We finally are able to identifypathology related to the symptoms of psychopaths. We always understood something was wrong andthat it was most likely physical rather than‘software ‘problem. The prevalence of behavior changes among headinjuries tended to confirm that.
So now there is a glimmer of hopethat practical protocols can be developed to diagnose the condition inchildhood (most important) and engage in practical protocols to at least offsetthe worst effects that could develop when they are most easily accomplished.
Once the condition becomeshardened and converted through the window of maturing sexuality, it isobviously both potentially dangerous and way less likely to be modified. Rationality of the individual may control theproblem in many if not most cases but there will always be a few who simplyfind succumbing the easier path.
Taking this a little further, thepublic deviants must represent the third standard deviation of the populationof similarly affected deviant personalities, the remainder of which havesuccessfully mastered the issues, but just as certainly suffer from them in a controlledfashion.
This then is perhaps thebeginning of a physical path to recognition that then leads to correction andan improvement in mental health for everyone affected.
Brain scans suggest psychopaths could be treated
06 April 2011 by JessicaHamzelou
Psychopaths are typically considered untreatable, DANGEROUS,manipulative and, above all, untreatable, but brain scans could change that.The traditional picture of the psychopath is one that everyone, frompsychiatrists to members of a jury, seems to share.
But although this picture encourages a "lock them up and throwaway the key" mentality, surprisingly little is really known about how, orif, rehabilitation is possible for psychopaths. Now, brain scans of childrenwith psychopathy-like conditions suggests objective ways to diagnosepsychopathy, new targets for therapy - and techniques for settling the questionof whether or not psychopaths can be successfully treated and released.
For 15 years, psychiatrists have relied on the Hare psychopathychecklist to diagnose the condition. The revised version - the PCL-R - consistsof a formal interview and an analysis of an individual's past behaviour, whichis scored for indicators including superficial charm, pathological lying, agrandiose sense of self-worth, and a lack of guilt or empathy. The PCL-R isgenerally accepted as the best available way to diagnose psychopathy, but suchinterview-based methods are vulnerable to subjective scoring, and cleverindividuals can learn how to pass them.
"Psychopaths by their nature are deceitful and cunning, so theycan pick up on what authorities want to hear," says MichaelKoenigs, a neuroscientist at the University of Wisconsin Madison
Looking for the signs of psychopathy in brain scans could sidestep suchproblems, but with every new glimpse into the psychopathic brain, the pictureseems to become more confused.
For instance, initial studies of brain activity as psychopaths werepresented with photographs of negative emotional scenes showed abnormally highactivity in the cerebellum, fusiform gyrus and postcentral gyrus, suggestingthese brain regions are involved in the condition. But a repeat run of theexperiment in different psychopaths revealed different foci of abnormalactivity: the medial temporal lobe, and occipital and parietal cortices (MolecularPsychiatry, DOI: 10.1038/mp.2010.124).
Such results suggest that identifying psychopaths through brain scansis no easy task, says Marcus Raichle at Washington University in St Louis , Missouri
The study of children with psychopathic traits could help. So-calledcallous unemotional traits are considered symptoms of psychopathy in children,and some, though not all, go on to be diagnosed with psychopathy as adults. Thecondition is thought to be genetic in around half of them. These youngsters mayalready have embarked on a similar lifestyle to adult psychopaths, but theirbrains have had less time to pick up the signatures associated with thisdamage, so pinpointing the brain behaviour relating directly to the conditionmay be easier.
Two recent studies point the way. Graeme Fairchild and his colleagues at Southampton University in the UK
However, a different picture emerged when Fairchild's team focused onthe adolescents with conduct disorder who also showed callous unemotionaltraits. Brain areas involved in reward processing, including the striatumand caudate nucleus, were larger than normal, whereas they were smaller thannormal in those with conduct disorder only (American Journal of Psychiatry,DOI:10.1176/appi.ajp.2010.10081184). The finding might explain why callousunemotional adolescents seek instant gratification, says Fairchild.
Raichle and his colleagues are also studying the adolescent brain, andin particular the structure of white matter - the tracts that make up thebrain's connections. They scanned the brains of 107 incarcerated teens andfound that, for those who showed impulsive behaviour, rising levels ofactivity in the motor cortex - a region responsible for planning voluntaryactions - were matched by rises in brain regions responsible for introspection.In contrast, there was a fall in introspection in non-impulsive teens when theyplanned actions, but a rise in the activity of regions involved in attentionand control.
This suggests that impulsivity - a key marker of psychopathy-liketraits in adolescents - is linked to abnormal connections between theseregions of the brain, says Raichle, who presented the findings at the Latin AmericanSchool for Education Cognitive and Neural Sciences in San Pedro de Atacama , Chile
The two studies provide the best evidence yet that there arestructural abnormalities in the brains of children with callous unemotionaltraits, says Koenigs. They also offer researchers new targets for attemptsto reverse the condition - and perhaps also for reversing the symptoms ofpsychopathy. For instance, the link between psychopathic-like traits andenlarged reward-processing areas suggests "we may need to focustherapies on rewards rather than punishments", Fairchild says.Raichle, meanwhile, thinks his work suggests that psychopaths could be helpedthrough training to better control their actions.
More importantly, the studies suggest there may be better ways to judgethe success of any therapy. Questionnaire-based methods rely on psychopathsgiving honest answers. A brain-scan approach gets around this obstacle andmeans the notion that psychopaths are untreatable can now be put to the test.
Kent Kiehl at the University of New Mexico in Albuquerque is using a mobile MRI scanner to study the brains of psychopathic inmates inprisons across New Mexico
The ability to be moral
"Language and general intelligence are intact in psychopaths, sothey can recite social norms and legal rules," says MichaelKoenigsof the University of Wisconsin , Madison
But are they able to make moral decisions?
To find out, Koenigs and his colleagues have used hypotheticalsituations. "For example, you're in a shipwreck and end up in a lifeboatthat's overcapacity," says Koenigs. "You would need to throw a numberof people overboard to save the rest. Could you do it?" Most people findit very difficult to answer this question, but psychopaths appear to makesimple mathematical calculations. This suggests these individuals can't tellthe difference between what is morally right and wrong.
However, Maaike Cima's team at Tilburg University in the Netherlands
The debate could raise issues of culpability in the courts. "Ifpsychopaths are lacking that moral response, you could argue that their abilityto control their behaviour is compromised," says Koenigs. "It couldaffect whether the sentence is punitive or a mental health issue."
Kent Kiehl, also at the University of New Mexico, thinksevidence of moral reasoning abilities could offer hope for treatingpsychopaths. "They have the capacity to make reasonable decisions,"Kiehl says. "It's now a case of getting them to do that in the real world."
No comments:
Post a Comment