Serotonergic and cognitive impairment in impulsive aggressive personality disordered offenders: are there implications for treatment?

BACKGROUND: Reduced serotonin (5-HT) function and deficits on neuropsychological tasks have been separately reported in antisocial populations. We investigated whether these impairments are independent or associated factors underlying impulsivity in aggressive personality disordered (PD) offenders and healthy controls and whether there are associated changes in quantitative brain measures. METHODS: This study reports on the findings from a sample of 51 PD offenders and 24 controls, recruited from maximum security psychiatric hospitals, who were characterized using the Special Hospital Assessment of Personality and Socialisation (SHAPS). Subjects underwent assessment of 5-HT function (prolactin response to D-fenfluramine challenge), neuropsychological testing and had a diagnostic MRI scan. Of this sample 19 controls and 24 patients also had quantitative measurement of frontal and temporal lobe volumes on magnetic resonance imaging (MRI). RESULTS: Non-psychopathic (low-impulsive) aggressive PDs had enhanced 5-HT function compared with controls and highly impulsive aggressive psychopaths. Primary and secondary psychopaths had poorer executive/frontal, but not memory/temporal neuropsychological function than controls and non-psychopaths. There were no significant group differences in frontal or temporal lobe brain volumes. Although impulsivity and aggression are correlated constructs impulsivity appeared to be related to both executive function and 5-HT function, while aggression only correlated inversely with executive/frontal and memory/temporal function. 5-HT did not directly correlate with frontal or temporal volume or function. CONCLUSION: Impulsivity appears to be contributed to by both impaired neuropsychological function and 5-HT function. Impaired neuropsychological function alone makes a contribution to aggression. Treatment needs to take account of the neuropsychological and biochemical deficits in this challenging population.     

Psychopathy and Detection of Deception In a Prison Population

The effectiveness of detection of deception was evaluated with a sample of 48 prisoners, half of whom were diagnosed psychopaths. Half of each group were “guilty” of taking $20 in a mock crime and half were “innocent.” An examiner who had no knowledge of the guilt or innocence of each subject conducted a field-type interview followed by a control question polygraph examination. Electrodermal, respiration, and cardiovascular activity was recorded, and field (semi-objective) and quantitative evaluations of the physiological responses were made. Field evaluations by the examiner produced 88% correct, 4% wrong, and 8% inconclusives. Excluding inconclusives, there were 96% correct decisions. Using blind quantitative scoring and field evaluations, significant discrimination between “guilty” and “innocent” subjects was obtained for a variety of electrodermal, respiration, and cardiovascular measures. Psychopaths were as easily detected as nonpsychopaths, and psychopaths showed evidence of stronger electrodermal responses and heart rate decelerations. The effectiveness of control question techniques in differentiating truth and deception was demonstrated in psychopathic and nonpsychopathic criminals in a mock crime situation, and the generalizability of the results to the field situation is discussed.     

P3 event-related potential impairments in antisocial and psychopathic individuals: A meta-analysis

Prior findings on P3 event-related potential deficits in antisocial populations are mixed and it has been suggested that these abnormalities may not apply to psychopaths. A meta-analysis of 38 studies (total N = 2616) was conducted to investigate the relationship of P3 measures to antisocial behavior. Reduced P3 amplitudes (d = 0.252, p < .001) and longer P3 latencies (d = 0.130, p = .019) were significantly associated with antisocial behavior across all electrode sites, and when using both normal and non-normal control groups. A significant moderating effect of electrode site indicated longer latencies at Fz but not Pz. Compared to non-psychopathic offenders, psychopathic offenders showed P3 amplitudes impairments in standard oddball tasks, but not other tasks. Findings suggest that reduced P3 amplitudes and prolonged P3 latencies may reflect inefficient deployment of neural resources in processing cognitive task-relevant information in individuals characterized with generic antisocial behavior (i.e., aggression, antisocial personality disorder, conduct disorder/oppositional-defiant disorder, and psychopathy), whereas this association in psychopaths may be moderated by the type of tasks.     

P3 event-related potential impairments in antisocial and psychopathic individuals: A meta-analysis

Prior findings on P3 event-related potential deficits in antisocial populations are mixed and it has been suggested that these abnormalities may not apply to psychopaths. A meta-analysis of 38 studies (total N = 2616) was conducted to investigate the relationship of P3 measures to antisocial behavior. Reduced P3 amplitudes (d = 0.252, p < .001) and longer P3 latencies (d = 0.130, p = .019) were significantly associated with antisocial behavior across all electrode sites, and when using both normal and non-normal control groups. A significant moderating effect of electrode site indicated longer latencies at Fz but not Pz. Compared to non-psychopathic offenders, psychopathic offenders showed P3 amplitudes impairments in standard oddball tasks, but not other tasks. Findings suggest that reduced P3 amplitudes and prolonged P3 latencies may reflect inefficient deployment of neural resources in processing cognitive task-relevant information in individuals characterized with generic antisocial behavior (i.e., aggression, antisocial personality disorder, conduct disorder/oppositional-defiant disorder, and psychopathy), whereas this association in psychopaths may be moderated by the type of tasks.     

Salivary cortisol patterns and cognitive speed in major depression: a comparison with allergic rhinitis and healthy control subjects

Few studies have investigated the relationship between cortisol and cognitive functions other than memory in depression. This study investigated daily salivary cortisol patterns (basal cortisol levels at 08:00, 16:00, and 21:00 h and flatness of the diurnal curve) in relation to cognitive speed and memory. Twenty-seven unmedicated outpatients with major depressive disorder (MDD) were compared with 36 healthy controls and with 20 allergic rhinitis patients, to determine whether effects should be ascribed to MDD or to more general disease-related processes. MDD patients were characterised by a flatter diurnal cortisol curve and by reduced cognitive speed. Flatter cortisol curves were associated with cognitive slowness. However, this relationship is unlikely to be causal; after control for depressive symptoms and group membership, flatness of the diurnal cortisol curve was no longer a significant predictor of cognitive slowness. Thus, MDD and related depressive symptoms appeared to be independently associated with altered cortisol secretory patterns and with decrements in cognitive speed.     

Psychopathic traits and autonomic responding to concealed information in a prison sample

We examined the role of psychopathic traits on physiological responding during a concealed information polygraph test among prison inmates (n = 40). The Psychopathic Personality Inventory (Lilienfeld & Andrews, 1996) was used to assess psychopathic traits. Cardiac, electrodermal, and respiratory responses were measured while participants were presented with personal and control names and asked to conceal recognition of personal information. We first piloted the present concealed information test in a sample of undergraduates (n = 27). Enhanced orienting to concealed information compared to control information was observed in both prisoners and undergraduates. However, prisoners scoring high on the Impulsive Antisociality factor of the Psychopathic Personality Inventory (PPI-II) exhibited reduced electrodermal responding. This finding indicates that the sensitivity of the concealed information test may be decreased in antisocial offenders.     

Effect of feeding on the diurnal rhythm of plasma cortisol and adrenocorticotrophic hormone concentrations in the pregnant ewe and sheep fetus.

The effects of two different feeding regimes on the 24 h profiles of maternal and fetal plasma cortisol and adrenocorticotrophic hormone (ACTH) concentrations were studied in eight pregnant ewes between 123 and 144 days of gestation. Once daily-fed ewes (n = 4) received 1 kg of lucerne-chaff at 11.00 h, and multi-fed ewes (n = 4) received 100-200 g of lucerne-chaff at 09.00, 11.00 and 13.00 h and then 150 g until 09.00 h the following day. There were significant differences between the two feeding groups in the 24 h profile of maternal plasma osmolality; once daily feeding at 11.00 h was associated with a peak in maternal plasma osmolality at 15.00 h whereas maternal plasma osmolality reached plateau levels at around 17.00 h in the multi-fed group. There were also differences between the two feeding groups in the 24 h profiles of maternal and fetal plasma glucose. Maternal and fetal plasma glucose reached peak concentrations at 19.00 h in the once daily-fed ewes in contrast to the multi-fed group, where a plateau in maternal and fetal plasma glucose was reached between 19.00 h and 09.00 h the following day. A significant diurnal variation in the plasma concentrations of cortisol was present in the once daily-fed ewes from 123 days gestation and in their fetuses after, but not before, 135 days gestation. Plasma cortisol peaked at 11.00 h in the ewes and at 13.00 h in the fetuses of this group. In the once daily-fed group there was also a significant diurnal variation in maternal and fetal plasma ACTH; plasma ACTH concentrations were highest at 11.00 h in the ewes aged between 123 and 144 days and in fetuses after 135 days gestation. In the multi-fed group, whilst ACTH was highest at 09.00 h in the ewes and at 13.00 h in the fetuses, there was no significant diurnal variation in the plasma concentrations of cortisol in the ewes or fetuses of this group at any stage between 123 and 144 days gestation.     

Applicability of the Group Personality Projective Test within a prison population.

Administered the Group Personality Projective Test (GPPT) to 60 male offenders incarcerated in a state penitentiary. A board of 10 prisoners selected inmates who clearly had demonstrated one of three patterns of assaultive behavior: undercontrolled aggressives, overcontrolled aggressives, and over controlled psychopaths. A control group was chosen randomly from the prison population, as well. Results failed to support the hypothesis that GPPT scores significantly differ among relatively homogeneous prisoner subgroups or between these groups and the control group of non-assaultive prisoners.     

童年期创伤性经历与青少年抑郁症的关系

目的:了解青少年抑郁患者童年期的创伤性经历对青少年抑郁症发病的影响。方法:对200名青少年抑郁症患者进行抑郁自评量表(SDS)和汉密尔顿抑郁量表(HRSD)测量,选取符合抑郁发作诊断标准、抑郁程度在重度以上的患者136名进行问卷调查,组成研究组。同时,选取130名心理健康的高中学生作为对照组。采用儿童期创伤性经历问卷对两组被试分别进行调查,并采用回归方式对数据进行分析。结果:青少年抑郁发病前有较多的创伤经历,童年期的创伤性经历与青少年抑郁症的发病率呈正相关(r=6.42,P0.01)。结论:童年期创伤性经历对青少年心理健康影响非常大,是导致青少年罹患抑郁发作的主要因素。     

Self-compassion,chronic age-related stressors,and diurnal cortisol secretion in older adulthood

Many older adults experience chronic age-related stressors (e.g., life regrets or health problems) that are difficult to control and can disturb cortisol regulation. Self-compassion may buffer adverse effects of these stressful experiences on diurnal cortisol secretion in older adulthood. To examine whether self-compassion could benefit older adults’ cortisol secretion in the context of chronic and largely uncontrollable age-related stressors, 233 community-dwelling older adults reported their levels of self-compassion, age-related stressors (regret intensity, physical health problems, and functional disability), and relevant covariates. Diurnal cortisol was measured over 3 days and the average area-under-the-curve and slope were calculated. Higher levels of self-compassion were associated with lower daily cortisol levels among older adults who reported higher levels of regret intensity, physical health problems, or functional disability (βs?<???.53, ps?<?.01), but not among their counterparts who reported lower levels of these age-related stressors (βs?<?.24, ps?>?.28). These results suggest that self-compassion may represent an important personal resource that could protect older adults from stress-related biological disturbances resulting from chronic and uncontrollable stressors.     

Work family balance, stress, and salivary cortisol in men and women academic physicians

Background: The stress of medical practice has been recurrently studied, but work- and family-related determinants of health by gender remain under researched. Purpose: To test the hypothesis that cortisol excretion would be affected by the perceived severity of total workload imbalance. Method: By hierarchical regression analysis, the associations between work-family balance and diurnal salivary cortisol levels by sex in academic physicians (n = 40) were investigated. Results: Men physicians reported more paid work hours per week than women physicians and women more time in childcare, but their total working hours were similar. Controlling for sex and age, the mean of the diurnal cortisol release was associated with a combined effect of sex and responsibility at home. When morning cortisol, sex, and children at home were held constant, cortisol levels in the evening were associated with responsibility at home without significant gender interaction. Conclusion: With increasing responsibility at home, women and men reacted differently with regard to cortisol responses over the day. However, in the evening, controlling for the morning cortisol, these gender differences were not as obvious. These findings highlight traditional gender patterns among both women and men physicians in the challenge of finding a balance between work and family.     

Personality, adrenal steroid hormones, and resilience in maltreated children: a multilevel perspective

In this multilevel investigation, resilience in adaptive functioning among maltreated and nonmaltreated low-income children (N = 677) was examined in relation to the regulation of two stress-responsive adrenal steroid hormones, cortisol and dehydroepiandrosterone (DHEA), as well as the personality constructs of ego resiliency and ego control. Maltreatment status was not related to differences in average levels of morning or afternoon cortisol or DHEA. However, lower morning cortisol was related to higher resilient functioning, but only in nonmaltreated children. In contrast, among physically abused children, high morning cortisol was related to higher resilient functioning. Morning and afternoon DHEA was negatively related to resilient functioning. Although diurnal change in cortisol was not related to resilience, for DHEA, maltreated children with high resilience showed an atypical rise in DHEA from morning to afternoon. Morning and afternoon cortisol/DHEA ratios were positively related to resilient functioning, but did not interact with maltreatment status. Ego resiliency and ego control strongly differentiated maltreated and nonmaltreated children, and the personality variables were substantially predictive of resilience. When considered together, demonstrated effects of personality, cortisol, and DHEA maintained independent contributions in predicting resilience among high-risk youth.     

Relations among posttraumatic stress disorder, comorbid major depression, and HPA function: a systematic review and meta-analysis

Exposure to traumatic stress is associated with increased risk for posttraumatic stress disorder (PTSD) and alterations of hypothalamic-pituitary-adrenocortical (HPA) function. Research linking traumatic stress with HPA function in PTSD has been inconsistent, however, in part due to (a) the inclusion of trauma-exposed individuals without PTSD (TE) in control groups and (b) a failure to consider comorbid major depressive disorder (MDD) and moderating variables. This meta-analysis of 47 studies (123 effect sizes, N=6008 individuals) revealed that daily cortisol output was lower for PTSD (d=-.36, SE=.15, p=.008) and PTSD+MDD (d=-.65, SE=.25, p=.008) groups relative to no trauma controls (NTC); TE and NTC groups did not differ significantly from each other. Afternoon/evening cortisol was lower in TE (d=-.25, SE=.09, p=.007) and PTSD (d=-.27, SE=.12, p=.021) groups and higher in PTSD+MDD groups (d=.49, SE=.24, p=.041) relative to NTC. Post-DST cortisol levels were lower in PTSD (d=-.40, SE=.12, p<.001), PTSD+MDD (d=-.65, SE=.14, p<.001), and TE groups (d=-.53, SE=.14, p<.001) relative to NTC. HPA effect sizes were moderated by age, sex, time since index event, and developmental timing of trauma exposure. These findings suggest that enhanced HPA feedback function may be a marker of trauma-exposure rather than a specific mechanism of vulnerability for PTSD, whereas lower daily cortisol output may be associated with PTSD in particular.     

Global life satisfaction predicts ambulatory affect,stress, and cortisol in daily life in working adults

Global life satisfaction has been linked with long-term health advantages, yet how life satisfaction impacts the trajectory of long-term health is unclear. This paper examines one such possible mechanism—that greater life satisfaction confers momentary benefits in daily life that accumulate over time. A community sample of working adults (n = 115) completed a measure of life satisfaction and then three subsequent days of ecological momentary assessment surveys (6 times/day) measuring affect (i.e., emotional valence, arousal), and perceived stress, and also provided salivary cortisol samples. Multilevel models indicated that people with higher (vs. lower) levels of life satisfaction reported better momentary affect, less stress, marginally lower momentary levels and significantly altered diurnal slopes of cortisol. Findings suggest individuals with high global life satisfaction have advantageous daily experiences, providing initial evidence for potential mechanisms through which global life satisfaction may help explain long-term health benefits.     

Interactive effects of corticotropin releasing hormone receptor 1, serotonin transporter linked polymorphic region, and child maltreatment on diurnal cortisol regulation and internalizing symptomatology

Within an allostatic load framework, the effect of Gene × Environment (G × E) interactions on diurnal cortisol regulation and internalizing symptomatology were investigated. Variation in the corticotropin releasing hormone receptor 1 (CRHR1) TAT haplotype and serotonin transporter linked polymorphic region (5-HTTLPR) was determined in a sample of maltreated (n = 238, 21.4% with early physical and sexual abuse) and nonmaltreated (n = 255) children (M age = 10.08) participating in a summer research camp. Internalizing and depressive symptoms were assessed by other and self-report. G × E effects for CRHR1 and maltreatment and early abuse on diurnal cortisol regulation were observed; CRHR1 variation was related to cortisol dysregulation only among maltreated children. Early abuse and high internalizing symptoms also interacted to predict atypical diurnal cortisol regulation. The interaction of CRHR1, 5-HTTLPR, and child maltreatment (G × G × E) identified a subgroup of maltreated children with high internalizing symptoms who shared the same combination of the two genes. The findings support an allostatic load perspective on the effects of the chronic stress associated with child maltreatment on cortisol regulation and internalizing symptomatology as moderated by genetic variation.     

The Associations Between Basal Salivary Cortisol and Illness Symptomatology in Chronic Fatigue Syndrome

Hypocortisolism has been reported in chronic fatigue syndrome (CFS), with the significance of this finding to disease etiology unclear. This study examined cortisol levels and their relationships with symptoms in a group of 108 individuals with CFS. CFS symptoms examined included fatigue, pain, sleep difficulties, neurocognitive functioning, and psychiatric status. Alterations in cortisol levels were examined by calculation of mean daily cortisol, and temporal variation in cortisol function was examined by means of a regression slope. Additionally, deviation from expected cortisol diurnal pattern was determined via clinical judgment. Results indicated that fatigue and pain were associated with salivary cortisol levels. In particular, variance from the expected pattern of cortisol was associated with increased levels of fatigue. The implications of these findings are discussed.     

Intervention effects on foster parent stress: associations with child cortisol levels

Foster children exhibit high rates of atypical neuroendocrine functioning compared to children in the general population. In particular, alterations in the daytime diurnal activity of the hypothalamic-pituitary-adrenal (HPA) axis have been observed in foster children, often characterized by blunted salivary cortisol levels (i.e., low morning levels that remain low throughout the day). There is emerging evidence that therapeutic interventions for foster children can affect this pattern of HPA axis activity, but the specific intervention components responsible for change have not been fully explicated. Within a randomized trial to evaluate a therapeutic intervention for foster preschoolers (n = 57 intervention condition; n = 60 comparison condition; n = 60 community comparison condition), the present study examined whether diurnal cortisol activity was associated with caregiver self-reported stress in response to child problem behavior. Results showed immediate reductions in caregiver stress that were sustained through 12 months postbaseline in the intervention condition. In contrast, caregivers in the regular foster care condition showed higher rates of stress across time and increased stress sensitivity to child problem behaviors. In addition, among caregivers in regular foster care, higher self-reported stress was associated with lower morning cortisol levels and more blunted diurnal cortisol activity. These results provide evidence that interventions can simultaneously impact caregiver stress and buffer children from the negative impacts of caregiver stress on HPA axis regulation.     

Adjustment issues with adult children of alcoholics

The current study assessed locus of control, general level of life satisfaction, and self-reported grade-point averages among adults who had experienced either alcoholism within the family of origin, traumatic life events other than alcoholism, or who indicated neither problem during their childhood. Results indicated that both the adult children of alcoholics (ACOA) and traumatic experience (TE) groups had lower life satisfaction scores than the control group. Significantly lower levels of locus of control also were found for the ACOA group in comparison to the control group. There were no significant differences among the three groups based on self-reported GPAs. Results of the current study support the concept that family dysfunction during childhood can influence negatively later life experiences and adjustment.     

Day-to-day friends’ victimization,aggression perpetration,and morning cortisol activity in late adolescents

This study investigates bidirectional associations between adolescents’ daily experiences of victimization and aggression perpetration within friendships. We investigated (a) across-day associations between victimization and aggression perpetration; (b) morning cortisol activity as a moderator of cross-day victimization and aggression links; and (c) potential sex differences in these patterns. For 4 consecutive days, 99 adolescents (M_age = 18.06, SD = 1.09, 46 females) reported whether they were victimized by or aggressive toward their friends. On three of these days, adolescents provided three morning saliva samples. Multilevel path analyses showed that across days, victimization and aggression were bidirectionally linked, but only for male adolescents. Additionally, for male adolescents, morning cortisol output (but not morning cortisol increase) moderated the association between victimization and next-day aggression; victimization predicted greater next-day aggression for boys with low, but not high, morning cortisol output. Findings implicate a physiological factor that may modify daily links between victimization and aggression in male adolescent friendships.     

Optimism,positive affectivity,and salivary cortisol

Objectives. Research on stress and salivary cortisol has focused almost exclusively on the effects of negative psychological conditions or emotional states. Little attention has been drawn to the impact associated with positive psychological conditions, which have been shown recently to have significant influences on neuroendocrine regulation. The aim of this study is to examine the impact of optimism and positive affect on salivary cortisol with the effects of their negative counterparts controlled for. Design. Optimism and pessimism, and positive and negative affectivity were studied in relation to the diurnal rhythm of salivary cortisol in a group of 80 Hong Kong Chinese, who provided six saliva samples over the course of a day on two consecutive days. The separate effects of optimism and positive affect on two dynamic components of cortisol secretion, awakening response, and diurnal decline were examined. Methods. Optimism and pessimism were measured using the Chinese version of the revised Life Orientation Test while generalized affects and mood states were assessed by the Chinese Affect Scale. An enzyme‐linked immunoabsorbent assay kit (EIA) developed for use in saliva was adopted for the biochemical analysis of cortisol. Testing of major group differences associated with positive psychological conditions was carried out using two‐way (group by saliva collection time) ANOVAs for repeated measures with negative psychological conditions and mood states as covariates. Results. Participants having higher optimism scores exhibited less cortisol secretion in the awakening period when the effect of pessimism and mood were controlled. This effect was more apparent in men than in women who had higher cortisol levels in the awakening period. Optimism did not have similar effect on cortisol levels during the underlying period of diurnal decline. On the other hand, higher generalized positive affect was associated with lower cortisol levels during the underlying period of diurnal decline after the effects of negative affect and mood states had been controlled. Generalized positive affect did not significantly influence cortisol secretion during the awakening period. Conclusions. These findings suggest that positive psychological resources including optimism and generalized positive affect had higher impact on cortisol secretion than their negative counterparts, and point to the need for increased attention to the potential contribution of positive mental states to well‐being.