Autonomic Nervous System and Possible Determinants of Social Behavior: A Systematic Review of its Relationship Among Psychopathy, Compassion, and Theory of Mind.

Objective: Sensitive alterations in the balance between physiological changes may be a relevant factor in the expression of social behavior and are systematically reported in a broad spectrum of psychopathological conditions. Among these, psychopathy, compassion and theory of mind hold a prominent role in social interaction. Biomarkers associated with such individual characteristics could represent an ambitious breakthrough in clinical practice, both diagnostically and therapeutically. The aim of this work is to evaluate the available evidence published in the past 20 years in order to investigate the relationship between the autonomic nervous system and the aforementioned individual characteristics.

Method: A literature search was conducted using dedicated search engines, including Pubmed, Scopus, and Google Scholar. The review focused on evidence published over the last two decades, from 2003 to 2024.

Results: Individuals with high trait psychopathy show reduced activation in skin conductance. This attenuation results in lower sensitivity to learning through fear conditioning mechanisms and an impaired ability to process affective stimuli. Studies focusing on compassion, while showing less variability in measures and proposed tasks, have revealed a possible effect of time in terms of efficacy, with therapeutic intervention programs (of at least 2 weeks' duration) also showing an impact on autonomic indices. Studies focused on theory of mind highlighted mixed findings and may require further investigation.

Conclusions: Interpretation of results may be limited by the numerosity and demographic characteristics of the participants, the plurality of autonomic indices used, and the heterogeneity of the proposed tasks. The ability to modify sensitivity to autonomic changes intentionally through possible specific therapeutic interventions could be a potential clinical goal.