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The neurobiology of psychopathy: recent developments and new directions in research and treatment

Published online by Cambridge University Press:  20 February 2015

Michael A. Cummings*
Affiliation:
Department of State Hospitals–Patton, Department of Psychiatry, Patton, California, USA; Department of Psychiatry and Human Behavior, University of California, Irvine, Orange, California, USA
*
*Address for correspondence: Michael A. Cummings, MD, Department of State Hospitals–Patton, Administrative Annex # 159, 3102 East Highland Avenue, Patton, CA 92369, USA. (Email: Michael.Cummings@DSH.CA.GOV)

Abstract

Psychopathic individuals account for substantial predatory and impulsive violence. To the present, the principal intervention used to decrease the harm inflicted by psychopaths has been confinement. Nevertheless, most confined psychopathic persons return to the community. Recent advances in the understanding of the neurobiology of psychopathy hold promise for new research directions and more effective treatments. In this article, we will explore recent advances in genetics, electrophysiology, brain imaging, and psychopharmacology, as well as, in brief, their implications for new directions in research and treatment.

Type
Review Articles
Copyright
© Cambridge University Press 2015 

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Footnotes

The author wishes to acknowledge the assistance of Ms. Tina Lache and Jonathan Meyer, MD, in proofing this manuscript and formatting figures.

References

1. Compton, WM, Conway, KP, Stinson, FS, Colliver, JD, Grant, BF. Prevalence, correlates, and comorbidity of DSM-IV antisocial personality syndromes and alcohol and specific drug use disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2005; 66(6): 677685.CrossRefGoogle ScholarPubMed
2. Anderson, NE, Kiehl, KA. Psychopathy and aggression: when paralimbic dysfunction leads to violence. Curr Top Behav Neurosci. 2014; 17: 369393.CrossRefGoogle ScholarPubMed
3. Michaud, SG, Aynesworth, H. Ted Bundy: Conversations with a Killer. Irving, TX: Authorlink Press; 2000.Google Scholar
4. Macmillan, MB. An Odd Kind of Fame: Stories of Phineas Gage. Boston, MA: The MIT Press; 2002.Google Scholar
5. Harlow, JM. Passage of an iron rod through the head. Boston Medical and Surgical Journal. 1848; 39(20): 389393.Google Scholar
6. Bigelow, HJ. Dr. Harlow’s case of recovery from the passage of an iron bar through the head. Am J Med Sci. 1850; 20(39): 1322.CrossRefGoogle Scholar
7. Harlow, JM. Recovery from the Passage of an Iron Bar through the Head. Boston: David Clapp & Son; 1869.Google Scholar
8. Van Horn, JD, Irimia, A, Torgerson, CM, Chambers, MC, Kikinis, R, Toga, AW. Mapping connectivity damage in the case of Phineas Gage. PLoS ONE. 2012; 7(5): e37454.CrossRefGoogle ScholarPubMed
9. Cleckley, HM. The Mask of Sanity: An Attempt to Clarify Some Issues about the So-Called Psychopathic Personality. 5th ed. Chicago: William A. Dolan; 1988.Google Scholar
10. Harpur, TJ, Hare, RD, Hakstain, AR. Two-factor conceptualization of psychopathy: construct validity and assessment implications. Psychol Assess. 1989; 11(1): 617.CrossRefGoogle Scholar
11. Cooke, DJ, Michie, C, Skeem, J. Understanding the structure of the psychopathy checklist–revised: an exploration of methodological confusion. Br J Psychiatry Suppl. 2007; 49: s39s50.CrossRefGoogle ScholarPubMed
12. Raine, A. The Psychopathology of Crime: Criminal Behavior as a Clinical Disorder. 1st ed. San Diego, CA: Academic Press; 1997.Google Scholar
13. Raine, A. Autonomic nervous system factors underlying disinhibited, antisocial, and violent behavior: biosocial perspectives and treatment implications. Ann N Y Acad Sci. 1996; 794: 4659.CrossRefGoogle ScholarPubMed
14. Thompson, DF, Ramos, CL, Willett, JK. Psychopathy: clinical features, developmental basis and therapeutic challenges. J Clin Pharm Ther. 2014; 39(5): 485495.CrossRefGoogle ScholarPubMed
15. Perry, BD, Pollard, R, Blakely, T, Baker, WL, Vigilante, D. Childhood trauma, the neurobiology of adaptation and “use-dependent” development of the brain: how “states” become “traits.” Infant Mental Health Journal. 1995; 16(4): 271291.3.0.CO;2-B>CrossRefGoogle Scholar
16. Byrd, AL, Manuck, SB. MAOA, childhood maltreatment, and antisocial behavior: meta-analysis of a gene-environment interaction. Biol Psychiatry. 2014; 75(1): 917.CrossRefGoogle ScholarPubMed
17. Haberstick, BC, Lessem, JM, Hewitt, JK, et al. MAOA genotype, childhood maltreatment, and their interaction in the etiology of adult antisocial behaviors. Biol Psychiatry. 2014; 75(1): 2530.CrossRefGoogle ScholarPubMed
18. Moul, C, Dobson-Stone, C, Brennan, J, Hawes, D, Dadds, M. An exploration of the serotonin system in antisocial boys with high levels of callous-unemotional traits. PLoS ONE. 2013; 8(2): e56619.CrossRefGoogle ScholarPubMed
19. Kretschmer, T, Vitaro, F, Barker, ED. The association between peer and own aggression is moderated by the BDNF Val-Met polymorphism. J Res Adolesc. 2014; 24(1): 177185.CrossRefGoogle ScholarPubMed
20. Smearman, EL, Winiarski, DA, Brennan, PA, Najman, J, Johnson, KC. Social stress and the oxytocin receptor gene interact to predict antisocial behavior in an at-risk cohort. Dev Psychopathol. In press. DOI: 10.1017/S0954579414000649.Google Scholar
21. Frick, PJ. Extending the construct of psychopathy to youth: implications for understanding, diagnosing, and treating antisocial children and adolescents. Can J Psychiatry. 2009; 54(12): 803812.CrossRefGoogle ScholarPubMed
22. Trebuchon, A, Bartolomei, F, McGonigal, A, Laguitton, V, Chauvel, P. Reversible antisocial behavior in ventromedial prefrontal lobe epilepsy. Epilepsy Behav. 2013; 29(2): 367373.CrossRefGoogle ScholarPubMed
23. Venables, NC, Patrick, CJ. Reconciling discrepant findings for P3 brain response in criminal psychopathy through reference to the concept of externalizing proneness. Psychophysiology. 2014; 51(5): 427436.CrossRefGoogle Scholar
24. Drislane, LE, Vaidyanathan, U, Patrick, CJ. Reduced cortical call to arms differentiates psychopathy from antisocial personality disorder. Psychol Medicine. 2013; 43(4): 825835.CrossRefGoogle ScholarPubMed
25. Yoder, KJ, Decety, J. Spatiotemporal neural dynamics of moral judgment: a high-density ERP study. Neuropsychologia. 2014; 60: 3945.CrossRefGoogle ScholarPubMed
26. Hyde, LW, Byrd, AL, Votruba-Drzal, E, Hariri, AR, Manuck, SB. Amygdala reactivity and negative emotionality: divergent correlates of antisocial personality and psychopathy traits in a community sample. J Abnorm Psychol. 2014; 123(1): 214224.CrossRefGoogle Scholar
27. Decety, J, Skelly, L, Yoder, KJ, Kiehl, KA. Neural processing of dynamic emotional facial expressions in psychopaths. Soc Neurosci. 2014; 9(1): 3649.CrossRefGoogle ScholarPubMed
28. Ermer, E, Cope, LM, Nyalakanti, PK, Calhoun, VD, Kiehl, KA. Aberrant paralimbic gray matter in criminal psychopathy. J Abnorm Psychol. 2012; 121(3): 649658.CrossRefGoogle ScholarPubMed
29. Shenhav, A, Greene, JD. Integrative moral judgment: dissociating the roles of the amygdala and ventromedial prefrontal cortex. J Neurosci. 2014; 34(13): 47414749.CrossRefGoogle ScholarPubMed
30. Motzkin, JC, Newman, JP, Kiehl, KA, Koenigs, M. Reduced prefrontal connectivity in psychopathy. J Neurosci. 2011; 31(48): 1734817357.CrossRefGoogle ScholarPubMed
31. Contreras-Rodríguez, O, Pujol, J, Batalla, I, et al. Functional connectivity bias in the prefrontal cortex of psychopaths. Biol Psychiatry. In press. DOI: 10.1016/j.biopsych.2014.03.007.Google Scholar
32. Li, W, Mai, X, Liu, C. The default mode network and social understanding of others: what do brain connectivity studies tell us? Front Hum Neurosci. 2014; 8: 74.CrossRefGoogle ScholarPubMed
33. Raine, A, Lencz, T, Taylor, K, et al. Corpus callosum abnormalities in psychopathic antisocial individuals. Arch Gen Psychiatry. 2003; 60(11): 11341142.CrossRefGoogle ScholarPubMed
34. Sundram, F, Deeley, Q, Sarkar, S, et al. White matter microstructural abnormalities in the frontal lobe of adults with antisocial personality disorder. Cortex. 2012; 48(2): 216229.CrossRefGoogle ScholarPubMed
35. Gregory, S, Ffytche, D, Simmons, A, et al. The antisocial brain: psychopathy matters: a structural MRI investigation of antisocial male violent offenders. JAMA Psychiatry. 2012; 69(9): 962972.Google Scholar
36. Haker, H, Schimansky, J, Rossler, W. [Sociophysiology: basic processes of empathy]. Neuropsychiatrie. 2010; 24(3): 151160.Google ScholarPubMed
37. Cai, X, Padoa-Schioppa, C. Neuronal encoding of subjective value in dorsal and ventral anterior cingulate cortex. J Neurosci. 2012; 32(11): 37913808.CrossRefGoogle ScholarPubMed
38. Buckholtz, JW, Treadway, MT, Cowan, RL, et al. Mesolimbic dopamine reward system hypersensitivity in individuals with psychopathic traits. Nat Neurosci. 2010; 13(4): 419421.CrossRefGoogle ScholarPubMed
39. Hare, RD, Neumann, CS. Psychopathy as a clinical and empirical construct. Ann Rev Clin Psychol. 2008; 4: 217246.CrossRefGoogle ScholarPubMed
40. Coid, JW. Personality disorders in prisoners and their motivation for dangerous and disruptive behaviour. Crim Behav Ment Health. 2002; 12(3): 209226.CrossRefGoogle ScholarPubMed
41. Sobral, J, Luengo, A, Gómez-Fraguela, JA, Romero, E, Villar, P. [Personality, gender and violent criminality in prison inmates]. Psicothema. 2007; 19(2): 269275.Google ScholarPubMed
42. Endrass, J, Urbaniok, F, Gerth, J, Rossegger, A. [Prison violence: prevalence, manifestation and risk factors]. Praxis (Bern 1994). 2009; 98(22): 12791283.CrossRefGoogle ScholarPubMed
43. Kennedy, HG. Therapeutic uses of security: mapping forensic mental health services by stratifying risk. Advances in Psychiatric Treatment. 2002; 8(6): 433443.CrossRefGoogle Scholar
44. Meffert, H, Gazzola, V, den Boer, JA, Bartels, AA, Keysers, C. Reduced spontaneous but relatively normal deliberate vicarious representations in psychopathy. Brain. 2013; 136(8): 25502562.CrossRefGoogle ScholarPubMed
45. Bonta, J, Andrews, DA. Risk-Need-Responsivity Model for Offender Assessment and Rehabilitation 2007–06. Ottawa: Her Majesty the Queen in Right of Canada; 2007.Google Scholar
46. Gitlin, MJ. Pharmacotherapy of personality disorders: conceptual framework and clinical strategies. J Clin Psychopharmacol. 1993; 13(5): 343353.CrossRefGoogle ScholarPubMed
47. Citrome, L, Volavka, J. Pharmacological management of acute and persistent aggression in forensic psychiatry settings. CNS Drugs. 2011; 25(12): 10091021.CrossRefGoogle ScholarPubMed
48. Ripoll, LH, Triebwasser, J, Siever, LJ. Evidence-based pharmacotherapy for personality disorders. Int J Neuropsychopharmacol. 2011; 14(9): 12571288.CrossRefGoogle ScholarPubMed
49. Tupin, JP, Smith, DB, Clanon, TL, Kim, LI, Nugent, A, Groupe, A. The long-term use of lithium in aggressive prisoners. Compr Psychiatry. 1973; 14(4): 311317.CrossRefGoogle ScholarPubMed
50. Dunlop, BW, DeFife, JA, Marx, L, Garlow, SJ, Nemeroff, CB, Lilienfeld, SO. The effects of sertraline on psychopathic traits. Int Clin Psychopharmacol. 2011; 26(6): 329337.CrossRefGoogle ScholarPubMed
51. Brown, D, Larkin, F, Sengupta, S, et al. Clozapine: an effective treatment for seriously violent and psychopathic men with antisocial personality disorder in a UK high-security hospital. CNS Spectr. 2014; 19(5): 391402.CrossRefGoogle Scholar
52. Bari, A, Niu, T, Langevin, JP, Fried, I. Limbic neuromodulation: implications for addiction, posttraumatic stress disorder, and memory. Neurosurg Clin N Am. 2014; 25(1): 137145.CrossRefGoogle ScholarPubMed