Psychopathy is marked by impulsivity, an absence of guilt over hurting others, and often superficial charm. 
 
 The brains of psychopathic violent criminals have abnormalities in regions related to punishment that are not seen in the brains of violent criminals who are not psychopathic, according to new research using brain scans. 
 
 These MRI scans suggest that psychopaths don't grasp punishment the same way as other people, the researchers said. This is likely why psychopaths do not benefit from rehabilitation programs, as other violent criminals often do, the scientists report today (Jan. 28) in the journal Lancet Psychiatry. 
 
 However, understanding these neurological underpinnings of psychopathy may improve interventions during childhood, when psychopathic behavior emerges as something distinct from ordinary delinquency, the scientists said. 
 
 "Psychopathic offenders are different from regular criminals in many ways," said Dr. Nigel Blackwood of King's College London, a senior author on the paper. "Regular criminals are hyper-responsive to threat, quick-tempered and aggressive, while psychopaths have a very low response to threats, are cold, and their aggressive behavior is premeditated." 
 
 In previous research, Blackwood has described psychopaths as "cold-hearted" and other violent offenders as "hot-headed." [Top 10 Controversial Psychiatric Disorders] 
 
 To understand this difference, Blackwood and his colleagues conducted MRI scans of the brains of 12 violent criminals with psychopathy, 20 violent criminals with antisocial personality disorder but not psychopathy, and 18 healthy people who were not criminals. The criminals had been convicted of murder, rape, attempted murder or grievous bodily harm in the United Kingdom. 
 
 While their brains were being scanned, the participants were asked to play a matching game to assess their ability to change their behavior when confronted with rewards and punishment. 
 
 In the group of criminals who were psychopathic, the scientists observed lower volumes of gray matter in brain regions involved in empathy, moral reasoning, and the processing of social emotions such as guilt and embarrassment. They also found abnormalities in white matter fibers leading to the prefrontal cortex, in regions involved in learning from reward and punishment. 
 
 The other violent criminals performed similarly to the people who were not criminals in this test, the researchers found. 
 
 For any person, deciding on how to behave involves generating a list of possible actions, weighing the negative and positive consequences of each, and, hopefully, choosing the behavior most likely to lead to a positive outcome, explained Sheilagh Hodgins, a professor of psychiatry at the University of Montreal, who co-led the study with Blackwood. 
 
 "Offenders with psychopathy may only consider the possible positive consequences and fail to take account of the likely negative consequences," Hodgins said. "Consequently, their behavior often leads to punishment rather than reward as they had expected." 
 
 So, approaches to rehabilitation that are based on treating the behavior problems of psychopaths similarly to those of criminals who are not psychopathic are bound to fail, the researchers said. 
 
 "Offender rehabilitation focuses on changing behavior, but to succeed it must take account of the personality characteristics of the offenders," Hodgins told Live Science. "Those with psychopathy are less empathetic, more callous, more manipulative, and they commit more violent crimes, some of which are premeditated." 
 
 What can be done to help psychopaths control their behavior? The researchers suggest focusing on learning-based interventions during childhood, when there still is the potential to alter brain structure and function. 
 
 Hodgins said that researchers are "only beginning to learn about the childhood antecedents of the syndrome of psychopathy," but that her group's study provides a hypothesis on the emergence of psychopathy and how to test for it in children. 
 
 There is ongoing research trying to understand how to help children with psychopathic characteristics — that is, being callous, unemotional and prone to disruptive conduct — to become more emotionally responsive, Hodgins said. This may include focusing on reward and using negative reinforcement sparingly when interacting with these children. 
 
 "Since most violent crimes are committed by men who display conduct problems from a young age, learning-based interventions that target the specific brain mechanisms underlying this behavior pattern and thereby change the behavior would significantly reduce violent crime," Hodgins said. 
 
 But the abnormalities of brain structure and function associated with persistent violent behavior are subtle and complex, Blackwood added. And little is still known about how genes and the environment conspire to create a cold, ruthless killer. 
 
 Follow Christopher Wanjek @wanjek for daily tweets on health and science with a humorous edge. Wanjek is the author of "Food at Work" and "Bad Medicine." His column, Bad Medicine, appears regularly on Live Science. ||||| Violent psychopaths seem to have abnormalities in the parts of the brain that learn from punishment, according to a new study published in the journal Lancet Psychiatry. Knowledge about these brain differences could one day be used to help children whose brain makeup puts them at risk for psychopathy. 
 
 Using fMRI imaging, a team of researchers looked at the brain signaling of 50 men: 12 violent offenders—all people with antisocial personality disorder and psychopathy who had been convicted of murder, rape, attempted murder or grievous bodily harm—20 violent offenders with antisocial personality disorder but not psychopathy, and 18 non-offenders. 
 
 While their brains were being scanned, the men completed an image matching test that measured their ability to change their behavior and choices based on feedback they were getting from the game. The psychopathic men had a much harder time with changing their behavior, and they took significantly longer to adapt when the game changed its rules. 
 
 Scans of the psychopaths’ brains looked different from both non-psychopathic criminals and non-offenders, showing noticeable abnormalities in their white and gray matter—both of which are involved with connecting brain regions. The abnormalities were observed in areas of the brain where emotions like guilt, embarrassment and moral reasoning are processed. Some of those abnormalities were linked to a lack of empathy. 
 
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 Prior studies of psychopaths have shown that rehabilitation efforts often fall short, which is why the researchers looked into the underlying mechanisms. 
 
 The authors write that many of the characteristics of psychopathy appear very early in age, and if caught early enough, interventions could alter brain structure. The researchers hope their findings could lead to the development of programs for parents who observe callousness and repeated violent behavior among their children early on. 
 
 “As most violent crimes are committed by men with this early-onset stable pattern of antisocial and aggressive behavior, interventions that target the specific underlying brain mechanisms and effect change in the behavior have the potential to significantly reduce the rate of violent crime,” the authors write. 
 
 Contact us at editors@time.com.
– Psychopaths just don't grasp punishment the way normal people do. So say researchers who used MRI scans to analyze the brains of 12 violent psychopathic criminals, 20 violent criminals who are not psychopaths, and 18 healthy controls who are not criminals. It turns out that the psychopath cohort had a much harder time changing their behaviors and choices when playing an image matching game, as well as adapting when the rules of the game changed, reports Time. Abnormalities were seen in brain regions that process things like moral reasoning, guilt, and embarrassment. This may explain why previous research has shown that rehabilitation using negative reinforcement like punishment rarely works on psychopaths. "Psychopathic offenders are different from regular criminals in many ways," one researcher tells LiveScience. "Regular criminals are hyper-responsive to threat, quick-tempered, and aggressive, while psychopaths have a very low response to threats, are cold, and their aggressive behavior is premeditated." On the plus side, researchers hope that earlier behavioral interventions in young kids could potentially change actual brain structure and function, though not much is yet understood about how one's genes and upbringing contribute to the making of cold-blooded, psychopathic killers. (Psychopaths also seem to have a terrible sense of smell.)