Psychopaths: Emotional & Behavior Responses

1. Psychopaths: Emotional & Behavior Responses Partial adaptation from Kline

2. I. What is psychopathy? Core features- • Psychopaths lack remorse • Poverty of emotions (positive & negative) Psychopaths might be: Superficially charming Pathological liars & cheaters Impulsive; sensation seekers Manipulative, will change story to fit facts Less responsive to fear/anxiety Immoral Usually diagnosed in men (sorry )

3. II. What is the fundamental distinction between APD & psychopathy??? • “Lack of remorse,” is needed for a diagnosis of psychopathy, but not for Antisocial Personality disorder.

4. Prevalence of psychopathy: • Affects approximately 1% of the general population (Hare, 1991). • Approximately 15-25% of incarcerated offenders meet criteria for psychopathy.

5. III. Historical Perspective of Clinical description of Psychopathy: • 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 abilities were intact. • 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 engaged in morally-deficient behavior. He coined the term “psychopathic” to describe these folks. • 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 facility.

6. Historical perspectives contd. • In 1941 Cleckley wrote, “The Mask of Sanity,” in which he provided not only a comprehensive description of psychopathy, but a method for assessing it. • His description of psychopathy was made on the basis of observations of caucasian, middle-class male inpatients in a psychiatric institution. This concept is still stable today. • Note: Cleckley focused on the psychopaths personality traits (poor judgment, impulsivity, lack of guilt or remorse, inability to learn from punishment, blaming others, etc.) and not on the patient’s criminal history. • Does this sound familiar at all?????

7. Hart & Hare (1998)’s summary of Cleckley’s psychopath: • “Interpersonally, psychopaths are grandiose, arrogant, callous, superficial, and manipulative; affectively, they are short-tempered, unable to form strong emotional bonds with others, and lacking in empathy, guilt or remorse; and behaviorally, they are irresponsible, impulsive, and prone to violate social and legal norms and expectations. (p.25)” • What neural structures might you expect to see altered in these individuals??

8. Hare’s contribution: Hare developed the Psychopathy Checklist in 1980 & then revised it in 1991.

9. IV. Items on the Psychopathy Checklist-Revised (PCL-R) • Factor 1- Factor 2- • Interpersonal//Affective Social Deviance • Superficial charm Need for stimulation • Grandiosity easily bored • Pathological lying parasitic lifestyle • Lack or remorse/guilt poor behavioral controls • Manipulative early behavioral problems • Shallow affect lack of realistic long-term goals • Callousness/lacks- Impulsivity • Empathy Irresponsibility • Failure to accept one’s Juvenile delinquency • Responsibilities

10. Rating system of Psychopathy Checklist (PCL-R) • The PCL-R (Hare, 1991) consists of 20 items. • A 3-point scale is used to score items: • 0=item does not apply • 1=item applies somewhat • 2=item definitely applies • Scores range from 0 to 40. A score of 30 or greater indicates psychopathy.

11. V. Do psychopaths experience emotions like non-psychopathic individuals?? • No!!! According to several studies (Hare, 1978; Siddle & Trasler, 1981; Kiehl, Hare, McDonald, & Brink, 1999; Patrick, 1994). • Psychopaths produce overt facial & verbal responses that are consistent with socially appropriate emotions, but produce autonomic activity that is incongruent with their overt behavioral responses!!!

12. “The Mirror Has Two Faces” • In other words, psychopaths can produce normal facial expressions & reactions to emotional events, but their bodily sensations don’t match their facial expressions. • (E.g., When psychopaths anticipate receiving electric shocks, they produce an anxious facial expression consistent with fear or anxiety, but show reduced galvanic skin responses (sweating) in response to receiving shocks. Normal individuals sweat more, not less when anticipating being shocked.)

13. VI. Studying emotion in psychopaths • A. Startle Blink studies— • The startle blink (eye blink) response is a good non-verbal indicator of emotional state. • Magnitude (strength) of the startle blink changes with emotional state. • Startle increases for a negative emotional state & decreases for a positive emotional state (e.g., you may be more likely to be startled after watching a horror movie, than when watching a comedy).

14. Patrick (1994) Startle blink study on psychopaths • Subjects: 4 groups of prisoners selected with Hare checklist participated. • Group 1: nonpsychopaths (low on antisocial behavior & emotional detachment) • Group 2: Detached white collar offenders (high only on emotional detachment) • Group 3: Antisocial offenders (high only on antisocial behavior) • Group 4: Psychopaths (high on both factors).

15. Experimental Paradigm-Patrick’s study • Baseline condition- prisoners were presented with a visual cue, and sometimes a blast of loud noise. • Experimental condition - Ss experienced the visual cue & were told that when it disappeared the loud noise would occur. • Results: Both psychopaths & detached offenders showed much smaller increases in their startle responses, indicating that less fear had been aroused.

16. B. Facial Affect Recognition studies in psychopaths • Kosson, Suchy, Mayer, & Libby (2002) examined the accuracy with which psychopaths & non-psychopaths classify facial expressions based on six specific emotions: fear, anger, disgust, happiness, sadness, and surprise. • Psychopaths (n=34) & non-psychopaths (N=33) were presented with 30 adult male & female caucasian faces each representing a specific emotion (5 slides for each of the 6 emotions) & required to press a button on a key pad signaling which emotion the face depicted.

17. Results of study 1. Psychopaths’ accuracy in classifying the “disgust” faces was significantly impaired compared to the non-psychopaths. This effect was not found for the other emotions in this study. 2. These results indicate the psychopaths exhibit deficits in the processing of emotional information.

18. C. Skin conductance Studies • Do psychopaths show less empathy for distress of others? • Yes!!! Blair & coworkers (1997), examined skin conductance of psychopaths & controls (men) to slides of varying images. • Ss were shown threatening (guns, knives), neutral (lamp, chair), & distress-provoking (crying person) slides.

19. Results of Blair’s study • 1. Both psychopaths and non-psychopaths showed same skin conductance responses to the threatening & neutral slides. • 2. Interestingly, psychopaths were less responsive to the distress slides. • This has been taken to imply that psychopaths are impaired in or lack the ability to empathize with others.

20. VII. Do psychopaths show neurological differences in processing of emotional information compared to normal people? • Yes!!! Kiehl, Smith, Hare, Mendrek, Forster, Brink, & Liddle (2001) measured functional MRI in psychopaths and normals while they read emotionally-ladden words. • Overall, psychopaths showed less affect-related brain activity compared to baseline conditions than did non-psychopaths.

21. Kiehl et al., (2001) results contd. • Criminal psychopaths showed less activation in the anterior cingulate cortex, posterior cingulate, left inferior frontal gyrus, amygdala, hippocampus, and frontal cortex. • Neural processing of non-affect related information, was not different for the psychopaths and non-psychopaths. • This is surprising, given that this circuitry is involved in multiple aspects of cognition?? • What next ??