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Spontaneous versus deliberate vicarious representations: different routes to empathy in psychopathy and autism.

Sir, We read the article recently published by Meffert et al. (2013) with great interest. The authors used functional MRI to investigate vicarious emotional representation in psychopathic offenders, scanning 18 psychopaths and 26 non-offending control subjects. Participants were either presented with video clips of short emotional interactions or experienced similar interactions themselves. Results showed that although psychopaths showed normal patterns of neural activation in response to experience, abnormal patterns of activation were observed during observation of others’ interactions in those regions known to be involved in vicarious emotional experience. However, when participants were instructed to ‘feel with the hands in the videos’ differences in activation between psychopaths and control subjects were significantly reduced in numerous regions of interest, including the medial and anterior left insula, left anterior cingulate cortex, and bilateral angular gyri (Meffert et al. , 2013). The authors conclude that these results point toward reduced spontaneous but intact deliberate vicarious representations in psychopathy.

Psychopathy represents a severe disorder of personality, characterized by a callous lack of empathy, shallow affect, and a lack of remorse or guilt (Hare, 1991, 2003). Traditional theories have emphasized poor recognition of others’ distress cues, including emotional facial expressions, as central to empathy deficits observed in psychopathy (Blair et al. , 2001, 2004; Montagne et al. , 2005; Dadds et al. , 2006; Dolan and Fullam, 2006; see also meta-analyses by Marsh and Blair, 2008; Wilson et al. , 2011). These findings are extended through the more recent results of Meffert et al. (2013), which suggest that psychopaths may exhibit a particular breakdown in the neural processes that underlie the spontaneous vicarious experience of the emotions of others. Thus, Meffert et al. (2013) findings add significantly to current understanding of empathy deficits in psychopathy, distinguishing between …