# Cortical Structure in Relation to Empathy and Psychopathy in 800 Incarcerated Men

## TL;DR

The study found that incarcerated men with high psychopathy scores have reduced empathy and specific changes in brain structure, which could help in developing treatments for psychopathy.

## Contribution

The study provides novel insights into the relationship between psychopathy, empathy, and cortical structure in a large sample of incarcerated men.

## Key findings

- Men with high psychopathy had reduced empathic concern and increased cortical surface area.
- Cortical thickness showed a compressed macroscale organization in men with high psychopathy.
- The study identified specific brain regions and networks affected by psychopathy.

## Abstract

Reduced empathy is a hallmark of individuals with high (i.e., clinical) levels of psychopathy, who are overrepresented among incarcerated men. However, a comprehensive, well-powered mapping of cortical structure in relation to empathy and psychopathy is still lacking.

In 804 incarcerated adult men, we administered the Perspective Taking (IRI-PT) and Empathic Concern (IRI-EC) subscales of the Interpersonal Reactivity Index (IRI), the Psychopathy Checklist-Revised (PCL-R; with interpersonal/affective [F1] and lifestyle/antisocial [F2] factors), and T1-weighted magnetic resonance imaging to quantify cortical thickness (CT), surface area (SA), and structural-covariance gradients.

PCL-R F1 was uniquely negatively related to IRI-EC, while PCL-R F2 was uniquely negatively related to IRI-PT. Cortical structure was not related to the IRI subscales. In contrast, CT was related to PCL-R F1 (mostly positively), SA was related to both PCL-R factors (only positively), and both cortical indices demonstrated out-of-sample predictive utility for PCL-R F1. Compared to men with low psychopathy, men with high psychopathy had uniquely lower IRI-EC scores and increased SA (but not CT); effect sizes across the cortex were largest in the paralimbic class and somatomotor network, while spatial overlap with meta-analytic task-based activations was highest for (social-)affective/sensory clusters. Finally, the total sample revealed anterior-posterior structural-covariance gradients; in men with high psychopathy, the gradient of CT (but not SA) was globally compressed.

Men with high psychopathy had reduced empathic concern, increased SA, and a compressed macroscale organization of CT, indicating selective co-alterations in empathy and cortical structure. Future work should build on these novel insights in both the general and incarcerated populations to inform the treatment of psychopathy.

Reduced empathy is a hallmark of individuals with high (i.e., clinical) levels of psychopathy. These individuals are overrepresented among incarcerated men and are at high risk for future antisocial behavior. However, relationships of cortical structure with empathy and psychopathy remain poorly understood. Here, we measured empathy and psychopathy alongside cortical thickness (CT) and surface area (SA) in ∼800 incarcerated men. Men with high psychopathy had reduced empathic concern, increased SA, and a distinct pattern of the way CT varied across the cortex. These novel insights into behavior and brain structure in a large antisocial sample aim to inform the treatment of psychopathy.

Reduced empathy is a hallmark of individuals with high (i.e., clinical) levels of psychopathy. These individuals are overrepresented among incarcerated men and are at high risk for future antisocial behavior. However, relationships of cortical structure with empathy and psychopathy remain poorly understood. Here, we measured empathy and psychopathy alongside cortical thickness (CT) and surface area (SA) in ∼800 incarcerated men. Men with high psychopathy had reduced empathic concern, increased SA, and a distinct pattern of the way CT varied across the cortex. These novel insights into behavior and brain structure in a large antisocial sample aim to inform the treatment of psychopathy.