Personality Disorder Traits, Rorschach Performance, and Neuropsychological Functioning in the Case of a Serial Killer: The Importance of a Multilevel Approach in the Assessment of Personalities Associated with Extreme and Repetitive Violence.

The present paper utilized the case study of an incarcerated serial killer ("Keith") to demonstrate how combining three assessment techniques (the Structured Clinical Interview for DSM-IV Axis II Personality Disorders, the Rorschach task, and a comprehensive battery of neuropsychological measures) within a multilevel personality assessment framework might elucidate possible personality-based underpinnings of extreme and repetitive violence-representing a "next wave" of serial killer research while also highlighting the empirical and clinical value of an empirically-neglected multilevel assessment approach. Gacono and Meloy's multimethod "levels" model was selected as a multilevel framework, and Leary's recommended examination of inter-level consistency was utilized as an integrative strategy. Results indicated marked divergencies among Keith's data levels in areas of executive abilities, psychotic symptoms, affective/emotional disconnectivity, and sexual disturbance that suggested areas for potential change (perhaps in therapy), while consistencies among levels in social cognition and object relations suggested more stable characteristics that may be resistant to modification.

Psychopathy Moderates the Relationship between Orbitofrontal and Striatal Alterations and Violence: The Investigation of Individuals Accused of Homicide.

Brain structural abnormalities in the orbitofrontal cortex (OFC) and striatum (caudate and putamen) have been observed in violent individuals. However, a uni-modal neuroimaging perspective has been used and prior findings have been mixed. The present study takes the multimodal structural brain imaging approaches to investigate the differential gray matter volumes (GMV) and cortical thickness (CTh) in the OFC and striatum between violent (accused of homicide) and non-violent (not accused of any violent crimes) individuals with different levels of psychopathic traits (interpersonal and unemotional qualities, factor 1 psychopathy and the expressions of antisocial disposition and impulsivity, factor 2 psychopathy).

Associations between psychopathic traits and brain activity during instructed false responding.

Lying is one of the characteristic features of psychopathy, and has been recognized in clinical and diagnostic descriptions of the disorder, yet individuals with psychopathic traits have been found to have reduced neural activity in many of the brain regions that are important for lying. In this study, we examine brain activity in sixteen individuals with varying degrees of psychopathic traits during a task in which they are instructed to falsify information or tell the truth about autobiographical and non-autobiographical facts, some of which was related to criminal behavior. We found that psychopathic traits were primarily associated with increased activity in the anterior cingulate, various regions of the prefrontal cortex, insula, angular gyrus, and the inferior parietal lobe when participants falsified information of any type.

Alpha-amylase reactivity in relation to psychopathic traits in adults.

Recent investigations of the psychobiology of stress in antisocial youth have benefited from a multi-system measurement model. The inclusion of salivary alpha-amylase (sAA), a surrogate marker of autonomic/sympathetic nervous system (ANS) activity, in addition to salivary cortisol, a biomarker of the hypothalamic-pituitary-adrenal (HPA) axis functioning, has helped define a more complete picture of individual differences and potential dysfunction in the stress response system of these individuals. To the authors' knowledge, no studies have examined sAA in relation to antisocial behavior in adults or in relation to psychopathic traits specifically.

Frontal information flow and connectivity in psychopathy.

Despite accumulating evidence of structural deficits in individuals with psychopathy, especially in frontal regions, our understanding of systems-level disturbances in cortical networks remains limited. We applied novel graph theory-based methods to assess information flow and connectivity based on cortical thickness measures in 55 individuals with psychopathy and 47 normal controls. Compared with controls, the psychopathy group showed significantly altered interregional connectivity patterns.

Somatic aphasia: mismatch of body sensations with autonomic stress reactivity in psychopathy.

Background: Although one of the main characteristics of psychopaths is a deficit in emotion, it is unknown whether they show a fundamental impairment in appropriately recognizing their own body sensations during an emotion-inducing task.

Method: Skin conductance and heart rate were recorded in 138 males during a social stressor together with subjective reports of body sensations. Psychopathic traits were assessed using the Psychopathy Checklist-Revised (PCL-R) 2nd edition (Hare, 2003).

Neurocriminology.

In the past several decades there has been an explosion of research into the biological correlates to antisocial behavior. This chapter reviews the state of current research on the topic, including a review of the genetics, neuroimaging, neuropsychological, and electrophysiological studies in delinquent and antisocial populations. Special attention is paid to the biopsychosocial model and gene-environment interactions in producing antisocial behavior.

Resting EEG deficits in accused murderers with schizophrenia.

Empirical evidence continues to suggest a biologically distinct violent subtype of schizophrenia. The present study examined whether murderers with schizophrenia would demonstrate resting EEG deficits distinguishing them from both non-violent schizophrenia patients and murderers without schizophrenia. Resting EEG data were collected from five diagnostic groups (normal controls, non-murderers with schizophrenia, murderers with schizophrenia, murderers without schizophrenia, and murderers with psychiatric conditions other than schizophrenia) at a brain hospital in Nanjing, China.

P3 event-related potentials and childhood maltreatment in successful and unsuccessful psychopaths.

Although P3 event-related potential abnormalities have been found in psychopathic individuals, it is unknown whether successful (uncaught) psychopaths and unsuccessful (caught) psychopaths show similar deficits. In this study, P3 amplitude and latency were assessed from a community sample of 121 male adults using an auditory three-stimulus oddball task. Psychopathy was assessed using the Psychopathy Checklist-Revised (Hare, 2003) while childhood physical maltreatment was assessed using the Conflict Tactic Scale (Straus, 1979).

Structural and psychosocial correlates of birth order anomalies in schizophrenia and homicide.

Birth order--a unique index of both neurodevelopmental and/or psychosocial factors in the pathogenesis of psychiatric disorder--remains largely unexplored in violent schizophrenia. We examined whether murderers with schizophrenia would demonstrate birth order anomalies, distinguishing them from both nonviolent schizophrenia patients and murderers without schizophrenia. Self-report birth order, psychosocial history data (i.

Increased testosterone-to-cortisol ratio in psychopathy.

Only a few studies have examined hormones in psychopathy, and results have been mixed. It has been suggested that because hormone systems are highly interconnected, it may be important to examine multiple systems simultaneously to gain a clearer picture of how hormones work together to predispose for a certain construct. In the present study, we attempt to clarify the role of the hormones cortisol and testosterone in psychopathy by examining both hormones in a community sample of 178 adults demonstrating a wide range of psychopathy scores.

Reduced hippocampal and parahippocampal volumes in murderers with schizophrenia.

Evidence has accumulated to suggest that individuals with schizophrenia are at increased risk for violent offending. Furthermore, converging evidence suggests that abnormalities in the fronto-limbic system, including the prefrontal cortex, the hippocampus, and the parahippocampal gyrus, may contribute towards both neuropsychological disturbances in schizophrenia and violent behavior. Since the behavioral and clinical consequences of disturbed fronto-limbic circuitry appear to differ in schizophrenia and violence, it may be argued that patients with schizophrenia who exhibit violent behavior would demonstrate different structural abnormalities compared to their non-violent counterparts.

The neurobiology of psychopathy: a neurodevelopmental perspective.

We provide an overview of the neurobiological underpinnings of psychopathy. Cognitive and affective-emotional processing deficits are associated with abnormal brain structure and function, particularly the amygdala and orbitofrontal cortex. There is limited evidence of lower cortisol levels being associated with psychopathic personality.

Comparative meta-analyses of neuropsychological functioning in antisocial schizophrenic persons.

To test the hypothesis that antisocial persons with schizophrenia are characterized by a distinct profile of neurocognitive deficits, meta-analyses of 43 studies were conducted to compare the neuropsychological performance of antisocial schizophrenic individuals to non-antisocial schizophrenic individuals, and to antisocial individuals without schizophrenia. Performance was evaluated across several different domains of neuropsychological functioning for both types of comparisons. Results indicated antisocial schizophrenic individuals demonstrated widespread deficits across multiple domains (Full Scale IQ, Verbal and Performance IQ, attention, broadly-defined executive function, and memory) in comparison to their antisocial counterparts.

Psychophysiological and behavioural characteristics of individuals comorbid for antisocial personality disorder and schizophrenia-spectrum personality disorder.

Background: Few studies have examined people with comorbid schizophrenia-spectrum personality disorder and antisocial personality disorder, a subgroup who may differ psychophysiologically and behaviourally from those with either condition alone.

Aims: To test whether individuals with both types of personality disorder are particularly characterised by reduced orienting and arousal and by increased criminal offending.

Method: In a community adult sample, self-reported crime and skin conductance orienting were collected on four diagnostic groups: schizophrenia-spectrum personality disorder only; antisocial personality disorder only; comorbidity of the two disorders; and a control group.