Empathy and violence in forensic addicted patients: An EEG study

Substance Use Disorder (SUD) is found to be a major risk factor for crime and
violence. SUD is costly, exacting over $600 billion annually in costs related
to crime, lost work productivity and healthcare. Consequently, addicted
patients pose a great burden on society.
Recent evidence suggests that a lack of empathy plays an important role
in the violent behavior of addicted individuals. Studies using
electroencephalography (EEG) demonstrate that different event related
potentials (ERPs) and mu rhythms can be a means to investigate the
neurophysiological involvement in empathy. In a recent pilot study in a sample
of 10 forensic addicted patients, we found that empathic responding could be
reliably measured with EEG using a newly developed empathy task.
Despite these above insights, no study has directly examined
electrophysiological correlates of empathy and its relation to violence in
addicted patients. The proposed study will be the first to study this.

The following research questions will be addressed in two different studies:
1. Do addicted patients with high scores on psychopathy have reduced empathic
concern associated with reduced LPP amplitude and mu-suppression during an
empathy task?
2. Are LPP amplitude reduction and reduction in mu-suppression predictive of
violent recidivism in patients scoring high on psychopathic traits?
3. Are addicted patients scoring high on psychopathic traits characterized by
alterations in brain topology of brain networks related to empathy when compare
to patients scoring low on psychopathy and healthy controls?

A total sample of 75 male participants will be included in the study. 25
addicted patients scoring high on psychopathic traits, 25 addicted patients
scoring low on psychopathic traits will be included from the Forensic Addiction
Clinic (FVK) of the Bouman GGZ. Also, 25 healthy controls will be included in
the study. They will be assessed for demographic variables and psychopathology
(DSM-5 criteria) using file data. In addition they will participate in an
interview session in which psychopathic traits will be determined using the
Psychopathic Personality Inventory Revised (PCL-R). The Self-Report Psychopathy
scale (SRP) will be used for assessment of psychopathic traits in the control
group. Also, aggression will be assessed using the Reactive and Proactive
Aggression Questionnaire (RPQ) and trait empathy using the Interpersonal
Reactivity Index (IRI).
To examine the predictive value of electrophysiological correlates, risk
assessment scores on the HKT-30 risk assessment tool and violent reoffending of
patients will be recorded during a six-month follow-up using official record of
the Ministry of Security and Justice.

The patients and controls will participate in two different sessions. One
session in which they will fill out different questionnaires and one in which
EEG during a task will be registered. The patients will be tested at the
Forensic Clinic and the controls will be tested in de lab at the university.