Neurodevelopmental and environmental pathways to psychopathy: Insights from minor physical anomalies in forensic psychiatric population

Psychopathy is a multidimensional disorder influenced by behavioral, social, and biological factors. Minor physical anomalies (MPAs) are subtle morphological variations that arise from developmental disruptions during the prenatal period and are considered potential phenotypic indicators of such neurodevelopmental irregularities. Previous research has examined several neurodevelopmental aspects of psychopathy. However, the specific relationship between MPAs and psychopathy has not yet been systematically investigated. This cross-sectional study investigated the association between MPAs and psychopathy levels. The sample comprised 114 male offenders meeting DSM-5 criteria for Antisocial Personality Disorder (ASPD) and 54 healthy controls matched for age and sex. Psychopathy was assessed using the Psychopathy Checklist-Revised, and participants were classified as low (LP) or high psychopathy (HP). MPAs were evaluated using the Waldrop Minor Physical Anomaly Scale. Results indicated that total, craniofacial, and peripheral MPA scores were significantly higher in the HP group than in LP and control groups (p < 0.001). Psychopathy level strongly correlated with total MPA score (r = 0.83, p < 0.001). Regression analysis showed that MPAs, particularly craniofacial anomalies, were stronger predictors of psychopathy than psychosocial factors (B = 0.710, p < 0.001). This study demonstrated a significant association between MPAs and the level of psychopathy. The findings suggest that lower levels of psychopathic traits are more closely related to psychosocial factors, whereas higher levels may be more strongly associated with craniofacial MPAs. Multicenter and longitudinal studies examining neurodevelopmental and psychosocial interactions may contribute to a deeper understanding of the developmental dynamics of psychopathy.