Lecture 9 - Psychopathy

Question 1

What percentage of the general population is psychopathy believed to affect?

Answer 1

1%

Question 2

What percentage of the male and female prison population is psychopathy believed to affect?

Answer 2

15%-25%

Question 3

What are the 3 areas thought to be hotspots for psychopathic traits?

Answer 3

• amygdala
• OFC
• cingulate cortex

Question 4

What does the OFC do and where does it receive input from?

Answer 4

OFC receives inputs from all the five senses, including abstract information such as money, value and reward (passed on from the striatum). Thought to be involved in decision making and prediction.

Compares current and predicted reward, actions required, and uses information to make (or to not make) a particular action.

Sense of morality seems to be involved/processed by the OFC.

Question 5

What seems to occur when the OFC is damaged?

Answer 5

Leads to pseudopsychopathy/acquired sociopathic personality. Coincides with symptoms:

• reactive aggression
• deficits in motivation
• empathy
• planning and organisation
• impulsivity and irresponsibility
• insight, and behavioural inhibition
• impairment on affective voice, face expression identification and response reversal/extinction tasks (shared with psychopathy)

Question 6

What is the caveat when it comes to potential involvement of OFC damage in psychopathy?

Answer 6

Patients with damage to the OFC rarely show instrumental or goal-directed aggression, which is a key feature of psychopathy.

Question 7

What did Blair et al., (1997) find about the processing of neutral or distressing stimuli in psychopaths?

Answer 7

Neutral, distressing (other people in distress) or threatening stimuli (threatening to self).

In controls, distressing and threatening stimuli caused a change in skin conductance (indicating arousal)
In psychopathic men, there was a little change for distress, only threatening stimuli lead to bigger changes in skin conductance.

Question 8

What does the ACC do?

Answer 8

Known as the brain’s Error detector - produces ERN (Coles, 1995)

Also - empathy, impulse-control, emotion and decision-making

Question 9

What is seen with lesions to the anterior cingulate cortex?

Answer 9

Disturbances in personality functioning similar to symptoms of those with OFC lesions.

Question 10

What is the evidence suggesting a role of the amygdala in psychopathy?

Answer 10

Amygdala is tied to the temporal cortex. individuals with temporal lobe epilepsy have a high incidence of psychopathic-like behaviour (up to 70%).

Removal of the anterior temporal lobe appears to alleviate the behavioural problems (as well as the epilepsy). Psychopathic-like behaviours, therefore, could be due to some pathological circuits involving the anterior temporal lobes.

Question 11

What is the function of the amygdala?

Answer 11

Involved in the storage, encoding and interpreting of emotion.

Question 12

What is seen in patients with bilateral amygdala damage?

Answer 12

Poor judgement of unfamiliar individuals - rated them as more approachable and trustworthy than control subjects rated them - especially for faces rated as unapproachable and untrustworthy

Associated with impairments in recognising angry and fearful faces.

When amygdalotomy was performed on those with disturbed behaviour (assaultiveness, aggression, etc), some evidence was found in reducing the behaviour. However some became violent again years later - removing the amygdala doesn’t prevent violence.

Question 13

What are the two parts of the amygdala?

Answer 13

BLA - basolateral amygdala, receives information from multiple systems. related to the perception of emotional stimuli, as well as memory formation for emotionally salient events

CMA - centromedial amygdala, less heavily integrated with cortical circuits. Thought to be involved in output of physiological aspects of emotions (skin conductance, increase in heart rate, etc)

Question 14

What was Moul et al.’s (2012) theory of psychopathy?

Answer 14

Cognitive and affective deficits in psychopathy result from chronic hypoactivity in the BLA, and hyperactivity in the CMA.

Implying that psychopaths are not encoding emotions correctly, and they have exaggerated response when they do come across emotional stimuli (perhaps the latter explains their high emotional reactivity and aggression, factor 2 symptoms, while the former could explain their lack of empathy, etc, - factor 1 symptoms.

Question 15

What is the P300?

Answer 15

A response 300ms after identification of a change in stimulus, only when told to be aware of that change.

Peak timing is negatively correlated with mental efficiency, as shorter latencies are associated with superior cognitive performance on neuropsychological tests.

Question 16

What did Kiehl etl al., (1999) find about the P300 of psychopaths compared to controls?

Answer 16

P300 is aberrant in psychopaths, due to temporal damage.

Individuals with temporal lobe damage have a very similar P300 to those with high psychopathy scores.

Question 17

What did ***Brazil et al., (2009) study and find about ERNs in psychopathy?

Answer 17

Compared brain activity between controls and psychopaths when they themselves made a mistake on a flanker task, and compared it to when they observed someone else making a mistake.

Not much of a difference when making a mistake themselves.

When watching someone else make a mistake, controls had a small but robust ERN. In psychopaths, error related negativity was far smaller.

Suggests, perhaps, they do not care about what someone else is doing (as much as what they’re doing at least). Or, maybe mirror neurons are not functioning normally in terms of understanding others’ actions in psychopathy - social implications.

Question 18

What did ***Gillian et al., (2007) find about performance by psychopaths on flanker tasks?

Answer 18

Emotional flanker task, where target face was surrounded by faces of alternative emotions.

More mistakes by psychopaths, show they are not as good at processing faces as controls.

The higher the psychopathy score, the higher the errors made, especially for fearful expressions. This correlation was not present on flanker tasks using just arrows, suggesting that it is something about the processing of emotional faces which is particularly deficient in psychopathy.

Question 19

What did ***Gillian et al., (2007) show to be the difference between performance on letter flankers and emotional face flankers by psychopaths?

Answer 19

When psychopaths did the letter flanker task, ERNs were present when a mistake was made. However, they didn’t get ERNs after mistakes on the facial flanker task.

Error detection, and ACC functioning is intact, as they are able to perform on letter flankers, but they are so poor at detecting faces that they do not know they are making mistakes on facial flankers, even on a subconscious/unaware level.

Question 20

What did ***Gillian et al., (2007) find about the relationship between ERNs and psychopathy scores?

Answer 20

Lack of ERN was also correlated with an individual’s psychopathy score.

Psychopaths struggle greatly in recognising facial expressions, especially fearful faces

Question 21

What is the limitation of studies into psychopaths?

Answer 21

Often are very small sample sizes, e.g. 12 controls and 11 offenders. Only a small proportion actually do meet the customary cut-off for psychopathy as a result.

Question 22

How did ***Blair et al., (2013) summarise the current view on the cause of psychopathy?

Answer 22

Many factors (trauma, neglect, genetic, perinatal), which affects amygdala function, and frontal function, and then cognitive function which leads to deficient emotion, empathy, decision-making issues. Overactive BLA, which leads to deficient behavioural outcomes.

Question 23

What did ***Blair et al., (2013) theorise to cause psychopathic traits in youths?

Answer 23

Trauma, neglect and violence leads to increased amygdala responsiveness. This increases threat sensitivity, leading to anxiety, threat-based reactive aggression and under-regulated responses to social provocation.

Perinatal and genetic factors also lead to decreased amygdala responsiveness and decreased striatal & vmPFC responsiveness. This causes reduced emotional empathy and impaired decision making respectively, leading to CU traits, ASB and instrumental aggression, and frustration-based reactive aggression.

These behavioural symptoms are consistent with conduct disorder, but may also underlie and progress into adult forms of psychopathy.

Question 24

What did Blair et al., (2013) find about the potential benefits of finding more about causes of psychopathy?

Answer 24

May identify biomarkers that can provide differential diagnoses and predict long-term prognosis and treatment efficacy