Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany.
Institute of Forensic Psychiatry, University of Duisburg-Essen, Essen, Germany.
Schizophr Bull. 2017 Oct 21;43(6):1229-1239. doi: 10.1093/schbul/sbx012.
Among violent offenders with schizophrenia, there are 2 sub-groups, one with and one without, conduct disorder (CD) and antisocial personality disorder (ASPD), who differ as to treatment response and alterations of brain structure. The present study aimed to determine whether the 2 groups also differ in Theory of Mind and neural activations subsuming this task. Five groups of men were compared: 3 groups of violent offenders-schizophrenia plus CD/ASPD, schizophrenia with no history of antisocial behavior prior to illness onset, and CD/ASPD with no severe mental illness-and 2 groups of non-offenders, one with schizophrenia and one without (H). Participants completed diagnostic interviews, the Psychopathy Checklist Screening Version Interview, the Interpersonal Reactivity Index, authorized access to clinical and criminal files, and underwent functional magnetic resonance imaging while completing an adapted version of the Reading-the-Mind-in-the-Eyes Task (RMET). Relative to H, nonviolent and violent men with schizophrenia and not CD/ASPD performed more poorly on the RMET, while violent offenders with CD/ASPD, both those with and without schizophrenia, performed similarly. The 2 groups of violent offenders with CD/ASPD, both those with and without schizophrenia, relative to the other groups, displayed higher levels of activation in a network of prefrontal and temporal-parietal regions and reduced activation in the amygdala. Relative to men without CD/ASPD, both groups of violent offenders with CD/ASPD displayed a distinct pattern of neural responses during emotional/mental state attribution pointing to distinct and comparatively successful processing of social information.
在患有精神分裂症的暴力罪犯中，有 2 个亚组，一个有，一个没有，即品行障碍（CD）和反社会人格障碍（ASPD），他们在治疗反应和大脑结构改变方面存在差异。本研究旨在确定这 2 个亚组在包含此任务的心理理论和神经激活方面是否也存在差异。比较了 5 组男性：3 组暴力罪犯-精神分裂症加 CD/ASPD、精神分裂症在发病前没有反社会行为史，以及 CD/ASPD 没有严重精神疾病，以及 2 组非罪犯，一组有精神分裂症，一组没有（H）。参与者完成了诊断访谈、精神病检查表筛查版访谈、人际反应指数、获得临床和犯罪档案的授权访问，并在完成改编版的读心眼任务（RMET）时接受了功能磁共振成像。与 H 相比，非暴力和暴力的精神分裂症男性而非 CD/ASPD 患者在 RMET 上的表现较差，而有 CD/ASPD 的暴力罪犯，无论是否患有精神分裂症，表现相似。有 CD/ASPD 的 2 组暴力罪犯，无论是否患有精神分裂症，与其他组相比，前额叶和颞顶叶区域的网络中显示出更高水平的激活，而杏仁核的激活减少。与没有 CD/ASPD 的男性相比，有 CD/ASPD 的 2 组暴力罪犯在情绪/心理状态归因期间表现出不同的神经反应模式，这表明对社会信息进行了不同且相对成功的处理。
