The Evil Inside : A Systematic Review of Structural Differences in Psychopathy

The purpose of this systematic review was to characterize further the structural differences in the prefrontal cortex, limbic and paralimbic regions and amygdala alone in psychopaths. Psychopathy is a multifaceted personality disorder characterized by interpersonal and affective traits like lack of empathy, guilt or remorse, shallow affect, and carelessness, as well as behavioral traits such as impulsivity, and poor behavioral control. In recent years, the interest in the neuroanatomical differences in psychopaths has grown. This review aims to understand the prefrontal cortex, limbic and paralimbic areas, and how these regions differ between psychopathic patients and healthy controls. By systematically screening articles that used magnetic resonance imaging (MRI) and voxel based morphometry (VBM) the studies in this review examined people with psychopathic traits. To assess for psychopathy, the most used assessment tool, the Psychopathy Checklist-Revised (PCL-R) was used. Results show that the higher the PCL-R scores of the offenders, the less gray matter volume was found in the superior parts of the prefrontal cortex, limbic and paralimbic areas. Additionally, amygdala deficits in individuals with psychopathy were found. This systematic review may benefit in the way that if we increase our understanding of psychopathy and pave the way forthe creation of effective psychopathic treatments it could prevent future acts of violence. The link between a structural brain anomaly and psychopathy may have a profound clinical, legal, and scientific impact. A psychopathy diagnosis may serve as a precursor to severe societal violence