Brain self-regulation in criminal psychopaths

Abstract

Psychopathic individuals are characterized by impaired affective processing, impulsivity, sensation-seeking, poor planning skills and heightened aggressiveness with poor self-regulation. Based on brain self-regulation studies using neurofeedback of Slow Cortical Potentials (SCPs) in disorders associated with a dysregulation of cortical activity thresholds and evidence of deficient cortical functioning in psychopathy, a neurobiological approach seems to be promising in the treatment of psychopathy. The results of our intensive brain regulation intervention demonstrate, that psychopathic offenders are able to gain control of their brain excitability over fronto-central brain areas. After SCP self-regulation training, we observed reduced aggression, impulsivity and behavioral approach tendencies, as well as improvements in behavioral-inhibition and increased cortical sensitivity for error-processing. This study demonstrates improvements on the neurophysiological, behavioral and subjective level in severe psychopathic offenders after SCP-neurofeedback training and could constitute a novel neurobiologically-based treatment for a seemingly change-resistant group of criminal psychopaths.

Figure 1. Slow Cortical Potential Neurofeedback.

(a). Mean SCP-differentiation of the first 6 and the last 6 training sessions: on the left side for the total regulation performance; and separately for the feedback (in the middle) and for the transfer condition (on the right side). Vertical lines represent the standard error. (b). Upper row: Mean Average of the first 6 training sessions for total (left), feedback (middle) and transfer (right) performance; Electrode FCz. Lower row: Mean Average of the last 6 training sessions for total (left), feedback (middle) and transfer (right) performance; Electrode FCz.

Figure 2. Changes in Self-Reports.

Ratings from before to after SCP-Training; Left: Reductions in Physical Aggression (BPAQ); Right: Reductions in Behavioral Approach (BAS). Vertical lines represent the standard error.

Figure 3. Error-Related-Negativity (ERN) and Error Positivity (Pe).

Grand average of Error response-locked waveforms showing the increase in ERN and Pe after (black line) compared to before SCP-Training (gray line). Electrode Cz.

Figure 4. Study Design.

(a). Upper row: Procedure and Timing with Pre-Assessment, SCP-Training Phase 1 (12 days), Training break (13 days; Patients were instructed to exercise regulation skills on their own, using a small card showing their preferred training object), SCP-Training Phase 2 (13 days) and Post-Assessment. Middle row: Example of one training session (~60 minutes per day) consisting of three blocks with different conditions: 1.Feedback-> 2. Transfer-> 3. Feedback. Lower row: Example of the time course of an SCP training trial with a 2 sec baseline and the following 8 sec regulation phase is depicted. The upper curve indicates a negative SCP shift, lower curve a positive SCP shift.(b). Location of the EEG feedback site: FCz is depicted (gray).