A New Path for Treating Psychopathy

Whether it’s through books, movies, T.V, or study, most of us have at least heard of psychopaths, cold, emotionless and manipulative people who will do anything to get what they want without regards for others, master criminals and the apparently good fodder for crime television shows. But psychopathy isn’t as distant a problem as you may think. Psychopathy is present in about 1% of men in the US. That may not sound like a lot until you realize that’s something like 1,150,000 people, with about 93% of those incarcerated or on parole (Kiehl and Hoffmam, 2011). Furthermore, the cost of the recidivism of people with psychopathy alone is a jaw dropping 460 billion dollars a year in criminal social costs. That’s more than the societal cost of obesity and smoking combined. Because of their high prevalence in prison populations and the cost incurred on society, there is allot of good in providing an effective treatment method, and by effective I mean effective at reducing recidivism rates and violent crime, not necessarily at changing their indifferent personalities.

            Until very recently, the hope of finding any sort of treatment for psychopathy was very thin. People with psychopathy don’t respond well to the average talk therapy, in fact a few famous studies show that group and psychoanalytic therapy actually helps them to become better psychopaths learning instead how to better manipulate others (Kiehl and Hoffman, 2011). The fatal flaw in these treatments tends to be that they focus on changing personality factors, believing that the way to deal with someone who seemingly lacks feeling is to somehow get them to feel their own feelings better (Lewis, Olver & Wong, 2013). A second and more effective form of treatment is to address strictly violent behavior through cognitive behavioral approach addressing and changing violent attitudes and behaviors. Programs like these such as the Aggressive Behavior Control (ABC) program have been implemented in Canada for just over a decade. The unfortunate part about this program and others like it is that they tend to have a very small effect on recidivism if any. In fact ABC program participants fared no better than controls in terms of recidivism in general. Although, those who completed the program were less likely to commit violent crime in order to earn their new sentences (Lewis, Olver & Wong, 2013).

            Fortunately, there’s a new treatment in the works, or at least what may be the start of one’s development. A group of psychologists and neuroscienctist at Yale recently completed part of study that tests a new theory of psychopathy treatment. One of the less sensationalized consequences of psychopathy is that people afflicted have a peculiar attention problem. They suffer from a kind of attentional bottle neck, filtering out information that is irrelevant to the goal at hand. People with psychopathy are actually able to do moral decision making tasks just fine as long as they aren’t distracted by some other goal (Baskin-Sommers, Curtin &Newman, 2014). This helps explain why recidivism rates for people with psychopathy are so high. They might know they are on parole, but that information is pushed aside in the face of the opportunity to gain something they want at that moment. It’s theorized that this hyper focused attention it what leads people with psychopathy to not consider the consequences of their actions, (they are not “addicted to murder” as a certain ShowTime drama would have you believe).

            With this view of psychopathy in mind, it makes sense that fixing the attention problem would help fix the criminal behavior problem. In order to treat this attention problem, the Yale study enlisted the help of a treatment type called cognitive remediation, in which specific cognitive skills related to cognitive deficits are trained up. The training (which consisted of essentially computer games) focused on getting participants to pay attention to context cues like subtle rule changes and incorporating emotional information. The results? People with psychopathy who were treated did improve significantly in their ability to complete not only the tasks they trained for, but also other tasks that tested attention deficit. In other words, their attention bottle neck was widened somewhat. How do these results relate to recidivism? Well it’s far too early to tell not enough time has elapsed to know how these new skills will relate to behavior, but the results are incredibly promising.

A full cognitive remediation treatment is still a ways off on the horizon, but these results are certainly a good first step. Not only would these treatments be cheap, they would also be effective. In a country that loses so much money to an inefficient prison system any across the board reduction could potentially save millions of dollars and help thousands on the way to a better life.

Baskin-Sommers, A. R., Curtin, J. J, & Newman, J. P. (2014). Altering the Cognitive-affective dysfunctions of psychopathic and externalizing offender subtypes with cognitive remediation. Clinical Psychological Science.

Kiehl, K., & Hoffman, M. (2011).The criminal psychopath: history, neuroscience, treatment, and economics. Jurimetrics, 51, 355-397. 

Olver, M. E., Lewis, K., & Wong, S. C. P. (2013). Risk reduction treatment of high-risk psychopathic offenders: the relationship of psychopathy and treatment change to violent recidivism. Personality Disorders: Theory, Research, and Treatment, 4(2), 160-167.

Train Your Brain

Train Your Brain

            Your brain is an amazing work of biological machinery with the ability to compute, file process, and understand the many complexities of the world around us. It has the ability to function on several different levels, focusing on one stimuli and then quickly shifting focus to the next, all while functioning under our subconscious. There are many hypotheses on how our attention relates and interacts with our cognition, and Dr. Zabelina from Northwestern University focuses primarily on two on her study, “Short-term attentional preservation associated with real-life creative achievement.” One hypothesis states that highly creative people are flexible at switching their attention. The second hypothesis states that creative people exhibit the ability for sustained attention. Her results from both the experiments demonstrated that real-world creative acts relates to increased level of sustained attention even if it comes with the cost of preservation in some occurrences. However, newer research from the University of Montreal indicates that targeted brain training may in fact help an individual multitask better. An individual can actually preform everyday tasks such as cooking, watching a movie, browsing the web or driving and train the flexibility of their brain. Divergent thinking is a phenomena that can actually be trained, and therefore just like an individual works on strengthening their body, they should also work on strengthening their brain. One of my favorite ways to work on working on my attention is by playing video games. It may seem obscure, but video games train your reaction time, your hand-eye coordination, your foresight and numerous other levels of thinking. If I had to choose between working out my brain by doing logic problems or by playing video games, gaming wins 11 times out of 10.

            The team in the University of Montreal explain how mental exercises improve our cognitive ability. The first obstacle in their research was understanding the association between the type of cognitive training preformed and the resulting effects on the brain. They needed to better understand the ways to activate certain areas of the brain and target these areas to get specific results. Researchers are now able to map our functioning to specific areas of our brain, using functional magnetic resonance imaging to assess the impact of training on various types of attentional tasks. The training increases functioning in the middle prefrontal region, which is the area known to be responsible for divergent thinking.

            Now that we know how cognitive training affects the portion of the brain that controls multitasking and attentional flexibility, individuals can work on finding the right combination of plasticity and attention control. Just as working out can improve one’s health and increases one’s life, cognitive training can increase mental life and cognitive functionality as one grows older. With Alzheimer’s, Parkinson’s, Schizophrenia, and other mental disorders around, shouldn’t one’ goal be to preserve their cognitive ability for as long as possible?  

Universite de Montreal. (2014, August 20). Targeted brain training may help you multitask better. ScienceDaily. Retrieved December 12, 2014             from www.sciencedaily.com/releases/2014/08/140820091050.htm

Zabelina DL and Beeman M (2013) Short-term attentional perseveration associated with real-life creative achievement.Front. Psychol. 4:191. doi: 10.3389/fpsyg.2013.00191

Mindful Undergraduate

“Attention is the gateway to awareness and probably happiness to.” Sometimes our awareness seems to be restricted to the stimuli of our focused attention, and other times, irrelevant distractors will dominate our awareness. At times we find that our awareness and attention appear to diverge, and we’re incapable of blocking awareness to irrelevant distractions despite focusing attention on our task, while other times, we find our selves solely aware of what we are attending to. According to Dr. Grabowecky, the selective nature of attention is important for goal-directed behavior. When we are really not expecting something, we may miss it entirely. Sometimes, even when we see something, we may miss a feature of the stimulus. Thus, the ultimate goal is to control attention. There are two forms of meditation discussed by Dr. Grabowecky; focused attention meditation, which entails voluntary focusing of attention on a chosen object, and reactive monitoring of the content of experience from moment to moment. Such meditation practices on attention may potentially have numerous long-term benefits to ones mental and behavioral well being.

            Now, take into account an undergraduate student that lives on campus. In an environment that is very academically demanding, attention can be elusive and even difficult to consistently maintain. This lack of concentration may potentially interfere with learning. As a result, it may further perpetuate stress to students that only increases as the academic term progresses.

Alexandra B. Morrison conducted a seven-week study on undergraduate students to see the effects of meditation on focus. Participants in the study were taught and practiced mindful meditation. Mindfulness is a mental state where the subject pays attention only to the present experience. They are not to worry about the past or the future.

            Interesting enough, the results of the study went in accordance to Dr. Graboweky’s claim of the positive effects of meditation on attention. The results of the study showed that the control group, the group of students who were not directed to partake in mindful meditation, showed diminished attention and reported increased mind wandering by the end of the study. On the other hand, the group that participated in the program showed significant improvements in attention. In addition to that, they reported no increase in mind wandering.

            The implications of this research are fascinating and helpful. Many undergraduate students succumb to the consumption of excess caffeine, vitamin B’s, and even various cognitive enhancing drugs in order to be able to study or focus longer. Some even consume strong prescription stimulants that may have a multitude of side effects. By constructively implementing a consistent meditation session on a regular basis, one may be able to naturally improve attention.

Journal Reference:

Lutz, A., Slagter, H. A., Dunne, J. D., & Davidson, R. J. (2008). Attention regulation and  monitoring in meditation. Trends in cognitive sciences, 12(4), 163-169.

Article Reference:

University of Miami. (2014, January 14). Mindfulness helps undergraduates stay on track. ScienceDaily. Retrieved December 12, 2014 from            www.sciencedaily.com/releases/2014/01/140114103042.htm

Alexandra B. Morrison, Merissa Goolsarran, Scott L. Rogers, Amishi P. Jha. Taming a wandering attention: short-form mindfulness training in student cohorts. Frontiers in Human Neuroscience, 2014; 7 DOI: 10.3389/fnhum.2013.00897

The Implications of Non-Invasive Testing

In the findings on noninvasive bladder sensory test, there is an interesting trend in noninvasive testing in the field of obstetrics and gynecology. Visceral pain conditions, like interstitial cystitis/bladder pain syndrome, plague about fifteen to twenty percent of women today. With no effective treatment to bladder pain syndrome, preventive measures become key to treating disease before it manifests into a larger issue. New research shows that noninvasive, three dimensional ultrasound testing connects dysmenorrhea, noxious mechanosensitivity, and bladder volumes to impact the way physicians test in clinical settings. For women, this new non-invasive testings option provides an excellent prevention measure for bladder pain, pelvic pain, and dysmenorrhea.

Similarly, there is a push for noninvasive testing in cardiology, orthopedics, and obstetrics (to name a few). Another significant and devastating diseases for women lies with the risk of aneuploidy during pregnancy. Aneuploidy describes a missing or extra chromosome; one common example is an extra chromosome at chromosome 21 resulting in Down syndrome. In the past three decades, the shift to prenatal testing has been able to improve early diagnosis of Down syndrome by 90%. The assessment of non-invasive testing from a obstetric point of view analyzed the prenatal techniques, costs, counseling and ethical issues. Most interesting, non-invasive prenatal testing (NIPT) was plainly stated as costly; however, the high-risk pregnancies have benefits that outweigh the costs for the well being of mother and baby. Unlike non-invasive gynecological testings, NIPT incorporates ethical decisions in this type of testings because many parents want the perfect pregnancy, the perfect delivery, and the perfect baby. In reality, prenatal testings can reveal genetic abnormalities in the child or children. This leads to parents making early decisions to deliver the baby or terminate the fetus. Although NIPT provides more extensive medical information, this early information can lead to ethical and moral decisions.

By looking at different spectrum of women’s medical concerns, there is a definite prevalence in non-invasive testing measures. Non-invasive testings has become a critical and innovative aspect to modern healthcare. New medical discoveries provide patients with more efficient ways to reveal information about the current state of their health. Gynecology non-invasive testing in comparison to NIPT displays one major distinction; non-invasive prenatal testing consequently involves an ethical component to healthcare. The continuance of new, non-invasive testings and research suggests that biomedical ethics will have to be side by side in future healthcare developments.

Benn, P., Cuckle, H., & Pergament, E. (2013). Non‐invasive prenatal testing for aneuploidy: current status and future prospects. Ultrasound in Obstetrics & Gynecology, 42(1), 15-33.

Tu, F. F., Epstein, A. E., Pozolo, K. E., Sexton, D. L., Melnyk, A. I., & Hellman, K. M. (2013). A noninvasive bladder sensory test supports a role for dysmenorrhea increasing bladder noxious mechanosensitivity. The Clinical journal of pain, 29(10), 883-890.

Cognitive Remediation and Neuroplasticity in the Treatment of Psychopathic Cognitive Deficits

People have always been fascinated by the minds of psychopaths. Validation of this ranges from its prevalence in mainstream media, to the abundance of horror flicks produced each year, to the popularity of TV series like American Horror Story, featuring this season’s beloved psychopath, “Dandy.” And fascinated we should be, the impact psychopaths have on society and the criminal justice system is tremendous. According to an article by Kent Kiehl and Morris Hoffman (2011), “Psychopaths are twenty to twenty-five times more likely than non-psychopaths to be in prison, four to eight times more likely to violently recidivate compared to non-psychopaths, and are resistant to most forms of treatment.” This is why research on the mind of individuals with psychopathic personality is so imperative—the pursuance of developing successful treatment options. Moreover, not only does this research shed light on the mysteries of psychopathic tendencies, but also the functionality and underlying mental processes of the normal human brain.

Kiehl, who has been studying the neurology of psychopaths for decades, has found that many of the behavioral markers of psychopathy, such as a lack of empathy, moral conscious, and a poor response to fear, appear to be intimately linked with the paralimbic regions. Specifically, fMRI scans show reduced activity in the amygdala, and anterior and posterior cingulate, as well as increased activity in the lateral frontal cortex in comparison to non-psychopaths (Kiehl & Hoffman). In the words of Kiehl, “These findings dovetail nicely with the central paradox of the psychopath: he is completely rational but morally insane. He is missing the moral core, which seems to be largely connected to the paralimbic regions.”

(Figure above from "the fMRI of an Affective Memory Task in Criminal Psychopaths showing reduced activity in paralimbic regions—amygdala, anterior and posterior cingulate—and increased activity in the lateral frontal cortex, an area typically associated with cognition, not emotion" (Kiehl & Hoffman).

In light of their findings, and in combination with several other treatment theories, Kiehl and Hoffman developed a therapy program they termed “decompression treatment,” that focuses on mending the social deficits present in psychopaths. The treatment was significantly more effective than any previous treatment of psychopathy; however, this doesn’t necessarily mean that the effects of the treatment were particularly sizable. In fact, therapies until recent have proven time and time again that treatment of psychopaths is incorrigible. What is more, some treatments, such as group therapy, have the possibility of making matters worse, increasing psychopathic tendencies.

Because decompression treatment is very intense, requiring one on one therapeutic treatment that lasts several hours a day for a minimum of six months, the program is very costly. However, due to the high costs of incarceration, the initial high cost of the program was made up for by its effectiveness.

Nevertheless, there is still need for a less time consuming program that illuminates and targets the core functional neural mechanisms underlying the individual emotional, cognitive, and social markers of psychopathy, rather than a holistic top-down treatment approach.

One study that specifically focuses on the individual differences between psychopathological disorders and the underlying neural mechanisms responsible for these individual differences is a study conducted by Arielle Baskin-Sommers, John Curtin, and Joseph Newman (2014). In the study, Baskin-Sommers et al. used cognitive remediation; a type of therapy that exercises the brain using specifically developed cognitive tasks, in order to target the individual deficit a patient is suffering from. Here, Baskin-Sommers et al. is focusing on a technique that was mentioned by Kiehl in his research; because brain-scan imaging technology has allowed researchers to pinpoint regions with abnormal activity in specific psychopathological disorders, this information can be used to facilitate synaptic strengthening in deficient regions with such cognitive exercises.

In brief, the method of the study consisted of assessing male prison inmates for either psychopathy or externalizing personalities and those who met the criteria were then randomly selected and divided into different cognitive remediation groups that specifically targeted each disorder. The first group contained both psychopaths and inmates with externalizing personalities and they received “interpersonal and situational cues and changes in their environment,” which was designed to improve psychopathic cognitive deficits. The second group was hypothesized to improve externalizing personality disorder deficits by teaching inmates ”to engage in affective cognitive control by acting rather than over-reacting to affective information.”

As predicted, the results showed that psychopaths in the attention to context condition, which was specifically designed to target a cognitive impairment of psychopaths, yielded significant improvements in performance, while externalizing inmates’ performance did not improve. Externalizing inmates did improve in the second cognitive remediation condition, which focused on affective cognitive control, and psychopaths did not show any improvement.

In view of these findings, it’s evident that cognitive remediation is an effective method of targeting specific cognitive deficits that are markers of psychopathological disorders, such as cognitive attention to context in psychopathy. Specifically, Baskin-Sommers et al.’s research has demonstrated that specific underlying neural mechanisms of psychopathy can be targeted for neuroplasticity training with a less time consuming program than decompression treatment.

Taken together, the studies by Kiehl and Hoffman, and Baskin-Sommers et al. give hope that psychopathy can be effectively treated with continued research for targeted, thoughtful treatment design efforts. Further research should possibly focus on the effects such cognitive remedial therapies would have on juveniles.

Baskin-Sommers, A.R., Curtin, J.J., & Newman, J.P. (2014). Altering the Cogntive-Affective Dysfunctions of Psychopathic and Externalizing Offender Subtypes with Cognitive Remediation. Clinical Psychological Science.

Kiehl, K. A., & Hoffman, M. B. (2011). The criminal psychopath: History, neuroscience, treatment, and economics. Institute of National Health, 51, 355-397.

Does Walking Improve Creativity?

As increasing amounts of research and data are collected regarding creativity, there are interesting developments that factor into our daily lives. . A study conducted by Darya Zabelina indicated a negative correlation between attentional persistence and creativity through divergent thinking and attentional flexibility tests. While attention may not be conducive towards creativity, physical activity like walking has been shown to benefit creative thinkers. Researchers at Stanford have found a particularly intriguing implication that has been linked to increased creativity. They illustrate the positive correlation between walking and creativity through four experiments with a sample of 176 college students and adults.  According to the study co-authored by Marily Oppezzo and Daniel Schwartz, creative thinking improves during and shortly after walking. There is a distinct difference between the creativity levels of those who are sitting when compared to those who are standing. This is exhibited through the significant majority of participants who were more creative while walking. 

Furthermore, this study examined the participants with respect to if they were standing or sitting. They also used indoor and outdoor settings in order to understand the effect that setting has upon creative thinking. Three of the creativity tests that were used under these conditions were based upon divergent thinking, which is the method used to think of creative ideas through the consideration of many potential solutions.  This test required the participants to propose substitute uses for an object in a span of four minutes. Their goal was to collect as many ideas they could in order to illustrate the extent of divergent thinking each participant experienced under the different conditions. The creative ideas were the ones that were appropriate and no one else had come across. The fourth method that the researchers used was dependent upon the complex analogies that the participants created in response to prompt phrases. 

After the results were collected, the researchers found, through the divergent tests that creative output increased in walking participants by approximately 60%. Additionally, the analogy test indicated that 100% of the participants who walked outside had at least one novel analogy while only 50% of those who were seated did. These results provide marked evidence for walking having a positive effect upon creative thinking; however, the results do not implicate a connection between focused thinking and walking. The results indicate that walking has a beneficial effect upon the beginning stages of creativity. It is not known, however, the extent to which this effect exists and whether it differs from person to person. The implications allow for another potential benefit of physical activity and provides an incentive for it in the process.

Wong, May. "Stanford Study Finds Walking Improves Creativity." Stanford University. N.p., 24 Apr. 2014. Web. 12 Dec. 2014.

Zabelina, D., & Beeman, M. (2013). Short-Term Attentional Perseveration Associated with Real-Life Creative Achievement. Frontiers in Psychology, 4. doi:10.3389/fpsyg.2013.00191