High psychopathic traits were associated with less emotional empathy and larger cortical area.

This is not a clinical treatment trial or the development of a diagnostic test for "psychopathy by brain imaging." It is a large neuroimaging study in which the authors compared psychological scales of empathy and psychopathic traits with magnetic resonance imaging (MRI) measurements of cortical brain structure in 804 adult male inmates.

The study's main finding: men with more pronounced psychopathic traits had lower emotional empathy, a larger cortical surface area, and altered large-scale cortical thickness organization. However, cortical structure itself was not directly related to empathy scale scores, making the results more complex than the simple formula "less empathy, different cortex."

Parameter	Research data
Magazine	Biological Psychiatry Global Open Science
Article number	100695
DOI	10.1016/j.bpsgos.2026.100695
Type of work	Neuroimaging study
Participants	804 adult male prisoners
Methods	Psychological scales, Psychopathy Checklist-Revised, T1-weighted magnetic resonance imaging
Key brain indicators	Cortical thickness, cortical surface area, structural-covariance gradients
The main conclusion	High psychopathic traits are associated with less emotional empathy, larger cortical area, and compressed cortical thickness organization

What happened?

An international team of researchers conducted one of the largest studies examining the relationship between psychopathic traits, empathy, and cortical structure in male prisoners. The authors emphasize that reduced empathy is considered a characteristic feature of individuals with high, clinically pronounced psychopathic traits, but large-scale, well-powered mapping of cortical structure in this area has been lacking.

The study included 804 adult males from the prison population. This is significant because psychopathic traits are much more common among prisoners than in the general population: Medical Xpress estimates the prevalence of psychopathic traits at up to 25% among prisoners versus approximately 1.2% in the general population.

The scientists measured two components of empathy: emotional empathic concern and cognitive acceptance of another person's perspective. They also assessed psychopathic traits using the Psychopathy Checklist-Revised, dividing them into two factors: an interpersonal-affective factor and a lifestyle or antisocial behavior factor.

Participants then underwent T1-weighted magnetic resonance imaging to assess cortical thickness, cortical surface area, and the larger organization of structural connections between cortical regions. This allowed the authors to view the brain not only as a set of distinct zones but also as a system in which different regions have a specific spatial and functional organization.

What was compared?	What does this mean?
Emotional empathy	The ability to feel empathy and concern for another person
Cognitive empathy	The ability to intellectually understand another person's position
Factor F1 Psychopathy Checklist-Revised	Interpersonal and emotional traits of psychopathy
Factor F2 Psychopathy Checklist-Revised	Lifestyle and antisocial behavior
Thickness of the bark	Gray matter thickness in cortical areas
Surface area of the cortex	Prevalence of the cortical surface
Structural gradients	Large-scale organization of differences between cortical areas

Why is this research important?

Psychopathic traits are often discussed oversimplified—as a lack of conscience or a complete lack of empathy. In reality, empathy consists of several components: one can understand what another person is feeling but not experience emotional empathy; one can be poor at perceiving others' perspectives but still retain distinct emotional reactions.

This is why the authors divided empathy into Perspective Taking and Empathic Concern. The former reflects the ability to mentally put oneself in another person's shoes, while the latter reflects the emotional response of compassion and concern. This distinction proved crucial for interpreting the results.

The study found that the interpersonal-affective factor of psychopathy was uniquely associated with lower emotional empathic concern, while the lifestyle and antisocial behavior factor was uniquely associated with lower perspective-taking. This suggests that different aspects of psychopathy may be associated with different components of empathy.

The study's importance also lies in its sample size. For neuroimaging studies, 804 participants is a large sample, especially when it comes to prisoners, who are difficult to access for magnetic resonance imaging and psychological assessment.

Why work matters	Explanation
Large sample	804 male prisoners - a large cohort for MRI research
Sharing empathy	Studied emotional and cognitive empathy separately
Division of psychopathy	The 2-factor Psychopathy Checklist-Revised was used.
Several MRI indicators	Not only the volume, but also the thickness, area and gradients of the cortex were assessed
Practical interest	It may help to better understand the mechanisms of psychopathic traits and plan future interventions.

What was found in behavior and empathy

The first important result concerns the emotional aspect of psychopathy. Factor F1, which reflects interpersonal and affective traits, was associated with lower empathic concern. Simply put, the higher these traits, the lower the expression of emotional empathy and concern for others.

The second result concerns factor F2, which is associated with lifestyle and antisocial behavior. It was associated with lower perspective-taking, that is, a weaker ability to intellectually see a situation through another person's eyes.

This distinction helps us avoid the crude assertion that "psychopathy equals a lack of empathy." Rather, the data show that different psychopathic traits are associated differently with different aspects of empathy: emotional empathy and cognitive understanding of another's perspective are not entirely consistent.

When comparing men with high and low psychopathy, the high-psychopathy group had particularly low scores on emotional empathic concern. This is one of the central behavioral findings of the study.

Behavioral indicator	Association with psychopathic traits
Empathic Concern	Lower with a more pronounced F1 factor
Perspective Taking	Lower with a more pronounced F2 factor
High psychopathy versus low psychopathy	Below is emotional empathic care
General interpretation	Different components of psychopathy are associated with different aspects of empathy
Important clarification	Empathy is not one simple indicator

What did the magnetic resonance imaging show?

The most striking neuroimaging finding was related to cortical surface area. Men with higher psychopathic traits had larger cortical surface area, with differences across 65 brain regions.

However, cortical thickness did not differ significantly when directly comparing men with high and low psychopathy. This is important because cortical thickness and surface area are different neuroanatomical indicators that may reflect different processes of brain development and organization.

The authors also found that cortical surface area was positively associated with both psychopathy factors, while cortical thickness was primarily associated with factor F1, and mostly positively. Both cortical measures had predictive utility beyond the training set for factor F1.

Interestingly, the empathy scales themselves showed no direct correlation with cortical thickness or area. This suggests that the structural brain changes observed in this study are more strongly associated with psychopathic traits as a complex phenotype than with individual self-reported measures of empathy.

MRI indicator	What did they find?
Surface area of the cortex	More in men with high psychopathy
Number of regions according to Medical Xpress	65 areas of the brain
Thickness of the bark	There were no obvious differences when comparing the high and low groups.
Relationship between bark thickness and F1 factor	Mostly positive
Relationship between cortical area and factors F1 and F2	Positive
The relationship between cortical structure and empathy	No direct relationship with IRI subscales was found.

Which areas of the brain were most noticeable?

The effects on cortical surface area were particularly pronounced in regions associated with social-emotional and sensory processing. The article indicates that the largest effects were observed in the paralimbic system and the somatomotor network.

Medical Xpress emphasizes that the increase in surface area was particularly noticeable in regions involved in social and emotional processing. This is important because psychopathic traits are clinically associated with impaired emotional responsiveness, interpersonal behavior, and antisocial risk.

The authors also compared the spatial pattern of their results with meta-analytic data on functional activations. The greatest overlap was with clusters associated with socio-affective and sensory tasks.

This doesn't mean that one specific area is "responsible for psychopathy." It's more accurate to talk about a distributed pattern: the changes affected several networks and cortical classes associated with social, emotional, sensory, and motor aspects of behavior.

Area or network	Why is this important?
Paralimbic areas	Often involved in emotional and motivational processing
Somatomotor network	Associated with the physical and motor aspects of the reaction
Social-affective clusters	Related to the processing of emotions and social signals
Sensory clusters	May be involved in the perception of significant stimuli
Distributed pattern	We are not talking about a single “psychopathy center,” but about a network organization.

What does "compressed organization" of the cortex thickness mean?

In addition to individual regions, the authors studied structural covariance gradients. This is a more complex measure that reflects how different cortical areas relate to each other based on structural characteristics. Normally, the brain has a specific macroorganization: from sensory areas to more complex association areas.

In the overall sample, the researchers found anterior-posterior structural-covariance gradients. In men with high psychopathy, the cortical thickness gradient was globally compressed, while no such effect was found for surface area.

Medical Xpress explains it this way: in a typical brain, there's a clearer progression from areas processing basic sensory signals to areas associated with more complex social cognition. In men with high psychopathy, this progression was less differentiated, meaning the brain map appeared more "compressed."

This may point to features of the large-scale organization of the cortex, rather than just local differences in individual areas. This interpretation is important because behavioral traits like psychopathy are unlikely to depend on a single brain structure; rather, they are associated with the functioning of distributed networks.

Concept	A simple explanation
Structural covariance gradient	An indicator of how the structural properties of different regions of the cortex are organized into a single map
Anterior-posterior gradient	One of the major directional patterns of cortical organization
Gradient compression	Less differentiation between regions
Found in high psychopathy	For bark thickness, but not for surface area
Interpretation	Possible change in large-scale organization of the cortex

Why the result shouldn't be interpreted as "MRI detects psychopaths"

The most important limitation: the study demonstrates statistical associations within a group, rather than creating an individual diagnostic test. A single brain scan cannot reliably predict whether a particular person is a "psychopath," whether they will commit a crime, or how dangerous they are.

A second limitation is that the sample consisted exclusively of incarcerated adult men. The authors emphasize the need for future research in both the general population and among incarcerated individuals, including both men and women, to understand the generalizability of the findings to other groups.

The third limitation is that the study design does not prove causality. These data cannot be used to conclude that cortical features caused psychopathic traits, that psychopathic traits altered the brain, or that both factors were influenced by early environment, trauma, genetics, substance use, education, stress, and other variables.

The fourth limitation is related to the topic itself. Psychopathic traits are not a simple binary "present or absent" indicator, but are measured on a scale. Therefore, it is more accurate to talk about the relationship between the severity of traits and brain and behavioral indicators, rather than a rigid division of people into two biological categories.

Misinterpretation	Correct interpretation
MRI can detect psychopathy in an individual	No, we are talking about group statistical relationships.
Increased bark area means danger	No, this is not an individual behavioral forecast.
Psychopathy is explained by one area of the brain.	No, the data point to distributed cortical patterns.
The results apply to all people.	No, the sample is adult male prisoners.
Research proves the cause of psychopathy	No, it shows associations.

Potential implications for psychiatry and neuroscience

The scientific value of this work lies in its distinction between several levels: emotional empathy, cognitive empathy, psychopathy factors, and various parameters of the cerebral cortex. This helps us avoid overly crude models and more accurately describe which behavioral aspects are associated with which biological traits.

The study also suggests that the previous focus solely on gray matter volume may be insufficient. Medical Xpress notes that many previous studies of brain morphology in psychopathic traits focused on gray matter volume, whereas the new study separately analyzed cortical thickness and surface area.

This may be important for future therapy and rehabilitation, as different profiles of psychopathic traits may require different interventions. For example, decreased emotional caring and decreased perspective-taking are not the same thing, and approaches to addressing them may differ.

However, practical programs are still a long way off. The authors cautiously conclude: future research should expand on these findings in the general and incarcerated populations to better inform the understanding and treatment of psychopathy.

Potential value	What can this give?
A more accurate model of psychopathy	Separation of emotional, cognitive and behavioral components
New research goals	Studying cortical area and cortical gradients, not just volume
Personalization of interventions	Different traits may require different approaches.
Forensic psychiatry	Better understanding of group neurobiological patterns
Limitation	It is not yet a clinical tool or a diagnostic test.

Limitations of the study

The first limitation is the homogeneity of the sample. All participants were adult men in prison, so the results cannot be automatically generalized to women, adolescents, individuals with psychopathic traits outside the prison system, or the general population.

A second limitation is the possible influence of coexisting factors. Prison populations may be more likely to have traumatic experiences, substance use, traumatic brain injuries, low socioeconomic status, chronic stress, and other variables that may also be associated with brain structure.

The third limitation is self-reported empathy scales. Although the Interpersonal Reactivity Index is widely used, responses to questions about empathy and perspective-taking may be affected by honesty, motivation, social desirability, and comprehension of the questions.

The fourth limitation is that neuroimaging data do not reveal the developmental mechanisms. Even if cortical surface area or gradients are associated with psychopathic traits, this does not indicate when exactly these differences emerged: in early development, after a traumatic experience, under the influence of behavior, or as a result of multiple factors.

Limitation	Why is it important?
Only male prisoners	Limits portability of results
Transverse design	Does not prove causality
Possible hidden factors	Trauma, substances, stress, and environment can affect the brain
Self-reported empathy	Answers may not be accurate
There is no individual diagnostics	The results work at the level of group patterns

Result

A study in Biological Psychiatry Global Open Science found that in 804 male prisoners, higher psychopathic traits were associated with lower emotional empathic concern, larger cortical surface area, and altered large-scale cortical thickness organization.

The study is particularly important because it distinguishes between emotional and cognitive empathy. The interpersonal-affective factor of psychopathy was associated with lower emotional concern, while the lifestyle and antisocial behavior factor was associated with weaker perspective-taking.

The neuroimaging result was unexpected: instead of simply reducing cortical indices, men with high psychopathic traits showed increased cortical surface area, particularly in the socio-emotional and sensory domains, with no similar difference in cortical thickness.

The practical conclusion should be cautious: this is not a "psychopathy scanner" or proof of the biological predetermination of behavior. It is a large-scale group study that helps us better understand how psychopathic traits, empathy, and brain structure may be linked, and it sets the direction for future research in more diverse populations.

This article is based on the article “Cortical Structure in Relation to Empathy and Psychopathy in 800 Incarcerated Men” by Marcin A. Radecki, J. Michael Maurer, Keith A. Harenski, David D. Stephenson, Erika Sampaolo, Giada Lettieri, Giacomo Handjaras, Emiliano Ricciardi, Samantha N. Rodriguez, Craig S. Neumann, Carla L. Harenski, Sara Palumbo, Silvia Pellegrini, Jean Decety, Pietro Pietrini, Kent A. Kiehl, and Luca Cecchetti, published in Biological Psychiatry Global Open Science. The article is available as an Elsevier open access publication, article number 100695. DOI: 10.1016/j.bpsgos.2026.100695.