While the idea of psychopathy as a “brain disorder” has a long history and has been studied using various technologies, it wasn’t until the year 2000 that scientists began to rigorously test it using structural and functional MRI methods. Since then, dozens of MRI studies have been published, yet the most reasonable conclusion to draw from this research is that no reliable evidence has emerged to corroborate the idea that psychopathy—as measured by the Psychopathy Checklist (PCL)—is correlated with brain abnormalities of any kind.
Overall, the experimental results are predominantly nulls with a few statistically significant but inconsistent effects (often in opposing directions), which might be better explained as a byproduct of confounding variables unrelated to psychopathy, such as substance misuse, medication, or head trauma.
This conclusion raises an important question: If there has never been any clear evidence of brain abnormalities in psychopathic persons, why do so many scientists keep portraying psychopathy as a neurodevelopmental disorder?
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Of course, it is inherently difficult to determine whether the systematic omission of null effects from the review literature is an act of scientific spin or simply an honest mistake of overlooking null effects, or a mixture of both. And perhaps it does not matter what the reason is because, whether the problem boils down to an issue with scientific spin or honest mistakes, the reality is the same: For the past two decades forensic practitioners and legal decision-makers would have been misled if they had followed due diligence and relied on the review literature when seeking information about neuroimaging research about psychopathy. The good news is that in the past years, we have seen the publication of high-quality review studies, where authors are now paying more attention to the extent of nulls.
However, even as the review literature is slowly correcting, readers should be aware that spin about the brain-disorder view of psychopathy is not a problem limited to the scientific peer-reviewed literature. It is arguably more rampant in public media, including op-eds and journalistic interviews, as well as in popular books about psychopathy, sometimes written by leading scientists. A search on YouTube and TikTok will readily yield hundreds of videos (amassing millions of views) where experts are explaining how psychopathy is caused by a brain abnormality, and it is not uncommon for TV documentaries about psychopathy to include a segment with MRI research.
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Similarly, the book The Psychopath Inside by James Fallon (from 2013) conveys an admittedly absorbing story about how Fallon himself, a neuroscientist, accidentally discovered that he was a psychopath by studying his own MRIs. Lastly, in The Psychopath Whisperer by Kent Kiehl (from 2014), the narrative centers around neuroimaging research on psychopathic persons, of which the author, a leading expert, writes that the “consistency of their [psychopathic persons’] brain abnormalities never ceased to amaze me.”
The ideas conveyed in these popular books are, of course, scientifically untenable, and they arguably border on sheer make-believe. While they are undoubtedly entertaining, they come across as a form of spin that ends up doing a disservice to forensic practitioners and legal decision-makers as they perpetuate scientifically misleading views.
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This is how science works - constantly correcting the past wrongs.
This is from 2014, I was fascinated by James Fallon's work that I posted on this blog too. Plus, I shared this story with so many people. I was wrong. Science is correcting it now.
There is a new book Murderland: Crime and Bloodlust in the Time of Serial Killers by Caroline Fraser which is making a serious impact now.
I have theory brewing inside me for a few years now and I will post it soon.
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