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Antisocial and aggressive behavior - blair (2013) Neurobiology of psychopathic traits

31 important questions on Antisocial and aggressive behavior - blair (2013) Neurobiology of psychopathic traits

Which two forms of conduct disorder do we have

- psychopathic traits
- associated with increased risk of mood and anxiety disorders and emotional instability

On which form from conduct disorder will we focus on in this paper?

On psychopathic traits, which have a core collous- unemotional component and impulsive antisocial compoment.
They are detectable early in childhood and persist into adulthood and their presence can interfere with socialization

The diagnosis for conduct disorder has been introduced in the DSM-5 an individual must have displayed two of four characteristics in the last 12 months in multiple settings

1) lack of concern about performance
2) callousness (lack of empathy)
3) shallow or deficient affect
4) lack of remorse or guilt

What is reactive aggression

Involves unplanned, enraged attacks on object perceived to be the source of threat or frustration

When is an individual more likely to respond with reactive aggression

If the basic threat circuit is overly responsive, either because of prior priming or inadequate regulation, the individual is more likely to respond to a threat with reactive aggression

In what type of youths is the circuit overly responsive

In youths with conduct problems and low callous- unemotional traits

Where is a high rating for psychopathic traits associated with

A decreased risk for anxiety and mood disorder symptoms, particulary when the relationship between anxiety on the one hand, and antisocial and impulsive behavior on the other hand is accounted for.

Youths with psychopathic traits show two main cognitive impairment. Which two?

1) specific form of emphatic dysfunction
2) impairments in decision making, specifically in reinforcement learning and the representation of reinforcement expectancies

The term empathy subsumes two critical processes that are distinct at both cognitive and neural level;

- cognitive empathy involves representation of the intentions and thoughts of other individuals
- emotional empathy involves affective responses to emotional displays of other individuals and to verbal descriptions of emotional states of other individuals

True or false

psychopathic traits are associated with reductions of specific forms of emotional empathy (responding to fear, sadness, pain and happiness of others)

True

Psychopathic traits (impairment of normal traits) is associated with impairments in which brain region

Reduced amygdala and ventromedial prefrontal cortex responsiveness to distress cues

The second cognitive impairment involves impairment in decision making (with youths with psychopathic traits). Which region of the brain is associated with this

Dysfunction in the vmPFC and striatum

What happens with cognitive empathy in psychopathic traits

Adults with psychopathic traits show no impairment in cognitive empathy.
A study with youths with psychopathic traits also showed normal recruitment of the medial frontal cortex, temporal parietal junction, posterior cingulate cortex and temporal pole when engaged in this cognitive empathy task.

What happens with emotional empathy in psychopathic traits in children en adults

- selective; they have normal recognition of expressions of anger and disgust, but they display impaired processing of distress cues, fear sadness or pain, and happy expressions.

- youths with psychopathic traits show reduced autonomatic responses to fearful and sad expressions and pain in other individuals.

- high callous-unemotional traits; less concerned that aggressive behavior will result in suffering in the victim

- IMPORTANT: although youths with psychopathic traits show a reduced response to emotional stimuli, the response is not absent and increasing the intensity of an emotional stimulus reduces or removes group differences in fearful expression recognition

The deficits in emotional empathy shown by adolescents with psychopathic involve amygdala dysfunction. What do they mean with this

They show reduced amygdala responses to images of faces with fearful expressions.

show reduced amygdala and rostral medial frontal cortical responses to images of other individuals in pain.

impaired recognition of happy expressions may also be related to amygdala dysfunction

Healthy individuals approach objects associated with happiness in another person and avoid objects associated with fear or disgust. How is this with individuals with psychopathic traits

In individuals with psychopathic traits reduced processing of distress cues by the amydala would lead to reduced aversion of actions that harm others, so that the individual is more likely to perform actions that harm others to achieve their goals

Which other communicatory function is important with emotional empathy?

It is critical for learning the social value of actions and objects and is important for appropriate decision making

Which brain regions are important for representing the valence of objects and actions and for using this information to guide choices towards or away from these objects and actions

VmPFC and anterior insular cortex

What do youths with conduct disorder show for information of objects of actions in social context

Show reduced rostral insula responses when using emotional reactions from other individuals to predict the subsequent behavior of these individuals.

adolescents with psychopathic traits not only form weaker associations between representations of actions that harm others and the aversive consequences of these actions to other individuals but also apply this information less during decision making

Where does care based judgments rely on ? (which brain area)

Amygdala, associating the aversive emotional response to the victim distress with the representation of the action that caused this distress and the vmPFC representing the value of the transgression

What is seen in individuals with psychopathic traits looking at moral judgements

Their moral judgments of conventional transgressions (which concern social normative behavior and are heavily reinforced by the anger of hierarchy figures) and disgust based transgressions is normal.

the selective impairment in recognizing distress cues but not disgusted or angry expressions in individuals with psychopathic traits agrees with impairment in processing of care-based transgressions but normal processing of conventional and disgust based transgressions

What is seen in individuals with psychopathic traits looking at emotional learning and decision making

- pronounced impairments in emotional learning and decision making

- deficits in the capacity to link outcomes with stimuli or response, and this is due to dysfunction within the amygdala, striatum and vmPFC.

-

The effective use of reinforcement outcome information during decision making requires two components. Which two?

- the appropriate representation of the reward or punishment received when an action had been performed.
Predicition error signaling is critical for this.
- the appropriate representation of expected value when considering whether to perform an action

One particularly interesting feature of prediction eroor signaling in youths with psychopathic traits concerns their response to punishment. Why is this

Punishment that are worse than expected are typically associated with reduction in striatal activity in healthy adults and youths. By contrast, adolescents with psychopathic traits showed a positive relationship between prediction errors to punishment and activity within the stratium. The reason for this increased, as opposed to decreased, striatal and vmPFC responses to unexpected punishment remains unclear, but probably contributes to their decision making impairment

Give a summary of emotional learning en decision making in psychopathic people

- weaker responses in the amygdala, vmPFC and anterior insula to empathy cues are associated with higher severity of psychopathic traits. Decision making deficits may not be specific to psychopathic traits but may also occur in individuals showing high level of externalizing behavior > high comorbidity of conduct disorder with ADHD.

psychopathic traits show reduced representations of reward outcomes and expected value in the vmPFC, as well as reduced reward prediction error signaling and potentially high atypical punishment prediction error signaling in the stratium

What were the finding of structural imaging studies on psychopathic traits

The strong fMRI evidence for amygdala and vmPFC abnormalities suggests a possible disruption in the uncinate fasciculus, the white matter tract that connects the amygdala to the frontal lobe.

fmri studies have shown that the ability to use expected value information to guide behavior may be compromised in adolescents with psychopathic traits

Structural MRI studies have relatively consistently reported reductions in the volume, thinkness or folding > no relationship of these reductions with psychopathic traits has been reported

Give a description of how psychopathic traits are developed

- genes
- environment plays role in dysfunction is structures which give rise to reduced anxiety and to decision making deficits.
- psychopathic traits are a risk factor for substance abuse > likely to further disrupt the functional integrity of neural systems that are already dysfunctional in youths in psychopathic traits.

- sMRI findings are consistent with the fMRI findings about the amygdala and caudate in individuals with conduct disorder but rather less consistent with fMRI findings about the vmPFC

What were the endocrinological findings on psychopathic traits

An aberrant cortisol response in childhood has been associated with an increased risk of antisocial behavior. Cortisol is important for the stress response (HPA).

Given that youths with psychopathic traits show abnormal activity, it could be expected that they show a reduced cortisol response

What are the genetic factors of psychopathic traits

- genetic contribution to agression and callous unemotional traits are heritable.

- specific genetic polymorphisms are associated with increased amygdala responsiveness to threat > increased risk of aggression

-

What are the environmental factors

Exposure to high threat levels and/or neglect leads to heightened amygdala responses to threat and increased risk of reactive agression.

environmental factors play a smaller part than genetic factors in high levels of aggression exhibited by youths who show collous unemotional traits.

maternal substance abuse during pregnancy
reduced socioeconomic status

What are the treatment implications of conduct disorder and psychopathic traits

Conduct disorder difficult to treat; findings that social and emotional learning prevention strategies > can prevent or reduce development of conduct disorder. Multidimensional treatment foster care of multisystemic therapy

children with callous unemotional traits have been found more resistant to psychosocial intervention than other aggressive children
interventions that increase amygdala responsiveness

atypical antipsychotic drugs > increase levels of dopamine serotonin noradrenaline and acetylcholine in the rat medial PFC
dopamine antagonists reduce amygdala responsiveness to threat stimuli

The question on the page originate from the summary of the following study material:

Affective Science and Psychopathology

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