Högskolan i Skövde

The purpose of this systematic review is to investigate the neurological pathology of psychopathy and more specifically the underlying structural differences between successful and unsuccessful psychopaths. This study primarily focuses on variations in gray matter volume and structural brain differences within brain regions such as the prefrontal cortex, orbitofrontal cortex, medial frontal cortex, amygdala and striatum. Psychopathy is a complex personality disorder consisting of affective, interpersonal, antisocial and affective traits. Distinct features of a psychopath are lack of remorse and empathy, impulsivity, callousness and manipulative tendencies. A psychopath cannot form any emotional connections nor any long-lasting meaningful relationship with others, resulting in not being able to live in harmony with societal norms. Within psychopathy there are two subtypes of psychopathy: successful and unsuccessful psychopaths. Unsuccessful psychopaths have difficulty living in harmony with societal norms, engage in violent crimes, which lead to incarceration. Successful psychopaths, however, do not have a history of crime or incarceration and can often achieve a successful career. By screening articles using magnetic resonance imaging (MRI), this study examined psychopathy with successful and unsuccessful psychopaths as the focal point. To assess psychopathy the most common measurement tool Psychopathy Checklist-Revised (PCL-R) was used. Results show that gray matter decreases are frequently seen in unsuccessful psychopaths, especially in the OFC and amygdala. These brain areas are strongly linked to deficiencies in emotional control, decision-making and social conduct. Successful psychopaths displayed a relatively intact prefrontal cortex which may explain their improved cognitive behavior and control of social situations to avoid punishment.