Tag: gender

Categories : Gender NeurologyTags :

Dopamine Involved in Both Autistic Behaviour and Motivation

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Dopamine can help explain both autistic behaviours and men’s need for motivation or ‘passion’ in order to succeed compared to women’s ‘grit’, according to a new study.

Men – more often than women – need passion to succeed at things. At the same time, boys are diagnosed as being on the autism spectrum four times as often as girls. Both statistics may be related to dopamine, one of our body’s neurotransmitters.

“This is interesting. Research shows a more active dopamine system in most men” than in women, says Hermundur Sigmundsson, a professor at the Norwegian University of Science and Technology’s (NTNU) Department of Psychology.

He is behind a new study addressing gender differences in key motivating factors to excel in something. The study uses men’s and women’s differing activity in the dopamine system as an explanatory model. The study enrolled 917 participants aged 14 to 77, consisting of 502 women and 415 men.

“We looked at gender differences around passion, self-discipline and positive attitude,” said Prof Sigmundsson. The study refers to these qualities as passion, grit and mindset. The researchers also applied theories to possible links with dopamine levels. Dopamine, a neurotransmitter that is released in the brain, is linked to learning, attention and our ability to focus. It can contribute to a feeling of satisfaction.

Men generally secrete more dopamine, but it plays a far more complex role than simply being a ‘happy hormone’. Dopamine is linked to learning, attention and our ability to focus.Previous studies on Icelandic students have shown that men are more dependent on passion in order to succeed at something. This study confirms the earlier findings. In six out of eight test questions, men score higher on passion than women.

However, the association with dopamine levels has not been established previously.

“The fact that we’ve developed a test to measure passion for goal achievement means that we can now relate dopamine levels to passion and goal achievement,” explained Prof Sigmundsson.

Women, on the other hand, may have greater self-discipline – or grit – and be more conscientious, according to other studies. Their level of passion may not be as pronounced in general, but they are also able to use this to excel.

The results for the women, however, are somewhat more ambiguous than men’s need to have a passion for something, and this study found no such gender difference. Nor did the researchers find any difference between the sexes in terms of growth mindset.

Previous studies have associated the dopamine system with many different conditions, such as ADHD, psychoses, manias and Parkinson’s disease. However, it may also be related to a certain form of autistic behaviour.

Some individuals with autism may develop a deep interest in certain topics, something which others may find strange or even off putting. People on the autism spectrum can focus intensely on these topics or pursuits, at least for a while, and dopamine may play a role in this.

“Other research in neuroscience has shown hyperactivity in the dopamine system in individuals with autism, and boys make up four out of five children on the autism spectrum. This, and dopamine’s relationship to passion, might be a mechanism that helps to explain this behaviour,” concluded Prof Sigmundsson.

Source: Norwegian University of Science and Technology


Journal reference: Sigmundsson, H., et al. (2021) Passion, grit and mindset: Exploring gender differences. New Ideas in Psychology. doi.org/10.1016/j.newideapsych.2021.100878.

Categories : Exercise GenderTags :

Having No Audience Slows Male Athletes but Boosts Females

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Researchers have found that having no audience present made men run slower, but helped women run faster.

The new study by Martin Luther University Halle-Wittenberg (MLU) examined the effect of an audience on performance of athletes at the 2020 Biathlon World Cup. According to the new analysis, women also performed better in complex tasks, such as shooting, when an audience was present while men did not.

According to social facilitation theory, a person’s performance is impacted if other people watch them. Merely having an audience improves the performance of simple tasks, especially those requiring stamina: and it is surprisingly hard to circumvent. One study showed that ‘virtual’ bystanders did not have the same effect as having real bystanders in firefighter’s performance in training tasks.

“The studies have been relatively clear so far, but the results are more heterogeneous when it comes to more complex coordinative tasks,” explains Amelie Heinrich from the Institute of Sports Science at MLU. Generally the assumption is that performance tends to drop when an audience is present.

Heinrich is a sports psychology expert who coaches Germany’s junior biathlon squad, and took advantage of the unique conditions created by COVID. “The pandemic offers a unique opportunity to study an audience’s influence outside of experimental conditions in the real world,” said Heinrich, who compared the running times and shooting successes of male and female biathletes from the 2018/2019 season with their performances in the 2020 season in the sprint and mass start events.

“The men’s results were as expected: they ran faster with an audience present, but performed more poorly in shooting,” noted Heinrich. Cross-country skiing mainly requires stamina while shooting is a coordinative task. 

“Interestingly, it was the other way around for women.” With spectators present they ran slower, but on average, it took them an entire second less to make their shot and, at least in the sprint, their scoring performance was five per cent higher. The researchers argue that it is not just due to fluctuation in the athletes’ performance; with 83 (sprint) and 34 (mass start) World Cup biathletes, the study has a good basis for evidence, and the same tendency was seen in both disciplines.

“To our knowledge, this is the first time that a study was able to show a different effect of the audience on men and women,” noted Professor Oliver Stoll, head of the sports psychology section at MLU. Most previous research focused on men. “Our study raises questions about the generalisability of the social facilitation theory and indicates there might be a previously unknown difference between men and women,” said Heinrich, adding that more research in sports with coordination and stamina is needed.

Thus far, the researchers can only speculate about the reasons for the possible gender-specific performance differences in response to audiences or the lack of. “It is possible that gender-specific stereotypes play a role,” said Heinrich. Men have a stereotype that they should be strong, while studies have shown that women are more sensitive to feedback. In any case, Heinrich concluded, this underscores the need to account for gender in studying psychological effects.

Source: Martin-Luther-Universität Halle-Wittenberg

Journal information: Heinrich A. et al. Selection bias in social facilitation theory? Audience effects on elite biathletes’ performance are gender-specific. Psychology of Sports and Exercise (2021). Doi: 10.1016/j.psychsport.2021.101943

Categories : GenderTags :

Bias Against Both Sexes Found in Clinical Trials

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Though evenly split overall, research shows that women and men in disease trials are not represented according to the population affected.

Clinical trial sample populations should be proportionate to the population affected by the disease, as some diseases are more prevalent or manifest differently in one sex versus the other. Neglecting one sex in clinical trials can skew medical evidence toward therapies for the neglected population.
The study cross-analysed over 20 000 US clinical trials between 2000-2020, and found that women are underrepresented in clinical trials in cardiology, oncology, neurology, immunology and haematology. Meanwhile, men are underrepresented in clinical trials in musculoskeletal disease and trauma, psychiatry and preventive medicine. 

This study, published JAMA Network Open, is the first to examine sex bias in all US human clinical trials relative to disease burden (which is the prevalence of disease based on factors such as sex and ethnicity).

“Sex bias in clinical trials can negatively impact both men and women by creating gendered data gaps that then drive clinical practice,” said first study author Dr Jecca Steinberg, a medical resident in the department of obstetrics and gynecology at Northwestern University Feinberg School of Medicine. “Neglecting one sex in clinical trials — the gold standard scientific exploration and discovery — excludes them from health innovation and skews medical evidence toward therapies with worse efficacy in that sex.”

Underrepresentating either sex in clinical trials can lead to less optimal health outcomes; differences exist for women and men in medical test results, disease progression, treatment response, drug metabolism and surgical outcomes, Dr Steinberg said.

These differences stem from variations in body size, composition, and hormones. Women’s smaller body sizes and higher fat contents typically result in varied drug responses. One study showed that aspirin has differential effects on the sexes with regard to primary protection against strokes and heart attacks. Aspirin only lowered women’s risk of stroke but had no effect on the risk of myocardial infarction or death.

“Identifying areas of research in which sex bias disadvantages males is important to improving population health,” Dr Steinberg said. “Our novel finding that men are underrepresented in trials related to mental health and trauma assumes greater urgency in American society where suicide, violence and substance use increasingly contribute to growing morbidity and premature male mortality in the US.”

Clinical trials for preventative medicine are more likely to have greater enrollment of women, the study found, adding credence to the notion that women, more than men, seek out preventive services and access to health care.  

Women-specific underrepresentation remains
“One of the top reasons for Food and Drug Administration drug recall is adverse effects in women,” Dr Steinberg said. “Millions and millions of dollars go into these trials, so to relatively neglect women in the trial population is a waste.

“A greater allocation of resources for female-focused trials could be critical to improving care for women and discerning the heterogenous manifestations of diseases within the female population.”

For example, women with heart disease often have different reactions to medications and experience different symptoms from men, such as feeling abdominal pain rather than their left arm. If a clinical trial implements its intervention based on symptoms predominantly exhibited by the male population, it could miss testing interventions in women with cardiac arrest. 

The reduced representation of women relative to disease burden specifically in oncology and cardiology clinical trials is especially troubling, said Steinberf, because cardiologic and oncologic diseases are among the leading causes of death among women in the US.

Participating in clinical trials is also one of the only ways to access cutting edge therapies, especially oncology, so the relative deficiency of one sex contributes to disparities in health outcomes, Steinberg said.  

“One of our hopes from this study is that scientists and physicians will read about our findings and be inspired to say, ‘Why is that happening in my field?’ and then address it,” Dr Steinberg said.

Source: Northwestern University

Categories : COVID GenderTags :

COVID Shown to Damage The Testes

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Researchers at the University of Texas Medical Branch have discovered SARS-CoV-2 in the testes of infected hamsters, findings which may explain certain COVID symptoms reported in men.

Clinicians are finding that COVID affects more than just the lungs; some patients have reported testicular pain and some reports have shown decreases in testosterone. Autopsies have also shown evidence of significant disruption of the testes at the cellular level, severe in some cases, and presence of immune cells. Since SARS-CoV-2 has an affinity for ACE-2 receptors, and ACE-2 receptor expression is high in the testes, this could explain why this tissue becomes an infection target for COVID.

“Given the magnitude of the COVID pandemic, it is critical to investigate how this disease can impact the testes, and the potential consequences for disease severity, reproductive health and sexual transmission,” said Dr Rafael Kroon Campos, the study’s lead author and postdoctoral fellow in the laboratory of Dr Shannan Rossi at UTMB.

For a number of years, the Rossi lab had been studying Zika virus infection in the testes and wondered if SARS-CoV-2 could cause a similar disease. Hamsters are common models for COVID since they develop similar signs of disease to humans. Virus was detected in the testes of all infected hamsters during the first week but tapered off. The authors think this may represent what could occur in men with mild to moderate COVID disease.

“These findings are the first step in understanding how COVID impacts the male genital tract and potentially men’s reproductive health,” said Rossi, an associate professor in the Departments of Pathology and Microbiology & Immunology. “We have much more to do before we have the full picture. Moving forward, we will investigate ways to blunt this impact, including using antivirals, antibody therapies and vaccines.”

Future research could also include conditions associated with severe COVID, such as pre-existing conditions like obesity and diabetes and SARS-CoV-2 variants of concern, the study authors said.

Source: University of Texas Medical Branch at Galveston

Categories : Cancer GenderTags :

Stronger Immune Systems in Women Protect against Skin Cancer

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Women may have a stronger immune response to a common form of skin cancer than men, according to a preliminary study on mice and human cells.

Men develop more skin squamous cell carcinoma (cSCC) than females and their tumours are more aggressive, though it is not clear if this is related to sunlight exposure. Using mouse models to answer the question, they found that male mice developed more aggressive tumours than females, despite receiving identical treatments.

In female mouse skin and tumours, the immune cell infiltration and gene expression related to the anti-cancer immune system were increased, suggesting a protective effect of the immune system.

In keeping with the animal study, 931 patient records collected from four hospitals in Manchester, London and France, the researchers identified that while women commonly have a more mild form of cSCC compared to men, immunocompromised women developed cSCC in a way more similar to men

That suggests the protective effect of their immune system may have been compromised.

These results were confirmed in a further cohort of sun-damaged skin from the US. In this cohort, human epidermal cells confirmed women’s skin activated immune-cancer fighting pathways and immune cells at sites damaged by sunlight.

The US cohort also that showed CD4 and CD8 T cells, which are important in our immune response to skin cancer, were twice as abundant in women as in men.

The researchers used RNA sequencing to examine differences in male and female immunosuppressed mice and human skin cells.

“It has long been assumed that men are at higher risk of getting non-melanoma skin cancer than women” said Dr Amaya Viros, from The University of Manchester.

“Other life-style and behavioural differences between men, such as the type of work or exposure to the sun are likely to be significant.

“However, we also identify for the first time the possible biological reasons, rooted in the immune system, which explains why men may have more severe disease.

“Although this is early research, we believe the immune response is sex-biased in the most common form of skin cancer, and highlights that female immunity may offer greater protection than male immunity.”

Dr Viros added: “We can’t yet explain why women have a more nuanced immune system than men.

“But perhaps it’s reasonable to speculate that women’s evolutionary ability to carry an unborn child of foreign genetic material may require their immunological system to be very finely tuned and have unique skills.

“Very little is known about how sex differences affect incidence and outcome in infectious diseases, autoimmune disorders and cancer. More work needs to be done. But we feel this study has opened a window into this area, and could one day have important implications on other types of immunologically based diseases.

“And it suggests if doctors are to offer personalised treatment of cancer, then biological sex should be one of the factors they take into account.”

Commenting on the study, Dr Samuel Godfrey, Research Information Manager at Cancer Research UK said: “Research like this chips away at the huge question of why people respond to cancer differently. Knowing more about what drives immune responses to cancer could give rise to new treatment options and show us a different perspective on preventing skin cancer.”

Source: Medical Xpress

Journal information: Timothy Budden et al, Female Immunity Protects from Cutaneous Squamous Cell Carcinoma, Clinical Cancer Research (2021). DOI: 10.1158/1078-0432.CCR-20-4261

Categories : Cardiovascular Disease GenderTags :

Heart Risk in Transgender Men Receiving Hormones

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A study of transgender people receiving gender-affirming hormone therapy found that certain hormones increased certain cardiometabolic risk factors. 

Gender-affirming or cross-sex hormone therapy is integral to the management of transgender individuals, but there is only limited understanding of the effects of such hormones on cardiovascular health. Research is limited by the absence of large cohort studies, lack of appropriate control populations, and inadequate data acquisition from gender identity services. Existing epidemiological data suggest that the use of oestrogens in transgender females increases the risk of myocardial infarction and ischaemic stroke. Conversely, testosterone use in transgender males is currently lacking any consistent or convincing evidence of increased risk of cardiovascular or cerebrovascular disease.

This retrospective study included 129 transgender individuals receiving gender-affirming hormone therapy. In transgender males receiving testosterone, there was an average 2.5% drop in HDL cholesterol levels seen each year of using gender-affirming hormone therapy (P=0.03). However, researchers did not see this change in transgender females on estradiol during the average 48-month follow-up period. Additionally, the researchers found no significant changes in LDL cholesterol, triglycerides, HbA1c, or 25-hydroxyvitamin D levels in transgender males or transgender females.

About 53% of the participants in the study identified as transgender males, and more than 60% of the cohort was white. The median age of the total cohort was 26 with a BMI of 25.5. The majority of transgender males were on intramuscular injectable preparations of testosterone cypionate.

Similar to prior studies, a significant decrease in HDL was noted in TM on testosterone therapy. The researchers noted that further study is needed on the correlation of this finding with changes in diet and exercise while on testosterone therapy and impact on cardiovascular events. Reassuringly, no other changes noted in cardiovascular parameters.

“Further long-term data is needed for patients receiving this hormone therapy to assure that their long-term cardiovascular risk is optimised,” concluded Samihah Ahmed, MD, MBA, of Northwell Health Lenox Hill Hospital in New York City, who presented the findings.

Source: MedPage Today

Presentation information: Ahmed S, et al “Cardiometabolic risk factors in transgender individuals taking gender-affirming hormone therapy through four years” AACE 2021. 

Categories : Gender General InterestTags :

Reviewing 50 Years of Progress in Women’s Health

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Woman receiving a mammogram. Photo by National Cancer Institute on Unsplash

As abortion comes under threat in the United States, a perspective article looks back at the progress made in women’s health, seeing significant improvements in areas like equitable access to health care and survivorship.

However, the article’s authors argue there is still a long road ahead, despite all of the progress.

The United States, for example, still has the highest rate of maternal death among high-income countries, particularly among African American women.

As the United States Supreme Court prepares to hear a Mississippi abortion case challenging the landmark 1973 Roe v. Wade decision, some experts are questioning whether the progress made in women’s health may be winding back.

Cynthia A Stuenkel, MD, clinical professor of medicine at University of California San Diego School of Medicine, and JoAnn E Manson, MD, DrPH, professor of epidemiology at Harvard TH Chan School Of Public Health, review 50 years of progress in women’s health in a perspective article published online in New England Journal of Medicine.

“Reproductive justice is broader than the pro-choice movement and encompasses equity and accessibility of reproductive health care, as well as enhanced pathways to parenthood,” wrote the authors.

In addition to Roe v. Wade, they authors reviewed advances in reproductive health including:

  • The 1972 US Supreme Court ruling on Eisenstadt vs Baird ensuring unmarried persons equal access to contraception
  • The 2010 Affordable Care Act in the US made contraceptives an insured preventive health benefit
  • The Reproductive technology advances, including in vitro fertilisation, genetic testing and fertility preservation by cancer specialists

Advances in women’s health encompass more than reproduction, the authors wrote. As interest and focus has expanded to all stages of a woman’s life, science has begun to catch up to the specialised needs of women and sex-specific risk factors for chronic diseases that disproportionately affect women’s health, such as autoimmune diseases, mental health, osteoporosis and coronary heart disease.

  • Progress in breast cancer care and prevention resulted in a five-year overall survival rate of 90%
  • The human papillomavirus (HPV) vaccine reduced cervical cancer mortality fell by 50%

“Moving forward, it will be essential to recognise and study intersectional health disparities, including disparities based on sex, race, ethnicity, gender identity, sexual orientation, income and disability status. Overcoming these challenges and addressing these inequities will contribute to improved health for everyone,” wrote the authors.

Source: News-Medical.Net

Journal information: Stuenkel, C. A., et al. (2021) Women’s Health — Traversing Medicine and Public Policy. New England Journal of Medicine. doi.org/10.1056/NEJMp2105292.

Categories : Gender Injury & TraumaTags :

Treating Brain Injuries with Sex-specific Interventions

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New research has identified a sex-specific window of opportunity to treat traumatic brain injuries (TBIs), which scientists are exploiting in a project to create a sex-targeted drug delivery for TBI.

The study, a collaboration of The University of Texas Health Science Center at Houston (UTHealth) and Arizona State University will be used to help design nanoparticle delivery systems targeting both sexes for treatment of TBI.

“Under normal circumstances, most drugs, even when encapsulated within nanoparticles, do not reach the brain at an effective concentration due to the presence of the blood-brain barrier. However, after a TBI this barrier is compromised, allowing us a window of opportunity to deliver those drugs to the brain where they can have a better chance of exerting a therapeutic effect,” said Rachael Sirianni, PhD, associate professor of neurosurgery at McGovern Medical School at UTHealth. Dr Sirianni’s collaborator and co-lead investigator on this grant, Sarah Stabenfeldt, PhD, was the first to demonstrate that the window of opportunity created in the blood-brain barrier differed between men and women, and it was this key finding that led them to apply for funding.

TBI results from blows to the head, and in the most severe form of TBI, the entirety of the brain is affected by a diffuse type of injury and swelling. The body responds with an acute response to the injury, followed by a chronic phase as it tries to heal.

“In this second phase, a variety of abnormal processes create additional injury that go well beyond the original physical damage to the brain,” Dr Sirianni said.

Normally, the blood vessels maintain a very carefully controlled blood-brain barrier to prevent the entry of harmful substances. However, during this second phase of healing following a TBI, those blood vessels are compromised, possibly allowing substances to seep in.

One of the numerous differences between female and male patients is varying levels and cycles of sex hormones such as oestrogen, progesterone, and testosterone. While these levels already differ in healthy people, additional hormone disruption for both sexes can result from a brain injury.

Dr Sirianni explained that this work is extremely important as presently TBIs have no effective treatment options. Current treatments for TBI vary widely based on injury severity and range from daily cognitive therapy sessions to radical surgery such as bilateral decompressive craniectomies. 

“The goal of this research is to develop different nanoparticle delivery systems that can target the unique physiological state of males versus females following a TBI. Through this research, we hope to develop an optimum distribution system for these drugs to be delivered to the brain and can hopefully find an effective treatment plan for TBIs,” Sirianni said.

Drugs that previously perceived as unsafe or ineffective when given systemically can instead be targeted directly to the injury microenvironment through nanoparticle delivery systems.

“With these nanoparticle systems, we’re looking at how we can revisit a drug that showed promise in preclinical studies or clinical trials but then failed,” Stabenfeldt said.

Source: The University of Texas Health Science Center at Houston

Categories : Gender Neurodegenerative DiseasesTags :

High Blood Pressure Dementia Risk Found for Women

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Differences in blood pressure’s influence on dementia risk in men and women may provide clues to help slow the rapid progress of the disease, according to new research.

In a study involving half a million people, researchers found that although the link between several mid-life cardiovascular risk factors and dementia was similar for both sexes, for blood pressure it was not. Low and high blood pressure were both shown to be associated with a greater risk of dementia in men, but for women the risk of dementia increased as blood pressure went up.

Lead author Jessica Gong said that while more research was needed to verify these findings, they may point to better ways of managing risk.

“Our results suggest a more tailored approach to treating high blood pressure could be more effective at preventing future cases of dementia,” she said.

Dementia is fast becoming a global epidemic, currently affecting an estimated 50 million people worldwide. This is projected to triple by 2050 – mainly driven by aging populations. Rates of dementia and associated deaths are both known to be higher in women than men.

In 2016 it overtook heart disease as the leading cause of death in Australian women and it is the second leading cause of death for all Australians.

With no treatment breakthroughs of any significance, the focus has therefore been on cutting the risk of developing the disease. Cardiovascular risk factors are increasingly recognised as contributors to different types of dementia.

To explore differences in major cardiovascular risk factors for dementia between the sexes, George Institute researchers accessed data from the UK Biobank, a large-scale biomedical database that recruited 502 489 dementia-free Britons 40-69 years old between 2006 and 2010.

They found that, to a similar degree in women and men, smoking , diabetes, high body fat levels, prior stroke history, and low socio-economic status were all linked to a greater risk of dementia.

But when it came to blood pressure, the relationship with dementia risk between the sexes was different. Although the reason for this wasn’t clear, the authors proposed some possible explanations.

“Biological differences between women and men may account for the sex differences we saw in the relationship between blood pressure and the risk of dementia,” said Ms Gong.

“But there may also be differences in medical treatment for hypertension. For example, women are less likely to take medication as prescribed by their healthcare provider than men and may be taking more medications and experiencing more side effects.”

While there are no effective treatments for dementia, trying to reduce the burden of the disease by encouraging healthier lifestyles is the priority, and the strongest evidence points to blood pressure management.

“Our study suggests that a more individualised approach to treating blood pressure in men compared to women may result in even greater protection against the development of dementia,” said study co-author Professor Mark Woodward.

“It also shows the importance of ensuring sufficient numbers of women and men are recruited into studies and that the data for women and men should be analysed separately,” he added.

Source: George Institute

Categories : Injury & Trauma Mental HealthTags :

Head Injuries Widespread Among Female Prisoners

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New research has found that 78% of women prisoners in Scotland have a history of significant head injury – most of which occurred in the context of years of domestic abuse.

The University of Glasgow-led study also found 66% of women prisoners had suffered repeat head injuries for many years. The majority of the study participants were from the most deprived 20% of the population. One US study of male prisoners found 63.7% of at least one traumatic brain injury, and 32.5% had experienced multiple such injuries.

Of those with a history of head injury, the most common cause (89%) of repeat head injury was domestic violence. Only five women had experienced a single incident of moderate-severe head injury. Of those with a history of significant head injury, a first head injury before the age of 15 was reported by 69% of women.

For the study, researchers interviewed around a quarter of women in Scottish prisons, 109 women in total, between 2018 and 2019. They were assessed for a history of head injury, including its causes, a history of abuse, as well as for disability and mental and physical health conditions.

Of the 78% with a history of significant head injury, 40% also had an associated disability. Previous research has reported that many women in prison have a history of head injury, but none looked at disability.

Those with a history of significant head injury were three times more likely to have violent criminal behaviour, and also spent three times longer in prison.

Nearly all participants (95%) reported a history of abuse, with over half reporting sexual abuse in childhood and 46% reporting sexual abuse in adulthood. Physical abuse in childhood was reported by 39%, while 81% of participants reported physical abuse in adulthood.

Alcohol or drug misuse history was common, with substantially higher rates in the group who reported significant head injuries. Almost all, 92%, complained of mental health difficulties, with anxiety and depression the most commonly reported. Although the participants had 12 years of education on average, schooling was often disrupted by exclusion or truanting and many required special schooling or support.

Professor Tom McMillan, Professor of Clinical Neuropsychology at the University of Glasgow and lead author of the study, said: “It is already recognised that women in prison are vulnerable because of histories of abuse and substance misuse. However, this research shows that a history of significant head injury is also a vulnerability and needs to be included when considering mental health needs and in developing criminal justice policy given the relationships with associated disabilities, abuse and violent crime’’.

“Our findings suggest that interventions to reduce mental health morbidity, and assessment and management of risk of violent offending should include history of significant head injury. There is a need to recognise these vulnerabilities at an early stage, including at the first contact with the criminal justice system, to assess these women and provide long term support.”

Common persistent effects of significant head injury include impairments in information processing and emotional changes associated with impulsivity, irritability and egocentricity. These effects can impair judgement and self-control, increase the risk of offending. Significant head injury can also impair the maturation of the developing brain if occurring before adulthood.

The characteristics of significant head injury in women in prison differ from women with significant head injury in the general population. Domestic violence was the most common cause of these injuries in women in prison, whereas  in the general population falls are most common. In addition head injury occurred repeatedly in around two-thirds of women in prison with significant head injury, whereas single incident head injury from an accident is more common in the general population.

Source: University of Glasgow

Journal information: Tom M McMillan et al. Associations between significant head injury and persisting disability and violent crime in women in prison in Scotland, UK: a cross-sectional study, The Lancet Psychiatry (2021). DOI: 10.1016/S2215-0366(21)00082-1