Cognitive remediation is a treatment approach with the potential to translate basic science into more specific, mechanism-based interventions by targeting particular cognitive skills. The present study translated understanding of two well-defined cognitive-affective dysfunctions into novel deficit-matched interventions and evaluated whether cognitive remediation would demonstrate specific and generalizable change. Two antisocial subtypes, individuals with psychopathy and externalizing traits, are characterized by cognitive-affective problems that predispose them to engage in significant substance abuse and criminal behavior, culminating in incarceration. Whereas individuals with psychopathy (...) fail to consider important contextual information, individuals with externalizing traits lack the capacity to regulate affective reactions. Training designed to remedy these subtype-specific deficits led to improvement on both trained and nontrained tasks. Such findings offer promise for changing neural and behavioral patterns, even for what many consider to be the most recalcitrant treatment population, and presage a new era of translating cognitive-affective science into increasingly specific and effective interventions. (shrink)

Context — Children and adults with psychopathic traits and conduct or oppositional defiant disorder demonstrate poor decision making and are impaired in reversal learning. However, the neural basis of this impairment has not previously been investigated. Furthermore, despite high comorbidity of psychopathic traits and attention deficit/hyperactivity disorder, to our knowledge, no research has attempted to distinguish neural correlates of childhood psychopathic traits and attention-deficit/hyperactivity disorder. Objective—To determine the neural regions that underlie the reversal learning impairments in children with psychopathic traits (...) plus conduct or oppositional defiant disorder. Design — Case-control study. Setting — Government clinical research institute. Participants — Forty-two adolescents aged 10 to 17 years: 14 with psychopathic traits and oppositional defiant disorder or conduct disorder, 14 with attention-deficit/hyperactivity disorder only, and 14 healthy controls. Main Outcome Measure — Blood oxygenation level–dependent signal as measured via functional magnetic resonance imaging during a probabilistic reversal task. Results — Children with psychopathic traits showed abnormal responses within the ventromedial prefrontal cortex (Brodmann area 10) during punished reversal errors compared with children wit hattention deficit/hyperactivity disorder and healthy children (P < .05 corrected for multiple comparisons). Conclusions — To our knowledge, this study provides the first evidence of abnormal ventromedial prefrontal cortex responsiveness in children with psychopathic traits and demonstrates this dysfunction was not attributable to comorbid attention-deficit/hyperactivity disorder. These findings suggest that reversal learning impairments in patients with developmental psychopathic traits relate to abnormal processing of reinforcement information. (shrink)

Research on passive avoidance learning has demonstrated reliable differences between psychopaths and controls when avoidance errors result in electric shock but not in loss of money (Schmauk, 1970). Using monetary punishments, Newman, Widom, and Nathan (1985) found that psychopathic delinquents performed more poorly than controls in an experimental paradigm employing monetary reward as well as the avoidance contingency. The present study was conducted to replicate and extend these findings using adult psychopaths and a computer controlled task. Sixty white male prisoners (...) were assigned to groups using Hare's (1980) Psychopathy Checklist and administered a "go/no-go" discrimination task involving monetary incentives. One condition entailed competing reward and punishment contingencies; the other, two punishment contingencies. As predicted, psychopaths made significantly more passive avoidance errors than nonpsychopaths when the task contained competing goals (p < .05)but performed as well as controls when the subjects' only goal was avoiding punishment. Results corroborate earlier findings that psychopaths are relatively poor at learning to inhibit reward-seeking behavior that results in monetary punishment. (shrink)

Psychopathy is a personality disorder characterized by callous antisocial behavior and criminal recidivism. Here we examine whether psychopathy is associated with alterations in functional connectivity in three large-scale cortical networks. Using fMRI in 142 adult male prison inmates, we computed resting-state functional connectivity using seeds from the default mode network, frontoparietal network, and cingulo-opercular network. To determine the specificity of our findings to these cortical networks, we also calculated functional connectivity using seeds from two comparison primary sensory networks: visual and (...) auditory networks. Regression analyses related network connectivity to overall psychopathy scores and to subscores for the “factors” and “facets” of psychopathy: Factor 1, interpersonal/affective traits; Factor 2, lifestyle/antisocial traits; Facet 1, interpersonal; Facet 2, affective; Facet 3, lifestyle; Facet 4, antisocial. Overall psychopathy severity was associated with reduced functional connectivity between lateral parietal cortex and dorsal anterior cingulate cortex. The two factor scores exhibited contrasting relationships with functional connectivity: Factor 1 scores were associated with reduced functional connectivity in the three cortical networks, whereas Factor 2 scores were associated with heightened connectivity in the same networks. This dissociation was evident particularly in the functional connectivity between anterior insula and dorsal anterior cingulate cortex. The facet scores also demonstrated distinct patterns of connectivity. We found no associations between psychopathy scores and functional connectivity within visual or auditory networks. These findings provide novel evidence on the neural correlates of psychopathy and suggest that connectivity between cortical association hubs, such as the dorsal anterior cingulate cortex, may be a neurobiological marker of the disorder. (shrink)

In this study, we examined decision-making to rewarding or punishing stimuli in individuals with psy- chopathy (n = 21) and comparison individuals (n = 19) using the Differential Reward/Punishment Learn- ing Task. In this task, the participant chooses between two objects associated with different levels of reward or punishment. Thus, response choice indexes not only reward/punishment sensitivity but also sensitivity to reward/punishment level according to inter-stimulus reinforcement distance. Individuals with psychopathy showed significant impairment when choosing between objects associated with differential (...) levels of reward but also significantly greater impairment when choosing between objects associated with differential levels of punishment. However, the two groups were comparably affected by inter-stimulus reinforcement distance. The results are discussed with reference to current models of psychopathy. (shrink)

The performance of adult psychopathic individuals on a novel response reversal task involving 2 reward–punishment contingencies (100–0 and 80–20) was investigated. In line with predictions, adults with psychopathy presented with impairment on the response reversal component but not on the acquisition component of this task. This selective impairment for response reversal was seen for both reward–punishment contingencies and was related to the tendency of individuals with psychopathy to be less likely to stay with a rewarded correct response to a stimulus (...) on the subsequent presentation of that stimulus. Results are discussed with reference to current models of the development of psychopathy. (shrink)

This study investigates the performance of psychopathic individuals on tasks believed to be sensitive to dorsolateral prefrontal and orbitofrontal cortex (OFC) functioning. Psychopathic and non-psychopathic individuals, as defined by the Hare psychopathy checklist revised (PCL-R) [Hare, The Hare psychopathy checklist revised, Toronto, Ontario: Multi-Health Systems, 1991] completed a gambling task [Cognition 50 (1994) 7] and the intradimensional/extradimensional (ID/ED) shift task [Nature 380 (1996) 69]. On the gambling task, psychopathic participants showed a global tendency to choose disadvantageously. Specifically, they showed an (...) impaired ability to show learning over the course of the task. On the ID/ED task, the performance of psychopathic individuals was not significantly different from incarcerated controls on attentional set-shifting, but significant impairments were found on response reversal. These results are interpreted with reference to an OFC and amygdala dysfunction explanation of psychopathy. (shrink)

Previous work has inconsistently reported difficulties with response reversal/extinction in children with psychopathic tendencies. Method: We tested the hypothesis that the degree of impairment seen in children with psychopathic tendencies is a function of the salience of contingency change. We investigated the performance of children with psychopathic tendencies on a novel prob- abilistic response reversal task involving four conditions with gradated reward–punishment contin- gencies (100–0, 90–10, 80–20 and 70–30; i.e., for the 100–0 contingency, responding to one object is always rewarded (...) while responding to the other is always punished). Results: In line with predictions, the impairment seen in the children with psychopathic tendencies was an inverse function of the salience of the contingency change. Conclusions: We suggest that this data is consistent with suggestions of subtle orbital frontal cortex impairment in children with psychopathic tendencies. (shrink)

Psychopathy is a severe personality disorder that has been linked to impaired behavioural adaptation during reinforcement learning. Recent electrophysiological studies have suggested that psychopathy is related to impairments in intentionally using information relevant for adapting behaviour, whereas these impairments remain absent for behaviour relying on automatic use of information. We sought to investigate whether previously found impairments in response reversal in individuals with psychopathy also follow this di- chotomy. We expected response reversal to be intact when the automatic use of (...) information was facilitated. In contrast, we expected im- paired response reversal when intentional use of information was required. Methods: We included offenders with psychopathy and matched healthy controls in 2 experiments with a probabilistic cued go/no-go reaction time task. The task implicated the learning and re- versal of 2 predictive contingencies. In experiment 1, participants were not informed about the inclusion of a learning component, thus making cue-dependent learning automatic/incidental. In experiment 2, the instructions required participants to actively monitor and learn predictive relationships, giving learning a controlled/intentional nature. Results: While there were no significant group differences in acqui- sition learning in either experiment, the results revealed impaired response reversal in offenders with psychopathy when controlled learn- ing was facilitated. Interestingly, this impairment was absent when automatic learning was predominant. Limitations: Possible limitations are the use of a nonforensic control group and of self-report measures for drug use. Conclusion: Response reversal deficits in individuals with psychopathy are modulated by the context provided by the instructions, according to the distinction between automatic and controlled processing in these individuals. (shrink)

This study investigated the performance of boys with psychopathic tendencies and comparison boys, aged 9 to 17 years, on two tasks believed to be sensitive to amygdala and orbitofrontal cortex func- tioning. Fifty-one boys were divided into two groups according to the Psychopathy Screening Device (PSD, P. J. Frick & R. D. Hare, in press) and presented with two tasks. The tasks were the gambling task (A. Bechara, A. R. Damasio, H. Damasio, & S. W. Anderson, 1994) and the Intradimensional/ (...) Extradimensional (ID/ED) shift task (R. Dias, T. W. Robbins, & A. C. Roberts, 1996). The boys with psychopathic tendencies showed impaired performance on the gambling task. However, there were no group differences on the ID/ED task either for response reversal or extradimensional set shifting. The implications of these results for models of psychopathy are discussed. (shrink)