Psychopathy Linked to Specific Structural Abnormalities in the Brain

Psychopathy Linked to Specific Structural Abnormalities in the Brain

New research provides the strongest evidence to date that psychopathy is linked to specific structural abnormalities in the brain.

The study, published in Archives of General Psychiatryand led by researchers at King’s College London is the first to confirm that psychopathy is a distinct neuro-developmental sub-group of anti-social personality disorder (ASPD).

Most violent crimes are committed by a small group of persistent male offenders with ASPD. Approximately half of male prisoners in England and Wales will meet diagnostic criteria for ASPD. The majority of such men are not true psychopaths (ASPD-P). They are characterised by emotional instability, impulsivity and high levels of mood and anxiety disorders. They typically use aggression in a reactive way in response to a perceived threat or sense of frustration.

However, about one third of such men will meet additional diagnostic criteria for psychopathy (ASPD+P). They are characterised by a lack of empathy and remorse, and use aggression in a planned way to secure what they want (status, money etc.). Previous research has shown that psychopaths’ brains differ structurally from healthy brains, but until now, none have examined these differences within a population of violent offenders with ASPD.

Dr Nigel Blackwood from the Institute of Psychiatry at King’s and lead author of the study says: ‘Using MRI scans we found that psychopaths had structural brain abnormalities in key areas of their ‘social brains’ compared to those who just had ASPD. This adds to behavioural and developmental evidence that psychopathy is an important subgroup of ASPD with a different neurobiological basis and different treatment needs.

‘There is a clear behavioural difference amongst those diagnosed with ASPD depending on whether or not they also have psychopathy. We describe those without psychopathy as ‘hot-headed’ and those with psychopathy as ‘cold-hearted’. The ‘cold-hearted’ psychopathic group begin offending earlier, engage in a broader range and greater density of offending behaviours, and respond less well to treatment programmes in adulthood, compared to the ‘hot-headed’ group. We now know that this behavioural difference corresponds to very specific structural brain abnormalities which underpin psychopathic behaviour, such as profound deficits in empathising with the distress of others.’

The researchers used Magnetic Resonance Imaging (MRI) to scan the brains of 44 violent adult male offenders diagnosed with Anti-Social Personality Disorder (ASPD). Crimes committed included murder, rape, attempted murder and grievous bodily harm. Of these, 17 met the diagnosis for psychopathy (ASPD+P) and 27 did not (ASPD-P). They also scanned the brains of 22 healthy non-offenders.

The study found that ASPD+P offenders displayed significantly reduced grey matter volumes in the anterior rostral prefrontal cortex and temporal poles compared to ASPD-P offenders and healthy non-offenders. These areas are important in understanding other people’s emotions and intentions and are activated when people think about moral behaviour. Damage to these areas is associated with impaired empathising with other people, poor response to fear and distress and a lack of ‘self-conscious’ emotions such as guilt or embarrassment.

Dr Blackwood explains: ‘Identifying and diagnosing this sub-group of violent offenders with brain scans has important implications for treatment. Those without the syndrome of psychopathy, and the associated structural brain damage, will benefit from cognitive and behavioural treatments. Optimal treatment for the group of psychopaths is much less clear at this stage.’

Notes about this psychopathy research article

The research was funded by research grants from the Department of Health, the Ministry of Justice, the Psychiatry Research Trust and the NIHR Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King’s College London.

Contact: Louise Pratt – King’s College London
Source: King’s College London press release
Original Research: Abstract for “The Antisocial Brain: Psychopathy Matters: A Structural MRI Investigation of Antisocial Male Violent Offenders” by Sarah Gregory, PhD; Dominic Ffytche, MD, MRCPsych; Andrew Simmons, PhD; Veena Kumari, PhD; Matthew Howard, PhD; Sheilagh Hodgins, PhD & Nigel Blackwood, MA, MD, MRCPsych in Archives of General Psychiatry Published online May 7, 2012. doi:10.1001/archgenpsychiatry.2012.222

Our ability to distinguish between what is real and what is perceived

People with psychotic-like experiences spend less time in healthy brain states

Image shows avatars.

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A new Lancet study reports auditory hallucinations may be reduced in people with schizophrenia following face-to-face discussions with an avatar that says the things they hear. Researchers report the patients were able to verbalize their feeling by ‘standing up to’ the avatars and taking control of the conversations. READ MORE…

Psychosis – page 2

People with Psychotic-Like Experiences Spend Less Time in Healthy Brain States

People with Psychotic-Like Experiences Spend Less Time in Healthy Brain States

Summary: According to researchers, healthy people who experience subtle symptoms of psychotic disorders, such as hallucinations, have altered brain dynamics.

Source: Elsevier.

Healthy people experiencing subtle symptoms observed in psychotic disorders, such as hallucinations and delusions, have altered brain dynamics, according to a new study published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. The alterations were found in patterns of brain activity that reoccur, or “states” that the brain moves in and out of over time. The participants who reported the psychotic-like experiences (PLEs) — considered to be at the low end of the psychosis spectrum — spent less time in a brain state reflecting healthier brain network activity.

Previous studies of PLEs have found alterations in specific brain networks, but the findings reveal that it is not just about damaged connections — the amount of time spent in uncommon brain states may contribute to psychosis.

“These altered brain dynamics are important because they provide a new biomarker for subclinical psychosis,” said Dr. Anita Barber of the Feinstein Institute for Medical Research in New York, first author of the study. The participants were all considered healthy, yet their subtle symptoms demonstrated unique brain fluctuations that could potentially be used to identify signs of psychosis.

In the study, Dr. Barber and colleagues analyzed brain imaging data from the Human Connectome Project of 76 otherwise healthy participants reporting PLEs and 153 control participants. Those experiencing PLEs spent less time in a more “typical” reoccurring brain state involving cognitive networks. They also spent more time in a state characterized by excessive communication in visual regions of the brain, which could be the basis for visual hallucinations experienced in psychosis. The study didn’t include people with a psychotic disorder, but the findings line up with brain alterations found in patients with schizophrenia.

According to Dr. Cameron Carter, Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, the study is an important example of how more sophisticated approaches to analyzing brain imaging data examining transitions between mental states over time can measure altered brain dynamics that can identify subtle risk states or even track the transition from subclinical to clinical psychopathology.

Image shows a brain.

“This has implications for improving health and well-being and for preventing conversion to a psychotic disorder,” said Dr. Barber. PLEs affect many more people than the number who will be diagnosed with a psychotic disorder, and can cause impairments in social and occupational functioning similar to, though less severe than, those experienced by people with psychosis. “The findings suggest that therapies encouraging greater engagement of goal-directed behaviors and less engagement of visual sensory processing could improve outcomes,” said Dr. Barber.

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Source: Rhiannon Bugno – Elsevier
Publisher: Organized by NeuroscienceNews.com.
Image Source: NeuroscienceNews.com image is in the public domain.
Original Research: Abstract for “Dynamic Functional Connectivity States Reflecting Psychotic-Like Experiences” by Anita D. Barber, Martin A. Lindquist, Pamela DeRosse, Katherine H. Karlsgodt in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. Published online September 28 2017 doi:10.1016/j.bpsc.2017.09.008

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Elsevier “People with Psychotic-Like Experiences Spend Less Time in Healthy Brain States.” NeuroscienceNews. NeuroscienceNews, 1 November 2017.
<http://neurosciencenews.com/psychosis-brain-state-7853/&gt;.

Abstract

Dynamic Functional Connectivity States Reflecting Psychotic-Like Experiences

Background

Psychotic-like experiences (PLEs) are associated with lower social and occupational functioning, and lower executive function. Emerging evidence also suggests that PLEs reflect neural dysfunction resembling that of psychotic disorders.

Methods

The present study examined dynamic connectivity related to a measure of PLEs derived from the Achenbach Adult Self-Report, in an otherwise-healthy sample of adults from the Human Connectome Project. 76 PLE-endorsing and 153 control participants were included in the final sample. To characterize network dysfunction, dynamic connectivity states were examined across large-scale resting-state networks using Dynamic Conditional Correlation (DCC) and k-means clustering.

Results

Three dynamic states were identified. The PLE-endorsing group spent more time than controls in State 1, a state reflecting hyper-connectivity within Visual regions and hypo-connectivity within the Default Mode Network, and less time in State 2, a state characterized by robust within-network connectivity for all networks and strong Default Mode Network anti-correlations. Within the PLE-endorsing group, worse Executive Function was associated with more time spent in and more transitions into State 1 and less time spent in and fewer transitions into State 3.

Conclusions

PLEs are associated with altered large-scale brain dynamics, which tip the system away from spending more time in states reflecting more “typical” connectivity patterns toward more time in states reflecting Visual hyper-connectivity and Default Mode hypo-connectivity.

“Dynamic Functional Connectivity States Reflecting Psychotic-Like Experiences” by Anita D. Barber, Martin A. Lindquist, Pamela DeRosse, Katherine H. Karlsgodt in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. Published online September 28 2017 doi:10.1016/j.bpsc.2017.09.008

Probing Psychopathic Brains

truProbing Psychopathic Brains

Summary: Taking a mobile neuroimaging system on the road to prisons, researchers look at the brain activity of those considered to be psychopaths and discover their brains are wired in a way that leads them to over-value immediate rewards while neglecting future consequences.Source: Harvard.

Josh Buckholtz wants to change the way you think about psychopaths — and he’s willing to go to prison to do it.

An Associate Professor of Psychology, Buckholtz is the senior author of a study that relies on brain scans of nearly 50 prison inmates to help explain why psychopaths make poor decisions that often lead to violence or other anti-social behavior.

What they found, he said, is psychopath’s brains are wired in a way that leads them to over-value immediate rewards and neglect the future consequences of potentially dangerous or immoral actions. The study is described in a July 5 paper in Neuron.

“For years, we have been focused on the idea that psychopaths are people who cannot generate emotion and that’s why they do all these terrible things,” Buckholtz said. “But what what we care about with psychopaths is not the feelings they have or don’t have, it’s the choices they make. Psychopaths commit an astonishing amount of crime, and this crime is both devastating to victims and astronomically costly to society as a whole.

“And even though psychopaths are often portrayed as cold-blooded, almost alien predators, we have been showing that their emotional deficits may not actually be the primary driver of these bad choices. Because it’s the choices of psychopaths that cause so much trouble, we’ve been trying to understand what goes on in their brains when the make decisions that involve trade-offs between the costs and benefits of action.,” he continued. “In this most recent paper…we are able to look at brain-based measures of reward and value and the communication between different brain regions that are involved in decision making.”

Obtaining the scans used in the study, however, was no easy feat — where most studies face an uphill battle in bringing subjects into the lab, Buckholtz’s challenge was in bringing the scanner to his subjects.

The solution came in form of a “mobile” scanner — typically used for cancer screenings in rural areas — that came packed in the trailer of a tractor trailer. After trucking the equipment to a two medium-security prisons in Wisconsin, the team — which included collaborators at the University of Wisconin-Madison and University of New Mexico — would spend days calibrating the scanner, and then work to scan as many volunteers as possible as quickly as possible.

“It was a huge undertaking,” he said. “Most MRI scanners, they’re not going anywhere, but in this case, we’re driving this inside a prison and then in very quick succession we have to assess and scan the inmates.”

The team ultimately scanned the brains of 49 inmates over two hours as they took part in a type of delayed gratification test which asked them to choose between two options — receive a smaller amount of money immediately, or a larger amount at a later time. The results of those tests were then fit to a model that allowed researchers to create a measure of not only how impulsive each participant’s behavior was, but to identify brain regions that play a role in assessing the relative value of such choices.

What they found, Buckholtz said, was people who scored high for psychopathy showed greater activity in a region called the ventral striatum — known to be involved in evaluating the subjective reward — for the more immediate choice.

“So the more psychopathic a person is, the greater the magnitude of that striatal response,” Buckholtz said. “That suggests that the way they are calculating the value rewards is dysregulated — they may over-represent the value of immediate reward.”

When Buckholtz and colleagues began mapping which brain regions are connected to the ventral striatum, it became clear why.

“We mapped the connections between the ventral striatum and other regions known to be involved in decision-making, specifically regions of the prefrontal cortex known to regulate striatal response,” he said. “When we did that, we found that connections between the striatum and the ventral medial prefrontal cortex were much weaker in people with psychopathy.”

That lack of connection is important, Buckholtz said, because this portion of the prefrontal cortex role is thought to be important for ‘mental time-travel’ — envisioning the future consequences of actions. There is increasing evidence that prefrontal cortex uses the outcome of this process to change how strongly the striatum responds to rewards. With that prefrontal modulating influence weakened, the value of the more immediate choice may become dramatically over-represented.

“The striatum assigns values to different actions without much temporal context” he said. “We need the prefrontal cortex to make prospective judgements how an action will affect us in the future — if I do this, then this bad thing will happen. The way we think of it is if you break that connection in anyone, they’re going to start making bad choices because they won’t have the information that would otherwise guide their decision-making to more adaptive ends.”

The effect was so pronounced, Buckholtz said, that researchers were able to use the degree of connection between the striatum and the prefrontal cortex to accurately predict how many times inmates had been convicted of crimes.

Ultimately, Buckholtz said, his goal is to erase the popular image of psychopaths as incomprehensible, cold-blooded monsters and see them for what they are — everyday humans whose brains are simply wired differently.

“They’re not aliens, they’re people who make bad decisions,” he said. “The same kind of short-sighted, impulsive decision-making that we see in psychopathic individuals has also been noted in compulsive over-eaters and substance abusers. If we can put this back into the domain of rigorous scientific analysis, we can see psychopaths aren’t inhuman, they’re exactly what you would expect from humans who have this particular kind of brain wiring dysfunction.”

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Source: Harvard
Image Source: NeuroscienceNews.com image is in the public domain.
Original Research: Abstract for “Disrupted Prefrontal Regulation of Striatal Subjective Value Signals in Psychopathy” by Jay G. Hosking, Erik K. Kastman, Hayley M. Dorfman, Gregory R. Samanez-Larkin, Arielle Baskin-Sommers, Kent A. Kiehl, Joseph P. Newman, and Joshua W. Buckholtz in Neuron. Published online July 5 2017 doi:10.1016/j.neuron.2017.06.030

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Harvard “Probing Psychopathic Brains.” NeuroscienceNews. NeuroscienceNews, 5 July 2017.
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Abstract

Disrupted Prefrontal Regulation of Striatal Subjective Value Signals in Psychopathy

Highlights

•Ventral striatal subjective value signals are amplified in incarcerated psychopaths
•Medial cortico-striatal intrinsic connectivity is weak in psychopathic individuals
•Cortico-striatal regulation of striatal activation is disrupted in psychopathy
•Diminished cortico-striatal regulation is associated with more criminal convictions

Summary
Psychopathy is a personality disorder with strong links to criminal behavior. While research on psychopathy has focused largely on socio-affective dysfunction, recent data suggest that aberrant decision making may also play an important role. Yet, the circuit-level mechanisms underlying maladaptive decision making in psychopathy remain unclear. Here, we used a multi-modality functional imaging approach to identify these mechanisms in a population of adult male incarcerated offenders. Psychopathy was associated with stronger subjective value-related activity within the nucleus accumbens (NAcc) during inter-temporal choice and with weaker intrinsic functional connectivity between NAcc and ventromedial prefrontal cortex (vmPFC). NAcc-vmPFC connectivity strength was negatively correlated with NAcc subjective value-related activity; however, this putative regulatory pattern was abolished as psychopathy severity increased. Finally, weaker cortico-striatal regulation predicted more frequent criminal convictions. These data suggest that cortico-striatal circuit dysregulation drives maladaptive decision making in psychopathy, supporting the notion that reward system dysfunction comprises an important neurobiological risk factor.

“Disrupted Prefrontal Regulation of Striatal Subjective Value Signals in Psychopathy” by Jay G. Hosking, Erik K. Kastman, Hayley M. Dorfman, Gregory R. Samanez-Larkin, Arielle Baskin-Sommers, Kent A. Kiehl, Joseph P. Newman, and Joshua W. Buckholtz in Neuron. Published online July 5 2017 doi:10.1016/j.neuron.2017.06.030