The neuropsychology of antisocial personality disorder

Background. The literature on executive function in antisocial populations is unclear due to variation in diagnostic criteria and variation in the inclusion of healthy control comparison groups. Some studies suggest prototypical psychopathy is associated with specific deficits in ventromedial prefrontal (VMPFC) function rather than dorsolateral prefrontal (DLPFC). Meta-analytical studies, however, suggest that antisocial personality disorder may be associated with a broader range of executive deficits. This study assessed DLPFC and VMPFC function in antisocial personality disorder subjects and controls using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and a Go/NoGo task respectively.Methods. All subjects were screened for Axis I pathology, substance misuse and prescribed medication. The performance of 29 subjects with antisocial personality disorder DSM-IV and 20 male right-handed controls (matched for age and IQ) on the neuropsychological test battery was compared.Results. Subjects with antisocial personality disorder displayed impairments on DLPFC executive function tasks of planning ability and set shifting. Impairments were also seen in VMPFC Go/NoGo tasks and in visual memory tasks.Conclusions. Antisocial personality disorder is associated with a broad range of deficits in DLPFC and VMPFC function. Future studies need to examine relationships between the interpersonal and behavioural components of antisocial personality disorder and neuropsychological function.