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Hans de Vries

Curing psychopathy?

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What are some potential pathways towards reversing structural deficits in the brain that are responsible for lack of empathy/inability to bond with other people, oresent in psychopathic individuals?

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Safe practice, ideally with a qualified guide. Consistently. Over time and in situations that progress in complexity. 

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Any potential pharmacological pathways? Two drugs for autism are currently in developmen, a condition previously considered untreatable.

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I'd be cautious taking that approach, but suspect anything related to oxytocin would be helpful, perhaps even MDMA... The core question is if the improvements would remain after the drug is done being metabolized and is no longer being introduced.

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29 minutes ago, iNow said:

I'd be cautious taking that approach, but suspect anything related to oxytocin would be helpful, perhaps even MDMA... The core question is if the improvements would remain after the drug is done being metabolized and is no longer being introduced.

AFAIK psychopathy as a personality disorder is not a proper diagnosis and is more a collection of traits, many of which overlap with other disorders. As such, it is not really suitable for a clinical diagnosis, much less treatment. 

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I don't think "cure" is the right word. You can certainly affect a person's personality in various ways, although I don't think it's very predictable. 

A brain injury can change a personality, and chemicals can too, and the lack of them. Maybe one day there might even be something that switches on some latent unused empathy in the brains of psychopaths, but I doubt it. 

In any population, natural variation means that some people will have more empathy than others. I think that psychopaths are just the people on the extreme negative end of the natural spectrum. There might even have been in the past an evolutionary advantage in having a wide spectrum of empathy. Psychopaths might have been advantageous in a small tribe with enemies all around. 

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7 hours ago, CharonY said:

AFAIK psychopathy as a personality disorder is not a proper diagnosis and is more a collection of traits, many of which overlap with other disorders. As such, it is not really suitable for a clinical diagnosis, much less treatment. 

I tend to agree. Also, realize it may not have been clear, but my previous response focused almost solely on the empathy / difficulty binding issue. 

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5 minutes ago, iNow said:

I tend to agree. Also, realize it may not have been clear, but my previous response focused almost solely on the empathy / difficulty binding issue. 

I think there are burgeoning studies trying to find neural correlates of psychopathy. The issue with these (typically neuroimaging) studies is that there is a high risk of spurious association of findings with a pre-defined conditions. That being said, there are a number differences in found in folks considered to be psychopaths. If those structures are indeed relevant to the condition, it is likely that the reaction to relevant signaling molecules may also be altered. For example, resistance to oxytocin could be related to psychopathy-related traits.

Actually, I believe I may have seen studies looking into that, but cannot really recall any details off the top of my head.

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In the pipeline there are two drugs for autism that work on oxytocin. Maybe thay can work on psychopathy as well?

Both have shown very promising effects (in phase 2 trials so far) for a condition once considered completely treatment-refractory. 

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It would ultimately depend on the mechanisms involved in the condition. But I do not think that we know enough about it to make a prediction. Which basically means that one would need an empirical study to look at it.

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