Psychopathic traits associated with abnormal hemodynamic activity in salience and default mode networks during auditory oddball task

Psychopathy is a personality disorder accompanied by abnormalities in emotional processing and attention. Recent theoretical applications of network-based models of cognition have been used to explain the diverse range of abnormalities apparent in psychopathy. Still, the physiological basis for these abnormalities is not well understood. A significant body of work has examined psychopathy-related abnormalities in simple attention-based tasks, but these studies have largely been performed using electrocortical measures, such as event-related potentials (ERPs), and they often have been carried out among individuals with low levels of psychopathic traits. In this study, we examined neural activity during an auditory oddball task using functional magnetic resonance imaging (fMRI) during a simple auditory target detection (oddball) task among 168 incarcerated adult males, with psychopathic traits assessed via the Hare Psychopathy Checklist-Revised (PCL-R). Event-related contrasts demonstrated that the largest psychopathy-related effects were apparent between the frequent standard stimulus condition and a task-off, implicit baseline. Negative correlations with interpersonal-affective dimensions (Factor 1) of the PCL-R were apparent in regions comprising default mode and salience networks. These findings support models of psychopathy describing impaired integration across functional networks. They additionally corroborate reports which have implicated failures of efficient transition between default mode and task-positive networks. Finally, they demonstrate a neurophysiological basis for abnormal mobilization of attention and reduced engagement with stimuli that have little motivational significance among those with high psychopathic traits.     

Visual complexity attenuates emotional processing in psychopathy: Implications for fear-potentiated startle deficits

A long-standing debate is the extent to which psychopathy is characterized by fundamental deficits in attention or emotion. We tested the hypothesis that the interplay of emotional and attentional systems is critical for understanding processing deficits in psychopathy. A group of 63 offenders were assessed using the Psychopathy Checklist: Screening Version. Event-related brain potentials (ERPs) and fear-potentiated startle (FPS) reflexes were collected while participants viewed pictures selected to disentangle an existing confound between perceptual complexity and emotional content in the pictures typically used to study fear deficits in psychopathy. As predicted, picture complexity moderated the emotional processing deficits. Specifically, the affective–interpersonal features of psychopathy were associated with greater allocation of attentional resources to processing emotional stimuli at initial perception (visual N1), but only when the picture stimuli were visually complex. Despite this, results for the late positive potential indicated that emotional pictures were less attentionally engaging and held less motivational significance for individuals high in affective–interpersonal traits. This deficient negative emotional processing was observed later in their reduced defensive fear reactivity (FPS) to high-complexity unpleasant pictures. In contrast, the impulsive–antisocial features of psychopathy were associated with decreased sensitivity to picture complexity (visual N1) and were unrelated to emotional processing, as assessed by both ERPs and FPS. These findings are the first to demonstrate that picture complexity moderates FPS deficits, and they implicate the interplay of attention and emotional systems as deficient in psychopathy.     

Psychopathy and physiological response to emotionally evocative sounds

Despite considerable evidence that psychopathic criminals are deviant in their emotional reactions, few studies have examined responses to both pleasurable and aversive stimuli or assessed the role of different facets of psychopathy in affective deviations. This study investigated physiological reactions to emotional sounds in prisoners selected according to scores on the 2 factors of Hare's Psychopathy Checklist--Revised (PCL-R; R. D. Hare, 1991). Offenders high on the PCL-R emotional-interpersonal factor, regardless of scores on the social deviance factor, showed diminished skin conductance responses to both pleasant and unpleasant sounds, suggesting a deficit in the action mobilization component of emotional response. Offenders who scored high only on the social deviance factor showed a delay in heart rate differentiation between affective and neutral sounds. These findings indicate abnormal reactivity to both positive and negative emotional stimuli in psychopathic individuals, and suggest differing roles for the 2 facets of psychopathy in affective processing deviations.     

Modification of the startle reflex in a community sample: do one or two dimensions of psychopathy underlie emotional processing?

Recent research on psychopathy has begun to explore two dimensions that possibly underlie psychopathy–one related more to emotional and interpersonal traits, and another related more to antisocial behaviors. A community sample of adults was assessed for psychopathy using Hare's (1991) Psychopathy Checklist-Revised (PCL-R). Eyeblinks elicited by startle probes were recorded while participants viewed pictures of emotionally-laden stimuli. Consistent with previous research, participants scoring high on PCL-R Factor 2 (“antisocial”) showed no affective modification of startle if they also scored high on PCL-R Factor 1 (“emotional detachment”). When the factor scores were analyzed together as continuous variables in a regression analysis, however, affective modification of startle was negatively related to Factor 1 but positively related to Factor 2. The results thus provide further support for a two-factor model of psychopathy.     

Neuroticism and psychopathy predict brain activation during moral and nonmoral emotion regulation

Functional neuroimaging has identified brain regions associated with voluntary regulation of emotion, including the prefrontal cortex and amygdala. The neural mechanisms underlying individual differences in emotion regulation have not been extensively studied. We investigated the neural correlates of neuroticism and psychopathic personality traits in the context of an emotion regulation task. Results showed that amygdala activity elicited by unpleasant pictures was positively correlated with neuroticism and negatively correlated with a specific psychopathic trait related to emotional underreactivity. During active attempts to decrease emotional responses to unpleasant pictures, superior and ventrolateral prefrontal activity was positively correlated with psychopathy, but not with neuroticism. In contrast, dorsolateral prefrontal activity was positively correlated with neuroticism, but not with psychopathy. Psychopathy was also negatively correlated with medial prefrontal activity in response to pictures depicting moral violations, suggesting reduced emotional responses to moral stimuli in individuals with high levels of psychopathic traits. These results demonstrate dissociable influences of different personality traits on neural activity associated with responses to emotional stimuli and on the recruitment of regulation-related brain activity during the active down-regulation of responses to negative emotional stimuli. These results have implications for the etiology of trait-based psychopathology involving emotional dysregulation.     

Psychopathy and Trait Emotional Intelligence

Psychopathic individuals are infamous for their chronic and diverse failures of social adjustment despite their adequate intellectual abilities. Non-cognitive factors, in particular trait emotional intelligence (EI), offer one possible explanation for their lack of success. This study explored the association between psychopathy and EI, as measured by the Psychopathy Checklist - Revised (PCL-R; Hare, 2003) and Trait Meta-Mood Scale (TMMS, Salovey, Mayer, Golman, Turvey & Palfai, 1995). Consistent with the Response Modulation (RM) model of psychopathy (Newman & Lorenz, 2003), low-anxious psychopathic individuals had significantly lower scores on TMMS Repair and Attention compared to controls. Consistent with proposals by Patrick and Lang (1999) regarding PCL-R factors, these EI deficits related to different aspects of the psychopathy construct. Correlations revealed significant inverse associations between PCL-R factor 1 and Attention and PCL-R factor 2 and Repair. We propose that the multi-dimensional EI framework affords a complementary perspective on laboratory-based explanations of psychopathy.     

An empirical investigation of psychopathy in a noninstitutionalized and noncriminal sample

This study examined the construct of psychopathy using the Psychopathy Checklist-Revised (PCL-R) in 54 participants from the general population. To obtain a sample of community participants with psychopathic characteristics, participants were recruited using advertisements for a "personality study" that incorporated the characteristics of psychopathy in a nonpejorative manner. The methodology successfully recruited community participants with moderately elevated PCL-R scores. Participants exhibited the personality features of psychopathy (Factor 1) to a greater extent than the behavioral features (Factor 2), which is consistent with the results obtained with the PCL-R normative samples. Roughly 40% of the sample reported no history of involvement with the criminal justice system, yet these participants exhibited moderately elevated PCL-R scores. Moreover, a sizeable portion of the noncriminal participants reported a substantial history of violent behavior. Comparisons of PCL-R scores between participants with and without a criminal history suggest that these two groups differ in ways unrelated to criminal justice system involvement.     

Response perseveration in psychopaths: Interpersonal/affective or social deviance traits?

In order to clarify the role of the two broad components of psychopathy (interpersonal/affective and social deviance; R. D. Hare, 2003) in explaining maladaptive response perseveration in psychopaths, as well as the role of reflection after punished responses in this deficit, the authors administered a card perseveration task to 47 Spanish male inmates assessed using the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991). Hierarchical regressions showed that psychopaths' maladaptive perseveration (more cards played and less money earned) was uniquely predicted by the social deviance features of psychopathy (PCL-R Factor 2)--particularly by its impulsive and irresponsible lifestyle facet (PCL-R Facet 3)--and not by its interpersonal/affective features (PCL-R Factor 1). Moreover, perseveration was related to a lack of reflection both after punishment and after reward feedback. The authors' results, in conjunction with previous evidence indicating perseverative deficits in several impulse control disorders, suggest that response perseveration may not be specific to psychopathy but rather is associated more generally with the externalizing dimension of psychopathology.     

Psychopathy, antisocial personality, and suicide risk

H. Cleckley (1976) maintained that psychopaths are relatively immune to suicide, but substantial evidence exists for a relationship between antisocial deviance and suicidal acts. This study was the first to explicitly examine suicidal history among psychopathic individuals as defined by R. D. Hare's (1991) Psychopathy Checklist--Revised (PCL-R). Male prison inmates (N = 313) were assessed using the PCL-R and DSM-III-R and DSM-IV criteria (American Psychiatric Association, 1987, 1994) for antisocial personality disorder (APD), and they completed A. Tellegen's (1982) Multidimensional Personality Questionnaire (MPQ). Presence or absence of prior suicide attempts was coded from structured interview and prison file records. Suicide history was significantly related to PCL-R Factor 2 (which reflects chronic antisocial deviance) and to APD diagnosis but was unrelated to PCL-R Factor 1, which encompasses affective and interpersonal features of psychopathy. Higher order MPQ dimensions of Negative Emotionality and low Constraint were found to account for the relationship between history of suicidal attempts and antisocial deviance, indicating that temperament traits may represent a common vulnerability for both.     

Inhibitory control and negative emotional processing in psychopathy and antisocial personality disorder

The field of personality disorders has had a long-standing interest in understanding interactions between emotion and inhibitory control, as well as neurophysiological indices of these processes. More work in particular is needed to clarify differential deficits in offenders with antisocial personality disorder (APD) who differ on psychopathic traits, as APD and psychopathy are considered separate, albeit related, syndromes. Evidence of distinct neurobiological processing in these disorders would have implications for etiology-based personality disorder taxonomies in future psychiatric classification systems. To inform this area of research, we recorded event-related brain potentials during an emotional-linguistic Go/No-Go task to examine modulation of negative emotional processing by inhibitory control in three groups: psychopathy (n = 14), APD (n = 16), and control (n = 15). In control offenders, inhibitory control demands (No-Go vs. Go) modulated frontal-P3 amplitude to negative emotional words, indicating appropriate prioritization of inhibition over emotional processing. In contrast, the psychopathic group showed blunted processing of negative emotional words regardless of inhibitory control demands, consistent with research on emotional deficits in psychopathy. Finally, the APD group demonstrated enhanced processing of negative emotion words in both Go and No-Go trials, suggesting a failure to modulate negative emotional processing when inhibitory control is required. Implications for emotion-cognition interactions and putative etiological processes in these personality disorders are discussed.     

Psychopathy, aggression, and the processing of emotional stimuli in non-referred girls and boys

Research shows that individuals with psychopathic traits differ in how they process negative emotional stimuli. However, it is unclear whether these differences are specific to certain types of negative emotional stimulus and whether they are more strongly associated with psychopathic traits or aggression. Further, it is not clear whether or not deficits in emotional processing generalize to females and ethnic minority individuals with psychopathic traits. In this study, we examined the emotional processing of visual stimuli using a dot-probe task in 50 non-referred girls and boys (mean age of 9.30; SD = 2.00). Overall, there was a significant association between proactive aggression and reduced responsiveness to distressing stimuli. In addition, the predicted association between psychopathic traits and reduced responsiveness to distressing stimuli was only found for children high on aggression. Also, the associations among aggression, psychopathic traits, and responsiveness to distressing stimuli did not differ for boys and girls.     

The interpersonal measure of psychopathy: construct and incremental validity in male prisoners

The authors examined the construct and incremental validity of the Interpersonal Measure of Psychopathy (IM-P), a relatively new instrument designed to detect interpersonal behaviors associated with psychopathy. Observers of videotaped Psychopathy Checklist-Revised (PCL-R) interviews rated male prisoners (N = 93) on the IM-P. The IM-P correlated significantly with the PCL-R total score. Moreover, the IM-P was preferentially related to the interpersonal rather than the affective and antisocial lifestyle features of psychopathy. IM-P scores were significantly correlated with age, antisocial behaviors, and self-reported fear, anxiety, and socialization (in reverse). Hierarchical multiple regression analyses demonstrated that although the IM-P exhibited incremental validity beyond the PCL-R total score in detecting self-reported fear, anxiety, and several personality traits, it did not exhibit much incremental validity beyond PCL-R Factor 1. These findings raise questions concerning the unique assessment contribution of the IM-P beyond PCL-R Factor 1. Potential reasons for these findings and alternative means of enhancing the interpersonal assessment of psychopathy are discussed.     

Recognition of facial affect in psychopathic offenders

The authors examined the reliability of facial affect processing deficits found in psychopathic individuals (R. Blair et al., 2004) and whether they could be modified by attentional set. One hundred eleven offenders, classified using the Psychopathy Checklist--Revised (R. Hare, 2003) and Welsh Anxiety Scale (G. Welsh, 1956), performed a facial affect recognition task under 2 conditions. On the basis of research linking psychopathy, amygdala dysfunction, and deficits in facial affect recognition, the authors predicted that psychopathic offenders would display performance deficits when required to identify the emotional expression of particular faces. In addition, given evidence linking the affective processing deficits in psychopathy to focus of attention, the authors predicted that any deficits in facial affect processing would disappear when participants could anticipate which affective cues would be relevant on a given trial. Contrary to expectation, psychopathic offenders performed as well as controls in both conditions. The authors conclude that the conditions that reveal affective deficits in psychopathic individuals require further specification.     

Psychopathy and the ability to read the “language of the eyes”: Divergence in the psychopathy construct

The capacity to interpret others people's behavior and mental states is a vital part of human social communication. This ability, also called mentalizing or Theory of Mind (ToM), may also serve as a protective factor against aggression and antisocial behavior. This study investigates the relationship between two measures of psychopathy (clinical assessment and self‐report) and the ability to identify mental states from photographs of the eye region. The participants in the study were 92 male inmates at Bergen prison, Norway. The results showed some discrepancy in connection to assessment methodology. For the self‐report (SRP‐III), we found an overall negative association between mental state discrimination and psychopathy, while for the clinical instrument (PCL‐R) the results were more mixed. For Factor 1 psychopathic traits (interpersonal and affective), we found positive associations with discrimination of neutral mental states, but not with the positive or negative mental states. Factor 2 traits (antisocial lifestyle) were found to be negatively associated with discrimination of mental states. The results from this study demonstrate a heterogeneity in the psychopathic construct where psychopathic traits related to an antisocial and impulsive lifestyle are associated with lower ability to recognize others' mental states, while interpersonal and affective psychopathic traits are associated with a somewhat enhanced ability to recognize others' emotional states.     

Attention Network Performance and Psychopathic Symptoms in Early Adolescence: An ERP Study

Reaction time (RT) and event-related potential (ERP) measures were used to examine the relationships between psychopathic symptoms and three major attention networks (alerting, orienting, and executive attention) among a community sample of youth. Antisocial Process Screening Device (APSD; Frick and Hare 2001) total and subscale scores were negatively correlated with ERP measures of attentional alerting, indicating that youth with psychopathic symptoms had difficulty using warning cues to prepare for upcoming targets. APSD total scores were not related to performance on measures of orienting or executive attention, although weaker executive attention was found among youth with higher scores on the Impulsivity subscale. These findings support attention-based models of psychopathy and provide evidence of specific deficits in attentional alerting among youth with psychopathic traits. Deficiencies in attentional alerting may be related to noradrenergic functioning and may have cascading effects on higher order cognitive and affective processing.     

Emotional processing in psychopathic personality

Emotional‐processing deficits may be one of the characteristic features of impaired affect in individuals with psychopathy. These include shallowness and profound lack of remorse or empathy. Performances on standardized emotion discrimination tasks and mood induction tasks were compared between 17 patients with antisocial personality disorder (DSM‐IV) and 17 nonpsychopaths. Subjects with psychopathic personality demonstrated poorer performance on emotion‐discrimination tasks compared with controls. However, higher scores on factor “emotional detachment” of the Psychopathy Checklist (PCL‐R) were associated with better discrimination ability. Subjective ratings were comparable between groups during mood induction. Although the findings support the hypothesis of a significant association between impaired emotional processing and psychopathy, they also suggest a relationship between emotional discrimination and the core personality features of psychopathy. Aggr. Behav. 28:394–400, 2002. © 2002 Wiley‐Liss, Inc.     

Psychopathy traits and the processing of emotion words: Results of a lexical decision task

Research has indicated that individuals possessing psychopathic traits exhibit a deficit in the processing of emotional stimuli. Lexical decision task studies found that psychopathic individuals do not demonstrate affective facilitation in processing emotional words relative to nonpsychopathic individuals. However, these investigations have not examined processing of discrete affective categories and their relation to the callous/unemotional (F1) and impulse control/antisocial (F2) factors of psychopathy. Sixty undergraduate men completed a self-report measure of psychopathy traits and a lexical decision task assessing response latencies to anger, sadness, fear, and happiness words. Results reflected an association between F2 and a heightened experience of anger, whereas F1 was associated with a diminished experience of sadness. Findings are discussed in terms of the relation to existing research using alternative methods of processing affect.     

Emotional intelligence in incarcerated men with psychopathic traits

The expression, recognition, and communication of emotional states are ubiquitous features of the human social world. Emotional intelligence (EI) is defined as the ability to perceive, manage, and reason about emotions, in oneself and others. Individuals with psychopathy have numerous difficulties in social interaction and show impairment on some emotional tasks. Here, the authors investigate the relation between EI and psychopathy in a sample of incarcerated men (N = 374), using the Psychopathy Checklist-Revised (PCL-R; Hare, 2003) and the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT; Mayer, Salovey, & Caruso, 2002). The MSCEIT is a well-validated ability-based EI measure that does not rely on self-report judgments of emotional skills. The Hare PCL-R is the gold standard for the assessment of psychopathy in clinical populations. Controlling for general intelligence, psychopathy was associated with lower EI. These findings suggest individuals with psychopathy are impaired on a range of EI abilities and that EI is an important area for understanding deficits in psychopathy.     

Psychopathic Traits in Adolescence: the Importance of Examining Components in Face Processing,Voice Processing,and Emotional Skill

This study examined relations among interpersonal, affective, and impulsive-irresponsible psychopathic traits, emotional capacities, and recidivism rates in 144 detained adolescents. Emotional skill was conceptualized using a range of constructs, including face and voice processing, emotional intelligence, and self-reported cognitive and affective empathy. In addition, the relation between these concepts and recidivism three years after the initial assessment was examined. Results indicated that interpersonal traits were positively associated with better facial identification of fearful faces, whereas affective traits were associated with worse facial identification of sad and happy faces as well as angry voices. Impulsive-irresponsible traits were associated with reduced emotional intelligence. Differential predictive utility of the three psychopathic traits dimensions was also evidenced. Findings highlight the need to consider the broad concept of psychopathy, but also its underlying dimensions.     

Two subtypes of psychopathic violent offenders that parallel primary and secondary variants

Although psychopathy usually is treated as a unitary construct, a seminal theory posits that there are 2 variants: Primary psychopathy is underpinned by an inherited affective deficit, whereas secondary psychopathy reflects an acquired affective disturbance. The authors investigated whether psychopathy phenotypically may be disaggregated into such types in a sample of 367 prison inmates convicted of violent crimes. Model-based cluster analysis of the Revised Psychopathy Checklist (PCL-R; R. D. Hare, 2003) and trait anxiety scores in the psychopathic subgroup (n = 123; PCL-R > or = 29) revealed 2 clusters. Relative to primary psychopaths, secondary psychopaths had greater trait anxiety, fewer psychopathic traits, and comparable levels of antisocial behavior. Across validation variables, secondary psychopaths manifested more borderline personality features, poorer interpersonal functioning (e.g., irritability, withdrawal, poor assertiveness), and more symptoms of major mental disorder than primary psychopaths. When compared with the nonpsychopathic subgroup (n = 243), the 2 psychopathic variants manifested a theoretically coherent pattern of differences. Implications for etiological research and violence prevention are discussed.