Superior temporal gyrus activation modulates revenge-like aggressive response tendencies in antisocial men after provocation: Evidence from an fMRI study using a modified Taylor aggression paradigm.

Antisocial personality disorder (ASPD) is characterized by a disregard of others' feelings, social norms, rules and obligations as well as increased reactive and proactive aggression among others. Experimental investigations of neural correlates of provocation and associated aggression often use competitive reaction time tasks played against a fictional opponent, such as the Taylor Aggression Paradigm (TAP). However, previous TAP neuroimaging research mainly focused on aggression levels in healthy and not forensic populations. This functional magnetic resonance imaging study on monetary TAP (mTAP) provocation and aggression assesses 20 violent offenders with ASPD and compares behavioral and neural responses to 17 age and education-matched healthy community participants (HC). Behaviorally, no significant group differences emerged, all participants reacted with increased punishment when faced with high vs. low provocation. On the neural level, offenders showed significantly stronger right superior temporal gyrus (STG) activation than HC during provocation. Exploratory analyses indicated that this STG activation was behaviorally relevant, as those with ASPD who expressed stronger STG activation during provocation also responded with stronger unprovoked punishment during the aggression phase. In addition, during the aggression phase, provocation was accompanied by increased left superior parietal lobe activation in ASPD compared to HC. In sum, this first mTAP fMRI study in ASPD found enhanced neural processing of provocation in ASPD which was also associated with more unprovoked aggression. The increased neural processing of provocation in ASPD and its association with subsequent higher aggression could have clinical relevance. At least, cognitive processing of perceived provocation could be a worthwhile intervention target for reducing aggressive response tendencies.