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Psychopaths’ brain activity indicated less concern for others’ well-being

Incarcerated men with psychopathy exhibited decreased activation in areas of the brain associated with empathic concern and valuing the well-being of others, according to new data published online in JAMA Psychiatry. The results may have implications for the treatment of the disorder in prisoners.

“A marked lack of empathy is a hallmark characteristic of individuals with psychopathy,” study researcher Jean Decety, PhD, the Irving B. Harris professor of psychology and psychiatry at the University of Chicago, said in a press release. “This is the first time that neural processes associated with empathic processing have been directly examined in individuals with psychopathy, especially in response to the perception of other people in pain or distress.”

 

Jean Decety

Decety and colleagues studied the neural activity of 80 incarcerated men using magnetic resonance imaging to determine their responses to a series of scenarios depicting people being intentionally hurt. The researchers also studied the prisoners’ reactions to short videos of facial expressions indicating pain. Participants were classified according to their scores on the Hare Psychopathy Checklist-Revised (PCL-R) as high (n=27), intermediate (n=28) or low (n=25).

The researchers observed significantly less activation in the ventromedial prefrontal cortex, lateral orbitofrontal cortex and periaqueductal gray region in participants with psychopathy vs. those in the control group. The ventromedial prefrontal cortex and orbitofrontal cortex have been commonly associated with monitoring ongoing behavior, estimating consequences and incorporating emotional learning into decision making, and both regions have been implicated in neuroimaging investigations of psychopathy.

However, participants with psychopathy exhibited greater activity in the insula relative to those without the disorder.

“The amplified involvement of the [anterior insular cortex] in participants with psychopathy is surprising because of the well-documented role of this region in the experience of empathy,” the researchers wrote.

Decety and colleagues noted that in a previous study using similar stimuli, children with aggressive conduct disorder also had increased activity in the insula, as well as reduced activity in the orbitofrontal cortex. One case study showed that a patient whose insula was completely destroyed still experienced all aspects of feelings and emotions, including empathy.

“This indicates that the role of the insula in emotion and empathy is complex and far from being understood,” they wrote.

The researchers concluded that examining an individual’s neural response to another’s pain can be an effective means of studying the emotional deficits associated with psychothapy, and may lead to better interventions for those with the disorder.

Disclosure: Decety reports no relevant financial disclosures.