The Neurobiological Basis for Psychopathy: Why Current Treatment is Inadequate

Research surrounding psychopathy has progressed greatly in the last two decades firmly establishing psychopathy as a psychological condition. However, clinical practice has not altered to keep pace with current research. This paper reviews evidence from imaging, behavioural, and clinical studies of psychopathy focusing on its etiology and treatment. A neurobiological basis for psychopathy is established from this evidence, and the Somatic Marker Hypothesis, Violence Inhibition Mechanism Model, and Integrated Emotional System Model are considered. This neurobiological basis is then used as a foundation for a discussion on how clinical practice should proceed. Clinical strategies such as cognitive behavioural therapy and behavioural therapy are reviewed, and current treatments are found to be lacking in effectiveness. Finally new clinical directions such as drug treatments, targeted neuropsychological interventions based on an individual’s specific neurological deficits, and targeting youth populations are suggested in order to improve the clinical prognosis and reduce incarceration levels for psychopathic individuals