Department of Psychology, University of Chicago, Chicago IL, USA ; Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago IL, USA.
Front Hum Neurosci. 2013 Sep 24;7:489. doi: 10.3389/fnhum.2013.00489. eCollection 2013.
While it is well established that individuals with psychopathy have a marked deficit in affective arousal, emotional empathy, and caring for the well-being of others, the extent to which perspective taking can elicit an emotional response has not yet been studied despite its potential application in rehabilitation. In healthy individuals, affective perspective taking has proven to be an effective means to elicit empathy and concern for others. To examine neural responses in individuals who vary in psychopathy during affective perspective taking, 121 incarcerated males, classified as high (n = 37; Hare psychopathy checklist-revised, PCL-R ≥ 30), intermediate (n = 44; PCL-R between 21 and 29), and low (n = 40; PCL-R ≤ 20) psychopaths, were scanned while viewing stimuli depicting bodily injuries and adopting an imagine-self and an imagine-other perspective. During the imagine-self perspective, participants with high psychopathy showed a typical response within the network involved in empathy for pain, including the anterior insula (aINS), anterior midcingulate cortex (aMCC), supplementary motor area (SMA), inferior frontal gyrus (IFG), somatosensory cortex, and right amygdala. Conversely, during the imagine-other perspective, psychopaths exhibited an atypical pattern of brain activation and effective connectivity seeded in the anterior insula and amygdala with the orbitofrontal cortex (OFC) and ventromedial prefrontal cortex (vmPFC). The response in the amygdala and insula was inversely correlated with PCL-R Factor 1 (interpersonal/affective) during the imagine-other perspective. In high psychopaths, scores on PCL-R Factor 1 predicted the neural response in ventral striatum when imagining others in pain. These patterns of brain activation and effective connectivity associated with differential perspective-taking provide a better understanding of empathy dysfunction in psychopathy, and have the potential to inform intervention programs for this complex clinical problem.
虽然已经明确表明，精神病患者在情感唤起、情感同理心和关心他人福祉方面存在明显缺陷，但尽管同理心在康复中具有潜在应用，同理心的换位思考能力是否能引起情感反应仍有待研究。在健康个体中，情感换位思考已被证明是引起同理心和对他人关心的有效手段。为了研究在情感换位思考中个体的精神病态程度不同时的神经反应，我们对 121 名被监禁的男性进行了扫描，这些男性被分为高（n = 37； Hare 精神病态检查表修订版，PCL-R ≥ 30）、中（n = 44；PCL-R 在 21 到 29 之间）和低（n = 40；PCL-R ≤ 20）精神病态者，他们观看了描绘身体伤害的刺激物，并采用了想象自我和想象他人的视角。在想象自我的视角中，高精神病态者在涉及疼痛同理心的网络中表现出典型的反应，包括前岛叶（aINS）、前扣带皮层（aMCC）、辅助运动区（SMA）、下额叶回（IFG）、体感皮层和右侧杏仁核。相反，在想象他人的视角中，精神病态者表现出一种非典型的大脑激活模式和有效连接，该模式以杏仁核和前岛叶为种子，与眶额皮质（OFC）和腹内侧前额叶皮质（vmPFC）相连。在想象他人时，杏仁核和前岛叶的反应与 PCL-R 因子 1（人际/情感）呈负相关。在高精神病态者中，PCL-R 因子 1 的分数预测了在想象他人疼痛时腹侧纹状体的神经反应。这些与同理心换位思考相关的大脑激活和有效连接模式为理解精神病患者同理心功能障碍提供了更好的认识，并有可能为这一复杂的临床问题提供干预方案。
