This Sunday’s observer had 4 pages devoted to the research and thinking of Adrian Raine, Professor at the University of Pennsylvania and one of the foremost researchers on the brain and psychopaths. The article asks many important questions about what gives rise to psychopaths, and is critical of the idea that nurture (such as childhood trauma or poverty) causes this. His new book, the Anatomy of Violence [1], also has in its title, the Biological Roots of Crime, and the guardian article was titled 'How to spot a murderers' brain (click for article) . It is the implications of this that worry me.

 

 It is important to understand why psychopaths exist, especially given the recent spate of abuse revelations and the likes of Jimmy Saville.. After all about 20% of the prison population are measurably psychopaths, and even worse, that 20% cause most of the violence and trouble within prisons. The million-dollar question is whether they born psychopaths or become so.

Serious questions should be raised about the use of brain scans to ascertain someone’s criminality or even the likelihood of them committing offences, something Raine suggests we are near being able to do. This kind of thinking worries many people, with its echoes of euegenics and even phrenology, that ancient science which condemned people as criminals merely by the shape of their heads. Could the shape of people’s amygdala or prefrontal cortex give rise to similar assumptions?

Of course not surprisingly people who meet the criteria for being a psychopath are likely to have more than just behaviours in common. It makes sense that they have deficits, for example in their prefrontal cortex, as Raine states, as many are notoriously impulsive and lacking in empathy, which we generally see in people with less frontal lobe activity. It is also to be expected that they would have a smaller and less active amygdala, as Raine states, given that the lack of fear is such a common feature of psychopaths. It is though a huge leap to suggest from such findings that the causes of psychopathy are in the brain. These are chicken and egg issues as there is no end of evidence that, for example, adverse earlier experiences affect both the way the amygdala develops, and also the extent to which frontal lobe capacities for self-regulation and empathy come on line (or don’t in the case of many psychopaths).

There are many routes to these brain changes. Antonio Damasio [2] described patients who had accidents affecting their prefrontal cortex, after which they became callous and impulsive. David Eagleman [3] described cases where someone  developed paedophilic fantasies, and then a brain tumor was discovered, the removal of which led to the end of such fantasies. A study of three years olds with damage in similar brain areas showed that they were prone to impulsivity, lying, stealing and cheating, and displayed many traits which were quite psychopathic as they grew up [4].Obviously organic damage can have an effect.

Some researchers using massive samples of twins, identical and non-identical, seem to have shown that there is a strong genetic loading for this condition [5]. Yet not everyone is convinced by research using twins [6], [7]. It is also likely that those with some genetic inheritances might be less susceptible to becoming psychopathic after abuse. Anyway  genes do not explain enough. Any trip into a high security prison reveals consistent tales of early abuse, neglect and trauma and lack of basic parenting, tales that therapists and others who spend their professional lives working in these units attest to. It is almost unheard of to come across a violent or psychopathic criminal who has had a relatively ordinary childhood, and often the stories of abuse are unthinkably horrendous, something that Ana Gullhaugen’s research backed up [8].  Of course it is interesting to know why others who suffered similarly terrible childhoods might not develop in this way.

We know though that trauma and abuse also has an effect. Poor early attachment has been linked to callous-unemotional traits [9], and trauma and abuse affect brain regions where we see abnormalities in psychopaths, such as the amygdala, hippocampus and ventromedial prefrontal cortex. The lack of early maternal care and maltreatment have been clearly linked to callous-unemotional traits and aggressiveness [10]. Very tellingly longitudinal samples from orphanages have found high levels of callous-unemotional traits in children adopted into even very caring and loving families [11]. In addition good parenting can effectively reduce the risk of externalising behaviours in children with callous-unemotional presentations [12].

Even those who argue strongly for a very high genetic loading agree that in these cases gene-environment interaction is always central. For example it may be that those with the long rather than the short version of the serotonin transporter gene might be more susceptible, in response to severe environmental triggers such as terrible early abuse [13]. No gene for psychopathy has been isolated nor is it likely to be and  unpicking nature and nurture is not straightforward and we have much yet to discover.  Raine too accepts that epigenetics are likely to show that nurture and nature interact in ways that we do not yet fully understand to give rise to these worrying personality traits. However we know that it is not just all about genes, and that  there are links between early trauma and both psychopathic traits in adults and callous-unemotional traits in children.

The other issue which is not raised and seems to me very important is the impact of the kind of society we create. There are disproportionate numbers of psychopaths not only in prisons but also in positions of power, such as political leaders, CEO’s, heads of cults, senior soldiers, conmen and unscrupulous salespeople. We might be living in a world which values charismatic individual leadership over cooperative action, logic over emotional connection, in which it is easier for people with sociopathic tendencies to flourish. As Martha Stout  [14] points out in her book The Sociopath Next Door, , there are higher numbers of sociopaths in the Western world than in most other cultures and societies. Eastern cultures seem to have between .03% and .14%, which is very different to the 4% and increasing in America. Cultural factors have a huge effect on downplaying psychopathic and callous behaviours. Gary Olson argues that if positions of power and leadership in so many walks of life suit psychopathic tendencies so well, then other people who find themselves in such roles might also need to act more psychopathically to be successful [15].

People with psychopathic traits are not all serial killers or paedophiles or criminal extortionists, and most have normal lives. Many seem to have the qualities the modern world seems to want, fearlessness, the ability to take risks, to confidently assert authority, to be cool-headed under pressure, be focussed and determined to succeed.  They certainly seem suited to the financial industry, so much so that Bob Hare stated that if he could not study psychopaths in prison, his next best choice would be a Stock Exchange [16]. Hare and others argue that some business models ape those of psychopaths, treating people coldly, as commodities, as units of labour or consumption, exploiting them, selling produce which people do not need and indeed which can be genuinely harmful, all for personal and corporate profit. Tobacco companies hiding clear evidence of the serious health dangers of smoking, while actively advertising their products, might well be such an example, as might pharmaceutical companies concealing poor long-term outcomes of drugs on which patients can develop a lifetime dependence  [17], [18].

Olson and others argue that a social system increasingly based on profit at all costs, on treating people as commodities, units of labour or as markets for goods, in which there is also increased competition, job insecurity and anxiety levels, might also tilt the balance towards less prosocial tendencies. Non-psychopaths will be pushed into less prosocial behaviours while many with actual psychopathic tendencies will thrive. Bob Hare co-wrote a book called ‘Snakes In Suits’  [16] which described this phenomenon, and we are living in an era where what has been called ‘situational psychopathy’ can flourish, in part because ruthless practices are  often financially rewarded. Bob Hare estimated that there are four times more psychopaths who are heads of large corporations than are in the general population, and that their ruthlessness is a huge advantage.

Researchers such as Raine are helping us learn more about people who display psychopathic  behaviours. Research is suggesting that early experiences play an important role, but that so do genes. We are also learning that psychopathic traits exist on a spectrum, some of us might have a higher or lower predisposition for psychopathy but some kinds of early experiences and some social conditions will play a large part in turning these on or off.  The research is suggesting that there are many lessons we might learn, about how we organise society and our institutions, the extent to which we  value individualism or collectivism, and of course how we bring up our children.

What the purely biological research leaves out is the role of the environment, both people’s emotional psychological influences from  childhood and also how society is organised and its values. It is possible that we are increasingly living in a world which might suit non-moral psychopathic tendencies and less emotionally attuned and empathic ways of living. Psychopaths, and presumably psychopathic traits, thrive in particular environments, such as harsh, ruthless ones, or where there is little room for softer feelings such as vulnerability They also do well under cover of  the anonymity of cities and where people can work unseen. The dark arts seen in the financial services industry before the financial crash might be a case in point.  We have moved into a world in which it can be an advantage to rely on a colder, calculating and rationally instrumental way of acting and relating.

[1]        A. Raine, The Anatomy of Violence: The Biological Roots of Crime. Allen Lane, 2013.

[2]        M. Koenigs, L. Young, R. Adolphs, D. Tranel, F. Cushman, M. Hauser, and A. R. Damasio, ‘Damage to the prefrontal cortex increases utilitarian moral judgements’, Nature, vol. 446, no. 7138, pp. 908–911, 2007.

[3]        D. Eagleman, Incognito: The Secret Lives of The Brain. Canongate Books Ltd, 2011.

[4]        S. W. Anderson, H. Damasio, D. Tranel, and A. R. Damasio, ‘Long-term sequelae of prefrontal cortex damage acquired in early childhood’, Dev. Neuropsychol., vol. 18, no. 3, pp. 281–296, 2000.

[5]        E. Viding, A. P. Jones, J. F. Paul, T. E. Moffitt, and R. Plomin, ‘Heritability of antisocial behaviour at 9: do callous‐unemotional traits matter?’, Dev. Sci., vol. 11, no. 1, pp. 17–22, 2008.

[6]        J. Joseph, The gene illusion: Genetic research in psychiatry and psychology under the microscope. Algora Pub, 2004.

[7]        K. Richardson and S. Norgate, ‘The equal environments assumption of classical twin studies may not hold’, Br. J. Educ. Psychol., vol. 75, no. 3, pp. 339–350, 2005.

[8]        A. S. Gullhaugen, ‘Redefining psychopathy?: Is there a need for a reformulation of the concept, assessment and treatment of psychopathic traits?’, Norwegian University of Science and Technology, 2012.

[9]        D. S. Pasalich, M. R. Dadds, D. J. Hawes, and J. Brennan, ‘Attachment and callous-unemotional traits in children with early-onset conduct problems’, J. Child Psychol. Psychiatry, Mar. 2012.

[10]      E. R. Kimonis, B. Cross, A. Howard, and K. Donoghue, ‘Maternal Care, Maltreatment and Callous-Unemotional Traits Among Urban Male Juvenile Offenders’, J. Youth Adolesc., pp. 1–13, 2012.

[11]      R. Kumsta, E. Sonuga-Barke, and M. Rutter, ‘Adolescent callous–unemotional traits and conduct disorder in adoptees exposed to severe early deprivation’, Br. J. Psychiatry, vol. 200, no. 3, pp. 197–201, 2012.

[12]      G. Kochanska, S. Kim, L. J. Boldt, and J. E. Yoon, ‘Children’s callous-unemotional traits moderate links between their positive relationships with parents at preschool age and externalizing behavior problems at early school age’, J. Child Psychol. Psychiatry, p. n/a–n/a, 2013.

[13]      A. L. Glenn, ‘The other allele: Exploring the long allele of the serotonin transporter gene as a potential risk factor for psychopathy: A review of the parallels in findings’, Neurosci. Biobehav. Rev., vol. 35, no. 3, pp. 612–620, 2011.

[14]      M. Stout, The Sociopath Next Door. Broadway Books (A Division of Bantam Doubleday Dell Publishing Group Inc), 2007.

[15]      G. Olson, Empathy Imperiled: Capitalism, Culture, and the Brain, 2013th ed. Springer, 2012.

[16]      R. D. Hare and P. Babiak, Snakes in suits: when psychopaths go to work. New York: Harper Collins, 2007.

[17]      R. Whitaker, Anatomy of an epidemic: Magic bullets, psychiatric drugs, and the astonishing rise of mental illness in America. Broadway Books, 2011.

[18]      B. Goldacre, ‘Bad Pharma’, Fourth Estate, 2012.