Can Genes And Brain Abnormalities Create Killers?

Guests

Barbara Bradley Hagerty, correspondent, NPR's national desk
Stephen Morse, professor of psychology and law in psychiatry, University of Pennsylvania
Joshua Greene, assistant professor, Harvard University
Kent Kiehl, director of Mobile Imaging Core and Clinical Cognitive Neuroscience at the University of New Mexico

Breakthroughs in neuroscience are changing the way criminals are defended in court. Scientific research on brain scans and DNA has provided new insight on how some kinds of criminals are different from law-abiding citizens. Differences in their brains and genes may predispose them to violence.

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NEAL CONAN, host:

This is TALK OF THE NATION. Im Neal Conan in Washington.

Today, the criminal brain and what's being called neurolaw. Scientific research on brain scans and DNA provide new insight on what makes some kinds of criminals different than you and me, information that's begun to be introduced as evidence in some trials.

The data challenge how we think about right and wrong, about guilt and innocent and about the penalty to fit the crime.

NPR's Barbara Bradley Hagerty just completed a three-part series for NPR on this topic. If you missed the broadcasts on MORNING EDITION, you can find a link to them on our website, and she joins us in just a moment.

Later in the hour, what makes a psychopath, and does neuroscience tell us that once a psychopath, always a psychopath? But first, we want to hear from those of you who have questions about this new research and its implications.

We're going to focus a little bit later in the program, on how it's being introduced as evidence in courts of law, so if you've dealt with criminals as lawyers or in law enforcement, if you've come in contact with neurolaw, give us a call, 800-989-8255. Email us, talk@npr.org. You can also join the conversation at that aforementioned website. Go to npr.org. Click on TALK OF THE NATION.

NPR's Barbara Bradley Hagerty joins us here in Studio 3A. Barbara, always nice to have you on the program.

BARBARA BRADLEY HAGERTY: Thanks so much, Neal.

CONAN: Now, you got interested in the subject through a neuroscientist named James Fallon at UC Irvine.

HAGERTY: That's right, that's right. Jim Fallon has studied the brains of serial killers for something like 20 years, and he had a theory about what makes a serial killer's brain different from yours and mine. And his theory basically involves a couple of things, three things, but two of them is brain function and genes.

So he believes that the brains of serial killers operate differently. On brain scans, it looks like their orbital frontal cortex, which is right above the eyes, is a little bit less active, or a lot less active, than the amygdale, when they're processing information.

He and others believe that the orbital frontal cortex is involved with moral decision-making and ethical behavior, and it...

CONAN: Executive decisions.

HAGERTY: Right, exactly. And it puts a brake on the amygdale, which is involved with fear, and anger, and violence, and appetites and that kind of thing.

CONAN: The reptile brain.

HAGERTY: That's exactly right. So if the orbital cortex, the moral decision-making area of the brain, is not doing its job, then he believes that this person is more likely to be violent. So it's a break the brakes aren't working, essentially.

CONAN: And the genetic component of this?

HAGERTY: Yeah, that's really interesting, too. There are certain genes that have been found to be related to violence, and one in particular that's gotten a lot of attention is called the MAOA gene. It's also called the warrior gene because it regulates the serotonin system in the brain - serotonin in the brain, which affects moods, you know, think Prozac, that kind of thing.

Fallon and others have found that if you have a particular variant of this warrior gene, you are going to be predisposed toward violence. So he believes that serial killers have both a different brain function and a different genetic makeup.

CONAN: Now, it's interesting. In one of the stories you did, you talked with Jim Fallon, and among the things he did, he's using scans called PET scans, which are one kind of brain scan, and, well, among the people he tested was himself.

HAGERTY: Right.

Mr. JIM FALLON: If you look at the PET scan, I look just like one of those killers. I have the pattern, a risky pattern. In a sense, I'm a born killer. It was, frankly, a little disturbing.

You know, you start to look at yourself, and you say: I may be a sociopath. I don't think I am, but this looks exactly like psychopaths, sociopaths, that I've seen before.

CONAN: So he's got the image.

HAGERTY: Yes, you know, I've got to tell you, it's the best part of this story. About four years ago, he was at a barbecue with his mother, who was then 88 years old, and he was telling her about the science he was doing, and she said, well, Jimmy, you know, have you looked at the people in your family, your ancestors on your father's side? They're a bunch of cuckoos there.

CONAN: Of course on his father's side.

HAGERTY: On his father's side. She was, you know, quick to point that out. It turns out that in his ancestry, about eight people have been accused of murder, including Lizzie Borden - you know, Lizzie Borden, right, took an axe...

CONAN: Took an axe, gave her mother 40 whacks.

HAGERTY: Right, exactly. And so what he decided to do with this little, you know, family experiment, he got family members, his brothers, sisters, mother, wife, all his children, to do brain scans. And he also did genotyping on all of them, to see if they had the brains and the genes of a serial killer. It turns out, everyone's normal except for him.

CONAN: And obviously, though, he's not a serial killer - or at least not that we know of.

HAGERTY: Right, right. And that brings us really to the third part or the third thing that you need, he believes, to be a serial killer, and that is you need to have been abused as a child. You need to have experienced violence as a child.

So it's both nature and nurture, and it was interesting because he said this really changed his view of nature and nurture. He used to believe everything was determined by genes and brain function. But now he doesn't believe it. He thinks that, you know, maybe his great childhood was the reason that he's not behind bars right now.

CONAN: So you can have a genetic disposition, but that is not fate.

HAGERTY: That's right, exactly.

CONAN: And so as he's going through this research, well, is it just sociopaths - psychopaths as he calls them - that look this way?

HAGERTY: Well, I think no, there are probably a lot we don't know. We haven't brain-scanned the entire population. But what we believe, what he believes, is that there are a lot of people out there with brains like his, people who have kind of psychopathic or sociopathic tendencies, who are not acting on those tendencies, who are making the right decisions, in other words.

And, you know, maybe we don't know exactly why. It's a very young science, I have to say that. But probably, part of it has to do with upbringing, that that is a brake on that bad behavior.

CONAN: You can be taught how to control these passions.

HAGERTY: That's right.

CONAN: in the meantime, though, even though it's a young science, it's being quick to be picked up by defense attorneys, who say wait a minute, this may help my client, well, maybe not get off from the crime, but, you know, explain why some behavior was more violent.

HAGERTY: Right, that's really one of the surprising things. Something like in something like 1,200 cases, neuroscience evidence has been presented. And if I can, let me just tell you about one of them that I found was so interesting.

There was a case in Tennessee, the case of Bradley Waldroup. And in 2006, Bradley Waldroup got into a fight with his wife and his wife's friend, who was there, ended up killing his wife's friend, a woman, shooting her eight times, going after her with a machete and then going after his own wife with a machete. So it was really, really gruesome - his four kids were watching this all go on.

And the prosecutors - it was pretty, kind of an open-and-shut case. Everyone knew who did this. But the prosecutors asked for the death penalty. But unfortunately for them, the judge let in evidence about Bradley Waldroup's genes, and he let it be put before the jury. Usually, it's only in the mitigation phase, the death penalty phase.

CONAN: The sentencing phase, yeah.

HAGERTY: Right. And so what the defense attorneys did, is they had William Burnette, who is a forensic psychiatrist at Vanderbilt University, not only analyze him but also genotype him to look for guess what? the warrior gene, the MAOA gene.

It turns out that Bradley Waldroup has the high-risk version of the warrior gene. And in court, William Burnette argued that while the gene didn't make him more violent, it increased the chances of him being more violent or snapping.

And here's what happened. I talked to several jurors, and they said, now, look, the genes weren't the only thing that we considered, but it was one factor; and instead of giving him the death penalty, as the prosecutors asked for, they gave him voluntary manslaughter. They agreed that that gene probably made him snap, and therefore, he shouldn't be put to death.

CONAN: And that is where this really gets interesting, because I think a lot of people, and we heard I your pieces, would argue look, a lot of people have problems, depression and all kinds of other problems with their brain. Does this give everybody an excuse?

HAGERTY: Well, I know. That is one of the really troubling things. I mean, Steven Ericson(ph), a forensic psychiatrist and lawyer, talks about this. He says, you know, alcoholics, alcoholism makes your brain different. It gives you kind of brain abnormalities. Does that mean that an alcoholic who kills someone while driving drunk should suddenly be able to argue hey, my brain made me do it, therefore I'm not as culpable.

This really opens a whole can of worms. This my brain made me do it, my genes made do it, is potentially a very well, it's going to really challenge our legal system. Some people believe that it will really cause a revolution in the legal system.

CONAN: Well, before we get there, I mean, brain abnormalities, what's a normal brain? Everybody has brain abnormalities.

HAGERTY: Right, you do, I do, everyone has brain abnormality - because, you know, the normal brain is the average of everyone. And so what are we going to do, slice and dice, everyone gets a brain scan when they are, you know, accused of some crime, and you're able to say, well, because of this abnormality or that one, I should get a lesser sentence - maybe not off the hook, but a lesser sentence.

And I think a lot of people have a lot of trouble with that. The other thing that they worry about is also that this kind of these brain images, if presented to juries, can be very misleading.

You know, someone can look at that and go, oh, look at the pretty blue there, and oh, it's, you know, yellow there, and his brain really is different from a normal brain. And they could say, well, that just means that he can't be he isn't culpable.

CONAN: Well, it seems to me that defense attorneys ought to be careful about what they ask for because this is a two-sided weapon, no?

HAGERTY: You're absolutely right. In fact, in one of the cases I looked at, the public defenders were very upset that FMRI, brain-scan evidence, was used. And the reason they were so upset is people, jurors could just as easily say, you know, that's a brain abnormality. That is not going to change. This guy is a danger to society. We're going to give him the ultimate penalty, whether it's life in prison or the death penalty. So it could really backfire.

CONAN: And could it eventually come up in cases like parole hearings, something like that?

HAGERTY: Absolutely. Absolutely, it could. And they, you know, the kind of downside for people with these abnormalities is - say you're put in civil confinement. You know, after you serve your sentence, you could be put in civil confinement because you're still considered a danger to society.

Well, who decides whether you get out? It's not just that you've served your time. You know, the folks who are making those decisions could say, you know, he still has this brain abnormality, we're not he's not safe. He's not safe to be put out in society.

CONAN: Twelve-hundred criminal cases - it's been introduced thus far. Has it come into civil court?

HAGERTY: Actually, I think the 1,200 includes both criminal and civil, but the large majority, as I understand it, are criminal cases. Now, you might we are beginning, beginning to see some civil cases. You see it in areas like when someone gets in an accident, and they say that they can no longer concentrate, you know, since they've had this car accident.

Well, now brain scans are beginning to be entered to show that, you know, in fact, he does have a brain dysfunction. There is damage here, and he's not faking it.

A much more controversial area that hasn't really come up yet, but people are talking about it, is child custody cases. You know, you could say oh, you know, my ex-husband has the warrior gene; or my ex-husband has this brain dysfunction, and that inclines him towards violence. I don't trust my children around my ex-husband anymore.

So you can see where this is going. It's very controversial.

CONAN: And some child custody cases, sadly, well, nothing is excluded from use by one side or the other.

HAGERTY: That's absolutely right.

CONAN: Barbara Bradley Hagerty, stay with us. When we come back, we're going to be discussing more in detail about the uses of this neurolaw evidence in the courtroom.

So we want to hear from those of you who have come into contact with it as prosecutors, as defense attorneys, as well, if you're an expert who's testified, give us a call, 800-989-8255. Email us, talk@npr.org. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

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CONAN: This is TALK OF THE NATION. Im Neal Conan in Washington. We're talking with NPR's Barbara Bradley Hagerty about her series of reports on the criminal brain.

Breakthroughs in neurosciences aren't challenging just the way we think about criminals. They're also beginning to change legal prosecutions and defense in court, what's become known as neurolaw.

We want to hear from those of you who have dealt with criminals as lawyers or in law enforcement. Have you come in contact with neurolaw? Does neuroscience have a place in the courtroom? 800-989-8255. Email us, talk@npr.org. You can also join the conversation on our website. Thats at npr.org. Click on TALK OF THE NATION.

Stephen Morse is a professor of psychology and law at the University of Pennsylvania. He joins us from a studio in Philadelphia. Nice to have you with us today.

Professor STEPHEN MORSE (Professor of Psychology and Law in Psychiatry, University of Pennsylvania): Thanks very much for having me.

CONAN: And Joshua Greene is an assistant professor of psychology at Harvard, with us from a studio in Cambridge. Nice of you to be with us.

Professor JOSHUA GREENE (Assistant Professor of Psychology, Harvard University): Hi, thanks.

CONAN: And Stephen Morse, let me begin with you. Neurolaw, how is affecting the legal system?

Prof. MORSE: Well, very little. The number of cases that Barbara Hagerty has referred to I think is overestimated, although it's very hard to get precise statistics about this.

The whole idea of neurolaw is now a sort of on-the-come, what's going to be in the future because there hasn't been much change in actual legal practice yet. Yes, there have been some cases where the evidence has been admitted, but not very many, and in many cases, it's been excluded, and the exclusion has been upheld.

But the real question is: As neuroscience advances, as it surely will, what should the law look like in the future as we learn more and more about the relation between brain and behavior?

CONAN: And Joshua Greene, what do you think? What should the law look like?

Prof. GREENE: Well, I think that the introduction of new neuroscientific data really cuts to the heart of an old philosophical question about why we are punishing in the first place. And one of the reasons, which has been alluded to before, is what you might call the utilitarian reason, which is that we punish people in order to prevent them and to deter others from committing crimes in the future.

And that rationale, I think, stands no matter what. The question is whether or not this other rationale, which is considered very important by some people, other people think it's a big mistake, which is the retributivist justification, that is punishing people simply to give them what they deserve.

And my sense is that what these new data are doing are poking at people's intuitive sense of justice. And because we're of two minds about punishment and of two minds about dessert and free will and responsibility and all of the complicated philosophical things like that that are lurking behind legal decisions, I think that's where this is really that's where this is really forcing us to rethink things.

CONAN: And Stephen Morse, let me get back to you on that. As this new evidence comes into consideration, if you will, precedents are being set all over the place, are they not?

Prof. MORSE: Not yet but conceivably in the future, yes. So Josh really raises a very, very interesting point. One question is what people will come to believe as a result of advances in neuroscience, genetics and the like, and the other is what they should believe, whether or not the advances and the findings really should cause us to rethink our fundamental notions of justice, that people should get what they deserve. We shouldn't punish people unless they deserve it, no more than they deserve.

The question is whether neuroscience will really cause us to rethink that point of view, and nothing in the neuroscience today I think causes us to do that. What will happen in the future as we discover more things about ourselves, especially when we figure out how the mind really is related to the brain, who knows what the world will look like then?

As for now, I think our very wide range of moral concepts we employ, including what Josh calls the utilitarian and the retributive, are likely to remain secure.

CONAN: And I wonder if there was a concept that was raised in Barbara's pieces called one of the scientists suggested we don't execute any more people with low IQs. If there's an equivalent to that of an emotional IQ, where somebody can be demonstrated scientifically to have less capacity to control their emotions than others, could that become one of the factors that you consider in sentencing?

Prof. MORSE: It certainly could become one of the factors, but notice deciding that that is the kind of factor we should consider is a moral judgment, it's not a scientific judgment.

Once we decide that we want to consider let me speak more generally now the capacity for self-control as a criterion of responsibility such that if it is sufficiently diminished, we would not want to give people the maximum penalties. Once we've decided that, then science may be able to help us discover which people have diminished capacity in that respect. But deciding whether that should be a criterion is not a scientific question to begin with.

CONAN: Joshua Greene, a scientific question or a moral question?

Prof. GREENE: Well, I agree with Professor Morse that it is indeed a moral question, but I think it's a moral question that we have deep intuitions about. And I think the core of the intuition goes something like this: We don't want to punish people for things that are beyond their control. No one chooses their genes. No one chooses the circumstances of their early childhood. And more generally, if you think of someone's behavior as ultimately a product of their genetic inheritance and the circumstances in which they find themselves, then unless you believe that there's some extra-special you that's above and beyond your physical self, then in a sense, everything is ultimately beyond your control.

Now, that's not to say that things aren't in a sense within your control. We have beliefs, and we have desires, and we have intentions and values, and we act on those things. But the thought is that if you chase those things far back enough, you're going to find things that are beyond your control.

And so I think a lot of people have the reaction, well, if this gene was a critical factor, or if this brain tumor was a critical factor, then I don't want to hold that person fully responsible.

Now, one way to go is to develop a consistent philosophy that says look, we may have these intuitions, but it just doesn't matter, and then specify what exactly it is that matters.

Another and this again a moral judgment another thing you can do is look at that and say okay, we think that intuition is right. But if it's right, then how does the law need to change to accommodate that.

HAGERTY: You know, if I can jump in here, I have a couple of questions, and one is the MacArthur Foundation is just an observation the MacArthur Foundation is really, really looking at this. They've thrown $10 million at the issue of neurolaw, and it's actually researchers from working with a...

Prof. MORSE: Barbara, let me interrupt you for just one second. Joshua and I are both members of the project.

CONAN: Okay.

HAGERTY: Right, right, and some of the researchers I knew that and some of the researchers there were the ones actually that unearthed this notion of 1,200 cases. They went through, like, in the state of California looking at one after another. It was very tedious work.

But a lot of people do think that neural science is like DNA. Just as DNA, people looked at it a little warily at the beginning, now it is standard operating procedure in the courtroom. And a lot of people believe that neuroscience will be, as well.

And I guess one thing I would wonder is what we're arguing here on this what we're arguing here, it's not that some of these people don't know the difference between right and wrong. We're not arguing, say, that a psychopath doesn't is hearing voices and thinking that God told him to kill that little girl. We know that these people know the difference between right and wrong. Doesn't the law care about whether you knew the difference between right and wrong at the time of the crime? Isn't that an important distinction? Or is that distinction just going to go away?

CONAN: Stephen Morse, you want to try first?

Prof. MORSE: Sure. Yes, we now consider the ability to know right from wrong to be an important criterion for criminal responsibility. Why? When we're thinking about human beings guiding their own behavior, one of the things we're most guided by is our moral compass, our set of knowledge of right and wrong. If you don't have that knowledge, then it's going to be very hard for you to behave well.

Now, the interesting thing about the psychopath is they can tell you true-false right or wrong, but the question is whether they really understand what it means, right versus wrong, whether it's just a true-false test or whether it's something that they've assimilated that they can actually use in their reasoning. And that is a matter of major dispute. The law now does not excuse psychopaths, but there are many people who think it should, even though it would then produce a very grave practical problem.

But notice what your question implies. It implies that you've got an acting human being. You don't just have a mass of neurons. And as long as we have acting human beings, to whom the law is addressed, then I think much of our fundamental ideas of justice, dessert and consequential concerns of the sort Joshua Greene raised will remain intact.

CONAN: Let's get a caller in on the conversation, 800-989-8255. Email us, talk@npr.org. Colin(ph) is with us from Cookeville in Tennessee.

COLIN (Caller): Hi, well, I'm going to (technical difficulties) from a slightly different angle. I'm not law enforcement, but I was convicted of armed bank robbery, and I got six months in a halfway house and six months of house arrest due to a diagnosis of dysthymia, a chronic depression.

CONAN: Chronic depression. So obviously, six months for armed robbery is very light time.

COLIN: Yeah, and it was in a halfway house, too, so they didn't even sentence me to prison time. They called it a downward departure due to aberrant behavior, I just snapped.

CONAN: And do you agree with the diagnosis, or are you sitting there saying ha-ha?

COLIN: Well, you know, it's hard to say. On one hand, I look today, and I say, well, (technical difficulties) know what people should get away with. But on the other hand, I see that people do get pushed to their limits. They do snap. And, you know, I'd never been in trouble before and since - I haven't been in trouble since.

And I've used my freedom to be a better father, a better person in the community. I'm involved with Dismas House. I've volunteered for five years. I went in every week to the public jail and brought in a 12 step program. And I've just - to be a better person. I stayed in the community, too. My now ex-wife wanted me to moved and never speak of this again, but I stayed and faced the ridicule and the derision and have tried to redeem myself to this community.

CONAN: Joshua Greene, Collin raises a number of issues. But among them, the thin end of the wedge issue. If you're going to get less culpability for emotional distress of one type or another. Where does that end?

Prof. GREENE: Right. So I think that one place where it certainly needs to end is the recognition that there is the other set of criteria for when it makes sense to punish someone or not. So independent of what we think about justice and desert in some grand metaphysical sense, there's certainly the challenge, the problem of preventing future crime. And even if you think that someone doesn't, deep down in their soul, deserve to be punished, if you think that punishing them is going to prevent them or prevent other people from committing crimes, then that's, I think - I think most people agree - a valid reason for punishing somebody.

Now, not everybody takes this view. For example, you had Kent Kiehl on earlier. And if I read him correctly, what he's saying is that the only thing I really care about is justice in the abstract sense, and I think it's unjust to punish somebody if they have some kind of disability such as being a psychopath or something a bit more mild, as what was described here. So I think that...

CONAN: Yeah. We're actually going to be talking with him in a bit. But, yeah, go ahead.

Prof. GREENE: Okay. So I think that that's one place where, so to speak, it does end. This worry that, well, everything has its brain problems that go along with it, does everybody get off the hook? And I think the answer may be, in an ultimate metaphysical sense, perhaps everybody should be off the hook. But in a practical sense, there are going to be some people who need to be on the hook and some people who don't, depending on what we expect the effects of our social sanctioning to be.

CONAN: Collin, thanks very much for the phone call. We appreciate it.

COLLIN: Thanks for having me on.

CONAN: All right. Bye-bye. We're talking about neurolaw with NPR's Barbara Bradley Hagerty. Also with us, Stephen Morse, a professor of psychology and law in psychiatry at the University of Pennsylvania, and Joshua Greene, an assistant professor of psychology at Harvard University. And you're listening TALK OF THE NATION coming to you from NPR News.

And let's get Mike(ph) on the line. Mike with us from St. Paul.

MIKE (Caller): Yes. Hi, Neal. Good to be on. I was a major in philosophy and psychology and I'm definitely no legal expert. But - and a lot of my questions have kind of been addressed already. But I guess what the real question for me, is how do we have a legal system that does not incorporate metaphysical or religious belief, you know, just kind of as a given because...

CONAN: Well, though we have a legal system that does incorporate them, it just depends which ones, doesn't it?

MIKE: Well, yes, yes. And I think that, you know, from everything that I've learned, the whole idea of kind of the ghost in the machine and freewill and these kinds of things, there are so many problems with them. And, you know, it's the idea that my brain made me do it is - you know, our brains make us do everything. There is nothing else to make us do what we do.

CONAN: Right.

MIKE: So...

CONAN: Well, Stephen Morse, let me turn to you on this. You've described this in other circumstances as a neuro arrogance.

Prof. MORSE: Well, there are two questions, one is claiming we know more about the relation between the brain and behavior than we actually do. But the other is the conceptual question that the caller raises, which is whether the law has certain kinds of commitments about the nature of a human being and the nature of society and the like, which the caller referred to as metaphysical. And I think the answer is, yes, the law does have a concept of the person. And that's a creature who can be guided by reason, who - for whom you can give reasons and to whom reasons appeal.

And, yes, it's true that if you're brain is dead, you have no reasons. But that doesn't mean we have - don't have reasons, we do, and they can be appealed, too. And that's the kind of creature the law presupposes. And as long as the law presupposes that kind of creature, then many of our most important concepts will continue intact.

Now, we all want the criminal justice system to make us safer. We want it to deter crime. We want to keep dangerous people off the street. But if all you're concerned with is the sort of social safety issues, then whether if someone is responsible or not in some important way, whether or not someone deserves to be locked up, drops out. And that leads to a real, in my view, social dystopia that we don't want to approach. And I don't think there's anything in neuroscience, yet, that says we have to.

CONAN: Mike, thanks very much for the call.

MIKE: Thank you, Neal.

CONAN: And let's see if we can get one more caller in. This is Bill(ph), Bill with us from Boston.

BILL (Caller): Yes. I just have a very - what I think is a simple question. I haven't looked at the research to see if, in fact, the study has been done. I'm a licensed PhD psychologist working in the statistics field. I'm wondering, has anyone simply looked at a random sample of people, looking at their criminal record, and looking, maybe, at their fMRI profile to see if there is, in fact, any correlation?

CONAN: Barbara Bradley Hagerty, I don't think...

HAGERTY: I don't think...

CONAN: ...all that many of us have that...

HAGERTY: Right. I don't...

CONAN: ...fMRI file.

HAGERTY: Right. No, I don't think so. I'd be interested in knowing if our guests have any idea about that because I haven't heard of that.

CONAN: Any - either one of you, Stephen Morse or Joshua Greene?

Prof. MORSE: I haven't.

Prof. GREENE: As far as - I mean, there has been no...

Prof. MORSE: I mean, there haven't...

Prof. GREENE: ...sorry - there's been no mass effort to do a wide screening of a large portion of the population. Earlier, we mentioned Kent Kiehl who has scanned the brains of many inmates and also many normal individuals. So, you know, he has done as much as anyone to sort of put his finger on what is the difference between typical people in the normal population, people who are in prison, and people who are in prison and who are psychopaths. But we certainly don't have anything like the neuro equivalent of a big fingerprint or DNA database.

CONAN: Okay. Bill, thanks very much. It's a provocative question, maybe more relevant in years to come.

BILL: Okay.

CONAN: Appreciate the call. And, gentlemen, thank you so much for your time today.

Dr. GREENE: Thank you.

CONAN: Stephen Morse...

Dr. MORSE: Thank you very much.

CONAN: ...is a professor of psychology and law in psychiatry at the University of Pennsylvania; and Joshua Greene, assistant professor of psychology at Harvard. They mentioned Kent Kiehl. He's studied the brains of murderers and other criminals, including Brian Dugan, a man serving two life sentences for the rape and murder of a 10-year-old girl.

Professor KENT A. KIEHL (University of New Mexico): Cognitively, he appreciated that he was committing a crime and that he was doing a bad thing and that, you know, he's likely to spend the rest of his life in prison or on death row if he did this. But the emotion and the affect and whatever typically causes the rest of us to really never even contemplate something like that, didn't come to pass.

CONAN: We'll talk about what happens inside a psychopath's brain. Barbara Bradley Hagerty will stay with us. We hope you do, too. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

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CONAN: Right now, we're talking with NPR correspondent Barbara Bradley Hagerty. Her series on the criminal mind, the brain and DNA traits shared by some violent criminals ran last week on MORNING EDITION. If you missed any of it, you could listen online. Go to npr.org for that.

Psychopath is one of those terms of art that many of us probably use too freely. In fact, the definition is quite specific and technology can now provide new insights.

Kent Kiehl studies the brains of psychopaths. He's the director of Mobile Imaging Core and Clinical Cognitive Neuroscience at the University of New Mexico and joins us now from his office. Nice to have you with us today.

Prof. KIEHL: Thank you for having me.

CONAN: And that definition, what is a psychopath?

Prof. KIEHL: The classic definition is someone who has real profound difficulties understanding empathy, guilt and remorse. They're pretty glib and superficial, somewhat charming. They tend to get themselves in all sorts of trouble, from - starting from a very early age. They're impulsive, they're nomadic, they jump in and out of relationships very quickly. And sometimes they do, you know, extremely bad things that tend to come to the attention of the criminal justice system.

CONAN: And is there a meaningful distinction between a psychopath and a sociopath?

Prof. KIEHL: That's really an evolution in terminology. The term sociopath was really meant to convey social forces have molded this individual to be this way. That was a behaviorist era term in the '70s. And psychopathy, or psychopathic personality, is a term that has kind of predated that and is now more the in-vogue or the, kind of, current, kind of, nomenclature we use now.

CONAN: And what are the things that you've been able to do with new technology, is literally look inside the brain?

Prof. KIEHL: Yes. We've been using a mobile MRI system and deploying that to regional facilities around the country, to work with individuals who are incarcerated who have psychopathy, to try to understand them in bigger numbers than we've been able to do by working with them just in the community.

CONAN: And bigger numbers - how many have you looked at?

Prof. KIEHL: In the past two years, a little over 1,100 inmates have volunteered for research, so it's quite a large database.

CONAN: And what brain patterns do they share in common?

Prof. KIEHL: The individuals who score really high in psychopathy, we're tending to find that older emotional areas of the brain, the regions that we refer to as limbic or even paralimbic regions, tend not to be engaged in the same way when they're processing different moral stimuli, for example, or when they're processing emotional stimuli, compared to individuals who are incarcerated but don't have psychopathy.

HAGERTY: Kent, can you just explain - you know, you've done an experiment where you show various pictures? It helped me understand it. Can you just explain what you did with that?

Prof. KIEHL: Sure. So in one of our studies, which is just now in press, we used three different types of pictures. One type of picture might depict kids who are looking over a Bunsen burner. That would be a neutral picture. People would rate that as not having a significant moral violation or moral content. And that will be contrasted to other pictures that might display like, you know, individuals around a burning cross, like a Ku Klux Klan picture. And most individuals rate that as having high moral contents or representing a moral violation. And then we would also contrast that to other emotional pictures that dont have moral content. So, for example, like a car that's burning. And so, we're interested in understanding the emotional responses in the brain when people are trying to make those judgments.

CONAN: And you show them those pictures while they're in the fMRI?

Prof. KIEHL: Yes. While they're in the MRI scanner, they're making decisions and they're viewing those pictures. And then we're studying how their brain responds while they're doing those - that task.

CONAN: And when you talk about the limbic system, that's the amygdala that we were talking about earlier?

Prof. KIEHL: Yes. That's a favorite for most people. The amygdala, the orbitofrontal cortex, the anterior cingulate cortex, those are kind of the centerpieces of the limbic system.

HAGERTY: And they don't light up in the same way that a normal person's brain -limbic system - would light up. Is that right?

Prof. KIEHL: Yeah. Well, in particular, we find that that orbitofrontal cortex doesn't appear to be engaged when they're seeing any affective pictures. And so this suggests that when they're viewing those pictures for the first time, those emotional pictures, they're not able to tap into it or we're not getting the same kind of response in them as we do in individuals who don't have these characteristics.

CONAN: And when you said earlier that somebody who scores high on psychopathy -explain what you mean by scoring high.

Prof. KIEHL: So there are officially about 20 characteristics. Then each of the characteristics of psychopathy are scored on a two-point scale, in the forensic way we assess the condition. And so if you score high on almost all of those items, you need to score almost 30 out of 40, or 30 out of 40 in order to kind of officially meet the criterion for what we're studying.

CONAN: And so, somebody who scores 30 out of 40. And I wonder, have you looked - done one of these fMRI examinations on anybody who scored very high and found that they did not - their brain did not look like that?

Prof. KIEHL: That's a great question. We actually haven't. We're kind of typically now looking at groups, you know, large numbers of groups to try to say with some specificity that a certain person that looks, you know, like, has all the criterion for psychopathy and doesn't engage the system. I don't think the science is quite there yet.

CONAN: And I wonder, obviously, you're still in early phases - 1,100 may sound like a lot, but I'm sure you want a lot more data before you come to conclusions. But the implications of this are fascinating.

Prof. KIEHL: Yeah. I mean, I agree with you and I hope that - you know, our goal by studying these large numbers is to try to really understand all of the different influences and (unintelligible) and issues that might lead someone to come on this path or to have this condition.

And the ideal is to be able to start intervening as early as possible, to try to treat, to try to get them back on the right track. Because all of the guys that we work with who were, you know, in prison for five or 10 years, they've all typically had a long history of getting in trouble. And if we could have identified them early and then steered them off this trajectory, it would have been the best thing for them as well as for society.

HAGERTY: You know, one of the things, Kent, that I heard about a lot was that people feel that psychopath's brains don't change over time. In fact, something that you said to me was very interesting. You said you've looked at the brains of psychopaths who are 50 and those who are 25, and they looked very much the same, that a psychopath's brain basically looks the same. Why then do you think that a psychopath can be rehabilitated? Why do you think that their brains can change?

Prof. KIEHL: Well, I think we have good evidence from - when they're youth. There's a treatment program in Wisconsin run by a guy named Michael Caldwell. And hes actually been able to show that in these highest risk kids, these kids that score very high on the youth version of the psychopathy checklist, he can take those kids and put them in very intensive treatment.

So, this isn't, you know, three days and you're out. This is like nine months to a year of intensive cognitive behavioral therapy. And that is then followed by those kids in his group showing a reduced recidivism rate of over 50 percent for violent recidivism. So that would suggest that there has been some change in their brain over time while they're doing this treatment program.

And so if we could study those kids and find out how they change exactly, that would be ideal. But I think that most of us, scientists would agree that the brain continually changes throughout your life, and even an individual's psychopathy are capable of change. It's just going to take a lot of effort and it's going to take potentially long term, you know, implementations of treatment in order to try to see that change come through.

CONAN: Earlier, we heard a story about Jim Fallon(ph), the scientist who did his own PET scan and found that he looked like a natural-born killer. And what he said was, you know, there have to be three things: yes, there's the brain pattern; yes, there's the gene; but there's also abuse when you're growing up. And he attributed the fact that he is not a natural-born killer to the fact that he had a great childhood.

Prof. KIEHL: I don't know that I can necessarily agree with him, but I think that we find - in psychopathy, in particular, we find that they come actually from kind of all walks of life. So, some actually come from good backgrounds, some come from not-so-good backgrounds, and some come from really bad backgrounds. And, you know, we're trying to understand how those different forces interact, you know, from the environment, the genetics and the biology, in order to lead someone to be like that.

CONAN: Here's an email from Dolly(ph) in Williamsburg, Virginia. Id like to know the sense in which your guest is using the term psychopath. I work in forensic psychology, treating NGRIs, and I find that those with axis one disorders like schizophrenia or bipolar disorder tend to respond to treatment and get out of the hospital with good prognosis. Those with an antisocial or other personality disorder often can't deal with the intensity and structure required.

When a person has not - has been adjudicated NGRI, they rail against the restrictions, try to gain the system. They do better in jail and often get out sooner than they would've gotten out of the hospital. They seem to respond better to this reward/punishment paradigm. Having a low level of moral development, would the neurologically predisposed patient be more treatable as opposed to needing to remain hospitalized or incarcerated? And while you're answering, you might tell us what NGRI is.

Prof. KIEHL: So NGRI stands for not guilty by reason of mental disease or insanity. And typically people who have committed a crime in the context of being psychotic like schizophrenia or a bipolar illness, and then when you treat the illness there, the underlying cause, that tends to have them get back and be very manageable and get released back into the society. So - and that's great if you can actually implement that kind of a treatment.

And what she's saying is the classic kind of antisocial personality or having psychopathy, that they're very resistant to standard forms of treatment. And so you might actually be surprised that there aren't - isn't even a single randomized placebo control study of treating psychopathy that's ever been published.

And so a lot of people don't spend a lot of effort to try to develop treatment programs that work with this population because, you know, when you treat somebody who has depression, for example, and they get up out of bed, you know, and go back to work, that's a great thing. And if they get depressed again, they go back to getting - going to bed and don't want to go to work. And that's easy for a clinician to deal with.

But when you work with individuals with psychopathy, you know, the outcome measure that they might have killed somebody or they might have robbed another bank or done something really bad, and that can be harder to deal with. So there's not a lot of clinicians that really want to work with remediating this condition. Like I'm...

CONAN: I want to get, quickly - one caller has got a question. I want to get to it quickly - we just have a little time left. Paul(ph) is with us from Grand Rapids.

PAUL (Caller): Hi, I'm a corrections officer and I work in one of my states prison. And one of the things that I see on a pretty regular basis is prisoners who abuse the mental health system by manipulating it, manipulating diagnosis and stuff like that.

And so the question I have is a practical one, and I understand it may be difficult to answer. Once we've identified these individuals, what are we actually going to do to help them? I just heard the speaker talk about how it's hard to find psychologists. And that's actually a difficulty that we have is once they get inside the prison, they're faced with a pretty overwhelming environment that's pretty violent and pretty negative at any given moment.

CONAN: Mm-hmm.

PAUL: What are we actually going to do once we identify these kids? Are we going to make better schools, betters psyches? What are we going to do to help?

CONAN: And Kent Kiehl, we'll give you a whole minute to answer that.

Prof. KIEHL: Sure. Well, like I said, I think that the state of Wisconsin has got that correct in the sense that if someone came to them with that exact same problem and said, well, what can we do to remediate these highest risk kids, these kids that have a 90 percent chance that when they're released from juvenile custody they're going to end up in prison as an adult? And again, he's one of my heroes, and again his name is Michael Caldwell. And what he designed was a very intensive treatment program, and he convinced the state to then fund it.

And they went and they treated several hundred kids who were in the highest risk group in the entire state. And then they followed those kids up, and they compared them to other kids that are treated in the facilities just as normal, so the average kind of kid, and who was incarcerated, mind you. And what they found was that this intensive treatment program that he design actually shows a huge reduction of violent recidivism, 50 percent.

CONAN: But, very quickly, would that same kind of treatment help somebody 35, 50 years old?

Prof. KIEHL: That's a great question. I would like to start with young offenders and then move to adolescent or - I mean, then move to first-time offenders and then move to then yet adult offenders. Maybe it just takes three or four times longer to change those attitudes and behaviors in the older offenders than it does in the younger offenders.

CONAN: Paul, thanks very much for the call. We appreciate it. And Kent Kiehl, thank you so much for your time today. We appreciate that.

Prof. KIEHL: Well, thank you very much for having me.

CONAN: Kent Kiehl studies the brains of psychopaths. He's a professor at the University of New Mexico and joined us today from his office. Our thanks as well to NPR's Barbara Bradley Hagerty. Again, go to npr.org, click on TALK OF THE NATION. There's a link to her series that was broadcast last week on MORNING EDITION. This is TALK OF THE NATION from NPR News.

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