Brain Injury (TBI) testing & Neuro-cognitive Function Reports

• The lifetime prevalence of TBI among individuals in the criminal justice system is substantially higher than in general population estimates.
• Meta-analyses and reviews estimate that 40-60 % of male prisoners report a history of TBI.
• Some individual studies report even higher rates: for example, one U.S. prison sample found 65 % reporting head injury, with 48 % classified as mild TBI and 16 % moderate-to-severe.
• A systematic review of prison populations found prevalence estimates ranging from 9.7 % to 100 %, with an average around 46 % across various studies
• Among youth in juvenile justice settings, prevalence estimates are also high—ranging broadly from 12 % to 82 % in various studies.
• In correctional populations, both repeated injuries and more severe TBIs are more common than in the general population.
• TBI in incarcerated populations is strongly associated with comorbidities: higher rates of substance use disorders, mental health issues (depression, anxiety, PTSD), aggressive or impulsive behavior, cognitive impairments, and disciplinary infractions while incarcerated.

• Because TBI often results in deficits in memory, attention, executive function, impulse control, and emotional regulation, individuals with undiagnosed brain injuries may struggle to understand legal proceedings, follow probation rules, or consistently comply with treatment or supervision requirements.
• Without proper screening, brain injury is often overlooked in legal, correctional, or mental health settings—leading to misinterpretation of behaviors (e.g. noncompliance seen as willful defiance).
• Recognizing TBI history in legal and pre-sentencing evaluations can allow for mitigation strategies (e.g. accommodations, tailored supervision, cognitive remediation, therapeutic approaches) that might reduce recidivism or institutional violations.
• Because many TBIs occur prior to justice involvement, incorporating brain injury screening into forensic or mitigation assessments can help build a more accurate “biopsychosocial profile” of a defendant.

CITATIONS

^a. (Williams WH, Mewse AJ, Tonks J, Mills S, Burgess CN, Cordan G. Traumatic brain injury in a prison population: prevalence and risk for re-offending. Brain Inj. 2010;24(10):1184-8. doi: 10.3109/02699052.2010.495697. PMID: 20642322.)
^b. (CNRS UMR 7371, Inserm UMR S 1146, Laboratory of Biomedical Imaging (LIB), Sorbonne University, UPMC University, Paris 06, 75005 Paris, France ;
^C GRC-UPMC n
^o 18 Cognitive Handicap and Rehabilitation HanCRe, 75013 Paris, France;
^d Rehabilitation Unit for acquired neurological pathologies in children, Saint-Maurice Hospital, 94410 Saint-Maurice, France
; ^e Physical medicine and rehabilitation unit, Caen University Hospital, 14000 Caen, France;
^fGeneral Medicine Intern, 75012 Paris, France;
^g Physical Medicine and Rehabilitation Unit, Raymond-Poincaré University Hospital, AP–HP, 92380 Garches, France;
^h Paris Resource Centre for Traumatic Brain Injury, Paris, France;
ⁱPhysical Medicine and Rehabilitation Unit, Pitié-Salpêtrière – Charles-Foix University Hospital, AP–HP, 75013 Paris, France.;
^j Schneider BS, Arciniegas DB, Harenski C, Clarke GJB, Kiehl KA, Koenigs M. The prevalence, characteristics, and psychiatric correlates of traumatic brain injury in incarcerated individuals: an examination in two independent samples. Brain Inj. 2021 Dec 6;35(14):1690-1701. doi: 10.1080/02699052.2021.2013534. Epub 2022 Jan 22. PMID: 35067151; PMCID: PMC8884136.)