A Crime Prevention Perspective

The criminal justice system works on a reactive rather thEtn proactive basis, that is, after the crime occurs action is taken to arrest, convict, and imprison the criminal. Such a model of justice is based on the theories of retribution and deterrence, neither of which has validity. The present project is an outgrowth of an interest this writer and others have had in crime prevention, or the prevention of criminal behavior before it occurs rather than waiting for it to occur (Jeffery, 1971, 1977; Brantingham and Brantingham, 1981; Brantingharn and Brantingham, 1984, Newman, 1972; Clarke and Mayhew, 1980; National Crime Prevention Institute, 1986; Rosenbaum, 1986).

Crime prevention is based on an interdisciplinary approach to crime and criminal behavior, involving criminology, urban planning, urban geography, neurology, psychobiology, and sociology (Jeffery, 1990) The focus is on the interaction of the individual and the environment, or an ORGANISM x ENVIRONMENT model of behavior, with the physical organism interacting with the physical environment by means of the brain and central nervous system.

There is little or no evidence that addictive behaviors are now being prevented. We do know that drug and alcohol prevention programs are not effective. Most drug prevention programs are based on a therapeutic community model as found in AA model of powerless and the need to seek spiritual help through God. Such programs are rarely researched due to the emphasis on privacy, but it is estimated that such programs are effective for 10-15 of those entering the programs (Witters and Venturelli, 1988; Galanter, 1983, Vol 2). Davidson and Neale (1986) summarize these therapeutic communities in these terms: "Unfortunately the claims made by AA about the effectiveness of its treatment have rarely been subjected to scientific scrutiny. Available findings indicate that they should be viewed with some caution. For example, as many as 80 percent of people who join AA drop out. Furthermore, without followup it is impossible to know how enduring are the short-term changes that AA may effect. Since return to excessive drinking is the norm rather than the exception for alcoholics, the absence of such information prevents an adequate evaluation of what many regard as the best treatment for alcoholism."

The drug treatment program of the Department of Corrections of the State of Florida is based on a therapeutic community model, without any medical or nutritional evaluation of subjects (Substance Abuse Program, Department of Corrections, September 1988) The program we wish to achieve begins with a thorough medical evaluation and neurological and nutritional intervention, to be followed by social learning and group therapies. A badly mangled brain will not respond to therapeutic intervention.

We hope to set up a program to prevent violence and drug addiction before they occur. Our policy today is equivalent to a public health policy which builds hospitals without paying attention to nutrition and sanitation, or cancer programs which are based on radioactive treatment, chemotherapy, and surgery, while at the same time no attention is paid to smoking, toxic wastes, and nutrition.

Crime prevention can focus on (1) the physical sites where crimes occur in relation to the physical geography and ecology of the community, a model based on epidemiological studies as found in the public health area, or (2) the study of individual offenders as related to genetic, neurological, and life history experiences (learning) This proposal is concerned primarily with the study of individual offenders.

The Youthful Violent Offender

Research has shown that few individuals (5 percent) commit 50 percent of the crimes, and 20 or less of the environments have 50 percent or more of the crime. Crime prevention focuses on high risk offenders and high crime rate environments.

A small grant was made by the Council on Research and Creativity at Florida State University to the writer to work on a project devoted to the early identification of violent youthful offenders who are involved at an early age in violent acts and drug and alcohol addiction. This grant allowed an interdisciplinary group of scientists from criminology, neurology, psychobiology, and medicine, as well as individuals from the Department of Corrections, State of Florida, to come together at two conferences to outline a major research proposal for the identification of youthful violent offenders. The proposal focused on the 5 to 8 percent of the delinquent youths who are hardcore offenders who commit 50 percent of the offenses and are involved in a pattern of violence and substance abuse. Such offenders have been labeled intensive offenders, violent predators, and career criminals (Wolfgang et al., 1972; Farrington, Ohlin, and Wilson, 1986; Petersilia et al., 1977; Chaiken and Chaiken, 1982; Conrad and Dinitz, 1977).

Past studies have shown that the youthful violent offender has a number of physical characteristics: underaroused autonomic nervous system; irregular brain laterality with major problems in the left frontal and temporal lobes; a history of medical problems including brain trauma, poor nutrition, contamination of the brain with heavy metals, hyperactivity, hypoglycemia, and premenstrual syndrome; and a history of drug and alcohol abuse. The interaction of violence, alcohol and drug abuse, and brain damage is by now well established in the research literature (Jeffery, 1990; Fishbein, 1990).

The following topics were discussed at the two conferences, and these variables form the framework for two ongoing project as well as for proposed research for the future:

Neurological Assessment of Brain Damage in Youthful Violent Offenders;
Brain Trauma and Violent Behavior; and
Nutrition, Brain Chemistry, and Addictive Behavior.

Neurological Assessment of Brain Damage in Violent Youthful Offenders

Neurological assessment of youthful offenders is often by means of a psychological test battery (the Halstead-Reitan or Luria-Nebraska Neuropsychological Battery) or by an EEG test. Such tests show wide-spread brain dysfunction among delinquent populations, that is, 50 to 70 percent of the violent delinquent populations suffer from one form of brain damage or another (Monroe, 1978; Mednick et al., 1982; Wolfgang and Weiner, 1982; Yeudall et al., 1985; Mednick et al., 1987; Volavka, 1987; Fishbein, 1990).

The impact of brain damage on behavior depends upon the part of the brain involved. The limbic system is a brain area involved in emotional behavior: anger, fear, aggression, sex, thirst, hunger; whereas the left frontal and temporal lobes function in an executive capacity for planning, evaluation, and abstract reasoning. The limbic system is an emotional brain whereas the temporal and frontal lobes are a rational brain. The interaction of left frontal and temporal lobes vvith the right frontal lobes and with the subcortical regions of the limbic system is by means of the neurotransmitter system. An excess or absence of certain neurochemicals will influence the type of interaction occurring in the brain. This interaction is also influenced by nutrition and learned experiences, as well as trauma to the brain. Since the left frontal lobes play a critical role of the control of violent behavior, any damage or malfunctioning of the left frontal lobe will result in a loss of control over the violent behavior originating in the limbic system.

Yeudall et al. (1985) found that 71 percent of the psychopaths they examined had left frontal and temporal lobe damage. Lewis (1981) and Lewis and Balla (1976) found a very high rate of brain damage among youthful offender due to child abuse, the violent environments in which they live, and a lack of adequate medical care attention. Lewis (1986) found that 15 of 15 adult death row inmates had neurological defects, and in another study she found that 14 of 14 juveniles sentenced to death for violent offenses had major neurological defects (Lewis, 1988).

Brain Chemistry, Violent Behavior and Addictive Behavior

Neurotransmitters are the chemical messengers in the brain that allow neural cells to communicate with one another. Numerous studies have shown that imbalances in the brain chemicals are responsible for behavioral disorders, including alcoholism, impulsivity, hyperactivity, and violence. Vulnerability to drugs is related to brain chemistry.

Acetylcholine increases all types of violence, whereas dopamine and norepinephrine increase emotional and sexual aggression. On the other hand serotonin decreases all forms of aggression (Moyer, 1976; Valzelli, 1981; Cloninger, 1987; Jeffery, 1990).

Alcohol and drugs which are closely related to adolescent violent behavior also act on the neurotransmitter system. Alcohol acts as a depressant by interfering with the release of dopamine and norepinephrine. Alcoholism can be treated by diet and by increasing the serotonin levels of the brain. The opiates act as depressants on the brain by occupying the receptor sites normally occupied by the endorphins and enkephlins (Fishbein and Pease, 1990) An individual can manipulate the pleasure and pain centers of the brain through the use of drugs and alcohol.

Cocaine acts as a stimulant to the central nervous system by increasing the amount of dopamine and serotonin in the brain. Linnoila and his associates have shown that levels of 5 HIAA (a metabolite of serotonin) are low in impulsive violent offenders. They found the same pattern for alcoholics, and they noted an association between impulsivity, violent behavior, alcoholism and low glucose tolerance levels (Linnoila, 1983; Virkkunen et al., 1987) From this research they found that they could accurately predict 84 percent of the violent offenders from low serotonin levels and low glucose tolerance levels. (Virkkunen et al., 1988)

The treatment for cocaine addiction includes antidepressants, anticonvulsants, and lithium, as well as a combination of amino acids which acts as precursors for the neurotransmitter systems, especially tryptophan. The opiate addict and the cocaine addict use drugs to self medicate so as to increase the dopamine levels in the brain (Daigle et al., 1988; Gawin et al., 1989; Gawin, 1986; Kleber and Gawin, 1986).

Nutrition, Brain Chemistry and Violence

Nutrition is related to behavior in several important ways. The major neurotransmitter systems use food substances or amino acids as precursors: choline is converted into acetylcholine; tyrosine is converted into dopamine and norepinephrine; and tryptophan s converted into serotonin (Fishbein and Pease, 1988). As was mentioned above, tryptophan is a common treatment for reducing the urge for cocaine, and for reducing violent behavior.

Nutritional problems come in several forms. Hypoglycemia or low blood sugar levels is a major problem associated with impulsivity, childhood behavioral problems and learning difficulties, violence, alcoholism, and the premenstrual syndrome. Low blood sugar levels can make one dizzy, irritable, confused, and even prone to violence (Fishbein and Pease, 1988).

The mineral content of the human body is a product of nutrition as well as air and water contamination. Certain levels of trace minerals (nutrient minerals) are necessary — zinc, calcium, potassium, magnesium, selenium, iron, and chromium. Toxic trace minerals which do damage to the brain are lead, cadmium, aluminum, arsenic, and mercury. A deficiency of vitamins and minerals can lead to such disorders as learning disabilities and alcoholism. For example, low levels of chromium will result in diabetes and low blood sugar levels. High levels of cadmium and lead in the body will lead to low intelligence scores, learning disabilities, and poor academic performance (Fishbein and Pease, 1988; Virkkunen, 1987; Moyer, 1987; Valzelli, 1981).

The biochemical composition of the body is revealed in hair since hair stores the nutritional and pollutant elements which are in the body (ICatz and Chatt, 1988; Doctor's Data, Inc, 1982). Hair samples are superior to blood and urine samples for testing the mineral content of the body.

Through hair analysis Walsh (1984) found high levels of lead and cadmium and low levels of zinc and magnesium in the hair of serial murderers. Hair analysis of James Q. Huberty (the man who killed 21 persons at a McDonald's restaurant in San Diego) revealed cadmium levels 30 times over the normal level and concentrations of lead 8 times over normal levels (Walsh, 1986). Pihl et al. (1982) found elevated levels of lead and cadmium in hair samples from violent offenders. Cromwell et al. (1989) studied hair samples from violent and nonviolent offenders in the Texas prison system, and they found they could correctly classify 86.8 percent of the violent offenders on the basis of levels of magnesium, sodium, potassium, copper, zinc, iron, chromium, lithium, silicon, and the ratios of zinc to copper and copper to iron.

Food allergies, food dyes, and food additives have also been associated with behavioral problems, especially as related to learning disabilities, hyperactivity, and attention-deficit disorders. Although the research in this area has been controversial, recent research has supported the food additive/hyperactivity hypothesis (Fishbein and Pease, 1988)

Fishbein and Pease (1988) recommend the use of diet as a part of the therapeutic program for any correctional institution. Such institutions have inadequate diets for individuals already suffering from major nutritional deficiencies.

Research Design and the Individual

The basic focus of research dealing with violence and drug abuse must be the individual offender. We cannot use aggregate data to study these topics since the variables involved vary from one individual to another; e.g. trace minerals, toxic trace minerals, brain trauma, nutrition, family history, and school records all vary from one individual to another. Even more critical is the fact that the interaction of these variables will vary over time with each individual.

Meyer Glantz, the Chief of the Etiology Research Center-, National Institute of Drug Abuse, stated the case very well when he noted that the clinical model was a model to study individual behavior. To quote, "although drugs and social factors are influential, characteristics of the individual user strongly determine the individual's vulnerability to drug abuse." He recommends a research model which looks at the interaction of biological, psychological, and social variables (APA Monitor, January 1990).

Research in Progress: the Thomasville Project

A project was established one year ago at the Regional Youth Development Center in Thomasville, Ga. This project was an extension and application of the Council on Creativity and Research grant. Several gradu-ate students and the writer have carried on this project without funding on a volunteer basis.

The RYDC is for youthful offenders 14 to 21 years of age who are waiting sentencing and disposition by the courts. As part of this project the following variables were measured:

Behavioral Assessment;
Nutritional Assessment; and
Neurological Assessment.

Behavioral Assessment

The Child Behavior Checklist and the Teacher's Report Form on Behavioral Problems from the Psychological Corporation were administered. These standardized tests are given to parents and teachers for an evaluation of the behavior of the child[ren] National norms exist for the test based on age and sex, and the items are scored for the following categories: somatic complaints, schizoid responses, uncommunicative, immature, obsessive-compulsive, hostile-withdrawal, delinquent, aggressive, and hyperactive. The teacher's form evaluates the students' school performance, work habits, behavioral problems, learning difficulties, social withdrawal, anxiety, unpopu-larity, obsessive compulsiveness, self-destructiveness, inattentiveness, and aggressiveness.

Legal records, interviews with parents and friends, as well as interviews with the subjects, were used to supplement the standardized tests.

Nutritional Assessment

A sample of hair was taken from the nap of the neck to be evaluated for minerals and heavy metals. The samples were sent to Doctor's Data of Chicago, Ill., for evaluation. It has been shown that nutrition and pollutants play an essential role in human behavior; for example, heavy metals can interfere with intelligence and learning and with the activities of the neurotransmitter system (see the discussion above).

Actual diets for a week, plus food preferences was given by the subjects, were also obtained. An analysis of the water supply was obtained for Thomasville for heavy metal contamination, and the same procedures are being followed for Albany.

Neurological Assessment

A quick neurological screening test was administered to the youths in order to determine if there were gross neurological syrtiptoms present. It is planned that in the future the complete Luria-Nebraska test will be administered to those who fall outside the established norms.

In future research we hope to use EEG measures and auditory brainstems evoked potentials as ways of following up on those subjects who appear to have neurological problems.

Results of the Thomasville Project

The preliminary results of the Thomasville project show that there is a high correlation between scores on the Child Behavior Checklist and the Teacher's Report Form on Behavioral Problems and results from the hair analysis and the quick neurological test. Students who scored high or at the abnormal range on the behavioral tests also scored high or low in trace minerals or toxic minerals. Hair analysis revealed very high levels of aluminum, lead, and cadmium, and low levels of calcium and chromium. Statistical analysis is now underway of the interaction of the trace minerals, the toxic minerals, and behavioral outcome as seen in school performance, drug use, hypoglycemia and hyperactivity, and violent behavior.

Research in Progress: Albany, Ga.

The writer received a grant of $37,500 from the Albany Housing Authority, Albany, Ga., for a project on crime prevention and cocaine abuse. The focus of the project is (1) the physical environment of the housing projects, and (2) the identification and testing of individuals from birth to adulthood for neurological disorders and nutritional deficiencies. A group of five graduate students and an urban planner with expertise in crime prevention and environmental design have been working on this project since May 15, 1990.

The following procedures are being followed for the early identification of violent youths. The basic plan is the same as above, that is, to secure neurological, nutritional and behavioral types of data. The medical histories and needs of tenants are being utilized through the cooperation of the District Health Director, Paul White, M.D., of the Georgia Department of Public Health. One of the graduate students, Jay Stephens, is working at the County Health Clinic with the nurses in obtained medical information for residents of the housing units who are using public health services. These services include pre and neonatal care, a well baby clinic, a family planning unit, an AIDS and sexually transmitted diseases clinic, a teenage pregnancy clinic, a clinic for drug and alcohol addiction, and a nutritional clinic. Complete medical examinations can be given for those wishing them. This is a comprehensive medical services facility. A representative of the tenants association of the Albany Housing Authority is coordinating the effort with the Director of Nurses and Clinical Services at the Clinic.

The research plan is to use 30 subjects each from age groups 0-3,4-5, 6-11, 12-16, and 17 and above. These subjects will be selected randomly from those clients using the hospital facilities, and therefore will include a great variety of medical backgrounds and problems. This raises a research issue concerning the fact that only those in the clinic are used and by definition they are self-selected for the project. A similar survey of 30 subjects selected at random from the housing projects will be interviewed for a medical history similar to that obtained from hospital records. Larger samples will be used if the budget allows for it. The subjects selected for medical evaluation will be interviewed, given the Child Behavior Checklist and the Child Behavior Profile, given a quick neurological test, and referred to special clinics as needed, e g. teenage pregnancy, sexually transmitted diseases, nutritional evaluation, or drug and alcohol abuse.

Complete medical and nutritional records have been obtained, including hair analysis, urine analysis, and blood analysis. It is expected that blood amino acid analysis and blood vitamin analysis will be available from the County Health Clinic.

Other facilities within the Albany community will be contacted and used, including the Substance Abuse program of the Department of Public Services, the Mental Health and Mental Retardation Clinic (involved in drug treatment programs), the Mayor's Task Force on Domestic Violence, Liberty House (a shelter for battered and abused women) and the Department of Family and Children' s Services. Individuals from the housing units who are clients of any of the above agencies will be contacted and interviewed, and individuals who are found to be in need of special services will be referred to the above agencies as needed.

Two special populations will be identified from the above procedures. One population will consist of individuals ages birth to 12 who are found to be outside the normal developmental ranges from the examinations or medical records. These individuals will be identified from the Child Behavior Checklist, the Child Behavior Profile, the hair analysis profile, the nutritional survey, the quick neurological test, and medical records as potentially violent and/or prone to anti-social acts. Special attention will be paid to infants who show signs of being "at risk."

A recent study out of the Stanford University School of Medicine (Journal of the American Medical Association, June 13, 1990) showed that infants with low birth weights are at high risk for learning and behavioral problems as well as low IQ's. We would add to this infants born of alcoholic or cocaine mothers, and infants of mothers with serious mental and emotional problems. A recent study by the Institute of Medicine of the National Academy of Sciences (Institute of Medicine, 1989) revealed that 12 percent of the children studied had identifiable mental health and behavioral disorders. Children "at risk" come from single parent families where the children have chronic medical problems, the parents are ill or abusive or addicts, the families are on welfare, the children suffer from physical and sexual abuse, and the children are characterized by low birth weight, brain damage, epilepsy, and mental retardation. The population with which we are dealing fits the above description of a high risk population (see Dorris, 1989, for a description of fetal alcohol syndrome) The Institute of Medicine recommended an interdisciplinary approach to the problem, an approach which would include genetics, psychopharmacology, neurology, and child development.

Early identification of these "at risk" populations of infants and youths will allow us to refer such individuals to proper medical and social service agencies for proper treatment and care. The ultimate goal of crime prevention is to identify individuals before they become criminals or addicts or alcoholics.

A second population to be identified will be a population of current addicts, alcoholics, and violent persons. A special clinic will be established at the County Health Clinic in cooperation with the tenants association of the housing units for tenants who are identified as in need of treatment and who volunteer for treatment. Local community facilities will be utilized, such as the Substance Abuse Clinic, Liberty House for abused and battered women, the Mental Health and Mental Retardation Center, the Mayor's Task Force on Domestic Violence, as well as the facilities of the County Health Clinic as discussed above. A detoxification center is available at the Clinic.

Therapeutic support groups will be established for those identified as violent and/or addicted. Such groups will work through the tenants association. A combination of neurological evaluation, medical examinations, nutritional evaluation, and other medical services will be provided for this population. The County Health Clinic, as well as local pediatricians, will be used in this effort.

Results of the Albany Project

Hair samples have been gathered from normal, violent, and drug/alcohol populations. Medical records have been secured from the County Health Clinic, and further medical information has been gotten from personal interviews. None of this data has been analyzed as yet, but the hair samples will be sent to Doctor's Data within a week or so.

Further information will be gathered from the County Health Clinic in terms of blood tests and neurological tests on those subjects deemed to be in need of further medical services. Statistical analysis of the results will be made to determine the interaction of levels of trace and toxic minerals, nutrition, blood sugar levels, behavioral assessments, and neurological assessments. A causal model will show how nutrition and brain functioning are related to violent and addictive behaviors.

C. Ray Jeffery is a professor of criminology at the Florida State University, Tallassee, Fla. 32306.

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