37 Neuroendocrinological aspects of social anxiety and aggression related disorders with psychopathy (Loomans et al., 2016), which predisposes individuals to aggressive behavior (Montoya et al., 2012; Terburg, Morgan, & van Honk, 2009). However, Welker et al. (2014 ) showed a different pattern of results in which the positive relationship between testosterone and psychopathy only emerged when cortisol was high. High testosterone levels in utero, during adolescence, and in response to stress might predispose to psychopathy, in combination with individual and environmental risk factors (Yildirim & Derksen, 2012). Testosterone likely dampens oxytocinergic effects on social empathy (see Yildirim & Derksen, 2012 for a review). Both lower oxytocin levels and certain variations in oxytocin receptor polymorphisms are related to risk factors for developing psychopathy (e.g., callous– unemotional traits and conduct problems) in children and adolescents (Dadds et al., 2014; Levy et al., 2015). Figure 2.2 Summary of results of approach – avoidance tendencies on the Approach Avoidance Task in psychopathic individuals and healthy controls. Adapted from Volman et al., 2016 . Panels A and B: Psychopathic individuals (violent offenders with high psychopathic traits) show reduced pattern of negative coupling between the anterior prefrontal cortex (aPFC) and the amygdala when they have to control their emotional actions on the approach– avoidance task (AAT, see panel E), compared to healthy matched controls. Panel C: Psychopathic individuals (compared to controls) show reduced local activity in the aPFC when they exert approach-avoidance control, and this effect is modulated by their testosterone levels (Panel D). Panel E: fMRI adapted AAT– people make affect-congruent reactions by pulling a joystick towards their body when detecting a happy face or by pushing the joystick away from their body in response to an angry face. In contrast, affect-incongruent responses involved the opposite reactions to the emotional faces, which requires AA control and is typically associated with increased reaction times and increased aPFC activity (Volman et al., 2011 , 2013). 2
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