La détermination d’un sous-groupe de contrevenants de la conduite avec capacités affaiblies à risque élevé de récidive : l’utilité de l’axe hypothalamo-hypophyso-surrénalien
Among driving while impaired (DWI) offenders, the risk of recidivism varies greatly. In order to overcome the heterogeneity among this population, the present thesis proposed a renewed conceptualization of DWI. More specifically, a model integrating disinhibitory personality traits and high-risk behaviours associated with DWI recidivism and the categorization of a high-risk subgroup of offenders based on hypothalamic-pituitary-adrenal (HPA) axis activity has been proposed. Three manuscripts aimed to answer these general objectives using salivary cortisol, that is, the stress hormone.   In the first manuscript, the current HPA axis literature of DWI offenders and other high-risk populations have been merged into a comprehensive theoretical model. Previous studies have demonstrated an inverse correlation between DWI convictions frequency and cortisol reactivity to stress. Among recidivists, cortisol reactivity was partially explained by experience seeking, a sensation seeking dimension. Beyond this disinhibitory personality trait, low HPA axis activity has been linked to various traits (e.g., impulsivity and antisocial tendencies) and high-risk behaviours (e.g., traffic infractions, criminal arrests, and psychoactive drugs). By incorporating cortisol reactivity, this model stimulates a thorough conceptualization of several DWI offenders’ characteristics and as such, explains hypothetically repetition of high-risk behaviours.  The following manuscripts are less theoretical and more empirical. The detection of a high-risk recidivism subgroup delineated with HPA axis activity has been investigated among two DWI offender populations. More specifically, the second manuscript hypothesized that among DWI recidivists (n = 30), low cortisol responders have more characteristics linked to recidivism such as disinhibitory personality traits and high-risk behaviours than high cortisol responders (as defined by the area under the curve sensitive to total hormonal release and to response to stimulation). This hypothesis was not supported. On the contrary, low cortisol DWI recidivists have less traffic infractions and criminal arrests than high cortisol recidivists. Finally, the third manuscript investigated a similar hypothesis but this time, among first-time DWI offenders (n = 139). Results demonstrated that low cortisol offenders have more attentional impulsiveness, non-planning impulsiveness, criminal arrests and cigarettes consumed per day than high cortisol offenders (as defined by post-stress minus pre-test episode). An exploratory analysis showed a more prevalent variety of disinhibitory personality trait and high-risk behaviours among low cortisol offenders compared to a non-DWI comparator group (n = 31). These results reinforce the potentially higher recidivism risk of this first-time DWI offenders subgroup.  Neurobiological mechanism usefulness in modelling disinhibitory personality trait and high-risk behaviours of DWI offenders has been investigated in the present thesis. Additionally, detection of a high-risk recidivism subgroup seems more relevant among heterogeneous first-time DWI offenders. Instead, HPA axis activity is not as useful in detecting a problematic subgroup among the most severe offenders, namely recidivists.
Cortisol Drunk driving Recidivist First-time offender Hypothalamic-pituitary-adrenal axis Detection High-risk behaviours Sensation seeking Impulsivity