Background It has been suggested that people with psychopathic disorders lack empathy because they have deficits in processing distress cues (e.g. fearful facial expressions). Aims Toinvestigate brain functionwhen individuals with psychopathy and a control group process facial emotion. Method Using event-related functional magnetic resonance imaging we compared six people scoring a‰￥25 on the Hare Psychopathy Checklista€“Revised and nine non-psychopathic healthy volunteers during an implicit emotion processing task using fearful, happy and neutral faces. Results The psychopathy group showed significantly less activation than the control group in fusiform and extrastriate cortices when processing both facial emotions. However, emotion type affected response pattern. Both groups increased fusiform and extrastriate cortex activation when processing happy faces compared with neutral faces, butthis increase was significantly smaller in the psychopathy group. In contrast, when processing fearful faces compared with neutral faces, the control group showed increased activation but the psychopathy group decreased activation in the fusiform gyrus. Conclusions People with psychopathy have biological differences from controls when processing facial emotion, and the pattern of response differs according to emotion type.
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