Neural correlates of moral and non-moral emotion in female psychopathy

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.

Quantitative Head Dynamics Associated with Interpersonal (Grandiose-Manipulative) Psychopathic Traits in Incarcerated Youth

Clinicians have long noted that individuals with elevated psychopathic traits can be characterized by unique interpersonal styles, including prolonged eye contact, invasion of interpersonal space, and frequent use of hand gestures. Such forms of nonverbal communication can be measured via hand, body, and head position and dynamics. Previous studies have developed an automated algorithm designed to capture head position and dynamics from digital recordings of clinical interviews in a sample of incarcerated adult men. We observed that higher psychopathy scores were associated with stationary head dwell time. Here, we applied a similar automated algorithm to assess head position and dynamics on videotaped clinical interviews assessing psychopathic traits from n = 242 youth housed at a maximum-security juvenile correctional facility. We observed that higher psychopathy scores (assessed via the Hare Psychopathy Checklist: Youth Version [PCL:YV]) were associated with unique patterns of head dynamics. Specifically, PCL:YV Total, Factor 1 (measuring grandiose-manipulative and callous-unemotional traits), and Facet 1 (measuring grandiose-manipulative traits) scores were associated with a higher proportion of time spent in a head dynamics pattern consisting of moderate movement away from the average head position. This study lays the groundwork for future investigations to apply quantitative methods to better understand patterns of nonverbal communication styles in clinical populations characterized by severe antisocial behavior.

Aberrant resting-state functional connectivity in incarcerated women with elevated psychopathic traits

Previous work in incarcerated men suggests that individuals scoring high on psychopathy exhibit aberrant resting-state paralimbic functional network connectivity (FNC). However, it is unclear whether similar results extend to women scoring high on psychopathy. This study examined whether psychopathic traits [assessed via the Hare Psychopathy Checklist - Revised (PCL-R)] were associated with aberrant inter-network connectivity, intra-network connectivity (i.e., functional coherence within a network), and amplitude of fluctuations across limbic and surrounding paralimbic regions among incarcerated women (n = 297). Resting-state networks were identified by applying group Independent Component Analysis to resting-state fMRI scans. We tested the association of psychopathic traits (PCL-R Factor 1 measuring interpersonal/affective psychopathic traits and PCL-R Factor 2 assessing lifestyle/antisocial psychopathic traits) to the three FNC measures. PCL-R Factor 1 scores were associated with increased low-frequency fluctuations in executive control and attentional networks, decreased high-frequency fluctuations in executive control and visual networks, and decreased intra-network FNC in default mode network. PCL-R Factor 2 scores were associated with decreased high-frequency fluctuations and default mode networks, and both increased and decreased intra-network functional connectivity in visual networks. Similar to previous analyses in incarcerated men, our results suggest that psychopathic traits among incarcerated women are associated with aberrant intra-network amplitude fluctuations and connectivity across multiple networks including limbic and surrounding paralimbic regions.

How reliable are amygdala findings in psychopathy? A systematic review of MRI studies

The amygdala is a key component in predominant neural circuitry models of psychopathy. Yet, after two decades of neuroimaging research on psychopathy, the reproducibility of amygdala findings is questionable. We systematically reviewed MRI studies (81 of adults, 53 of juveniles) to determine the consistency of amygdala findings across studies, as well as within specific types of experimental tasks, community versus forensic populations, and the lowest- versus highest-powered studies. Three primary findings emerged. First, the majority of studies found null relationships between psychopathy and amygdala structure and function, even in the context of theoretically relevant tasks. Second, findings of reduced amygdala activity were more common in studies with low compared to high statistical power. Third, the majority of peak coordinates of reduced amygdala activity did not fall primarily within the anatomical bounds of the amygdala. Collectively, these findings demonstrate significant gaps in the empirical support for the theorized role of the amygdala in psychopathy and indicate the need for novel research perspectives and approaches in this field.

Reduced structural integrity of the uncinate fasciculus in incarcerated women scoring high on psychopathy

Both men and women scoring high on psychopathy exhibit similar structural and functional neural abnormalities, including reduced volume of the orbitofrontal cortex (OFC) and reduced hemodynamic activity in the amygdala during affective processing experimental paradigms. The uncinate fasciculus (UF) is a white matter (WM) tract that connects the amygdala to the OFC. Reduced structural integrity of the UF, measured via fractional anisotropy (FA), is commonly associated with men scoring high on psychopathy. However, only one study to date has investigated the relationship between psychopathic traits and UF structural integrity in women, recruiting participants from a community sample. Here, we investigated whether Hare Psychopathy Checklist-Revised (PCL-R) facet scores (measuring interpersonal, affective, lifestyle/behavioral, and antisocial psychopathic traits, respectively) were associated with reduced FA in the left and right UF in a sample of 254 incarcerated women characterized by a wide range of psychopathy scores. We observed that PCL-R Facet 3 scores, assessing lifestyle/behavioral psychopathic traits, were associated with reduced FA in the left and right UF, even when controlling for participant's age and history of previous substance use. The results obtained in the current study help improve our understanding of structural abnormalities associated with women scoring high on psychopathy. Specifically, reduced UF structural integrity may contribute to some of the deficits commonly associated with women scoring high on psychopathy, including emotion dysregulation.

THE IMPLICATIONS OF FRONTOTEMPORAL DEMENTIA FOR BRAIN DYSFUNCTION IN PSYCHOPATHY

Understanding how psychopathy compares with brain disease can help clarify its underlying mechanisms. This literature review is a broad overview of the neurobiology of psychopathic traits in comparison to behavioral variant frontotemporal dementia (bvFTD), a disorder uniquely associated with criminal behavior. In addition to violation of social norms, both psychopathy and bvFTD result in impaired socioemotional perception and empathy, impulsivity, and altered moral judgment. Despite wide areas of decreased function in psychopathy, structural changes are primarily evident in amygdala and, to a lesser extent, anterior insula, whereas in bvFTD neuropathology involves a wider paralimbic region. In psychopathy, relatively intact medial prefrontal and anterior cingulate cortices facilitate theory of mind and psychopathic traits such as deceitfulness and manipulation, bold fearlessness, and risk-taking behavior. In conclusion, many frontotemporal areas are hypoactive in psychopathy and bvFTD, but differences in dysfunctional connectivity in psychopathy vs. direct involvement in bvFTD potentially explain similarities and differences between these two conditions.

Do psychopathic traits vary with age among women? A cross-sectional investigation

Previous studies with men suggest that certain psychopathic traits vary with age. Specifically, younger men score higher on psychopathic traits measuring impulsive-antisocial behavior, including impulsivity, irresponsibility, and criminal versatility, compared to older men. On the other hand, younger and older men score comparably on psychopathic traits reflecting core personality traits of interpersonal and affective dysfunction, including conning and manipulative behavior and a lack of empathy, guilt, and remorse. However, it is currently not known whether psychopathic traits similarly vary with age among women. This study examined whether psychopathy scores (assessed via the Hare Psychopathy Checklist - Revised [PCL-R]) varied with age among a sample of 501 incarcerated women ranging from 19 to 57 years of age. Consistent with previous studies performed with men, younger women scored higher on psychopathic traits measuring impulsive-antisocial behavior (i.e., PCL-R Factor 2, Facet 3, and Facet 4 scores) compared to older women. However, scores on PCL-R Factor 1, Facet 1, and Facet 2, assessing core personality traits, including interpersonal and affective dysfunction, were comparable across women in different age categories investigated. Results obtained in this preliminary study suggest the variation of PCL-R Factor 2 traits and the stability of PCL-R Factor 1 traits across the lifespan is invariant across gender.

Psychopathy in women: insights from neuroscience and ways forward for research

Psychopathy is a severe form of personality disturbance, resulting in a detrimental impact on individuals, healthcare systems, and society as a whole. Until relatively recently, most research in psychopathy has focused on male samples, not least because of its link with criminal behavior and the large proportion of violent crime committed by men. However, psychopathy in women also leads to considerable problems at an individual and societal level, including substance misuse, poor treatment outcomes, and contribution to ever-increasing numbers of female prisoners. Despite this, due to relative neglect, most research into adult female psychopathy is underpowered and outdated. We argue that the field needs revitalizing, with a focus on the developmental nature of the condition and neurocognitive research. Recent work international consortia into conduct disorder in female youth-a precursor of psychopathy in female adults-gives cause for optimism. Here, we outline key strategies for enriching research in this important field with contemporary approaches to other psychiatric conditions.

Phonological processing in psychopathic offenders

Recent research has demonstrated that psychopathic offenders exhibit dynamic cognitive and behavioral deficits on a variety of lab tasks that differentially activate left hemisphere resources. The Left Hemisphere Activation (LHA) hypothesis is a cognitive perspective that aims to address these deficits by conceptualizing psychopathy as a disorder in which behavior and cognitive processing change dynamically as a function of the differential taxation of left hemisphere resources. This study aimed to investigate whether psychopathic traits are associated with electrophysiological anomalies under conditions that place differential demands on left hemisphere language processing systems. We examined in a sample of 43 incarcerated indivdiuals the evocation of the N320, an event-related potential (ERP) elicited by nontarget stimuli during a phonological/phonetic decision task that has been shown to elicit greater activation and cognitive processing within the left hemisphere than the right hemisphere. Findings for a subsample of 18 offenders low in psychopathic traits were generally consistent with previous findings in healthy individuals, suggesting similar electrophysiological activity during phonological processing. However, psychopathic traits impacted the amplitude of the N320. Higher levels of psychopathic traits were associated with reduced left-lateralization in phonological processing as well as enhanced ERP differentiation between pronounceable and nonpronounceable stimuli. These findings provide physiological evidence of a relationship between psychopathic traits and anomalous language processing at the phonological level of word processing.

Reduced endorsement of specific moral foundations in incarcerated adult women with elevated psychopathic traits

Previous studies have associated adult men with elevated psychopathic traits with reduced endorsement of certain moral foundations measured with the Moral Foundations Questionnaire (MFQ), including Harm/Care (measuring one's concern for protecting individuals from harm) and Fairness/Reciprocity (measuring one's concern for the rights of individuals). However, it is not known whether such results extrapolate to women with elevated levels of psychopathic traits. Here, we examined the relationship between endorsement of moral foundations (assessed via the MFQ) and psychopathy scores (assessed via the Psychopathy Checklist - Revised [PCL-R]) in a sample of 299 incarcerated adult women. Consistent with hypotheses, higher PCL-R total scores were associated with reduced endorsement of MFQ Harm/Care and Fairness/Reciprocity foundations. Additionally, we extended upon previous studies, observing higher PCL-R total, Factor 1 (measuring interpersonal/affective psychopathic traits), and Facet 1 (measuring interpersonal psychopathic traits) scores were associated with reduced endorsement of the MFQ Authority/Respect foundation (measuring one's respect for authority figures) in incarcerated adult women. Our results highlight reduced endorsement for similar moral foundations between men and women scoring high on psychopathic traits (i.e., Harm/Care and Fairness/Reciprocity), while also outlining a moral foundation that may be uniquely associated with women scoring high on psychopathic traits (i.e., Authority/Respect).

Neural responses to morally laden interactions in female inmates with psychopathy

Much of social cognition requires making inferences about the mental and emotional states of others. Moreover, understanding the emotions of others is an important foundation for moral decision-making. Psychopathy is associated with both aberrant emotional understanding and atypical hemodynamic responses when viewing and evaluating morally laden social interactions. In the present functional MRI study, female inmates (N = 107) were asked to evaluate the likely emotional state of either the recipient or the initiator of harmful or helpful interactions. Psychopathy was assessed with the Psychopathy Checklist-Revised (PCL-R). PCL-R scores were not associated with differences in confidence or accuracy ratings. However, psychopathy scores were significantly related to increased hemodynamic response in right dorsolateral prefrontal cortex when viewing harmful interactions and decreased functional connectivity from right amygdala to inferior parietal cortex and insula, and from temporal parietal junction to dorsomedial prefrontal cortex. Overall, this work indicates that in females, psychopathy is associated with normal behavioral accuracy and confidence but alterations in neural network activity during moral decision-making.

Neural processing of socioemotional content in conduct-disordered juvenile offenders with limited prosocial emotions

BACKGROUND

Reflecting evidence on Callous-Unemotional (CU) traits (e.g., lack of empathy and guilt, shallow affect), the DSM-5 added a categorical CU-based specifier for Conduct Disorder (CD), labeled 'with Limited Prosocial Emotions' (LPE). Theory and prior work suggest that CD youths with and without LPE will likely differ in neural processing of negative socioemotional content. This proposition, however, is mainly derived from studies employing related, yet distinct, operationalizations of CU traits (e.g., dimensional measure/median split/top quartile), thus precluding direct examination of LPE-specific neurocognitive deficits.

METHODS

Employing a DSM-5 informed LPE proxy, neural processing of recognizing and resonating negative socioemotional content (angry and fearful faces) was therefore examined here among CD offenders with LPE (CD/LPE+; N = 19), relative to CD offenders without LPE (CD/LPE-; N = 31) and healthy controls (HC; N = 31).

RESULTS

Relative to HC and CD/LPE- youths and according to a linearly increasing trend (CD/LPE- < HC < CD/LPE+), CD/LPE+ youths exhibited hyperactivity within dorsolateral, dorsomedial, and ventromedial prefrontal regions during both emotion recognition and resonance. During emotion resonance, CD/LPE+ youths additionally showed increased activity within the posterior cingulate and precuneal cortices in comparison to HC and CD/LPE- youths, which again followed a linearly increasing trend (CD/LPE- < HC < CD/LPE+). These effects moreover seemed specific to the LPE specifier, when compared to a commonly employed method for CU-based grouping in CD (i.e., median split on CU scores).

CONCLUSIONS

These data cautiously suggest that CD/LPE+ youths may exhibit an over-reliance on cortical neurocognitive systems when explicitly processing negative socioemotional information, which could have adverse downstream effects on relevant socioemotional functions. The findings thus seem to provide novel, yet preliminary, clues on the neurocognitive profile of CD/LPE+, and additionally highlight the potential scientific utility of the LPE specifier.

Neurofunctional abnormalities in antisocial spectrum: A meta-analysis of fMRI studies on Five distinct neurocognitive research domains

Past functional magnetic resonance imaging on antisocial subjects have shown important inconsistencies and methodological problems (e.g. heterogeneity in fMRI tasks domain, small sample sizes, analyses on regions-of-interest). We aimed to conduct a meta-analysis of whole-brain fMRI studies on antisocial individuals based on distinct neurocognitive domains. A voxel-based meta-analysis via permutation of subject images (SDM-PSI) was performed on studies using fMRI tasks in the domains of acute threat response, cognitive control, social cognition, punishment and reward processing. Overall, 83 studies were retrieved. Using a liberal statistical threshold, several key regions were identified in the meta-analysis, principally during acute threat response, social cognition and cognitive control tasks. Additionally, we observed that the right amygdala was negatively associated with both callous-unemotional traits and severity of antisocial behaviors, in meta-analyses on region-of-interest and on dimensional studies, respectively. The findings show that the most prominent functional brain deficits arise during acute threat response, social cognitions and cognitive control neurocognitive domains. These results provide substantial insights for our understanding of aberrant neural processing across specific contexts.

The personality dispositions and resting-state neural correlates associated with aggressive children

Despite aggression being detrimental to children's physical health, mental health and social development, the dispositional and neurological antecedents of aggression in the child are poorly understood. Here we examined the relationship between trait aggression as measured by Buss and Warren's Aggression Questionnaire and personality traits measured with Big Five Questionnaire for Children in 77 primary-school children and recorded resting-state brain activity (fractional amplitude of low-frequency fluctuations [fALFF]) and resting-state functional connectivity (rsFC) using functional magnetic resonance imaging. The present results showed that trait aggression was negatively correlated with agreeableness and positively correlated with neuroticism. The brain analyses showed that children with a higher propensity for aggression had a lower fALFF mainly in the left superior temporal gyrus, right parahippocampal gyrus and left supramarginal gyrus. Physical and total aggressions were negatively associated with rsFC between the right parahippocampal gyrus and the right putamen. Further analysis revealed that this rsFC could moderate the influence of neuroticism on total aggression. Moreover, the results suggest the presence of a sex difference in the neurodevelopmental mechanisms underlying aggression in middle childhood. Overall, our findings indicate that aggressive children have lower agreeableness and higher neuroticism, and the underlying neural systems are mainly implicated in social judgment and empathy.

Functional neural correlates of psychopathy: a meta-analysis of MRI data

Neuroimaging studies over the last two decades have begun to specify the neurobiological correlates of psychopathy, a personality disorder that is strongly related to criminal offending and recidivism. Despite the accumulation of neuroimaging studies of psychopathy, a clear and comprehensive picture of the disorder's neural correlates has yet to emerge. The current study is a meta-analysis of functional MRI studies of psychopathy. Multilevel kernel density analysis was used to identify consistent findings across 25 studies (460 foci) of task-related brain activity. Psychopathy was associated with increased task-related activity predominantly in midline cortical regions overlapping with the default mode network (dorsomedial prefrontal cortex, posterior cingulate, and precuneus) as well as medial temporal lobe (including amygdala). Psychopathy was related to decreased task-related activity in a region of the dorsal anterior cingulate cortex overlapping with the salience network. These findings challenge predominant theories of amygdala hypoactivity and highlight the potential role of hyperactivity in medial default mode network regions and hypoactivity in a key node of the salience network during task performance in psychopathy.

Neural correlates of moral goodness and moral beauty judgments

The objects of moral goodness and moral beauty judgments both generally refer to the positive moral acts or virtues of humans, and goodness must precede moral beauty. The main difference is that moral beauty, but not moral goodness, triggers emotional elevation. However, little is known about the neural mechanisms involved in both judgments. In the current study, 28 healthy female participants were scanned when they rated the good and beautiful extent of positive moral acts in daily life depicted in scene drawings to investigate the neural systems supporting moral goodness and moral beauty, specifically to test whether neural activity associated with moral beauty is same or different than moral goodness. The conjunction analysis of the contrasts between moral goodness judgment and moral beauty judgment identified the involvement of the left inferior orbitofrontal cortex (OFC), suggesting that the two judgments recruited the activity of a common brain region. Importantly, compared with the moral goodness judgment, the moral beauty judgment induced greater activity in more advanced cortical regions implicated in elevated emotions, including the anterior cingulate cortex (ACC), medial prefrontal cortex (mPFC), superior frontal gyrus (SFG) and the left temporo-parietal junction (TPJ). These regions have been strongly correlated with the cognitive aspects of moral cognition, including theory of mind (ToM). In addition, moral beauty judgment also activated brain regions implicated in empathy including the midline structures and the anterior insula. Based on these results, the brain harbors neural systems for common and for domain-specific evaluations of moral goodness and moral beauty judgments. Our study thus provides novel and compelling neural evidence for the essence of moral beauty and advances the current knowledge of the neural mechanisms underlying the beauty-is-good stereotype.

Psychopathy is associated with shifts in the organization of neural networks in a large incarcerated male sample

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Psychopathy is linked to disruptions in neural information processing.

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Graph analysis revealed that psychopathy impacts neural network organization.

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Psychopathy is linked to a hyper-efficiently organized dorsal attention network.

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Subcortical structures are less central to neural communication in psychopathy.

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No psychopathy differences were found in default or salience network graph metrics.

Psychopathy is a personality disorder defined by antisocial behavior paired with callousness, low empathy, and low interpersonal emotions. Psychopathic individuals reliably display complex atypicalities in emotion and attention processing that are evident when examining task performance, activation within specific neural regions, and connections between regions. Recent advances in neuroimaging methods, namely graph analysis, attempt to unpack this type of processing complexity by evaluating the overall organization of neural networks. Graph analysis has been used to better understand neural functioning in several clinical disorders but has not yet been used in the study of psychopathy. The present study applies a minimum spanning tree graph analysis to resting-state fMRI data collected from male inmates assessed for psychopathy with the Hare Psychopathy Checklist-Revised (n = 847). Minimum spanning tree analysis provides several metrics of neural organization optimality (i.e., the effectiveness, efficiency, and robustness of neural network organization). Results show that inmates higher in psychopathy exhibit a more efficiently organized dorsal attention network (β = =0.101, p_corrected = =0.018). Additionally, subcortical structures (e.g., amygdala, caudate, and hippocampus) act as less of a central hub in the global flow of information in inmates higher in psychopathy (β = =−0.104, p_corrected = =0.048). There were no significant effects of psychopathy on neural network organization in the default or salience networks. Together, these shifts in neural organization suggest that the brains of inmates higher in psychopathy are organized in a fundamentally different way than other individuals.

A review of psychopathy and Cluster B personality traits and their neural correlates in female offenders

Although men commit more crime and are incarcerated at higher rates than women, women represent the fastest growing segment of the justice system. Empirical work suggests that psychopathy and Cluster B disorders are implicated in antisocial behavior across gender, and that neurobiological correlates of personality may inform such behavior. This review utilizes a gendered perspective to discuss psychopathy and Cluster B disorders in relation to antisocial behavior and incorporates work on neural correlates of personality disorders. Co-morbidity across these conditions may be partly explained by similar frontal deficits, reflective of disinhibition. Affective processing abnormalities appear to be characterized by distinct deficits in limbic/paralimbic regions, reflecting differential etiological underpinnings and behavioral outcomes. This review underscores the utility in examining personality pathology together with neurobiological and environmental factors. Methodological issues and clinical implications are also discussed.

Neural Mechanisms Involved in Social Conformity and Psychopathic Traits: Prediction Errors, Reward Processing and Saliency

Aligning behavior in favor of group norms, i.e., social conformity, can help to successfully adapt to uncertain environments and may result in social approval. This may lead to enhanced feelings of belongingness and is found to be associated with reward-related activations in the brain. Individuals high on psychopathic traits violate group norms regularly. Yet, it is unclear how psychopathic traits are related to neural mechanisms involved in social conformity. This functional magnetic resonance imaging (fMRI) study includes 42 healthy females scoring low or high on the Psychopathic Personality Inventory questionnaire (PPI). Participants were asked to rate the trustworthiness of 120 faces while lying in the scanner. After rating each face, participants were presented with the group rating of European students. In an unanticipated second part participants rated all faces again, allowing us to focus on two main contrasts: (1) “Social conflict”: group opinion in conflict with the participant’s rating vs. group opinion aligned with participant rating; and (2) “Conformity”: conflict trials followed by conformity vs. conflict trials followed by non-conformity. Behaviorally, the two groups showed similar conformity behavior. fMRI results showed that both groups activated the nucleus accumbens (NAc) following alignment, suggesting the central role of prediction errors and reward. The data also showed a significant interaction between group and conformity in the amygdala. Following conflicts, females scoring low on psychopathic traits showed a trend in enhanced amygdala activation for conformity relative to non-conformity. Additionally, results showed a trend significant group effect for non-conformity. Females scoring high on psychopathic traits showed more activation for non-conformity compared to females scoring low on psychopathic traits, suggesting altered emotional salience of experiencing conflict depending on psychopathic traits. Taken together, these results support the importance of investigating the role of relevant traits in adaptive behavior when facing uncertain social situations and the neural mechanisms involved in this process.

The neuromoral theory of antisocial, violent, and psychopathic behavior

The neuromoral theory of antisocial behaviors argues that impairment to the neural circuitry underlying morality provides a common foundation for antisocial, violent, and psychopathic behavior in children, adolescents, and adults. This article reviews new findings in two research fields since this theory was first proposed: brain mechanisms underlying moral decision-making, and brain systems subserving antisocial behaviors. The neuromoral theory is updated to take into account new empirical findings. Key areas implicated in both moral decision-making and the spectrum of antisocial behaviors include fronto-polar, medial, and ventral prefrontal cortical regions, and the anterior cingulate, amygdala, superior temporal gyrus, and angular gyrus / temporoparietal junction. It is hypothesized that different manifestations of antisocial behavior are characterized by differing degrees of neuromoral dysfunction, with primary psychopathy, proactive aggression, and life-course persistent offending being more affected, and secondary psychopathy, reactive aggression, and crimes involving drugs relatively less affected by neuromoral dysfunction. Limitations of the current model, social contextual factors, neural remediation interventions, ascertaining whether the affective or cognitive component of empathy is most implicated, and directions for future research are outlined. One forensic implication of the model is that significant impairment to the neuromoral circuit could constitute diminished criminal responsibility.

Emotional Intelligence in Incarcerated Female Offenders With Psychopathic Traits

Emotional impairment is a core feature of psychopathy, and the disorder has been linked to an inability to recognize and regulate emotion, leading to deficiencies in empathy and difficulties in social functioning. This study investigated associations among psychopathic traits and ability-based emotional intelligence (EI) in female offenders and integrated data with previously published male offender data (Ermer, Kahn, Salovey, & Kiehl, 2012) to examine gender differences in relationships. Results showed that female offenders were impaired in the understanding and management of emotion relative to the general population, and that female offenders scored higher than male offenders in EI. Affective psychopathic traits (e.g., callousness) yielded a small relationship with difficulties in managing emotion in female offenders, and few gender differences in relationships between psychopathy and EI were found. Findings contribute to literature on emotional functioning in females with psychopathic traits and further understanding of gender differences in emotional abilities among offenders.

Amygdala functioning during threat acquisition and extinction differentiates antisocial subtypes

Extensive work implicates abnormal amygdala response during threatening stimuli in youth with antisocial behaviour. However, no research has examined whether youth identified in Primary and Secondary psychopathy subtypes would show differences in amygdala activity in response to threat acquisition and extinction. Latent profile analysis (LPA) was used to identify distinct antisocial groups based on participants' scores on callous-unemotional (CU) traits, anxiety, and familial abuse in a sample of 136 high-risk adolescents (mean age = 17.7, SD = 1.6; 86% male). Functional MRI was then used to assess amygdala activation patterns during a classical differential delay threat-conditioning task. In addition to the Primary and Secondary subtypes, we identified groups mainly high on anxiety and others who were mainly high on abuse. Participants in the Primary group showed lower right amygdala activity in response to neutral male faces compared to the low, Anxious, and Secondary groups, whereas participants in the group with history of abuse exhibited higher right amygdala activity during threat acquisition compared to the rest of the groups. During threat extinction, the Primary group showed lower right amygdala activity compared to the Secondary and abuse groups. This is the first study to reveal amygdala activation in identified psychopathy-related variants during threat conditioning. We found that stratifying the sample based on the identified variants revealed amygdala functioning patterns that furthered our understanding of emotion-based deficits among high-risk adolescents.

Capacity for upregulation of emotional processing in psychopathy: all you have to do is ask

Historically, psychopathic individuals have been described as suffering a chronic hyporesponsivity to negatively valent stimuli. However, while a wide body of empirical work indicates that the psychopath does not manifest normal reactivity to emotional stimuli, it does not similarly indicate that they cannot do so. To attempt to differentiate these alternatives, the current functional magnetic resonance imaging (fMRI) study evaluated the extent to which offenders with varying PCL-R scores could up- (or down-) regulate their neural response to negatively valent stimuli. Participants were asked to either watch negatively- and neutrally-valent images naturally (passive-processing), or to try to increase or decrease their emotional response to the images (instructed-processing). During passive processing, high-psychopathy offenders showed reduced activity compared to both low- and mid-psychopathic offenders through a majority of emotion-relevant regions. However, when participants were instructed to try to increase their emotional response all groups showing increased activity throughout relevant regions, including left insula, orbitofrontal cortex and anterior cingulate/medial frontal cortex (ACC/mFC). Comparison of participants' subjective emotion ratings indicated that all groups showed symmetry between their neural/subjective emotion metrics, and the high-psychopathy group may have showed the greatest such symmetry. These findings suggest that psychopathic individuals may be capable of manifesting emotional reactivity to negatively valent stimuli, at least under certain conditions. Relevance for traditional and developing models of psychopathy is discussed in turn.

A Systematic Literature Review of Neuroimaging of Psychopathic Traits

INTRODUCTION

Core psychopathy is characterized by grandiosity, callousness, manipulativeness, and lack of remorse, empathy, and guilt. It is often comorbid with conduct disorder and antisocial personality disorder (ASPD). Psychopathy is present in forensic as well as prison and general populations. In recent years, an increasing amount of neuroimaging studies has been conducted in order to elucidate the obscure neurobiological etiology of psychopathy. The studies have yielded heterogenous results, and no consensus has been reached.

AIMS

This study systematically reviewed and qualitatively summarized functional and structural neuroimaging studies conducted on individuals with psychopathic traits. Furthermore, this study aimed to evaluate whether the findings from different MRI modalities could be reconciled from a neuroanatomical perspective.

MATERIALS AND METHODS

After the search and auditing processes, 118 neuroimaging studies were included in this systematic literature review. The studies consisted of structural, functional, and diffusion tensor MRI studies.

RESULTS

Psychopathy was associated with numerous neuroanatomical abnormalities. Structurally, gray matter anomalies were seen in frontotemporal, cerebellar, limbic, and paralimbic regions. Associated gray matter volume (GMV) reductions were most pronounced particularly in most of the prefrontal cortex, and temporal gyri including the fusiform gyrus. Also decreased GMV of the amygdalae and hippocampi as well the cingulate and insular cortices were associated with psychopathy, as well as abnormal morphology of the hippocampi, amygdala, and nucleus accumbens. Functionally, psychopathy was associated with dysfunction of the default mode network, which was also linked to poor moral judgment as well as deficient metacognitive and introspective abilities. Second, reduced white matter integrity in the uncinate fasciculus and dorsal cingulum were associated with core psychopathy. Third, emotional detachment was associated with dysfunction of the posterior cerebellum, the human mirror neuron system and the Theory of Mind denoting lack of empathy and persistent failure in integrating affective information into cognition.

CONCLUSIONS

Structural and functional aberrancies involving the limbic and paralimbic systems including reduced integrity of the uncinate fasciculus appear to be associated with core psychopathic features. Furthermore, this review points towards the idea that ASPD and psychopathy might stem from divergent biological processes.

A taxometric investigation of psychopathy in women

The taxonomic status of psychopathy is the topic of considerable research interest. The latent structure of psychopathy will latent structure will guide the determination of the best assessment approaches, maximize the reliability and validity, will help to establish optimal cutting scores that minimize decision errors and will also facilitate the selection of the best research designs to advance the study of the construct. In the present study, taxometric analyses were used for assessing taxonicity, and they were applied to Psychopathy Checklist-Revised (PCL-R) ratings of 1218 female offenders. Hare's four-factor solution to the PCL-R was used as the bases of the analyses. The results of the various analytical strategies obtained dimensional solutions and corroborated that for females, as well as for males, psychopathy as measured by the PCL-R, may best be conceptualized as distinct configurations of extreme scores on personality traits rather than as a distinct, nonarbitrary class. These results reaffirm the fact that cut-off scores of are arbitrary in nature.

Neural Correlates of Moral Evaluation and Psychopathic Traits in Male Multi-Problem Young Adults

Multi-problem young adults (18-27 years) present with a plethora of problems, including varying degrees of psychopathic traits. The amygdala and ventromedial prefrontal cortex (vmPFC) have been implicated in moral dysfunction in psychopathy in adolescents and adults, but no studies have been performed in populations in the transitional period to adulthood. We tested in multi-problem young adults the hypothesis that psychopathic traits are related to amygdala and vmPFC activity during moral evaluation. Additionally, we explored the relation between psychopathic traits and other regions consistently implicated in moral evaluation. Our final sample consisted of 100 multi-problem young adults and 22 healthy controls. During fMRI scanning, participants judged whether pictures showed a moral violation on a 1-4 scale. Whole brain analysis revealed neural correlates of moral evaluation consistent with the literature. Region of interest analyses revealed positive associations between the affective callous-unemotional dimension of psychopathy and activation in the left vmPFC, left superior temporal gyrus, and left cingulate. Our results are consistent with altered vmPFC function during moral evaluation in psychopathy, but we did not find evidence for amygdala involvement. Our findings indicate the affective callous-unemotional trait of psychopathy may be related to widespread altered activation patterns during moral evaluation in multi-problem young adults.

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.

Neural networks underlying trait aggression depend on MAOA gene alleles

Low expressing alleles of the MAOA gene (MAOA-L) have been associated with an increased risk for developing an aggressive personality. This suggests an MAOA-L-specific neurobiological vulnerability associated with trait aggression. The neural networks underlying this vulnerability are unknown. The present study investigated genotype-specific associations between resting state brain networks and trait aggression (Buss-Perry Aggression Questionnaire) in 82 healthy Caucasian males. Genotype influences on aggression-related networks were studied for intrinsic and seed-based brain connectivity. Intrinsic connectivity was higher in the ventromedial prefrontal cortex (VMPFC) of MAOA-L compared to high expressing allele (MAOA-H) carriers. Seed-based connectivity analyses revealed genotype differences in the functional involvement of this region. MAOA genotype modulated the relationship between trait aggression and VMPFC connectivity with supramarginal gyrus (SMG) and areas of the default mode network (DMN). Separate analyses for the two groups were performed to better understand how the genotype modulated the relationship between aggression and brain networks. They revealed a positive correlation between VMPFC connectivity and aggression in right angular gyrus (AG) and a negative correlation in right SMG in the MAOA-L group. No such effect emerged in the MAOA-H carriers. The results indicate a particular relevance of VMPFC for aggression in MAOA-L carriers; in specific, a detachment from the DMN along with a strengthened coupling to the AG seems to go along with lower trait aggression. MAOA-L carriers may thus depend on a synchronization of emotion regulation systems (VMPFC) with core areas of empathy (SMG) to prevent aggression.

Emotion-based learning systems and the development of morality

In this paper it is proposed that important components of moral development and moral judgment rely on two forms of emotional learning: stimulus-reinforcement and response-outcome learning. Data in support of this position will be primarily drawn from work with individuals with the developmental condition of psychopathy as well as fMRI studies with healthy individuals. Individuals with psychopathy show impairment on moral judgment tasks and a pronounced increased risk for instrumental antisocial behavior. It will be argued that these impairments are developmental consequences of impaired stimulus-aversive conditioning on the basis of distress cue reinforcers and response-outcome learning in individuals with this disorder.

The neural correlates of moral decision-making: A systematic review and meta-analysis of moral evaluations and response decision judgements

The aims of this systematic review were to determine: (a) which brain areas are consistently more active when making (i) moral response decisions, defined as choosing a response to a moral dilemma, or deciding whether to accept a proposed solution, or (ii) moral evaluations, defined as judging the appropriateness of another's actions in a moral dilemma, rating moral statements as right or wrong, or identifying important moral issues; and (b) shared and significantly different activation patterns for these two types of moral judgements. A systematic search of the literature returned 28 experiments. Activation likelihood estimate analysis identified the brain areas commonly more active for moral response decisions and for moral evaluations. Conjunction analysis revealed shared activation for both types of moral judgement in the left middle temporal gyrus, cingulate gyrus, and medial frontal gyrus. Contrast analyses found no significant clusters of increased activation for the moral evaluations-moral response decisions contrast, but found that moral response decisions additionally activated the left and right middle temporal gyrus and the right precuneus. Making one's own moral decisions involves different brain areas compared to judging the moral actions of others, implying that these judgements may involve different processes.

Core, social and moral disgust are bounded: A review on behavioral and neural bases of repugnance in clinical disorders

Disgust is a multifaceted experience that might affect several aspects of life. Here, we reviewed research on neurological and psychiatric disorders that are characterized by abnormal disgust processing to test the hypothesis of a shared neurocognitive architecture in the representation of three disgust domains: i) personal experience of 'core disgust'; ii) social disgust, i.e., sensitivity to others' expressions of disgust; iii) moral disgust, i.e., sensitivity to ethical violations. Our review provides some support to the shared neurocognitive hypothesis and suggests that the insula might be the "hub" structure linking the three domains of disgust sensitivity, while other brain regions may subserve specific facets of the multidimensional experience. Our review also suggests a role of serotonin core and moral disgust, supporting "neo-sentimentalist" theories of morality, which posit a causal role of affect in moral judgment.

As Far as the Eye Can See: Relationship between Psychopathic Traits and Pupil Response to Affective Stimuli

Psychopathic individuals show a range of affective processing deficits, typically associated with the interpersonal/affective component of psychopathy. However, previous research has been inconsistent as to whether psychopathy, within both offender and community populations, is associated with deficient autonomic responses to the simple presentation of affective stimuli. Changes in pupil diameter occur in response to emotionally arousing stimuli and can be used as an objective indicator of physiological reactivity to emotion. This study used pupillometry to explore whether psychopathic traits within a community sample were associated with hypo-responsivity to the affective content of stimuli. Pupil activity was recorded for 102 adult (52 female) community participants in response to affective (both negative and positive affect) and affectively neutral stimuli, that included images of scenes, static facial expressions, dynamic facial expressions and sound-clips. Psychopathic traits were measured using the Triarchic Psychopathy Measure. Pupil diameter was larger in response to negative stimuli, but comparable pupil size was demonstrated across pleasant and neutral stimuli. A linear relationship between subjective arousal and pupil diameter was found in response to sound-clips, but was not evident in response to scenes. Contrary to predictions, psychopathy was unrelated to emotional modulation of pupil diameter across all stimuli. The findings were the same when participant gender was considered. This suggests that psychopathy within a community sample is not associated with autonomic hypo-responsivity to affective stimuli, and this effect is discussed in relation to later defensive/appetitive mobilisation deficits.

Functional Neuroimaging in Psychopathy

BACKGROUND AND AIM

Psychopathy is associated with cognitive and affective deficits causing disruptive, harmful and selfish behaviour. These have considerable societal costs due to recurrent crime and property damage. A better understanding of the neurobiological bases of psychopathy could improve therapeutic interventions, reducing the related social costs. To analyse the major functional neural correlates of psychopathy, we reviewed functional neuroimaging studies conducted on persons with this condition.

METHODS

We searched the PubMed database for papers dealing with functional neuroimaging and psychopathy, with a specific focus on how neural functional changes may correlate with task performances and human behaviour.

RESULTS

Psychopathy-related behavioural disorders consistently correlated with dysfunctions in brain areas of the orbitofrontal-limbic (emotional processing and somatic reaction to emotions; behavioural planning and responsibility taking), anterior cingulate-orbitofrontal (correct assignment of emotional valence to social stimuli; violent/aggressive behaviour and challenging attitude) and prefrontal-temporal-limbic (emotional stimuli processing/response) networks. Dysfunctional areas more consistently included the inferior frontal, orbitofrontal, dorsolateral prefrontal, ventromedial prefrontal, temporal (mainly the superior temporal sulcus) and cingulated cortices, the insula, amygdala, ventral striatum and other basal ganglia.

CONCLUSIONS

Emotional processing and learning, and several social and affective decision-making functions are impaired in psychopathy, which correlates with specific changes in neural functions.

Distinct neuronal patterns of positive and negative moral processing in psychopathy

Psychopathy is a disorder characterized by severe and frequent moral violations in multiple domains of life. Numerous studies have shown psychopathy-related limbic brain abnormalities during moral processing; however, these studies only examined negatively valenced moral stimuli. Here, we aimed to replicate prior psychopathy research on negative moral judgments and to extend this work by examining psychopathy-related abnormalities in the processing of controversial moral stimuli and positive moral processing. Incarcerated adult males (N = 245) completed a functional magnetic resonance imaging protocol on a mobile imaging system stationed at the prison. Psychopathy was assessed using the Hare Psychopathy Checklist-Revised (PCL-R). Participants were then shown words describing three types of moral stimuli: wrong (e.g., stealing), not wrong (e.g., charity), and controversial (e.g., euthanasia). Participants rated each stimulus as either wrong or not wrong. PCL-R total scores were correlated with not wrong behavioral responses to wrong moral stimuli, and were inversely related to hemodynamic activity in the anterior cingulate cortex in the contrast of wrong > not wrong. In the controversial > noncontroversial comparison, psychopathy was inversely associated with activity in the temporal parietal junction and dorsolateral prefrontal cortex. These results indicate that psychopathy-related abnormalities are observed during the processing of complex, negative, and positive moral stimuli.

Moral competence and brain connectivity: A resting-state fMRI study

Moral competence (MC) refers to the ability to apply certain moral orientations in a consistent and differentiated manner when judging moral issues. People greatly differ in terms of MC, however, little is known about how these differences are implemented in the brain. To investigate this question, we used functional magnetic resonance imaging and examined resting-state functional connectivity (RSFC) in n=31 individuals with MC scores in the highest 15% of the population and n=33 individuals with MC scores in the lowest 15%, selected from a large sample of 730 Master of Business Administration (MBA) students. Compared to individuals with lower MC, individuals with higher MC showed greater amygdala-ventromedial prefrontal connectivity, which may reflect better ability to cope with emotional conflicts elicited by moral dilemmas. Moreover, individuals with higher MC showed less inter-network connectivity between the amygdalar and fronto-parietal networks, suggesting a more independent operation of these networks. Our findings provide novel insights into how individual differences in moral judgment are associated with RSFC in brain circuits related to emotion processing and cognitive control.

Mesocorticolimbic dopamine functioning in primary psychopathy: A source of within-group heterogeneity

Despite similar emotional deficiencies, primary psychopathic individuals can be situated on a continuum that spans from controlled to disinhibited. The constructs on which primary psychopaths are found to diverge, such as self-control, cognitive flexibility, and executive functioning, are crucially regulated by dopamine (DA). As such, the goal of this review is to examine which specific alterations in the meso-cortico-limbic DA system and corresponding genes (e.g., TH, DAT, COMT, DRD2, DRD4) might bias development towards a more controlled or disinhibited expression of primary psychopathy. Based on empirical data, it is argued that primary psychopathy is generally related to a higher tonic and population activity of striatal DA neurons and lower levels of D2-type DA receptors in meso-cortico-limbic projections, which may boost motivational drive towards incentive-laden goals, dampen punishment sensitivity, and increase future reward-expectancy. However, increasingly higher levels of DA activity in the striatum (moderate versus pathological elevations), lower levels of DA functionality in the prefrontal cortex, and higher D1-to-D2-type receptor ratios in meso-cortico-limbic projections may lead to increasingly disinhibited and impetuous phenotypes of primary psychopathy. Finally, in order to provide a more coherent view on etiological mechanisms, we discuss interactions between DA and serotonin that are relevant for primary psychopathy.

Neural networks underlying implicit and explicit moral evaluations in psychopathy

Psychopathy, characterized by symptoms of emotional detachment, reduced guilt and empathy and a callous disregard for the rights and welfare of others, is a strong risk factor for immoral behavior. Psychopathy is also marked by abnormal attention with downstream consequences on emotional processing. To examine the influence of task demands on moral evaluation in psychopathy, functional magnetic resonance imaging was used to measure neural response and functional connectivity in 88 incarcerated male subjects (28 with Psychopathy Checklist Revised (PCL-R) scores ⩾ 30) while they viewed dynamic visual stimuli depicting interpersonal harm and interpersonal assistance in two contexts, implicit and explicit. During the implicit task, high psychopathy was associated with reduced activity in the dorsolateral prefrontal cortex and caudate when viewing harmful compared with helpful social interactions. Functional connectivity seeded in the right amygdala and right temporoparietal junction revealed decreased coupling with the anterior cingulate cortex (ACC), anterior insula, striatum and ventromedial prefrontal cortex. In the explicit task, higher trait psychopathy predicted reduced signal change in ACC and amygdala, accompanied by decreased functional connectivity to temporal pole, insula and striatum, but increased connectivity with dorsal ACC. Psychopathy did not influence behavioral performance in either task, despite differences in neural activity and functional connectivity. These findings provide the first direct evidence that hemodynamic activity and neural coupling within the salience network are disrupted in psychopathy, and that the effects of psychopathy on moral evaluation are influenced by attentional demands.