Background: Major damage to gray and white matter in the prefrontal cortex and autonomic deficits have been found to result in pseudopsychopathic personality in patients with neurological disorders, but it is not known whether people with antisocial personality disorder (APD) in the community who do not have discernable brain trauma also have subtle prefrontal deficits. Methods: Prefrontal gray and white matter volumes were assessed using structural magnetic resonance imaging in 21 community volunteers with APD (APD group) and in 2 control groups, comprising 34 healthy subjects (control group), 26 subjects with substance dependence (substancedependent group), and 21 psychiatric controls. Autonomic activity (skin conductance and heart rate) was also assessed during a social stressor in which participants gave a videotaped speech on their faults. Results: TheAPD group showed an 11.0% reduction in prefrontal gray matter volume in the absence of ostensible brain lesions and reduced autonomic activity during the stressor. These deficits predicted group membership independent of psychosocial risk factors. Conclusions: To our knowledge, these findings provide the first evidence for a structural brain deficit in APD. This prefrontal structural deficit may underlie the low arousal, poor fear conditioning, lack of conscience, and decision-making deficits that have been found to characterize antisocial, psychopathic behavior. Arch Gen Psychiatry. 2000;57:119-127

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/481571/yoa9157.pdf

Reduced prefrontal gray matter volume and reduced autonomic activity in antisocial personality disorder.

This article provides a comprehensive review of the research on the use of callous and unemotional (CU) traits for designating an important subgroup of children and adolescents with severe conduct problems. It focuses on the etiological significance of recognizing this subgroup of youths with severe conduct problems, its implications for diagnostic classification, and the treatment implications of this research. The review highlights limitations in existing research and provides directions for future research. The available research suggests that children and adolescents with severe conduct problems and elevated CU traits show distinct genetic, cognitive, emotional, biological, environmental, and personality characteristics that seem to implicate different etiological factors underlying their behavior problems relative to other youths with severe conduct problems. Recognizing these subgroups could be critical for guiding future research on the causes of severe conduct problems in children and adolescents. Further, children and adolescents with both severe conduct problems and elevated CU traits appear to be at risk for more severe and persistent antisocial outcomes, even controlling for the severity of their conduct problems, the age of onset of their conduct problems, and common comorbid problems, which supports the clinical importance of designating this group in diagnostic classification systems. Finally, although children and adolescents with both severe conduct problems and elevated CU traits tend to respond less positively to typical interventions provided in mental health and juvenile justice settings, they show positive responses to certain intensive interventions tailored to their unique emotional and cognitive characteristics.

http://labs.uno.edu/developmental-psychopathology/articles/PB%202014%20CU%20Traits%20Review.pdf

Can callous-unemotional traits enhance the understanding, diagnosis, and treatment of serious conduct problems in children and adolescents? A comprehensive review.

The present meta-analysis integrated effect sizes from 95 non-overlapping studies (N=15,826) to summarize the relation between Hare Psychopathy Checklists and antisocial conduct. Whereas prior meta-analyses focused on specific subdomains of the literature, we used broad inclusion criteria, incorporating a diversity of samples, settings, methodologies, and outcomes in our analysis. Our broad perspective allowed us to identify general trends consistent across the entire literature and improved the power of our analyses. Results indicated that higher PCL Total, Factor 1 (F(1)), and Factor 2 (F(2)) scores were moderately associated with increased antisocial conduct. Study effect sizes were significantly moderated by the country in which the study was conducted, racial composition, gender composition, institutional setting, the type of information used to score psychopathy, and the independence of psychopathy and transgression assessments. However, multiple regression analyses indicated that the information used to assess psychopathy did not have a unique influence on effect sizes after accounting for the influence of other moderator variables. Furthermore, racial composition of the sample was related to the country in which the study was conducted, making it unclear whether one or both of these moderators influenced effect sizes. We provide potential explanations for the significant findings and discuss implications of the results for future research.

A Large-Scale Meta-Analysis Relating the Hare Measures of Psychopathy to Antisocial Conduct

The roles of orbital frontal cortex in the modulation of antisocial behavior

The clinical assessment of psychopathy in adulthood is well established via programmatic research. More recently, psychopathy has been extended to children and adolescents with correlates to maladaptive personality traits, violent behavior, and noncompliance with institutional rules. To screen for adolescent psychopathy, the Antisocial Process Screening Device (APSD) was developed as a 20-item self-report measure of psychopathy. The original validation of the APSD was limited to samples of clinic-referred and community-based children. In extending this research to delinquent populations, the current article uses two separate samples of adolescent offenders incarcerated in a maximum security facility (n = 78) and a local juvenile detention facility (n = 77). As evidence of criterion-related validity, the APSD was compared with two versions of the Psychopathy Checklist that yielded mixed results. Construct validity was examined via a confirmatory factor analysis that provided support for a three-factor model of the APSD.

/pdf/the-antisocial-process-screening-device-an-examination-of-1mjjb7qwh2.pdf

The Antisocial Process Screening Device An Examination of its Construct and Criterion-Related Validity

Current knowledge about the validity of the psychopathy syndrome in youth is limited largely to studies relying on parent-teacher rating scales or slight modifications of adult measures. Recently, the Psychopathy Checklist: Youth Version (PCL:YV) was designed for use with adolescents. However, most studies that have used this measure examined incarcerated males and addressed only validity criteria related to antisocial behavior. We investigated the generality and construct validity of the psychopathy syndrome in an adolescent sample by assessing 115 adolescent males on probation with the PCL:YV. Reliability of measurement was high. PCL:YV ratings predicted not only antisocial behaviour but also other indices of childhood psychopathology, interpersonal behaviors associated with adult psychopathy, and a lack of attachment to parents. These findings suggest that the PCL:YV identifies a syndrome in adolescence consistent with theory and research on adult males.

The reliability and validity of the psychopathy checklist: youth version (PCL:YV) in nonincarcerated adolescent males.

Two studies examined whether increased attention to interpersonal behaviors would improve assessments of the personality core underlying psychopathy. After item analysis, 21 items measuring interpersonal interactions and nonverbal behaviors associated with psychopathy were retained as the Interpersonal Measure of Psychopathy (IM-P). Federal prison inmates (Study 1, N = 98) and undergraduates (Study 2, N = 92) were rated on occurrence of these behaviors during an interview conducted to complete either Hare's Psychopathy Checklist-Revised (PCL-R) or Psychopathy Checklist: Screening Version (PCL: SV). In both studies, IM-P scores correlated more highly with PCL Factor 1 than with PCL Factor 2 scores. Regression analyses indicated that, after controlling for demographic variables and PCL factor scores, IM-P scores predicted interviewer emotional responses and participants' adult fighting (Study 1) and ratings of participants' interpersonal dominance (Study 2). Thus, measurement of interpersonal behavior appears to permit improved prediction of several criteria linked to the personality core of psychopathy.

A new method for assessing the interpersonal behavior of psychopathic individuals: Preliminary validation studies.

This chapter discusses the major theoretical positions regarding emotions and psychopathy, review relevant empirical studies, and provides preliminary suggestions for clinicians working with psychopaths, as well as suggestions for future research directions. It demonstrates the simple and widespread assumption that psychopaths are relatively emotionless is contradicted by the complexity of research findings on psychopathy. The chapter suggests that, to the extent that assumptions regarding the absence of emotions significantly impact management or treatment strategies, generalizations are potentially maladaptive or dangerous. It considers the research findings on emotion and psychopathy and how they fit with these theoretical perspectives. The unusual emotional experiences associated with psychopathy occupy a central role in many descriptions of the disorder. Psychopaths also rated the anxiety scenarios as more threatening and the anger scenarios as less threatening. Film studies of psychopaths' capacity for emotion may be confounded by psychopaths' inability to empathize with film characters.

Emotional Experiences of the Psychopath

Gough's (1960) Socialization (So) scale has been widely used as a measure of the extent to which societal values are internalized. It is well documented that antisocial individuals evidence low So scores but less clear that low So scores predict antisocial behavior in nonclinical samples Two studies conducted at different universities in different geographical regions and different decades provided evidence consistent with this hypothesis. Results from Study 1 revealed that self-reports of several types of antisocial behavior and substance use were significantly more common among Low-So than High-So undergraduate men and women. Study 2 replicated principal findings for both men and women using correlational analyses. In addition, Study 2 yielded a significant relation between low So scores and greater family conflict as well as several gender differences reflecting stronger correlations in men than in women. These findings indicate substantial generality for the relations between socialization and antisoc...

The relation between socialization and antisocial behavior, substance use, and family conflict in college students

Purpose




The purpose of this paper is to test the attenuated-anger and heightened-anger hypotheses of psychopathy by assessing the physiological, behavioral, and subjective measures of anger in individuals with and without psychopathic traits.




Design/methodology/approach




In all, 62 male college students were assigned to one of three groups based on evidence of elevated affective-interpersonal (Factor 1) and antisocial lifestyle (Factor 2) traits associated with psychopathy (the IF1+F2 group), evidence of only Factor 2 traits (the F2 only group), or based on the absence of psychopathic traits (the control group), using Gough’s (1957) Socialization scale and a modified, interview only form of Hare’s (1991) Psychopathy Checklist-Revised. To induce anger, participants received unjust criticism about their performance on a computer-based affective lexical decision task and were denied a performance bonus they had reason to expect.




Findings




Following provocation, the three groups displayed similar increases in blood pressure, pulse, and self-reported anger. The control and IF1+F2 groups also displayed similar retaliation toward the confederate. However, the IF1+F2 group displayed smaller increases on two of three measures of facial muscle activity associated with anger.




Originality/value




This study is one of the first to assess anger responsiveness in individuals with psychopathic traits using a powerful anger induction and using physiological, behavioral, and subjective indices of anger. It is also the first to assess both the attenuated-anger and the heightened-anger hypotheses of psychopathy. The findings appear largely inconsistent with both perspectives.

Brian L. Steuerwald

Papers

The reliability and validity of the psychopathy checklist: youth version (PCL:YV) in nonincarcerated adolescent males.

A new method for assessing the interpersonal behavior of psychopathic individuals: Preliminary validation studies.

Emotional Experiences of the Psychopath

The relation between socialization and antisocial behavior, substance use, and family conflict in college students

Anger following provocation in individuals with psychopathic traits