Regret in the context of unobtained rewards in criminal offenders.

In this study, we investigated whether differences in the experience of regret may be a potential explanation for damaging behaviours associated with psychopathy and criminal offending. Participants were incarcerated offenders (n = 60) and non-incarcerated controls (n = 20). Psychopathic traits were characterised with the Psychopathic Checklist: Screening Version. Regret was assessed by responses to outcomes on a simulated gambling task. Incarcerated offenders experienced a reduced sense of regret as compared to non-incarcerated controls. We obtained some evidence that specific psychopathic factors and facets could differentially relate to the experience and use of emotions. Our data provide initial evidence of important associations between negative emotions and decision behaviour in the context of criminal offending.

Criminally violent victimisation in schizophrenia spectrum disorders: the relationship to symptoms and substance abuse.

BACKGROUND: Violent victimisation among people with major mental illness is well-documented but the risk factors for criminal violent victimisation are not well understood. METHODS: We examined the relationship between illness-related variables, indices of substance abuse and previous history of violence in a sample of 23 male criminally violently victimized and 69 non-criminally violently victimized male patients with DSM-IV-TR diagnoses of schizophrenia and schizoaffective disorder that were resident in the community and in contact with public mental health services in Victoria Australia. Data on criminal victimisation was acquired from the police database. RESULTS: Demographic, a history of violence or illness-related variables did not distinguish between those had been the victim of a violent crime and those who had not. Our data indicated that drug abuse was a key factor in distinguishing between the groups, but the age of onset of substance abuse was not a significant factor. Scores on measures of drug abuse were modest predictors of criminal victimisation status in our Receiver Operator Characteristic analyses. CONCLUSION: Overall, our findings suggest that substance abuse (particularly drug abuse) is a key predictor of violent victimisation based on criminal statistics. The latter has implications for mental health professions involved in the care planning and community management of patients with major mental illness and work points to the importance of substance abuse treatment in the prevention of victimisation as well as violence perpetration.

Mirtazapine antagonises the subjective, hormonal and neuronal effects of m-chlorophenylpiperazine (mCPP) infusion: a pharmacological-challenge fMRI (phMRI) study.

Aberrant signalling through central 5-HT(2C) receptor pathways has been implicated in various psychiatric disorders but this has not been amenable to experimental investigation in the absence of a valid in-vivo biomarker of functional 5-HT(2C) neurotransmission. One approach is drug-challenge pharmaco-magnetic resonance imaging (phMRI). We have previously shown that intravenous administration of the 5-HT(2C) agonist m-chlorophenylpiperazine (mCPP) elicits increases in blood oxygenation dependent signal (BOLD) in regions consistent with the distribution of 5-HT(2C) receptors. In the current study we determined whether BOLD signal responses to mCPP could be blocked by pre-treatment with a 5-HT(2C) antagonist. Healthy male volunteers received oral mirtazapine, 5-HT(2)/5-HT(3) receptor antagonist, or placebo 90min prior to intravenous mCPP challenge phMRI. BOLD signal increases following mCPP infusion occurred in areas known to be rich in 5-HT(2C) receptors such as the substantia nigra, hypothalamus, pallidum and amygdala. These responses were attenuated by mirtazapine pre-treatment. The results suggest that mCPP-challenge phMRI produces reliable patterns of response that are mediated by 5-HT(2C) receptors; these responses may therefore be useful in-vivo measures of 5-HT(2C) function in psychiatric disorders.

What imaging tells us about violence in anti-social men.

This paper provides an overview of imaging studies in samples of men with personality disorder (PD) who have been violent. Mention is also made of the work of two groups that have looked at the neural correlates of violence across diagnostic categories, including schizophrenia and anti-social PD given their relevance in the field. The paper focuses on the notion that aggressive behaviour can be conceptualised in terms of at least two types, reactive and pro-active, and that few studies separate them. The neuro-anatomical basis of aggression and associated neurobehavioural theories are discussed in relation to clinical disorders (mainly anti-social personality pathology) associated with these different types of aggressive behaviour. Structural (computed tomography, magnetic resonance imaging) and functional (positron emission tomography, fMRI, single-photon emission tomography) studies with violent people variously characterised as anti-social or having psychopathy will be critically reviewed.

The significance of protective factors in the assessment of risk.

BACKGROUND: Few studies have explored protective factors in the assessment of risk, despite acknowledgement that protective factors may play an important role. AIM: To examine the significance of protective factors in assessment of risk using the Structured Assessment of Violence Risk in Youth (SAVRY). METHOD: The SAVRY was completed on 135 male adolescents in custody in the UK. Data on previous offending and childhood psychopathology were collected. Participants were prospectively followed up at 12 months using data from the Home Office Police National Computer (HOPNC). RESULTS: Participants with protective factors were older when first arrested, were less prolific offenders and had fewer psychopathological problems. The number of protective factors present was significantly higher for participants who did not re-offend during the follow-up. The total number of SAVRY protective factors significantly predicted desistance at follow-up and resilient personality traits constituted the only significant individual protective factor. CONCLUSIONS AND IMPLICATIONS: Protective factors might buffer the effects of risk factors and a resilient personality may be crucial. Recognition of protective factors should be an essential part of the risk management process and for interventions with high-risk adolescents to reduce re-offending.

Psychopathy and functional magnetic resonance imaging blood oxygenation level-dependent responses to emotional faces in violent patients with schizophrenia.

BACKGROUND: Comorbidity between schizophrenia and psychopathy has been noted in violent patients in forensic settings. Both disorders are characterized by deficits in processing sad and fearful emotions, but there have been no imaging studies examining the impact of comorbid psychopathic traits on emotional information processing in violent patients with schizophrenia. We tested the hypothesis that violent patients with schizophrenia who had high psychopathy scores would show attenuated amygdala responses to emotional (particularly fearful) faces compared with those with low psychopathy scores. METHODS: Twenty-four violent male patients with schizophrenia were categorized as high/low scorers based on the Psychopathy Checklist: Screening Version. Participants underwent functional magnetic resonance imaging during a block-designed implicit face affect processing task. In a region of interest approach, responses in the amygdala and prefrontal cortex were examined with contrasts between sad/fearful/angry/disgusted faces and neutral faces. RESULTS: High psychopathy scorers exhibited reduced blood oxygenation level-dependent (BOLD) responses in the amygdala during exposure to fearful faces. Psychopathy scores, particularly the affective facets, correlated negatively with amygdala responses. The BOLD responses in the orbitofrontal cortex were negatively correlated with the lifestyle and antisocial facets of psychopathy during exposure to sad faces. Psychopathy scores were positively correlated with neural activation in amygdala and inferior prefrontal regions for disgust but negatively correlated for anger. CONCLUSIONS: Patients with schizophrenia and high levels of psychopathic traits appear to have blunted amygdala responses to fearful faces. At a dimensional level, psychopathy subfacets show a differential relationship to functioning in amygdala-prefrontal circuitry.

Psychopathic traits and deception: functional magnetic resonance imaging study.

BACKGROUND: There is relatively little existing information regarding the neural correlates of deception in individuals with psychopathic traits. AIMS: To investigate the relationship between neural responses during deception and psychopathic personality traits in a sample of male participants drawn from the normal population. METHOD: Twenty-four male participants carried out a simple deception paradigm while undergoing functional magnetic resonance imaging. Psychopathic traits were assessed in the sample using the Psychopathic Personality Inventory (PPI). RESULTS: Mean response times were greater for the lie than truth condition. Lie responses resulted in enhanced activation of the ventrolateral prefrontal cortex. The PPI sub-scales, coldheartedness, fearlessness, Machiavellian egocentricity, social potency and stress immunity were found to be correlated with activation patterns in the brain circuitry implicated in both deception and related processes such as behavioural restraint and social cognition. CONCLUSIONS: This is a novel technology that may prove useful in our understanding of some of the key components of the psychopathy construct in both clinical and non-clinical contexts.

A voxel-based morphometric MRI study in men with borderline personality disorder: preliminary findings.

OBJECTIVE: There is increasing evidence for subtle changes in brain morphology and function in patients with borderline personality disorder (BPD). Structural brain imaging studies show lower volume in frontal, temporal and parietal brain regions than in healthy controls. The aim of our preliminary study of men with BPD was to investigate structural brain changes and their relationship with a measure of impulsivity. METHODS: We examined seven male patients with BPD and six control men using voxel-based morphometry. Analysis of covariance was carried out to assess regionally specific differences in grey and white matter (WM) volumes. Correlations between trait impulsivity as measured using the Impulsiveness-Venturesomeness-Empathy scale and brain volumes were studied. RESULTS: Compared with healthy men, men with BPD had similar WM volumes but smaller grey matter (GM) volumes in frontal, temporal and parietal cortices. The latter were negatively correlated with trait impulsivity. CONCLUSIONS: Our findings fit with previous reports of smaller regional GM volumes reported in women with BPD, and suggest that in men there may be an association between smaller GM volumes and impulsivity.

Executive function and in-patient violence in forensic patients with schizophrenia.

BACKGROUND: The literature on the association between neuropsychological deficits and in-patient violence in schizophrenia is limited and the findings inconsistent. AIMS: To examine the role of executive function deficits in inpatient violence using measures of dorsolateral (DLPFC) and ventrolateral prefrontal cortical (VLPFC) function. METHODS: Thirty-three violent and forty-nine non-violent male forensic in-patients with schizophrenia were assessed using neuropsychological tasks probing DLPFC and VLPFC function and on measures of symptoms and psychopathy. RESULTS: There were no significant group differences in neuropsychological task performance. Higher rates of violence were significantly associated with lower current IQ scores and higher excitement symptom scores. The 'violent' group had significantly higher interpersonal and antisocial domain psychopathy scores. In a logistic regression analysis, IQ and the interpersonal domain of psychopathy were significant discriminators of violent v. non-violent status. CONCLUSIONS: Personality factors rather than symptoms and neuropsychological function may be important in understanding in-patient violence in forensic patients with schizophrenia.

The Structured Assessment of Violence Risk in Youth as a predictor of recidivism in a United Kingdom cohort of adolescent offenders with conduct disorder.

This prospective study examined the predictive validity of the Structured Assessment of Violence Risk in Youth (SAVRY) and the Psychopathy Checklist: Youth Version (PCL: YV) in 99 male adolescents who were assessed in custody and followed up 12 months post release. Outcome data on recidivism were based on official Home Office records. The base rates for violent and general recidivism, respectively, were 38.4% and 70.7%. The predictive validity of the SAVRY Risk Total and the SAVRY Risk Rating was moderate for both violent and general recidivism, but both showed incremental validity in predicting outcomes compared with the PCL: YV. Data are discussed in relation to the limited published international literature.

Is juvenile psychopathy associated with low anxiety and fear in conduct-disordered male offenders?

Although the traditional conceptualization of psychopathy suggests that this construct is negatively associated with anxiety the literature has produced mixed findings. The present study examined the relationship between self-report measures of anxiety/fear and psychopathy assessed using the Psychopathy Checklist: Youth Version in 110 adolescent male offenders with conduct disorder. In line with the literature in children, we found that measures of anxiety and fearfulness exhibited differential associations with different elements of psychopathy. Specifically, we found that trait anxiety was negatively correlated with the affective components of the psychopathy construct and that fearfulness was negatively correlated with the more antisocial components of the construct. The findings are discussed in the context of growing literature on psychopathy assessment in younger cohorts.

The relationship between psychopathic traits measured by the Youth Psychopathic trait Inventory and psychopathology in a UK sample of conduct disordered boys.

The Youth Psychopathy traits Inventory (YPI) is a newly developed self-report measure of psychopathy. There are no studies looking at the validity of this measure in UK samples. We assessed 115 male adolescents (mean age 16.22 years) with DSM-IV conduct disorder on a range of measures including the YPI, Child Behaviour Checklist (CBCL) and the Impulsivity-Venturesomeness-Empathy Questionnaire (IVE). The YPI had showed the expected positive correlations with aggression, delinquency and impulsivity. The YPI was able to identify a "psychopathic-like" subgroup with higher impulsive/aggressive and delinquent scores and lower empathy. The YPI may be of value as a screening tool for cases that require further assessment and evaluation using interview based measures of psychopathic traits.

The relationship between serotonergic function and the Psychopathy Checklist: Screening Version.

Reduced serotonergic (5-HT) neurotransmission has been reported in impulsive and aggressive personality disordered and offender samples. What is not clear is the relationship between 5-HT function and the North American construct of psychopathy assessed using the Psychopathy Checklist and its derivatives, which emphasizes the core interpersonal/affective as well as behavioural components of this syndrome. Fifty-one DSM-III-R personality disordered offenders who had a dynamic assessment of 5-HT function (prolactin response to 30 mg d-fenfluramine challenge) were rated on the Psychopathy Checklist: Screening Version based on interview and file data. The Psychopathy Checklist: Screening Version (PCL: SV) mean score in the sample was similar to other reports in European forensic samples. A three-factor structure best explained the PCL: SV data: arrogant/deceitful, callous-unemotional and impulsive-antisocial behaviour factors. 5-HT function did not correlate with psychopathy as a unidimensional phenomenon. The impulsive-antisocial component correlates negatively with 5-HT function while the arrogant/deceitful component correlates positively with 5-HT. In line with previous research findings, impulsive-antisocial conduct shows an inverse relationship with 5-HT function. Arrogant/deceitful traits correlate positively with 5-HT function and may be an adaptive component of psychopathy.