My first lesson in the effects of brain injury came at an early age, when a schoolmate accidentally ran in front of a car. Poor Ralph was never the same. We didn’t see much of him after that, but the stories we heard of his impaired cognitive abilities, suddenly acquired profanity and impulsive behaviors were not happy ones. In one quick moment, his brain, and pretty much everything else about him, had changed. As a science nerd with dreams of medical school, I was horrified by Ralph’s suddenly limited intellectual ability, but intrigued by the change in his behavior.

Forty-plus years later, the importance of the brain in every aspect of human behavior is clear. Functional brain imaging reveals increased activity in specific areas as we engage in various tasks and experience different emotions, with low levels of activity in those areas considered abnormal. The cognitive and behavioral changes suffered by some professional athletes, as well as returning veterans from Iraq and Afghanistan, have driven home the effects of brain injuries. The human genome has been mapped, revealing that specific genetic changes are associated with certain personality traits, antisocial behavior and mental disorders. For decades, most physicians relied exclusively on psychological and sociological theories to explain human behavior. In the 21st century, however, the prevailing view is that we cannot explain people’s actions without understanding brain structure and function.  

Throughout these four decades, Adrian Raine has explored the physiological differences between “normal” individuals and those who engage in criminal and other antisocial behavior. Raine describes himself as a “neurocriminologist,” devoted to understanding the biological bases of criminal behavior. He has been a leader among the growing number of researchers working to demonstrate that biological factors — as invisible as genetic variations and poor nutrition, and as obvious as brain tumors and Ralph’s head injury — play a role in criminal behavior.

In The Anatomy of Violence: The Biological Roots of Crime, Raine argues that biological factors can explain acts of violence as diverse as intertribal warfare, pedophilia, rape, domestic violence, serial murder and terrorism. Using case examples and extensive references, he presents evidence that the origins of criminal behavior may lie in such factors as genetic abnormalities, the evolutionary drive to spread one’s DNA, nutrition, physiological and anatomic anomalies in offenders’ brains, and environmental influences on the developing fetus.

Raine’s work has focused on establishing the biological markers that cause, or at least correlate with, criminal behavior. The author makes his case forcefully, fueled by the criticism of those who adhere to traditional psychological and sociological theories of crime and violence. Although he does not dismiss the role of environmental factors, Raine believes that the importance of “nurture” lies in its interactions with “nature.” For Raine, biology is more important by far.  

If, in fact, the roots of crime are to be found in biology, is there anything we can do? Raine offers an array of suggestions for interventions that may modify or prevent criminal behavior. He describes a model in which biological and social risk factors give rise to “brain risk factors” that play out at three levels: cognition, emotion and motor behavior.  Society, he asserts, needs to address the problem of criminal behavior by intervening at each of these stages; it needs to identify children at risk (prenatally, if possible) and address the myriad social and biological risk factors through improved parenting skills, better nutrition, cognitive stimulation and physical exercise.  

Raine takes his analysis a step further, offering a brief discussion of how the courts might deal with evidence of criminal biomarkers. He focuses on the issue of criminal responsibility in jurisdictions that employ a pure cognitive standard for criminal responsibility; that is, when a defendant lacks the ability to appreciate the wrongfulness of his or her actions. He suggests that most criminals influenced by biological factors are aware of the wrongfulness of their actions, and as such, would still be criminally responsible. But Raine overlooks those jurisdictions that apply a volitional as well as a cognitive standard, looking to whether the defendant was able to conform his or her behavior to the requirements of the law. Evidence of brain abnormalities that impair impulse control and judgment would be relevant in such cases, but Raine does not address these issues.  

Having presented the case for neurocriminology, Raine suggests some of its implications for the future. He points out that courts may view criminal biomarkers in a deterministic fashion, leading judges to impose harsher sentences on those who display these factors  in an effort to protect society from further offenses. He then takes us on a journey through a 21st-century in which hypothetical programs screen ever-younger children for criminal potential, with enforced interventions for them, and even for adults who plan to have children. 

Raine points out the ethical, social and legal issues raised by such programs, reminiscent of the film “Minority Report.” Elements of such programs already exist, in the United States and elsewhere, in laws aimed at sexual predators and the U.K.’s “Imprisonment for Public Protection” program.  Because such programs detain people based on psychological and social factors, Raine suggests that there is more than a little hypocrisy in refusing to base such interventions on biological factors, which can actually provide a basis for effective prevention and treatment.  
Raine concludes this readable, and at times controversial, book by suggesting that society will miss an important opportunity to reduce crime if it refuses to acknowledge the importance of biological factors in crime and fails to address directly the ethical quandaries raised by neurocriminology. In the end, the book is worth reading by anyone who has an interest in violence and criminal behavior, not because it provides definitive answers, but for its value in setting the stage for ongoing thought and discussion.

Ronald Schouten is a clinical and forensic psychiatrist. He is an associate professor of psychiatry at Harvard Medical School; director of the Law and Psychiatry Service at Massachusetts General Hospital’ and co-author of Almost a Psychopath: Do I (or Does Someone I Know) Have a Problem with Manipulation and Lack of Empathy? (Hazelden, 2012). He is on Twitter at @RonSchouten.