Bully on the Brain
WebMD News Archive
Feb. 14, 2000 (Boston) -- For the first time, a brain defect that could be
at least partly responsible for extremely violent criminal actions and
antisocial behaviors of some men has been identified, report researchers from
the University of Southern California (USC).
Men with antisocial personality disorder (APD) -- a form of mental illness
often seen in serial killers and other violent, aggressive, wildly impulsive,
or dangerous people -- had an 11% reduction in a certain type of tissue (gray
matter) in the part of the brain known as the prefrontal cortex when compared
with either normal men or men with a history of drug or alcohol abuse but no
Researchers have pinpointed the prefrontal cortex as the part of the brain
where emotion, arousal, attention, moral conscience, and self-control primarily
The link between extremely violent and antisocial behavior and damage to
prefrontal cortex from disease or trauma has been long established. One of the
most famous cases was that of a Vermont railroad worker named Phineas Gage, who
in 1848 survived and, remarkably, recovered rapidly from a horrific accident in
which a heavy iron tamping rod more than three feet in length was driven by an
explosion completely through his skull. Following the accident, however, he
underwent a dramatic personality change, and began to display many of the
traits of APD, including antisocial behavior, use of sexually explicit
language, apparent lack of moral conscience, impulsiveness, irritability,
aggressiveness, and an inability to focus on work or plan for the future.
Although children are not typically diagnosed with personality disorders
until they reach adulthood, according to the American Psychiatric Association,
children that exhibit signs similar to APD typically violate rules and show
signs of extreme aggression, such as the torture of animals or other people,
frequent bullying or threatening, use of weapons that could cause serious
injury, lying, sexual aggression, vandalism, and theft. Adults with APD
frequently commit criminal acts, get into fights, cheat, show a general
disregard for the safety of themselves or others, and show a lack of remorse
for their own behavior.
But the findings from the USC study raise legal and ethical questions about
whether some violent offenders are completely responsible for their actions,
and whether they can or should be treated with specific interventions that
could curb impulsive behaviors and dampen their aggressive tendencies so that
they no longer present a threat to society at large.
"I don't think anyone would argue that you can treat extreme antisocial
behavior by locking people away, but then how would we treat them, and is it
possible to prevent such behaviors from occurring in the first place?" asks
M. Marsel Mesulam, MD, in an interview with WebMD seeking objective analysis.
Mesulam is professor of psychiatry and behavioral sciences at Northwestern
University Medical School in Chicago.