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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and Suicidality in Female Offenders: Mediating Influences of Personality and Abuse.

The influence of personality and childhood abuse on suicidal behaviors and psychopathy was examined among female prisoners. Scores on the affective/interpersonal component (Factor 1; F1) and the antisocial deviance (Factor 2; F2) component of psychopathy were obtained from the Psychopathy Checklist-Revised (R. D. Hare, 1991). Suicide attempt and childhood physical and sexual abuse history were coded from interviews and prison files, and personality was assessed using the Multidimensional Personality Questionnaire (A. Tellegen, in press). Suicide attempts were positively associated with F2 and negatively associated with F1, and each factor accounted for unique variance in suicidality. Path analyses demonstrated that personality mediated the effects of physical abuse on F2, but sexual abuse accounted for unique variance in both suicide attempts and F2. Abuse and personality accounted for minimal variance in F1. These results are discussed in relation to the identification of individuals at risk for both self- and other-harm behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Common and distinct patterns of affective response in dimensions of anxiety and depression.

The authors examined the time course of affective responding associated with different affective dimensions--anxious apprehension, anxious arousal, and anhedonic depression--using an emotion-modulated startle paradigm. Participants high on 1 of these 3 dimensions and nonsymptomatic control participants viewed a series of affective pictures with acoustic startle probes presented before, during, and after the stimuli. All groups exhibited startle potentiation during unpleasant pictures and in anticipation of both pleasant and unpleasant pictures. Compared with control participants, symptomatic participants exhibited sustained potentiation following the offset of unpleasant stimuli and a lack of blink attenuation during and following pleasant stimuli. Common and unique patterns of affective responses in the 3 types of mood symptoms are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of psychopathy as a function of age.

The assessment of psychopathy was examined as a function of age in 889 male prison inmates between the ages of 16 and 69. Ratings of psychopathy were made with the Psychopathy Checklist (PCL), which measures 2 correlated factors. Factor 1 describes a cluster of affective-interpersonal traits central to psychopathy. Factor 2 describes traits and behaviors associated with an unstable, unsocialized lifestyle, or social deviance. Cross-sectional analyses revealed that mean scores on Factor 1 were stable across the age-span; mean scores on Factor 2 declined with age. The prevalence of antisocial personality disorder, and, to a lesser extent of PCL-defined psychopathy, also declined with age. The results are consistent with a conceptualization of psychopathy as encompassing 2 correlated but distinct constructs. They also suggest that age-related differences in traits related to impulsivity, social deviance, and antisocial behavior are not necessarily paralleled by differences in the egocentric, manipulative, and callous traits fundamental to psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional Response in Patients With Frontal Brain Damage: Effects of Affective Valence and Information Content.

The authors investigated the role of the frontal lobes in the emotional response in 19 patients with brain damage and 23 control subjects. They studied the modulation of the startle blink reflex by affective pictures, and other autonomic responses. Patients showed a dissociation between the startle reflex and the affective valence ratings of the pictures, as a result of a low inhibition of the startle reflex by pleasant pictures. Pictures elicited lower skin conductance responses (SCRs) in patients than in controls, whereas the groups did not differ in the SCRs prompted by less significant acoustic stimuli. The findings point to the frontal lobe as a structure involved in the emotional response and in the physiological emotional arousal related to the complexity of the stimuli. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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

Co-occurrence of psychopathy (assessed with the Revised Psychopathy Checklist [R. D. Hare, 1985]) and lifetime Diagnostic and Statistical Manual of Mental Disorders (DSM-III) alcohol and drug disorders (assessed with the Diagnostic Interview Schedule; National Institute of Mental Health) 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 disorder. The relation between substance abuse and the 2 factors of the Revised Psychopathy Checklist was also examined. Substance abuse was significantly related to general social deviance (Factor 2) but was unrelated to core personality features of psychopathy (Factor 1). Two possible models of psychopathy (unitary syndrome vs dual-diathesis model) are presented that may account for the association between psychopathy and substance abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dual temperamental risk factors for psychopathic personality: Evidence from self-report and skin conductance.

Psychopathy is a personality disorder consisting of dysfunctional affective interpersonal features (Factor 1) and impulsive-antisocial behavior (Factor 2) that exhibit differential associations with palmar skin conductance (SC) reactivity. The goal of this study was to determine whether the distinct SC reactivity observed in incarcerated psychopaths generalizes to university students who score high on personality dimensions hypothesized to be the risk factors for these psychopathy factors. Lilienfeld's Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996) was used to compute scores on 2 factor-analytically derived dimensions that have been the focus of recent research in psychopathy. PPI-1 is hypothesized to relate to the low-fear temperamental risk factor, whereas PPI-2 is hypothesized to relate to regulatory dysfunction. SC reactivity was measured during tasks previously used in studies of diagnosed psychopaths. Results indicated that PPI-1 was associated with reduced SC during anticipation of an aversive noise and PPI-2 was associated with enhanced SC reactivity during presentation of a speech about one's faults. Additional analyses explored an 8-factor solution of the PPI and 3 temperament dimensions derived from factor analysis of several personality measures. Together, the SC results suggest that the Factor 1 pathway, best captured with refined assessments of behavioral fearlessness, related to reduced SC reactivity to an aversive noise—consistent with a weak defense system. The Factor 2 pathway, best captured by higher order dimensions reflecting externalizing, disinhibited forms of negative temperament, related to enhanced SC reactivity to a speech stressor—consistent with high stress reactivity. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Intoxication level and emotional response.

We used affective modulation of the eye-blink component of the startle reflex to examine effects of three levels of alcohol intoxication and a no-intoxication control on emotional responses to pleasant, neutral, and unpleasant pictures. Non-problematic student drinkers (n = 101; 48 female) were randomly assigned to intoxication groups. Normal inhibition of startle during exposure to pleasant pictures was intact across groups. In contrast, potentiation of startle during viewing of unpleasant pictures was evident in the no- and low-intoxication groups, compared to the intermediate- and high-intoxication groups, in which it was significantly reduced. This pattern suggests that a direct and selective anxiolytic effect of alcohol can occur at higher levels of intoxication without an analogous impact on response to emotionally positive stimuli at similar levels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychopath as observer: Emotion and attention in picture processing.

This study extended prior work showing abnormal affect–startle modulation in psychopaths. Male prisoners viewed specific categories of pleasant (erotic or thrilling) and unpleasant (victim or direct threat) slide pictures, along with neutral pictures. Acoustic startle probes were presented early (300 and 800 ms) and late (1,800, 3,000, and 4,500 ms) in the viewing interval. At later times, nonpsychopaths showed moderate and strong reflex potentiation for victim and threat scenes, respectively. For psychopaths, startle was inhibited during victim scenes and only weakly potentiated during threat. Psychopaths also showed more reliable blink inhibition across pleasant contents than nonpsychopaths and greater heart rate orienting to affective pictures overall. These results indicate a heightened aversion threshold in psychopaths. In addition, deficient reflex modulation at early times suggested a weakness in initial stimulus evaluation among psychopaths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol expectancies and reactivity to alcohol-related and affective cues.

Recent conceptualizations of alcohol expectancies relate cognitive schemas to their neurobiological underpinnings; cue reactivity paradigms lend themselves well to testing this broadened conceptual framework. In the present study, we examined the relationship between self-reported alcohol expectancies and responses to alcohol-related and affective picture cues among fifty-five young adults. In addition to traditional subjective and psychophysiological indices of cue reactivity, the startle eyeblink reflex was obtained during picture cue presentations to address both attention-arousal (early probes) and affective-motivational (late probes) aspects of cue processing. Analyses indicated that participants reporting greater positive, arousing, and social alcohol expectancies rated alcohol cues as more pleasant, arousing, and craving-inducing. In addition, participants displayed inhibited startle reactivity to late alcohol cue probes, indicative of an appetitive reaction. Finally, startle responding to early probes indicated that participants with greater alcohol expectancies displayed blunted attention to negative affect cues. Findings are discussed in terms of the utility of the startle reflex and cue reactivity paradigms for clarifying the relationship between alcohol expectancies and motivated attention to salient cues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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 × Factor 2 interaction predicted violence in both samples, such that the predictive power of Factor 2 was attenuated at lower levels of Factor 1. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in autonomic indicators of antisocial personality disorder features.

We investigated the autonomic indicators of antisocial personality disorder (APD) features in a mixed gender student sample. One hundred college students (50 men, 50 women) were administered an interview of APD and self-report measures of aggression and psychopathy. Participants completed a passive coping task and viewed emotionally valenced slideshows while their electrodermal activity (EDA), pre-ejection period (PEP), and respiratory sinus arrhythmia (RSA) were measured. Associations between APD features and autonomic reactivity were examined, controlling for aggression and psychopathy. APD features were associated with EDA hyporeactivity in men, but not women, during passive coping. While viewing threatening slides, APD features were associated with RSA hyperreactivity in women and with PEP hyperreactivity in men. APD features were associated with RSA hyperreactivity in women, but not men, while viewing slides of others in distress. These findings suggest that APD features are characterized by parasympathetic nervous system dysfunction in women but sympathetic nervous system dysfunction in men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multimethod assessment of psychopathy in relation to factors of internalizing and externalizing from the Personality Assessment Inventory: The impact of method variance and suppressor effects.

Research to date has revealed divergent relations across factors of psychopathy measures with criteria of internalizing (INT; anxiety, depression) and externalizing (EXT; antisocial behavior, substance use). However, failure to account for method variance and suppressor effects has obscured the consistency of these findings across distinct measures of psychopathy. Using a large correctional sample, the current study employed a multimethod approach to psychopathy assessment (self-report, interview and file review) to explore convergent and discriminant relations between factors of psychopathy measures and latent criteria of INT and EXT derived from the Personality Assessment Inventory (Morey, 2007). Consistent with prediction, scores on the affective–interpersonal factor of psychopathy were negatively associated with INT and negligibly related to EXT, whereas scores on the social deviance factor exhibited positive associations (moderate and large, respectively) with both INT and EXT. Notably, associations were highly comparable across the psychopathy measures when accounting for method variance (in the case of EXT) and when assessing for suppressor effects (in the case of INT). Findings are discussed in terms of implications for clinical assessment and evaluation of the validity of interpretations drawn from scores on psychopathy measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotion in the criminal psychopath: Startle reflex modulation.

Measured startle-elicited blinks during presentation of affective slides to test hypotheses concerning emotional responding in psychopaths. Ss were 54 incarcerated sexual offenders divided into nonpsychopathic, psychopathic, and mixed groups based on file and interview data. Consistent with findings for normal college students, nonpsychopaths and mixed Ss showed a significant linear relationship between slide valence and startle magnitude, with startle responses largest during unpleasant slides and smallest during pleasant slides. This effect was absent in psychopaths. Group differences in startle modulation were related to affective features of psychopathy, but not to antisocial behavior per se. Psychopathy had no effect on autonomic or self-report responses to slides. These results suggest an abnormality in the processing of emotional stimuli by psychopaths that manifests itself independently of affective report. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factor Structure of the Psychopathic Personality Inventory: Validity and Implications for Clinical Assessment.

Psychopathy is a personality disorder characterized by impulsive antisocial deviance in the context of emotional and interpersonal detachment. A factor analysis of the subscales of the Psychopathic Personality Inventory (PPI) yielded evidence for 2 factors. One factor showed relations with external criteria mirroring those of the emotional-interpersonal facet of psychopathy, including high dominance, low anxiety, and venruresomeness. The other factor showed relations paralleling those of the social deviance facet of psychopathy, including positive correlations with antisocial behavior and substance abuse, negative correlations with socioeconomic status and verbal ability, and personality characteristics including high negative emotionally and low behavioral constraint. Findings support using the PPI to assess these facets of psychopathy in community samples and to explore their behavioral correlates and genetic-neurobiological underpinnings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loss of emotional experience after traumatic brain injury: Findings with the startle probe procedure.

The authors used affective modulation of the eyeblink startle response to examine the impact of traumatic brain injury (TBI) on emotional reactions to pictures. Participants were 13 individuals with severe TBI and 24 controls. Participants were presented with pictures that differed in affective valence (e.g., mutilated bodies, erotic couples, and household objects) while the eyeblink startle response to an acoustic probe was measured. Startle amplitude was used to assess valence of emotional response, and startle latency was used to index interest in the pictures. Subjective ratings of the affect and arousal elicited by the various pictures were also obtained. TBI impaired startle potentiation to unpleasant pictures but not startle attenuation to pleasant pictures. Further, subjective ratings indicated that TBI participants found unpleasant pictures less arousing than did controls. The results are consistent with recent evidence of differential impairment in negative versus positive emotions after TBI and are discussed in relation to 2 competing explanations of startle modulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating the Screening Version of the Hare Psychopathy Checklist—Revised (PCL:SV): An item response theory analysis.

The Screening Version of the Psychopathy Checklist—Revised (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995) was developed to complement the Psychopathy Checklist—Revised (PCL-R; R. D. Hare. 1991), and for use outside forensic settings. The PCL:SV takes less time to administer and requires less collateral information than the PCL-R. An item response theory approach was adopted to determine similarities in the structural properties of the 2 instruments and whether the PCL:SV could be regarded as a short form of the PCL-R. Eight of the 12 items in the PCL:SV were strongly parallel to their equivalent PCL-R items. Of the 4 items PCL:SV items which differed from their equivalent PCL-R items, all 4 were found to be equal or superior to their equivalent PCL-R item in terms of discrimination. The analyses confirmed previous results that the interpersonal and affective features of psychopathy have higher thresholds than do the impulsive and antisocial behavioral features; individuals have to be at a higher level of the psychopathic trait before the interpersonal and affective features become evident. The PCL:SV is an effective short form of the PCL-R. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Affective ratings and startle modulation in people with nonclinical depression.

This study tested predictions based on the emotion context insensitivity (ECI) hypothesis of Rottenberg, Gross, and Gotlib (2005) that a nonclinical sample of people with depressive symptoms would show reduced responses to both positive and negative stimuli relative to people without depression and would show an enhanced response to novelty. Seventy individuals completed diagnostic questionnaires, made ratings of 21 affectively valenced pictures, and then viewed the same 21 pictures and 21 novel pictures while startle blink responses were recorded from electromyographic activity of the orbicularis oculi. People with scores on the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) indicative of depression demonstrated a lack of affective startle modulation compared to the nondepression group. For all participants, the startle response was larger for novel pictures than for previously viewed pictures, but scores on the BDI were not related to response to novelty. Taken together, the results suggest that nonclinical depression is associated with a lack of affective modulation of startle, as has been shown for clinical depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)