Psychopaths: Emotional & Behavior Psychopaths: Emotional & Behavior ResponsesResponses

Partial adaptation from KlinePartial adaptation from Kline

I. What is psychopathy? I. What is psychopathy?

Core features-Core features- Psychopaths lack remorsePsychopaths lack remorse Poverty of emotions (positive & negative)Poverty of emotions (positive & negative)

Psychopaths might be:Psychopaths might be:Superficially charmingSuperficially charmingPathological liars & cheaters Pathological liars & cheaters Impulsive; sensation seekersImpulsive; sensation seekersManipulative, will change story to fit factsManipulative, will change story to fit factsLess responsive to fear/anxietyLess responsive to fear/anxietyImmoral Immoral Usually diagnosed in men (sorry Usually diagnosed in men (sorry ))

II. What is the fundamental distinction II. What is the fundamental distinction between APD & psychopathy???between APD & psychopathy???

““Lack of remorseLack of remorse,” is needed for a diagnosis ,” is needed for a diagnosis of psychopathy, but not for Antisocial of psychopathy, but not for Antisocial Personality disorder. Personality disorder.

Prevalence of psychopathy:Prevalence of psychopathy:

Affects approximately 1% of the general Affects approximately 1% of the general population (Hare, 1991). population (Hare, 1991).

Approximately 15-25% of incarcerated Approximately 15-25% of incarcerated offenders meet criteria for psychopathy.offenders meet criteria for psychopathy.

III. Historical Perspective of Clinical III. Historical Perspective of Clinical description of Psychopathy:description of Psychopathy:

Pinel, a physician in the 1700s, noticed that some of his patients were impulsive & self-Pinel, a physician in the 1700s, noticed that some of his patients were impulsive & self-destructive. These patients were aware of the irrationality of their acts & their reasoning destructive. These patients were aware of the irrationality of their acts & their reasoning abilities were intact.abilities were intact.

He called this illness, manie sans delire (insanity without delirium)He called this illness, manie sans delire (insanity without delirium)

Benjamin Rush also reported cases of individuals who were clear in their thought processes, yet Benjamin Rush also reported cases of individuals who were clear in their thought processes, yet engaged in morally-deficient behavior. He coined the term “psychopathic” to describe these engaged in morally-deficient behavior. He coined the term “psychopathic” to describe these folks.folks.

In his book, “The Mast of Sanity,” Cleckley developed a description of psychopathy based on In his book, “The Mast of Sanity,” Cleckley developed a description of psychopathy based on observations of caucasian, middle-class male patients who were inpatients of a psychiatric observations of caucasian, middle-class male patients who were inpatients of a psychiatric facility. facility.

Historical perspectives contd.Historical perspectives contd.

In 1941 Cleckley wrote, “In 1941 Cleckley wrote, “The Mask of SanityThe Mask of Sanity,” in which ,” in which he provided not only a comprehensive description of he provided not only a comprehensive description of psychopathy, but a method for assessing it.psychopathy, but a method for assessing it.

His description of psychopathy was made on the basis of His description of psychopathy was made on the basis of observations of caucasian, middle-class male inpatients in observations of caucasian, middle-class male inpatients in a psychiatric institution. This concept is still stable today.a psychiatric institution. This concept is still stable today.Note: Cleckley focused on the psychopaths Note: Cleckley focused on the psychopaths personality personality traitstraits (poor judgment, impulsivity, lack of guilt or (poor judgment, impulsivity, lack of guilt or remorse, inability to learn from punishment, blaming remorse, inability to learn from punishment, blaming others, etc.) and not on the patient’s criminal history.others, etc.) and not on the patient’s criminal history.Does this sound familiar at all?????Does this sound familiar at all?????

Hart & Hare (1998)’s summary of Hart & Hare (1998)’s summary of Cleckley’s psychopath:Cleckley’s psychopath:

““Interpersonally, psychopaths are grandiose, Interpersonally, psychopaths are grandiose, arrogant, callous, superficial, and manipulative; arrogant, callous, superficial, and manipulative; affectively, they are short-tempered, unable to affectively, they are short-tempered, unable to form strong emotional bonds with others, and form strong emotional bonds with others, and lacking in empathy, guilt or remorse; and lacking in empathy, guilt or remorse; and behaviorally, they are irresponsible, impulsive, behaviorally, they are irresponsible, impulsive, and prone to violate social and legal norms and and prone to violate social and legal norms and expectations.expectations. (p.25)” (p.25)”What neural structures might you expect to see What neural structures might you expect to see altered in these individuals??altered in these individuals??

Hare’s contribution:Hare’s contribution:

Hare developed the Hare developed the Psychopathy ChecklistPsychopathy Checklist in 1980 & then revised it in 1991. in 1980 & then revised it in 1991.

IV. Items on the Psychopathy Checklist-IV. Items on the Psychopathy Checklist-Revised (PCL-R)Revised (PCL-R)

Factor 1-Factor 1- Factor 2-Factor 2-Interpersonal//AffectiveInterpersonal//Affective Social DevianceSocial Deviance

Superficial charmSuperficial charm Need for stimulationNeed for stimulationGrandiosityGrandiosity easily boredeasily boredPathological lyingPathological lying parasitic lifestyleparasitic lifestyleLack or remorse/guiltLack or remorse/guilt poor behavioral controlspoor behavioral controlsManipulativeManipulative early behavioral problemsearly behavioral problemsShallow affectShallow affect lack of realistic long-term goalslack of realistic long-term goalsCallousness/lacks-Callousness/lacks- ImpulsivityImpulsivityEmpathyEmpathy IrresponsibilityIrresponsibilityFailure to accept one’sFailure to accept one’s Juvenile delinquencyJuvenile delinquencyResponsibilities Responsibilities

Rating system of Psychopathy Checklist Rating system of Psychopathy Checklist (PCL-R)(PCL-R)

The PCL-R (Hare, 1991) consists of 20 items. The PCL-R (Hare, 1991) consists of 20 items.

A 3-point scale is used to score items:A 3-point scale is used to score items:

0=item does not apply0=item does not apply

1=item applies somewhat1=item applies somewhat

2=item definitely applies2=item definitely applies

Scores range from 0 to 40. A score of Scores range from 0 to 40. A score of 30 30 or or greater indicates psychopathy. greater indicates psychopathy.

V. Do psychopaths experience emotions like V. Do psychopaths experience emotions like non-psychopathic individuals??non-psychopathic individuals??

No!!!No!!! According to several studies (Hare, According to several studies (Hare, 1978; Siddle & Trasler, 1981; Kiehl, Hare, 1978; Siddle & Trasler, 1981; Kiehl, Hare, McDonald, & Brink, 1999; Patrick, 1994).McDonald, & Brink, 1999; Patrick, 1994).

Psychopaths Psychopaths produce overt facial & verbal produce overt facial & verbal responses that are consistent with socially responses that are consistent with socially appropriate emotionsappropriate emotions, but produce , but produce autonomic activity that is autonomic activity that is incongruent with incongruent with their overt behavioral responses!!! their overt behavioral responses!!!

““The Mirror Has Two Faces”The Mirror Has Two Faces”

In other words, psychopaths can produce normal facial In other words, psychopaths can produce normal facial expressions & reactions to emotional events, but their expressions & reactions to emotional events, but their bodily sensations bodily sensations don’t matchdon’t match their facial expressions. their facial expressions.

(E.g., When psychopaths anticipate receiving electric (E.g., When psychopaths anticipate receiving electric shocks, they produce an anxious facial expression shocks, they produce an anxious facial expression consistent with fear or anxiety, but show reduced consistent with fear or anxiety, but show reduced galvanic skin responses (sweating) in response to galvanic skin responses (sweating) in response to receiving shocks. Normal individuals sweat more, not receiving shocks. Normal individuals sweat more, not less when anticipating being shocked.)less when anticipating being shocked.)

VI. Studying emotion in psychopathsVI. Studying emotion in psychopaths

A. Startle Blink studies—A. Startle Blink studies—

The startle blink (eye blink) response is a good non-The startle blink (eye blink) response is a good non-verbal indicator of verbal indicator of emotional emotional state.state.

Magnitude (strength) of the startle blink changes with Magnitude (strength) of the startle blink changes with emotional state. emotional state.

Startle increases for a negative emotional state & Startle increases for a negative emotional state & decreases for a positive emotional statedecreases for a positive emotional state (e.g., you may (e.g., you may be more likely to be startled after watching a horror be more likely to be startled after watching a horror movie, than when watching a comedy).movie, than when watching a comedy).

Patrick (1994) Startle blink study on Patrick (1994) Startle blink study on psychopathspsychopaths

Subjects:Subjects: 4 groups of prisoners selected with Hare 4 groups of prisoners selected with Hare checklist participated.checklist participated.

Group 1: Group 1: nonpsychopathsnonpsychopaths (low on antisocial (low on antisocial behavior & emotional detachment)behavior & emotional detachment)

Group 2: Group 2: Detached white collar offendersDetached white collar offenders (high (high only on emotional detachment)only on emotional detachment)

Group 3: Group 3: Antisocial offendersAntisocial offenders (high only on (high only on antisocial behavior)antisocial behavior)

Group 4: Group 4: PsychopathsPsychopaths (high on both factors). (high on both factors).

Experimental Paradigm-Patrick’s studyExperimental Paradigm-Patrick’s study

Baseline conditionBaseline condition- prisoners were presented with a - prisoners were presented with a visual cue, and sometimes a blast of loud noise.visual cue, and sometimes a blast of loud noise.

Experimental conditionExperimental condition - Ss experienced the visual - Ss experienced the visual cue & were told that when it disappeared the loud cue & were told that when it disappeared the loud noise would occur. noise would occur.

Results: Results: Both psychopaths & detached offenders Both psychopaths & detached offenders showed much smaller increases in their startle showed much smaller increases in their startle responses, indicating that less fear had been responses, indicating that less fear had been arousedaroused..

B. B. Facial Affect Recognition studies in Facial Affect Recognition studies in psychopathspsychopaths

Kosson, Suchy, Mayer, & Libby (2002) Kosson, Suchy, Mayer, & Libby (2002) examined the examined the accuracy with which psychopaths & non-psychopaths accuracy with which psychopaths & non-psychopaths classify facial expressionsclassify facial expressions based on six specific based on six specific emotions: fear, anger, disgust, happiness, sadness, and emotions: fear, anger, disgust, happiness, sadness, and surprise. surprise.

Psychopaths (n=34) & non-psychopaths (N=33) were Psychopaths (n=34) & non-psychopaths (N=33) were presented with 30 adult male & female caucasian faces presented with 30 adult male & female caucasian faces each representing a specific emotion (5 slides for each each representing a specific emotion (5 slides for each of the 6 emotions) & required to press a button on a of the 6 emotions) & required to press a button on a key pad signaling which emotion the face depicted.key pad signaling which emotion the face depicted.

Results of studyResults of study

1. Psychopaths’ accuracy in classifying the 1. Psychopaths’ accuracy in classifying the ““disgustdisgust”” faces was significantly impaired faces was significantly impaired compared to the non-psychopaths. This effect compared to the non-psychopaths. This effect was was not foundnot found for the other emotions in this study. for the other emotions in this study.

2. These results indicate the psychopaths 2. These results indicate the psychopaths exhibit exhibit deficits in the processing of emotional deficits in the processing of emotional information.information.

C. Skin conductance StudiesC. Skin conductance Studies

Do psychopaths show less empathy for Do psychopaths show less empathy for distress of others?distress of others?

Yes!!!Yes!!! Blair & coworkers (1997), examined skin Blair & coworkers (1997), examined skin conductance of psychopaths & controls (men) to conductance of psychopaths & controls (men) to slides of varying images.slides of varying images.

Ss were shown threatening (guns, knives), Ss were shown threatening (guns, knives), neutral (lamp, chair), & distress-provoking neutral (lamp, chair), & distress-provoking (crying person) slides.(crying person) slides.

Results of Blair’s studyResults of Blair’s study

1. Both psychopaths and non-psychopaths showed 1. Both psychopaths and non-psychopaths showed same skin conductance responses to the threatening & same skin conductance responses to the threatening & neutral slides. neutral slides.

2. Interestingly, psychopaths were less responsive to 2. Interestingly, psychopaths were less responsive to the the distress slides.distress slides.

This has been taken to imply that psychopaths are This has been taken to imply that psychopaths are impaired in or lack the ability to empathize with impaired in or lack the ability to empathize with others.others.

VII. Do psychopaths show neurological VII. Do psychopaths show neurological differences in processing of emotional differences in processing of emotional

information compared to normal people? information compared to normal people? Yes!!! Kiehl, Smith, Hare, Mendrek, Forster, Yes!!! Kiehl, Smith, Hare, Mendrek, Forster, Brink, & Liddle (2001) measured functional Brink, & Liddle (2001) measured functional MRI in psychopaths and normals while they MRI in psychopaths and normals while they read emotionally-ladden words.read emotionally-ladden words.

Overall, psychopaths showed less affect-Overall, psychopaths showed less affect-related brain activity compared to baseline related brain activity compared to baseline conditions than did non-psychopaths. conditions than did non-psychopaths.

Kiehl et al., (2001) results contd.Kiehl et al., (2001) results contd.

Criminal psychopaths showed less activation in Criminal psychopaths showed less activation in the anterior cingulate cortex, posterior cingulate, the anterior cingulate cortex, posterior cingulate, left inferior frontal gyrus, amygdala, left inferior frontal gyrus, amygdala, hippocampus, and frontal cortex.hippocampus, and frontal cortex.Neural processing of non-affect related Neural processing of non-affect related information, was not different for the information, was not different for the psychopaths and non-psychopaths. psychopaths and non-psychopaths. This is surprising, given that this circuitry is This is surprising, given that this circuitry is involved in multiple aspects of cognition??involved in multiple aspects of cognition??What next ??What next ??