Relations between psychopathy facets and externalizing in a criminal offender sample

The construct of psychopathy is viewed as comprising distinctive but correlated affective-interpersonal and social deviance facets. Here, we examined these facets of Hare's Psychopathy Checklist-Revised (PCL-R) in terms of their associations with the externalizing dimension of adult psychopathology, defined as the common factor underlying symptoms of conduct disorder, adult antisocial behavior, alcohol use/abuse, and drug abuse, along with disinhibitory personality traits. Correlational analyses revealed a strong relationship between this externalizing dimension and the social deviance facet of psychopathy (r = .84), and a lesser relationship with the emotional-interpersonal component (r = .44). Structural models controlling for the moderate overlap between the PCL-R factors revealed that externalizing was substantially related to the unique variance in the social deviance features of psychopathy, but unrelated to the unique variance of the emotional and interpersonal features whether modeled together or as separate factors. These results indicate that the social deviance factor of the PCL-R reflects the externalizing dimension of psychopathology, whereas the emotional-interpersonal component taps something distinct aside from externalizing. In addition, based on our finding of an association between PCL-R social deviance and externalizing, we were able to predict new relations between this facet of psychopathy and criterion variables, including nicotine use and gambling, that have previously been linked to externalizing. Implications for future research on the causes and correlates of psychopathy are discussed.     

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.     

Differential effects of psychopathy and antisocial personality disorder symptoms on cognitive and fear processing in female offenders

Psychopathy and antisocial personality disorder (APD) have long been considered important risk factors for criminal behavior and incarceration. However, little is known about the psychobiological underpinnings that give rise to the disinhibited behavior of female offenders. Using an instructed fear-conditioning paradigm and a sample of incarcerated female offenders, we manipulated attentional focus and cognitive load to characterize and differentiate between the dysfunctional cognitive and affective processes associated with these syndromes. We used fear-potentiated startle (FPS) and event-related potentials as measures of affective and cognitive processing, respectively. After controlling for APD symptoms, psychopathic women displayed greater FPS while attending directly to threat-relevant stimuli and displayed less FPS while performing a demanding task that directed attention to threat-irrelevant information. Conversely, controlling for psychopathy, women with high APD symptoms displayed less overall FPS, especially when instructed to focus on threat-relevant stimuli. However, as the demands on cognitive resources increased, they displayed greater FPS. For both psychopathy and APD, analysis of the event-related potentials qualified these findings and further specified the abnormal cognitive processes associated with these two syndromes. Overall, simultaneous analysis of psychopathy and APD revealed distinct patterns of cognitive processing and fear reactivity.     

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.     

Neuropsychological correlates of psychopathic traits in a non-incarcerated sample

The present study examined the association between neuropsychological behavioral performance and psychopathic personality traits, measured via the Psychopathic Personality Inventory (PPI), in a non-incarcerated sample. Specifically, performance involving general executive cognitive functioning (ECF) and response inhibition was investigated in regards to the two main psychopathy factors (affective-interpersonal and social deviance) of the PPI. A group of 95 student volunteers were administered the PPI and a variety of neuropsychological measures. Analyses revealed that total PPI scores were related to deficits in response inhibition but not general ECF. However, this relationship was qualified by the differential associations observed for the two PPI factors. The social deviance factor was associated with deficits in general ECF and response inhibition, whereas the affective-interpersonal facet was associated with enhanced general ECF performance but not response inhibition. The results suggest that cognitive functioning shows predicted associations with a self-report measure of psychopathy among non-incarcerated young adults, providing further evidence for psychopathy conceptualizations from a normal-range personality perspective.     

Alcohol and drug abuse-dependence disorders in psychopathic and nonpsychopathic criminal offenders

Co-occurrence of psychopathy (assessed with the Psychopathy Checklist) and lifetime Diagnostic and Statistical Manual of Mental Disorders (3rd ed.) alcohol and drug disorders (assessed with the National Institute of Mental Health Diagnostic Interview Schedule) was examined in a sample of 360 male inmates. Consistent with previous research that used diagnoses of antisocial personality disorder, psychopaths were more likely than nonpsychopaths to have lifetime diagnoses of alcoholism, any drug disorder, and multiple drug disorders. We also examined the relation between substance abuse and the 2 factors of the Psychopathy Checklist. Substance abuse was significantly related to general social deviance (Factor 2) but was unrelated to core personality features of psychopathy (Factor 1). We present two possible models of psychopathy (unitary syndrome vs. dual-diathesis model) that may account for the association between psychopathy and substance abuse.     

Troubled or Traumatized Youth? The Relations Between Psychopathy,Violence Exposure,Posttraumatic Stress Disorder,and Antisocial Behavior Among Juvenile Offenders

The current study examined how psychopathy, exposure to violence, and posttraumatic stress disorder (PTSD) are associated with antisocial behavior among 1,354 serious delinquent adolescents from the Pathways to Desistance study. Results showed that psychopathy, violence exposure, and PTSD are independently linked to self-reported involvement of delinquency, even after controlling for respondents’ demographic characteristics. However, the effect of PTSD on antisocial behavior was small. Differential associations were observed between the 2 factors of psychopathy, interpersonal/affective and social deviance, and PTSD symptoms. Specifically, the effect of social deviance characteristics on delinquency was above and beyond that of interpersonal/affective features. In addition, exposure to violence as a victim or witness were uniquely associated with increased delinquent behavior. Findings clarified the relations among psychopathy, violence exposure, PTSD, and antisocial behavior, and highlighted the differential links between psychopathy factors and delinquency.     

Psychophysiological responses to sport-specific affective pictures: A study of morality and emotion in athletes

ObjectivesThe link between morality and emotion has received little attention in the sport context. To address this issue, we examined whether moral disengagement, empathy, antisocial behaviour and psychopathy were associated with emotional reactions to unpleasant pictures depicting players being hurt or deliberately fouled in a sport context.DesignA cross-sectional design was employed.MethodTeam sport athletes (N = 66) completed measures of moral disengagement, empathy, antisocial behaviour and psychopathy and then viewed unpleasant, neutral, and pleasant sport pictures while emotional reactions to the pictures were assessed using valence and arousal ratings of the pictures as well as electrocutaneous startle blink, heart rate, skin conductance, and evoked potentials.ResultsMoral disengagement, empathy and psychopathy, but not antisocial behaviour, were associated with emotional reactions to the unpleasant pictures. Specifically, moral disengagement was related to attenuated startle blink responses and higher valence (less unpleasant) ratings, whereas empathy was associated with lower valence (more unpleasant) ratings. Psychopathy was associated with smaller startle blink responses and less heart rate deceleration.ConclusionOur findings provide support for the link between morality and emotion in athletes. Moral variables may be more closely linked with specific measures of emotion, highlighting the utility of taking a multi-measure approach in the assessment of emotion.     

Social stimuli increase physiological reactivity but not defensive responses

Emotional reactions are crucial in survival because they provide approach and withdrawal behaviors. However, an unsolved question is whether the social content of the affective stimuli has a specific effect on emotional responses. We studied whether the social content of affective pictures influenced the defensive response and response mobilization. For this purpose, we recorded startle blink reflex (a defensive response) and skin conductance responses (a measure of unspecific physiological reactivity or arousal) in 73 participants while they viewed a series of 81 pictures of varying affective valence and social content. Our results revealed that defense response, as indicated by increases in the magnitude of the startle blink reflex, was mainly dependent on threatening or unpleasant cues, but was unrelated to the social content of the pictures. The social content, however, had an influence on pleasant stimuli, provoking an increase in resource mobilization, as reflected by changes in electrodermal activity. Hence, the social content of the affective stimuli may increase the physiological arousal elicited by pleasant stimuli, and it appears to be unrelated to the defense reactivity provoked by unpleasant stimuli.     

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.     

Differentiating emotional processing and attention in psychopathy with functional neuroimaging

Individuals with psychopathy are often characterized by emotional processing deficits, and recent research has examined the specific contexts and cognitive mechanisms that underlie these abnormalities. Some evidence suggests that abnormal features of attention are fundamental to emotional deficits in persons with psychopathy, but few studies have demonstrated the neural underpinnings responsible for such effects. Here, we use functional neuroimaging to examine attention–emotion interactions among incarcerated individuals (n = 120) evaluated for psychopathic traits using the Hare Psychopathy Checklist–Revised (PCL-R). Using a task designed to manipulate attention to emotional features of visual stimuli, we demonstrate effects representing implicit emotional processing, explicit emotional processing, attention-facilitated emotional processing, and vigilance for emotional content. Results confirm the importance of considering mechanisms of attention when evaluating emotional processing differences related to psychopathic traits. The affective-interpersonal features of psychopathy (PCL-R Factor 1) were associated with relatively lower emotion-dependent augmentation of activity in visual processing areas during implicit emotional processing, while antisocial-lifestyle features (PCL-R Factor 2) were associated with elevated activity in the amygdala and related salience network regions. During explicit emotional processing, psychopathic traits were associated with upregulation in the medial prefrontal cortex, insula, and superior frontal regions. Isolating the impact of explicit attention to emotional content, only Factor 1 was related to upregulation of activity in the visual processing stream, which was accompanied by increased activity in the angular gyrus. These effects highlight some important mechanisms underlying abnormal features of attention and emotional processing that accompany psychopathic traits.     

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 and violence: the importance of factor level interactions

The power of scales based on the Psychopathy Checklist (PCL; R. D. Hare, 1980) for prediction of violent behavior is well established. Although evidence suggests that this relationship is chiefly due to the impulsive and antisocial lifestyle component (Factor 2), the predictive power of psychopathy for violence may also reflect the multiplicative effects of this component with interpersonal and unemotional traits (Factor 1). The determination of the extent to which psychopathy subcomponents interact to predict violence has theoretical and practical implications for PCL-assessed psychopathy. However, the relationship between violence and the interactive effects of psychopathy subcomponents remains largely undetermined. The authors used prospective and cross-sectional designs to examine the independent and interactive effects of the factors of PCL-assessed psychopathy in 2 samples: (a) 199 county jail inmates and (b) 863 civil psychiatric patients. The Factor 1 x Factor 2 interaction predicted violence in both samples, such that the predictive power of Factor 2 was attenuated at lower levels of Factor 1.     

High psychopathic trait females exhibit reduced startle potentiation and increased p3 amplitude

While there has been steady progress in identifying psychophysiological traits associated with psychopathy, most of the existing research has been carried out using incarcerated male participants, and data that include females are particularly rare. This study examined both affective startle blink modulation and P3 amplitude in a sample of female undergraduates grouped by scores on the Psychopathic Personality Inventory-Revised (PPI-R). Those scoring high for psychopathic traits lacked startle blink potentiation and demonstrated larger P3 amplitudes during auditory and visual oddball tasks. These data support the generalizability of deficient startle potentiation to non-incarcerated females with psychopathic traits, and add to a growing body of literature suggesting that psychopathic traits are associated with distinctive information-processing characteristics as indexed by P3 amplitude.     

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.     

Emotional responses in patients with borderline as compared with avoidant personality disorder

The aim of this study was to assess psychophysiological affect correlates, in addition to the usual self-report in borderline personality disorder (BPD) compared with avoidant personality disorder (APD) and normal controls (NCs), when responding to standardized experimental stimuli. In 24 BPD female patients, 23 APD female patients, and 27 female NCs, skin conductance response (SCR), heart rate (HR) change, and startle response were recorded while the subjects viewed slides with emotional content. Neither the self-report nor the psychophysiological data supported the hypothesis that affective responses of BPD individuals are generally stronger than those with APD. BPD patients showed no potentiation of the affective modulation of the startle reflex and their electrodermal reactivity was lower than in either the APD subjects or the NCs. The hypothesis of a general affective hyperresponsivity could not be confirmed. Low somatic arousal in BPD can interfere with the anticipation of signal stimuli and may explain the exaggerated openness borderline personalities show to stimuli, particularly in interpersonal situations.     

Investigating associations between empathy, morality and psychopathic personality traits in the general population

Although atypical moral and empathy processing are considered core features of psychopathic personality, little is known about how these constructs are associated with psychopathic traits in the general population. One-hundred and twenty-four adult males from the community were administered the Self-Report Psychopathy Scale 4 Short Form, as well as a wide battery of affect, empathy and morality tasks and questionnaires. Our findings indicate that both core affective-interpersonal, as well as lifestyle-antisocial features of psychopathy are associated with weaker empathic responses to fearful faces. However, only the unique variance of the affective-interpersonal features is associated with weaker empathic response to happy stories, lower propensity to feel empathic concern and less difficulty in making decisions on moral dilemmas. In contrast, the unique variance of the lifestyle-antisocial features is associated with greater propensity to feel empathic concern. These preliminary findings extend previous research and suggest that, while the joint variance between affective-interpersonal and lifestyle-antisocial features might drive some ‘deficits’ associated with psychopathy, there also appears also to be unique ‘deficits’ associated with the core affective-interpersonal features, particularly in relation to affective aspects of moral processing.     

Cognitive flexibility mediates the relation between intolerance of uncertainty and safety signal responding in those with panic disorder

There is a growing literature associating anxiety disorders with an inability to inhibit defensive responding during safety conditions of threatening tasks. However, investigations on the relation between panic disorder (PD) and defensive responding to safety have yielded mixed results. A recent study from our laboratory revealed that intolerance of uncertainty (IU) moderates this association, such that only individuals with PD and a high IU exhibit heightened startle potentiation during safety. The mechanism underlying this relationship is unknown. Given that safety conditions typically alternate with periods of threat, cognitive flexibility (i.e., the ability to adjust one's habitual responding to a situation, given the input of new information) may be involved in the ongoing reappraisal of danger and adjustment of defensive responding. Thus, the present study sought to investigate whether deficits in cognitive flexibility mediate the association between IU and defensive responding to safety among a sample of 71 adults diagnosed with PD. As hypothesised, cognitive flexibility mediated the relationship between IU and heightened startle potentiation during safety conditions. This finding suggests that within this subgroup, a failure to inhibit defensive responding during safety conditions may be due to deficits in cognitive flexibility.     

The Relation Between the Two Factors of Psychopathy and Intimate Partner Aggression

Psychopathy is a personality disorder that has emerged as a correlate of antisocial, impulsive, and violent behavior, including intimate partner violence (IPV). In the current study, we sought to explore the complex relationship between two factors of psychopathy and IPV perpetration. The Fearlessness-Dominance Factor I (PPI-I) assesses the affective-interpersonal traits of psychopathy, whereas the Impulsive-Antisociality Factor II (PPI-II) assesses the behavioral-lifestyle traits of psychopathy. Data from 114 couples was utilized in the current study. When using male self-report of IPV, all forms of violence were significantly correlated with PPI-I. No male self-report or female-report of any of the forms of violence were significantly correlated with PPI-II. Hierarchical regression was utilized to study the impact of psychopathy factors in predicting physical violence while controlling for demographic variables. In predicting women’s report of men’s violence, the addition of psychopathy factors to the model explained significantly more of the variance (F = 2.71; p < .05) above and beyond demographic variables. The addition of psychopathy factors to the model predicting men’s self-reported physical violence was also significant (F = 4.78, p < .001). These results suggest that individuals high in PPI-I may be at higher risk of IPV perpetration compared to those high in PPI-II.     

When good things go bad: the reflex physiology of defense

For humans, the threat of painful shock greatly potentiates the reflexive startle blink. Moreover, viewing unpleasant, compared with pleasant, pictures also prompts heightened startle reflexes, suggesting that the startle reflex indexes general defensive activation. In this study, pleasant or unpleasant pictures were used to signal shock threat in order to explore how previous affective associations modulate new defensive reactions. When cuing threat of shock, pleasant and unpleasant pictures prompted physiological profiles consistent with defensive activation, indicating that threat of shock renders previously pleasant cues aversive. For unpleasant pictures only, defensive startle was potentiated even when these cues signaled safety. Taken together, the data indicate that (a) regardless of their intrinsic affective meaning, cues signaling shock threat prompt somatic and autonomic reactions consistent with defense, and that (b) intrinsically unpleasant cues continue to prompt defensive activation even when the context of their presentation is specifically non-threatening.