Pseudopsychopathy: A perspective from cognitive neuroscience

Abstract

In 1975, Blumer and Benson coined the term 'pseudopsychopathy' to describe the personalities of a subset of frontal lobe patients who lacked adult tact and restraint. In contrast to conventional, or developmental, psychopathy, in which psychopathic traits emerge in childhood and adolescence with no gross structural brain lesion, pseudopsychopathic behaviors arise following brain injury. This chapter reviews data linking pseudopsychopathy to damage to the orbitofrontal and neighboring ventral mesial cortex. The neuropsychological profile of pseudopsychopaths is described with reference to deficits in decision making, emotion, and autonomic functioning, despite relatively normal performance on traditional neuropsychological measures. The data are interpreted in light of clinical and laboratory explorations linking social and moral behavior with lower mesial and orbital cortices.