Violence risk assessment tools are increasingly used within criminal justice and forensic psychiatry, however there is little relevant, reliable and unbiased data regarding their predictive accuracy. We argue that such data are needed to (i) prevent excessive reliance on risk assessment scores, (ii) allow matching of different risk assessment tools to different contexts of application, (iii) protect against problematic forms of discrimination and stigmatisation, and (iv) ensure that contentious demographic variables are not prematurely removed from risk assessment tools.

The last two decades have seen tremendous growth in biological research on psychopathy, a mental disorder distinguished by traits including a lack of empathy or emotional response, egocentricity, impulsivity, and stimulation seeking. But how does a psychopath’s brain work? What makes a psychopath? Psychopathy provides a concise, non-technical overview of the research in the areas of genetics, hormones, brain imaging, neuropsychology, environmental influences, and more, focusing on explaining what we currently know about the biological foundations for this disorder and offering (...) insights into prediction, intervention, and prevention. It also offers a nuanced discussion of the ethical and legal implications associated with biological research on psychopathy. How much of this disorder is biologically based? Should offenders with psychopathic traits be punished for their crimes if we can show that biological factors contribute? The text clearly assesses the conclusions that can and cannot be drawn from existing biological research, and highlights the pressing considerations this research demands. (shrink)

Background -/- Psychopathy is a mental health disorder characterized by callous and impulsive antisocial behavior, and it is associated with a high incidence of violent crime, substance abuse, and recidivism. Recent studies suggest that the striatum may be a key component of the neurobiological basis for the disorder, although structural findings have been mixed, and functional connectivity of the striatum in psychopathy has yet to be fully examined. Methods -/- We performed a multimodal neuroimaging study of striatum volume and functional (...) connectivity in psychopathy using a large sample of adult male prison inmates (N = 124). We conducted volumetric analyses in striatal subnuclei and subsequently assessed resting-state functional connectivity in areas where volume was related to psychopathy severity. -/- Results -/- Total Psychopathy Checklist Revised and factor 2 scores (which index the impulsive/antisocial traits of psychopathy) were associated with larger striatal subnuclei volumes and increased volume in focal areas throughout the striatum, particularly in the nucleus accumbens and putamen bilaterally. Furthermore, at many of the striatal areas where volume was positively associated with factor 2 scores, psychopathy severity was also associated with abnormal functional connectivity with other brain regions, including dorsolateral prefrontal cortex, ventral midbrain, and other areas of the striatum. The results were not attributable to age, race, IQ, substance use history, or intracranial volume. Conclusions -/- These findings associate the impulsive/antisocial dimension of psychopathy with enlarged striatal subnuclei and aberrant functional connectivity between the striatum and other brain regions. Furthermore, the colocalization of volumetric and functional connectivity findings suggests that these neural abnormalities may be pathophysiologically linked. (shrink)

In this paper, our goal is to survey some of the legal contexts within which violence risk assessment already plays a prominent role, explore whether developments in neuroscience could potentially be used to improve our ability to predict violence, and discuss whether neuropredictive models of violence create any unique legal or moral problems above and beyond the well worn problems already associated with prediction more generally. In Violence Risk Assessment and the Law, we briefly examine the role currently played by (...) predictions of violence in three high stakes legal contexts: capital sentencing, civil commitment hearings, and sexual predator statutes. In Clinical vs. Actuarial Violence Risk Assessment, we briefly examine the distinction between traditional clinical methods of predicting violence and more recently developed actuarial methods, exemplified by the Classification of Violence Risk software created by John Monahan and colleagues as part of the MacArthur Study of Mental Disorder and Violence [1]. In The Neural Correlates of Psychopathy, we explore what neuroscience currently tells us about the neural correlates of violence, using the recent neuroscientific research on psychopathy as our focus. We also discuss some recent advances in both data collection and data analysis that we believe will play an important role when it comes to future neuroscientific research on violence. In The Potential Promise of Neuroprediction, we discuss whether neuroscience could potentially be used to improve our ability to predict future violence. Finally, in The Potential Perils of Neuroprediction, we explore some potential evidentiary, constitutional, and moral issues that may arise in the context of the neuroprediction of violence. (shrink)

Linking psychopathy to a specific brain abnormality could have significant clinical, legal, and scientific implications. Theories on the neurobiological basis of the disorder typically propose dysfunction in a circuit involving ventromedial prefrontal cortex (vmPFC). However, to date there is limited brain imaging data to directly test whether psychopathy may indeed be associated with any structural or functional abnormality within this brain area. In this study, we employ two complementary imaging techniques to assess the structural and functional connectivity of vmPFC in (...) psychopathic and non-psychopathic criminals. Using diffusion tensor imaging, we show that psychopathy is associated with reduced structural integrity in the right uncinate fasciculus, the primary white matter connection between vmPFC and anterior temporal lobe. Using functional magnetic resonance imaging, we show that psychopathy is associated with reduced functional connectivity between vmPFC and amygdala as well as between vmPFC and medial parietal cortex. Together, these data converge to implicate diminished vmPFC connectivity as a characteristic neurobiological feature of psychopathy. (shrink)

The current paper examines the functional contributions of the amygdala and ventromedial prefrontal cortex (vmPFC) and the evidence that the functioning of these systems is compromised in individuals with psychopathy. The amygdala is critical for the formation of stimulus–reinforcement associations, both punishment and reward based, and the processing of emotional expressions. vmPFC is critical for the representation of reinforcement expectancies and, owing to this, decision making. Neuropsychological and neuroimaging data from individuals with psychopathy are examined. It is concluded that these (...) critical functions of the amygdala and vmPFC, and their interaction, are compromised in individuals with the disorder. It is argued that these impairments lead to the development of psychopathy. (shrink)

A common feature of the antisocial, rule-breaking behavior that is central to criminal, violent and psychopathic individuals is the failure to follow moral guidelines. This review summarizes key findings from brain imaging research on both antisocial behavior and moral reasoning, and integrates these findings into a neural moral model of antisocial behavior. Key areas found to be functionally or structurally impaired in antisocial populations include dorsal and ventral regions of the prefrontal cortex (PFC), amygdala, hippocampus, angular gyrus, anterior cingulate and (...) temporal cortex. Regions most commonly activated in moral judgment tasks consist of the polar/medial and ventral PFC, amygdala, angular gyrus and posterior cingulate. It is hypothesized that the rule-breaking behavior common to antisocial, violent and psychopathic individuals is in part due to impairments in some of the structures (dorsal and ventral PFC, amygdala and angular gyrus) subserving moral cognition and emotion. Impairments to the emotional component that comprises the feeling of what is moral is viewed as the primary deficit in antisocials, although some disruption to the cognitive and cognitive-emotional components of morality (particularly self-referential thinking and emotion regulation) cannot be ruled out. While this neurobiological predisposition is likely only one of several biosocial processes involved in the etiology of antisocial behavior, it raises significant moral issues for the legal system and neuroethics. (shrink)

Psychopathy is characterised by emotional disturbances that affect interpersonal behaviour and decision-making. The objective of this paper is to review the most recent contributions to the field of neuroscience of psychopathy and the implications that this disorder has on the criminal legal field. In regards to this last aspect, we evaluate the issue of psychopaths’ accountability and the incidence of psychopathy in many other penal institutions. In terms of the contributions of neuroscience, we will focus on the orbitofrontal (ofPFC) and (...) ventromedial (vmPFC) regions of the frontal lobes and on the amygdala. Data spanning from the nineteenth century to the present indicate that damage to the ofPFC and vmPFC is the basis of behaviours that have been referred to as pseudopsychopathic. The earlier during brain development the damage occurs, the more likely these behaviours will resemble those of psychopaths. The damage to the amygdala is rather related to impairments in the ability to distinguish facial expressions of fear and the capacity to feel emotions. Damage to ofPFC, vmPFC, and amygdala are highly relevant to the expression of pseudopsychopathic behaviours. (shrink)