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Adrian Raine, DPhil; Todd Lencz, PhD; Susan Bihrle, PhD; Lori LaCasse, BA; Patrick Colletti, MD

Arch Gen Psychiatry. 2000;57:119-127.

Background  Major damage to gray and white matter in the prefrontal cortex and autonomic deficits have been found to result in pseudopsychopathic personality in patients with neurological disorders, but it is not known whether people with antisocial personality disorder (APD) in the community who do not have discernable brain trauma also have subtle prefrontal deficits.

Methods  Prefrontal gray and white matter volumes were assessed using structural magnetic resonance imaging in 21 community volunteers with APD (APD group) and in 2 control groups, comprising 34 healthy subjects (control group), 26 subjects with substance dependence (substance-dependent group), and 21 psychiatric controls. Autonomic activity (skin conductance and heart rate) was also assessed during a social stressor in which participants gave a videotaped speech on their faults.

Results  TheAPD group showed an 11.0% reduction in prefrontal gray matter volume in the absence of ostensible brain lesions and reduced autonomic activity during the stressor. These deficits predicted group membership independent of psychosocial risk factors.

Conclusions  To our knowledge, these findings provide the first evidence for a structural brain deficit in APD. This prefrontal structural deficit may underlie the low arousal, poor fear conditioning, lack of conscience, and decision-making deficits that have been found to characterize antisocial, psychopathic behavior.

From the Department of Psychology, University of Southern California, Los Angeles (Drs Raine and Bihrle and Ms LaCasse); the Department of Research, Hillside Hospital, North Shore–Long Island Jewish Health System, Glen Oaks, NY (Dr Lencz); and the Department of Radiology, University of Southern California School of Medicine, Los Angeles (Dr Colletti).

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