Article2012

The Antisocial Brain: Psychopathy Matters

233 citations0/0 files storedArchives of General Psychiatry

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Psychopathy, Forensic Psychiatry, Sexual Offending Personality Traits and Psychology Neural and Behavioral Psychology Studies

Abstract

CONTEXT: The population of men who display persistent antisocial and violent behavior is heterogeneous. Callous-unemotional traits in childhood and psychopathic traits in adulthood characterize a distinct subgroup. OBJECTIVE: To identify structural gray matter (GM) differences between persistent violent offenders who meet criteria for antisocial personality disorder and the syndrome of psychopathy (ASPDP) and those meeting criteria only for ASPD (ASPD-P). DESIGN: Cross-sectional case-control structural magnetic resonance imaging study. SETTING: Inner-city probation services and neuroimaging research unit in London, England. PARTICIPANTS: Sixty-six men, including 17 violent offenders with ASPDP, 27 violent offenders with ASPD-P, and 22 healthy nonoffenders participated in the study. Forensic clinicians assessed participants using the Structured Clinical Interview for DSM-IV and the Psychopathy Checklist-Revised. MAIN OUTCOME MEASURES: Gray matter volumes as assessed by structural magnetic resonance imaging and volumetric voxel-based morphometry analyses. RESULTS: Offenders with ASPDP displayed significantly reduced GM volumes bilaterally in the anterior rostral prefrontal cortex (Brodmann area 10) and temporal poles (Brodmann area 20/38) relative to offenders with ASPD-P and nonoffenders. These reductions were not attributable to substance use disorders. Offenders with ASPD-P exhibited GM volumes similar to the nonoffenders. CONCLUSIONS: Reduced GM volume within areas implicated in empathic processing, moral reasoning, and processing of prosocial emotions such as guilt and embarrassment may contribute to the profound abnormalities of social behavior observed in psychopathy. Evidence of robust structural brain differences between persistently violent men with and without psychopathy adds to the evidence that psychopathy represents a distinct phenotype. This knowledge may facilitate research into the etiology of persistent violent behavior.

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References

1993Adolescence-limited and life-course-persistent antisocial behavior: A developmental taxonomy.2002The world report on violence and health 2008How do you feel — now? The anterior insula and human awareness 1992The Structured Clinical Interview for DSM-III-R (SCID)2004Empathy for Pain Involves the Affective but not Sensory Components of Pain 2002Males on the life-course-persistent and adolescence-limited antisocial pathways: Follow-up at age 26 years 2006The reactive–proactive aggression questionnaire: differential correlates of reactive and proactive aggression in adolescent boys 2007The Neural Substrate of Human Empathy: Effects of Perspective-taking and Cognitive Appraisal

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2021Psychopathy 2013Antisocial Personality Disorder: A Current Review 2019The Sensitivity to Threat and Affiliative Reward (STAR) model and the development of callous-unemotional traits 2013Empathy and social problem solving in alcohol dependence, mood disorders and selected personality disorders 2013Cool and Hot Executive Function Impairments in Violent Offenders with Antisocial Personality Disorder with and without Psychopathy

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