Recent neuro-imaging findings with respect to conduct disorder, callous-unemotional traits and psychopathy.

Abstract

To review recent neuro-imaging findings with respect to conduct disorder and callous-unemotional traits in childhood and comparable psychopathy in adult-hood that deepen the literature in important ways. Recent structural findings particularly bring clarity to the literature. First, they reinforce previous work indicating that severity of psychopathy is positively associated with extent of cavum septum pellucidum. This suggests psychopathy is associated with early neurodevelopmental disruption within limbic structures. Second, they clarify the direction of the association between conduct disorder and particularly callous-unemotional traits and white matter tract abnormalities even if it remains less transparent exactly which tracts are disrupted. However, conclusions based on recent functional imaging studies are more equivocal with inconsistencies in direction of emotional (albeit with notably more work confirming the previous reports of hypo-responsiveness in limbic regions) and reward responsiveness. The recent data are, for the most part, consistent with a view that callous-unemotional traits/psychopathy represents an early appearing neuro-developmental disorder particularly associated with compromised emotional (limbic) functioning. However, some patients presenting with severe antisocial behavior may also show hyper-threat sensitivity, perhaps reflecting trauma exposure, and require different clinical interventions.