Increased testosterone-to-cortisol ratio in psychopathy

International Journal of Law and Psychiatry, 2009

a b s t r a c t a r t i c l e i n f o Social aggression is an escalating hazard for individuals and society. It is most frequently observed as impulsive-reactive aggression in antisocial personality disorder (APD), but in psychopathic aggressive personalities instrumental social aggression is more prominent. However, the psychobiological mechanisms underlying human social aggression are still poorly understood. Here we propose a psychobiological mechanism that may explain human social aggression wherein the steroid hormones cortisol and testosterone play a critical role. High levels of testosterone and low levels of cortisol have been associated with social aggression in several species but it seems that in those individuals wherein these hormonal markers combine social aggression is most violent. In this review we discuss fundamental and clinical research which underscores the potential of the testosterone-cortisol ratio as a possible marker for criminal aggressive tendencies.

Psychopharmacology, 2013

Rationale-Child abuse and neglect are universal risk factors for delinquency, violence, and aggression; this phenomenon is known as the cycle of violence. Additional factors-psychopathy, impulsiveness, and disruptions in the hypothalamic-pituitary-adrenal (HPA) axis-play a role in aggressive behavior but have rarely been examined in the same conceptual and experimental framework. Objectives-We sought to examine the above-mentioned risk factors for aggression in a prospective study employing psychopharmacologic and psychometric techniques. Methods-Sixty-seven adult participants were given an acute dose of 20 mg cortisol in a placebo-controlled, within-subject, counterbalanced dosing design. Salivary cortisol was measured at baseline and at regular intervals across a 5 h testing period. Following dosing, stateaggressive behavior was measured by a laboratory task, the Point-Subtraction Aggression Paradigm. History of child abuse/−neglect, psychopathy, impulsivity, and a trait measure of aggression were assessed through self-report questionnaires. Results-Using multiple regression, a model including abuse/neglect, psychopathy, impulsivity, and baseline cortisol explained 58 % of the variance in trait aggression and 26 % of the variance in state aggression. Abuse/neglect predicted diminished HPA-axis reactivity and HPA-axis reactivity showed a trend toward predicting state and trait aggression, although it was not a significant mediating variable between abuse/neglect and aggression. Conclusions-The results indicate that child maltreatment, psychopathy and HPA-axis reactivity interact to provide a confluence over aggressive behavior, and intervention efforts need to consider all these factors.

Psychoneuroendocrinology, 2013

Previous research revealed hypothalamic-pituitary-adrenal (HPA) axis abnormalities in relation to antisocial and aggressive behavior. Some evidence suggests that low cortisol levels may serve as a biological marker for a severe antisocial subgroup with pronounced callousunemotional (CU) traits. Children displaying the combination of severe antisocial behavior and CU traits appear to be particularly at risk of developing adult psychopathy. Given the lack of studies on the relationship between cortisol levels and CU traits in antisocial adolescents, the current study investigates whether cortisol levels are uniquely associated with CU traits as compared to other psychopathy dimensions (i.e., narcissism and impulsivity). Detained antisocial adolescents (n = 63) and a community comparison group (n = 62) completed diaries and collected three saliva samples daily on two days, with compliance monitored electronically. Psychopathy dimensions were assessed through self-report questionnaires. Externalizing symptoms were assessed by structured clinical interview. Multilevel regression analyses indicated no differences in cortisol levels or diurnal slopes between the two groups. Overall, cortisol levels were not significantly related to psychopathy dimensions. However, greater impulsivity was associated with lower cortisol levels in the community sample, but not in the antisocial group. Conclusion: Results cast doubt on the notion of low cortisol levels as a biological marker for CU traits. Low basal cortisol levels appear to be more closely related to a general deficit in behavioral regulation. Implications for future research are discussed. #

Acta Psychiatrica Scandinavica, 2007

Although previous studies have revealed an association between androgens and aggression, there is a lack of knowledge of this issue in different mental disorders. The associations between serum testosterone levels and criminal behaviour in different mental disorders were examined using data collected from forensic psychiatric male patients (20 schizophrenics and 42 subjects with personality disorders). Male criminals with personality disorders had significantly higher serum levels of total and free testosterone than criminal schizophrenics. Among schizophrenics, total (P=0.01) and free testosterone (P=0.01) declined significantly more with age compared to healthy controls and patients with personality disorders, and also correlated with duration of neuroleptic drug use (r=-0.60, P=0.000 for total and r=-0.46, P=0.0001 for free testosterone). The recidivists with personality disorder had higher total (P=0.04) and free testosterone (P=0.05) levels than non-recidivists with personality disorder. Personality disordered criminals with multiple offences had high serum testosterone levels. The low testosterone concentrations among schizophrenics may be due either to long-term use of neuroleptic agents or to the mental illness itself and its possible inhibition of the pituitary-gonadal axis.

Biological Psychology, 2008

The relationship between self-reported traumatic childhood experiences, cortisol levels, aggression, and psychopathy was investigated in prison inmates (n = 47) and healthy controls (n = 27). Besides questionnaires, a brief salivary diurnal profile was measured. Results show that criminals (both psychopaths and non-psychopaths) demonstrate more traumatic childhood experiences than the control group. Within the group of criminals, psychopaths showed the lowest diurnal cortisol concentrations, whereas the non-psychopaths demonstrated highest daily average cortisol (DAC) scores. High levels of aggression were related to traumatic childhood experiences in non-psychopaths and control participants, but not in psychopaths. Although psychopathic offenders demonstrated low levels of cortisol, high levels of childhood traumatic experiences and high levels of aggression, cortisol was not a mediating factor between childhood traumatic experiences and aggression. Implications of the finding that psychopathic offenders displayed lower and non-psychopaths showed higher daily cortisol levels are discussed. #

Since its theoretical inception, psychopathy has been considered by philosophers, clinicians, theorists, and empirical researchers to be substantially and critically explained by genetic factors. In this systematic review and structural analysis, new hypotheses will be introduced regarding gene–gene and gene–environment interactions in the etiology of psychopathy and sociopathy. Theory and research from neurobiological and behavioral sciences will be integrated in order to place this work in a broader conceptual framework and promote synergy across fields. First, a between groups comparison between psychopathy and sociopathy is made based on their specific dysfunctions in emotional processing, behavioral profiles, etiological pathways, HPA-axis functioning, and serotonergic profiles. Next, it is examined how various polymorphisms in serotonergic genes (e.g., TPH, 5HTT, HTR1A, HTR2A, HTR2C, and HTR3) might contribute either individually or interactively to the development of these disorders and through which specific biological and behavioral endophenotypes this effect could be mediated. A short introduction is made into mediating variables such as GABAergic functioning and testosterone which could potentially alter the decisive effect of serotonergic genotypes on behavior and physiology. Finally, critical commentary is presented on how to interpret the hypotheses put forward in this review.

Journal of Psychopathology and Behavioral Assessment, 2014

Psychopathy is thought to be related to a lack of empathy which interferes with conscience development and promotes aggressive behavior. Little research has examined underlying mechanisms contributing to psychopathy, empathy, and aggression, such as an altered Hypothalamic-Pituitary-Adrenal axis response system. The current study examined how subscales of psychopathic personality traits, empathy, and aggression are related to the cortisol awakening response (CAR), an index of an individual's physiological preparedness for the challenges of the upcoming day. A mixed-sex sample of 57 college students was recruited for the study, and HLM analyses tested whether these constructs were related to blunted CAR. Results indicated that Machiavellian Egocentricity, Blame Externalization, and Carefree Nonplanfulness subscales of the Psychopathic Personality Inventory -Short Form were all related to blunted CAR, whereas the Social Potency subscale was significantly related to steeper CAR increase. Further, affective empathy and reactive physical aggression were related to blunted CAR. Findings suggest that CAR provides a novel biological index of psychopathic personality traits, affective empathy, and reactive physical aggression.

eNeuro, 2016

Psychopathic individuals are notorious for their controlled goal-directed aggressive behavior. Yet, during social challenges, they often show uncontrolled emotional behavior. Healthy individuals can control their social emotional behavior through anterior prefrontal cortex (aPFC) downregulation of neural activity in the amygdala, with testosterone modulating aPFC-amygdala coupling. This study tests whether individual differences in this neuroendocrine system relate to the paradoxical lack of emotional control observed in human psychopathic offenders. Emotional control was operationalized with an fMRI-adapted approach-avoidance task requiring rule-driven control over rapid emotional responses. Fifteen psychopathic offenders and 19 matched healthy control subjects made approaching and avoiding movements in response to emotional faces. Control of social emotional behavior was required during affect-incongruent trials, when participants had to override affect-congruent, automatic action...

2024

Psychopathy is a personality disorder characterized by a lack of empathy, antisocial behavior, manipulation, and superficial charm. This study comprehensively reviews the neurobiological aspects, including anomalies in the prefrontal cortex and amygdala, as well as abnormal brain activity related to emotional regulation and reward processing. Additionally, genetic and environmental factors, such as child abuse and family dynamics, are explored for their interactive influence on the disorder's development. Successful and unsuccessful psychopathy is distinguished based on neurobiological and behavioral differences. Evaluation is primarily conducted using the Hare Psychopathy Checklist-Revised (PCL-R). Current interventions, including cognitive-behavioral therapy and the potential use of oxytocin, show limited results, highlighting the need for future research to develop more effective and personalized preventive and therapeutic strategies.

Psychoneuroendocrinology, 2021

Social anxiety and psychopathy have conceptually been linked to nearly opposite emotional, behavioral and endocrinological endophenotypes, representing social fearfulness and fearlessness, respectively. Although such a dimensional view has theoretical and practical implications, no study has directly compared social anxiety and psychopathy in terms of emotional experiences, relevant hormones (i.e. cortisol, testosterone) and behavioral tendencies (i.e. social approach-avoidance). Therefore, the present study examined 1) whether self-reported social anxiety and psychopathic traits are indeed anticorrelated, and 2) whether social anxiety, psychopathic traits, cortisol, testosterone and their interplay are differentially linked to social approach-avoidance tendencies. In a well-powered study, a sample of 196 healthy female participants, we assessed self-reported emotional and behavioral tendencies of social fear (i.e. social anxiety and social avoidance) and psychopathic traits (i.e. Factor I [interpersonal-affective deficit] and Factor II [impulsive behavior]). Furthermore, hormone levels were assessed, and approach-avoidance tendencies towards emotional (angry, happy) facial expressions were measured by means of a joystick reaction time task. Results confirmed that self-reported emotional tendencies of social anxiety and psychopathy Factor I (interpersonal-affective deficit) correlated negatively, but self-reported behavioral tendencies (social avoidance and psychopathy Factor II [impulsive behavior]) correlated positively. Furthermore, Structural Equation Modelling demonstrated that participants with higher social anxiety and higher cortisol levels showed an avoidance tendency towards happy faces, while participants with higher psychopathic traits showed an approach tendency towards angry faces. In sum, the notion that social anxiety and psychopathic traits are opposing ends of one dimension was supported only in terms of self-reported emotional experiences, but a comparable relationship with regard to behavioral and endocrinological aspects is debatable. The current findings stress the necessity to study emotional, endocrinological and behavioral factors in unison in order to better understand the shared and distinctive mechanisms of social anxiety and psychopathic traits.