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Neurophysiological correlates of action monitoring in violent psychopathic offenders

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Inti A. Brazil
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Psychopathie wordt gekenmerkt door affectieve disfuncties in combinatie met antisociaal gedrag. Individuen met psychopathie zijn onder andere te vinden in Forensisch Psychiatrische Centra (tbs-klinieken), waar ze een behandeling krijgen. Hoewel er successen worden geboekt, blijft het een uitdaging om het gedrag van patiënten met psychopathie te behandelen. Om beter te begrijpen waarom dit zo is, vindt er steeds meer onderzoek plaats over cognitief functioneren bij deze patiënten. Een van de aspecten waarop zij lijken te verschillen van de gezonde populatie is de manier waarop zij omgaan met informatie over fouten, die als cues horen te fungeren om gedrag aan te passen. Dit artikel geeft een beknopt overzicht van recente bevindingen over foutenverwerking in het brein van forensische patiënten gediagnosticeerd met psychopathie, en bespreekt een mogelijke richting voor het ontwikkelen van nieuwe behandelvormen voor deze groep.
Inti A. Brazil
added 6 research items
Psychopathy is a severe personality disorder often leading to violent and disruptive antisocial behavior. Efficient and proper social behavior crucially relies on monitoring of one's own as well as others' actions, but the link between antisocial behavior in psychopathy and action monitoring in a social context has never been investigated. Event-related potentials were used to disentangle monitoring of one's own and others' correct and incorrect actions in psychopathic subjects (n = 18) and matched healthy control subjects (n = 18). The error-related negativity (ERN) was investigated following own and other's responses in a social flanker task. Although both groups showed similar event-related potentials in response to own actions, amplitudes after the observation of others' action-outcome were greatly reduced in psychopathy. More specifically, the latter was not unique to observed errors, because the psychopathic group also showed reduced brain potentials after the observation of correct responses. In contrast, earlier processing of observed actions in the motor system, as indicated by the lateralized readiness potential, was unimpaired. Monitoring of own behavior is not affected in psychopathy, whereas processing of the outcome of others' actions is disturbed. Specifically, although psychopathic individuals do not have a problem with initial processing of the actions of others, they have problems with deeper analyses of the consequences of the observed action, possibility related to the reward value of the action. These results suggest that aspects of action monitoring in psychopathy are disturbed in social contexts and possibly play a central role in the acquisition of abnormal social behavior.
Recent studies have shown that while psychopathy and non-psychopathic antisociality overlap, they differ in the extent to which cognitive impairments are present. Specifically, psychopathy has been related to abnormal allocation of attention, a function that is traditionally believed to be indexed by event-related potentials (ERPs) of the P3-family. Previous research examining psychophysiological correlates of attention in psychopathic individuals has mainly focused on the parietally distributed P3b component to rare targets. In contrast, very little is known about the frontocentral P3a to infrequent novel events in psychopathy. Thus, findings on the P3 components in psychopathy are inconclusive, while results in non-psychopathic antisocial populations are clearer and point toward an inverse relationship between antisociality and P3 amplitudes. The present study adds to extant literature on the P3a and P3b in psychopathy by investigating component amplitudes in psychopathic offenders (N = 20), matched non-psychopathic offenders (N = 23) and healthy controls (N = 16). Also, it was assessed how well each offender group was able to differentially process rare novel and target events. The offender groups showed general amplitude reductions compared to healthy controls, but did not differ mutually on overall P3a/P3b amplitudes. However, the psychopathic group still exhibited normal neurophysiological differentiation when allocating attention to rare novel and target events, unlike the non-psychopathic sample. The results highlight differences between psychopathic and non-psychopathic offenders regarding the integrity of the neurocognitive processes driving attentional allocation, as well as the usefulness of alternative psychophysiological measures in differentiating psychopathy from general antisociality.
One of the most recognizable features of psychopathy is the reduced ability to successfully learn and adapt overt behavior. This might be due to deficient processing of error information indicating the need to adapt controlled behavior. Event-related potentials (ERPs) and behavioral components of error-monitoring processes were investigated in 16 individuals with psychopathy and in 18 healthy subjects. A letter version of the Eriksen flanker task was used in two conditions. The first condition (normal condition) required participants to press one of two buttons depending on the identity of the target stimulus. The second condition (signaling condition) required them to signal each time they had committed an error by making a second press on a signaling button. Early stages of error monitoring were investigated by using the error-related negativity (ERN/Ne) and post-error slowing as indexes. Later stages were explored by examining the error positivity (Pe) and signaling rates. Both groups showed similar ERN amplitudes and amounts of post-error slowing. The psychopathic group exhibited both reduced Pe amplitudes and diminished error-signaling rates compared with the control group. Individuals with psychopathy show intact early error processing and automatic behavioral adaptation but have deficits in later stages of error processing and controlled behavioral adaptation. This is an indication that individuals with psychopathy are unable to effectively use error information to change their behavior adequately.