526 EXAM 1 Flashcards
personality disorder
an enduring pattern of inner experience and behavior that deviates from the expectations of the individual’s culture
manifested in 2+
- cognition
- affectivity
- interpersonal functioning
- impulse control
antisocial personality disorder
a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years
- primarily defined by behavior
- majority of prisoners have this disorder
need 3+ of the following
- illegal behavior
- deceitfulness
- impulsivity
- aggressiveness
- reckless disregard for safety of self or others
- irresponsibility
- lack of remorse
narcissistic personality disorder
a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning in early adulthood and present in a variety of contexts
Need at leas 5+
- grandiose sense of self-importance
- preoccupied with fantasies of brilliance
- believes “special” and unique
- requires excessive admiration
- sense of entitlement
- interpersonally exploitative
- lacks empathy
- envious of others
- arrogant or haughty behaviors
psychopathy as a personality construct
- not DSM-5, but clearly defined and demonstrated cluster of personality traits (similar to APD but emphasis on interpersonal/affective traits)
- reliable assessment of construct: PCL-R gold standard
Psychopathy and APD: how are they related?
in prison populations:
- base rate APD 50-80%
- base rate psychopathy 15-25%
- most psychopaths are APD
-most APD are not psychopaths
APD/Narcissism/Psychopathy: how are they different?
- psychopathy interpersonal affective traits = “aggressive narcissism”
- narcissistic person may devalue you in their own mind, psychopaths do behaviorally
- narcissistic individuals are anxious if esteem is threatened
- APD is a behavioral piece of psychopathy
The PCL-R Assessment
- clinical interview and collateral information
- 20 items, 0-2 on item
- 0-40 continuum, high psychopathy is rates 30+
- avg inmate scores 22
psychopathy: primary v secondary distinction
1) interpersonal/affective
- primary psychopathy is defined as a majority of factor 1 traits
2) social deviance/behavioral
- secondary psychopathy is defined as a majority of factor 2 traits
psychopathy factor 1
interpersonal/affective
- glibness/superficial charm
- grandiose sense of self worth
- pathological lying
- conning/manipulation
- lack of remorse/guilt
- shallow affect
- callous lack of empathy
- failure to accept responsibility
psychopathy factor 2
social deviancy
- need for stimulation/proneness to boredom
- parasitic lifestyle
- poor behavioral controls
- early behavior problems
- lack of realistic, long tern goals
- impulsivity
- irresponsibility
- juvenile delinquency (only formal contacts with criminal justice system)
- revocation of release
- criminal versatility (adult criminal record: charges/convictions for different types of crimes)
secondary psychopathy is associated with:
- borderline personality disorder traits
- poorer interpersonal functioning
- increased psychological distress
- greater potential treatment responsiveness
- higher rates of childhood abuse
Two key differentiating variables in high PCL - R samples
1) trait anxiety and/or fearfulness
2) hostility and/or aggression
Lykken theorizes about psychopathy and sociopathy:
- psychopaths born with differences that lead them to risk-seeking and an inability to internalize social norms
- sociopaths have relatively normal temperaments. their disorder is more of an effect of negative sociological factors
instrumental aggression
- predatory, planned, controlled, purposeful
- violence used to achieve a goal (money, drugs, sex, status)
- lack of strong emotion preceding violence
Reid Meloy’s characterization of instrumental (predatory) vs reactive (affective)
- predatory: minimal or no ANS, no conscious emotion. planned, purposeful. no or minimal threat
- affective: intense ANS arousal subjective experience of emotion. reactive and immediate. internal/external threat present. goal is threat reduction
psychopathy and instrumental violence
high psychopathy associated with more instrumental violence than reactive violence
prevalence of psychopathy in women
- using PCL-R of 30+, very few females characterized as psychopaths
- F samples avg about 4-6 points lower than male samples
role of abuse in psychopathy
poythress, skeem, & lilienfeld 2006
- abuse not related to core interpersonal/emotional aspects of psychopathy
- abuse is related to irresponsible & impulsive lifestyle factors
- primary psychopathy may not be influenced by abuse
is witnessing domestic violence as a child associated with psychopathic traits in adults?
- vmPFC lesions result in pseudopsychopathy
- somatic marker hypothesis and vmPFC related feedback
somatic marker hypothesis
Damasio
- gut feelings are crucial for efficient decision making
- concept that not only the mind thinks, the body also plays a role in how we think
- somatic markers are created during the process of education and socialization through the connection between certain types of stimuli and certain types of affective states
uncinate fasciculus
white matter tracts between limbic and medial frontal cortex (including amygdala to vmPFC)
violence inhibition mechanism: blair, 1995
cognitive mechanism which, when activated by non-verbal communications of distress, initiates a withdrawal response; a schema will be activated predisposing the individual to withdraw from the attack
summary of brain data on moral decision making
-vmPFC increased activity during moral vs nonmoral in non-psychopaths but not psychopaths
- atypical pattern of brain activation and connectivity from anterior insula and amygdala to OFC and vmPFC in “imagine other empathy” but not “imagine self”
Actus reus
guilty act
mens rea
guilty mind
moral penal code standard
a defendant is not responsible for criminal conduct if “at the time of such conduct as a result of mental disease or defect he lacks substantial capacity either to appreciate the criminality of his conduct or to conform his conduct to the requirements of the law”
Frye admissibility of scientific evidence
expert opinion based on scientific technique is generally accepted as reliable in the relevant scientific community
Daubert admissibility of scientific evidence
“validity” of scientific testimony based on: empirical testing, peer review/publication, known/potential error rate, the existence and maintenance of standards and controls, the degree to which the theory and technique is generally accepted by a relevant scientific community
amygdala
fear, threat, arousal, aggression
summary of the social decision-making studies
- primary (but not secondary) psychopaths resemble vmPFC lesion patients in their decision making
- this shows that vmPFC may play a critical role in certain types of psychopathy
summary of prison MRI studies
- psychopathic criminals have measurable abnormalities in the vmPFC-amygdala circuit
- deficient connectivity may relate to deficits in emotion, empathy, social/moral decision-making, reinforcement learning
affective perspective taking
- affective empathy and cognitive empathy
- psychopathy is related to deficits in affective empathy
- results: psychopathy was negatively re;ated to accuracy when identifying fear, happiness, and sadness
psychopathy is negatively related to fear perspective-taking in:
- left anterior insula, precuneus
- prediction signals in anterior insula may be impaired in psychopathy
meta-anayltic results show psychopathy is related to
- increased volume of striatum
- increased activity in amygdala across a variety of tasks
- increased activity in default mode network across a variety in anterior cingulate across a variety of tasks
The low fear hypothesis
Lykken, 1995
1) people with primary psychopathy are born with below average levels of fearfulness ( a low fear IQ)
2) the fearfulness of psychopathic individuals makes them difficult to socialize (explaining psychopathic traits)
low fear>weak attachment
- children typically seek reassurance from parents to reduce fear. this makes children dependent on their parents and increases “social monitoring” to maintain parents’ approval
- low fear weakens this attachment by reducing motivation to seek approval and attachment
critique = is it a fear deficit or more general problem
passive avoidance learning
learning to avoid aversive stimuli
- not engaging in a behavior to avoid negative consequences
Newman’s response modulation hypothesis
- psychopaths are characterized by a response modulation deficit that interferes with their ability to use secondary (or non dominant information) to regulate goal directed behavior
- over-selective attention process
how do we test Newman’s response modulation hypothesis?
passive avoidance tasks
General Newman’s hypothesis
- the principal behavioral, cognitive, affective, and neural correlates of psychopathy will be moderated by their focus of attention
- deficit on tasks due to focus on reward and failure to attend to losses. this over-selective attention results in a failure to self regulate
psychopaths have deficits in:
- passive avoidance learning
- conflict monitoring (stroop and flanker tasks)
- fear potentiated startle/emotion modulated startle
- amygdala activation
- electrodomal reactivity
- empathy related brain activation
- facial affect recognition
these findings are all moderated by their focus of attention
all of the deficits appear and disappear depending upon whether the critical stimuli are intrinsic, or peripheral to, psychopath’s primary focus of attention
Impaired integration model of psychopathy
- psychopathic individuals have difficulty rapidly integrating multicomponent perceptual info (attention bottleneck), which in turn influences the quality of mental representations and shapes the development of associative neural networks in the brain
- language component as well
distal-proximal causes
1) low fear hypothesis: amygdala dysfunction - poor fear conditioning - poor passive avoidance
2) somatic marker hypothesis: vmPFC dysfunction - weak somatic markers - poor violence inhibition
3) impaired integration hypothesis: reduced connectivity - impaired integration - shallow affect, week inhibitory associations
PCL-R: an accidental risk tool
- designed to assess personality construct
- happens to predict general and violent recidivism
-NOT a comprehensive risk tool
psychopathy as risk factor for violent and general recidivism
- 2-5x more likely to recidivate than non-psychopathic offenders
- meta-analytic studies have consistently indicated that factor 2 is a stronger predictor of recidivism than factor 1 (whereas factor 1 is more instrumental violence)
Violence risk assessment guide (V-RAG)
12 items scored related to violent recidivism
(improved predictive ability if incorporated other risk items) - better than the PCL-R alone
summary: violence & psychopathy
- higher risk of violence
- violence is more predatory than affective
- commit more crimes
- more likely to use weapons
- more aggressive in prison
- more likely to escape
- more likely to have staff relations
- correlates with sadism, but its not the same thing
- serial murders are psychopathic but most high in psychopathy are NOT murders
Wong & Hare psychopathy treatment program
- goal is to reduce the frequency and severity of violence
- appeal to their self - interest to use strengths in non-criminal manner
- behavioral self-management vs cure
- CBT
cognitive remediation
- “brain training”
- increasing focus on context to address over-selection attention
- can lab tasks on computer, video games, meditation, train the brain?
- learning to focus on peripheral cues; recognize emotions; pick up on subtle cues; proactive pro-social behaviors in games/tasks
key neuropsychological factors & relationship to self-regulation
- vmPFC lesions result in ‘pseudopsychopathy’
- vmPFC associated with impaired emotional processing/regulation
- social/emotional & economic decision making in primary psychopathy & vmPFC patients similar
- Damasio’s somatic marker hypothesis (related with vmPFC related feedback)
summary of key points with comparison of vmPFC and primary psychopathy
- ultimatium game: more likely to make unfair
- dictator game: lack of empathy
- primary psychopaths similar to vmPFC lesion patients
vmPFC-amygdala connectivity
- vmPFC and amygdala are densely interconnected
- amygdala involved in fear and anxiety
- vmPFC involved in emotion regulation and socio-moral decision-making
- psychopaths have deficits in fear, affect, aggression, and decision-making
