurses were less likely to have low birth weight. When the children were age four, the mothers and children were more sensitive and responsive to
each other. There was less domestic violence. More of these mothers enrolled their
children into preschool programs. The homes became more supportive of early learning. The mothers’
executive functioning also improved, and they had better
mental health. These improvements were especially true for mothers who were less intelligent and competent.
¹¹
When the children were age twelve, the mothers were less impaired from alcohol and
drug use, their partnerships were lasting longer, and they continued to have a greater sense of mastery.
¹²

Providing those mothers most at risk for having wayward offspring with health information, education, and support can reverse later adolescent problems that are the harbingers of adult violence. David Olds was tackling not just the social risk factors we see in
Figure 9.1
, but also the biomedical health factors that join forces with social risk factors to create antisocial behavior. He was tackling the biosocial part of the equation in
Figure 9.1
, and that’s why it worked so well.

The
cost of the
intervention per mother was $11,511 in 2006—but the government saved $12,300 in food stamps, Medicaid, and other financial aid to the families. The government actually spent less on the intervention group than they spent on the control group.
¹³
And that’s not counting the savings brought about by reducing crime, and the incalculable benefits of improving people’s lives.

You’ll remember Beauty and the Beast from Mauritius in
chapter 4
.
Joëlle, who became Miss Mauritius, and
Raj, the biker who became a career criminal. They were two of the three-year-old children in the study that my PhD supervisor
Peter Venables set up—an environmental
enrichment from ages three to five that tells us that while it’s never too early to start to prevent crime, it’s also never too late.

What did our
enrichment intervention consist of? It started at age three, had a duration of two years, and consisted of three main elements:
nutrition,
cognitive stimulation, and physical
exercise. The enrichment was conducted in two specially constructed
nursery schools. Staff members were brought up to speed on physical health—including nutrition, hygiene, and childhood disorders. They also received training on physical activities, including gymnastics and rhythm activities, outdoor activities, and physiotherapy. They were trained on multimodal cognitive
stimulation with the use of toys, art, handicrafts, drama, and music.
¹⁴
A structured nutrition program provided milk, fruit juice, a hot meal of fish or chicken or mutton, and a salad, each day. Physical-exercise sessions in the afternoons consisted of gym, structured outdoor games, and free play. The enrichment also included walking field trips, basic hygiene skills, and medical inspections.
¹⁵
In fact, there was an average of two and a half hours of physical activity each day. Cognitive skills focused on
verbal skills, visuospatial coordination, concept formation, memory, sensation, and perception.

What happened to the control group? These kids underwent the usual Mauritian experience of attendance at
petite écoles
that focused on a traditional ABC curriculum.
¹⁶
No lunch, milk, or structured exercise was provided. For lunch, children typically ate rice and bread.

Stratified random sampling was conducted to select which 100 of the 1,795 would enter the environmental enrichment. From the remainder, 355 controls were selected who matched the enrichment group on ten cognitive, psychophysiological, and demographic measures. We then followed up on the children for eighteen years.

What were the results? At age eleven we reassessed the children on a psychophysiological measure of
attention—
skin-conductance
orienting. The bigger the sweat-rate response to the tones played over headphones, the greater the attention that is being paid. The two groups were matched very exactly on this measure at age three—before the intervention began.
¹⁷
When they were retested eight years later, at age eleven, the enrichment group showed a 61 percent increase in orienting—a big jump in their ability to focus their attention and be alert to what was going on around them.
¹⁸

We also measured their
EEG—
brain-wave activity—at age eleven. Brain waves can be grouped into four basic frequency bands. Right now, as you are reading this, fast-wave
beta activity predominates because your brain is aroused and activated, scanning this page, absorbing the text, and forming associations. When you are relaxed,
alpha predominates. When you are asleep, however, slow-wave
delta activity takes over. When you are awake but not very alert, you have more sluggish
theta activity. Children in general have relatively more slow-wave theta activity because their brains are immature and still developing. We found that children from the environmentally enriched group showed significantly
less
theta activity than the controls six years after the intervention
had finished.
¹⁹
Their brains had matured more and become more aroused. In developmental terms their brains were 1.1 years older than those of the controls.
²⁰

We then followed the children up for another six years, and behavior problems were assessed at age seventeen. The enriched children had significantly lower scores on ratings of
conduct disorder and
hyperactivity. They were less cruel to others, not so likely to pick fights, not so hot-tempered, and less likely to
bully other children. In addition, they were less likely to be bouncing around the place and seeking out stimulation.
²¹

We continued to follow them. When they were aged twentythree we interviewed all the subjects on their perpetration of criminal offending using a structured interview to measure self-reported crime.
²²
Those who admitted to committing a criminal offense were categorized as an offender. In addition, we also scoured every single courthouse in Mauritius and searched the records for registrations of offenses that included property damage, drug use, violence, and drunk driving—we excluded petty offenses like parking fines or a lack of vehicle registration. The enriched children showed a 34.6 percent reduction in self-reported offending compared with controls.
²³
For court convictions the enriched group had a much-reduced rate of offending, at 3.6 percent compared with 9.9 percent in the control group—but this difference just failed to reach statistical significance.
²⁴
The enrichment really did seem to make a difference—even twenty years later.