反社会人格障碍的神经生物学基础及其司法启示

反社会人格障碍(Antisocial Personality Disorder, ASPD)是一种漠视或侵犯他人权益的普遍行为模式, 是与犯罪关联极高的精神障碍。ASPD的形成受基因和环境因素的影响, 表现为神经递质和激素系统的紊乱, 以及自主神经系统活跃程度和大脑结构与功能的异常。上述神经生物学因素可能导致ASPD患者表现出执行控制障碍、情绪功能障碍、无视惩罚信息和奖赏偏好等特点。神经生物学研究的证据为ASPD罪犯的循证矫治、风险评估、定罪量刑等司法实践提供了启示。建议未来从神经生物学角度对ASPD的诊断分类标准、治疗方法和影响因素等方面开展研究。     

Meditation and Health: The Search for Mechanisms of Action

Psychological interest in the impact of mental states on biological functioning is growing rapidly, driving a need for new methods for inducing mental states that last long enough, and are sufficiently impactful, to have significant effects on physical health. The many traditions of meditative practice are one potential pathway for studying mind‐body interactions. The purpose of this review is to introduce personality and social psychologists to the field of meditation research. Beginning with a brief introduction to meditation and the heterogeneity of meditative practices, we showcase research linking meditative practice to changes in immune and cardiovascular functioning and pain perception. We then discuss theoretical and empirical evidence that meditation works by inducing changes in psychological capacities such as emotion regulation and self‐regulation or through repeated induction of specific mental states such as love or meta‐cognitive awareness. At the frontier of the science of meditation is the need to empirically test whether meditation‐driven changes in cognitive and affective processes are the cause of improvements in physical health. Emerging challenges in meditation research include a need for large studies using randomized controlled and dual‐blind designs with active control groups and an increased focus on measuring mechanisms of action as well as outcomes. Meditation represents a potentially powerful tool for generating new knowledge of mind‐body interactions.     

The relationship between distress tolerance and antisocial personality disorder among male inner-city treatment seeking substance users

There is currently limited research on the potential mechanisms underlying the development of antisocial personality disorder (ASPD). One such mechanism, distress tolerance (defined as an individual's behavioral persistence in the face of emotional distress) may underlie the development of ASPD and its associated behavioral difficulties. It was hypothesized that substance users with ASPD would evidence significantly lower levels of distress tolerance than substance users without ASPD. To test this relationship, we assessed 127 inner-city males receiving residential substance abuse treatment with two computerized laboratory measures of distress tolerance. The mean age of the sample was 40.1 years (SD = 9.8) and 88.2% were African American. As expected, multiple logistic regression analyses indicated that distress intolerance significantly predicted the presence of an ASPD diagnosis, above and beyond key covariates including substance use frequency and associated Axis I and II psychopathology. Findings suggest that distress tolerance may be a key factor in understanding the development of ASPD, setting the stage for future studies expanding on the nature of this relationship, as well as the development of appropriate interventions for this at-risk group.     

Cognitive Behavioral Therapy for Attention-Deficit/Hyperactivity Disorder in College Students: A Review of the Literature

The current review presents a theory-guided review of the existing cognitive behavioral therapy (CBT) interventions for attention-deficit/hyperactivity disorder (ADHD) in college students. Across the eight studies that investigated this topic, moderate reductions were shown in inattentive symptoms but little to no change was reported in hyperactive/impulsive symptoms. Results indicated a moderate treatment effect on self-reported quality of life and school/work functioning, yet less of an impact on GPA, response inhibition, social functioning, and executive functioning. Methodological and statistical problems and inconsistencies were noted. Since college students are emerging adults, it is likely that the optimum CBT intervention for college students with ADHD lies somewhere in between the existing clinic-based adult ADHD CBT interventions as well as the school-based adolescent ADHD psychosocial interventions. Directions for future research and recommendations for clinicians in university settings are provided in an attempt to further develop the existing college students CBT clinical research evidence base.     

The etiology of psychopathy: A neuropsychological perspective

While there is no universally accepted cause of psychopathy, there are basic biological patterns in brain dysfunction observed in individuals who display psychopathic tendencies. These individuals show significant impairment in specific regions of the brain, particularly the orbital frontal cortex (OFC). Such abnormalities exist in brain areas most involved in impulse control and behavior inhibition. There are also significant environmental factors that the majority of these individuals have in common. For example, a strong correlation exists between attachment disorder and anti-social personality disorder (ASPD). Finally, the differences between ASPD, psychopathy, and sociopathy are considered. While these terms are often used interchangeably, there are clear differences between these psychopathologies.     

Die Antisoziale Persönlichkeitsstörung des DSM-IV-TR - Befunde, Untergruppen und Unterschiede zu Psychopathy

The diagnosis of Antisocial Personality Disorder (ASPD) is based on robust scientific evidence identifying a group of individuals who display antisocial behaviour from a very young age that remains stable across the life-span. This population of persons with ASPD is heterogeneous, composed of distinct sub-types defined by comorbid disorders. Evidence indicates that ASPD is distinct from both psychopathy, as defined by the PCL-R, and from Dissocial Personality Disorder, as defined by ICD-10. Studies of the prevalence of ASPD are reviewed, highlighting the difficulties inherent in designing and conducting investigations of community samples that derive accurate estimates. The few studies of the socio-demographic correlates of ASPD are presented followed by a review of the evidence on disorders that are comorbid with ASPD. Finally, a hypothesis is presented for orienting future research on the aetiology of ASPD and the development of effective programmes for reducing violence among persons with ASPD.     

Brain Function Associated with Cooccurring Trauma and Depression Symptoms in College Students

The goal of this pilot study was to determine if functional brain differences are present among individuals with high and low cooccurring trauma and depression symptoms. This pilot study examined how the P300 latency component of event-related potentials (ERPs), measured using electroencephalography (EEG) while participants performed a go/no-go task, might be associated with cooccurring self-report of trauma and depression symptoms in a sample of college students (N = 38). Alpha-corrected independent sample t tests revealed statistically significant differences in ERP P300 peak latencies between those in the high cooccurring trauma and depression symptoms group (n = 12) and those in the low group (n = 26) for all 3 midline electrode sites (Fz, Cz, and Pz). This pilot study provides preliminary evidence of differential brain functioning in individuals experiencing cooccurring trauma and depression symptoms. Accordingly, these findings support future research examining brain functioning in cooccurring symptoms.     

Unique roles of antisocial personality disorder and psychopathic traits in distress tolerance

Previous research indicates that individuals with antisocial personality disorder (ASPD) evidence low distress tolerance, which signifies impaired ability to persist in goal-directed behavior during an aversive situation, and is associated with a variety of poor interpersonal and drug use outcomes. Based on theory and research indicating that psychopathic traits are associated with hypo-reactivity in emotional responding, a unique hypothesis emerges where psychopathic traits should have the opposite effect of ASPD and be related to high levels of distress tolerance. In a sample of 107 substance-dependent patients in an inner-city substance use residential treatment facility, this hypothesis was supported. ASPD was related to lower distress tolerance, while psychopathic traits were related to higher distress tolerance, with each contributing unique variance. Findings are discussed in relation to different presentations of distress tolerance as a function of psychopathic traits among those with an ASPD diagnosis.     

Spirituality and Meditative Practice: Research Opportunities and Challenges

Meditative practices have a long history in India and have influenced contemporary meditative programs elsewhere in the world. Over the last several decades, the use of meditation as a therapeutic tool has been investigated in regard to physical, emotional and behavioral effects with impressive results. In parallel to this has been a growing interest in research on spirituality, spiritual growth, and therapeutic modalities that incorporate the spiritual dimension of the person. Ironically, very little research has explored the interface between these two constructs, despite how closely linked they are traditionally. This paper addresses the range of ways in which spirituality and spiritual development might be fruitfully investigated in the context of meditative practice, bringing further understanding to both psychological constructs. Furthermore, the widely recognized significance of both meditative and spiritual experiences suggests that cross-cultural research may be particularly valuable at identifying factors that engage the universal human capacity of spirituality, and the particular potential for meditative practice in doing so.     

Effects of comorbid psychopathy on criminal offending and emotion processing in male offenders with antisocial personality disorder

Antisocial personality disorder (ASPD) and psychopathy are two syndromes with substantial construct validity. To clarify relations between these syndromes, the authors evaluated 3 possibilities: (a) that ASPD with psychopathy and ASPD without psychopathy reflect a common underlying pathophysiology; (b) that ASPD with psychopathy and ASPD without psychopathy identify 2 distinct syndromes, similar in some respects; and (c) that most correlates of ASPD reflect its comorbidity with psychopathy. Participants were 472 incarcerated European American men who met Diagnostic and Statistical Manual (4th ed., American Psychiatric Association, 1994) criteria for ASPD and Psychopathy Checklist criteria for psychopathy, who met the criteria for ASPD but not for psychopathy, or who did not meet diagnostic criteria for either ASPD or psychopathy (controls). Both individuals with ASPD only and those with ASPD and psychopathy were characterized by more criminal activity than were controls. In addition, ASPD with psychopathy was associated with more severe criminal behavior and weaker emotion facilitation than ASPD alone. Group differences in the association between emotion dysfunction and criminal behavior suggest tentatively that ASPD with and ASPD without prominent psychopathic features may be distinct syndromes.     

Interventions to Address the Academic Impairment of Children and Adolescents with ADHD

There exists a strong link between ADHD and academic underachievement. Both the core behavioral symptoms of ADHD and associated executive functioning deficits likely contribute to academic impairment. Current evidence-based approaches to the treatment of ADHD (i.e., stimulant medication, clinical behavior therapy and classroom behavioral interventions) have demonstrated a robust impact on behavioral variables such as attention and disruptive behavior within classroom analogue settings; however, their efficacy in improving academic outcomes is much less clear. Although surprisingly few treatment outcome studies of ADHD have attempted to incorporate interventions that specifically target academic outcomes, the studies that are available suggest that these interventions may be beneficial. The state of the treatment literature for addressing academic impairment in children and adolescents with ADHD will be reviewed herein, as well as limitations of current research, and directions for future research.     

Utilization of emotion cues in male and female offenders with antisocial personality disorder: results from a lexical decision task

Antisocial personality disorder (ASPD) diagnoses have demonstrated good reliability and validity in male offenders. However, there is a paucity of research assessing utilization of emotion cues in ASPD individuals and the extent to which correlates of ASPD in males generalize to females. This investigation examined emotion utilization in incarcerated men and women with and without ASPD using a lexical decision task with emotional and neutral words. The performance of male offenders with ASPD was similar to that of male controls, whereas women with ASPD demonstrated greater emotional facilitation than female controls. Moreover, the number of violent crimes committed by female inmates with ASPD was related to emotion facilitation, suggesting a link between their sensitivity to emotion cues and antisocial behavior.     

Sustained attention and age predict inhibitory control during early childhood

Executive functioning skills develop rapidly during early childhood. Recent research has focused on specifying this development, particularly predictors of executive functioning skills. Here we focus on sustained attention as a predictor of inhibitory control, one key executive functioning component. Although sustained attention and inhibitory control have been linked in older children and adults, these links have not been well specified during early childhood. The current study examined both parent-rated and laboratory measures of sustained attention as predictors of both parent-rated and laboratory measures of inhibitory control among 3- to 6-year-olds. As expected, children with higher sustained attention abilities exhibited greater inhibitory control. Moreover, inhibitory control increased across age. These findings reveal important details about the development of sustained attention and inhibitory control during early childhood.     

Histrionic personality disorder and antisocial personality disorder: sex-differentiated manifestations of psychopathy?

Little is known about the etiology of histrionic personality disorder (HPD) or its relation to other personality disorders. In this study, we examined whether HPD is etiologically related to psychopathy and more specifically whether HPD and antisocial personality disorder (ASPD) are sex-typed alternative manifestations of psychopathy. In addition, based on Newman's (1987) response modulation hypothesis of psychopathy, we examined the associations between psychopathic, HPD, and ASPD features and performance on laboratory measures of passive avoidance errors and interference effects. Seventy-five live theater actors completed self-report questionnaires and two laboratory measures of response modulation, and peers completed questionnaires concerning the participants' personality disorder features. The results provided weak and inconsistent support for the hypotheses that HPD is a female-typed variant of psychopathy and that ASPD is a male-typed variant of psychopathy. Contrary to previous findings, scores on response modulation tasks were not significantly related to psychopathy, or to either HPD or ASPD. The limitations of this study and possibilities for future research in this area are outlined.     

A neurocognitive model of meditation based on activation likelihood estimation (ALE) meta-analysis

Meditation comprises a series of practices mainly developed in eastern cultures aiming at controlling emotions and enhancing attentional processes. Several authors proposed to divide meditation techniques in focused attention (FA) and open monitoring (OM) techniques. Previous studies have reported differences in brain networks underlying FA and OM. On the other hand common activations across different meditative practices have been reported. Despite differences between forms of meditation and their underlying cognitive processes, we propose that all meditative techniques could share a central process that would be supported by a core network for meditation since their general common goal is to induce relaxation, regulating attention and developing an attitude of detachment from one's own thoughts. To test this hypothesis, we conducted a quantitative meta-analysis based on activation likelihood estimation (ALE) of 10 neuroimaging studies (91 subjects) on different meditative techniques to evidence the core cortical network subserving meditation. We showed activation of basal ganglia (caudate body), limbic system (enthorinal cortex) and medial prefrontal cortex (MPFC). We discuss the functional role of these structures in meditation and we tentatively propose a neurocognitive model of meditation that could guide future research.     

Prayer: A Helpful Aid in Recovery from Depression

Depression is a growing issue within the field of medicine. It negatively impacts individuals’ lives and the people they are most connected to. For decades, medical professionals have been searching for solutions to assist those who are suffering from this illness. The use of drugs has not been a sufficient means of treatment to alleviate depression and its symptoms. There is a dire need to expand therapeutic interventions that can attribute meaningful recovery for victims of depression. One means of positive treatment is the use of prayer. Prayer, one of the most ancient forms of meditation, aligns and relaxes the mental state of the mind. The uses of drugs are limited by physiological focus, but prayer is a mechanism that brings human beings into a unique state of oneness. Oneness comprises the holistic nature of a human being and asserts the triad of well-being: mind, body, and spirit. As the emergence of humanities and holism continues in medicine, centering/meditative prayer and similar practices like mindfulness-based cognitive therapy can be useful therapeutic interventions specifically for major depressed patients.     

The Emotional Lexicon of Individuals Diagnosed with Antisocial Personality Disorder

This study investigated the specific emotional lexicons in narratives created by persons diagnosed with antisocial personality disorder (ASPD) to test the hypothesis that individuals with ASPD exhibit deficiencies in emotional language. Study participants consisted of 60 prison inmates with ASPD, 40 prison inmates without ASPD, and 60 men without antisocial tendencies who described situations involving love, hate and anxiety depicted by photographs. The lexical choices made in the narratives were analyzed, and a comparison of the three groups revealed differences between the emotional narratives of inmates with ASPD, inmates without ASPD, and the control group. Although the narratives of the individuals with ASPD included more words describing emotions and higher levels of emotional intensity, the valence of these words was inappropriate. The linguistic characteristics of these narratives were associated with high levels of psychopathy and low emotional reactivity.     

Association of social-environmental factors with cognitive function in children with sickle cell disease

The aim of this study was to examine the relationship between cognitive function in pediatric sickle cell disease (SCD) patients and mothers’ reports of social-environmental stress, depressive symptoms, and parenting. A total of 65 children with SCD completed comprehensive neuropsychological testing to assess several domains of cognitive functioning, including general intellectual ability, academic achievement, and executive function. Mothers reported on demographics, social-environmental stress, depressive symptoms, and parenting. As predicted, children with SCD significantly underperformed relative to normative data on measures of cognitive function. Associations between maternal social-environmental stress, maternal depressive symptoms, and parenting were mixed. The results show partial support for the hypothesis that greater stress and depressive symptoms and less positive parenting are associated with poorer cognitive function in children with SCD. Linear regression analyses showed that maternal financial stress was the strongest predictor across all domains of cognitive function. The findings replicate and extend past research, reaffirming that children with SCD are at risk for cognitive impairment across multiple domains. Additionally, social-environmental stress, particularly financial strain, is linked to mothers’ depressive symptoms and parenting behaviors as well as children’s cognitive function. Future studies using direct observations of parenting behaviors are needed. These findings, along with recent research on parenting interventions, may inform the development of concrete, teachable parenting and coping skills to improve cognitive functioning in children with SCD.     

Towards an ecologically grounded functional practice in rehabilitation

According to the International Classification of Functioning, Disability and Health, effective rehabilitation requires interventions that go beyond minimizing pathological conditions and associated symptoms. The scope of practice must include promoting an individual’s activity within relevant contexts. We argue that best practice requires decisions that are not only evidence-based but also theory-based. Perception and action theories are essential for interpreting evidence and clinical phenomena as well as for developing new interventions. It is our contention that rehabilitation goals can best be achieved if inspired by the ecological approach to perception and action, an approach that focuses on the dynamics of interacting constraints of performer, task and environment. This contrasts with organism-limited motor control theories that have important influence in clinical practice. Parallels between such theories and the medical model of care highlight their fundamental inconsistency with the current understanding of functioning. We contend that incorporating ecological principles into rehabilitation research and practice can help advance our understanding of the complexity of action and provide better grounding for the development of effective functional practice. Implications and initial suggestions for an ecologically grounded functional practice are outlined.