#520 Is a psychopath’s brain different?

Is a psychopath’s brain different? Yes. There are differences in the areas that deal with empathy and guilt, and the areas that deal with fear and anxiety.

What exactly is a psychopath? “Psychopath” is not actually a clinical diagnosis. The real condition is antisocial personality disorder (ASPD) and a psychopath would be on the far edge of ASPD. The word psychopath was first used in Germany in 1847 (psychopatisch) and was first used in English in 1885. It is made from the Greek words psyche meaning “soul” and pathos meaning “suffering, feeling”.

As psychopath is not a clinical definition, it is impossible to ask what makes a psychopath. We need to look at what someone needs to be diagnosed with ASPD. The Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition (DM-5) says that someone with three or more of the following criteria has ASPD.

・failure to conform to social norms concerning lawful behaviors, such as performing acts that are grounds for arrest

・deceitfulness, repeated lying, use of aliases, or conning others for pleasure or personal profit

・impulsivity or failure to plan

・irritability and aggressiveness, often with physical fights or assaults

・reckless disregard for the safety of self or others

・consistent irresponsibility, failure to sustain consistent work behavior, or honor monetary obligations

・lack of remorse, being indifferent to or rationalizing having hurt, mistreated, or stolen from another person

ASPD is a very broad diagnosis and it is estimated that as many as 3 percent of men and 1 percent of women have it. That rises to between 50 and 80% of men imprisoned in America. That would make sense, seeing as anti-social behavior is likely to get one arrested. It is also likely that most serial killers also have ASPD, but obviously not all of them.

Psychopathy is far to the edge of ASPD and there is a psychopathy checklist. The list has 20 items and each item is scored from 0 to 2. In the UK, anyone with a score over 25 out of 40 is a psychopath and in the USA, anyone with a score over 30 is a psychopath. Here is the checklist:

Item 1: Glibness/superficial charm

Item 2: Grandiose sense of self-worth

Item 3: Need for stimulation/proneness to boredom

Item 4: Pathological lying

Item 5: Cunning/manipulative

Item 6: Lack of remorse or guilt

Item 7: Shallow affect

Item 8: Callous/lack of empathy

Item 9: Parasitic lifestyle

Item 10: Poor behavioral controls

Item 11: Promiscuous sexual behavior

Item 12: Early behavior problems

Item 13: Lack of realistic long-term goals

Item 14: Impulsivity

Item 15: Irresponsibility

Item 16: Failure to accept responsibility for own actions

Item 17: Many short-term marital relationships

Item 18: Juvenile delinquency

Item 19: Revocation of conditional release

Item 20: Criminal versatility

So, is a psychopath’s brain different to a regular person’s brain. Studies have shown that it is. Several studies have been carried out on the brains of people with ASPD in prison. They found three significant differences in the brains of people with ASPD, although it should be stressed that there is not a standard “psychopath brain”.

The first thing they found was that the psychopaths had a larger striatum. The striatum is the largest part of the basal ganglia and is vital for the motor system and the reward system. It is responsible for mediating rewards, cognition, reinforcement, motivational salience, inhibitory control, and impulsivity. People with addictive personalities of OCD often have some kind of dysfunction in the striatum. Psychopaths have a larger striatum which could lead to an increased need for stimulation, and a higher likelihood of impulsive behavior.

The second thing that all of the people with ASPD had was a reduced connection between their ventromedial prefrontal cortex and the amygdala. The prefrontal cortex is largely responsible for empathy and guilt. The amygdala is responsible for fear and anxiety. The brains of psychopaths in prison have fewer connections between the two areas, which means they don’t communicate as they would in a normal brain. It appears that the higher the score the person gets on the psychopath checklist, the more likely it is that they will have significant abnormality in this part of the brain.

The third thing is that psychopaths tend to have much higher levels of testosterone and much lower levels of serotonin and cortisol. Testosterone increases risk taking, aggressiveness, and reward sensitivity. The low levels of cortisol and serotonin decrease stress levels and anxiety, while also reducing sensitivity to punishment.

These are just three of the differences that were found in the brains of psychopaths, but there are obviously many more differences and no two brains are exactly alike. It is impossible to say exactly what causes a psychopath, but the experts do have several ideas. And this is what I learned today.

Sources

https://www.bbc.com/future/article/20180518-can-you-ever-change-a-violent-psychopaths-mind

https://en.wikipedia.org/wiki/Psychopathy