Blair R J R
Mood and Anxiety Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA.
Ann N Y Acad Sci. 2007 Dec;1121:461-79. doi: 10.1196/annals.1401.017. Epub 2007 Aug 14.
Psychopathy is a developmental disorder marked by emotional hypo-responsiveness and an increased risk for instrumental and reactive aggression. In this paper, it will be argued that the developmental origins of psychopathy do not lie in orbitofrontal cortex (OFC) dysfunction. This is because the key functional impairments seen in psychopathy are associated with amygdala damage, not with OFC damage. However, it will be argued that the role played by the integrated functioning of the amygdala and medial OFC in stimulus-reinforcement learning and decision making is disrupted in psychopathy. Impaired learning of stimulus-reinforcement associations and representation of reinforcement expectations are thought to underlie the impairments in socialization and appropriate decision making seen in psychopathy. It is suggested that the impairment in the role of medial OFC in prediction error signaling and the detection of contingency change may underlie the impairments in flexible behavioral change seen in psychopathy.
精神变态是一种发育障碍，其特征为情感反应不足以及工具性攻击和反应性攻击风险增加。在本文中，将论证精神变态的发育起源并不在于眶额皮质（OFC）功能障碍。这是因为在精神变态中所见的关键功能损害与杏仁核损伤相关，而非与OFC损伤相关。然而，将论证在精神变态中，杏仁核和内侧OFC的整合功能在刺激 - 强化学习和决策中所起的作用受到了干扰。刺激 - 强化关联学习受损以及强化预期的表征被认为是精神变态中社交化和适当决策受损的基础。有人提出，内侧OFC在预测误差信号传递和意外变化检测中的作用受损可能是精神变态中灵活行为改变受损的基础。
