Oxytocin normalizes the implicit processing of fearful faces in psychopathy: a randomized crossover study using fMRI

John Tully; Arjun Sethi; Julia Griem; Yannis Paloyelis; Michael C. Craig; Steven C.R. Williams; Declan Murphy; Robert James Blair; Nigel Blackwood

doi:10.1038/s44220-023-00067-3

Oxytocin normalizes the implicit processing of fearful faces in psychopathy: a randomized crossover study using fMRI

John Tully^*, Arjun Sethi, Julia Griem, Yannis Paloyelis, Michael C. Craig, Steven C.R. Williams, Declan Murphy, Robert James Blair, Nigel Blackwood

^*Corresponding author for this work

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Abstract

Adults with antisocial personality disorder with (ASPD + P) and without (ASPD – P) psychopathy commit the majority of violent crimes. Empathic processing abnormalities are particularly prominent in psychopathy, but effective pharmacological interventions have yet to be identified. Oxytocin modulates neural responses to fearful expressions in healthy populations. The current study investigates its effects in violent antisocial men. In a placebo-controlled, randomized crossover design, 34 violent offenders (19 ASPD + P; 15 ASPD – P) and 24 healthy non-offenders received 40 IU intranasal oxytocin or placebo and then completed an fMRI morphed faces task examining the implicit processing of fearful facial expressions. Increasing intensity of fearful facial expressions failed to appropriately modulate activity in the bilateral mid-cingulate cortex in violent offenders with ASPD + P, compared with those with ASPD – P. Oxytocin abolished these group differences. This represents evidence of neurochemical modulation of the empathic processing of others’ distress in psychopathy.

Original language	English
Pages (from-to)	420-427
Number of pages	8
Journal	Nature Mental Health
Volume	1
Issue number	6
DOIs	https://doi.org/10.1038/s44220-023-00067-3
Publication status	Published - 25 May 2023

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Oxytocin normalizes_TULLY_Publishedonline25May2023_GOLD VoR (CC-BY)Final published version, 2.67 MBLicence: CC BY

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abstract = "Adults with antisocial personality disorder with (ASPD + P) and without (ASPD – P) psychopathy commit the majority of violent crimes. Empathic processing abnormalities are particularly prominent in psychopathy, but effective pharmacological interventions have yet to be identified. Oxytocin modulates neural responses to fearful expressions in healthy populations. The current study investigates its effects in violent antisocial men. In a placebo-controlled, randomized crossover design, 34 violent offenders (19 ASPD + P; 15 ASPD – P) and 24 healthy non-offenders received 40 IU intranasal oxytocin or placebo and then completed an fMRI morphed faces task examining the implicit processing of fearful facial expressions. Increasing intensity of fearful facial expressions failed to appropriately modulate activity in the bilateral mid-cingulate cortex in violent offenders with ASPD + P, compared with those with ASPD – P. Oxytocin abolished these group differences. This represents evidence of neurochemical modulation of the empathic processing of others{\textquoteright} distress in psychopathy.",

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Oxytocin normalizes the implicit processing of fearful faces in psychopathy: a randomized crossover study using fMRI

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