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Concept: Hare Psychopathy Checklist


While it is well established that individuals with psychopathy have a marked deficit in affective arousal, emotional empathy, and caring for the well-being of others, the extent to which perspective taking can elicit an emotional response has not yet been studied despite its potential application in rehabilitation. In healthy individuals, affective perspective taking has proven to be an effective means to elicit empathy and concern for others. To examine neural responses in individuals who vary in psychopathy during affective perspective taking, 121 incarcerated males, classified as high (n = 37; Hare psychopathy checklist-revised, PCL-R ≥ 30), intermediate (n = 44; PCL-R between 21 and 29), and low (n = 40; PCL-R ≤ 20) psychopaths, were scanned while viewing stimuli depicting bodily injuries and adopting an imagine-self and an imagine-other perspective. During the imagine-self perspective, participants with high psychopathy showed a typical response within the network involved in empathy for pain, including the anterior insula (aINS), anterior midcingulate cortex (aMCC), supplementary motor area (SMA), inferior frontal gyrus (IFG), somatosensory cortex, and right amygdala. Conversely, during the imagine-other perspective, psychopaths exhibited an atypical pattern of brain activation and effective connectivity seeded in the anterior insula and amygdala with the orbitofrontal cortex (OFC) and ventromedial prefrontal cortex (vmPFC). The response in the amygdala and insula was inversely correlated with PCL-R Factor 1 (interpersonal/affective) during the imagine-other perspective. In high psychopaths, scores on PCL-R Factor 1 predicted the neural response in ventral striatum when imagining others in pain. These patterns of brain activation and effective connectivity associated with differential perspective-taking provide a better understanding of empathy dysfunction in psychopathy, and have the potential to inform intervention programs for this complex clinical problem.

Concepts: Brain, Cerebrum, Limbic system, Frontal lobe, Prefrontal cortex, Psychopathy, Hare Psychopathy Checklist, Robert Hare


Previous research has shown that victims display characteristic body language, specifically in their walking style (Grayson & Stein, 1981). Individuals scoring higher on the interpersonal/affective aspects of psychopathy (Factor 1) are more accurate at judging victim vulnerability simply from viewing targets walking (Wheeler, Book, & Costello, 2009). The present study examines the relation between psychopathy and accuracy in assessing victim vulnerability in a sample of inmates from a maximum security penitentiary in Ontario, Canada. Forty-seven inmates viewed short video clips of targets walking and judged how vulnerable each target was to victimization. Higher Factor 1 psychopathy scores (as measured by the PCL-R; Hare 2003) were positively related to accuracy in judging victim vulnerability. Contrary to research with noninstitutional participants (Wheeler et al., 2009), inmates higher on Factor 1 of psychopathy were more likely to rationalize their vulnerability judgments by mentioning the victim’s gait. Implications of these findings are discussed.

Concepts: Choice, Walking, Psychopathy, Victim, Judgment, Concepts in aesthetics, Video clip, Hare Psychopathy Checklist


Although criminal psychopathy is starting to be relatively well described, our knowledge of the characteristics and scientific markers of serial murdering is still very poor. A serial killer who murdered more than five people, KT, was administered a battery of standardized tests aimed at measuring neuropsychological impairment and social/emotional cognition deficits. KT exhibited a striking dissociation between a high level of emotional detachment and a low score on the antisocial behavior scale on the Psychopathy Checklist-Revised (PCL-R). The Minnesota Multiphasic Personality Inventory-2 showed a normal pattern with the psychotic triad at borderline level. KT had a high intelligence score and showed almost no impairment in cognitive tests sensitive to frontal lobe dysfunction (Wisconsin Card Sorting Test, Theory of Mind, Tower of London, this latter evidenced a mild impairment in planning performance). In the tests on moral, emotional and social cognition, his patterns of response differed from matched controls and from past reports on criminal psychopaths as, unlike these individuals, KT exhibited normal recognition of fear and a relatively intact knowledge of moral rules but he was impaired in the recognition of anger, embarrassment and conventional social rules. The overall picture of KT suggests that serial killing may be closer to normality than psychopathy defined according to either the DSM IV or the PCL-R, and it would be characterized by a relatively spared moral cognition and selective deficits in social and emotional cognition domains.

Concepts: Psychology, Crime, Antisocial personality disorder, Psychopathy, Murder, Hare Psychopathy Checklist, Robert Hare, The Mask of Sanity


Individuals with psychopathy have an increased tendency toward certain types of aggression. We hypothesized that successful psychopaths, who have no criminal convictions but can be diagnosed with psychopathy in terms of personality characteristics, are skilled at regulating aggressive impulses, compared to incarcerated unsuccessful psychopaths. Methods: In this block-designed functional magnetic resonance imaging (fMRI) study, we sought to clarify the neural mechanisms underlying differences in frustration-induced aggression as a function of psychopathy in non-criminal populations. Twenty male undergraduate students who completed a self-report psychopathy questionnaire were scanned while they completed a task in which they either could or could not punish other individuals who made unfair offers of monetary distribution.

Concepts: Nuclear magnetic resonance, Sociology, Magnetic resonance imaging, Crime, Criminology, Antisocial personality disorder, Psychopathy, Hare Psychopathy Checklist


Psychopathy is a disorder that is characterized by marked emotional deficiencies. Because previous studies suggest that an individual’s sensitivity to bodily signals-or “interoceptive awareness”-is associated with various components of emotional functioning, the authors expected this capacity to be reduced in psychopathic individuals. Therefore, the current study examined the relationship between psychopathy and interoceptive awareness by assessing heartbeat detection abilities in a group of 75 male personality disordered offenders, varying in their degree of psychopathy, as assessed with the Hare Psychopathy Checklist-Revised (PCL-R; Hare, 2003). Regression analyses revealed that PCL-R Facet 4, which reflects antisocial behavior, was predictive of reduced interoceptive awareness. These findings suggest that the expression of psychopathic behavior might be influenced by an attenuated sensitivity to one’s own bodily signals.

Concepts: Mental disorder, Antisocial personality disorder, Conduct disorder, Psychopathy, Hare Psychopathy Checklist, Robert Hare, Remorse, The Mask of Sanity


Psychopathic individuals are characterized by impaired affective processing, impulsivity, sensation-seeking, poor planning skills and heightened aggressiveness with poor self-regulation. Based on brain self-regulation studies using neurofeedback of Slow Cortical Potentials (SCPs) in disorders associated with a dysregulation of cortical activity thresholds and evidence of deficient cortical functioning in psychopathy, a neurobiological approach seems to be promising in the treatment of psychopathy. The results of our intensive brain regulation intervention demonstrate, that psychopathic offenders are able to gain control of their brain excitability over fronto-central brain areas. After SCP self-regulation training, we observed reduced aggression, impulsivity and behavioral approach tendencies, as well as improvements in behavioral-inhibition and increased cortical sensitivity for error-processing. This study demonstrates improvements on the neurophysiological, behavioral and subjective level in severe psychopathic offenders after SCP-neurofeedback training and could constitute a novel neurobiologically-based treatment for a seemingly change-resistant group of criminal psychopaths.

Concepts: Crime, Mental disorder, Psychopathy, Hare Psychopathy Checklist


The authors investigated the relationship between cinema and psychopathy to describe and analyze the portrayal of fictional psychopathic characters in popular films and over cinematic history. From 400 films (1915-2010), 126 fictional psychopathic characters (21 female and 105 male) were selected based on the realism and clinical accuracy of their profiles. Movies were then analyzed by senior forensic psychiatrists and cinema critics. Secondary (71%) and manipulative (48%) subtypes were the most common in the female group, while secondary (51%) and prototypical (34%) were the most common in the male group. Corresponding to the increased understanding of clinical psychopathy by professional mental health providers over time, the clinical description of and epidemiological data on fictional psychopaths in popular films have become more realistic. Realistic fictional psychopaths remain in the minority but are very important for didactic purposes in Academic facilities, as “teaching Movies.”

Concepts: Epidemiology, Mental disorder, Psychiatry, Film, Psychopathy, Movie projector, Movie studio, Hare Psychopathy Checklist


Psychopathic offenders show a persistent pattern of emotional unresponsivity to the often horrendous crimes they perpetrate. Recent studies have related psychopathy to alterations in white matter. Therefore, diffusion tensor imaging followed by tract-based spatial statistics (TBSS) analysis in 11 psychopathic offenders matched to 11 healthy controls was completed. Fractional anisotropy was calculated within each voxel and comparisons were made between groups using a permutation test. Any clusters of white matter voxels different between groups were submitted to probabilistic tractography. Significant differences in fractional anisotropy were found between psychopathic offenders and healthy controls in three main white matter clusters. These three clusters represented two major networks: an amygdalo-prefrontal network, and a striato-thalamo-frontal network. The interpersonal/affective component of the PCL-R correlated with white matter deficits in the orbitofrontal cortex and frontal pole whereas the antisocial component correlated with deficits in the striato-thalamo-frontal network. In addition to replicating earlier work concerning disruption of an amygdala-prefrontal network, we show for the first time that white matter integrity in a striato-thalamo-frontal network is disrupted in psychopathic offenders. The novelty of our findings lies in the two dissociable white matter networks that map directly onto the two major factors of psychopathy.

Concepts: Magnetic resonance imaging, Cerebrum, Frontal lobe, Antisocial personality disorder, Conduct disorder, Psychopathy, Hare Psychopathy Checklist, Robert Hare


Despite a wealth of research, the core features of psychopathy remain hotly debated. Using network analysis, an innovative and increasingly popular statistical tool, the authors mapped the network structure of psychopathy, as operationalized by the Psychopathy Checklist-Revised (PCL-R; Hare, 2003) in two large U.S. offender samples (nNIMH = 1559; nWisconsin = 3954), and 1 large Dutch forensic psychiatric sample (nTBS = 1937). Centrality indices were highly stable within each sample, and indicated that callousness/lack of empathy was the most central PCL-R item in the 2 U.S. samples, which aligns with classic clinical descriptions and prototypicality studies of psychopathy. The similarities across the U.S. samples offer some support regarding generalizability, but there were also striking differences between the U.S. samples and the Dutch sample, wherein the latter callousnesss/lack of empathy was also fairly central but irresponsibility and parasitic lifestyle were even more central. The findings raise the important possibility that network-structures do not only reflect the structure of the constructs under study, but also the sample from which the data derive. The results further raise the possibility of cross-cultural differences in the phenotypic structure of psychopathy, PCL-R measurement variance, or both. Network analyses may help elucidate the core characteristics of psychopathological constructs, including psychopathy, as well as provide a new tool for assessing measurement invariance across cultures. (PsycINFO Database Record

Concepts: Sample, The Network, Analysis of variance, Psychiatry, Psychopathy, Social network, Hare Psychopathy Checklist, Robert Hare


Research on psychopathic personality has been dominated by a focus on criminality and social deviance, but some theoretical models argue that certain putatively adaptive features are important components of this construct. In 3 samples (forensic mental health practitioners, probation officers and a layperson community sample), we investigated adaptive traits as conceptualized in the Triarchic model of psychopathy (Patrick et al., 2009), specifically the relevance of boldness to construals of psychopathic personality. Participants completed prototypicality ratings of psychopathic traits, including 3 items created to tap components of boldness (Socially bold, Adventurous, Emotionally stable), and they also rated a series of attitudinal statements (e.g., perceived correlates of being psychopathic, moral judgments about psychopaths). The composite Boldness scale was rated as moderately to highly prototypical among forensic mental health practitioners and probation officers and positively associated with other theoretically relevant domains of psychopathy. Across samples, higher composite Boldness ratings predicted greater endorsement of adaptive traits (e.g., social skills) as characteristic of psychopathy. For the individual items, Socially bold was rated as highly prototypical and was associated with theoretically relevant correlates. Adventurous also was seen as prototypical, though to a lesser degree. Only forensic mental health practitioners endorsed Emotionally stable as characteristic of psychopathy. Our results provide partial support for the contention that the boldness concept is viewed as an important component of psychopathy, particularly among professionals who work directly with offender populations. (PsycINFO Database Record

Concepts: Psychology, Sociology, Crime, Mental disorder, Criminology, Antisocial personality disorder, Psychopathy, Hare Psychopathy Checklist