Economic decision-making in psychopathy: a comparison with ventromedial prefrontal lesion patients

Psychopathy and medial frontal cortex: A systematic review reveals predominantly null relationships

Theories have posited that psychopathy is caused by dysfunction in the medial frontal cortex, including ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), and dorsomedial prefrontal cortex (dmPFC). Recent reviews have questioned the reproducibility of neuroimaging findings within this field. We conducted a systematic review to describe the consistency of magnetic resonance imaging (MRI) findings according to anatomical subregion (vmPFC, ACC, dmPFC), experimental task, psychopathy assessment, study power, and peak coordinates of significant effects. Searches of PsycInfo and MEDLINE databases produced 77 functional and 24 structural MRI studies that analyzed the medial frontal cortex in relation to psychopathy in adult samples. Findings were predominantly null (85.4 % of 1573 tests across the three medial frontal regions). Studies with higher power observed null effects at marginally lower rates. Finally, peak coordinates of significant effects were widely dispersed. The evidence failed to support theories positing the medial frontal cortex as a consistent neural correlate of psychopathy. Theory and methods in the field should be revised to account for predominantly null neuroimaging findings.

Reduced prosocial motivation and effort in adolescents with conduct problems and callous-unemotional traits

BACKGROUND

Prosocial behaviours - acts that benefit others - are of crucial importance for many species including humans. However, adolescents with conduct problems (CP), unlike their typically developing (TD) peers, demonstrate markedly reduced engagement in prosocial behaviours. This pattern is particularly pronounced in adolescents with CP and high levels of callous-unemotional traits (CP/HCU) who are at increased risk of developing psychopathy in adulthood. While a substantial amount of research has investigated the cognitive-affective mechanisms thought to underlie antisocial behaviour, much less is known about the mechanisms that could explain reduced prosocial behaviours in adolescents with CP.

METHODS

Here we examined the willingness to exert effort to benefit oneself (self) and another person (other, prosocial condition) in children with CP/HCU, CP and lower levels of CU traits (CP/LCU) and their TD peers. The task captured both prosocial choices, and actual effort exerted following prosocial choices, in adolescent boys aged 11-16 (27 CP/HCU; 34 CP/LCU; 33 TD). We used computational modelling to reveal the mechanistic processes involved when choosing prosocial acts.

RESULTS

We found that both CP/HCU and CP/LCU groups were more averse to initiating effortful prosocial acts than TD adolescents - both at a cognitive and at a behavioural level. Strikingly, even if they chose to initiate a prosocial act, the CP/HCU group exerted less effort following this prosocial choice than other groups.

CONCLUSIONS

Our findings indicate that reduced exertion of effort to benefit others may be an important factor that differentiates adolescents with CP/HCU from their peers with CP/LCU. They offer new insights into what might drive low prosocial behaviour in adolescents with CP, including vulnerabilities that may particularly characterise those with high levels of CU traits.

Social preferences and psychopathy in a sample of male prisoners-a pilot study

Social decisions are influenced by a person's social preferences. High psychopathy is defined by antisocial behaviour, but the relationship between psychopathy and social preferences remains unclear. In this study, we used a battery of economic games to study social decision-making and social preferences in relation to psychopathy in a sample of 35 male prison inmates, who were arrested for sexual and severe violent offenses (mean age = 39 years). We found no evidence for a relationship between social preferences (measured with the Dictator and Ultimatum Games, Social Value Orientation, and one-shot 2 × 2 games) and psychopathy (measured by the overall Hare Psychopathy Checklist-Revised score and both factors). These results are surprising but also difficult to interpret due to the small sample size. Our results contribute to the ongoing debate about psychopathy and social decision-making by providing crucial data that can be combined with future datasets to reach large sample sizes that can provide a more nuanced understanding about the relationship between psychopathy and social preferences.

Morality, self-control, age, type of offence and sentence length as predictors of psychopathy amongst female incarcerated offenders in South Africa

There has been an increase in female incarcerated offenders nationally and internationally. Despite this trend, literature and research on female offenders remain limited compared to their male counterparts. Evidence of the relationship between certain personality disorders and offending behaviour has led numerous countries to prioritise identifying and assessing personality disorders among the offender population. Psychopathic personality traits may contribute to women's risk factors for expressing antisocial behaviours, resulting in their potential future incarceration. Thus, a need exists to understand possible factors that may predict the expression of psychopathic traits in females, which may have notable utility among female offenders. This study aimed to investigate possible predictor variables of psychopathy amongst incarcerated female offenders in South Africa. A quantitative research approach, non-experimental research type, and correlational research design were employed. A convenience sampling technique was used. The sample consisted of 139 (N = 139) female offenders housed in two correctional centres in South Africa who voluntarily participated in this study. Correlation analyses and hierarchical regression analysis procedures were conducted to analyse the results. Results indicated (i) a certain combination of predictor variables that statistically and practically significantly explained both primary and secondary psychopathy and (ii) individual predictor variables (e.g., Impulsivity, Simple Tasks, Risk-Seeking, and Self-Centredness) that explained both primary and secondary psychopathy statistically and practically significantly. This study provides valuable information about the possible predictor variables of psychopathy amongst female offenders within the context of South Africa. However, further research must be conducted to validate these findings and advance our knowledge on this topic.

Functional Connectivity of the Nucleus Accumbens across Variants of Callous-Unemotional Traits: A Resting-State fMRI Study in Children and Adolescents

A large body of literature suggests that the primary (high callousness-unemotional traits [CU] and low anxiety) and secondary (high CU traits and anxiety) variants of psychopathy significantly differ in terms of their clinical profiles. However, little is known about their neurobiological differences. While few studies showed that variants differ in brain activity during fear processing, it remains unknown whether they also show atypical functioning in motivational and reward system. Latent Profile Analysis (LPA) was conducted on a large sample of adolescents (n = 1416) to identify variants based on their levels of callousness and anxiety. Seed-to-voxel connectivity analysis was subsequently performed on resting-state fMRI data to compare connectivity patterns of the nucleus accumbens across subgroups. LPA failed to identify the primary variant when using total score of CU traits. Using a family-wise cluster correction, groups did not differ on functional connectivity. However, at an uncorrected threshold the secondary variant showed distinct functional connectivity between the nucleus accumbens and posterior insula, lateral orbitofrontal cortex, supplementary motor area, and parietal regions. Secondary LPA analysis using only the callousness subscale successfully distinguish both variants. Group differences replicated results of deficits in functional connectivity between the nucleus accumbens and posterior insula and supplementary motor area, but additionally showed effect in the superior temporal gyrus which was specific to the primary variant. The current study supports the importance of examining the neurobiological markers across subgroups of adolescents at risk for conduct problems to precise our understanding of this heterogeneous population.

The science of justice: The neuropsychology of social punishment

The social punishment (SP) of norm violations has received much attention across multiple disciplines. However, current models of SP fail to consider the role of motivational processes, and none can explain the observed behavioral and neuropsychological differences between the two recognized forms of SP: second-party punishment (2PP) and third-party punishment (3PP). After reviewing the literature giving rise to the current models of SP, we propose a unified model of SP which integrates general psychological descriptions of decision-making as a confluence of affect, cognition, and motivation, with evidence that SP is driven by two main factors: the amount of harm (assessed primarily in the salience network) and the norm violator's intention (assessed primarily in the default-mode and central-executive networks). We posit that motivational differences between 2PP and 3PP, articulated in mesocorticolimbic pathways, impact final SP by differentially impacting the assessments of harm and intention done in these domain-general large-scale networks. This new model will lead to a better understanding of SP, which might even improve forensic, procedural, and substantive legal practices.

Economic and social values in the brain: evidence from lesions to the human ventromedial prefrontal cortex

Making good economic and social decisions is essential for individual and social welfare. Decades of research have provided compelling evidence that damage to the ventromedial prefrontal cortex (vmPFC) is associated with dramatic personality changes and impairments in economic and social decision-making. However, whether the vmPFC subserves a unified mechanism in the social and non-social domains remains unclear. When choosing between economic options, the vmPFC is thought to guide decision by encoding value signals that reflect the motivational relevance of the options on a common scale. A recent framework, the "extended common neural currency" hypothesis, suggests that the vmPFC may also assign values to social factors and principles, thereby guiding social decision-making. Although neural value signals have been observed in the vmPFC in both social and non-social studies, it is yet to be determined whether they have a causal influence on behavior or merely correlate with decision-making. In this review, we assess whether lesion studies of patients with vmPFC damage offer evidence for such a causal role of the vmPFC in shaping economic and social behavior.

Social incentives foster cooperation through guilt aversion: An effect that diminishes with primary psychopathic traits

The association between primary psychopathic traits and non-cooperative behaviors is well-identified. There is a lack of studies on how to motivate cooperative behaviors in individuals with primary psychopathic traits. This study investigated the effects of monetary incentives and social incentives on promoting cooperation in healthy adults with varying primary psychopathic traits. Participants played a one-shot public goods game (PGG) with other anonymous players in three different contexts: a social incentives context where participants' decisions would be judged by others, a monetary incentives context where participants' decisions would result in winning or losing money depending on their contributions, and a control condition where no additional incentives were implemented. We found that, compared to the control condition, both monetary and social incentives significantly improved participants' contributions to the public project-an indicator of cooperative behavior. However, the association between higher primary psychopathic traits and less cooperation was only observed in the context of social incentives. Computational modeling further revealed that this effect can be explained by the diminishing guilt aversion when participants deliberately violated their inferred expectations of themselves from others' perspectives. This study found that social incentives can encourage cooperative behaviors in non-clinical psychopathy, and identified the mental processes navigating this effect.

Neural bases of frustration-aggression theory: A multi-domain meta-analysis of functional neuroimaging studies

BACKGROUND

Early evidence suggests that unexpected non-reward may increase the risk for aggressive behaviors. Despite the growing interest in understanding brain functions that may be implicated in aggressive behaviors, the neural processes underlying such frustrative events remain largely unknown. Furthermore, meta-analytic results have produced discrepant results, potentially due to substantial differences in the definition of anger/aggression constructs.

METHODS

Therefore, we conducted a coordinate-based meta-analysis, using the activation likelihood estimation algorithm, on neuroimaging studies examining reward omission and retaliatory behaviors in healthy subjects. Conjunction analyses were further examined to discover overlapping brain activations across these meta-analytic maps.

RESULTS

Frustrative non-reward deactivated the orbitofrontal cortex, ventral striatum and posterior cingulate cortex, whereas increased activations were observed in midcingulo-insular regions. Retaliatory behaviors recruited the left fronto-insular and anterior midcingulate cortices, the dorsal caudate and the primary somatosensory cortex. Conjunction analyses revealed that both strongly activated midcingulo-insular regions.

LIMITATIONS

Spatial overlap between neural correlates of frustration and retaliatory behaviors was conducted using a conjunction analysis. Therefore, neurobiological markers underlying the temporal sequence of the frustration-aggression theory should be interpreted with caution.

CONCLUSIONS

Nonetheless, our results underscore the role of anterior midcingulate/pre-supplementary motor area and fronto-insular cortex in both frustration and retaliatory behaviors. A neurobiological framework for understanding frustration-based impulsive aggression is provided.

Prosocial behavior is associated with transdiagnostic markers of affective sensitivity in multiple domains

Prosocial behaviors-actions that benefit others-fundamentally shape our interpersonal interactions. Psychiatric disorders have been suggested to be related to prosocial disturbances, which may underlie many of their social impairments. However, broader affective traits, present to different degrees in both psychiatric and healthy populations, also have been linked to variability in prosociality. Therefore, it is unclear to what extent prosocial variability is explained by specific psychiatric disorders relative to broad affective traits. Using a computational, transdiagnostic approach in two online studies, we found that participants who reported being more affectively reactive across a broad cluster of traits manifested greater frequencies of prosocial actions in two different contexts: They reported being more averse to harming others for profit, and they were more willing to exert effort to benefit others. These findings help illuminate the profile of prosociality across psychiatric conditions as well as the architecture of prosocial behavior in healthy individuals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Sinful pleasures and pious woes? Using fMRI to examine evaluative and hedonic emotion knowledge

Traditionally, lust and pride have been considered pleasurable, yet sinful in the West. Conversely, guilt is often considered aversive, yet valuable. These emotions illustrate how evaluations about specific emotions and beliefs about their hedonic properties may often diverge. Evaluations about specific emotions may shape important aspects of emotional life (e.g. in emotion regulation, emotion experience and acquisition of emotion concepts). Yet these evaluations are often understudied in affective neuroscience. Prior work in emotion regulation, affective experience, evaluation/attitudes and decision-making point to anterior prefrontal areas as candidates for supporting evaluative emotion knowledge. Thus, we examined the brain areas associated with evaluative and hedonic emotion knowledge, with a focus on the anterior prefrontal cortex. Participants (N = 25) made evaluative and hedonic ratings about emotion knowledge during functional magnetic resonance imaging (fMRI). We found that greater activity in the medial prefrontal cortex (mPFC), ventromedial PFC (vmPFC) and precuneus was associated with an evaluative (vs hedonic) focus on emotion knowledge. Our results suggest that the mPFC and vmPFC, in particular, may play a role in evaluating discrete emotions.

The origins of evil: From lesions to the functional architecture of the antisocial brain

In the past decades, a growing body of evidence has suggested that some individuals may exhibit antisocial behaviors following brain lesions. Recently, some authors have shown that lesions underpinning antisocial behaviors may disrupt a particular brain network during resting-state. However, it remains unknown whether these brain lesions may alter specific mental processes during tasks. Therefore, we conducted meta-analytic co-activation analyses on lesion masks of 17 individuals who acquired antisocial behaviors following their brain lesions. Each lesion mask was used as a seed of interest to examine their aberrant co-activation network using a database of 143 whole-brain neuroimaging studies on antisocial behaviors (n = 5,913 subjects). We aimed to map the lesion brain network that shows deficient activity in antisocial population against a null distribution derived from 655 control lesions. We further characterized the lesion-based meta-analytic network using term-based decoding (Neurosynth) as well as receptor/transporter density maps (JuSpace). We found that the lesion meta-analytic network included the amygdala, orbitofrontal cortex, ventro- and dorso-medial prefrontal cortex, fusiform face area, and supplementary motor area (SMA), which correlated mainly with emotional face processing and serotoninergic system (5-HT_1A and 5-HTT). We also investigated the heterogeneity in co-activation networks through data-driven methods and found that lesions could be grouped in four main networks, encompassing emotional face processing, general emotion processing, and reward processing. Our study shows that the heterogeneous brain lesions underpinning antisocial behaviors may disrupt specific mental processes, which further increases the risk for distinct antisocial symptoms. It also highlights the importance and complexity of studying brain lesions in relationship with antisocial behaviors.

Effects of group affiliation on neural signatures of fairness norm violations in antisocial violent offenders

While norm-violating behavior in antisocial individuals has been widely studied, little is known about how these people react to unfair behavior directed towards them. Previous research yields inconclusive results with some evidence for rational and strategic behavior in antisocial individuals. Electrophysiological correlates as well as socio-contextual factors such as group affiliation that may inform decision making on fairness considerations have not been investigated in previous studies. This study compared fairness considerations of antisocial violent offenders (N = 25) and controls (N = 26) by using the Ultimatum Game where one player proposes a split of resources and the other player has to respond by accepting or declining the offer. Group affiliation of the proposer (in- vs. out-group) and fairness of offers (fair vs. unfair) were manipulated. We found no difference between groups regarding decision behavior. However, healthy participants showed an electrophysiological response to group affiliation, which was attenuated in the violent offender group. This data suggests intact understanding of social norms in antisocial violent offenders while electrophysiological response pattern may be linked to impaired emotional reactions to expectancy violations.

Leveraging economic games to integrate and differentiate personality and psychopathology

A comprehensive model that integrates, yet differentiates, between personality and psychopathology is needed. Emerging empirical models of psychopathology are aligned structurally with trait models of personality, suggesting clear points of convergence. However, traits, themselves, are not sufficient to quantify consequential adaptivity and maladaptivity. Rather, as multiple theoretical accounts argue, unsuccessful pursuit of goals and needs, and the inability to flexibly adapt goals to fit the situation, is how maladaptivity is understood to emerge. Thus far, though, the empirical literature has suffered from an unsatisfactory connection between structural (or trait-based personality) models and our understanding of dysfunctional processes (psychopathology). Economic games, which elicit intensive repeated behavior suitable for studying dynamic processes, have been leveraged to explore how personality and pathology are associated with behavior across a variety of tasks. When coupled with computational modeling, economic games offer a promising method for integrating and differentiating personality and psychopathology. Ultimately, a fully formed model of psychopathology will be achieved when structural models of personality and psychopathology can be merged with a better understanding of the underlying functional processes of each. This will likely only be achieved by leveraging a number of available tools across disciplines.

Serotonin depletion amplifies distinct human social emotions as a function of individual differences in personality

Serotonin is involved in a wide range of mental capacities essential for navigating the social world, including emotion and impulse control. Much recent work on serotonin and social functioning has focused on decision-making. Here we investigated the influence of serotonin on human emotional reactions to social conflict. We used a novel computerised task that required mentally simulating social situations involving unjust harm and found that depleting the serotonin precursor tryptophan-in a double-blind randomised placebo-controlled design-enhanced emotional responses to the scenarios in a large sample of healthy volunteers (n = 73), and interacted with individual differences in trait personality to produce distinctive human emotions. Whereas guilt was preferentially elevated in highly empathic participants, annoyance was potentiated in those high in trait psychopathy, with medium to large effect sizes. Our findings show how individual differences in personality, when combined with fluctuations of serotonin, may produce diverse emotional phenotypes. This has implications for understanding vulnerability to psychopathology, determining who may be more sensitive to serotonin-modulating treatments, and casts new light on the functions of serotonin in emotional processing.

When the killing has been done: Exploring associations of personality with third-party judgment and punishment of homicides in moral dilemma scenarios

Killing people is universally considered reprehensible and evokes in observers a need to punish perpetrators. Here, we explored how observers' personality is associated with their cognitive, emotional, and punishing reactions towards perpetrators using data from 1,004 participants who responded to a set of fifteen third-party perspective moral dilemmas. Among those, four scenarios (architect, life boat, footbridge, smother for dollars) describing deliberate killings were compared to investigate the role of the content features "motive for killing" (selfish vs. utilitarian) and "evitability of victims' death". Participants' moral appropriateness ratings, emotions towards perpetrators, and assigned punishments revealed complex scenario-personality interactions. Trait psychopathy was associated with harsher punishments in all scenarios but also with less concern about killing in general, an increased moral appreciation of utilitarian motives for killing, and a reduced concern about the killing of avoidable victims. Need for cognition was associated with considering a utilitarian motive for killing as a mitigating factor, while intuitive/authority-obedient thinking was linked to a strong focus on avoidability of harm as an aggravating factor when assigning punishments. Other-oriented empathy, trait anxiety, and justice sensitivity did not account for differences in third-party punishments. Our explorative findings highlight the importance of inter-individual differences for moral decision making and sense of justice.

Risk-taking and fairness among cocaine-dependent patients in dual diagnoses: Schizophrenia and Anti-Social Personality Disorder

This study reports experimental results from a clinical sample of patients with a cocaine-related disorder and dual diagnosis: Schizophrenia and Anti-Social Personality Disorder. Both types of patients as well as a non-clinical group of students performed two incentivized decision-making tasks. In the first part of the experiment, they performed a lottery-choice task in order to elicit their degree of risk aversion. In the second part, they decided in two modified dictator games aimed at eliciting their aversion to advantageous and disadvantageous inequality. It is found that the Anti-Social Personality Disorder group exhibits no significant differences from the non-clinical sample in either task. However, compared with the students' sample, subjects from the group with schizophrenia show more risk aversion and exhibit more aversion towards disadvantageous inequality.

Anomalous Moral Intuitions in Juvenile Offenders with Psychopathic Traits

Since the historical conception of psychopathy, researchers have been interested in understanding moral functioning among psychopathic individuals. The present study investigated the association between psychopathic traits and moral intuitions among incarcerated juvenile offenders (N = 178). Participants were assessed using the Psychopathy Checklist:Youth Version (Forth et al., 2003) and the Moral Foundations Questionnaire (Graham et al., 2011), which defines five core moral foundations: Harm/care, Fairness/reciprocity, Ingroup/loyalty, Authority/respect, and Purity/sanctity. As expected, psychopathy in juvenile offenders negatively predicted endorsement of all five foundations. This study is the first to demonstrate broad abnormalities in Haidt et al.'s moral foundations in a juvenile sample and can help explain delinquent behavior in juveniles with psychopathic traits. Implications for theories of psychopathy are discussed.

Neuropsychiatric Effects on Decision-Making in Early Alzheimer Disease

BACKGROUND

Neuropsychiatric symptoms can impact decision-making in patients with Alzheimer disease (AD).

METHODS

Using a simple decision-making task, a variant of the ultimatum game (UG) modified to control feelings of unfairness, this study investigated rejection responses among responders to unfair offers. The UG was administered to 11 patients with AD, 10 comparably demented patients with behavioral variant frontotemporal dementia (bvFTD), and 9 healthy controls (HC). The results were further compared with differences on the caregiver Neuropsychiatric Inventory (NPI).

RESULTS

Overall, patients with AD significantly rejected more total offers than did the patients with bvFTD and the HC (P < .01). On the NPI, the only domain that was significantly worse among the patients with AD compared to the other groups was dysphoria/depression.

CONCLUSIONS

These results suggest that early AD can be distinguished based on increased rejections of offers in decision-making, possibly consequent to a heightened sense of unfairness from dysphoria/depression.

Mediating role of attenuated physiological arousal on the association between psychopathic traits and fairness norm violation

The low-fear model of primary psychopathy has been supported by empirical findings such as attenuated physiological arousal in anticipation of threatening stimuli. The somatic marker hypothesis proposes that salient changes in the bodily state are processed as signals of whether a situation is good or bad and guide an individual to avoid potential adverse consequences. The present study aimed to elucidate the role that attenuated physiological arousal plays in the relationship between primary psychopathy and fairness norm violations both under the threat of punishment and under no potential for punishment. Primary psychopathy was associated with an attenuated skin conductance response prior to the choice of unfair monetary offers to another person, regardless of the potential for punishment. Attenuated skin conductance mediated the association between primary psychopathy and the choice of an unfair offer, especially in the no-punishment condition. However, in the punishment condition, primary psychopathy significantly predicted the choice of unfair offers even after controlling for the magnitude of skin conductance. The bodily response may have only a marginal effect on interpersonal decision-making under a threat of punishment. The present results suggest that the low-fear account of social norm violations as a function of primary psychopathy should be re-discussed.

Fairness norm violations in anti-social psychopathic offenders in a repeated trust game

Psychopathic offenders have a high propensity to violate social norms, as indicated for instance by their widespread lying and cheating behaviour. The reasons for their norm violations are not well understood, though, as they are able to recognise norms in a given situation and also punish norm violators. In this study, we investigated whether psychopathic offenders would violate fairness norms during a repeated trust game because of increased profit-maximising concerns. We measured back-transfer decisions in the repeated trust game, and affective arousal by means of skin conductance responses (SCR) in violent offenders with varying degrees of psychopathy, and non-offenders with low-trait psychopathy. Psychopathy in offenders was measured with the Psychopathy Checklist-Revised (PCL-R). In the task, a participant and an interaction partner entrusted each other money for multiple rounds with the goal to earn as much money as possible. Fairness norm violations were positively associated with Factor 2 scores (the lifestyle/anti-social psychopathy subscale) of the PCL-R, but this was not accompanied by clear profit-maximising behaviour. In addition, anticipatory arousal to self-advantageous decisions was higher in all offenders, independent of their degree of psychopathy, compared with non-offenders. The results of our study widen our understanding of social decision-making in psychopathy. They also suggest treatment possibilities in offenders scoring high on Factor 2, targeting empathic concern and related prosocial intentions to overcome norm-violating behaviour.

When Do Psychopathic Traits Affect Cooperative Behavior?

Abstract. Personality traits have been long recognized to have a strong impact on human decision-making. In this study, a sample of 314 participants took part in an online game to investigate the impact of psychopathic traits on cooperative behavior in an iterated Prisoner’s dilemma game. We found that disinhibition decreased the maintenance of cooperation in successive plays, but had no effect on moving toward cooperation after a previous defection or on the overall level of cooperation over rounds. Furthermore, our results underline the crucial importance of a good model selection procedure, showing how a poor choice of statistical model can provide misleading results.

Behavioral and electrophysiological responses to fairness norm violations in antisocial offenders

Antisocial personality disorder is characterized by a stable, lifelong pattern of disregard for and violation of others' rights. Disruptions in the representation of fairness norms may represent a key mechanism in the development and maintenance of this disorder. Here, we investigated fairness norm considerations and reactions to their violations. To examine electrophysiological correlates, we assessed the medial frontal negativity (MFN), an event-related potential previously linked to violations of social expectancy and norms. Incarcerated antisocial violent offenders (AVOs, n = 25) and healthy controls (CTLs, n = 24) acted as proposers in the dictator game (DG) and ultimatum game (UG) and received fair vs. unfair UG offers from either another human (social context) or a computer (non-social context). Results showed that AVOs made lower offers in the DG but not the UG, indicating more rational and strategic behavior. Most importantly, when acting as recipients in the UG, acceptance rates were modulated by social context in CTLs, while AVOs generally accepted more offers. Correspondingly, ERP data indicated pronounced MFN amplitudes following human offers in CTLs, whereas MFN amplitudes in AVOs were generally reduced. The current data suggest intact fairness norm representations but altered reactions to their violation in antisocial personality disorder.

Psychopathic traits are related to diminished guilt aversion and reduced trustworthiness during social decision-making

Individuals with high levels of psychopathic tendencies tend to show a lack of guilt, a lack of empathic concern, and a disregard for the impact of their decisions on others. However, how guilt influences social decision-making for those with high psychopathic traits is still unknown. Here, we investigated how psychopathic traits relate to the capacity to acquire knowledge about social expectations, and to what extent guilt aversion affects subsequent decision-making. 63 participants completed self-report measures of psychopathy, and then played a modified Trust Game in the role of the Trustee. Results showed that participants’ self-reported beliefs about their partner’s expectations were largely predictive of the amount of money they returned to the partner. These decisions were negatively correlated with the PPI-I scores. Furthermore, participants’ degree of guilt aversion were negatively correlated with PPI total scores. Our findings suggest that individuals with higher psychopathic traits are indeed capable of understanding the expectations of others, but do not seem to directly utilise this knowledge in their social decision-making, and experience less anticipated guilt about this. The present study provides empirical evidence of intact social knowledge coupled with decreased reciprocity and diminished guilt aversion as levels of psychopathic traits increase.

A Systematic Review and Meta-Analysis of Decision-Making in Offender Populations with Mental Disorder

Decision-making has many different definitions and is measured in varied ways using neuropsychological tasks. Offenders with mental disorder habitually make disadvantageous decisions, but no study has systematically appraised the literature. This review aimed to clarify the field by bringing together different neuropsychological measures of decision-making, and using meta-analysis and systematic review to explore the performance of offenders with mental disorders on neuropsychological tasks of decision-making. A structured search of PubMed, Embase, PsycINFO, Medline, Cinahl was conducted with additional hand searching and grey literature consulted. Controlled studies of decision-making in offenders with evidence of any mental disorder, including a validated measure of decision-making were included. Total score on each relevant decision-making task was collated. Twenty-three studies met inclusion criteria (n = 1820), and 10 studies (with 15 experiments) were entered into the meta-analysis (n = 841). All studies included in the meta-analysis used the Iowa Gambling Task (IGT) to measure decision-making. Systematic review findings from individual studies showed violent offenders made poorer decisions than matched offender groups or controls. An omnibus meta-analysis was computed to examine performance on IGT in offenders with mental disorder compared with controls. Additionally, two sub-group meta-analyses were computed for studies involving offenders with personality disorder and psychopathy, and recidivists who were convicted of Driving While Intoxicated (DWI). Individual studies not included in the meta-analysis partially supported the view that offenders make poorer decisions. However, the meta-analyses showed no significant differences in performance on IGT between the offender groups and controls. Further research is required to ascertain whether offenders with mental disorder have difficulty in making advantageous decisions. An analysis of cause and effect and various directions for future work are recommended to help understand the underpinning of these findings. Trial Registration: CRD42018088402.

The Caring Continuum: Evolved Hormonal and Proximal Mechanisms Explain Prosocial and Antisocial Extremes

Implicit in the long-standing disagreements about whether humans’ fundamental nature is predominantly caring or callous is an assumption of uniformity. This article reviews evidence that instead supports inherent variation in caring motivation and behavior. The continuum between prosocial and antisocial extremes reflects variation in the structure and function of neurohormonal systems originally adapted to motivate parental care and since repurposed to support generalized forms of care. Extreme social behaviors such as extraordinary acts of altruism and aggression can often be best understood as reflecting variation in the neural systems that support care. A review of comparative, developmental, and neurobiological research finds consistent evidence that variations in caring motivations and behavior reflect individual differences in sensitivity to cues that signal vulnerability and distress and in the tendency to generalize care outward from socially close to distant others. The often complex relationships between caring motivation and various forms of altruism and aggression are discussed.

Investigating social-contextual determinants of cooperation in incarcerated violent offenders

Antisocial and psychopathic personality traits constitute a severe and treatment resistant form of externalizing psychopathology. While deficits in social information processing have been extensively investigated in these individuals, less is known about their capacity for altruism and cooperation. In particular, no studies to date have investigated whether established social-contextual determinants of cooperation, e.g., group affiliation and number of expected interactions, can motivate cooperative behaviour in antisocial individuals. The present study compared cooperative behaviour of incarcerated violent offenders (N = 52) and controls (N = 46) by using an established social interaction paradigm (Give Some Dilemma) where two players divide monetary units between themselves and the counterpart. Group affiliation (in- vs. out-group) and number of expected interactions (single-trial vs. repeated-trial interactions) were manipulated. Violent offenders as compared to controls shared less monetary units with their counterparts, indicating an overall reduced cooperation. Both groups showed increased cooperation rates towards in-group members and in repeated interactions. Higher psychopathic traits were associated with lower cooperation in single-trial interactions in the violent offender group. Although cooperation was comparably reduced in violent offenders, behaviour in both groups was determined by the number of expected interactions as well as group affiliation, thus providing evidence for equivalent social-contextual determinants.

Empathy and altruistic behavior in antisocial violent offenders with psychopathic traits

Deficiencies in empathic functioning are considered a core characteristic of violent behavior. Enhancing empathy in aggressive populations may thus represent a promising intervention target. Hence, the aims of the present work were two-fold: First, we wanted to thoroughly assess empathic competencies and second, we aimed to investigate effects of an empathy induction on experienced empathy levels and prosocial behavior in a sample of violent offenders relative to matched controls. Empathy was assessed using both self-report as well as objective measures. For the empathy induction, participants were presented with empathy inducing and control videos. To assess the effects of the empathy induction on behavior, participants played a dictator game indicative of prosocial behavior after every video. Violent offenders showed no systematic impairment in empathy measures. Despite lower shares in the dictator game across conditions, the empathy induction led to a substantial increase in prosocial behavior in both groups. Importantly, high psychopathy scores were distinctively associated with lower self-reported empathy levels, an attenuated affective responsiveness to the empathy induction, and less altruistic behavior. Treatment programs aiming to improve empathy should take individual characteristics into account and may be applied to distinctive subgroups rather than to violent offenders per se.

Norms and the Flexibility of Moral Action

A complex web of social and moral norms governs many everyday human behaviors, acting as the glue for social harmony. The existence of moral norms helps elucidate the psychological motivations underlying a wide variety of seemingly puzzling behavior, including why humans help or trust total strangers. In this review, we examine four widespread moral norms: Fairness, altruism, trust, and cooperation, and consider how a single social instrument-reciprocity-underpins compliance to these norms. Using a game theoretic framework, we examine how both context and emotions moderate moral standards, and by extension, moral behavior. We additionally discuss how a mechanism of reciprocity facilitates the adherence to, and enforcement of, these moral norms through a core network of brain regions involved in processing reward. In contrast, violating this set of moral norms elicits neural activation in regions involved in resolving decision conflict and exerting cognitive control. Finally, we review how a reinforcement mechanism likely governs learning about morally normative behavior. Together, this review aims to explain how moral norms are deployed in ways that facilitate flexible moral choices.

Contributions of the Medial Prefrontal Cortex to Social Influence in Economic Decision-Making

Economic decisions are guided by highly subjective reward valuations (SVs). Often these SVs are over-ridden when individuals conform to social norms. Yet, the neural mechanisms that underpin the distinct processing of such normative reward valuations (NVs) are poorly understood. The dorsomedial and ventromedial portions of the prefrontal cortex (dmPFC/vmPFC) are putatively key regions for processing social and economic information respectively. However, the contribution of these regions to economic decisions guided by social norms is unclear. Using functional magnetic resonance imaging and computational modeling we examine the neural mechanisms underlying the processing of SVs and NVs. Subjects (n = 15) indicated either their own economic preferences or made similar choices based on a social norm-learnt during a training session. We found that that the vmPFC and dmPFC make dissociable contributions to the processing of SV and NV. Regions of the dmPFC processed "only" the value of rewards when making normative choices. In contrast, we identify a novel mechanism in the vmPFC for the coding of value. This region signaled both subjective and normative valuations, but activity was scaled positively for SV and negatively for NV. These results highlight some of the key mechanisms that underpin conformity and social influence in economic decision-making.

Ventromedial Prefrontal Cortex Is Critical for Helping Others Who Are Suffering

Neurological patients with damage to the ventromedial prefrontal cortex (vmPFC) are reported to display reduced empathy toward others in their daily lives in clinical case studies. However, the empathic behavior of patients with damage to the vmPFC has not been measured experimentally in response to an empathy-eliciting event. This is important because characterizing the degree to which patients with damage to the vmPFC have lower empathic behavior will allow for the development of targeted interventions to improve patients’ social skills and in turn will help family members to better understand their impairments so they can provide appropriate supports. For the first time, we induced empathy using an ecologically-valid empathy induction in neurological patients with damage to the vmPFC and measured their empathic emotional responses and behavior in real time. Eight neurological patients with focal damage to the vmPFC were compared to demographically-matched brain-damaged and healthy comparison participants. Patients with damage to the vmPFC gave less money in the empathy condition to a person who was suffering (a confederate) than comparison participants. This provides the first direct experimental evidence that the vmPFC is critical for empathic behavior toward individuals who are suffering.

Quantitative account of social interactions in a mental health care ecosystem: cooperation, trust and collective action

Mental disorders have an enormous impact in our society, both in personal terms and in the economic costs associated with their treatment. In order to scale up services and bring down costs, administrations are starting to promote social interactions as key to care provision. We analyze quantitatively the importance of communities for effective mental health care, considering all community members involved. By means of citizen science practices, we have designed a suite of games that allow to probe into different behavioral traits of the role groups of the ecosystem. The evidence reinforces the idea of community social capital, with caregivers and professionals playing a leading role. Yet, the cost of collective action is mainly supported by individuals with a mental condition - which unveils their vulnerability. The results are in general agreement with previous findings but, since we broaden the perspective of previous studies, we are also able to find marked differences in the social behavior of certain groups of mental disorders. We finally point to the conditions under which cooperation among members of the ecosystem is better sustained, suggesting how virtuous cycles of inclusion and participation can be promoted in a 'care in the community' framework.

Psychopathic traits linked to alterations in neural activity during personality judgments of self and others

Psychopathic individuals are notorious for their grandiose sense of self-worth and disregard for the welfare of others. One potential psychological mechanism underlying these traits is the relative consideration of "self" versus "others". Here we used task-based functional magnetic resonance imaging (fMRI) to identify neural responses during personality trait judgments about oneself and a familiar other in a sample of adult male incarcerated offenders (n = 57). Neural activity was regressed on two clusters of psychopathic traits: Factor 1 (e.g., egocentricity and lack of empathy) and Factor 2 (e.g., impulsivity and irresponsibility). Contrary to our hypotheses, Factor 1 scores were not significantly related to neural activity during self- or other-judgments. However, Factor 2 traits were associated with diminished activation to self-judgments, in relation to other-judgments, in bilateral posterior cingulate cortex and right temporoparietal junction. These findings highlight cortical regions associated with a dimension of social-affective cognition that may underlie psychopathic individuals' impulsive traits.

Lesion network localization of criminal behavior

Cases like that of Charles Whitman, who murdered 16 people after growth of a brain tumor, have sparked debate about why some brain lesions, but not others, might lead to criminal behavior. Here we systematically characterize such lesions and compare them with lesions that cause other symptoms. We find that lesions in multiple different brain areas are associated with criminal behavior. However, these lesions all fall within a unique functionally connected brain network involved in moral decision making. Furthermore, connectivity to competing brain networks predicts the abnormal moral decisions observed in these patients. These results provide insight into why some brain lesions, but not others, might predispose to criminal behavior, with potential neuroscience, medical, and legal implications.

Following brain lesions, previously normal patients sometimes exhibit criminal behavior. Although rare, these cases can lend unique insight into the neurobiological substrate of criminality. Here we present a systematic mapping of lesions with known temporal association to criminal behavior, identifying 17 lesion cases. The lesion sites were spatially heterogeneous, including the medial prefrontal cortex, orbitofrontal cortex, and different locations within the bilateral temporal lobes. No single brain region was damaged in all cases. Because lesion-induced symptoms can come from sites connected to the lesion location and not just the lesion location itself, we also identified brain regions functionally connected to each lesion location. This technique, termed lesion network mapping, has recently identified regions involved in symptom generation across a variety of lesion-induced disorders. All lesions were functionally connected to the same network of brain regions. This criminality-associated connectivity pattern was unique compared with lesions causing four other neuropsychiatric syndromes. This network includes regions involved in morality, value-based decision making, and theory of mind, but not regions involved in cognitive control or empathy. Finally, we replicated our results in a separate cohort of 23 cases in which a temporal relationship between brain lesions and criminal behavior was implied but not definitive. Our results suggest that lesions in criminals occur in different brain locations but localize to a unique resting state network, providing insight into the neurobiology of criminal behavior.

The influence of gender on the relationship between psychopathy and five moral foundations

Previous research has demonstrated that individuals higher in psychopathy are less concerned about preventing harm and preserving fairness than individuals lower in psychopathy, yet it is unclear whether this is true for both genders. Females have been shown to be more concerned about moral issues related to preventing harm, being fair and maintaining purity, and males are more concerned about in-group loyalty and respecting authority. In addition, females on average are more empathic, less willing to cause harm and may be less sensitive to fairness. The goal of this study was to examine gender's influence on the relationship between psychopathy and five moral foundations. In a large online sample, we found that although gender moderated the relationship between psychopathy and harm and fairness, the magnitude of these interactions was small. The main effects of gender and of psychopathy support previous research. Overall, females were more concerned than males about preventing harm. Both males and females scoring higher in psychopathy were less concerned about harm and fairness than those lower in psychopathy. Copyright © 2017 John Wiley & Sons, Ltd.

The moral bioenhancement of psychopaths

We argue that the mandatory moral bioenhancement of psychopaths is justified as a prescription of social morality. Moral bioenhancement is legitimate when it is justified on the basis of the reasons of the recipients. Psychopaths expect and prefer that the agents with whom they interact do not have certain psychopathic traits. Particularly, they have reasons to require the moral bioenhancement of psychopaths with whom they must cooperate. By adopting a public reason and a Kantian argument, we conclude that we can justify to a psychopath being the recipient of mandatory moral bioenhancement because he has a reason to require the application of this prescription to other psychopaths.

Human lesion studies of ventromedial prefrontal cortex

Studies of neurological patients with focal lesions involving ventromedial prefrontal cortex (vmPFC) have demonstrated a critical role for this brain area in various aspects of cognition, emotion, and behavior. In this article, we review the key themes, methods, and findings from neuropsychological research on vmPFC lesion patients. Early case studies demonstrated profound disruptions in personality and behavior following vmPFC damage, including blunted affect, poor decision-making, and inappropriate social behavior. Subsequent laboratory investigations with groups of vmPFC lesion patients have revealed deficits in a host of interrelated functions, such as value-based decision-making, future and counterfactual thinking, physiological arousal to emotional stimuli, emotion recognition, empathy, moral judgment, and memory confabulation. The compendium of findings described here demonstrates that vmPFC is crucial for diverse aspects of adaptive function.

Selective Fair Behavior as a Function of Psychopathic Traits in a Subclinical Population

Psychopathy is a group of personality traits that are associated with violations of social norms. Previous studies have suggested that people with psychopathic traits in subclinical populations do not necessarily display antisocial, self-defeating behaviors, and instead may strategically show adaptive behaviors in response to cues during reciprocal social interactions. Therefore, in the present study, we examined whether the association between psychopathic traits and unfair behavior can be moderated by a potential for punishment and social distance (anonymity), which are known to facilitate fair behavior. We focused on two psychopathic traits: primary and secondary psychopathy. Primary psychopathy is characterized by callousness, shallow affect, manipulation, and superficial charm. In contrast, secondary psychopathy is associated with impulsivity and lack of long-term goals, and is related to hostile behavior. A total of 348 undergraduate students determined the amounts of money that they would offer to strangers or friends at their university in hypothetical scenarios of the ultimatum game (UG) and the dictator game (DG). While gender affected decisions in the hypothetical scenarios of the DG, it did not interact with psychopathic traits. The score for primary psychopathy on the Levenson self-report psychopathy scale predicted unfair monetary offers to strangers in the DG, where participants could not be punished. However, compared with their offers in the DG, individuals with higher scores for primary psychopathy made larger offers in the UG, where low offers could trigger punishment from the recipient. Moreover, primary psychopathy did not decrease the amounts of offers in either game when the participant considered the recipient to be a friend. On the other hand, secondary psychopathy was not associated with differences in behavioral fairness depending on a potential for punishment or social distance. Based on these findings, we discuss strategic social skills as a function of primary psychopathy.

Impulsive-antisocial psychopathic traits linked to increased volume and functional connectivity within prefrontal cortex

Psychopathy is a personality disorder characterized by callous lack of empathy, impulsive antisocial behavior, and criminal recidivism. Studies of brain structure and function in psychopathy have frequently identified abnormalities in the prefrontal cortex. However, findings have not yet converged to yield a clear relationship between specific subregions of prefrontal cortex and particular psychopathic traits. We performed a multimodal neuroimaging study of prefrontal cortex volume and functional connectivity in psychopathy, using a sample of adult male prison inmates (N = 124). We conducted volumetric analyses in prefrontal subregions, and subsequently assessed resting-state functional connectivity in areas where volume was related to psychopathy severity. We found that overall psychopathy severity and Factor 2 scores (which index the impulsive/antisocial traits of psychopathy) were associated with larger prefrontal subregion volumes, particularly in the medial orbitofrontal cortex and dorsolateral prefrontal cortex. Furthermore, Factor 2 scores were also positively correlated with functional connectivity between several areas of the prefrontal cortex. The results were not attributable to age, race, IQ, substance use history, or brain volume. Collectively, these findings provide evidence for co-localized increases in prefrontal cortex volume and intra-prefrontal functional connectivity in relation to impulsive/antisocial psychopathic traits.

Effect of self-esteem on social interactions during the Ultimatum Game

Self-esteem is an attitude formed by self-evaluation based on positive and negative aspects of oneself. Low self-esteem is a risk factor for psychiatric disorders and is especially associated with social difficulties. Recently, behavioral economics has allowed the quantitative study of social interactions. We investigated the association between self-esteem and interpersonal problems and whether self-esteem modulates behavior and emotions during an economic task, the Ultimatum Game (UG). In this task participants accept or reject fair/unfair monetary offers from others. Low (LSE, n=40) and high (HSE, n=45) self-esteem participants were assessed in their interpersonal problems and psychiatric symptoms using self-reported questionnaires, and were compared on their decision making and emotional response during the UG. LSE was associated with depression and anxiety symptoms. In addition, LSE was associated with interpersonal problems, especially in the domains of socially inhibited, nonassertive, overly accommodating, self-sacrificing and cold/distant. During the UG, LSE women reported more anger towards unfair offers than HSE women. Our findings suggest that low self-esteem individuals experience high distress by interpersonal problems in several domains. Importantly, low self-esteem in women seems to be associated with an accentuated emotional response to unfair social exchanges. These results may contribute to treat social difficulties in this population.

Take the Money and Run: Psychopathic Behavior in the Trust Game

We study the association among different sources of individual differences such as personality, cognitive ability and risk attitudes with trust and reciprocate behavior in an incentivized experimental binary trust game in a sample of 220 (138 females) undergraduate students. The game involves two players, player 1 (P1) and player 2 (P2). In the first stage, P1 decides whether to trust and let P2 decide, or to secure an egalitarian payoff for both players. If P1 trusts P2, the latter can choose between a symmetric payoff that is double than the secure alternative discarded by P1, and an asymmetric payoff in which P2 earns more than in any other case but makes P1 worse off. Before the main experiment, we obtained participants' scores for Abstract Reasoning (AR), risk attitudes, basic personality characteristics, and specific traits such as psychopathy and impulsivity. During the main experiment, we measured Heart Rate (HR) and ElectroDermal Activity (EDA) variation to account for emotional arousal caused by the decision and feedback processes. Our main findings indicate that, on one hand, P1 trust behavior associates to positive emotionality and, specifically, to the extraversion's warmth facet. In addition, the impulsivity facet of positive urgency also favors trust behavior. No relation to trusting behavior was found for either other major personality aspects or risk attitudes. The physiological results show that participants scoring high in psychopathy exhibit increased EDA and reduced evoked HR deceleration at the moment in which they are asked to decide whether or not to trust. Regarding P2, we find that AR ability and mainly low disagreeable disinhibition favor reciprocal behavior. Specifically, lack of reciprocity significantly relates with a psychopathic, highly disinhibited and impulsive personality. Thus, the present study suggests that personality characteristics would play a significant role in different behaviors underlying cooperation, with extraversion/positive emotionality being more relevant for initiating cooperation, and low disagreeable disinhibition for maintaining it.

Psychopathic individuals exhibit but do not avoid regret during counterfactual decision making

Psychopathy is associated with persistent antisocial behavior and a striking lack of regret for the consequences of that behavior. Although explanatory models for psychopathy have largely focused on deficits in affective responsiveness, recent work indicates that aberrant value-based decision making may also play a role. On that basis, some have suggested that psychopathic individuals may be unable to effectively use prospective simulations to update action value estimates during cost-benefit decision making. However, the specific mechanisms linking valuation, affective deficits, and maladaptive decision making in psychopathy remain unclear. Using a counterfactual decision-making paradigm, we found that individuals who scored high on a measure of psychopathy were as or more likely than individuals low on psychopathy to report negative affect in response to regret-inducing counterfactual outcomes. However, despite exhibiting intact affective regret sensitivity, they did not use prospective regret signals to guide choice behavior. In turn, diminished behavioral regret sensitivity predicted a higher number of prior incarcerations, and moderated the relationship between psychopathy and incarceration history. These findings raise the possibility that maladaptive decision making in psychopathic individuals is not a consequence of their inability to generate or experience negative emotions. Rather, antisocial behavior in psychopathy may be driven by a deficit in the generation of forward models that integrate information about rules, costs, and goals with stimulus value representations to promote adaptive behavior.