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Schizophr Bull. 2017 Oct 21;43(6):1229-1239. doi: 10.1093/schbul/sbx012.

Neural Mechanisms Underlying Affective Theory of Mind in Violent Antisocial Personality Disorder and/or Schizophrenia.

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Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany.
Institute of Forensic Psychiatry, University of Duisburg-Essen, Essen, Germany.
LVR-Clinic for Psychiatry and Psychotherapy, University of Duisburg-Essen, Essen, Germany.
Department of Psychiatry and Psychotherapy, University Hospital Göttingen, Göttingen, Germany.
Division of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany.
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
Department of Neuroradiology, University Hospital Innsbruck, Innsbruck, Austria.
Département de Psychiatrie, Institut Universitaire en Santé Mentale de Montréal, Université de Montréal, Canada and Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.


Among violent offenders with schizophrenia, there are 2 sub-groups, one with and one without, conduct disorder (CD) and antisocial personality disorder (ASPD), who differ as to treatment response and alterations of brain structure. The present study aimed to determine whether the 2 groups also differ in Theory of Mind and neural activations subsuming this task. Five groups of men were compared: 3 groups of violent offenders-schizophrenia plus CD/ASPD, schizophrenia with no history of antisocial behavior prior to illness onset, and CD/ASPD with no severe mental illness-and 2 groups of non-offenders, one with schizophrenia and one without (H). Participants completed diagnostic interviews, the Psychopathy Checklist Screening Version Interview, the Interpersonal Reactivity Index, authorized access to clinical and criminal files, and underwent functional magnetic resonance imaging while completing an adapted version of the Reading-the-Mind-in-the-Eyes Task (RMET). Relative to H, nonviolent and violent men with schizophrenia and not CD/ASPD performed more poorly on the RMET, while violent offenders with CD/ASPD, both those with and without schizophrenia, performed similarly. The 2 groups of violent offenders with CD/ASPD, both those with and without schizophrenia, relative to the other groups, displayed higher levels of activation in a network of prefrontal and temporal-parietal regions and reduced activation in the amygdala. Relative to men without CD/ASPD, both groups of violent offenders with CD/ASPD displayed a distinct pattern of neural responses during emotional/mental state attribution pointing to distinct and comparatively successful processing of social information.


conduct disorder; functional magnetic resonance imaging; psychotic disorders; social cognition; types of violent offenders

[Available on 2018-10-01]
[Indexed for MEDLINE]

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