Brain imaging research on psychopathy: Implications for punishment, prediction, and treatment in youth and adults

Abstract

While there has been an exponential increase in brain imaging research on psychopathy in the past two decades, knowledge on the brain basis to child and adolescent psychopathic-like behavior is relatively new. This adult and child research has potential future implications for the development of new interventions, prediction of future offending, and punishment. This review examines both adult and child literatures on the neural basis of psychopathy, together with implications for the criminal justice system. The adult imaging literature provides growing evidence for amygdala structural and functional impairments in psychopaths, and more variable evidence for prefrontal deficits. The emerging child and adolescent imaging literature with notable exceptions broadly parallels these adult findings and may help explain the development of fearlessness, disinhibition, and lack of empathy. This knowledge places policy makers at a crossroads. Should new biological interventions be developed to remediate these brain abnormalities? Would imaging be used in the future to predict offending? Could imaging findings help excuse psychopathic behavior or alternatively argue for longer sentences for public protection? This review attempts to address these issues at the child and adult levels and provides directions for future research that include the incorporation of biological measures into treatment programs. AbstractWhile there has been an exponential increase in brain imaging research on psychopathy in the past two decades, knowledge on the brain basis to child and adolescent psychopathic-like behavior is relatively new. This adult and child research has potential future implications for the development of new interventions, prediction of future offending, and punishment. This review examines both adult and child literatures on the neural basis of psychopathy, together with implications for the criminal justice system. The adult imaging literature provides growing evidence for amygdala structural and functional impairments in psychopaths, and more variable evidence for prefrontal deficits. The emerging child and adolescent imaging literature with notable exceptions broadly parallels these adult findings and may help explain the development of fearlessness, disinhibition, and lack of empathy. This knowledge places policy makers at a crossroads. Should new biological interventions be developed to remediate these brain abnormalities? Would imaging be used in the future to predict offending? Could imaging findings help excuse psychopathic behavior or alternatively argue for longer sentences for public protection? This review attempts to address these issues at the child and adult levels and provides directions for future research that include the incorporation of biological measures into treatment programs.4

Aberrant functional network connectivity in psychopathy from a large (N = 985) forensic sample

“…One of the most prominent neurobiological models of psychopathy focuses on dysfunctions in amygdala and ventromedial prefrontal cortex (vmPFC) (Anderson & Kiehl, 2012;Blair, 2006;Korponay et al, 2017). Imaging studies have been providing evidence for amygdala and prefrontal deficits in psychopathy (Blair, 2008;Kiehl et al, 2001;Koenigs, 2012;Motzkin et al, 2011;M€ uller et al, 2003;Philippi et al, 2015;Umbach et al, 2015;Yoder et al, 2015). The amygdala is important for the processing of emotionally salient information including threatening emotions and fear (Davis & Whalen, 2001).…”

“…A study based on independent component analysis (ICA), a data-driven approach, found significant associations between psychopathy scores and functional connectivity in three networks including the default mode network, frontoparietal network, and visual network in fMRI data collected during an auditory oddball task (Juarez, et al, 2013). A review on brain imaging research on psychopathy by Umbach and collaborators empathizes the need of exploration of other brain regions and circuits besides the amygdala and prefrontal cortex that may give rise to different features of psychopathy (Umbach, et al, 2015). …”

Can the causal mechanisms underlying chronic, serious, and violent offending trajectories be elucidated using the psychopathy construct?

“…Psychopathy seems necessary, though not sufficient, for explaining the causal mechanisms associated with chronic, serious, and violent (CSV) offending trajectories. The articles in this special issue illustrate both strengths and weaknesses concerning psychopathy and (a) its integration into existing criminological theories (DeLisi & Vaughn, 2015;Fox, Jennings, & Farrington, 2015) and neuropsychological models of offending (Umbach, Berryessa, & Raine, 2015), (b) its use as a risk factor for the development of offending over time Walters, 2015), and (c) its use as a risk factor for specific types of offenders, including female offenders (Forouzan & Nicholls, 2015), institutional offenders (Shaffer, McCuish, Corrado, Behnken, & DeLisi, 2015), sexual offenders (Cale, Lussier, McCuish, & Corrado, 2015), and violent offenders . Given the research in this special issue and elsewhere (e.g., DeLisi, 2009;DeLisi & Piquero, 2011;Vaughn, Howard, & DeLisi, 2008), we believe that the construct is necessary, though not sufficient, for identifying causal mechanisms underlying CSV offending trajectories.…”

Physiological Arousal and Juvenile Psychopathy: Is Low Resting Heart Rate Associated with Affective Dimensions?

“…Copious research findings have shown that psychopathy is significantly associated with an array of antisocial and other problem behaviors, including conduct problems, delinquency, externalizing symptoms, crime, and violence. Due to the numerous studies that have found a link between low physiological arousal and antisocial behavior [4,5,6,13], it is somewhat surprising that little research has examined the relations between low physiological arousal and psychopathy facets. At the very least, it seems plausible that low physiological arousal should be related to the affective dimensions of juvenile psychopathy such as Callous-Unemotionality and Uncaring.…”