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@ARTICLE{Poeppl:865238,
author = {Poeppl, Timm B. and Mokros, Andreas and Bzdok, Danilo and
Eickhoff, Simon B.},
title = {{W}hat matters and what is possible in neuroimaging
meta-analyses (of psychopathy)},
journal = {Molecular psychiatry},
volume = {25},
issn = {1476-5578},
address = {London},
publisher = {Macmillan},
reportid = {FZJ-2019-04769},
pages = {3125–3126},
year = {2019},
abstract = {We thank Robert Latzmann, Christopher Patrick, and Scott
Lilienfeld for their interest in and thoughtful comment [1]
on our paper [2]. The commentary provides the opportunity
for clarification, to prevent possible misunderstanding
regarding the potential of neuroimaging meta-analyses of
(not only) psychopathy with this response.First, the authors
of the comment briefly mention “a failure to distinguish
among alternative measures of a target construct (i.e.,
psychopathy) and collapsing across non-interchangeable
dependent measures (i.e., MRI-brain activations from
different tasks)”, which they regard as limitations. We
concur that our meta-analyses did not assess putative
differences between measures that literally purport to
capture the same entity (so-called psychopathy scales) or
between various tasks performed by subjects with the same
disorder (i.e., psychopathy). That is, our intention was not
to isolate task-related differences in neural activity
response in psychopathy nor to isolate neural differences
between competing psychopathy concepts. Rather, the
objective of our meta-analytic study was to identify brain
regions showing aberrant activity associated with
psychopathy across the whole neuroimaging literature.
Indeed, it also seems interesting to investigate if
above-mentioned differences can in fact be spotted.
Unfortunately, there are simply not enough experiments
available to disentangle such subtle effects in valid
subanalyses presently (cf., work by Eickhoff et al. [3]).
For instance, only 14 of the 24 experiments using an
alternative measure of psychopathy (the Psychopathic
Personality Inventory [4]) found any (i.e., either positive
or negative) association of brain activity with the scale at
all. From these 14 experiments, seven showed a positive and
seven a negative relationship. Data underlying the
experiments were collected in only four independent studies
(i.e., samples). However, at least about 20 independent
experiments would be needed for a valid activation
likelihood estimation meta-analysis [3].The main criticism
raised by Latzman and colleagues, however, is the
“treatment of this condition as a unitary construct,
largely neglecting its heterogeneity”. To illustrate the
relevance to neuroimaging, they quote three individual
studies in which diverging activity corresponding to
psychopathy subdimensions was found within the same brain
regions.In fact, there is a heated debate whether
psychopathy is of a multidimensional or a unidimensional
nature. Although there are arguments for its
multidimensionality, there is also strong evidence against.
The Psychopathy Checklist-Revised (PCL-R) as well as its
derivative, the Psychopathy Checklist: Screening Version
(PCL:SV), are arguably the most important psychometric
instruments for assessing psychopathy. Most of the studies
included in our meta-analyses relied on the PCL (113 out of
155 experiments). Both the PCL-R [5] and the PCL:SV [6] have
been shown to be commensurate with a bifactor model of
psychopathy that includes a general (g) factor [6]. One of
the first applications of such a model to the PCL-R
instruments was published by Patrick et al. [5]. According
to these models [5, 6], the items of the PCL-R/SV
instruments load onto a common factor, with specific
portions of variance relegated to nuisance factors.
Moreover, taxometric research [7] indicates that the
disorder as such (i.e., psychopathy) is a dimensional trait,
not a taxon. From this point of view, it may even be
regarded as implausible to hypothesize that there should be
subtraits of the disorder that do not add up to a common
core and that have unique correlates in the brain. However,
neuroimaging meta-analyses (of psychopathy subscales) could
indeed serve as a useful tool to test if proposed subtraits
are neurobiologically founded. Also for this purpose, there
are unfortunately not enough experiments available from the
literature.Irrespective of the dimensionality discussion, it
has to be noted that the very same regions (where aforesaid
studies located diverging activity) emerged in our
meta-analyses. This militates against the concern that
subdivisions of psychopathy scales would lead to divergent
psychopathic subgroups or distinct traits which, in turn,
could cancel each other out with respect to neural
correlates. Apart from that, this issue does not apply to
the analyses in our paper, which was looking for convergence
in brain associations with psychopathy (scales).
Interestingly, there was indeed strong concordance in
several regions. Be it that the commentators’ argument of
subscales neutralizing each other is valid, then why have
these scales converging neural correlates?Moreover, our
findings provide robust evidence for neural alterations
associated with psychopathy and hence validate this
psychological construct using rigorous neurobiological
mapping. This result seems even more intriguing as similar
attempts with respect to other disorders, such as
depression, did not succeed [8]. In this context, we want to
mention that—contrary to the presentation by Latzman and
colleagues—we did not claim “that certain neural
activation patterns are “pathognomonic” of
psychopathy”. Rather, we used a general approach, which
avoids a priori assumptions about (putative differences
between) psychological constructs and their relationship
among one another as well as to neurobiology, to
meta-analyze brain activation changes associated with
psychopathy. In a second step, we characterized the ensuing
regions functionally using independent data from healthy
subjects. These analyses indicated that brain regions
showing aberrant activity in psychopaths fulfill mental
functions in healthy subjects which, in turn, happen to be
disturbed in psychopaths. We thus stated that these mental
functions correspond with the deviant behavioral patterns
that are characteristic and pathognomonic of psychopathy.
This reverse approach hence validated that the neural
aberrances were associated with (the overarching construct
of) psychopathy (and not with epiphenomena).Although we
provided robust evidence for a general neurobiological
foundation of psychopathy, we agree that further
investigations into particular aspects of this disorder are
desirable. Therefore, we will wait together with Latzman and
colleagues for “finer-grained meta-analyses”—for
instance on psychopathy subdimensions. Many more individual
studies on this topic, however, are necessary to constitute
a solid basis for such endeavors. Until then, our
consolidating results, establishing the robustness of a
neural signature underlying common conceptualization of
psychopathy, can provide guidance for future studies on the
potential heterogeneity in psychopathic traits, once
sufficiently large consortium datasets will be available in
the future},
cin = {INM-7 / JARA-BRAIN},
ddc = {610},
cid = {I:(DE-Juel1)INM-7-20090406 / $I:(DE-82)080010_20140620$},
pnm = {574 - Theory, modelling and simulation (POF3-574)},
pid = {G:(DE-HGF)POF3-574},
typ = {PUB:(DE-HGF)16},
pubmed = {31481757},
UT = {WOS:000608499700006},
doi = {10.1038/s41380-019-0515-0},
url = {https://juser.fz-juelich.de/record/865238},
}