Psychopathy and P3 amplitude: a commentary on Raine

Raine (1989) reviewed the literature on event-related potentials (ERPs) in psychopathic adults and antisocial adolescents and concluded that findings support an extended sensation-seeking model of psychopathy. Specifically, he suggested that P3 findings were indicative of unusually enhanced attentional processing in psychopaths. It will be argued in this paper that evidence from recent ERP studies is insufficient to challenge notions of information processing deficit in psychopathy, and that an extended 'cortical immaturity' hypothesis can better account for psychopathic behaviour than the model proposed by Raine.     

Evoked potentials and psychopathy: a commentary on Raine

Raine's (1989) paper on evoked potentials and psychopathy is critically reviewed and is found to be wanting at both a conceptual and an empirical level. Conceptually it ignores important issues surrounding the term 'psychopathy' and proposes a theoretical model of psychopathy based on a tripartite division of evoked potentials (early, middle and late) which ignores differences between stimulus modalities. Empirically, the extended sensation seeking model is not well substantiated by the data reviewed. An alternative approach is outlined which views psychopathy in the sense of chronic socially-deviant behaviour as reflecting a maturational deficit, and psychopathy in the personality deviation sense as reflecting deficits in cognitive appraisal processes. This approach embraces the pathological sensation-seeking aspect of psychopathy as well as other important aspects not addressed by Raine's model (lack of moral reasoning and characteristic style of coping both in impersonal and inter-personal contexts.     

Enhanced P3 Evoked Potentials and Longer P3 Recovery Times in Psychopaths

A recent study by Raine and Venables (1987) reported increased P3 amplitudes in antisocial adolescents, a replicable result indicating enhanced processing of task-relevant events. The present study assesses whether adult psychopaths similarly show enhanced P3 amplitudes; latency of P3 recovery to baseline was also measured to assess Jutai et al.'s (1987) finding of sustained late positivity in psychopaths. EPs were measured at T₃, T₄, P₃, and P₄ to targets and nontargets during a continuous performance task in 14 psychopathic and 14 nonpsychopathic top-security prisoners. Psychopaths showed larger P3 amplitudes to targets relative to nontargets at parietal but not temporal sites, and larger P3 recovery times. Psychopaths also scored higher on WAIS subtests sensitive to parietal lobe functioning but not on non-parietal subtests. No laterality effects were uncovered to support a left hemisphere dysfunction theory of psychopathy. It is argued that this evidence for proficient information-processing on parietal-related tasks may underlie clinical reports of enhanced short-term attentional ability in psychopaths.     

Evoked potentials and psychopathy

All previous studies which have assessed evoked potentials (EPs) in psychopathic populations are critically reviewed. Three main themes emerge from this review. Firstly early EP studies suggest a dysfunctional arousal system at a brainstem or parietal cortex level in psychopaths. Secondly, middle-latency EP studies suggest that psychopaths show larger visual EP amplitudes, particularly at high intensity levels, indicating cortical augmenting. Thirdly, psychopaths are characterised by enhanced P3 EPs to task-relevant events. An extended sensation-seeking model of psychopathy is proposed which attempts to incorporate these electrophysiological findings into an information-processing framework. It is argued that under certain circumstances psychopaths are characterised by information-processing proficiencies and that they are clearly differentiated from schizophrenics at a psychophysiological level in terms of P3. It is concluded that current 'processing deficit' conceptions of antisociality are overly restrictive and ignore performance superiorities which may have important implications for our understanding of psychopathy.     

Psychopathic traits in a large community sample: links to violence, alcohol use, and intelligence

Numerous studies conducted with offender or forensic psychiatric samples have revealed that individuals with psychopathic traits are at risk for violence and other externalizing psychopathology. These traits appear to be continuously distributed in these samples, leading investigators to speculate on the presence of such traits in the general population. Nonetheless, few studies of psychopathy have been conducted with large random samples of individuals from the community. The community sample from the MacArthur Violence Risk Assessment Study provides an opportunity to examine the prevalence and structural nature of psychopathic traits, as well as their association with external correlates in an urban community. The community data (N = 514) represent a stratified random sample of persons between the ages of 18 and 40 who were assessed on the Psychopathy Checklist: Screening Version (PCL: SV) and also for violent behavior, alcohol use, and intellectual functioning. Structural equation model analyses revealed that a 4-factor model found in offender and forensic psychiatric samples fit the community data well and was invariant across sex and ethnicity. Also, a superordinate factor comprehensively accounted for the 4 psychopathy first-order factors and significantly predicted the external correlates. The findings offer insight into the dimensional nature of the psychopathy construct.     

Psychopathy, attention and emotion

Psychopathy is a developmental disorder marked by emotional hypo-responsiveness and an increased risk for antisocial behavior. Influential attention-based accounts of psychopathy have long been made; however, these accounts have made relatively little reference to general models of attention in healthy individuals. This review has three aims: (1) to summarize current cognitive neuroscience data on differing attentional systems; (2) to examine the functional integrity of these attentional systems in individuals with psychopathy; and (3) to consider the implications of these data for attention and emotion dysfunction accounts of psychopathy.     

Psychopathy, IQ, and violence in European American and African American county jail inmates

The accuracy of the prediction of criminal violence may be improved by combining psychopathy with other variables that have been found to predict violence. Research has suggested that assessing intelligence (i.e., IQ) as well as psychopathy improves the accuracy of violence prediction. In the present study, the authors tested this hypothesis by using a contemporary measure of psychopathy, the Psychopathy Checklist--Revised (R. D. Hare, 2003), in a sample of 326 European American and 348 African American male offenders. The postdictive power of psychopathy was evident for both ethnic groups and robust across most changes in the operationalization of violence and the analysis conducted, whereas the postdictive power of IQ was not. No Psychopathy x IQ interactions were identified. Implications of these results for violence prediction are discussed.     

Mutations in FAM20C also identified in non-lethal osteosclerotic bone dysplasia

Raine syndrome is an osteosclerotic bone dysplasia, which has proved to be lethal within the first few weeks of life in all the reported cases to date. We recently identified a chromosomal rearrangement and telomeric microdeletion in a patient with Raine syndrome and subsequently identified mutations in the FAM20C gene, located within the deleted region, in six additional Raine syndrome cases. The phenotype of Raine syndrome in the cases examined was remarkably consistent with generalized osteosclerosis of all bones, periosteal bone formation, characteristic facial phenotype and lethal within the first few weeks of life. In the current study, we have identified two unrelated individuals who presented at birth with a sclerosing bone dysplasia with features very similar to those in Raine syndrome but who survived infancy and are now aged 8 and 11 years, respectively. Mutations in FAM20C, consistent with autosomal recessive inheritance, were identified in both cases. In the first case, a homozygous non-synonymous mutation in exon 7 (1309G>A D437N) was identified, and in the second case, compound heterozygosity for non-synonymous mutations in exon 2 (731T>A I244N) and in exon 3 (796G>A G266R) was revealed. Raine syndrome has been previously considered to be a neonatal lethal condition. However, the identification of mutations in these two patients confirms a broader phenotypic spectrum and that mutation of FAM20C does not always lead to the infantile lethality previously seen as a prerequisite for Raine syndrome diagnosis.     

Face affect recognition deficits in personality-disordered offenders: association with psychopathy

BACKGROUND: There is a limited literature examining face affect recognition in offenders. In line with the Integrated Emotion Systems (IES) model, existing studies suggest a psychopathy-related deficit in sad/fear recognition. However, many of these studies have small samples, and few include a healthy control group in order to examine the contribution of criminality. METHOD: We compared the performance of male criminals with dissocial (antisocial) personality disorder (PD group) and healthy male IQ-matched controls, on a morphed face affect-processing task and examined the relationship between psychopathy (assessed using the Psychopathy Checklist: Screening Version, PCL: SV), score and performance on this task in the PD sample. RESULTS: The PD group had a specific deficit in the recognition of sad facial affect that was present even at 100% expression intensity. This deficit could not be attributed to impulsive responding as the PD group generally had longer mean reaction times than healthy controls. Within the PD group, those with high scores on the PCL: SV were less accurate than low scorers at classifying sad facial affect. There was also a significant negative correlation between total psychopathy score and sad affect recognition accuracy. There were no specific relationships between affect recognition and the subcomponents of psychopathy. CONCLUSIONS: The findings suggest that criminality/antisocial personality may be associated with a deficit in the recognition of aversive cues in others, and that this deficit is more severe in psychopathic offenders. The findings lend further support to the IES model.     

Physiological reactivity in response to a fear‐induced virtual reality experience: Associations with psychopathic traits

Despite the longstanding discussion around the link between psychopathy and fearlessness, few studies have explicitly tested this association, and results have been mixed. This may be due, in part, to the lack of specificity in fear assessment. Further, the relation between psychopathy and fear may be better understood using the two‐factor model because, in theory, fear has opposing associations with interpersonal‐affective (Factor 1) and impulsive‐antisocial (Factor 2) traits. The present study aimed to test if the two factors of psychopathy are deferentially related to fear reactivity. To examine this, we collected sympathetic (SNS; skin conductance) and parasympathetic (PNS; respiratory sinus arrhythmia) nervous system reactivity to an interactive virtual reality horror video in a nonclinical sample (N = 103). Also, we included measures of emotional reactivity to fear and self‐report of situational fear. Results indicated that coinhibition (i.e., low PNS and SNS) of the two physiological systems predicted Factor 1, suggesting that individuals high on Factor 1 showed little change in both branches of the autonomic nervous system in response to fear. In contrast, Factor 2 was predicted by high PNS reactivity, suggesting a vulnerability to emotion dysregulation. On emotional reactivity, Factor 1 was related to feeling happier after the fear condition, whereas Factor 2 was related to feeling less in control. Factor 1 was inversely associated with situational fear, specifically, lower scores of social phobias, fear of aggression, and physical injury. In summary, the results provide evidence that psychopathy is related to fearlessness; however, this is unique to the personality features of psychopathy.     

Interpersonal and affective features of psychopathy in children and adolescents: advancing a developmental perspective. Introduction to special section.

The interpersonal (e.g., manipulative, deceitful) and affective (e.g., callous, unemotional) features associated with adult psychopathy have been identified in children and adolescents. Although early research suggests that these features have clinical utility in identifying a particularly severe and recalcitrant form of antisocial behavior with unique developmental origins, several issues regarding these features need to be addressed. This special section is designed to address developmental questions regarding the interpersonal/affective features of psychopathy that have been posed by researchers in the field. Articles included in this special section focus on the structure and stability of the interpersonal/affective features of psychopathy from childhood to adolescence as well as the relation between these features and measures of psychopathy in adulthood. Articles also address the relation between the affective components of psychopathy and ADHD symptoms, emotional problems, and parenting practices in young girls, as well as the interactive role of temperamental fearfulness/anxiety and parenting practices in predicting the development of the affective features of psychopathy. Finally, the influence of a parenting intervention on the affective features of psychopathy in boys diagnosed with Oppositional Defiant Disorder is examined.     

Fetal ultrasonographic findings including cerebral hyperechogenicity in a patient with non‐lethal form of Raine syndrome

Raine syndrome is a rare osteosclerotic bone dysplasia characterized by craniofacial anomalies and intracranial calcification. Most patients with Raine syndrome are of Arab ancestry and die during the neonatal period. We herein report a Japanese patient with non‐lethal Raine syndrome who presented with characteristic cerebral hyperechogenicity and a hypoplastic nose by fetal ultrasonography. She was admitted to the NICU due to pyriform aperture stenosis. Craniofacial abnormalities, intracranial calcification, osteosclerosis, chondrodysplasia punctata, and a mutation of FAM20C was identified. She was subsequently discharged without surgical intervention and is now 2 years old with mild neurodevelopmental delays. Images of cerebral hyperechogenicity by fetal ultrasonography in a non‐lethal case were described herein for the first time. This patient represents a rare occurrence of a child with Raine syndrome born to Japanese parents and confirms that this syndrome is not always lethal. Even if Raine syndrome is suspected in a fetus due to cerebral hyperechogenicity and a hypoplastic nose, cerebral hyperechogenicity without pulmonary hypoplasia does not always predict lethality or severe neurodevelopmental delays. The information provided herein will be useful for prenatal counseling.

     

Unmasking feigned sanity: A neurobiological model of emotion processing in primary psychopathy

Introduction. The neurobiological basis of primary psychopathy, an emotional disorder characterised by a lack of fear and empathy, on the one hand, and extremely violent, antisocial tendencies, on the other, is relatively unknown. Nevertheless, theoretical models that emphasise the role of fearlessness, imbalanced motivation, defective somatic markers, and dysfunctional violence inhibition mechanisms have complementary proposals regarding motivations and brain mechanisms involved.

Methods. Presently, incorporating the heuristic value of these models and further theorising on the basis of recent data from neuropsychology, neuroendocrinology, neuroimaging, and repetitive transcranial magnetic stimulation (rTMS), an attempt is made to construct a neurobiological framework of emotion processing in primary psychopathy with clinical applicability.

Results. According to this framework, defective emotional processing in primary psychopathy results from bottom‐up hormone‐mediated imbalances at: (1) the subcortical level; (2) in subcortico‐cortical “cross‐talk”; that end up in an instrumental stance at the cortical level (3). An endocrine dual‐system approach for the fine‐tuned restoration of these hormone‐mediated imbalances is proposed as a possible clinical application.

Discussion. This application may be capable of laying a neurobiological foundation for more successful sociotherapeutic interventions in primary psychopathy.     

Using the Psychopathy Checklist-Revised With Female Samples: Reliability, Validity, and Implications for Clinical Utility

Since the introduction of the Psychopathy Checklist-Revised in 1991 (PCL-R), numerous studies have examined the reliability and validity of this assessment instrument in samples of institutionalized and noninstitu-tionalized females. We reviewed these data to determine the current state of PCL-R psychopathy assessment in females and to guide a discussion of the clinical utility of the PCL-R in female samples. Here we discuss issues generated by existing data and offer specific research suggestions. This review shows that there is support for the measure's reliability in women and modest support for its validity. However, studies of the predictive utility and the factor structure of the PCL-R in women are required to demonstrate the generalize ability of PCL-R psychopathy to women.     

Psychopathy and community violence among civil psychiatric patients: results from the MacArthur Violence Risk Assessment Study

Although psychopathy is recognized as a relatively strong risk factor for violence among inmates and mentally disordered offenders, few studies have examined the extent to which its predictive power generalizes to civil psychiatric samples. Using data on 1,136 patients from the MacArthur Violence Risk Assessment project, this study examined whether the 2 scales that underlie the Psychopathy Checklist: Screening Version (PCL:SV) measure a unique personality construct that predicts violence among civil patients. The results indicate that the PCL:SV is a relatively strong predictor of violence. The PCL:SV's predictive power is substantially reduced, but remains significant, after controlling for a host of covariates that reflect antisocial behavior and personality disorders other than psychopathy. However, the predictive power of the PCL:SV is not based on its assessment of the core traits of psychopathy, as traditionally construed. Implications for the 2-factor model that underlies the PCL measures and for risk assessment practice are discussed.     

Frontal alpha asymmetry and emotional processing in youth with psychopathic traits

Emotional processing deficits are often considered central to psychopathy. There is evidence that those high in psychopathy pay less attention to emotional stimuli, and it is possible that these individuals experience diminished withdrawal motivation or heightened approach motivation in response to emotional stimuli. Studying emotional processing abnormalities, especially among youth, may be essential for better understanding psychopathy's development and for informing interventions. However, few studies on psychopathy have experimentally manipulated emotional processing, and despite the growing literature on neuroscience and psychopathy, there are aspects of neural activity that have yet to be investigated. The current study used a sample of 52 justice-involved youth to examine how psychopathy, as measured by the Proposed Specifiers for Conduct Disorder scale, relates to frontal alpha asymmetry (FAA), a neural correlate of approach and withdrawal motivation. Alpha asymmetry was first measured at rest and then while youth were asked to process emotional stimuli spontaneously as well as to increase and decrease their responses to emotional stimuli. Results indicated that total psychopathy was not related to FAA at rest or during task performance. However, youth higher in callous-unemotional traits demonstrated similar patterns of neural activity to youth lower in callous-unemotional traits when instructed to increase their response to emotional stimuli. These findings were not evident for grandiose-manipulative or daring-impulsive traits. These findings may indicate that youth high in callous-unemotional traits are capable of modulating their emotional responding, which could in turn have treatment implications for youth high in psychopathic traits.     

Response inhibition in psychopathy: The frontal N2 and P3

Psychopathy has been associated with atypical function of the anterior cingulate cortex (ACC) and adjacent brain regions and with abnormalities in performance monitoring, which is thought to rely on these structures. The ACC and adjacent regions are also involved in the generation of two characteristic components of the event-related potential: the frontal N2 and P3. Both components are enhanced when a response is withheld (NoGo trial) within a series of positive-responses (Go trials) and are considered an index of response inhibition. We recorded event-related potentials while violent offenders who varied on the dimension of psychopathy and non-offender controls performed a Go/NoGo task. The offenders made more errors of commission on NoGo trials but this effect was unrelated to level of psychopathy within the group and, inconsistent with a previous report, they produced the enhanced frontal N2 and P3 effect in response to NoGo relative to Go conditions. We conclude that the neural processes involved in response inhibition are not abnormal in psychopaths when both stimuli and context are affectively neutral and suggest that a more nuanced perspective regarding impulsivity in this population be considered.     

Sex differences in psychopathy and antisocial personality disorder. A review and integration

Although the correlates and causes of psychopathy and antisocial personality disorder (ASPD) have been the subject of extensive investigation, researchers in this area have until recently focused almost exclusively on males. As a consequence, relatively little is known about psychopathy and ASPD in females. In this paper, we review the empirical literature on sex differences in the base rates, mean symptom levels, correlates, and factor structure of psychopathy and ASPD. In addition, we discuss the potential sex-differentiated phenotypic expressions of psychopathy and ASPD (e.g., somatization disorder [SD]) as well as sex differences in the developmental trajectories of these conditions. There is suggestive evidence that these conditions may be differentially expressed across biological sex, although further investigation of this issue is warranted. We conclude with recommendations for future research in this area, including suggestions for embedding the study of sex differences in psychopathy and ASPD within a construct validational framework.     

精神病态的理论研究进展

精神病态与反社会行为、犯罪的关系十分密切,因此了解精神病态者的功能缺陷与成因对预防反社会行为、暴力、犯罪等非常重要。既往有研究者针对精神病态的成因分别提出了情感缺陷理论及注意缺陷理论。近年来随着神经影像学的发展,有研究者从系统的角度针对精神病态的功能缺陷提出了整合的观点,以弥补既往理论只能解释某一方面功能缺陷的不足。目前最具代表性的是整合受损理论。本文将逐一梳理以上关于精神病态功能缺陷的理论研究进展,并结合目前的研究证据提出未来的理论研究方向,从而为制定更好的针对精神病态的干预措施提供理论借鉴。     

Testing a four-factor model of psychopathy and its association with ethnicity, gender, intelligence, and violence

Although a 2-factor model has advanced research on the psychopathy construct, a 3-factor model was recently developed that emphasized pathological personality and eliminated antisocial behavior. However, dropping antisocial behavior from the psychopathy construct may not be advantageous. Using a large sample of psychiatric patients from the MacArthur Risk Assessment Study (J. Monahan & H. J. Steadman, 1994), the authors used confirmatory factor analysis to test a 4-factor model of psychopathy, which included interpersonal, affective, and behavioral impulsivity dimensions and an antisocial behavior dimension. Model fit was good for this 4-factor model, even when ethnicity, gender, and intelligence variables were included in the model. Structural equation modeling was used to compare the 3- and 4-factor models in predicting proximal (violence) and distal (intelligence) correlates of psychopathy.