Some people are now quite optimistic about the possibility of treating psychopathy with drugs that directly modulate brain function. I argue that this optimism is misplaced. Psychopathy is a global disorder in an individual’s worldview, including his social and moral outlook. Because of the unity of this Weltanschauung, it is unlikely to be treatable in a piecemeal fashion. Recent neuroscientific methods do not give us much hope that we can replace, in a wholesale manner, problematic views of the world with (...) more socially desirable ones. There are, therefore, principled reasons that psychopathy is so singularly treatment resistant. (shrink)

Psychopathic behavior is characteristically amoral, but to date research studies have largely failed to identify any systematic differences in moral judgment capability between psychopaths and non-psychopaths. In this study, we investigate whether significant differences in moral judgment emerge when taking into account the phenotypic heterogeneity of the disorder through a well-validated distinction between psychopathic subtypes. Three groups of incarcerated participants [low-anxious psychopaths (n 1⁄4 12), high-anxious psychopaths (n 1⁄4 12) and non-psychopaths (n 1⁄4 24)] completed a moral judgment test involving (...) hypothet- ical dilemmas. The moral dilemmas featured personal (i.e. involving direct physical harm) or impersonal (i.e. involving indirect or remote harm) actions. Compared to non-psychopaths, both groups of psychopaths were significantly more likely to endorse the impersonal actions. However, only the low-anxious psychopaths were significantly more likely to endorse the personal harms when commission of the harm would maximize aggregate welfare the utilitarian choice. High-anxious psychopaths and non-psychopaths did not significantly differ in their personal moral judgments. These results provide novel laboratory evidence of abnormal moral judgment in psychopaths, as well as additional support for the importance of considering psychopathic subtypes. (shrink)

Psychopathy attracts considerable interdisciplinary interest. The idea of a group of people with abnormal morality and interpersonal relations raises important philosophical, legal, and clinical issues. However, before engaging these issues, we ought to examine whether this category is scientifically grounded. We frame the issue in terms of the question whether ‘psychopathy’ designates a natural kind according to the cluster approaches. We argue that currently there is no sufficient evidence for an affirmative answer to this question. Furthermore, we examine three ways (...) of dealing with the category of psychopathy. We could eliminate the category, revise it, or subscribe to a more encompassing account of kinds, which could capture psychopathy as it is currently conceptualized. We argue that while a revision of the category of psychopathy is to be expected with empirical and theoretical advancements, we also emphasize its role in clinical and forensic research that makes it an important pragmatic kind. (shrink)

We argue that the mandatory moral bioenhancement of psychopaths is justified as a prescription of social morality. Moral bioenhancement is legitimate when it is justified on the basis of the reasons of the recipients. Psychopaths expect and prefer that the agents with whom they interact do not have certain psychopathic traits. Particularly, they have reasons to require the moral bioenhancement of psychopaths with whom they must cooperate. By adopting a public reason and a Kantian argument, we conclude that we can (...) justify to a psychopath being the recipient of mandatory moral bioenhancement because he has a reason to require the application of this prescription to other psychopaths. (shrink)

Psychopathy is associated with persistent antisocial behavior and a striking lack of regret for the consequences of that behavior. Although explanatory models for psychopathy have largely focused on deficits in affective responsiveness, recent work indicates that aberrant value-based decision making may also play a role. On that basis, some have suggested that psychopathic individuals may be unable to effectively use prospective simulations to update action value estimates during cost–benefit decision making. However, the specific mechanisms linking valuation, affective deficits, and maladaptive (...) decision making in psychopathy remain unclear. Using a counterfactual decision-making paradigm, we found that individuals who scored high on a measure of psychopathy were as or more likely than individuals low on psychopathy to report negative affect in response to regret-inducing counterfactual outcomes. However, despite exhibiting intact affective regret sensitivity, they did not use prospective regret signals to guide choice behavior. In turn, diminished behavioral regret sensitivity predicted a higher number of prior incarcerations, and moderated the relationship between psychopathy and incarceration history. These findings raise the possibility that maladaptive decision making in psychopathic individuals is not a consequence of their inability to generate or experience negative emotions. Rather, antisocial behavior in psychopathy may be driven by a deficit in the generation of forward models that integrate information about rules, costs, and goals with stimulus value representations to promote adaptive behavior. (shrink)

Researchers who argue that moral judgment is based on emotions (`emotion-backers') and those who believe that it is based on reasoning and deliberation (`reasoning-backers') have both struggled to account for the notorious moral deviance of incarcerated psychopaths. Emotion-backers, such as Jonathan Haidt, focus on psychopaths' lack of a affect,or defciencies in particular emotions, such as sympathy. Reasoning-backers, such as Lawrence Kohlberg, focus instead on psychopaths' de cient reasoning. Both accounts offer separate descriptions of what goes wrong in the disorder, but (...) neither can fully explain psychopathic moral deviance. The moral account that I built, bridges these accounts in an attempt to better and more fully describe the empirical data available on psychopathic moral judgment. I argue that their judgment is best explained with a dual-process account of moral judgment that incorporates a large system of moral emotions as well as integrates multiple bases of morality, such as concerns of fairness, harm, and purity. It is only by focusing on both the reasoning and emotional de cits in psychopaths that we can begin to understand psychopaths' use of utilitarian reasoning, general population psychopaths, and psychopaths' di erential presence in the prison popu- lation. All of these issues are best described using a dual-process account of moral judgment that incorporates a larger system of moral emotions than other accounts of morality as well as a pluralistic conception of moral foundations. I used psychopaths because their moral deviance can teach us about morality more broadly. By understanding the cognitive processes implicated in the moral judgment of psychopaths, I better explain how moral judgment works in the general population more broadly. My account of moral judgment has both theoretical and practical applications. Theoretically, it o ers a new dual-process paradigm for describing moral behaviour which bridges reasoning-based and emotion-based accounts. This description can explain both the moral deviance of psychopaths as well as, more broadly, moral judgment in non-psychopaths. Additionally, my theory challenges accounts of moral emotion that narrowly focus on speci c emotions, such as guilt or empathy. It in- stead integrates all emotions, including disgust, fear, and sympathy, and links speci c emotions to moral judgments. Practically, my paradigm of moral judgment encourages the development of new moral judgment measurements such as new self-report questionnaires of moral reasoning. According to my research, in order for these tools to accurately measure morality, they need to account for both emotion-based and reasoning-based judgments. (shrink)

Psychopathy is a personality disorder characterized by callous antisocial behavior and criminal recidivism. Here we examine whether psychopathy is associated with alterations in functional connectivity in three large-scale cortical networks. Using fMRI in 142 adult male prison inmates, we computed resting-state functional connectivity using seeds from the default mode network, frontoparietal network, and cingulo-opercular network. To determine the specificity of our findings to these cortical networks, we also calculated functional connectivity using seeds from two comparison primary sensory networks: visual and (...) auditory networks. Regression analyses related network connectivity to overall psychopathy scores and to subscores for the “factors” and “facets” of psychopathy: Factor 1, interpersonal/affective traits; Factor 2, lifestyle/antisocial traits; Facet 1, interpersonal; Facet 2, affective; Facet 3, lifestyle; Facet 4, antisocial. Overall psychopathy severity was associated with reduced functional connectivity between lateral parietal cortex and dorsal anterior cingulate cortex. The two factor scores exhibited contrasting relationships with functional connectivity: Factor 1 scores were associated with reduced functional connectivity in the three cortical networks, whereas Factor 2 scores were associated with heightened connectivity in the same networks. This dissociation was evident particularly in the functional connectivity between anterior insula and dorsal anterior cingulate cortex. The facet scores also demonstrated distinct patterns of connectivity. We found no associations between psychopathy scores and functional connectivity within visual or auditory networks. These findings provide novel evidence on the neural correlates of psychopathy and suggest that connectivity between cortical association hubs, such as the dorsal anterior cingulate cortex, may be a neurobiological marker of the disorder. (shrink)