Psychotherapy helps some people with psychopathy, but could hormone treatment be a new line of therapy?
The media portrays psychopaths as people who are prone to planned and targeted, "cold-blooded" criminality.
Psychopathy is a condition characterized by an inability to empathize with others and to feel, or show, social emotions such as guilt, embarrassment or shame. Psychopaths may not be able to understand when another person is afraid.
They also appear to have a high threshold for disgust, which makes it more difficult for them to be repulsed by unethical activities. Aggression and violence are often associated with the condition.
Studies have shown that the individual who suffers from psychopathy is less able to control his or her emotional actions. He or she may succumb to impulsive behavior, making social contact difficult. They can also find themselves in trouble with the law as a result of losing their cool.
Weak connections in the brain could be the cause
Previous studies have indicated weak connections among components that regulate the emotional systems in the brain, believed to account for the psychopath's inability to experience emotions deeply.
Researchers from the Donders Institute at Radboud University in the Netherlands, led by Prof. Karin Roelofs, studied 15 psychopathic criminal offenders to learn more about the effect of testosterone supply on the regulation of emotions.
The research involved the 15 offenders and a control group of healthy subjects completing a task in a magnetic resonance imaging (MRI) scanner. The participants were shown images of faces and were instructed to move a joystick toward themselves if the face was "friendly" and away from themselves if it was "unfriendly."
Moving the joystick required control. Each time the healthy participants moved the joystick in the opposite direction, either toward or away from themselves, the controlling action caused their brains to show a particular pattern of communication between the amygdala, or "emotion center," and the prefrontal cortex.
This was not seen in the people with psychopathy. Moreover, patients with high endogenous testosterone levels displayed far less activity in the prefrontal brain regions. There was also far less communication between the amygdala and the prefrontal brain.
This suggests limited communication between the regions of the brains that control emotions in people with psychopathy. It could offer a neurohormonal explanation for why a person with psychopathy has difficulty regulating their emotions.
The authors comment:
"This study shows how this paradoxical aspect of psychopathy relates to altered neuro-endocrine interactions between testosterone and the cerebral circuit coordinating emotional action tendencies."
While long considered untreatable, researchers from the University of Alabama cited statistics in a 2010 study showing that psychotherapy can have "low to moderate success" among adults with psychopathy, and a higher level of progress among young people. If depression and ADHD can be treated, they argue, why not psychopathy?
The current findings indicate a potential role for testosterone-regulating therapy to help psychopathic patients to control emotions.
Medical News Today has previously published findings indicating a role for learning-based interventions to help people with psychopathy.