Jean Decety, PhD; Laurie R. Skelly, PhD; Kent A. Kiehl, PhD

Importance  A marked lack of empathy is a hallmark characteristic of individuals with psychopathy. However, neural processes associated with empathic processing have not yet been directly examined in psychopathy, especially in response to the perception of other people in pain and distress.

Objective  To identify potential differences in patterns of neural activity in incarcerated individuals with psychopathy and incarcerated persons serving as controls during the perception of empathy-eliciting stimuli depicting other people experiencing pain.

Design  In a case-control study, brain activation patterns elicited by dynamic stimuli depicting individuals being harmed and facial expressions of pain were compared between incarcerated individuals with psychopathy and incarcerated controls.

Setting  Participants were scanned on the grounds of a correctional facility using the Mind Research Network’s mobile 1.5-T magnetic resonance imaging system.