The Neuroendocrinology of Psychopathy Abraham J. Nunes MD, MBA - - PowerPoint PPT Presentation

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The Neuroendocrinology of Psychopathy Abraham J. Nunes MD, MBA - - PowerPoint PPT Presentation

Apr 11, 2023 291 likes •658 views

Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions The Neuroendocrinology of Psychopathy Abraham J. Nunes MD, MBA PGY-1, Psychiatry Dalhousie University Abraham J.

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

The Neuroendocrinology of Psychopathy

Abraham J. Nunes MD, MBA

PGY-1, Psychiatry Dalhousie University

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

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Introduction to Psychopathy

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Somatic Findings in Psychopathy

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Neural Bases of Psychopathy

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A Focus on OXT/AVP

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Future Directions

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

What is a psychopath?

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

The Dual-Deficit Model

Affective-Interpersonal Impulsive-Antisocial Predatory disposition Disinhibition/impulsivity Lack of empathy Pervasive antisocial behaviour Shallow affect Lack of concern about performance

Table: Broad overview of the dual-deficit (a.k.a two-factor model of psychopathy.

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

They were all once children...

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Conduct Disorder

Children with conduct disorder are a heterogeneous population:

1 Those with callous-unemotional traits 2 Those with high mood lability and

increased risk for mood and anxiety disorders

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Psychology of CU Traits

Predominant impairments in the following neuropsychological domains:

1 Emotional empathy 2 Emotional learning and decision making Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Psychopaths Re-offend More...

Salekin et al. J Personality Assessment 2003;80:154-63

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

...and Sooner after Release

Olver & Wong. Personality Disorders 2014; Advance Online Pub.

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Hypoarousal: Resting HR

  • Raine. Ann NY Acad Sci 1996;794:46-59

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Hypoarousal: HR Reactivity

Ortiz & Raine. J Am Acad Child Adol Psychiatry 2004;2:154-62

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Hypoarousal: HR Reactivity

Casey et al. Biol Psychol 2013;92:541-48

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Hypoarousal: SCR & Startle

Rothemund et al. Biol Psychol 2012;90:50-9

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Hypoarousal: Cortisol

Oosterlaan et al. Psychiatry Res 2005;134:1-10

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Hypoarousal: Cortisol

Holi et al. Psychopathol 2006;39:102-4

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Hypoarousal: Anti-ACTH Antibody

Schaefer et al. Psychoneuroendocrinology 2013;38:3039-47

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Anti-ACTH & Cortisol Response

Schaefer et al. Psychoneuroendocrinology 2013;38:3039-47

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Role for Testosterone?

Johnson et al. Dev Psychobiol JT 2014;56:448-58

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Heritability

Viding et al. J Child Psychol Psychiatry 2005;46:592-7

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Persistence

Lynam et al. J Abn Psych 2007;116:155-65

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Neural Basis of Moral Deficits

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Neural Basis of Social Behaviour

Millan et al. Nat Rev Drug Disc 2012;11:141-168

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Neural Basis of Social Behaviour

Tost & Meyer-Lindenberg. Nat Med 2012;18:211-213

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Cognitive Model of Psychopathy

  • Blair. Nat Rev Neurosci 2013;14:786-99

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Neural Basis of Deficits

  • Blair. Nat Rev Neurosci 2013;14:786-99

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Neural Basis of Deficits

  • Blair. Nat Rev Neurosci 2013;14:786-99

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Amygdalal Connectivity

Motzkin et al. J Neurosci 2011;30:17348-57

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Amygdalal Connectivity

Motzkin et al. J Neurosci 2011;30:17348-57

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

OXTR and AVPR Genes

Meyer-Lindenberg et al. Nat Rev Neurosci 2011;12:524-38

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

OXT/AVP Neurosignalling

  • Benarroch. Neurology 2013;80:1521-8

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

OXTR & Social Neurosignalling

Meyer-Lindenberg & Tost. Nat Neurosci 2012;15:663-68

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

OXT/AVP: Behavioural Effects

Neuropeptide Effects OXT ↓ cortisol during social stress ↓ amygdala during social stress ↑ empathic accuracy ↑ eye gaze AVP ↑ cortisol during social stress ↓ trustingness in males ↑ trustingness in females ↓ social motivation

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Integrative Model

Meyer-Lindenberg et al. Nat Rev Neurosci 2011;12:524-38

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Studies of OXTR and Psychopathy

Children with ↑ CU traits have: OXTR polymorphisms Greater OXTR methylation ...but we dont know much more!

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Research Questions

1

(How) would exogenous OXT/AVP alter psychopathic cognition?

2

Do HPA/HPG axis function play moderating or mediating roles?

3

Are changes in OXT/AVP system a state or trait phenomenon in psychopathy?

4

Is OXT integral to theory of mind, or vice versa?

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy

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Introduction to Psychopathy Somatic Findings in Psychopathy Neural Bases of Psychopathy A Focus on OXT/AVP Future Directions

Summary

Significant public health issue Hereditary and persistent Deficits in social-emotional processing Generalized autonomic hypoarousal Significant endocrine correlates Impaired amygdalal fx & connectivity

Abraham J. Nunes MD, MBA The Neuroendocrinology of Psychopathy