Empathy circuits are abnormal in psychopathy.JAMA Psy.2013.June


Empathy is the the natural capacity to share and understand the affective states of others. Empathic arousal/ empathic sensitivity is the automatic sharing of the affective states of others. This arousal is the primary component of empathy  and that can lead to the experience of empathic concern ( emotional response felt towards others with their welfare as the focus ).

Empathic sensitivity is the basic form of intra species communication and is the first component of empathy to develop in children.To be motivated to help another, one needs to be affectively, empathically aroused and anticipate the cessation of mutually experienced personal distress.It is also known that certain brain areas  are activated when  one experiences pain and when one perceives, anticipates, or even imagines pain happening to others.  This response to the distress of others, such as pain, is thought to reflect an aversive response in the ob- server that may act as a trigger to inhibit aggression or prompt motivation to help. Individuals with psychopathy show lack of empathy, attachment as well as callous lack of regard for others. Would fMRI in this group show deficits in empathy circuits?

Jean Decety, Laurie R. Skelly and Kent A. Kiehl report the results of an fMRI study done in 80 incarcerated  adults with different levels of psychopathy in a medium- security North American correctional facility. 27 had high psychopathy scores, 28 had moderate scores and  25 had low scores. groups were matched in other variables.They had to view  short dynamic visual stimuli depicting persons harming one another and neural responses were captured.They were also tested with facial expressions of pain.

Findings: Significant signal increase was detected in several  brain areas ( eg AIC ( anterior insular cortex)  up on viewing the images of individuals being physically injured.Controls showed greater activation in the OFC ( Orbito frontal cortex and vmPFC (ventromedial prefrontal cortex) when perceiving individuals being injured as well as during facial expressions of pain.  These regions are important for monitoring ongoing behavior, estimating consequences, and incorporating emotional learning into decision making.  These are the same regions  implicated in neuroimaging investigations of psychopathy.

Limitations: Passive viewing may not be replicating the actual life reactions.Tasks were not able to elicit reactions in amygdala , a well studied region in psychopathy.

Conclusions:  In response to pain and distress cues expressed by others, individuals with psychopathy exhibit deficits in the ventromedial prefrontal cortex and orbitofrontal cortex regardless of stimulus type.

Summary of article:

Brain response to empathy-eliciting scenarios involving pain in incarcerated individuals with psychopathy.Decety J, Skelly LR, Kiehl KA.JAMA Psychiatry. 2013 Jun 1;70(6):638-45

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