The development of psychopathy.
The current review focuses on the construct of psychopathy, conceptualized as a clinical entity that is fundamentally distinct from a heterogeneous collection of syndromes encompassed by the term 'conduct disorder'. We will provide an account of the development of psychopathy at multiple levels: ultimate causal (the genetic or social primary cause), molecular, neural, cognitive and behavioral. The following main claims will be made: (1) that there is a stronger genetic as opposed to social ultimate cause to this disorder. The types of social causes proposed (e.g., childhood sexual/physical abuse) should elevate emotional responsiveness, not lead to the specific form of reduced responsiveness seen in psychopathy; (2) The genetic influence leads to the emotional dysfunction that is the core of psychopathy; (3) The genetic influence at the molecular level remains unknown. However, it appears to impact the functional integrity of the amygdala and orbital/ventrolateral frontal cortex (and possibly additional systems); (4) Disruption within these two neural systems leads to impairment in the ability to form stimulus-reinforcement associations and to alter stimulus-response associations as a function of contingency change. These impairments disrupt the impact of standard socialization techniques and increase the risk for frustration-induced reactive aggression respectively.
Mood and Anxiety Disorders Program, National Institute of Mental Health, National Institutes of Heath, Department of Health and Human Services, Bethesda, MD, USA.
R J R
RJ
Blair
K S
KS
Peschardt
S
S
Budhani
D G V
DG
Mitchell
D S
DS
Pine
D000679:Amygdala / Q000503:physiopathology; D000987:Antisocial Personality Disorder / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D001244:Association; D003072:Cognition Disorders / Q000453:epidemiology / Q000503:physiopathology; D018450:Disease Progression; D004645:Empathy; D005239:Fear; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D009014:Morals; D017397:Prefrontal Cortex / Q000503:physiopathology; D012054:Reinforcement, Psychology; D012931:Social Environment