A Person-Centered App Commentary BPC roach to Research on the Nature and Meaning of Psychopathy – Brain Relations

Figure 1. Mean z scores of each latent class on each Psychopathy Checklist–Revised (PCL-R) facet, referenced against the mean facet scores of 5408 male offenders described in the PCL-R Manual (2), depicted on the bottom line as a z score of 0. The offenders each had a PCL-R score $27. [Adapted from Mokros et al. (5) with permission.] The article by Korponay et al. (1) in this issue of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging is an important contribution to our understanding of the neurobiological bases of psychopathy. It describes interesting associations among striatal neurobiology and the Psychopathy Checklist– Revised (PCL-R) (2). In particular, it provides evidence that factor 2, but not factor 1, is associated with “enlarged striatal subnuclei and aberrant functional connectivity between the striatum and other brain regions.” This finding is consistent with empirical evidence that the impulsive/antisocial dimensions of psychopathy are related to the anticipation and attainment of reward (2). Several of the authors are leaders in their field, and I leave it others to evaluate the technical aspects of the imaging procedures described by Korponay et al. (1). I offer a potential connection between their findings and recent person-centered research using latent profile analysis (LPA) to delineate theoretically meaningful latent classes (LCs) of offenders, based on the four-factor model of the PCL-R. I also provide some brief comments on the issue of whether neuroimaging research indicates that psychopathy is characterized by dysfunctional or abnormal brain structure and function. The two-factor model of psychopathy (factor 1: interpersonal/affective; factor 2: lifestyle/antisocial) is in wide use, with many replicable findings in cognitive and affective neuroscience. In some situations, the four-factor model (interpersonal, affective, lifestyle, and antisocial) provides a more nuanced picture of the associations between psychopathy and a variety of behavioral, criminal justice, and neurobiological variables (2–4). The reason is that the dimensions that make up factors 1 and 2 often relate to other variables in different ways. The four-factor model also lends itself readily to conducting LPA. My colleagues and I (5–7) have performed person-oriented LPAs of the PCL-R four-facet profiles, with results that are relevant to the findings of Korponay et al. (1). For example, Mokros et al. (5) conducted an LPA of the facet profiles of 1451 male offenders with a PCL-R score $27. Three LCs emerged (Figure 1). We viewed LCs 1 and 2 as reflections of two variations on the theme of psychopathy, one manipulative (LC1) and the other aggressive (LC2). LC3 differed dramatically from the other LCs, with a low score on the interpersonal facet, a very low score on the affective facet, and very high scores on the lifestyle and antisocial facets. Put another way, LC3 was low on factor 1 and high on factor 2. We labeled this LC as sociopathic, but it might also be referred to as an externalizing or antisocial personality disorder class. Mokros et al. (5) conducted a supplementary LPA on 856 offenders with a PCL-R score of $30. Two LCs emerged, labeled LC1 and LC2, virtually identical to the like-named profiles in Figure 1.