Violent behavior sometimes occurs in Schizophrenia and Mood Disorder, in people with Borderline and Antisocial Personality Disorder.
Psychopathy describes individuals who suffer from a profound affective deficit, including shallow emotion and inability to experience empathy, guilt or remorse.These behavioral deficits are believed to predispose psychopaths to high rates of criminal transgression and recidivism.
Advanced MR techniques have been proved of the utmost importance in investigating neuro-psychiatric disorders.
Functional and ultrastructural neuroimaging studies have shown altered function and structure of brain regions in various psychiatric conditions, contrarily to conventional magnetic resonance (MR) sequences that are generally unrevealing in patients with neurosis or psychosis.
Among mental disorders psychopathy, one of the least understood, can be associated to other mental illnesses.
Advanced MRI techniques may be useful in delineating the neurobiology of psychopathy and to differentiate changes linked specifically to psycopathy from brain functional changes associated with other mental disorders.
The aim of our project is to perform a multiparametric MR study in adult inmates with variable degrees of psycopathy and other mental disorders in order to evaluate morphologic and functional changes specifically attributable to psycopathy.
This study will include adult male subjects prospectively recruited from a cohort of prison inmates with varying degrees of psychopathy and mental disorders.
All subjects will undergo a neurocognitive and psychiatric evaluation.
MRI structural and functional data will be correlated with clinical data in order to assess how morpho-functional changes in the brain related to the Hare's Psychopathy Checklist-Revised (PCL-r), the most widely used clinimetric tool in this domain and to other mental disorders often associated to psycopathy.
No studies have been published in literature, since R.E.M.S. were opened in Italy in 2008 so we haven't yet any data about Italian criminal population admitted in these structures. Considering the high impact of this population on society this is particularly surprising. In the REMS of ASL Rm5, NGRI and social dangerous people undergo an extensive psychiatric treatment that include a complete assessment of mental functioning, PCL-r for measuring psychopathic pathways and a risk assessment to evaluate future probability of violence.
It is of utmost importance to understand future circumstances that will be likely riskful and address which changes can be made to decrease the risks. However, an assessment based only on clinical and psychopathological patterns has not been proved adequate to predict recidivism at the short-medium terms, because psychopaths could be able to conceal their symptoms. Neuroimaging data elucidating brain functioning may parallel psychiatric assessment and allow a better understanding oh this particular subgroup of criminal; it could also aid in reducing crime rates through the reduction of recidivism rates.
The strength of this project consists in the synergy between a neuroradiology unit equipped with a high-field MR system, where a research team has a specific expertise in multimodal brain investigations and a psychiatric unit of the R.E.M.S in the ASL Rm5, devoted to forensic sample especially on psychopathic evaluation.
The study will generate a comprehensive database including detailed biographical, clinical, judicial and neuropsychological data of NGRI social dangerous with functional and morphological brain characteristics of the same subjects. Such a data set will offer unique opportunities to explore the neural correlates of psychopathy.
The multidisciplinary approach to psychopathy provides innovative information over current state of the art, improving knowledge of this complex disease to better understand differences between psychopathic criminals and non-psychopathic criminal. We aim to draw up a protocol trying to predict violence and recidivism of crimes that could also be useful to develop specific treatment to reduce risk of violent behavior.
Also we have conducted a study on adult inmates in the past year. This study have proved that imaging adult inmates transferred from a REMS, although not free from risks and difficulties, is feasible. Results form the first group of subjects have produced extremely interesting result that have confirmed previous findings and also provided original observations. Also it has suggested important development of the project that is the focus of the current study.