Neural responses to emotional and neutral facial expressions in chronically violent men

Background: Abnormal neural responses to others' emotions, particularly cues of threat and distress, have been implicated in the development of chronic violence. We examined neural responses to several emotional cues within a prospectively identified group of chronically violent men. We also explored the association between neural responses to social emotions and psychopathic features. Methods: We compared neural responses to happy, sad, angry, fearful and neutral faces between chronically violent (n = 22) and non-violent (n = 20) men using functional magnetic resonance imaging (fMRI). Participants were prospectively identified from a longitudinal study based on information collected from age 7 to 27 years. We assessed psychopathic features using a self-report measure administered in adulthood. Results: The chronically violent men exhibited significantly reduced neural responses in the dorsomedial prefrontal cortex to all faces, regardless of the emotional content, compared with nonviolent men. We also observed a hyperactive amygdala response to neutral faces in chronically violent men, but only within the context of viewing happy faces. Moreover, they exhibited a greater dorsomedial prefrontal cortex response to mildly fearful faces than nonviolent men. These abnormalities were not associated with psychopathic features in chronically violent men. Limitations: It remains unclear whether the observed neural abnormalities preceded or are a consequence of persistent violence, and these results may not generalize to chronically violent women. Conclusion: Chronically violent men exhibit a reduced neural response to facial cues regardless of emotional content. It appears that chronically violent men may view emotionally ambiguous facial cues as potentially threatening and implicitly reinterpret subtle cues of fear in others so they no longer elicit a negative response.