Can Serial Killers Be Rehabilitated?

This article examines the neural mechanisms at work in the decision making process of psychopathic killers and whether or not these mental processes and outcomes can be changed.

Almost all serial killers are psychopaths (1). The Diagnostic and Statistical Manual, Fifth Edition (DSM-5) defines psychopaths as having Antisocial Personality Disorder characterized by "a pervasive pattern of disregard for the violation of the rights of others."

Prior Research

Prior research into the causation of a psychopath's violence focused on a psychopath's lack of empathy and emotion. These factors were considered critical to the ability of the serial killer to kill without remorse. The DSM-5 diagnostic criteria for antisocial personality disorder is characterized by the lack of remorse and empathy and outwardly aggressive behaviors. The DSM-5 definition of antisocial personality disorder includes, among other diagnostic criteria, deceitfulness, irritability or aggressiveness, reckless disregard for others, lack of remorse and emotional attachment and failure to conform to social norms and laws. Past studies oversimplified the psychopathic mind as lacking empathy and emotion even though the medical definition was more complex and included numerous other traits.

New Research Emphasizes Psychopaths Are Focused on Rewards

However, the new research on psychopathic serial killers emphasizes decision making and examination of how the serial killer mind can be so unaffected by the consequences of their brutal actions. A recent 2017 study published in the Journal Neuron (2) analyzed brain scans of psychopathic individuals in prisons. The study focused on the part of the brain involved in decision making and behavior, the prefrontal cortex. The prefrontal cortex sits in the front of the brain just behind the forehead. The prefrontal cortex is also influential in an individual's consideration of the consequences of one's actions. This Wisconsin prison study marked a change in how scientists should examine the causation of violence in a serial killer's mind.

The prison study in Wisconsin showed that the violent behavior of psychopaths emerges not only from a lack of empathy and emotion, but also results directly from a skewed risk/reward analysis in the mind of the serial killer, which highly values the reward and doesn't care about consequences. In fMRI studies done scanning the brains of psychopaths in prison, the study indicated that the decision making process of psychopaths functions differently from non-psychopaths. In the psychopathic brain, the benefits of the rewards always outweigh the risks of all negative consequences including getting caught, going to prison, getting hurt in prison and harming others. In the mind of a psychopath, the benefits of the reward of doing a violent act are all that matters and the consequences have no relevance. It is a reward driven process. This conclusion was drawn from scanning psychopaths' brains while they completed a psychological assessment requiring decision making. The decision making process was highly influenced by the thought of a reward and not influenced by potential consequences. Thus the conclusion of this study was that psychopaths have a skewed risk reward analysis process which tips their behavior in favor of rewards at any cost.

Can We Rehabilitate a Psychopathic Mind?

A normal brain makes decisions by weighing out the rewards of a particular action against the consequences. For example, in making the decision to not drive drunk, we are weighing and measuring the potential consequences of our actions. In the psychopathic mind, an action which gives a reward is the most valued in the decision making process and the consequences are of little or no concern.

Can this psychopathic decision making process which overvalues rewards be changed or rehabilitated? For a majority of the population, through global history, prison has been a deterrent to crime. For serial killers, prison is not a deterrent to crime. Then, the question arises, how can modern science rehabilitate a defective decision making process if that process is influenced and biased in favor of seeking rewards at all costs? It involves understanding how the brain of a psychopath works. The psychopathic mind does not give proper value to the negative consequences of violent behavior.

Neural Mechanisms

Decision making is part of the executive function of the prefrontal cortex. Neural mechanisms are hard at work to achieve a properly weighed and objectively measured decision involving all of our actions and their corresponding consequences. Recent studies on the psychopathic brain patterns from Japan have examined the spontaneous firing of prefrontal neurons just before a decision is made and these firings have a biasing effect on decisions in the psychopathic brain (3). Additional factors which influence decision making for all brains are value systems and memories of past rewards and consequences.

Conclusion

If the spontaneous firing of neurons in the psychopathic brain unduly influences the psychopath toward violence, then controlling the spontaneous neuronal activity would be critical to controlling the harmful decision making of psychopaths.

The above referenced study from Japan gives hope to changing or rehabilitating the psychopathic mind. If the spontaneous firing of neurons can be controlled in the future with pharmacological interventions, it could be possible to change the negative influence these spontaneously fired neurons have on the decision making process in psychopaths. According to the National Institute on Health (4) for example, some drugs are known to interfere with the way neurons send, receive and process signals in the brain and some drugs can impair neuronal circuits. Drugs can also affect stress reactivity, mood and behavior (4). Further research is needed, but the new studies are hopeful in how science can learn to rehabilitate the serial killers by using drug therapy to impede the firing of neurons in the prefrontal cortex.