Psychopaths: Emotional

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Psychopaths Emotional Behavior Responses

• Partial adaptation from Kline

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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 ?)

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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.

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Prevalence of psychopathy

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

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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.

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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
  patients criminal history.
• Does this sound familiar at all?????

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Hart Hare (1998)s summary of Cleckleys
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??

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Hares contribution

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

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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 ones Juvenile delinquency
• Responsibilities

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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
• 0item does not apply
• 1item applies somewhat
• 2item definitely applies
• Scores range from 0 to 40. A score of 30 or
  greater indicates psychopathy.

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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!!!

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The Mirror Has Two Faces

• In other words, psychopaths can produce normal
  facial expressions reactions to emotional
  events, but their bodily sensations dont 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.)

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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).

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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).

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Experimental Paradigm-Patricks 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.

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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 (n34) non-psychopaths (N33) 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.

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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.

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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.

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Results of Blairs 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.

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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.

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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 ??