A systematic review and meta-analysis of brain volume abnormalities in disruptive behaviour disorders, antisocial personality disorder and psychopathy

ABSTRACT Individuals with disruptive behaviour disorders in youth and antisocial personality disorder and psychopathy as adults share some clinical characteristics, but also diverge in

important ways. Existing meta-analyses of structural imaging studies suggest abnormalities within these disorders; however, so far none has examined the role of variability. Here we

performed a systematic review and meta-analysis to examine both variability (coefficient of variation ratio) and magnitude of brain volume differences between antisocial groups and healthy

controls (quantified using Hedges’ _g_). A comprehensive search was conducted of PubMed, EMBASE, Web of Science, Scopus and PsycINFO from inception to 31 January 2022 (pre-registered with

PROSPERO, ID number CRD42021250980, registered 25 June 2021). We included studies which included individuals with disruptive behaviour disorder (± callous–unemotional traits) or antisocial

personality disorder (± psychopathy), defined using standardized classificatory tools (Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases

criteria for disruptive behaviour disorders and antisocial personality disorder, Psychopathy Checklist: Revised or Psychopathy Checklist: Screening Version for psychopathy) and a healthy

control group, and which had sufficient data to extract mean and standard deviations, or _t_ or _P_ values, for both groups. We measured the relative variability of brain regions in

antisocial individuals compared with controls, by using the log coefficient of variability ratio. Between-group differences in mean volumes were quantified using standardized mean

difference. Risk of bias was assessed using modified version of the Newcastle–Ottawa Scale for case–control studies. Twenty-three studies met inclusion criteria. In antisocial individuals,

there was significantly increased variability for total grey matter (_Z_ = −2.6581, _P_ = 0.0079) and overall decreases in mean volume for total whole brain (_g_ = −0.41; 95% confidence

interval (CI) −0.67 to −0.15, _P_ = 0.0016), total grey matter (_g_ = −0.6; 95% CI −0.93 to −0.26, _P_ = 0.004) and amygdala (_g_ = −0.89; 95% CI −1.55 to −0.22, _P_ = 0.009), compared with

healthy controls. This suggests a key role for structural variability in clinical divergence within these disorders. The key limitations were lack of studies for some brain regions of

interest, including insula, and inconsistent clinical phenotyping. Further studies should seek to specify how this neurobiological variability maps to clinical variability and whether this

holds potential value as a biomarker to guide prognosis or treatment selection. Access through your institution Buy or subscribe This is a preview of subscription content, access via your

institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 digital issues and online access to articles $79.00 per year only $6.58 per issue Learn more

Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS:

* Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS INDIVIDUAL-LEVEL DEVIATIONS FROM NORMATIVE BRAIN

MORPHOLOGY IN VIOLENCE, PSYCHOSIS, AND PSYCHOPATHY Article Open access 02 April 2025 SHARED AND SEPARATE PATTERNS IN BRAIN MORPHOMETRY ACROSS TRANSDIAGNOSTIC DIMENSIONS Article 19 January

2023 DISTINCT BRAIN STRUCTURAL ABNORMALITIES IN ATTENTION-DEFICIT/HYPERACTIVITY DISORDER AND SUBSTANCE USE DISORDERS: A COMPARATIVE META-ANALYSIS Article Open access 06 September 2022 DATA

AVAILABILITY Analysis data are available at https://github.com/JohnTullyPsych/AntisocialStructuralVariabilityMeta ref. 85, and data sources are all listed in

AntisocialStructuralVariabilityMeta_Excel.csv. CODE AVAILABILITY Analysis code is available at https://github.com/JohnTullyPsych/AntisocialStructuralVariabilityMeta ref. 85, and code sources

are all listed in AntisocialStructuralVariabilityMeta_Excel.csv. REFERENCES * Falk, Ö. et al. The 1% of the population accountable for 63% of all violent crime convictions. _Soc. Psychiatry

Psychiatr. Epidemiol._ 49, 559–571 (2014). Article  PubMed  Google Scholar  * Piquero, A. R., & Moffitt, T. E. in _Encyclopedia of Criminology and Criminal Justice_ (ed. Weisburd, D.)

3121–3127 (Springer, 2014). * Moffitt, T. E. Male antisocial behaviour in adolescence and beyond. _Nat. Hum. Behav._ 2, 177 (2018). Article  PubMed  PubMed Central  Google Scholar  * Viding,

E. & McCrory, E. J. Genetic and neurocognitive contributions to the development of psychopathy. _Dev. Psychopathol._ 24, 969–983 (2012). Article  PubMed  Google Scholar  * Lynam, D. R.,

Derefinko, K. J., Caspi, A., Loeber, R. & Stouthamer-Loeber, M. The content validity of juvenile psychopathy: an empirical examination. _Psychol. Assess._ 19, 363 (2007). Article 

PubMed  Google Scholar  * Forsman, M., Lichtenstein, P., Andershed, H. & Larsson, H. Genetic effects explain the stability of psychopathic personality from mid-to late adolescence. _J.

Abnorm. Psychol._ 117, 606 (2008). Article  PubMed  Google Scholar  * Kosson, D. S., Lorenz, A. R. & Newman, J. P. Effects of comorbid psychopathy on criminal offending and emotion

processing in male offenders with antisocial personality disorder. _J. Abnorm. Psychol._ 115, 798 (2006). Article  PubMed  Google Scholar  * Coid, J. & Ullrich, S. Antisocial personality

disorder is on a continuum with psychopathy. _Compr. Psychiatry_ 51, 426–433 (2010). Article  PubMed  Google Scholar  * Frick, P. J., Ray, J. V., Thornton, L. C. & Kahn, R. E. Can

callous-unemotional traits enhance the understanding, diagnosis, and treatment of serious conduct problems in children and adolescents? A comprehensive review. _Psychol. Bull._ 140, 1–57

(2014). Article  PubMed  Google Scholar  * Guy, L. S., Edens, J. F., Anthony, C. & Douglas, K. S. Does psychopathy predict institutional misconduct among adults? A meta-analytic

investigation. _J. Consult. Clin. Psychol._ 73, 1056 (2005). Article  PubMed  Google Scholar  * Noordermeer, S. D. S., Luman, M. & Oosterlaan, J. A systematic review and meta-analysis of

neuroimaging in oppositional defiant disorder (ODD) and conduct disorder (CD) taking attention-deficit hyperactivity disorder (ADHD) into account. _Neuropsychol. Rev._ 26, 44–72 (2016).

Article  PubMed  PubMed Central  Google Scholar  * Rogers, J. C., De & Brito, S. A. Cortical and subcortical gray matter volume in youths with conduct problems a meta-analysis. _JAMA

Psychiatry._ 73, 64–72 (2016). Article  PubMed  Google Scholar  * Santana, E. J. The brain of the psychopath: a systematic review of structural neuroimaging studies. _Psychol. Neurosci._ 9,

420–443 (2016). Article  Google Scholar  * Anderson, N. E. & Kiehl, K. A. The psychopath magnetized: insights from brain imaging. _Trends Cogn. Sci._ 16, 52–60 (2012). Article  PubMed 

Google Scholar  * Harenski, C., Hare, R. D., & Kiehl, K. A. in _Responsibility and Psychopathy: Interfacing Law, Psychiatry and Philosophy_ (eds Malatesti, L. & McMillan, J.) Ch. 8

(Oxford University Press, 2010). * De Brito, S. A., McDonald, D., Camilleri, J. A. & Rogers, J. C. Cortical and subcortical gray matter volume in psychopathy: a voxel-wise meta-analysis.

_J. Abnorm. Psychol._ 130, 627 (2021). Article  PubMed  Google Scholar  * Brugger, S. P. & Howes, O. D. Heterogeneity and homogeneity of regional brain structure in schizophrenia: a

meta-analysis. _JAMA Psychiatry_ 74, 1104–1111 (2017). Article  PubMed  PubMed Central  Google Scholar  * Rogdaki, M. et al. Magnitude and heterogeneity of brain structural abnormalities in

22q11.2 deletion syndrome: a meta-analysis. _Mol. Psychiatry_ 25, 1704–1717 (2020). Article  PubMed  PubMed Central  Google Scholar  * Kaminski, J. et al. Glutamate in the dorsolateral

prefrontal cortex in patients with schizophrenia: a meta-analysis of 1H-magnetic resonance spectroscopy studies. _Biol. Psychiatry_ 89, 270–277 (2021). Article  PubMed  Google Scholar  *

Fairchild, G. et al. Decision making and executive function in male adolescents with early-onset or adolescence-onset conduct disorder and control subjects. _Biol. Psychiatry_ 66, 162–168

(2009). Article  PubMed  PubMed Central  Google Scholar  * Fanti, K. A., Kimonis, E. R., Hadjicharalambous, M.-Z. & Steinberg, L. Do neurocognitive deficits in decision making

differentiate conduct disorder subtypes? _Eur. Child Adolesc. Psychiatry_ 25, 989–996 (2016). Article  PubMed  Google Scholar  * Schwenck, C. et al. Empathy in children with autism and

conduct disorder: group‐specific profiles and developmental aspects. _J. Child Psychol. Psychiatry_ 53, 651–659 (2012). Article  PubMed  Google Scholar  * Marsh, A. A. & Blair, R. J. R.

Deficits in facial affect recognition among antisocial populations: a meta-analysis. _Neurosci. Biobehav. Rev._ 32, 454–465 (2008). Article  PubMed  Google Scholar  * Dawel, A., O’Kearney,

R., McKone, E. & Palermo, R. Not just fear and sadness: meta-analytic evidence of pervasive emotion recognition deficits for facial and vocal expressions in psychopathy. _Neurosci.

Biobehav. Rev._ 36, 2288–2304 (2012). Article  PubMed  Google Scholar  * Gregory, S. et al. The antisocial brain: psychopathy matters: a structural MRI investigation of antisocial male

violent offenders. _Arch. Gen. Psychiatry_ 69, 962–972 (2012). Article  PubMed  Google Scholar  * Pappa, I. et al. A genome‐wide approach to children’s aggressive behavior: the EAGLE

consortium. _Am. J. Med. Genet. B_ 171, 562–572 (2016). Article  Google Scholar  * Tielbeek, J. J. et al. Unraveling the genetic etiology of adult antisocial behavior: a genome-wide

association study. _PLoS ONE_ 7, e45086 (2012). Article  PubMed  PubMed Central  Google Scholar  * Rautiainen, M. et al. Genome-wide association study of antisocial personality disorder.

_Transl. Psychiatry_ 6, e883 (2016). Article  PubMed  PubMed Central  Google Scholar  * Panizzon, M. S. et al. Distinct genetic influences on cortical surface area and cortical thickness.

_Cerebr. Cortex_ 19, 2728–2735 (2009). Article  Google Scholar  * Ecker, C. et al. Brain surface anatomy in adults with autism: the relationship between surface area, cortical thickness, and

autistic symptoms. _JAMA Psychiatry_ 70, 59–70 (2013). Article  PubMed  Google Scholar  * Gudbrandsen, M. et al. Brain morphometry in 22q11.2 deletion syndrome: an exploration of

differences in cortical thickness, surface area, and their contribution to cortical volume. _Sci. Rep._ 10, 1–12 (2020). Article  Google Scholar  * Pardini, D. A., Raine, A., Erickson, K.

& Loeber, R. Lower amygdala volume in men is associated with childhood aggression, early psychopathic traits, and future violence. _Biol. Psychiatry_ 75, 73–80 (2014). Article  PubMed 

Google Scholar  * Hofhansel, L. et al. Morphology of the criminal brain: gray matter reductions are linked to antisocial behavior in offenders. _Brain Struct. Funct._ 225, 2017–2028 (2020).

Article  PubMed  PubMed Central  Google Scholar  * Schiffer, B. et al. Disentangling structural brain alterations associated with violent behavior from those associated with substance use

disorders. _Arch. Gen. Psychiatry_ 68, 1039–1049 (2011). Article  PubMed  Google Scholar  * Yang, Y., Raine, A., Narr, K. L., Colletti, P. & Toga, A. W. Localization of deformations

within the amygdala in individuals with psychopathy. _Arch. Gen. Psychiatry_ 66, 986–994 (2009). Article  PubMed  PubMed Central  Google Scholar  * Yang, Y. et al. Volume reduction in

prefrontal gray matter in unsuccessful criminal psychopaths. _Biol. Psychiatry_ 57, 1103–1108 (2005). Article  PubMed  Google Scholar  * Raine, A. et al. Corpus callosum abnormalities in

psychopathic antisocial individuals. _Arch. Gen. Psychiatry_ 60, 1134–1142 (2003). Article  PubMed  Google Scholar  * Raine, A., Lencz, T., Bihrle, S., LaCasse, L. & Colletti, P. Reduced

prefrontal gray matter volume and reduced autonomic activity in antisocial personality disorder. _Arch. Gen. Psychiatry_ 57, 119–127 (2000). Article  PubMed  Google Scholar  * Griem, J.,

Kolla, N. J. & Tully, J. Key challenges in neurocognitive assessment of individuals with antisocial personality disorder and psychopathy. _Front. Behav. Neurosci._ 16, 1007121 (2022).

Article  PubMed  PubMed Central  Google Scholar  * Birbaumer, N. et al. Deficient fear conditioning in psychopathy: a functional magnetic resonance imaging study. _Arch. Gen. Psychiatry_ 62,

799–805 (2005). Article  PubMed  Google Scholar  * Gregory, S. et al. Punishment and psychopathy: a case–control functional MRI investigation of reinforcement learning in violent antisocial

personality disordered men. _Lancet Psychiatry_ 2, 153–160 (2015). Article  PubMed  Google Scholar  * Decety, J., Skelly, L., Yoder, K. J. & Kiehl, K. A. Neural processing of dynamic

emotional facial expressions in psychopaths. _Soc. Neurosci._ 9, 36–49 (2014). Article  PubMed  PubMed Central  Google Scholar  * Sebastian, C. L. et al. Neural responses to affective and

cognitive theory of mind in children with conduct problems and varying levels of callous–unemotional traits. _Arch. Gen. Psychiatry_ 69, 814–822 (2012). Article  PubMed  Google Scholar  *

Lockwood, P. L. et al. Association of callous traits with reduced neural response to others’ pain in children with conduct problems. _Curr. Biol._ 23, 901–905 (2013). Article  PubMed  PubMed

Central  Google Scholar  * Walter, H. Social cognitive neuroscience of empathy: concepts, circuits, and genes. _Emot. Rev._ 4, 9–17 (2012). Article  Google Scholar  * Blair, R., Veroude, K.

& Buitelaar, J. Neuro-cognitive system dysfunction and symptom sets: a review of fMRI studies in youth with conduct problems. _Neurosci. Biobehav. Rev._ 91, 69–90 (2018). Article 

PubMed  Google Scholar  * O’Doherty, J. P. Contributions of the ventromedial prefrontal cortex to goal‐directed action selection. _Ann. N. Y. Acad. Sci._ 1239, 118–129 (2011). Article 

PubMed  Google Scholar  * Hiser, J. & Koenigs, M. The multifaceted role of the ventromedial prefrontal cortex in emotion, decision making, social cognition, and psychopathology. _Biol.

Psychiatry_ 83, 638–47. (2018). Article  PubMed  Google Scholar  * Finger, E. C. et al. Disrupted reinforcement signaling in the orbitofrontal cortex and caudate in youths with conduct

disorder or oppositional defiant disorder and a high level of psychopathic traits. _Am. J. Psychiatry_ 168, 152–162 (2011). Article  PubMed  Google Scholar  * Decety, J., Michalska, K. J.,

Akitsuki, Y. & Lahey, B. B. Atypical empathic responses in adolescents with aggressive conduct disorder: a functional MRI investigation. _Biol. Psychol._ 80, 203–211 (2009). Article 

PubMed  Google Scholar  * Glenn, A. L., Raine, A., Yaralian, P. S. & Yang, Y. Increased volume of the striatum in psychopathic individuals. _Biol. Psychiatry_ 67, 52–58 (2010). Article 

PubMed  PubMed Central  Google Scholar  * Báez-Mendoza, R. & Schultz, W. The role of the striatum in social behavior. _Front. Neurosci._ 7, 233 (2013). Article  PubMed  PubMed Central 

Google Scholar  * Wickens, J. R., Budd, C. S., Hyland, B. I. & Arbuthnott, G. W. Striatal contributions to reward and decision making. _Ann. N. Y. Acad. Sci._ 1104, 192–212 (2007).

Article  PubMed  Google Scholar  * Alegria, A. A., Radua, J. & Rubia, K. Meta-analysis of fMRI studies of disruptive behavior disorders. _Am. J. Psychiatry_ 173, 1119–30. (2016). Article

  PubMed  Google Scholar  * Floresco, S. B., Montes, D. R., Maric, M. & van Holstein, M. Differential contributions of nucleus accumbens subregions to cue-guided risk/reward decision

making and implementation of conditional rules. _J. Neurosci._ 38, 1901–14. (2018). Article  PubMed  PubMed Central  Google Scholar  * Sethi, A. et al. Emotional detachment in psychopathy:

involvement of dorsal default-mode connections. _Cortex_ 62, 11–19 (2015). Article  PubMed  Google Scholar  * Craig, M. C. et al. Altered connections on the road to psychopathy. _Mol.

Psychiatry_ 14, 946–953 (2009). Article  PubMed  Google Scholar  * Jones, A. P., Laurens, K. R., Herba, C. M., Barker, G. J. & Viding, E. Amygdala hypoactivity to fearful faces in boys

with conduct problems and callous-unemotional traits. _Am. J. Psychiatry_ 166, 95–102 (2009). Article  PubMed  Google Scholar  * Lozier, L. M., Cardinale, E. M., VanMeter, J. W. & Marsh,

A. A. Mediation of the relationship between callous-unemotional traits and proactive aggression by amygdala response to fear among children with conduct problems. _JAMA Psychiatry_ 71,

627–636 (2014). Article  PubMed  PubMed Central  Google Scholar  * Viding, E. et al. Amygdala response to preattentive masked fear in children with conduct problems: the role of

callous–unemotional traits. _Am. J. Psychiatry_ 169, 1109–1116 (2012). Article  PubMed  Google Scholar  * White, S. F. et al. Reduced activity within the dorsal endogenous orienting of

attention network to fearful expressions in youth with disruptive behavior disorders and psychopathic traits. _Dev. Psychopathol._ 24, 1105–1116 (2012). Article  PubMed  PubMed Central 

Google Scholar  * Passamonti, L. et al. Abnormal anatomical connectivity between the amygdala and orbitofrontal cortex in conduct disorder. _PLoS ONE_ 7, e48789 (2012). Article  PubMed 

PubMed Central  Google Scholar  * Cohn, M. D. et al. Fear conditioning, persistence of disruptive behavior and psychopathic traits: an fMRI study. _Transl. Psychiatry_ 3, 89 (2013). * Rubia,

K. et al. Disorder-specific dissociation of orbitofrontal dysfunction in boys with pure conduct disorder during reward and ventrolateral prefrontal dysfunction in boys with pure ADHD during

sustained attention. _Am. J. Psychiatry_ 166, 83–94 (2009). Article  PubMed  Google Scholar  * Crowley, T. J. et al. Risky decisions and their consequences: neural processing by boys with

Antisocial Substance Disorder. _PLoS ONE_ 5, e12835 (2010). Article  PubMed  PubMed Central  Google Scholar  * Finger, E. C. et al. Disrupted reinforcement signaling in the orbitofrontal

cortex and caudate in youths with conduct disorder or oppositional defiant disorder and a high level of psychopathic traits. _Am. J. Psychiatry_ 168, 152–162 (2011). * Hosking, J. G. et al.

Disrupted prefrontal regulation of striatal subjective value signals in psychopathy. _Neuron_ 95, 221–31. e4 (2017). Article  PubMed  PubMed Central  Google Scholar  * Pujol, J., Batalla,

I., et al. Breakdown in the brain network subserving moral judgment in criminal psychopathy. _Soc. Cogn. Affect. Neurosci._ 7, 917–923 (2012). * Contreras-Rodriguez, O. et al. Disrupted

neural processing of emotional faces in psychopathy. _Soc. Cogn. Affect. Neurosci._ 9, 505–512 (2014). Article  PubMed  Google Scholar  * Decety, J., Skelly, L. R. & Kiehl, K. A. Brain

response to empathy-eliciting scenarios involving pain in incarcerated individuals with psychopathy. _JAMA Psychiatry_ 70, 638–645 (2013). Article  PubMed  PubMed Central  Google Scholar  *

Raine, A. Antisocial personality as a neurodevelopmental disorder. _Annu. Rev. Clin. Psychol._ 14, 259–89. (2018). Article  PubMed  Google Scholar  * Lange, N., Froimowitz, M. P., Bigler, E.

D., Lainhart, J. E. & Group, B. D. C. Associations between IQ, total and regional brain volumes, and demography in a large normative sample of healthy children and adolescents. _Dev.

Neuropsychol._ 35, 296–317 (2010). Article  PubMed  PubMed Central  Google Scholar  * Shaw, P. et al. Intellectual ability and cortical development in children and adolescents. _Nature_ 440,

676–679 (2006). Article  PubMed  Google Scholar  * Cox, S. R., Ritchie, S. J., Fawns-Ritchie, C., Tucker-Drob, E. M. & Deary, I. J. Structural brain imaging correlates of general

intelligence in UK Biobank. _Intelligence_ 76, 101376 (2019). Article  PubMed  PubMed Central  Google Scholar  * Blair, R. Psychopathy: cognitive and neural dysfunction. _Dialogues Clin.

Neurosci._ 15, 181–190 (2013). Article  Google Scholar  * Kong, X.-Z. et al. Individual differences in impulsivity predict head motion during magnetic resonance imaging. _PLoS ONE_ 9,

e104989 (2014). Article  PubMed  PubMed Central  Google Scholar  * Reuter, M. et al. Head motion during MRI acquisition reduces gray matter volume and thickness estimates. _NeuroImage_ 107,

107–115 (2015). Article  PubMed  Google Scholar  * Dosenbach, N. U. et al. Real-time motion analytics during brain MRI improve data quality and reduce costs. _NeuroImage_ 161, 80–93 (2017).

Article  PubMed  Google Scholar  * Sui, Y., Afacan, O., Gholipour, A. & Warfield, S. K. SLIMM: slice localization integrated MRI monitoring. _NeuroImage._ 223, 117280 (2020). Article 

PubMed  Google Scholar  * D’Andrea, C. B. et al. Real-time motion monitoring improves functional MRI data quality in infants. _Dev. Cogn. Neurosci._ 55, 101116 (2022). Article  Google

Scholar  * McCutcheon, R., Beck, K., Jauhar, S. & Howes, O. D. Defining the locus of dopaminergic dysfunction in schizophrenia: a meta-analysis and test of the mesolimbic hypothesis.

_Schizophr. Bull._ 44, 1301–1311 (2018). Article  PubMed  Google Scholar  * Hedges, L. V., & Olkin, I. _Statistical Methods for Meta-analysis_ (Academic Press, 2014). * Higgins, J. P. et

al. _Cochrane Handbook for Systematic Reviews of Interventions_ (John Wiley & Sons, 2019). * Becker L. A. Effect size (ES). https://www.uv.es/~friasnav/EffectSizeBecker.pdf (2000). *

Tully J. McCutcheon, RA. https://github.com/JohnTullyPsych/AntisocialStructuralVariabilityMeta (2022). * Barkataki, I., Kumari, V., Das, M., Taylor, P. & Sharma, T. Volumetric structural

brain abnormalities in men with schizophrenia or antisocial personality disorder. _Behav. Brain Res._ 169, 239–247 (2006). Article  PubMed  Google Scholar  * Boccardi, M. et al. Atypical

nucleus accumbens morphology in psychopathy: another limbic piece in the puzzle. _Int. J. Law Psychiatry_ 36, 157–167 (2013). Article  PubMed  PubMed Central  Google Scholar  * Budhiraja, M.

et al. Brain structure abnormalities in young women who presented conduct disorder in childhood/adolescence. _Cogn. Affect. Behav. Neurosci._ 17, 869–885 (2017). Article  PubMed  PubMed

Central  Google Scholar  * Dolan, M. C., Deakin, J. F. W., Roberts, N. & Anderson, I. M. Quantitative frontal and temporal structural MRI studies in personality-disordered offenders and

control subjects. _Psychiatry Res. Neuroimaging_ 116, 133–149 (2002). Article  Google Scholar  * Glenn, A. L., Yang, Y., Raine, A. & Colletti, P. No volumetric differences in the

anterior cingulate of psychopathic individuals. _Psychiatry Res. Neuroimaging_ 183, 140–143 (2010). Article  Google Scholar  * Huebner, T. et al. Morphometric brain abnormalities in boys

with conduct disorder. _J. Am. Acad. Child Adolesc. Psychiatry_ 47, 540–547 (2008). Article  PubMed  Google Scholar  * Ibrahim, K. et al. Sex differences in medial prefrontal and parietal

cortex structure in children with disruptive behavior. _Dev. Cogn. Neurosci._ 47, 100884 (2021). Article  PubMed  Google Scholar  * Kaya, S., Yildirim, H. & Atmaca, M. Reduced

hippocampus and amygdala volumes in antisocial personality disorder. _J. Clin. Neurosci._ 75, 199–203 (2020). Article  PubMed  Google Scholar  * Kruesi, M. J., Casanova, M. F., Mannheim, G.

& Johnson-Bilder, A. Reduced temporal lobe volume in early onset conduct disorder. _Psychiatry Res. Neuroimaging_ 132, 1–11 (2004). Article  Google Scholar  * Kumari, V. et al. Reduced

thalamic volume in men with antisocial personality disorder or schizophrenia and a history of serious violence and childhood abuse. _Eur. Psychiatry_ 28, 225–234 (2013). Article  PubMed 

Google Scholar  * Laakso, M. P. et al. Prefrontal volumes in habitually violent subjects with antisocial personality disorder and type 2 alcoholism. _Psychiatry Res. Neuroimaging_ 114,

95–102 (2002). Article  Google Scholar  * Narayan, V. M. et al. Regional cortical thinning in subjects with violent antisocial personality disorder or schizophrenia. _Am. J. Psychiatry_ 164,

1418–1427 (2007). Article  PubMed  PubMed Central  Google Scholar  * Noordermeer, S. D. S. et al. Structural brain abnormalities of attention-deficit/hyperactivity disorder with

oppositional defiant disorder. _Biol. Psychiatry_ 82, 642–650 (2017). Article  PubMed  Google Scholar  * Sebastian, C. L. et al. Grey matter volumes in children with conduct problems and

varying levels of callous-unemotional traits. _J. Abnorm. Child Psychol._ 44, 639–649 (2016). Article  PubMed  Google Scholar  * Tiihonen, J. et al. Brain anatomy of persistent violent

offenders: more rather than less. _Psychiatry Res. Neuroimaging_ 163, 201–212 (2008). Article  Google Scholar  * Vetter, N. C., Backhausen, L. L., Buse, J., Roessner, V. & Smolka, M. N.

Altered brain morphology in boys with attention deficit hyperactivity disorder with and without comorbid conduct disorder/oppositional defiant disorder. _Hum. Brain Mapp._ 41, 973–983

(2020). Article  PubMed  Google Scholar  * Wallace, G. L. et al. Cortical and subcortical abnormalities in youths with conduct disorder and elevated callous-unemotional traits. _J. Am. Acad.

Child Adolesc. Psychiatry_ 53, 456–465 (2014). Article  PubMed  Google Scholar  Download references ACKNOWLEDGEMENTS R.A.M.’s work is funded by a Wellcome Clinical Research Career

Development Fellowship (224625/Z/21/Z). None of the other authors received funding towards this work. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Academic Unit of Mental Health and

Clinical Neurosciences, School of Medicine, University of Nottingham, Jubilee Campus, University of Nottingham, Nottingham, UK John Tully & Brooke Gerrie * MerseyCare NHS Trust, Oxford,

UK Ben Cross * Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK Julia Griem & Nigel

Blackwood * Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark Robert James Blair * Department of Psychiatry, University of

Oxford, Oxford, UK Robert A. McCutcheon Authors * John Tully View author publications You can also search for this author inPubMed Google Scholar * Ben Cross View author publications You can

also search for this author inPubMed Google Scholar * Brooke Gerrie View author publications You can also search for this author inPubMed Google Scholar * Julia Griem View author

publications You can also search for this author inPubMed Google Scholar * Nigel Blackwood View author publications You can also search for this author inPubMed Google Scholar * Robert James

Blair View author publications You can also search for this author inPubMed Google Scholar * Robert A. McCutcheon View author publications You can also search for this author inPubMed 

Google Scholar CONTRIBUTIONS J.T. and R.A.M. conceived the idea. J.T., B.C. and B.G. performed the literature search and cross-checking of papers. J.T. performed the analyses, with input

from R.A.M. J.T. wrote the initial draft. J.T., B.C., B.G., J.G., N.B., R.J.B. and R.A.M. all provided critical analysis on scientific content on this and further drafts. CORRESPONDING

AUTHOR Correspondence to John Tully. ETHICS DECLARATIONS COMPETING INTERESTS R.A.M. has received honoraria for educational talks from Otsuka and Janssen. None of the other authors has any

conflict of interest, financial or otherwise, to disclose. PEER REVIEW PEER REVIEW INFORMATION _Nature Mental Health_ thanks Nathaniel Anderson, Olivia Choy and Natalia Tesli for their

contribution to the peer review of this work. ADDITIONAL INFORMATION PUBLISHER’S NOTE Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional

affiliations. SUPPLEMENTARY INFORMATION SUPPLEMENTARY INFORMATION All supplementary text and figures. REPORTING SUMMARY RIGHTS AND PERMISSIONS Springer Nature or its licensor (e.g. a

society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript

version of this article is solely governed by the terms of such publishing agreement and applicable law. Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Tully, J., Cross, B.,

Gerrie, B. _et al._ A systematic review and meta-analysis of brain volume abnormalities in disruptive behaviour disorders, antisocial personality disorder and psychopathy. _Nat. Mental

Health_ 1, 163–173 (2023). https://doi.org/10.1038/s44220-023-00032-0 Download citation * Received: 01 August 2022 * Accepted: 01 February 2023 * Published: 22 March 2023 * Issue Date: March

2023 * DOI: https://doi.org/10.1038/s44220-023-00032-0 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable

link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative