Psychopathy.

Psychopathy is a personality disorder characterized by a constellation of affective, interpersonal, lifestyle and antisocial features whose antecedents can be identified in a subgroup of young people showing severe antisocial behaviour. The prevalence of psychopathy in the general population is thought to be ~1%, but is up to 25% in prisoners. The aetiology of psychopathy is complex, with contributions of both genetic and environmental risk factors, and gene-environment interactions and correlations. Psychopathy is characterized by structural and functional brain abnormalities in cortical (such as the prefrontal and insular cortices) and subcortical (for example, the amygdala and striatum) regions leading to neurocognitive disruption in emotional responsiveness, reinforcement-based decision-making and attention. Although no effective treatment exists for adults with psychopathy, preliminary intervention studies targeting key neurocognitive disturbances have shown promising results. Given that psychopathy is often comorbid with other psychiatric disorders and increases the risk of physical health problems, educational and employment failure, accidents and criminality, the identification of children and young people at risk for this personality disorder and preventative work are important. Indeed, interventions that target the antecedents of psychopathic features in children and adolescents have been found to be effective.

Cognitive mechanisms influencing facial emotion processing in psychopathy and externalizing.

Psychopathy and externalizing are distinct forms of disinhibitory psychopathology whose destructive social behaviors are thought to be underpinned by different aberrations in social cognition. Facial emotion processing is a foundational component of social cognition, yet previous studies on facial emotion processing in psychopathy and externalizing have focused on traditional behavioral measures (e.g., response accuracy), which have limited reliability and precision. Diffusion modeling is a valuable tool for elucidating more reliable and precise sources of performance differences because it estimates parameters that reflect latent cognitive processes, including bias, drift rate (efficiency of evidence accumulation), threshold separation (extent of evidence accumulation), and nondecision time (time spent on non-decision-related processes such as stimulus encoding and motor response execution). In a sample of 92 incarcerated males, we applied diffusion modeling to an emotion identification task in which ambiguous blends of anger, happiness, and fear were identified while contextual threat (i.e., apparent movement of faces) was manipulated. Results indicated that psychopathy was associated with longer nondecision time (i.e., slower processing) across all the emotion blends in the task and particularly for mostly angry faces under greater ambiguity. In direct contrast, externalizing was associated with shorter nondecision time (i.e., faster processing) as well as greater threshold separation (i.e., more extensive evidence accumulation) for mostly angry faces under greater ambiguity, but this pattern of preferential processing of anger was only evident in the absence of contextual threat. These findings link psychopathy and externalizing to different profiles of cognitive processes influencing facial emotion processing. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Aggressive Realism: More Efficient Processing of Anger in Physically Aggressive Individuals.

Physically aggressive individuals' heightened tendency to decide that ambiguous faces are angry is thought to contribute to their destructive interpersonal behavior. Although this tendency is commonly attributed to bias, other cognitive processes could account for the emotion-identification patterns observed in physical aggression. Diffusion modeling is a valuable tool for parsing the contributions of several cognitive processes known to influence decision-making, including bias, drift rate (efficiency of information accumulation), and threshold separation (extent of information accumulation). In a sample of 90 incarcerated men, we applied diffusion modeling to an emotion-identification task. Physical aggression was positively associated with drift rate (i.e., more efficient information accumulation) for anger, and drift rate mediated the association between physical aggression and heightened anger identification. Physical aggression was not, however, associated with bias or threshold separation. These findings implicate processing efficiency for anger-related information as a potential mechanism driving aberrant emotion identification in physical aggression.

Understanding positive emotion deficits in depression: From emotion preferences to emotion regulation.

Depression is characterized by increased levels of negative affect and decreased levels of positive affect. Prior research shows that individual differences in emotion regulation play an important role in understanding sustained negative affect within the disorder; yet, much less is known about the regulation of positive emotion in depression. The current paper utilizes emotion regulation models that synthesizes multiple emotion processes, including what people want to feel (emotion preferences) and the ways in which people typically respond to emotion (habitual use of emotion regulation strategies), to increase our understanding of positive emotion in depression. In doing so, we propose that depression is associated with relative reductions in the preference for positive emotion; these reductions may therefore increase the habitual use of emotion regulation strategies that serve to down-regulate positive emotion and decrease the use of strategies that serve to up-regulate positive emotion. Dysfunction in habitual emotion regulation strategy use may, in turn, contribute to the relatively low levels of positive emotion within the disorder. The paper also discusses important empirical gaps in the extant literature on emotion preferences and emotion regulation in depression and highlights novel treatment targets (e.g., emotion preferences) for interventions aimed at improving emotion dysfunction in depression.

Physical aggression is associated with heightened social reflection impulsivity.

Physical aggression harms individuals, disrupts social functioning across multiple forms of psychopathology, and leads to destruction within communities. Physical aggression is associated with aberrations in the interpretation of ambiguous information. However, the specific cognitive mechanisms supporting this link remain elusive. One potentially relevant cognitive mechanism is reflection impulsivity, the amount of information gathered during decision-making. Reflection impulsivity characterizes how individuals resolve ambiguity in the process of forming judgments when multiple interpretations of a stimulus are possible. In a sample of 98 incarcerated men, we examined reflection impulsivity using a novel social information sampling task. The primary aim of the study was to investigate the relationship between physical aggression and social reflection impulsivity. Additionally, we assessed the frequency of different social judgments (hostile vs. benign), the extent to which reflection impulsivity varied in the context of these different social judgments, and subjective certainty about social judgments. Finally, we investigated whether social reflection impulsivity moderated the relationship between physical aggressiveness and violent crime. Results indicated that more physically aggressive individuals displayed heightened social reflection impulsivity, which was amplified in the context of hostile judgments. Moreover, more physically aggressive individuals were more certain about their hostile judgments and more certain when judgments were made with unconstrained access to behavioral information. Finally, impulsive hostile judgments in physically aggressive individuals related to a more extensive history of assault charges. These findings suggest that physically aggressive individuals exhibit deficits in information gathering, leading to ill-informed and inflexible social judgments. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Psychological interventions potentially useful for increasing conscientiousness.

Conscientiousness is commonly conceptualized as a personality trait that reflects tendencies to be disciplined, goal oriented, self-controlled, responsible to others, hardworking, orderly, and rule following. Higher levels of conscientiousness reliably predict a host of desirable life outcomes, including longevity and better health throughout the life span. Given the consistently positive relationship of conscientiousness to desirable behaviors and outcomes, there is considerable enthusiasm for researching interventions to improve conscientiousness. The goals of the current review are twofold: (a) to provide an overview of several existing cognitive-behavioral, metacognitive, and cognitive remediation interventions with the potential to influence conscientiousness and (b) to present several suggestions, related to sample selection, intervention components, and sources of support and motivation, for adapting these interventions to promote healthy aging in the general population. As research continues to progress, new psychological interventions may be developed to effectively target conscientiousness and related constructs, ultimately promoting desirable behaviors and outcomes associated with higher levels of this personality trait. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Neural processing of social exclusion in individuals with psychopathic traits: Links to anger and aggression.

Psychopathy is a cluster of personality traits associated with high rates of aggression. While research on psychopathic traits largely focuses on neurobiological factors implicated in aggression, other research suggests that contextual factors, such as social exclusion, also contribute to promoting aggression. Yet, the relationships among psychopathic traits, neural processing of exclusion, and aggression remain unknown. A sample of 76 adolescents and young adults completed Cyberball, a task involving conditions of social inclusion, ambiguous exclusion, and unambiguous exclusion. During Cyberball, a slow wave (SW) event-related potential (an index of elaborative processing) and self-reported anger were measured. Additionally, acts of real-world aggression were assessed. Results indicated that as psychopathic traits increased, SW during ambiguous exclusion also increased, but SW during inclusion decreased. However, the combination of smaller SW during ambiguous exclusion and higher psychopathic traits predicted heightened anger following Cyberball and more frequent real-world aggression. This response to social exclusion among individuals with elevated psychopathic traits may represent an unreflective, reactive style that exacerbates anger and aggression in certain contexts. These data suggest that neurobiological dysfunction in elaborative processing is related to psychopathic traits, and social context comprises another important influence on the aggression of individuals with elevated psychopathic traits.

Abnormal cortical gyrification in criminal psychopathy.

Background: Psychopathy is a personality disorder characterized by interpersonal and emotional abnormalities (e.g., lack of empathy and guilt) and antisocial behavior. Psychopathy has been associated with a number of structural brain abnormalities, most notably in orbital frontal and anterior/medial temporal regions, that may underlie psychopathic individuals' problematic behaviors. Past research evaluating cortical structure in psychopathy has considered thickness and volume, but to date no study has investigated differences in cortical gyrification, a measure of cortical complexity thought to reflect early neurodevelopmental cortical connectivity. Methods: We measured the local gyrification index (LGI) in a sample of 716 adult male inmates and performed a whole brain analysis assessing the relationship between LGI and total and factor scores on the Hare Psychopathy Checklist-Revised (PCL-R). Results: PCL-R scores were negatively associated with LGI measures within the right hemisphere in the midcingulate cortex (MCC) and adjacent regions of the superior frontal gyrus as well as lateral superior parietal cortex. Additionally, PCL-R Factor 1 scores (interpersonal/affective traits) predicted less LGI within the right MCC and adjacent dorsomedial frontal cortex and greater LGI in bilateral occipital cortex. Scores on PCL-R Factor 2, indicating impulsivity and antisocial behaviors, did not predict LGI in any regions. Conclusions: These findings suggest that psychopathy, particularly the interpersonal and affective traits, are associated with specific structural abnormalities that form during neurodevelopment and these abnormalities may underlie aberrant brain functioning in regions important in emotional processing and cognitive control.

Brain-behavior relationships in externalizing: P3 amplitude reduction reflects deficient inhibitory control.

The use of endophenotypes to classify individuals at risk for or suffering from psychopathology has been criticized for lacking specificity and predictive utility. This issue is apparent in research on externalizing, a heritable predisposition to disinhibitory psychopathology and personality traits. Numerous studies have shown that P3 amplitude reduction (P3AR) reliably reflects externalizing, implicating P3AR as a candidate endophenotype for externalizing psychopathology. However, this endophenotype has not been connected directly to a key deficit in executive function (e.g., inhibitory control) commonly related to externalizing. Using a modified oddball task in a sample (N=74) of at-risk adolescents and young adults, we examined the associations among externalizing, P3AR, and inhibitory control. We also examined the associations of P3AR and inhibitory control with frequency of real-world disinhibited behavior. Results indicated that externalizing related to P3AR, which in turn related to deficient inhibitory control. Additionally, there were both unique and interactive associations of P3 amplitude and inhibitory control with indicators of real-world behavior. These findings provide the first direct evidence that P3AR reflects deficits in inhibitory control, thus linking this externalizing-related endophenotype to a specific cognitive process. Moreover, the results highlight the value of considering psychobiological measures alongside behavioral measures for indexing risk for externalizing behavior and psychopathology.

Examining Predictors of Callous Unemotional Traits Trajectories Across Adolescence Among High-Risk Males.

Among high-risk youth, those with high levels of callous unemotional (CU) traits show more severe and chronic forms of antisocial behavior. Although ecological models have linked factors across multiple domains of risk to broader antisocial behavior development, fewer studies have adopted this approach in relation to understanding the unique development of CU traits. Further, a paucity of evidence exists from studies that have examined predictors of trajectories of CU traits. In the current study using data from the Pathways to Desistance data set, we examined prospective risk factors for CU traits trajectories modeled from ages 14 to 24. The sample included male adolescents who had interacted with the justice system (N = 1,170). CU traits were assessed using the Youth Psychopathic Traits Inventory. Risk factors were assessed at baseline via youth self-report across multiple domains of risk (individual, parenting, and broader contextual risk). Our results demonstrated higher risk factor scores across individual characteristics (higher anxiety and more substance use), parenting (higher harshness, and lower monitoring and knowledge), and broader contextual risk (more violence exposure) for youth with a "high" and stable CU traits trajectory. Adolescents with stable "high" CU traits likely need interventions capable of addressing and changing multiple aspects of their ecology across individual-, parent-, family-, and community-level targets.

Corrigendum: Psychopaths Show Enhanced Amygdala Activation during Fear Conditioning.

[This corrects the article on p. 348 in vol. 7, PMID: 27014154.].

Interactions between Callous Unemotional Behaviors and Executive Function in Early Childhood Predict later Aggression and Lower Peer-liking in Late-childhood.

Callous unemotional (CU) behaviors are linked to aggression, behavior problems, and difficulties in peer relationships in children and adolescents. However, few studies have examined whether early childhood CU behaviors predict aggression or peer-rejection during late-childhood or potential moderation of this relationship by executive function. The current study examined whether the interaction of CU behaviors and executive function in early childhood predicted different forms of aggression in late-childhood, including proactive, reactive, and relational aggression, as well as how much children were liked by their peers. Data from cross-informant reports and multiple observational tasks were collected from a high-risk sample (N = 240; female = 118) at ages 3 and 10 years old. Parent reports of CU behaviors at age 3 predicted teacher reports of reactive, proactive, and relational aggression, as well as lower peer-liking at age 10. Moderation analysis showed that specifically at high levels of CU behaviors and low levels of observed executive function, children were reported by teachers as showing greater reactive and proactive aggression, and were less-liked by peers. Findings demonstrate that early childhood CU behaviors and executive function have unique main and interactive effects on both later aggression and lower peer-liking even when taking into account stability in behavior problems over time. By elucidating how CU behaviors and deficits in executive function potentiate each other during early childhood, we can better characterize the emergence of severe and persistent behavior and interpersonal difficulties across development.

Smith and Lilienfeld's meta-analysis of the response modulation hypothesis: Important theoretical and quantitative clarifications.

In the first meta-analytic review of the response modulation hypothesis (RMH), an attention-based model for understanding the etiology of psychopathy, Smith and Lilienfeld (2015) report that the average effect size for response modulation deficits in psychopathic individuals fell in the small to medium range (r = .20; p < .001, d = .41). Moreover, support for the RMH extended to both psychopathy dimensions, applied across diverse assessments and settings, and spanned child, adult, female, and male samples. The analysis also revealed good empirical support for a central tenet of the RMH, namely that response modulation deficits are not limited to the processing of threat or other emotion stimuli. Unfortunately, the Smith and Lilienfeld meta-analysis contains several theoretical and quantitative problems, including failing to distinguish adequately between the tasks used to evaluate RMH predictions and the theory itself, confusion regarding the evolution of the RMH and its impact on effect sizes, misinterpretations of RMH predictions and evidence regarding dominant response sets, passive avoidance, and primary task performance, and biased statements promoting the low fear model over the RMH. In this response, we endeavor to reduce misunderstanding by addressing the most salient issues, with the hope that increasing clarity will sharpen the focus of future research and result in more valid assessments of the RMH. (PsycINFO Database Record

Latent-variable modeling of brain gray-matter volume and psychopathy in incarcerated offenders.

Advanced statistical modeling has become a prominent feature in psychological science and can be a useful approach for representing the neural architecture linked to psychopathology. Psychopathy, a disorder characterized by dysfunction in interpersonal-affective and impulsive-antisocial domains, is associated with widespread neural abnormalities. Several imaging studies suggest that underlying structural deficits in paralimbic regions are associated with psychopathy. Although these studies are useful, they make assumptions about the organization of the brain and its relevance to individuals displaying psychopathic features. Capitalizing on statistical modeling, in the present study (N = 254), we used latent-variable methods to examine the structure of gray-matter volume in male offenders, and assessed the latent relations between psychopathy and gray-matter factors reflecting paralimbic and nonparalimbic regions. Results revealed good fit for a 4-factor gray-matter paralimbic model and these first-order factors were accounted for by a superordinate paralimbic "system" factor. Moreover, a superordinate psychopathy factor significantly predicted the paralimbic, but not the nonparalimbic factor. The latent-variable paralimbic model, specifically linked with psychopathy, goes beyond understanding single brain regions within the system and provides evidence for psychopathy-related gray-matter volume reductions in the paralimbic system as a whole. (PsycINFO Database Record

Psychopaths Show Enhanced Amygdala Activation during Fear Conditioning.

Psychopathy is a personality disorder characterized by emotional deficits and a failure to inhibit impulsive behavior and is often subdivided into "primary" and "secondary" psychopathic subtypes. The maladaptive behavior related to primary psychopathy is thought to reflect constitutional "fearlessness," while the problematic behavior related to secondary psychopathy is motivated by other factors. The fearlessness observed in psychopathy has often been interpreted as reflecting a fundamental deficit in amygdala function, and previous studies have provided support for a low-fear model of psychopathy. However, many of these studies fail to use appropriate screening procedures, use liberal inclusion criteria, or have used unconventional approaches to assay amygdala function. We measured brain activity with BOLD imaging in primary and secondary psychopaths and non-psychopathic control subjects during Pavlovian fear conditioning. In contrast to the low-fear model, we observed normal fear expression in primary psychopaths. Psychopaths also displayed greater differential BOLD activity in the amygdala relative to matched controls. Inverse patterns of activity were observed in the anterior cingulate cortex (ACC) for primary versus secondary psychopaths. Primary psychopaths exhibited a pattern of activity in the dorsal and ventral ACC consistent with enhanced fear expression, while secondary psychopaths exhibited a pattern of activity in these regions consistent with fear inhibition. These results contradict the low-fear model of psychopathy and suggest that the low fear observed for psychopaths in previous studies may be specific to secondary psychopaths.

The impact of psychopathology, race, and environmental context on violent offending in a male adolescent sample.

Research has identified a multitude of demographic, psychological, and contextual factors that are associated with violent offending among youth. However, much of the previous research has focused on single factors, and little is known about the effects of these various factors in tandem. The present study examines whether certain community factors impact the effects of race and psychopathology on violent crime. Multivariate analyses were used to investigate race-psychopathology combinations and the moderating influence of exposure to community violence in a sample of youth (N = 1,116). Youth without antisocial personality disorder (APD) or psychopathy were less violent than the other diagnostic groups, and Black youth were less likely to have psychopathy compared with Whites and Hispanics. However, Black youth with APD and psychopathy were twice as likely to exhibit violent crime versatility. Furthermore, Black and Hispanic youth demonstrating aggressive conduct problems committed a greater number of violent crime types than Whites. This relationship was further qualified, such that Black and Hispanic youth with APD and psychopathy, who were more exposed to community violence, committed a greater number of violent crime types compared with Whites. These results suggest that prevention and intervention strategies should consider individual and community-level factors. (PsycINFO Database Record

Elevated Preattentive Affective Processing in Individuals with Borderline Personality Disorder: A Preliminary fMRI Study.

BACKGROUND: Emotion dysregulation is central to the clinical conceptualization of borderline personality disorder (BPD), with individuals often displaying instability in mood and intense feelings of negative affect. Although existing data suggest important neural and behavioral differences in the emotion processing of individuals with BPD, studies thus far have only explored reactions to overt emotional information. Therefore, it is unclear if BPD-related emotional hypersensitivity extends to stimuli presented below the level of conscious awareness (preattentively). METHODS: Functional magnetic resonance imaging (fMRI) was used to measure neural responses to happy, angry, fearful, and neutral faces presented preattentively, using a backward masked affect paradigm. Given their tendency toward emotional hyperreactivity and altered amygdala and frontal activation, we hypothesized that individuals with BPD would demonstrate a distinct pattern of fMRI responses relative to those without BPD during the viewing of masked affective versus neutral faces in specific regions of interests (ROIs). RESULTS: RESULTS indicated that individuals with BPD demonstrated increases in frontal, cingulate, and amygdalar activation represented by number of voxels activated and demonstrated a different pattern of activity within the ROIs relative to those without BPD while viewing masked affective versus neutral faces. CONCLUSION: These findings suggest that in addition to the previously documented heightened responses to overt displays of emotion, individuals with BPD also demonstrate differential responses to positive and negative emotions, early in the processing stream, even before conscious awareness.

Callous-Unemotional Traits Trajectories Interact with Earlier Conduct Problems and Executive Control to Predict Violence and Substance Use Among High Risk Male Adolescents.

Callous-unemotional (CU) traits, conduct problems (CP), and deficits in executive control are all linked to the development of more severe antisocial behavior, including violence and substance use. Though previous research has examined the impact of these factors on antisocial outcomes, little work has examined trajectories of CU traits across adolescence and how these trajectories predict greater antisocial behavior in adulthood. Moreover, no study has assessed how severity of early CP and executive control may exacerbate these pathways and increase risk for later violence and substance use. The current study (a) identified trajectories of CU traits among a large, high-risk sample of adolescent males, (b) examined the relationship between CU traits trajectories and future violence and substance use, and (c) examined whether early CP and executive control moderated the effects of a high CU traits trajectory membership and high CP on violence and substance use. Results indicated that: (a) CU traits could be grouped into three stable trajectories across adolescence, (b) the 'high' CU traits trajectory, particularly in the presence of 'elevated' CP, was related to higher violence and substance use, over and above a variety of environmental risk factors, and (c) the effects the 'high' CU traits trajectory on both violence and substance and in the presence of 'elevated' CP was stronger among youth with high executive control. These findings highlight the utility of identifying subgroups of youth who differ on trajectories of CU traits for understanding the development and maintenance of severe antisocial behavior.