RxPG News : Forensic Psychiatry

Criminal Psychopaths showed reduced activation in brain when processing emotional facial expressions

Fri, 01 Dec 2006 16:30:02 PST

( from http://www.rxpgnews.com ) A new study has found that there are biological brain differences among criminal psychopaths, compared with normal people, when they process facial emotion.

The criminal psychopaths showed reduced activation in brain when processing emotional facial expressions. Also, viewing fearful faces is associated with relative deactivation of face processing areas in psychopaths.

It has been suggested that people with psychopathic disorders lack empathy because they have defects in processing facial and vocal expressions of distress, such as fear and sadness, in others.

The aims of this study, published in the December issue of the British Journal of Psychiatry, were to investigate brain function when people with psychopathy and a control group process facial emotion.

The researchers used a brain imaging technique known as event-related functional magnetic resonance imaging (fMRI) to examine neural responses when people with psychopathy and a control group viewed expressions of distress (fearful faces), of positive emotion (happy faces), and neutral faces.

They compared 6 psychopaths (people scoring over 25 on a psychopathy checklist) and 9 non-psychopathic healthy volunteers. All the people with psychopathy were repeat offenders with multiple offence types, including attempted murder, manslaughter, multiple rape with strangulation and grievous bodily harm.

Participants were studied, using a brain scanner, when they were presented with facial expressions of happiness and fear, and also with neutral expressions. They were asked to decide the gender of each face, so allowing ‘implicit’ or automatic brain responses to facial expressions to be measured.

It was found that the psychopathy group showed significantly less activation than the control group in the fusiform and extrastriate areas of the brain when processing both facial expressions. These brain regions are known, in the healthy population, to be involved in the visual analysis of faces, and are more active when processing emotional, compared to neutral, facial expressions.

However, emotion type affected response pattern.

Both groups increased fusiform and extrastriate cortex activation when processing happy faces compared with neutral faces, but this increase was significantly smaller in the psychopathy group.

By contrast, when processing fearful faces compared with neutral faces, the control group showed increased activation, but the psychopathy group decreased activation, in the fusiform area.

In summary, people with psychopathy showed reduced activation in brain regions which process facial expressions in response to both fearful and happy faces, compared with controls. Also viewing fearful faces is associated with relative deactivation of face processing areas in psychopaths.

These results suggest that the neural pathways for processing facial expressions of happiness are functionally intact in people with psychopathic disorder, although less responsive than those of controls. In contrast, fear is processed in a very different way.

The researchers comment that failure to recognise and emotionally respond to facial and other signals of distress may underlie failure to inhibit behaviour that causes distress in others during social interactions – or, more generally, may underlie the lack of emotional empathy observed among people with psychopathy.

Reduced emotional responses to facial expressions of distress may lead to failure to learn links between behaviour causing distress to others and ‘aversive arousal’, so contributing to impaired moral socialisation in people with psychopathy.

Further, impairment of aversive conditioning may make people with psychopathy less anxious when anticipating the consequences of their actions, and less responsive to punishment for them.

Further studies are needed to clarify how brain abnormalities in people with psychopathy arise, and how they affect social behaviour and socialisation.

Sleep Apnea Treatment Curbs Aggression in Sex Offenders

Fri, 17 Nov 2006 13:35:37 PST

( from http://www.rxpgnews.com ) Obstructive sleep apnea (OSA) affects up to 20% of men in western cultures, 5% of whom experience significant physical symptoms. A study published in Journal of Forensic Sciences finds that sex offenders who suffer from OSA experience more harmful psychological symptoms than do sex offenders with normal sleep patterns.

Sex offenders with known OSA were administered a treatment using continuous positive airway pressure (CPAP), whereby compressed air is applied into the nose and/or mouth through a respiratory mask while the subject sleeps. The subjects were given criteria and asked to score themselves based on personal anger, verbal aggression, hostility and physical aggression before and after treatment.

The subjects scored themselves significantly lower (better) post-CPAP treatment, but it is unclear whether this treatment will lead to observational changes in behavior.

The current study shows a potentially important relationship between sleep and aggression, and supports the need for further investigation of sleep disorders and disordered sexual behavior, says Dr. J. Paul Fedoroff, lead author of the study.

Adding Scientific Insight to Loaded Label of 'Psychopath'

Tue, 04 Jul 2006 01:51:37 PST

( from http://www.rxpgnews.com ) For most people on the planet, the term "psychopath" evokes thoughts of violence and bloodshed - and evil of the darkest kind. But during 25 years, a psychologist at the University of Wisconsin-Madison has built a body of work that may help temper such deeply ingrained perceptions.

Sure, people do commit horrific, unimaginable crimes. But does that automatically mean they are psychopathic? And what is "psychopathy" anyway? With unique research access to prison inmate populations in Wisconsin, Joseph Newman has devoted his career to answering such questions.

The proper understanding of psychopathy has implications for the treatment of inmates everywhere - particularly for those who are wrongfully labeled. Newman's work could also serve as the backbone of new behavioral interventions that target psychopathic behaviors.

"My main concern is that the label (of psychopath) is applied too liberally and without sufficient understanding of the key elements," says Newman, who is chair of the UW-Madison psychology department. "As a result, the term is often applied to ordinary criminals and sex offenders whose behavior may reflect primarily social factors or other emotional problems that are more amenable to treatment than psychopathy."

But trying to alter stereotypes about a reviled segment of society has been a long and uphill road. For one thing, prison studies are notoriously difficult to do, as researchers must contend with a laundry list of challenges such as issues of access and other constraints related to the protection of inmate rights. The field of psychopathy is also a contentious one, and Newman - who has put forward a provocative theory about the condition - has consistently faced opposition from his scientific peers.

The scientist has persevered, however, demonstrating in study after study the potential merit of his claims. And during the years, Newman's patient, steady approach has earned the respect of top researchers in the field.

"In looking back, I see (Newman) as one of the preeminent research scientists in the field - his work is ingenious, meticulous, methodologically sophisticated and driven by theory," says Robert Hare, a leading psychopathy expert at the University of British Columbia. "I really think he's the top man in the area."

So who are psychopaths? Broadly speaking, they are people who use manipulation, violence and intimidation to control others and satisfy selfish needs. They can be intelligent and highly charismatic, but display a chronic inability to feel guilt, remorse or anxiety about any of their actions.

Scientists estimate that 15-25 percent of men and 7-15 percent of women in U.S. prisons display psychopathic behaviors. The condition, however, is hardly restricted to the prison system. Newman estimates that up to 1 percent of the general population could be described as psychopathic. Surprisingly, many who fall into that bracket might lead perfectly conventional lives as doctors, scientists and company CEOs.

"Psychopathy appears to exist throughout the world and has probably existed throughout history," Newman says.

Behavioral specialists now use the Psychopathy Checklist-Revised - a diagnostic questionnaire created by Hare - to detect psychopathy. But although there is finally consensus on the best way to identify the condition, there is still a lot of disagreement on why it occurs in the first place.

The dominant scientific model asserts that psychopathic individuals are incapable of fear or other emotions, which in turn makes them indifferent to other people's feelings.

But Newman has a different idea entirely. He believes that psychopathy is essentially a type of learning disability or "informational processing deficit" that makes individuals oblivious to the implications of their actions when focused on tasks that promise instant reward. Being focused on a short-term goal, Newman suggests, makes psychopathic individuals incapable of detecting surrounding cues such as another person's discomfort or fear.

In a study he repeated in different prison populations, for instance, Newman examined how quickly psychopathic and non-psychopathic individuals respond to a series of mislabeled images, such as a drawing of a pig with the word "dog" superimposed on it. Researchers flashed each image and then timed how long it took for subjects to name what they saw.

Over and over again, Newman found that non-psychopathic subjects subconsciously stumbled on the misleading labels and took longer to name the images. But psychopathic subjects barely noticed the discrepancy and consistently answered more quickly.

Newman says the result is one instance of how psychopathic individuals have difficulty processing peripheral cues, even when those cues are entirely obvious to everyone else. Furthermore, the study task didn't involve any of the emotions that people commonly associate with psychopathy, such as anger or a lack of fear. So the fact that psychopathic subjects barely noticed the wrongful labels - even in the absence of emotional cues - supports the idea that a psychological deficit might be at play.

"People think (psychopaths) are just callous and without fear, but there is definitely something more going on," Newman says. "When emotions are their primary focus, we've seen that psychopathic individuals show a normal (emotional) response. But when focused on something else, they become insensitive to emotions entirely."

Such studies certainly haven't been easy to do. Prison staff, space and financial resources are usually in short supply, and because inmate movements are restricted, Newman and his students routinely work under challenging time limitations. Still, the unwavering cooperation from the Wisconsin Department of Corrections (DOC) has far outweighed any problems. Indeed, the willingness of the DOC to grant him research access was one of the main reasons why Newman, a New Jersey native, decided to join the UW-Madison faculty in 1981.

"The cooperation that exists between the Wisconsin DOC and my university project is unprecedented and enviable," says Newman. "Over the years, the project has involved thousands of inmates, prison staff, university research assistants and correctional officials. We have never had a negative incident or breach of confidentiality and I believe everyone has benefited from this collaboration and found it to be enjoyable."

Dale Bespalec, the psychologist supervisor at the Milwaukee Secure Detention Facility, believes that Newman's work is crucial at a time when correctional authorities nationwide are struggling to understand the most effective ways to work with psychopathic individuals.

"We need to know more about this population as it presents unique challenges to the prison system and our efforts at rehabilitation and treatment," he says. " Everything that we can learn (about psychopathy) can impact our attempts to change people's patterns of behavior. Newman's work is likely to impact the entire field and not just Wisconsin."

But in order for psychopathy research to give rise to new behavioral treatment approaches, Newman says scientists need to get together, discuss ideas and continually challenge the status quo. "There has been a tendency to recycle the same intuitively appealing ideas rather than pursue critical tests of new ideas," he says.

To help generate fresh discussion and debate, Newman and others recently founded the Society for the Scientific Study of Psychopathy. The group, which has about 100 members, held its first international meeting in Canada last year.

"In addition to attracting talent to the field, it is important for investigators to cooperate," says Newman. "We need to listen to each other to benefit from feedback, we need to acknowledge the importance of diverse questions, and we need to cooperate in communicating the importance of this significant mental health problem."

Religion Helps Reduce Negative Prison Behaviors

Fri, 02 Dec 2005 19:25:38 PST

( from http://www.rxpgnews.com ) A new study in the December issue of the Journal for the Scientific Study of Religion finds that the practice of religion in prison reduces the likelihood of arguments and physical fights among inmates. It is the first study of religion and prison behavior using a random sample survey of inmates at a large prison facility.

Researchers, led by University of Alabama at Birmingham (UAB) criminologist Kent Kerley, Ph.D., surveyed 386 inmates at the Mississippi State Penitentiary. Inmates were asked about family and criminal histories, religious beliefs, participation in prison ministries and the frequency of arguments and physical fighting among themselves.

The study found that religious beliefs and participation in religious services or faith-based programs significantly reduced inmates chances for getting into arguments with other inmates. Inmates who believed in a higher power were 74 percent less likely to engage in arguments than non-believers. Inmates who attended weekly religious services and faith-based programs were half as likely to engage in arguments than other inmates.

The researchers found no direct link between religious beliefs and physical fighting. Religious inmates, however, generally argued less, and therefore, were less likely to get into physical fights.

We dont suggest that prisons devote more funds to chaplains and faith-based programs at the expense of programs that have been found to be effective such as GED and college programs and job training programs, said Kerley. But the results suggest that inmates should be given the options. Faith-based programs are usually inexpensive and are conducted by staff chaplains and local volunteers.

Antisocial Behaviour Associated With Gene Variant

Tue, 08 Nov 2005 17:40:38 PST

( from http://www.rxpgnews.com ) For children with attention deficit hyperactivity disorder (ADHD), possessing a variant of a gene involved in brain signaling may predict antisocial behavior and increase susceptibility to the effects of lower birth weight, according to a study in the November issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

Biological processes play a key role in the genesis of antisocial behavior with specific evidence of brain involvement and contribution of genetic and early environmental risk factors, including prenatal factors, according to background information in the article. Given the links between deficits in a brain region called the prefrontal cortical and antisocial behavior and between the enzyme catechol O-methyltranferase (COMT) and prefrontal cortical functioning, the authors suggest that a variant of the COMT gene might be associated with antisocial behavior.

Anita Thapar, M.D., of Cardiff University, Cardiff, Wales, and colleagues looked for the presence of a variant in the COMT gene in 240 British children, aged five to 14 years with ADHD or hyperkinetic disorder who are at high risk for early-onset antisocial behavior. The researchers used the children's birth weight as a marker for prenatal risk to determine the contribution of the environment to risk of developing symptoms of early-onset antisocial behavior.

The researchers found a significant association between the COMT variant and antisocial behavior; and between low birth weight and antisocial behavior. There was also a significant gene and environment (low birth weight) interaction associated with antisocial behavior.

"Early-onset antisocial behavior in a high-risk clinical group is predicted by a specific COMT gene variant previously linked with prefrontal cortical function and birth weight, and those possessing the val/val genotype are more susceptible to the adverse effects of prenatal risk as indexed by lower birth weight," the authors conclude.

Simple screening tool enables prison officers to identify prisoners with severe mental illness

Fri, 02 Sep 2005 02:30:38 PST

( from http://www.rxpgnews.com ) A new screening tool has been developed that shows promise for the identification of prisoners with severe mental illness by prison officers.

Many prisoners have severe mental health problems, but traditional mthods of health screening at reception into prison are quite ineffective.

Once prisoners with mental illness find their way on to ordinary prison wings, there is a significant risk that their mental problems will remain unrecognised, and their needs unmet.

The Department of Health wants to develop prison mental health services. According to the National Health Service Plan, 5000 prisoners at any one time should be receiving comprehensive mental health services in prison; all those with severe mental illness should receive treatment; and no prisoner with severe mental illness will leave prison without a care plan and a care co-ordinator.

Reception health screening will play a key part in achieving this, but other screening methods, such as using the observational skills of prison officers, could make an important contribution.

This study, published in the September issue of the Psychiatric Bulletin, took place at Her Majesty's Prison Winchester, a local prison housing adult male prisoners. At the time of the study the prison held about 550 men (30% sentenced and 70% on remand).

The screening tool was developed from open-ended interviews with prison officers, and diagnostic interviews with prisoners. The researchers selected the behaviours identified by prison officers that were most consistently associated with a finding of severe mental illness (based on the diagnostic interview), and grouped these into themes to develop the criteria in the tool.

The screening tool
1. Is the inmate excessively isolating himself from staff and other inmates?
2. Is the inmate's behaviour persistently erratic and/or bizarre?
3. Are the sleeping and eating patterns of the inmate causing concern?
4. Has there been a sudden unexplained change in the inmate's presentation, such as stopping work for no obvious reason?
5. Has the inmate's personal hygiene appeared strange, changed suddenly or deteriorated?
6. Any other symptoms that are likely to suggest the inmate has a mental illness? (If yes, then specify).

A case-comparison study was used to evaluate the tool. 50 prisoners identified by officers as meeting one or more of the screening tool criteria, and 50 randomly selected prisoners, were given diagnostic interviews to determine the proportion in each group with severe mental illness.

19 out of 50 (38%) of the cases identified by prison officers were found to have severe mental illness, compared with none in the comparison group. Prisoners from the case group were more likely to have been living in temporary accommodation or to have been homeless before imprisonment.

The authors of the study conclude that they have developed a short and simple screening tool that has proved to be quick and easy to use with prison officers. Like a new prison reception health screen that has been developed, this screening tool does not rely on staff having to make judgements they are not necessarily trained to make, but uses simple yes/no criteria linked to a protocol.

The tool needs to be evaluated further in other male prisons to determine its effectiveness in these settings. It also needs to be tested in clinical practice when it is applied by prison mental health in-reach staff, rather than a researcher. Similar tools should be developed for use in young offender and women's prisons.

Dads behind bars see Prison as a chance to Think

Thu, 31 Mar 2005 21:05:38 PST

( from http://www.rxpgnews.com ) Dads behind bars see prison as a chance to think about the needs of their children and an opportunity to re-bond with them.

Over the last few years, issues about fathers living apart from their children have been in the spotlight, and with the growing prisoner population in this country, fathering from prison is emerging as another context in which to understand the contemporary experience of fathers. In fact research indicates that 25% of young men in prison are fathers or expectant fathers, so there are growing concerns about the impact of paternal imprisonment on child and family welfare.

Dr Van Lesson conducted interviews with 43 prisoners, with 21 cases also involving telephone interviews with partners. She also held a focus group with a further group of prisoners.

She found many prisoners viewed prison as a fresh start which gave them the space to think about the needs of their children and the opportunity to re-bond with them either through visits, telephone calls or letters.

Despite the physical boundaries imposed by a prison environment, many dads reported feeling emotionally closer to their children since imprisonment. There were many instances of dads expressing that they did not want their children to go down the same route as they had and finish up in prison, and that they needed to become better role models on release.

Dr Van Lesson states: "This research shows that not only do we need to start taking account of the impact of offenders on society, but we also need to start looking at the impact their imprisonment has on their children. In the UK the prison service is well placed to integrate some prison based rehabilitation initiatives with family life and positive parenting becoming part of the wider release plan for prison Dads. Most importantly, findings from this prison based research have implications for being able to motivate prison Dads to stop re-offending in the future".

Poor Educational Outcomes are linked to Youth Offending

Thu, 31 Mar 2005 21:05:38 PST

( from http://www.rxpgnews.com ) Youngsters who commit crime are more likely to have problems at school and to have missed weeks of teaching because they were excluded.

She examined all of the 73 secondary school age youngsters who were sentenced to work with Peterborough's Youth Offending Service on one day at the beginning of the 2003/2004 school year.

The researcher discovered that three quarters of the youngsters had been excluded from school and that this exclusion was not due to being in custody. The average length of exclusion was 32 days and nearly one in five (19%) had a permanent exclusion.

A number of concerns had also been highlighted in the educational and youth offending records of the young people with the highest number of days out of education due to exclusions. These were reported experiences of bullying, mental health concerns, having educational needs, having a family history of crime, domestic violence in the family, poor teacher relationships and educational underachievement.

Seven young people were without an allocated school place at the time of the study. The research showed that these youngsters were prolific offenders. Between them they were convicted of a total of 162 separate offences, which is an average of 23 each.

Zoë Ashmore said: "Keeping young people engaged in education is an essential building block for their future. Young people not attending school can become socially excluded and their lack of education means they can struggle in later life, meaning their adolescent educational difficulties can mar them long afterwards. They also miss out on the whole range of social and life skills, both taught formally and informally, through our education system."

The researcher admitted overcoming these difficulties is a major challenge for Youth Offending Teams who want to integrate young offenders into their community to reduce offending.