Lecture psychiatric disorders 11: neurobiology of Anti-Social Personality Disorder (ASPD) Flashcards
What is antisocial behavior?
Behavior that lacks consideration for others and that may cause damage to society
When is a patient diagnosed with Antisocial Personality Disorder (ASPD)?
A patient is diagnosed with ASPD when their antisocial behavior becomes pathological, where they consistently show no regard for right and wrong and ignore the rights and feelings of others.
Is psychopathy the same as Antisocial Personality Disorder?
No, psychopathy is a subset of ASPD. Characteristics of a psychopath differ from the characteristics of other types of ASPD.
What is Conduct Disorder (CD)?
Childhood antisocial disorder
What are characteristics of someone with Antisocial Personality Disorder (ASPD)?
- Apparant lack of remorse
- Persistent lying or stealing
- Cruelty to animals
- Recurring difficulties with the law
- Promiscuity / Poor or abusive relationships
- Aggressive, often violent behavior; prone to getting involved in fights
- Inability to tolerate boredom
- Lack access to own feelings and emotions
- Not good at detecting emotions (especially fear) in others
- Reduced empathy
- Severe disruption in moral behavior
What are characteristics of a psychopath?
- Callousness, manipulativeness, glibness and superficial charm
- Often (highly) intelligent
- Grandiose sense of self-worth
- Faking normal emotions: appearance of normalcy and mask of sanity
- Seemingly charming
- Often seems to function normal in society
What makes Antisocial Personality Disorder (ASPD) different from a psychopath?
In ASPD, there’s more pronounced poor behavioral controls, like the inadequate control of anger and temper. They’re often more rude, aggressive, abusive and show angry behavior, compared to a psychopath.
In the first study discussed in the lecture, two things were studied. The first being whether there was any damage to white or grey matter in patients with ASPD. What was the other?
Measuring autonomic nervous system (ANS) functioning. It was already known that ASPD patients showed less emotion, so they wanted to see how the ANS would react to certain stressors by measuring heart rate and skin conductance.
What were the results of the first study when they looked at the grey and white matter of the prefrontal cortex of ASPD patients? Can this result be explained?
The gray matter volume of the PFC was slightly reduced in patients with ASPD. This can be explained by the fact that ASPD patients have less impulse control and the PFC is important for impulse control. So a reduction in gray matter volume of the PFC could explain this.
What was the result of the first study where they measured autonomic nervous system (ANS) activity during a stress test?
The heart rate and skin conductance of people diagnosed with ASPD was clearly reduced.
Name brain areas that:
- are impaired only in ASPD
- are important only in moral decision-making
- are impaired in ASPD and important in moral decision-making
- Impaired in ASPD (red) → anterior cingulate (part of limbic system), temporal lobes, hippocampus, prefrontal cortex and amygdala.
- Important in decision-making (green) → posterior cingulate, prefrontal cortex and amygdala
- Impaired in ASPD and important in moral decision-making (yellow) → prefrontal cortex, amygdala, angular gyrus, superior temporal gyrus
What structures are impaired in rule-breaking behavior?
Prefrontal cortex, amygdala and angular gyrus. These structures are important for moral cognition and emotion.
What is an important structure that is impaired in ASPD or psychopaths? And how is it impaired?
The amygdala, there’s significant reduction in volume and activity.
What’s an important structure that is impaired in antisocial behavior and how is it impaired?
Prefrontal cortex is impaired, it displays robust structural and functional deficits.
What kind of technique is used to study moral decision making in psychopaths where we want to know if their behavior results from deficiencies in moral neural circuits?
functional MRI (fMRI) is used
17 subjects with varying degrees of psychopathy were asked for their judgements on 10 moral dilemmas during fMRI. What results were found?
That subjects with higher psychopathy scores, had a reduced amygdala activity during moral decision making.
What role does the amygdala have in regard to fear?
It’s important in regulation of emotions, where fear is a very important one. The amygdala does not only play a role in regulating fear, but is also important in recognising fear in others.