Lower anterior cingulate volume in seriously violent men with antisocial personality disorder or schizophrenia and a history of childhood abuse

Abstract

Objective: Antisocial personality disorder (ASPD) and schizophrenia, as well as childhood abuse, are associated with violent behaviour and show marked volumetric reduction in the anterior cingulate (AC), a brain region implicated in regulation of violence through its involvement in decision making, empathy, impulse control, and emotion regulation. The present study examined, for the first time to the authors' knowledge, the grey matter volume of the AC in relation to seriously violent behaviour and childhood psychosocial deprivation (including physical and sexual abuse) in the context of a mental disorder (schizophrenia or ASPD).Methods: Fifty-seven men [14 with ASPD and a history of serious violence; 13 with schizophrenia and a history of serious violence (VSZ); 15 with schizophrenia without a violence history (SZ); 15 nonviolent healthy participants] underwent whole-brain magnetic resonance imaging and were rated on the presence of physical abuse, sexual abuse, neglect, extreme poverty, foster home placement, criminal parent, severe family conflict, and broken home (collectively 'psychosocial deprivation'). Stereological volumetric ratings of the AC were examined for group differences and their association with childhood psychosocial deprivation.Results: A higher proportion of ASPD and VSZ patients had suffered psychosocial deprivation as children, in particular severe physical abuse, relative to SZ patients and healthy participants. ASPD and VSZ, but not SZ, patients had significantly lower AC volume relative to healthy participants. AC volumes correlated negatively with (total) psychosocial deprivation as well as physical and sexual abuse ratings. Group differences in AC volume became nonsignificant when psychosocial deprivation ratings were covaried for. Conclusions:Violent mentally disordered individuals with ASPD or schizophrenia suffer from a significant AC volume loss and this deficit, at least in part, is explained by their histories of stressful childhood experiences. Current and future therapies aiming to reduce violence in such populations would benefit by attending to biological (and other) correlates of childhood abuse.

Annual Research Review: Enduring neurobiological effects of childhood abuse and neglect

“…Similarly, Kumari et al. () reported that group differences in anterior cingulate volume between patients with schizophrenia, antisocial personality disorder and healthy controls disappeared once history of psychosocial deprivation was taken into account. Hence, childhood abuse appears to exert a prepotent influence on cortical development even in subjects with the most severe psychiatric disorders, and efforts to identify the neurobiological correlates of psychopathology, as noted above, must disambiguate the confounding effects of abuse or neglect (Sheffield et al., ).…”

Brain structure differences among male schizophrenic patients with history of serious violent acts: an MRI voxel-based morphometric study

“…Reduced hippocampal and parahippocampal volume among murderers with schizophrenia relative to non-murderers with schizophrenia was also reported by another group [19]. Volumetric abnormalities in other brain areas have also been reported, such as reduced thalamic volume in participants with schizophrenia or antisocial personality disorder and a history of psychosocial deprivation [20], as well as lower anterior cingulate volume in subjects with antisocial personality and/or schizophrenia and a history of serious violence, but not in patients with non-violent schizophrenia relative to normal subjects [10]. Regarding cortical thickness, Narayan et al showed that violence was associated with cortical thinning in the medial inferior frontal and lateral sensory motor cortex, as only violent subjects with antisocial personality disorder exhibited cortical thinning in inferior mesial frontal cortices [21].…”

“…Some patients with organic frontal damage show similar behaviors to psychopathy [5], and frontal abnormalities have been reported in patients with antisocial personality disorder or psychopathy [6]. Morphological abnormalities in other regions such as the temporal pole [7–9], anterior cingulate cortex [10], nucleus accumbens [11], amygdala [12], and hippocampus [9, 13] were also reported in individuals with psychopathy or antisocial personality disorder. However, to what extent these abnormalities are shared among individuals with schizophrenia and violent traits remains unclear.…”

Preventing Violence in Patients with Schizophrenia

“…History of severe physical abuse in childhood was more prevalent among violent than nonviolent adult schizophrenia patients. Furthermore, violent schizophrenia patients exhibited a significant volume loss of anterior cingulate, and this deficit was explained, at least in part, by their histories of stressful childhood experiences [17]. A cross-sectional, noninterventional study of 195 adolescent nonpregnant girls assessed the potential for child abuse using an inventory [18].…”