Lecture 4: Psychopathy

Question 1

Is there a treatment for psychopathy?

Answer 1

No - and psychopaths are very difficult to manage

Question 2

What did Rice et al. (1992) find? (prisoners released from a therapeutic community in Canada)

Answer 2

Looked at convictions after 2 years of release - Found groups who convicted most were psychopaths those who were treated – treatment did opposite of what it intended
WHY? - study not randomised (those chosen wanted to be released) and possibly learnt how to manipulate people

Question 3

Why are psychopaths so hard to treat and manage?

Answer 3

• Do not want to change - will only take program as route to affect release.
• Most programs were not designed with the psychopaths in mind. It might be safer to say that they do not respond well to traditional (current) programs, rather than they cannot be treated…
• In UK people scoring high are not allowed onto certain treatment programs (e.g., SOTP in the prison service)

Question 4

How do psychopaths behave in prisons?
Hobson et al. (2000)

Answer 4

PCL-R scores predict disturbing behaviours in a high secure hospital (HMP Grendon)
- very disruptive when trying to give treatments in groups - blames others, evasive, lies, intellectualises things, outbursts
- on the wing - Seeks attention, manipulates others for own needs, quick to exploit loopholes in rules and entitlements, targets vulnerable staff, inflated sense of self-importance, speaks at staff, not to them, rigorous about psychologists’ behaviour

Question 5

How do offending psychopaths get treated differently compared to typical offenders?

Answer 5

• Psychopaths are (often) skilled at manipulating their projected image
• Porter et al. 2009 - show that they gain conditional release at a far greater rate than other offenders – niceness personified during court etc.
• Häkkänen-Nyholm & Hare (2009) – show psychopaths gains more lenient sentences.
• Reported examples of individuals who can manipulate their profiles on self-report measures and even help others do the same (Hare, 1985).

Question 6

How many theories to psychopathy are there and what are they called?

Answer 6

2 theories:
1. Emotional deficit theory - EMOTION THEORY
2. Response Modulation Hypothesis (Newman) - COGNITIVE THEORY

Question 7

What is the Emotional Deficit Theory? 2 theorists…

Answer 7

• original idea = low levels of fear – problem with amygdala + problems processing fear-type stimuli
• Dysfunctional amygdala (Blair) - poor processing of emotional material and insensitivity to punishment. Stressed OFC (alias vmPFC). Psychopaths are not easily conditioned - early in life, they do not show fear or distress/sadness (stops us from doing something negative)
• Paralimbic dysfunction (Kiehl) -leads to inability to use emotion to guide behaviour and poor decision-making
  similarities to ^ Blair (including dysfunction of amygdala and OFC).

Question 8

What is a problem with the Emotional Deficit Theory?

Answer 8

Issue with theory: psychopaths have problems with processing emotional material, but is it just fear…? – emotionally salient) emotion processing is not just amygdala based + is related to OBC + PFC…

Question 9

What is the Response Modulation Hypothesis?

Answer 9

Newman et al.

• Attentional issue
• NOT amygdala based - no specific brain area (maybe VLPFC?)
• a deficit in processing “secondary” information - emotion may not be processed if not the focus of attention
• psychopaths are over-focussed/fixate on goals at expense of others

Question 10

What did Dadds et al. (2008) show in support of Response Modulation Hypothesis?

Answer 10

Dadds et al. (2008) - noted that children with psychopathic tendencies were poor at spotting facial expressions (see earlier) – and also failed to spend time looking at a person’s eyes (looked at mouth, chin, nose etc. instead – not as useful than looking at the eyes).
o FOUND: By either only presenting the eyes, or forcing them to look at the eyes, the deficit disappeared.
o If get them to look at the right place, deficit will disappear…

Question 11

What did Newman et al. (2010) show in support of Response Modulation Hypothesis?

Answer 11

Fear Potentiated Startle (FPS):
-(Pre-train) Trained participants to expect shocks to RED letters but not to GREEN letters – people become scared of RED letter
Then measured startle to these red and green letters under 2 conditions:
1) Fear-focus (dimension)
2) Alternate-focus

-FOUND: No effect of psychopathy in the fear-focus condition.
-FOUND: Reduced FPS in psychopaths (Factor 1) in alternate-focus condition
-FOUND: In controls the fear-inducing stimulus produces effect even if not initial focus of attention
-FOUND: Psychopaths show normal potentiation when focussing on colour
- BUT if get people focused on other things – they won’t care because they have been fear conditioned

• FOUND: for non-psychopaths - FPS under both conditions
  SUPPORTS attentional issue (over-focussed)

Question 12

What is the Triarchic model of psychopathy?

Answer 12

boldness, meanness and disinhibition
via the TriPM self-report questionnaire (Patrick, 2010)

Question 13

What did Gray et al. (2022) find regarding the emotional deficit theory?

Answer 13

• used Triarchic model of psychopathy (via questionnaire)
• also SRP-4 + TCI
• used sounds (instead of images) and measured response of pupil
• FOUND: for those high in psychopathy, both the positive and negative emotional sounds produced greater dilation in the pupil size than neutral.
• was reduced for negative sounds for people high on the “callous/affective” components of psychopathy (Meanness scale of the TriPM)
• SRP-4 FOUND: got smaller with people low on effective emotional components

Question 14

What did Hare et al. (1978) find when looking at fear response? (SCR)

Answer 14

• Ppts. shown a screen which counts down to a loud noise blast – ppt. knows that something bad is going to happen at the end of the countdown
• Expect typical ppts. to watch counter + then wait and expect something bad to happen, expect skin conductance responses to increase as counter heads towards 0…
• Those HIGH in psychopathy showed SMALLER SCR as the blast approached – do not actually have to shock them but can introduce fear stimulus

Question 15

What did Patrick et al. (1993) find when measuring eye-blink responses?

Answer 15

• startle response modified by emotional state (emotional processing)
• those high in psychopathy – seem to show less startle response when show them nice pictures BUT when show nasty pictures, they don’t get the increase like typical ppts. do
• There was no effect of psychopathy on the SCR to pleasant or unpleasant pictures.
• Lack of emotional modulation of startle appears to be driven mainly by Factor 1 (cold).

Question 16

What did Esteller et al., 2016 find regarding FPS?

Answer 16

-FOUND: (TriPM) Boldness was associated with reduced FPS to the threat stimuli (showed with different images presented). No effect on other affective images (e.g., mutilations).
o For those high in boldness, nearly all those results the same, BUT there’s no difference between showing neutral pictures and threat pictures

• refines Patrick et al. (1993) findings - not just negative pictures BUT psychopaths are not responsive to those threatening type pictures rather than the nasty pictures…

Question 17

What is the difference between psychopathy and personality disorders?

Answer 17

Herpertz et al., (2001) – showed pleasant reaction to unpleasant stimuli BUT this was not a feature of other Personality disorders (e.g., BPD)
* if psychopathy is under-reaction, BPD is often seen as an overreaction to emotions – SPECIFIC TO PSYCHOPATHY

Question 18

What did Hare et al. (1991) show studying the Lexical decision task and WHAT did it show in support of WHICH theory?

Answer 18

• used to measure the impact of the affective connotations of words
• PCL-R measured psychopathy in offenders
• briefly presented in random order: neutral & emotional words, and pronounceable non-words
• FOUND: psychopaths respond same to neutral words than the non-psychopath group BUT there is no speeding up with positive or negative – took even longer – opposite findings to non-psychopath group
  o To be slower, shows processing of emotion (emotion deficit theory)

Question 19

What did Blair et al (2004) find regarding deficits in specific emotion recognition in faces? Is it supported by other studies?

Answer 19

Faces “morphed” from neutral expressions to a particular expression over time – press button when they recognise the expression

FOUND: claims difference for fearful faces – psychopaths make more errors + get fewer correct
evidence for selective deficit for FEAR

BUT other studies disagree… - general consensus is that psychopaths have deficient emotional experience/processing - Brook et al. (2013) (review)

issue with study - is it just measuring impulsivity (more/less willing to press their buttons)?

Question 20

Do psychopaths have an issue with both processing emotions and emotional self-ratings or just one?

Answer 20

Brook et al. (2013)
- Psychopaths appear to have difficulty processing emotions shown by studies (behavioural + regional brain activation anomalies) BUT their self ratings of self-arousal and stimulus valence/intensity do not differ from controls!
- they know how to respond (understand emotions) BUT do not show physiological response to emotions
* ‘they know the words but not the music’ of emotions’

Question 21

What do we NOT know in regards to psychopathy and emotion processing?

Answer 21

Psychopaths have a problem processing emotions, but research has not found exactly the problem/what emotions are involved!

Question 22

What brain areas are specific to psychopathy during neuropsychological tasks?

Answer 22

Characterized difference in as those that rely on DFLC (WCST & Brixton test) vs. OFC (Tower of London task, Iowa Gambling task, Maze task & Go-no go task)

Question 23

What brain areas are specific to psychopathy during neuropsychological tasks?

Answer 23

Characterised difference in neuropsychological tasks as those that rely on DLPC (dorsolateral prefrontal cortex) vs. OFC (orbitofrontal cortex)

Question 24

WHO found and WHAT neuropsychological tasks are affected by psychopaths?

Answer 24

Lapierre et al (1995)
Go-Nogo task: psychopaths have higher commission errors (going when you should not go) - OFC

Partens Maze test: much higher for qualitative (cheating in task) task for psychopaths than quantitative (mistake) - OFC

WCST: no difference compared to non-psychopaths - DLPC

Smell discrimination - requires frontal lobe to discriminate

Question 25

What did Mitchell et al. (2022) find during the Iowa gambling task (risky behaviour)?

Answer 25

presented with 2 groups:
- 4 blocks – high rewards + high punishment
- 2 blocks – low rewards + low punishment – over time, should learn to do this one…

• Control groups - as experiment progresses from block 1 to block 2, ppts. picked less risky ones
• Psychopaths - no change in which block they chose
  o At start, 2 groups fairly similar – something we LEARN (often without realising)

Question 26

What did Bagshaw, Gray and Snowden (2014) find regarding the Tower of London task and the Hayling and Brixton test?

Answer 26

Tower of London task: Found that psychopathy is associated with a lack of planning - those high on PCL-R could not wait to try and complete the hard task = IMPULSIVE (those low on PCL took more time)

Brixton test (bit like WCST) – Burgess & Shalice, 1997 psychopaths have no trouble detecting the “rule” + can change the rule just fine – BUT then had trouble “sticking to the rule” (make more errors DURING THE RULE) – many verbalised that they were trying to anticipate the rule change or “beat the system”

Question 27

What did Raine et al. (1994) find? (OFC and murderers)

Answer 27

NGRI (not guilty by reason of insanity): FOUND reduced activity & volume in OFC in murderers
= area associated with impulsivity, loss of self-control, immaturity, altered emotionality

BUT ‘these were not found in murderers where crime classed as “predatory” (AKA: psychopaths)

Question 28

What did Yang et al. (2006) find? amygdala volume

Answer 28

Found reduced amygdala volume for psychopaths – effect much greater for Factor 1 than Factor 2
BUT what does the size matter here…?

Question 29

What did Decety et al. (2014) find?

Answer 29

Found reduced brain activity in 4 dynamic facial expressions BUT insula (responsible for disgust) gave greater response than amygdala - surprising result

BUT not clear what this study shows…? It is hard to detect disgust and does it suggest psychopaths show more disgust or less?

Question 30

What did Harenski et al. (2010) show? vmPFC

Answer 30

Showed either (x3): 1. neutral pictures, 2. nasty but non-moral pictures (e.g., mutilated hand) and 3. nasty, but moral violations (person attacking, hand breaking into house)

FOUND (fMRI) Reduced moral/nonmoral picture distinctions in activity in the vmPFC and anterior temporal cortex for psychopath group
No effect for non-psychopaths

Question 31

What should future research focus on regarding specific brain dysfunction?

Answer 31

• Case “not proven” for any specific brain dysfunction – but evidence is converging
• Needs more careful consideration of sub-types of psychopathy (Factor 1 and Factor 2) and nature of tasks – many are so complex that many explanations possible.
• lack of reliable paradigms on behavioural measures
• Will we find dysfunction in amygdala – related to factor 1?
• Will we find problems with orbital frontal - Factor 2?