By Shawn Doherty
The Capital Times
MADISON, Wisc. — The way psychopathic prisoners play games resembles patterns shown by people whose brains have been damaged by such medical conditions as strokes and tumors, according to an intriguing set of experiments conducted by University of Wisconsin-Madison researchers.
The research, published in this month’s issue of Neuropsychologia, is the latest contribution to a growing trove of evidence challenging long-standing notions about the nature and roots of psychopathic behavior.
Mention the word “psycho,” and most of us think of mass murderer Ted Bundy or the seemingly wimpy hotel clerk in the Hitchcock thriller — people who hide under a veneer of ordinariness and even charm but who, in reality, are cold-blooded predators who commit horrific crimes because they lack normal human emotions like remorse or guilt. Not all psychopaths are violent, of course. Wall Street con artist Bernie Madoff has been termed a psychopath for manipulating and financially destroying the people around him without moral compunction.
Such behavior, luckily, is relatively rare. Only around 1 percent of the general population and up to 20 percent of prison populations could be diagnosed — using a 20-item checklist scientists consider fairly accurate — as being psychopathic. “Most of us have an innate affective aversion to committing up-close-and-personal harms, which makes evolutionary sense,” says Michael Koenigs, assistant professor of psychiatry in the UW School of Medicine and Public Health, and a co-author of the recent study on psychopathic criminals and games. “It is to everyone’s advantage if nobody wants to hurt each other.”
Psychopaths lack this aversion.
The recent UW experiments support the theory that a defect or wiring flaw in a portion of the brain behind the eyes called the ventromedial prefrontal cortex (vmPFC) offers one potential explanation for why. This part of the brain is significantly larger in humans than in animals, and has been identified as the origin for emotions like empathy, guilt and shame.
In their experiments, Koenigs and UW-Madison psychology professor Joseph Newman had 47 inmates in a Wisconsin prison play two economic decision-making games. The prisoners were playing for the chance to win money, which they could then exchange for shampoo and food or other items in the prison store.
Prisoners diagnosed with primary psychopathy who played the games with UW researchers used the same kinds of strategies and made similar decisions to players who had suffered devastating damage, often due to medical conditions such as strokes and tumors, to this portion of their brain.
Interestingly, these patients had led perfectly normal and healthy emotional lives until their brains were damaged. Then they started acting like psychopaths to the extent that scientists have labeled their condition “pseudopsychopathy” and “acquired psychopathy.”
“They have strokes or tumors that leave them with lesions in this part of the brain, and then their lives fall apart. They lose jobs, get divorced, and are totally irresponsible. They show no amount of empathy or guilt or regret for their actions,” says Koenigs.
Newman has worked with prisoners since 1981, thanks to what he calls remarkable cooperation from the state Department of Corrections. But for Koenigs, meeting some of the psychopathic prisoners was a new and unsettling experience. “These were bad dudes,” he recalls. “You don’t want to mess with them. You sit with them and sort of like them, but then they start to tell you about these horrific things they’ve done, stuff about how they’ve beat people to death with their bare hands, and they express no remorse or guilt about it. It was frightening.”
In the first game, called the Ultimatum Game, two players were allowed to split a sum of money — usually around $10 — if they could agree on how to split it. If the “responder” rejected the offer made by the other participant, both players ended up with nothing.
A purely rational player would accept any amount of money, Koenigs explained, since the alternative meant getting nothing, and indeed, that is how most prisoners played the game. Except for prisoners diagnosed with primary psychopathy. They rejected the offers, angrily.
Next, prisoners played the “Dictator Game,” in which there was no negotiation at all over the split. Players simply made an offer. “Normal people were really altruistic,” Koenigs says. “But the psychopaths gave almost nothing.
In both matches, the behaviors of the primary psychopaths mirrored responses of patients with brain damage to their vmPFC. (The game playing of a second group of psychopathic prisoners diagnosed as secondary psychopaths, meaning that their pathology resulted not from a fundamental and intrinsic brain deficit but from an acquired disturbance of brain processing due to environmental factors such as parental abuse or substance addiction, was more in line with behaviors of the regular prisoner population.)
Researchers were not at all surprised by the outcome of the dictator game. They had figured that the primary psychopathic prisoners would have no problem behaving selfishly. But they were stunned at the psychopathic prisoners’ behavior in the first game. Traditional views of psychopathic behaviors would have predicted that the players would take even the lowest and most insulting offers of money, since it’s thought that people with psychopathy rarely let emotion sway them and operate from pure rationality. But in fact, the opposite seemed to be true: The prisoners diagnosed with primary psychopathy became angry and insulted, and refused low offers. “Quite frankly, I was surprised by that, and I’m an expert. I’m not usually surprised,” Newman says. “The cold and calculating thing to do would have been to take the money.”
Newman has come up with a potential explanation for this puzzling behavior. In another study done two years ago on prisoners, he says, he found that an attention deficit rather than lack of emotion could explain psychopathic behaviors. This would suggest that the psychopathic game players may have been unable to focus on more than their initial anger at the lowball offers. “It’s not that they are incapable of emotion, or not motivated to use it,” Newman says. “It’s that when attending to a goal, they become oblivious to everything else. I see that as a kind of learning disability.”
There have been other hints that this portion of the brain is key to the development of pathologies. While a graduate student at the University of Iowa, Koenigs participated in a study that found that some patients who had experienced debilitating strokes or tumors in that area experienced a loss of depressive and anxiety symptoms. In probably the most stunning example, a depressed woman who had shot herself, nearly destroying this part of the cortex, survived and experienced a complete disappearance of her symptoms.
Over the past decades, other researchers have honed in on the vmPFC, sometimes in horrific ways. The infamous ice-pick lobotomies of the ‘60s and ‘70s, for example, took aim at this portion of the brain. Doctors shoved the picks into the heads of patients and twirled them around in the brain behind patient’s eyes. Doctors claimed some of their patients were helped by these crude procedures, but many more — including Rosemary Kennedy, a sister of President John F. Kennedy — suffered irremediable brain damage as a result. Kennedy spent the rest of her life in a Wisconsin institution.
Newman and Koenigs believe that brain scans could offer more persuasive evidence than their behavioral studies with game playing that structural abnormalities or problems with the way the brain’s wiring operates could be at the root of psychopathic behavior, and help lead to advances in diagnosis and treatment. Currently, they are attempting to work out an agreement with the Department of Corrections for conducting brain scans on the prisoner population. “I am just dying to see the data,” Koenigs says.
At the same time, he realizes that such research might, in his words, “open up a big can of worms.” If psychopathy can be proven to be a brain defect or a mental disorder like schizophrenia, there could be tremendous moral and legal ramifications. “It gets to a question of culpability,” he says. “To what extent are we culpable for our own brains?”
Advocates for inmates on death row have already contacted Koenigs to ask if brain scans of their clients could offer exculpatory evidence. Such use of scans is not possible now, he says. But it might be in the near future, given the rate at which brain imaging technology is growing.
Koenigs says that at heart of the scientific quest into the causes of psychopathy is the age-old philosophical debate over human morality, self-determination, and the nature of good and evil. “The question is, do we need to start thinking of psychopaths as patients as well as perpetrators?” he says. “Of course, I would be reluctant to say that to anybody who has had a family member victimized by one of them.”
Copyright 2010 Madison Newspapers, Inc.