Can brain MRI identify psychopaths?Arch Gen Psych Sept 2012

A subgroup of ASPD ( antisocial personality disorder)  also meets the criteria for the syndrome of psychopathy. ie a lack of empathy and remorse, as well as persistent reactive and instrumental aggression. This subgroup meets diagnostic criteria for conduct disorder with callous-unemotional traits in childhood and for the syndrome of psychopathy as defined by the Psychopathy Checklist–Revised.This group (ASPD PLUS)  might have different neurobiological mechanisms that initiate and maintain their aggressive behaviors differ compared to rest of the ASPD.The authors describe the different neural mechanisms behind the psychopathological  elements of  ASPD plus.
66 adult ASPD violent offenders with no major mental illness were studied (MRI Brain). Three groups studied were 1. ASPD PLUS  2. ASPD  ( without PLUS) 3.  Healthy non offenders.

Results: The offenders with ASPD Pus demonstrated reduced grey matter volume in the bilateral anterior rostral medial prefrontal cortex (arMPFC) and  bilateral anterior temporal areas.

These areas are known to play key part in some functions impaired in ASPD Plus. for example: the  medial prefrontal cortex  monitors and coordinates  complex social goals. The arMPFC engages in self-reflective processing and enables an emotional understanding of others’ intentional acts. It also facilitates the si- multaneous consideration of self and other perspectives. It is also involved in fear appraisal.The temporal poles are thought to be important in using stored social  knowledge and contextual framing to facilitate understanding of social stimuli.

Authors claim this as the  first structural imaging study to compare two subtypes of violent offenders.The structural defects could explain some of the core difficulties these individuals have.Authors raise the possibility that psychopathy is perhaps a neuro developmental disorder characterized by structural abnormalities from a young age.

The Antisocial Brain: Psychopathy Matters: A Structural MRI Investigation of Antisocial Male Violent Offenders.Gregory S, Ffytche D, Simmons A, Kumari V, Howard M, Hodgins S, Blackwood N.

Arch Gen Psychiatry. 2012

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