# Emotion and psychopathy

* Multimedia presentation (5 min)

## Introduction

Psychopathy, otherwise known as Psychopathic Personality Disorder (PPD), has been the most studied personality disorder with much literature and research conducted in an attempt to understand it (Hesse, 2009).
There is a perception that psychopaths are noticeable within our society, that they fit a certain stereotype. This however, is incorrect. Psychopaths are characterised by their ability to be charming, agreeable, have above average intelligence and above all, lie with extreme conviction (Freedman, Verdun-Jones, 2010). Each of these hallmark traits of a psychopath can make them look just like you or I on the surface which is shown throughout history. Infamous psychopaths such as Charles Manson, Jeffery Palmer, (girl one), etc, may have looked “normal” enough on the surface, yet each committed crimes and held thoughts within themselves that are unconscionable to nonpsychopathic individuals.
Robert Hare designed the most commonly used measure to test for psychopathic traits in individuals and is still used today, with various additions to test for such traits in children (PCL- Youth Version) and as a screening measure (PCL: Screening Version) (Hare & Neumann, 2009).

## What is Psychopathy?

In his 1982 works Cleckley, a significant player in the field, defined psychopathy as a “psychological construct that describes chronic immoral and antisocial behaviour, a lack of consciousness, and the ability to lie and deceive without feeling guilt or discomfort” (Hesse, 2009).
According to Bishopp and Hare (2008), psychopaths are impulsive sensation seekers with a range of defining features. Such key features include superficial charm, absence of nervousness which would suggest low anxiety, unreliability, intelligence, and most significant of all, psychopaths lack empathy and remorse. Another key feature of psychopaths is their inability to learn from experience which, most troubling of all, means they do not respond to punishment (Bishopp & Hare). In part, this is due to psychopaths failing to accept responsibility for their actions and their lack of remorse (Freedman & Verdun-Jones, 2010). Other key features of psychopaths which often makes them appear like any other “normal” person, is their agreeableness and their ability to lie and be extremely convincing (Freedman, Verdun-Jones, 2010).
Psychopaths are considered as sane individuals in the mental health community according to Freedman and Verdun-Jones (2010). The basis for this being that psychopaths have an accurate sense of reality and “appear to be rational and aware of their actions”. Because of this, psychopathy is considered independent from any mental disorder. Also because psychopathy reflects innate dispositions as opposed to resulting from reactions to trauma or extreme dispositions as is the case in other forms of disorder (Bishopp & Hare, 2008).
The Psychopathy Checklist- Revised (PCL-R) was developed by Robert Hare and is “the most commonly used measure of psychopathic behaviour” (Hesse, 2009) and is used to measure psychopathic traits in individuals. The PCL-R is a rating scale comprised of 20 items, each pertaining to a different trait or symptom of psychopathy (Cooke, Hart, Hare & Michie, 1999). The rating scale is a 3-point scale based on 0= doesn’t apply, 1= item applies somewhat, and 2= item definitely applies (Cooke, Hart, Hare & Michie, 1999). The scores are totalled ranging from 0-40, reflecting how strongly the person matches the traits of a prototypical psychopathic person (Hare and Neumann, 2009). A score of 30 or higher is most often used as the cut off score to diagnose psychopathy (Cooke, et al, 1999).
The 20 items on this scale come under two factors. Factor 1 pertains to the “affective and interpersonal features” of psychopathy and is labelled Selfish, Callous, and Remorseless use of others. Factor 2 pertains to the “social deviance features of psychopathy” and is labelled Chronically Unstable and Antisocial Lifestyle (Cooke, et al, 2009).

## Items in the Hare Psychopathy Checklist—Revised

Item / Factor loading
Glibness/superficial charm/ 1
Grandiose sense of self-worth/ 1
Need for stimulation/proneness to boredom/ 2
Pathological lying/ 1
Conning/manipulative/ 1
Lack of remorse or guilt/ 1
Shallow affect/ 1
Callous/lack of empathy/ 1
Parasitic lifestyle/ 2
Poor behavioural controls/ 2
Promiscuous sexual behaviour/ -
Early behaviour problems/ 2
Lack of realistic, long-term goals/ 2
Impulsivity/ 2
Irresponsibility/ 2
Failure to accept responsibility for own actions/ 1
Many short-term marital relationships/ -
Juvenile delinquency/ 2
Revocation of conditional release/ 2
Criminal versatility/ -
Note. Factor 1 = Selfish, Callous, and Remorseless Use of Others; Factor 2 = Chronically Unstable and Antisocial Lifestyle. A dash indicates the item does not load on either factor.
Glenn, Raine and Schug (2009) suggest there are four factors of psychopathy, each of which are covered in Hare’s PCL-R. These four factors and their associated psychopathic traits are:

### Interpersonal Factor

* Glib, superficially charming
* Callous, manipulative
* Pathological lying
* Grandiose sense of self-worth

### Affective Factor

* Lack of remorse of guilt
* Shallow affect
* Callous, lacking empathy
* Failure to accept responsibility

### Lifestyle Factor

* Stimulation seeking
* Impulsive
* Irresponsible
* Parasitic lifestyle
* Lack of realistic goals

### Antisocial Factor

* Poor behavioural controls
* Early behaviour problems
* Juvenile delinquency
* Revocation of conditional release
* Criminal versatility

## Psychopathy and Emotion

According to diagnostic criteria, a main hallmark of psychopaths is their lack of emotion. They are unable to feel remorse, shame or empathy, all important personality traits to maintain a civilised society. There are many reasons as to why they cannot experience these emotions, ranging from neurobiological to environmental.
Fear is an emotional response innately experienced by, what should be, all human beings. There is much research however that suggests that psychopaths do not experience the responses of fear that non-psychopaths do. This further supports the notion that psychopaths lack emotion and is a distinctive characteristic of psychopathy. Freedman and Verdun-Jones (2010) discuss various studies that have tested different aspects of this notion that psychopaths do not have the same responses to fear, each resulting in the same findings. One study Freedman and Verdun-Jones (2010) noted as significant found when shown pleasant, neutral and unpleasant images, psychopaths blinking patterns and heart rates remained constant. As this is significantly different to the responses “normal” individuals would have, these findings support the notion that psychopaths are not emotionally affected by unpleasant images as well as not displaying signs of fear (Freedman & Verdun-Jones, 2010). Another study discussed by Freedman and Verdun-Jones (2010) involved psychopaths listening to sentencing designed to elicit fear. The results of this study found that not only did psychopaths not respond to these fear inducing sentences, but they also did not produce the same physiological responses as would be expected by “normal” people. In such a setting, one's muscles would usually tense on an unconscious level however psychopaths failed to show any signs of this. Freedman and Verdun-Jones (2010) suggest these findings indicate that psychopaths have difficulty interpreting emotion, particularly on this level of fear. According to Freedman and Verdun-Jones (2010), this difficulty interpreting emotion also pertains to identifying it being expressed by others. Research has found that psychopaths have difficulty identifying fear and sadness in other people although, interestingly, they can recognise happy facial expressions. This also applies to the psychopathic individual, that is, they can both experience happiness themselves and recognise that emotion in others, however they cannot experience, nor can they recognise fear (Freedman & Verdun-Jones, 2010).

## Neurobiological Processing

The lack of emotion psychopaths display has been argued to be a result of neurobiological deficits. Gao, Glenn, Raine, Schug and Yang (2009) discuss research which suggests deficits in the prefrontal cortex or in the amygdala are the main neurobiological areas that are associated with psychopathic-like traits. It is suggested reduced grey matter volume in the prefrontal cortex is associated with “poor decision-making, emotional dysregulation, and impaired moral judgment in psychopathic people” (Gao, Glenn, Raine, Schug & Yang, 2009). In terms of lack of remorse, it is suggested this could be due to deficits in the amygdala (Gao, Glenn, Raine, Schug & Yang, 2009). Cantani, Craig, Daley, Deely, Fahy, Kanaan, Latham, McGuire, Murphy and Picchioni (2009) suggest this effect of amygdala dysfunction is supported by research in which psychopaths performance in tasks sensitive to amygdala damage reflects that dysfunction. This research also suggests that amygdala volume is significantly reduced in psychopaths, as well as decreased brain activity in those areas controlled by the amydala during various learning and emotive tasks (Cantani, et al, 2009).
In support of reduced amygdala activity being the “core deficit in psychopathy Glenn, Raine and Schug (2009) suggest there is a strong association between the four factors of psychopathy and reduced activity in the amygdala, particularly during emotional moral decision making. Further research indicates the reduction in amygdala activity disrupts moral decision making in psychopaths and, as a result, making them unable to identify distress etc. in other individuals (Glenn, Raine and Schug, 2009). As a result of this disruption to amygdala functioning, psychopathic individuals may be undeterred from “conning and manipulating others, making impulsive, irresponsible decisions, and engaging in criminal behavior without feeling guilt or remorse”, all key characteristics of psychopathy (Glenn, Raine and Schug, 2009).

## Theories of Psychopathy
### Response Modulation Hypothesis (RMH)

According to the RMH, a failure to process the meaning of information they consider unimportant in terms of its effect on them personally, could explain psychopathic individuals “impulsivity, poor passive avoidance, and emotion-processing deficits” (Lorenz and Newman, 2002). Glass and Newman (2009) state that the based on RMH, psychopathic individuals can display normal emotional responses when it is their primary attentional focus, that is, when it relates to them specifically. In contrast, when faced with information that is secondary to their primary attentional focus, psychopathic individuals have difficulty processing this affective information, suggestibly because in the latter, they are not the focus (Glass and Newman, 2009). Response modulation is defined by Lorenz and Newman (2002) as “a brief and highly automatic shift of attention that enables individuals to monitor and, if relevant, use information that is peripheral to their dominant response set (i.e., deliberate focus of attention)”. According to Lorenz and Newman (2002), RMH is evident in such situations as when the psychopathic individual is avoiding punishment, a primary task as it directly affects them, and thus they display appropriate responses. In contrast, when attention needs to be on processing secondary information, that is, does not directly affect them, psychopathic individuals experience performance deficits (Lorenz and Newman, 2002).

### Gray’s Theory of Behavioural Inhibition System (BIS)

Gray’s BIS pertains to the inhibition of goal-directed behaviour, as in the RMH, as a result of potential threats or when inconsistent stimuli is detected within the environment (Baskin-Sommers, Curtin, MacCoon, Newman & Wallace, 2009). As a result of this inhibition, attention is redirected in an attempt to process the threatening stimuli (Baskin-Sommers, et al., 2009). According to Baskin-Sommers, Curtin, MacCoon, Newman and Wallace (2009), this process is based on the individuals past experiences with punishment and nonreward and, according to Glas and Newman (2009), when operating effectively, the BIS “enables a person to use environmental cues to anticipate future significant negative events and inhibit behaviour accordingly”. This theory is of importance specifically to psychopathy as according to Fowles (1980), “psychopathy could be understood as a consequence of weak BIS functioning”. Baskin-Sommers, et al. (2009) discuss supporting research which indicates and association between psychopathy and BIS-related deficiencies including poor passive avoidance learning and “weak skin conductance responses in anticipation of aversive events”.