There have been suggestions that Theory of Mind (ToM) impairment might lead to aggressive behaviour and psychopathy. Psychopathic and matched non-psychopathic individuals, as defined by the Hare Psychopathy Checklist [The Hare Psychopath Checklist-Revised, 1991] completed the ‘Reading the Mind in the Eyes’ ToM Test [Journal of Child Psychology and Psychiatry, 1997;38:813]. This test requires the self-paced identification of mental states from photographs of the eye region alone. Results indicated that the psychopathic individuals did not present with any generalised impairment in ToM. The data are discussed with reference to the putative neural system mediating performance on this task and models of psychopathy.
Psychopathy is a disorder characterised in part by callousness, a diminished capacity for remorse, superficial charm, impulsivity, and poor behavioural controls. The disorder is identified using a clinically-based rating scale, the Psychopathy Checklist-Revised, which has been extensively validated (PCL-R; [9]).
There have been repeated suggestions that a deficient or a biased understanding of other people’s mental states (i.e. impaired Theory of Mind (ToM)) might lead to antisocial and aggressive behaviour and psychopathy (e.g. [7] and [8]). Thus, Feshbach [8] has argued that role-taking (which involves the representation of another individual’s mental states) is a prerequisite for empathic responding which, in turn, is involved in the inhibition of antisocial behaviour. Individuals deficient in role-taking should be less likely to empathize and thus less likely to inhibit antisocial behavior.
The data has been inconsistent, however, Hughes et al. [10] did find some indication of ToM impairment in their “hard-to-manage” preschoolers relative to the comparison group. However, two out of three studies on adult psychopathic individuals found no indications of ToM impairment ([6] and [15] did not, [16] did). Of course, the failure to find group differences in the studies with adults may reflect the ease of many ToM measures. The development of an advanced, adult ToM Task has attempted to overcome this problem [1] and [3]. This test, named the ‘Reading the Mind in the Eyes’ Test, requires participants to view photographs of the eye region of individuals, and from this information alone to attribute a mental state to the person in the photograph (forced choice from a selection of mental state descriptors). Individuals with autism, with known ToM deficits, present with significant difficulty on this task [3].
The Eyes Test is also interesting because of its known anatomical correlates. Thus, a recent functional Magnetic Resonance Imaging study showed that presentation of the task produced increased activation in several areas, including the dorsolateral prefrontal and the left medial frontal cortices, the superior temporal gyrus, and the left amygdala. The finding of amygdala activation is of particular interest given the extensive literature suggesting amygdala dysfunction in psychopathy (see, for a review, [5]). Thus, if the Eyes Test requires the involvement of the amygdala, and psychopathy reflects amygdala dysfunction, it should be predicted that individuals with psychopathy will perform poorly on the Eyes Test.
