Katarina Howner

Cortical thickness alterations in social anxiety disorder

Social anxiety disorder (SAD) has been associated with aberrant processing of socio-emotional stimuli and failure to adaptively regulate emotion, corroborated by functional neuroimaging studies. However, only a few studies of structural brain abnormalities in SAD have been reported, and among these only one investigated cortical thickness. In the present study we used magnetic resonance imaging (MRI) in conjunction with an automated method to measure cortical thickness in patients with SAD (n=14) and healthy controls (n=12). Results showed significantly increased thickness of the left inferior temporal cortex in SAD patients relative to controls. Within the patient group, a negative association was found between social anxiety symptom severity and thickness of the right rostral anterior cingulate cortex. The observed alterations in brain structure may help explain previous findings of dysfunctional regulation and processing of emotion in SAD.

Altered fusiform connectivity during processing of fearful faces in social anxiety disorder

Social anxiety disorder (SAD) has been associated with hyper-reactivity in limbic brain regions like the amygdala, both during symptom provocation and emotional face processing tasks. In this functional magnetic resonance imaging study we sought to examine brain regions implicated in emotional face processing, and the connectivity between them, in patients with SAD (n=14) compared with healthy controls (n=12). We furthermore aimed to relate brain reactivity and connectivity to self-reported social anxiety symptom severity. SAD patients exhibited hyper-reactivity in the bilateral fusiform gyrus in response to fearful faces, as well as greater connectivity between the fusiform gyrus and amygdala, and decreased connectivity between the fusiform gyrus and ventromedial prefrontal cortex. Within the SAD group, social anxiety severity correlated positively with amygdala reactivity to emotional faces, amygdala-fusiform connectivity and connectivity between the amygdala and superior temporal sulcus (STS). These findings point to a pivotal role for the fusiform gyrus in SAD neuropathology, and further suggest that altered amygdala-fusiform and amygdala-STS connectivity could underlie previous findings of aberrant socio-emotional information processing in this anxiety disorder.

Classifying social anxiety disorder using multivoxel pattern analyses of brain function and structure

Highlights • Social anxiety disorder (SAD) is a common and disabling psychiatric disorder.• Support vector machines (SVM) were trained to separate SAD from controls.• Neural face processing in the fear network separated SAD patients from controls.• Gray matter volume alterations over the whole brain separated SAD from controls.• SVM classifiers may be useful for identifying imaging biomarkers of SAD.

Thinner cortex in the frontal lobes in mentally disordered offenders

Antisocial and violent behaviour have been associated with both structural and functional brain abnormalities in the frontal and the temporal lobes. The aim of the present study was to assess cortical thickness in offenders undergoing forensic psychiatric assessments, one group with psychopathy (PSY, n=7) and one group with autism spectrum disorder (ASD, n=7) compared to each other as well as to a reference group consisting of healthy non-criminal subjects (RG, n=12). A second aim was to assess correlation between scores on a psychopathy checklist (PCL-SV) and cortical thickness. Magnetic resonance imaging (MRI) and surface-based cortical segmentation were used to calculate cortical thickness. Analyses used both regions of interest and statistical maps. When the two groups of offenders were compared, there were no differences in cortical thickness, but the PSY group had thinner cortex in the temporal lobes and in the whole right hemisphere compared to RG. There were no differences in cortical thickness between the ASD group and RG. Across subjects there was a negative correlation between PCL-SV scores and cortical thickness in the temporal lobes and the whole right hemisphere. The findings indicate that thinner cortex in the temporal lobes is present in psychopathic offenders and that these regions are important for the expression of psychopathy. However, whether thinner temporal cortex is a cause or a consequence of the antisocial behaviour is still unknown.

Differentiating Male and Female Intimate Partner Homicide Perpetrators: A Study of Social, Criminological and Clinical Factors

Abstract It is recognized that the majority of intimate partner homicide (IPH) victims are female; simultaneously, when females do commit homicide, they are more likely to perpetrate against an intimate partner. To date, there are only a few studies that discuss IPH across gender, leading to a gap of knowledge with regard to gender aspects of perpetration. The present nationwide study has a retrospective design, based on registries of all female (n = 9) and stratified male (n = 36) IPH committed in Sweden between 2007 and 2009. Our study suggests that female perpetrators are more likely to be unemployed, to have suffered from a substance abuse disorder at some point in life and to have been victimized by the victim. In other words, scrutiny of these characteristics reveals that females who commit partner-related homicides are qualitatively and clinically different from their male counterparts. Furthermore, the prevailing feature of intoxication in connection to the crime, both in male and female perpetrators, indicates that perpetrators might benefit from elements of substance abuse treatment in interventions targeting partner violence.

Differentiating intimate partner homicide from other homicide: a Swedish population-based study of perpetrator, victim, and incident characteristics

Objective: Intimate partner homicides (IPHs) continue to be widespread and constant over time when compared with other types of homicide. Yet research addressing IPH particularly within the European context, is limited. The question of whether perpetrators of partner-related violence differ from offenders of general violence has been raised in research. In light of inconsistent findings and ongoing debate, the aim was to identify sociodemographic and criminological characteristics in perpetrators and victims of IPH, and to determine whether they differ from other types of homicides in Sweden. Method: This retrospective study was based on national data of all male-perpetrated homicides (N = 211) in Sweden committed between 2007 and 2009. Characteristics of IPH (n = 46) and non-IPH (n = 165) were compared and analyzed by conducting bivariate and multiple logistic regressions. Results: Perpetrators of IPH were older, more likely to be employed, less likely to have been convicted, and had less persistent criminal histories. Perpetrators of IPH were also less likely to be intoxicated at the time of the offense; nonetheless, intoxication was a common feature among victims and perpetrators in both groups. Further, perpetrators of partner-related homicides are substantially more likely to commit suicide. Conclusion: The present study illustrates critical differences between IPH and non-IPH perpetrators. As hypothesized, IPH perpetrators were less socially disadvantaged, less likely to have past criminal offenses, and more likely to commit suicide following the homicidal act. This study demonstrates that perpetrators of IPH constitute a separate subtype and, conceptually, ought to be treated separately.

Reliability and Construct Validity of the Psychopathic Personality Inventory-Revised in a Swedish Non-Criminal Sample – A Multimethod Approach including Psychophysiological Correlates of Empathy for Pain

Cross-cultural investigation of psychopathy measures is important for clarifying the nomological network surrounding the psychopathy construct. The Psychopathic Personality Inventory-Revised (PPI-R) is one of the most extensively researched self-report measures of psychopathic traits in adults. To date however, it has been examined primarily in North American criminal or student samples. To address this gap in the literature, we examined PPI-R’s reliability, construct validity and factor structure in non-criminal individuals (N = 227) in Sweden, using a multimethod approach including psychophysiological correlates of empathy for pain. PPI-R construct validity was investigated in subgroups of participants by exploring its degree of overlap with (i) the Psychopathy Checklist: Screening Version (PCL:SV), (ii) self-rated empathy and behavioral and physiological responses in an experiment on empathy for pain, and (iii) additional self-report measures of alexithymia and trait anxiety. The PPI-R total score was significantly associated with PCL:SV total and factor scores. The PPI-R Coldheartedness scale demonstrated significant negative associations with all empathy subscales and with rated unpleasantness and skin conductance responses in the empathy experiment. The PPI-R higher order Self-Centered Impulsivity and Fearless Dominance dimensions were associated with trait anxiety in opposite directions (positively and negatively, respectively). Overall, the results demonstrated solid reliability (test-retest and internal consistency) and promising but somewhat mixed construct validity for the Swedish translation of the PPI-R.

Effects of 25 mg oxazepam on emotional mimicry and empathy for pain: a randomized controlled experiment

Emotional mimicry and empathy are mechanisms underlying social interaction. Benzodiazepines have been proposed to inhibit empathy and promote antisocial behaviour. First, we aimed to investigate the effects of oxazepam on emotional mimicry and empathy for pain, and second, we aimed to investigate the association of personality traits to emotional mimicry and empathy. Participants (n=76) were randomized to 25 mg oxazepam or placebo. Emotional mimicry was examined using video clips with emotional expressions. Empathy was investigated by pain stimulating the participant and a confederate. We recorded self-rated experience, activity in major zygomatic and superciliary corrugator muscles, skin conductance, and heart rate. In the mimicry experiment, oxazepam inhibited corrugator activity. In the empathy experiment, oxazepam caused increased self-rated unpleasantness and skin conductance. However, oxazepam specifically inhibited neither emotional mimicry nor empathy for pain. Responses in both experiments were associated with self-rated empathic, psychopathic and alexithymic traits. The present results do not support a specific effect of 25 mg oxazepam on emotional mimicry or empathy.

Examination of the Triarchic Assessment Procedure for Inconsistent Responding in Six Non-English Language Samples

The Triarchic Assessment Procedure for Inconsistent Responding (TAPIR; Mowle et al., 2016) was recently developed to identify inattentiveness or comprehension difficulties that may compromise the validity of responses on the Triarchic Psychopathy Measure (TriPM; Patrick, 2010). The TAPIR initially was constructed and cross-validated using exclusively English-speaking participants from the United States; however, research using the TriPM has been increasingly conducted internationally, with numerous foreign language translations of the measure emerging. The present study examined the cross-language utility of the TAPIR in German, Dutch, Swedish, and Italian translations of the TriPM using 6 archival samples of community members, university students, forensic psychiatric inpatients, forensic detainees, and adolescents residing outside the United States (combined N = 5,404). Findings suggest that the TAPIR effectively detects careless responding across these 4 translated versions of the TriPM without the need for language-specific modifications. The TAPIR total score meaningfully discriminated genuine participant responses from both fully and partially randomly generated data in every sample, and demonstrated further utility in detecting fixed “all true” or “all false” response patterns. In addition, TAPIR scores were reliably associated with inconsistent responding scores from another psychopathy inventory. Specificity for a range of tentative cut scores for assessing profile validity was modestly reduced among our samples relative to rates previously obtained with the English version of the TriPM; however, overall the TAPIR appears to demonstrate satisfactory cross-language generalizability.

Amygdala reactivity and connectivity during social and non-social aversive stimulation in social anxiety disorder

Social anxiety disorder (SAD) is characterized by exaggerated amygdala reactivity in response to symptom provocation, but it is unclear if such hyper-reactivity is elicited by disorder-specific challenges only or characterizes reactions to aversive stimuli in general. Here, using functional magnetic resonance imaging in 14 patients with SAD, as compared to 12 healthy controls, we found that amygdala hyper-reactivity is confined to disorder-relevant social stimulation. SAD patients displayed increased amygdala reactivity to fearful as compared to neutral facial pictures, but not in response to generally aversive but mainly non-social stimulation when compared to neutral pictorial stimuli taken from the International Affective Picture System. The increased amygdala reactivity was not mediated by an altered prefrontal inhibition among SAD patients as compared to controls, suggesting increased bottom-up processes rather than attenuated top-down control. In conclusion, the enhanced amygdala reactivity in SAD seems specific to socially relevant stimuli rather than aversive stimuli in general.