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Lecture 9

PSY240 Lecture 9

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M.Mc Kay

PSY240 Lecture 9 June 20: Controversies in Abnormal Psych (NCRMD & Psychopathy) (Chp 18) NCMRD • Not Criminally Responsible on Account of Mental Disorder • Accused incapable of either appreciating the nature and quality of the act or omission or know it was wrong as a result of having a mental disorder at the time of the offence o Most common one = schizophrenia (e.g., individual with delusion neighbors are aliens, must kill them to prevent takeover) • In states: NGRI (Not Guilty Reason Insanity) Comparison of public perception • 0.25% of all cases = insanity pleas that result in NGRI What qualifies? • Unclear and inconsistent in what disorders it recognizes as diseases of the mind o Has to have a very significant impact (mostly schizophrenia qualifies, sometimes mood disorders but rare) • Even when everyone agrees that a defendant has a severe psychological disorder, this does not necessarily mean that, at the time of the crime, he or she was incapable of knowing “right from wrong” Are psychopaths criminally responsible? What is psychopathy? • Lack of empathy • Lack of remorse • Glib/superficial charm • Callous/unemotional • Muted stress/fear response • Social dominance association with manipulation Construct with two factors 1. Emotional dysfunction  Guilt/remorse  Empathy  Ability to attach to significant others 2. Antisocial behaviour  Antisocial acts/violent tendencies  Impulsive behaviours Psychopathy checklist – revised • Hare (2004) [developed this gold standard of measuring psychopaths] • 20 item scale scored 0 to 2 • Factor 1 - Facet 1 (interpersonal characteristics) - Facet 2 (affective characteristics) • Factor 2 - Facet 3 (impulsive lifestyle) - Facet 4 (antisocial lifestyle) 78 Psychopathy • Shows a developmental trends: characteristics emerge prior to 10 years old and persists through adulthood, suggesting there is something biological/inherited • Heritable: callous-unemotional traits = 67% heritability at 7 years - Polymorphisms that affect responsiveness of neural systems involved in psychopathy - Genetic component stronger than social component (like parenting impact) to its development •  Instrumental and reactive aggression (they respond to threat/insult). Instrumental aggression is the use of aggression to get something they want/to benefit themselves; instrumental aggression decreases when goal has been achieved (e.g. Billy hits Sally until he gets her new toy). Functional impairments • Stimulus-reinforcement learning • Impaired fear conditioning - Cannot predict impending harm from threat signals - Deficient autonomic responding (e.g., skin conductance) in anticipation of punishment/threat • Impaired startle reflex Fear and sadness • Processing of fearful or sad facial expressions - Children with psychopathic tendencies exhibit impaired recognition of sad and fearful facial expressions and reduce autonomic response - Responding to those fearful or sad expressions important for development of moral socialization • Processing of fearful or sad vocal affect - Severely impaired recognition of fearful vocal affect - They don’t recognize sadness in the voice either - Association between psychopathy scores and ability to recognize sad facial expressions Evidence from imaging (brain) • Dissociable systems process sad and fearful facial expressions versus other expressions • The fearful and sad facial expression system deficient in the psychopath • This has been measured by reduced BOLD responses within the amygdala to fearful expressions Implicated brain regions: the amygdala • Amygdala allows individual to learn goodness/badness of object/actions and whether reward/punishment will result when action is committed • As such, amygdala is important for stimulus-reinforcement learning; stimulus-reinforcement learning is decreased in psychopaths • Psychopaths have reduced anygdaloid volume • Psychopaths have reduced amygdaloid activation during emotional memory test Implicated brain regions: lesions of the amygdala • Lead to certain characteristics of psychopathy: - Impairment in aversive conditioning (learning in response to punishment/addition of unpleasant stimulus like a shock) - Augmentation of startle response to visual threat stimuli - Impairment in fearful expression recognition Implicated brain regions: the ventromedial prefrontal cortex (vmPFC) • Crucial for reversal learning (for psychopathic individuals, if Action A has been rewarded, but suddenly it is punished. Individuals with psychopathy have problem with contingency change; once behaviour has been rewarded, they have trouble changing it.) • “Critical for the representation of reinforcement outcome expectancies associated with object, information that is then used by other systems to affect decision making” • Iowa gambling task: used to tap into reward-contingency-change paradigm. Bad decks: immediate reward, long-term problem, good decks: low immediate reward, long-term reward/benefits. 79 Implicated brain regions: the orbitofrontal cortex • Not only closely relwated to vmPFC in terms of location, but function • It is related to the anticipation of reward/punishment & contingency learning and also related to social cognition in general Acquired sociopathy: Phineas Gage • Significant damage in pre-frontal region of brain • This led to idea of idea of acquired sociopathy • As result of his injury, Gage’s behaviour was changed significantly; he was impatient, showed little care for others, unable to proceed with any plans, generally impulsive Accquired sociopathy has similartities to, but is not quite psychopathy • Acquired sociopathy results from OFC/vmPFC damage - Generalized impairment for recognition of all negative emotional facial expressions o Psychopaths are specific to fear and violence - Violence is the result of impaired inhibition of violent impulses o Psychopathy they commit aggression in purposeful manner - Do not show impaired aversive conditioning we see in psychopaths Temporal lobe • “The healthy controls show enhanced differential activation in the limbic-prefrontal circuit (amygdala, orbitofrontal cortex, insula, and anterior cingulate) during the acquisition of fear and successful verbal and autonomic conditioning. The psychopaths displayed no significant activity in this circuit and failed to show conditioned skin conductance and emotional valence ratings, although contingency and arousal ratings were normal.” • Psychopaths don’t have any of the significant brain reactions we see in control as result of emotional stimuli (also in their skin) Psychopaths vs. control • Have over-activation is PFC and amygdala Controversies in Abnormal Psychology Outline & Goals • Three “mini” lectures o Criminal responsibility & mental health o Diagnoses: are they helpful? o Translation of research into practice Diagnoses: are they helpful Review: Diagnosis • A syndrome is a set of symptoms representing the observable manifestation of an un
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