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International Journal of Law and... 2020This research presents a series of linked studies exploring the association between psychopathy and trauma. It comprises a systematic review (n = 58), followed by an...
This research presents a series of linked studies exploring the association between psychopathy and trauma. It comprises a systematic review (n = 58), followed by an expert Delphi (n = 19), and patient file trawl using a male forensic psychiatric patient sample (n = 66). An association between psychopathy and developmental trauma was predicted. It was further predicted that different types of trauma would be associated with different subtypes of psychopathy and that the severity of trauma would be important. The systematic review identified the following core themes: presence of Post-Traumatic Stress Disorder and/or symptoms; trauma type; trauma/abuse variables; and sex differences. The ensuing Delphi study indicated the specific variant of psychopathy to be important, with secondary psychopathy particularly relevant. The final study found that the severity of developmental trauma related differentially to primary and secondary psychopathy. Implications and directions for future research are discussed, most notably with regards to the conceptualisation of psychopathy.
Topics: Antisocial Personality Disorder; Delphi Technique; Female; Humans; Male; Prisoners; Psychological Trauma; Psychopathology; Stress Disorders, Post-Traumatic
PubMed: 32241459
DOI: 10.1016/j.ijlp.2020.101543 -
Personality and Mental Health Feb 2023Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment program for patients with borderline personality disorder (BPD). The...
Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment program for patients with borderline personality disorder (BPD). The program was intended to be highly accessible, both for patients and therapists. During STEPPS, patients are taught emotion regulation and behavior management skills. This systematic review synthesizes the current empirical status of STEPPS, focusing on research designs, quality of studies, target groups, protocols, and outcome. We selected 20 studies, with three randomized controlled trials. Patients with BPD, subthreshold BPD, and patients with BPD and comorbid antisocial personality disorder were investigated. One study was conducted in adolescents. There were no studies in older adults. Results demonstrated STEPPS to be associated with reduced BPD symptoms, improved quality of life, decreased depressive symptoms, and decreased negative affectivity. Mixed results were found for impulsivity and suicidal behaviors. STEPPS has both been studied as an add-on therapy to patients' ongoing treatment, and, with the addition of individual STEPPS sessions, as a stand-alone treatment. High attrition rates were found in patients attending STEPPS, complicating the generalizability of the results. Although the evidence for STEPPS is promising, further research is needed before firm conclusions can be drawn. Recommendations for future research are discussed.
Topics: Adolescent; Humans; Aged; Psychotherapy, Group; Treatment Outcome; Borderline Personality Disorder; Quality of Life; Problem Solving
PubMed: 35729869
DOI: 10.1002/pmh.1558 -
Translational Psychiatry Oct 2023The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, includes an alternative model of personality disorders (AMPD)...
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, includes an alternative model of personality disorders (AMPD) focusing on a maladaptive trait model utilized to diagnose several personality disorders. Borderline personality disorder (BPD) and antisocial personality disorder (ASPD) are two conditions categorized by AMPD that exhibit high rates of violence and aggression. Several of the traits outlined in the AMPD, including hostility, impulsivity, risk-taking, and callousness, have been previously linked to aggression in BPD and ASPD. However, to the best of our knowledge, there has never been a synthesis of neuroimaging studies that have investigated links between these traits and aggression in BPD and ASPD. To overcome this gap, we conducted a systematic review under the PRISMA framework to locate neuroimaging articles published since the release of AMPD linking trait anger/hostility, impulsivity, risk-taking, and callousness to aggression in BPD and ASPD. Key findings included the following: i) anger/hostility, associated with alterations in the interplay between prefrontal and subcortical regions (primarily the amygdala), may be a common factor explaining aggressive reactions to response to interpersonal threat or provocation; ii) alterations of fronto-temporal-limbic regions and serotonergic and endocannabinoid signaling systems may link impulsivity to aggression in BPD and ASPD; iii) weaker cortico-striatal connectivity could relate to greater risk taking and greater proclivity for violence. Insufficient evidence from neuroimaging articles was discerned to describe a relationship between callousness and aggression. Overall, results of this review reveal a relative paucity of neuroimaging studies examining AMPD traits relevant to aggression in BPD and ASPD. In addition to encouraging further investigation of neuroimaging markers of AMPD traits linked to aggression, we recommend multi-methodological designs, including the incorporation of other biomarkers, such as hormones and indices of physiological arousal, to fully expand our understanding of aggression in BPD and ASPD.
Topics: Humans; Aggression; Anger; Antisocial Personality Disorder; Borderline Personality Disorder; Diagnostic and Statistical Manual of Mental Disorders
PubMed: 37884552
DOI: 10.1038/s41398-023-02612-1 -
International Journal of Molecular... Feb 2022Psychopathic traits in youth may lead to adult criminal behaviors/psychopathy. The Val158Met polymorphism of catechol-O-methyltransferase () may influence the risk for...
Psychopathic traits in youth may lead to adult criminal behaviors/psychopathy. The Val158Met polymorphism of catechol-O-methyltransferase () may influence the risk for psychopathy-related behaviors, while acting as a biomarker for predicting treatment response to dopaminergic medications. The literature shows inconsistent findings, making the interpretation of 's role difficult. The aims of this article are (i) to conduct a systematic review to analyze the effects of Val158Met on psychopathic traits in children and adolescents, and (ii) to present new evidence on the developmental trajectory of the association of Val158Met and youth psychopathic traits. For the systematic review, a literature search was conducted using PubMed, EMBASE, OVID Medline and PsychINFO with the search terms for psychopathic traits, Val158Met and age of interest. In our genotype study, the Val158Met genotype of 293 youth with European ancestry was analyzed in association with the psychopathy-related behavior scores from the Child Behavior Checklist and the Psychopathy Screening Device. To examine the potential influence of developmental changes, the sample was split into at or above and below age 13, and analyses were performed in males and females separately. The literature search yielded twenty-eight articles to be included in the systematic review, which demonstrated mixed results on the association depending on environmental factors, sex ratios, age groups and behavioral disorder diagnoses. The results from our genotype study revealed that Met homozygous youth in the below age 13 group and conversely Val carrier youth in the above age 13 group were more likely to display psychopathic traits. To our knowledge, this is the first study to systematically review the effects of Val158Met on psychopathic traits in childhood and adolescence, and to provide new evidence on the changing effects of Val158Met on psychopathy-related behaviors with development. Elucidating the role of the genotype in conjunction with the child versus adolescent stage of development for psychopathic traits may help predict treatment response, and may lead to early intervention and prevention strategies.
Topics: Adolescent; Antisocial Personality Disorder; Catechol O-Methyltransferase; Child; Female; Genetic Predisposition to Disease; Humans; Male; Polymorphism, Single Nucleotide
PubMed: 35163702
DOI: 10.3390/ijms23031782 -
Frontiers in Psychiatry 2019Core psychopathy is characterized by grandiosity, callousness, manipulativeness, and lack of remorse, empathy, and guilt. It is often comorbid with conduct disorder and...
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.
PubMed: 32116828
DOI: 10.3389/fpsyt.2019.01027 -
Neuroscience and Biobehavioral Reviews Dec 2023The CNV is analyzed in tasks related to EEG studies, often with participants presenting psychopathic personality traits. A systematic search of the literature was... (Meta-Analysis)
Meta-Analysis Review
The CNV is analyzed in tasks related to EEG studies, often with participants presenting psychopathic personality traits. A systematic search of the literature was conducted, to solve some inconsistencies regarding CNV amplitude modulation by psychopathy. Nine studies (N = 317) were retrieved for analysis. Three meta-analyses were run - CNV, iCNV, tCNV. A qualitative analysis - reporting CNV amplitudes modulated by psychopathy dimensional features - was also featured. Overall effects for CNV and iCNV were not significant. Larger tCNV amplitudes were found in participants reporting higher psychopathy traits, g = -0.58, 95% CI [- 0.94, - 0.22]. These findings were surprising when confronted with previous assumptions in the literature, especially considering that no significant heterogeneity between studies was found. Neither of the studies' characteristics was a significant moderator. Findings require the need to discuss key differences between adaptive/(mal)adjustment patterns in participants presenting psychopathic traits. Future studies dissociating iCNV and tCNV modulation by psychopathy, especially in community samples and through a dimensional lens, could help to better understand the construct of psychopathy.
Topics: Humans; Contingent Negative Variation; Antisocial Personality Disorder
PubMed: 37977277
DOI: 10.1016/j.neubiorev.2023.105469 -
Child Abuse & Neglect Sep 2020ASPD describes individuals with a pervasive pattern of disregard for the rights of others that begins in childhood and continues into adulthood. The relationship between...
BACKGROUND
ASPD describes individuals with a pervasive pattern of disregard for the rights of others that begins in childhood and continues into adulthood. The relationship between parental bonding, trauma, and ASPD is well established, however, it remains unclear what types of trauma or which patterns of bonding are more associated with ASPD.
OBJECTIVES
Review the literature regarding what types of trauma and bonding characteristics were related to antisocial personality traits.
METHOD
Systematic searches of PubMed, Embase, Web of Science, and Scielo for studies about the relationship between antisocial personality traits and the Childhood Trauma Questionnaire (CTQ) and/or the Parental Bonding Instrument (PBI).
RESULTS
357 abstracts were selected, and 18 studies met the inclusion criteria. Regarding CTQ, the most consistent finding was the association between physical abuse and neglect to antisocial traits. Sexual abuse was the variable least related to antisocial traits. Regarding PBI, the most consistent finding was the inverse relationship between maternal and paternal care and antisocial traits. Concerning overprotection, the data is less consistent. Also, there was a considerable heterogenity between studies.
CONCLUSIONS
The literature little explores how these variables interact with each other. Thus, more studies are important to aidpolitical,educational, and public health programs to create preventive initiatives for ASPD.
Topics: Adult; Adverse Childhood Experiences; Antisocial Personality Disorder; Child; Child Abuse; Child Abuse, Sexual; Child, Preschool; Humans; Object Attachment; Parent-Child Relations; Parents; Surveys and Questionnaires
PubMed: 32603957
DOI: 10.1016/j.chiabu.2020.104621 -
Personality Disorders Nov 2018Antisocial Behavior (AB) has a tremendous societal cost, motivating investigation of the mechanisms that cause individuals to engage and persist in AB. Recent theories...
Antisocial Behavior (AB) has a tremendous societal cost, motivating investigation of the mechanisms that cause individuals to engage and persist in AB. Recent theories of AB emphasize the role of reward-related neural processes in the etiology of severe and chronic forms of AB, including antisocial personality disorder and psychopathy. However, no systematic reviews have evaluated the hypothesis that reward-related neural dysfunction is an etiologic factor in AB in adult samples. Moreover, it is unclear whether AB is linked to a hyper- or hyposensitive reward system and whether AB is related to neural sensitivity to losses. Thus, the current systematic review examined whether AB (including antisocial personality disorder) and psychopathic traits are related to neural reactivity during reward processing, loss processing, or both. Our review identified seven task-based functional MRI or functional connectivity studies that examined associations between neural response to reward and loss, and dimensional and categorical measures of adult AB and/or psychopathy. Across studies, there was evidence that AB is associated with variability in neural functioning during both reward and loss processing. In particular, impulsive-antisocial traits appeared to be specifically associated with hypersensitivity in the ventral striatum during the anticipation, but not the receipt, of rewards. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Topics: Antisocial Personality Disorder; Brain; Functional Neuroimaging; Humans; Impulsive Behavior; Magnetic Resonance Imaging; Reward
PubMed: 30080060
DOI: 10.1037/per0000308 -
JAMA Psychiatry Apr 2024Several factors may place people with mental health disorders, including substance use disorders, at increased risk of experiencing homelessness and experiencing...
IMPORTANCE
Several factors may place people with mental health disorders, including substance use disorders, at increased risk of experiencing homelessness and experiencing homelessness may also increase the risk of developing mental health disorders. Meta-analyses examining the prevalence of mental health disorders among people experiencing homelessness globally are lacking.
OBJECTIVE
To determine the current and lifetime prevalence of mental health disorders among people experiencing homelessness and identify associated factors.
DATA SOURCES
A systematic search of electronic databases (PubMed, MEDLINE, PsycInfo, Embase, Cochrane, CINAHL, and AMED) was conducted from inception to May 1, 2021.
STUDY SELECTION
Studies investigating the prevalence of mental health disorders among people experiencing homelessness aged 18 years and older were included.
DATA EXTRACTION AND SYNTHESIS
Data extraction was completed using standardized forms in Covidence. All extracted data were reviewed for accuracy by consensus between 2 independent reviewers. Random-effects meta-analysis was used to estimate the prevalence (with 95% CIs) of mental health disorders in people experiencing homelessness. Subgroup analyses were performed by sex, study year, age group, region, risk of bias, and measurement method. Meta-regression was conducted to examine the association between mental health disorders and age, risk of bias, and study year.
MAIN OUTCOMES AND MEASURES
Current and lifetime prevalence of mental health disorders among people experiencing homelessness.
RESULTS
A total of 7729 citations were retrieved, with 291 undergoing full-text review and 85 included in the final review (N = 48 414 participants, 11 154 [23%] female and 37 260 [77%] male). The current prevalence of mental health disorders among people experiencing homelessness was 67% (95% CI, 55-77), and the lifetime prevalence was 77% (95% CI, 61-88). Male individuals exhibited a significantly higher lifetime prevalence of mental health disorders (86%; 95% CI, 74-92) compared to female individuals (69%; 95% CI, 48-84). The prevalence of several specific disorders were estimated, including any substance use disorder (44%), antisocial personality disorder (26%), major depression (19%), schizophrenia (7%), and bipolar disorder (8%).
CONCLUSIONS AND RELEVANCE
The findings demonstrate that most people experiencing homelessness have mental health disorders, with higher prevalences than those observed in general community samples. Specific interventions are needed to support the mental health needs of this population, including close coordination of mental health, social, and housing services and policies to support people experiencing homelessness with mental disorders.
PubMed: 38630486
DOI: 10.1001/jamapsychiatry.2024.0426 -
Criminal Behaviour and Mental Health :... Feb 2015A neurobiological perspective has become accepted as a valuable approach for understanding anti-social behaviour. There is literature to suggest that, in non-offending... (Review)
Review
BACKGROUND
A neurobiological perspective has become accepted as a valuable approach for understanding anti-social behaviour. There is literature to suggest that, in non-offending populations, psychological treatments affect both neurobiological measures and clinical presentation. A theoretical position to this effect has been adopted with respect to offender treatment, but there has been no systematic review of empirical literature on this point.
AIMS
This study aimed to ascertain from published literature firstly whether there is evidence of change in neuropsychological or physiological measures after behavioural treatments/programmes for people with anti-social behaviour and secondly whether these neurobiological changes are associated with behavioural change.
METHOD
A systematic search strategy was formulated to include studies considering 'neurobiological factors', 'anti-social population', 'treatment' and 'treatment outcome'. The Maryland Scientific Methods Scale was used to select relevant studies of sufficient methodological quality.
RESULTS
Eleven studies were found, only one with adults. Overall, the values of specific neurobiological risk factors, particularly of basal cortisol, become less abnormal following intervention. There was some evidence for a link between change in neurobiological functioning and behavioural improvement.
CONCLUSIONS
Findings, although provisional, may provide new insights into the underlying mechanisms of interventions for anti-social behaviour. Future studies that include pre-treatment neurobiological assessment could help reveal physical vulnerabilities that interventions should target to improve treatment efficacy, and provide for objective, independent corroboration of change.
Topics: Adult; Antisocial Personality Disorder; Behavior Therapy; Criminals; Executive Function; Female; Humans; Male; Mental Disorders; Psychotherapy; Social Behavior; Treatment Outcome
PubMed: 24888269
DOI: 10.1002/cbm.1915