Cortical correlates of impaired self-regulation in personality disordered patients with traits of psychopathy.

Psychopathic personality disordered patients would, by virtue of a failure to self-regulate, be expected to show diminished amplitudes of feedback-related brain potentials. Among a sample of personality disordered patients detained at different levels of security, those who met a Psychopathy Checklist (PCL) criterion of 25 or above were identified (N = 27). Their event-related brain potentials (ERPs), together with those of their nonpsychopathic counterparts (N = 22) and healthy male controls (N = 20), were measured while they performed a visual Go/No Go task, with feedback given for correct and incorrect performance. Psychopathic patients showed a significantly reduced amplitude of an early frontal negative ERP component maximally evoked by negative feedback, and a high rate of errors of commission. Findings are consistent with the idea that psychopathic patients' unsuccessful attempts to self-regulate reflect a cognitive deficit characterised by a failure to attend and respond to a mismatch between expected and obtained outcomes.