
Oct 02, 2011, 05:19 AM
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This article caught my eye because periodically I get tested for temporal lobe epilepsy: Detailed psychological and personality assessments of patients with temporal lobe epilepsy suggests a high incidence of psychopathic-like behavior. Indeed, some studies have reported that pre-operatively the prevalence of psychopathic-like behaviors is as high as 70% of patients with anterior temporal lobe epilepsy (Blumer, 1975; Hill et al., 1957) http://www.ncbi.nlm.nih.gov/pmc/arti...5/?tool=pubmed
The introduction explains: Psychopathy is a serious mental health disorder. Psychopathy is believed to affect approximately 1% of the general population, 15–25% of the male and female prison population (Hare, 1991, 2003), and 10–15% of substance abuse populations (Alterman and Cacciola, 1991; Alterman et al., 1993, 1998). Over the last 20 years, much has been learned about the assessment and characterization of the forensic and legal aspects of psychopathy. However, compared with other psychiatric disorders of similar prevalence, relatively little is known about the neural systems implicated in psychopathy. This review will draw on information from multiple disciplines, including neurology, psychiatry, psychology, cognitive neuroscience, psychophysiology, and epileptology. The literatures will be integrated and a new model of the functional neuroanatomy underlying psychopathy will be presented. The review is offered in several parts. First, the assessment and classification of psychopathy is reviewed. The second part of the review will draw upon indirect evidence from studies of how insults or damage to regions of the brain may lead to symptoms and cognitive abnormalities consistent with those observed in psychopathy suggesting that these latter circuits may be implicated in the disorder. The third part of the review focuses on the cognitive and affective neuroscience studies of psychopathy. Finally, a new model of the functional neuroanatomy underlying psychopathy will be presented.
As with other illnesses, the cause of psychopothy may be the result of brain abnormalities or trauma: These data suggest that the relevant functional neuroanatomy implicated in psychopathy is the paralimbic system. Now it is not known how or when in development these abnormalities in psychopathy arise. Clinical (Cleckley, 1941; Hare, 1993) and recent research data suggest that psychopathic symptoms are present at a very early age (Frick, 1995, 1998; Frick et al., 2000). Given that the brain structures implicated in psychopathy are linked based on cytoarchitectural similarities, it is tempting to argue that psychopathy may be neurodevelopmental in nature. However, at present, there are little data speaking to structural brain alternations in psychopathy. Two structural MRI studies have shown that psychopathy is associated with hippocampal abnormalities (Laakso et al., 2001; Raine et al., 2004). Clearly, more research on functional and structural brain changes in psychopathy is needed. (Emphasis added)
The authors conclude: In summary, converging evidence suggests that psychopathy is associated with paralimbic system dysfunction. This hypothesis is supported by indirect evidence from studies of behavioral changes following lesions or damage to the paralimbic system, bolstered by findings from analog studies, and further supported by the extant cognitive neuroscience literature in psychopathy. The particular neural regions implicated include the orbital frontal cortex, insula, amygdala, parahippocampal regions, anterior superior temporal gyrus, and rostral, caudal and posterior cingulate. It is important to note that the studies reviewed employed the PCL-R or its derivatives to assess psychopathy (Hare, 2003). The PCL-R is widely considered to be the best metric for assessing psychopathy in forensic and clinical contexts. The replicability and consistency of the neurobiological findings are a further testament to the psychometric robustness of the PCL-R and the construct of psychopathy in general. To conclude, this review has examined data from psychological, electrophysiological, and brain-imaging studies in psychopathy during language, attention and orienting, and affective tasks. In addition, this review has considered indirect evidence from behavioral and cognitive changes associated with brain damage or insults. These converging results suggest that the relevant functional neural architecture implicated in psychopathy is the paralimbic system.
As one unfamiliar with much of the terminology and science involved, this article was challenging. Nonetheless, each time I look at the possibility I may have antisocial or psychopathic traits, I learn something.
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