Lecture 8: Psychopathy Flashcards
What are the four main symptoms categories for the diagnosis of conduct disorder? Name some of the symptoms. How many symptoms have to be present for a diagnosis?
(1) Aggression to people and animals (bullying, threatening or intimidating others, physical fights, weapon usage, physically cruel to humans / animals, robbery, forcing someone into sexual activity)
(2) Destruction of property (fire setting, deliberately destroying others property)
(3) Deceitfulness or Theft (breaking into someones house, building or car, lying to obtain goods or avoid obligations, stealing without confronting a victim)
(4) Serious violations of rules (staying out during night despite parental prohibition [< 13 years], running away from home, truancy [< 13 years].
3 out of 15 symptoms have to be present for a diagnosis.
Name the diagnostic specifiers for conduct disorder (DSM-5).
Age specifier: 1. Childhood-onset type At least 1 symptom present before age 10 2. Adolescent-onset type No symptoms present before age 10
New specifier: Limited Prosocial Emotions:
At least 2 of the following characteristics
1. Lack of remorse or guilt
2. Callous - lack of empathy
3. Unconcerned about performance
4. Shallow or deficient affect
Name the three psychopathic traits.
(1) Grandiose - manipulative (GM)
(2) Impulsive - irresponsible (II)
(3) Callous - unemotional (CU)
What is the general prognosis for conduct disorder with CU traits?
In general worse prognosis with potential treatment resistance and more severe behavioral problems, including aggression, delinquency, fearlessness and insensitivity to punishment.
Name the two kinds of aggression and associated features.
Reactive aggression, can either be externalizing (response to perceived threat) or internalizing (frustration).
Proactive aggression is instrumental and goal-directed.
What was the finding regarding IQ and proactive aggression?
Proactive aggression was not related to higher IQ.
Name the three subparts of TACt (aggression regulation training).
Social skill training (behavioral component), anger management training (affective component) and moral reasoning training (cognitive component).
Name respectively two cognitive distortions in reactive and proactive aggression.
Reactive: blaming others, assuming the worst.
Proactive: self-centeredness, minimalizing / mislabelling.
How is antisocial behavior related to executive functioning?
Decreased inhibition and increased planning abilities are both related to higher levels of antisocial behavior.
Regarding the HPA axis, what are the general findings in patients with psychopathic traits?
In patients with psychopathic traits there is less (or even no) stress response in potential negative consequences. This is also reflected by lower heart rate and cortisol levels in saliva measurements (public speaking task).
Moreover, there is a decreased cortisol awakening response in conduct disorder plus a less steep decrease during the day.
What were the treatment effects of TACt (aggression regulation training) in conduct disorder with CU traits?
In low CU patients there was a decrease in cortisol levels, while in high CU patients there was an increase in cortisol levels. Moreover, in both groups the aggression went down.
Which brain areas are the most affected in conduct disorder?
Late-developing brain areas are the most affected, especially PFC (even more vmPFC).
What were the general findings regarding Ritalin (Methylphenidate) in conduct disorder?
Ritalin can be effective as treatment in conduct disorder. It had an immediate effect on amygdala functioning.
What were the general findings regarding genetics in antisocial behavior?
Genes only have an effect when childhood maltreatment occurs as well. In a good environment a genetic predisposition does not have any effect on the development of antisocial behavior.
What could be an underlying mechanism linking genes to antisocial behavior?
An increased genetic risk for antisocial behavior is associated with variations in white-matter microstructure of the right uncinate fasciculus (UF), a white matter tract that links the limbic system with the prefrontal cortex. This may contribute to variation in emotion regulation.
