Executive Function Deficits and Emotion Dysregulation as Neurocognitive Predictors of Violent Behaviour in Forensic Populations: A Systematic Review and Clinical Implications

Abstract

Background: This systematic review synthesises existing literature on executive function deficits and emotion dysregulation as predictors of violent behaviour in forensic samples.
Methods: PubMed, PsycINFO, Scopus, and Web of Science were searched for empirical studies published between 2015 and 2025. Included studies focused on adult forensic populations, employed validated measures of EF and/or emotion regulation (ER), assessed violent or aggressive outcomes, and utilised cross-sectional, cohort, or review designs. Selection followed PRISMA guidelines. Data extraction was conducted independently by two reviewers, with effect sizes synthesised narratively due to methodological heterogeneity. Study quality was assessed using an adapted NIH/NHLBI risk-of-bias tool.
Results: From 1,597 initial records, 55 studies met inclusion criteria. Inhibitory control deficits consistently distinguished violent from non-violent offenders. Meta-analytic evidence indicated modest EF impairments in justice-involved adults compared to controls (d = 0.55 overall; d = 0.72 for adults). Modest, significant correlations were found between ED measures and aggression (pooled r = 0.25–0.33), with ED explaining incremental variance in aggression beyond trait emotionality. Study quality was mixed, with few prospective designs and substantial methodological heterogeneity across studies (I² > 80% for ER-aggression relationships).