Psychopathy and callous-unemotional traits in adolescence: A systematic review of cultural inclusion and meta-analysis of fMRI neural correlates

The past 15 years has witnessed an increase in neuroimaging examining individuals with psychopathic traits, including adolescent populations. Neuroimaging findings have identified a wide range of structural and functional abnormalities associated with psychopathy or callous-unemotional (CU) traits that have lacked consistency. Even with this increase in attention, neuroimaging research on psychopathy has not given proper attention to the role of cultural factors as a source of heterogeneous findings. Aims: Accordingly, the present study is a systematic review and coordinate based meta-analysis (CBMA) that seeks to add to the existing literature in two important ways. First, by focusing exclusively on the consistency of neuroimaging outcomes for adolescents with psychopathy/CU traits, and second, by reporting the prevalence of cultural group inclusion within this body of research. Methods: The systematic review consisted of 52 articles, published or authored prior to June 2021, 19 of which met inclusion criteria for the meta-analysis. Results: Out of the 52 adolescent articles, 98% reported the gender makeup of their sample; however, most articles reported only the number of male adolescents in their sample. Most articles (61.5%) reported at least one racial/ethnic group membership for their sample; however, almost 40% of articles did not report any information regarding the race/ethnicity of their sample. Three articles reported neuroimaging results for female participants and no articles reported results for racial/ethnic minority group members. Meta-analytic results revealed adolescents with psychopathy/CU traits had decreased brain activity in the anterior cingulate, insula, thalamus/hypothalamus, and increased activity in the prefrontal cortex. Conclusions: To our knowledge, the present study is the only systematic review of cultural inclusion and meta-analysis of functional neural correlates within neuroimaging research on adolescents with psychopathy/CU traits. Results highlight several important implications and areas for future direction for the improvement of cultural inclusion within neuroimaging research and its incorporation into the courtroom.