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Running head: THE PSYCHOPATH NEXT DOOR 1
The Psychopath Next Door: How Similar Are They to Those Behind Bars? Criminality,
Executive Functioning, and Emotion Processing in ‘Noncriminal’ Psychopathy.
Emily Louise Adam
Bachelor of Arts (Psychology)
Bachelor of Psychological Science (Honours)
Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy (IF49)
The School of Psychology and Counselling
Faculty of Health
Institute of Health and Biomedical Innovation
Queensland University of Technology
2017
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Keywords
Criminality, psychopathy, noncriminal psychopathy, primary psychopathy, secondary psychopathy, executive function, emotion, emotion-processing, gender differences, lexical decision task.
Running head: THE PSYCHOPATH NEXT DOOR 3
“Though not deeply vicious, he carries disaster lightly in each hand”
Hervey Cleckley, The Mask of Sanity (1955)
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List of Abbreviations
ASD Antisocial Personality Disorder (in quoted material)
ASPD Antisocial Personality Disorder
ASPD+P Antisocial Personality Disorder with Psychopathy
ASPD-P Antisocial Personality Disorder without Psychopathy
AX-CPT A/X Continuous Performance Test
BAS Behaviour Activation System
BE Blame Externalisation
BIS Behavioural Inhibition System
C Coldheartedness
calCAP-SPM2 California Computerised Assessment Package Serial Pattern Matching 2
CAT Categories Achieved
CFA Confirmatory factor analysis
CH Coldheartedness
CN Carefree Nonplanfulness
CSS-M Criminal Sentiments Scale-Modified
CSS-R Criminal Sentiments Scale-Revised
DLPFC Dorsolateral prefrontal cortex
DSM Diagnostic and statistical manual of mental disorders
DSM-II Diagnostic and statistical manual of mental disorders second edition
DSM-III Diagnostic and statistical manual of mental disorders third edition
DSM-III-R Diagnostic and statistical manual of mental disorders third revised edition
DSM-IV Diagnostic and statistical manual of mental disorders fourth edition
DSM-IV-TR Diagnostic and statistical manual of mental disorders fourth revised edition
DSM-V Diagnostic and statistical manual of mental disorders fifth edition
EF Executive Function
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ERN Error-related negativity
ERP Event-related potential
F Fearlessness
F1 Factor one
F2 Factor two
FD Fearless Dominance
FFFS Fight-Flight-Freeze System
FFM Five-Factor Model of personality
HH High Factor 1 and Factor 2 Scores
HL High Factor 1 Scores and Low Factor 2 Scores
HR Heart Rate
IA Impulsive Antisociality
ICO Identification with criminal others
ID/ED Intradimensional/Extradimensional
IES Integrated Emotions Systems
IGT Iowa Gambling Task
IMC’s Instructional manipulation checks
IQ Intelligence Quotient
LCP Law-Court-Police
LDT lexical decision task
LH Low Factor 1 Scores and High Factor 2 Scores
LL Low Factor 1 and Factor 2 Scores
LSRP Levenson Self-Report Psychopathy
ME Machiavellian Egocentricity
MI Mental Illness
MPQ Multidimensional Personality Questionnaire – Brief form
NART National Adult Reading Tests
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NPE Nonperseverative errors
NTV Number of Traffic Violations
OFC Orbitofrontal cortex
OLD20 Orthographic Levenshtein distance
PAS Personality Assessment Screener
PCL Psychopathy Checklist
PCL:SV Psychopathy Checklist: Screening Version
PCL-R Psychopathy Checklist-Revised
PCL-R Psychopathy Checklist Revised
PCL-SV Psychopathy Checklist Screening Version
PCL-YV Psychopathy Checklist Youth Version
PE Preservative errors
PEBL Psychology Experiment Building Language
PET Positron Emission Tomography
PPI Psychopathic Personality Inventory
PPI:SF Psychopathic Personality Inventory: Short Form
PPI-C Psychopathic Personality Inventory
PPI-FD Psychopathic Personality Inventory-Fearless Dominance
PPI-I Psychopathic Personality Inventory
PPI-II Psychopathic Personality Inventory
PPI-R Psychopathic Personality Inventory-Revised
PPI-SCI Psychopathic Personality Inventory- Self-Centred Impulsivity
rCBF Cerebral blood flow
RMH Response Modulation Hypothesis
RN Rebellious Nonconformity
RST Reinforcement Sensitivity Theory
RT Reaction times
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SCI Self-Centred Impulsivity
SES Socioeconomic status
SI STOP-IT
SOI Social Influence
SPM-P Standard Progressive Matrices Plus
SRCS Self-reported criminal offending
SRCS Self-Report Criminality Scale
SRDS Self-Report Delinquency Scale
SRP-III Self-Report Psychopathy Scale – Version Three
SSDs Stop-signal delays
SSRT Stop-signal reaction time
STI Stress Immunity
TLV Tolerance for law violations
TMT-B Trail-Making Test Part B
TOL Tower of London
TOL-DX Tower of London Drexal University
WAIS Weschler Abbreviated Scale for Intelligence
WAIS-III Weschler Adult Intelligence Scale – Third Edition
WAS Welsh Anxiety Scale
WCST Wisconsin Card Sorting Test
WCST:CV4 Wisconsin Card Sorting Test: Computer Version Four
WISC-III Wechsler Intelligence Scale for Children Third Edition;
WMC Working memory capacity
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Table of Contents
List of Abbreviations ................................................................................................................. 4
List of Figures .......................................................................................................................... 14
List of Tables ........................................................................................................................... 15
Abstract .................................................................................................................................... 18
Acknowledgements .................................................................................................................. 19
Chapter One - Thesis Overview ............................................................................................... 21
Chapter Overview ................................................................................................................ 21
Background and Context ...................................................................................................... 21
Purpose of Research Program .............................................................................................. 22
Thesis Structure .................................................................................................................... 23
Chapter Two - General Literature Review ............................................................................... 24
Chapter Overview ................................................................................................................ 24
Psychopathy Defined ............................................................................................................ 24
Assessment of Criminal Psychopathy .................................................................................. 26
Assessment of Noncriminal Psychopathy ............................................................................ 27
Review of Psychopathy Assessments .................................................................................. 28
Psychopathy Variants ........................................................................................................... 29
Psychopathy and Antisocial Personality Disorder ............................................................... 31
Psychopathy and Affective Deficits ..................................................................................... 34
Psychopathy and Cognitive Deficits .................................................................................... 40
Executive Functioning .......................................................................................................... 41
Summary of Affective and Cognitive Deficits ..................................................................... 45
Theories of Psychopathy .......................................................................................................... 46
Lykken’s Low Fear Hypothesis ........................................................................................... 46
Gray’s Reinforcement Sensitivity Theory ............................................................................ 48
The Somatic Marker Hypothesis .......................................................................................... 50
The Integrated Emotions Systems Model ............................................................................ 52
The Response Modulation Hypothesis ................................................................................. 54
Review of Current Theories of Psychopathy ....................................................................... 55
What is Noncriminal Psychopathy? ..................................................................................... 56
Theoretical Perspectives of Noncriminal Psychopathy ........................................................ 57
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Subclinical psychopathy. .................................................................................................. 58
Successful psychopathy. ................................................................................................... 58
A dual process model of psychopathy. ............................................................................. 59
Triarchic Model of Psychopathy .......................................................................................... 60
Review of Theories of ‘Noncriminal’ Psychopathy ............................................................. 61
The Current Research ........................................................................................................... 62
Original Contribution to Knowledge ....................................................................................... 62
Psychopathy and Criminality ............................................................................................... 62
Executive Function ............................................................................................................... 63
Emotion Processing .............................................................................................................. 63
Research Questions .................................................................................................................. 65
Research Question One: How central is criminal behaviour to the construct of psychopathy? ........................................................................................................................ 66
Research Question Two: Is the relationship between criminality and psychopathy the same for males and females? ......................................................................................................... 66
Research Question Three: What is the relationship between psychopathy variants and executive function in a community sample? ........................................................................ 66
Research Question Four: Is the pattern of relationships between psychopathy variants and executive function the same for males and females? ........................................................... 67
Research Question Five: What is the relationship between psychopathy variants and emotion processing in a community sample? ...................................................................... 67
Research Question Six: Is the relationship between psychopathy variants and emotion processing abnormalities the same for males and females? ................................................. 67
Chapter Three........................................................................................................................... 68
Chapter Overview ................................................................................................................ 68
Background to Research ....................................................................................................... 68
Examination of the PCL-R. .............................................................................................. 70
Noncriminal Measures of Psychopathy. ........................................................................... 73
Theories of noncriminal psychopathy. ............................................................................. 76
Crime and Criminality. ..................................................................................................... 79
Gender. ............................................................................................................................. 82
The Current Study .................................................................................................................... 84
Method ..................................................................................................................................... 86
Participants ........................................................................................................................... 86
Materials ............................................................................................................................... 88
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Demographic questionnaire. ............................................................................................. 88
Levenson Self-Report Psychopathy Scale (LSRP) (Levenson et al., 1995). .................... 88
The Criminal Sentiments Scale Modified (CSS-M) (Simourd, 1997). ............................ 89
Self-Report Criminal Activity Scale. ................................................................................ 90
Instructional manipulation checks (IMC’s) (Oppenheimer, Meyvis, & Davidenko, 2009). .......................................................................................................................................... 90
Procedure .............................................................................................................................. 90
Design ...................................................................................................................................... 91
Results ...................................................................................................................................... 92
Data Screening ..................................................................................................................... 92
Descriptive Statistics ............................................................................................................ 92
Inferential Statistics .............................................................................................................. 94
Criminal Attitudes. ........................................................................................................... 95
Attitudes Toward Law, Courts and Police. ....................................................................... 97
Tolerance for Law Violations. .......................................................................................... 99
Identification with Criminal Others. ............................................................................... 101
Self-Reported Criminal Behaviour. ................................................................................ 103
Follow-up Mediation Analyses .......................................................................................... 105
Discussion .............................................................................................................................. 108
Overview of Research ........................................................................................................ 108
Key Findings ...................................................................................................................... 108
Gender. ........................................................................................................................... 108
Criminal convictions and traffic violations. ................................................................... 109
Criminal attitudes. .......................................................................................................... 109
Self-Reported Criminal Behaviour. ................................................................................ 112
Implications, Limitations, and Future Directions .................................................................. 115
Chapter Summary .................................................................................................................. 116
Chapter Four .......................................................................................................................... 117
Chapter Overview .............................................................................................................. 117
Background to Research ........................................................................................................ 119
Executive Function ................................................................................................................ 120
Hot and Cool Executive Function .......................................................................................... 122
Cool Executive Functions in Psychopathy ............................................................................ 126
Cool Executive Function in Unsuccessful Psychopathy ........................................................ 128
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Cool Executive Function in Successful Psychopathy ............................................................ 136
Summary of Cool Executive Functioning in Successful and Unsuccessful Psychopathy . 143
The Current Study .................................................................................................................. 157
Aims and Hypotheses ......................................................................................................... 160
Method ................................................................................................................................... 161
Participants ......................................................................................................................... 161
Materials ............................................................................................................................. 162
The Psychopathic Personality Inventory-Revised (PPI-R) (Lilienfeld & Widows, 2005). ........................................................................................................................................ 162
The Wisconsin Card Sorting Task (WCST). .................................................................. 163
The N-Back Task. ........................................................................................................... 164
The Tower of London. .................................................................................................... 164
The Stop-Signal Task. .................................................................................................... 165
The Raven’s Standard Progressive Matrices Plus (SPM-P). .......................................... 165
Procedure ............................................................................................................................ 166
The computerised executive function tasks. ................................................................... 166
The WCST:CV4. ............................................................................................................ 166
The N-Back..................................................................................................................... 167
STOP-IT (Verbruggen et al., 2008). ............................................................................... 167
TOL-DX (Culbertson & Zillmer, 1998; Mueller, 2010). ............................................... 168
Design .................................................................................................................................... 168
Results .................................................................................................................................... 169
Data Screening ................................................................................................................... 169
Descriptive Statistics ...................................................................................................... 170
Inferential Statistics ........................................................................................................ 173
Psychopathic Personality Inventory – Revised .................................................................. 175
Raven’s Standard Progressive Matrices-Plus ..................................................................... 175
Tower of London ................................................................................................................ 176
Tower of London -Total Score. ...................................................................................... 176
Tower of London – Planning and Execution Time. ....................................................... 179
Stop-Signal Reaction Time ................................................................................................ 181
Wisconsin Card Sorting Task ............................................................................................. 182
Categories Achieved. ...................................................................................................... 182
Percentage of Perseverative Errors. ................................................................................ 182
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N-Back Task ....................................................................................................................... 184
Self-Report Criminality Scale (SRCS) ............................................................................... 185
Discussion .............................................................................................................................. 186
Overview of Research ........................................................................................................ 186
Key Findings ...................................................................................................................... 187
Males. ............................................................................................................................. 188
Females. .......................................................................................................................... 190
Psychopathy, Executive Function, and Self-Report Criminality ....................................... 193
Limitations and Directions for Future Research ................................................................ 194
Chapter Summary ............................................................................................................... 195
Chapter Five ........................................................................................................................... 196
Chapter Overview .............................................................................................................. 196
Emotion Deficits in Psychopathy ....................................................................................... 197
Emotion Deficits in Primary and Secondary Psychopathy ................................................ 200
Affective and Semantic Language Processing ................................................................... 202
Lexical Decision Task Research in Psychopathy ............................................................... 204
Summary of Implicit Language Tasks in Psychopathy ...................................................... 210
Study 3 ................................................................................................................................... 212
Method ................................................................................................................................... 213
Participants ......................................................................................................................... 213
Materials ............................................................................................................................. 214
Demographic questionnaire. ........................................................................................... 214
The Psychopathic Personality Inventory-Revised (PPI-R) (Lilienfeld & Widows, 2005). ........................................................................................................................................ 214
Word Stimuli. ................................................................................................................. 215
Pseudoword stimuli. ....................................................................................................... 215
Procedure ............................................................................................................................ 216
The Lexical Decision Task. ............................................................................................ 216
Word rating task. ............................................................................................................ 217
Design................................................................................................................................. 218
Results .................................................................................................................................... 218
Data Screening ................................................................................................................... 218
Lexical Decision Data ........................................................................................................ 219
Psychopathy and Priming Effects ................................................................................... 220
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Word Rating Task .............................................................................................................. 222
Discussion .............................................................................................................................. 224
Overview of Research ........................................................................................................ 224
Key Findings ...................................................................................................................... 225
Psychopathy and priming. .............................................................................................. 225
Psychopathy and word ratings. ....................................................................................... 226
Summary of Findings ......................................................................................................... 227
Limitations, Implications and Directions for Future Research .............................................. 228
Chapter Six............................................................................................................................. 229
Psychopathy and Criminality ............................................................................................. 230
Executive Function ............................................................................................................. 231
Emotion Processing ............................................................................................................ 233
Theoretical Implications, Practical Applications, and Directions for Future Research ..... 234
References .............................................................................................................................. 236
Appendix 1 ............................................................................................................................. 277
Appendix 2 ............................................................................................................................. 278
Appendix 3 ............................................................................................................................. 280
Appendix 4 ............................................................................................................................. 282
Appendix 5 ............................................................................................................................. 283
Appendix 6 ............................................................................................................................. 284
Appendix 7 ............................................................................................................................. 292
Appendix 8 ............................................................................................................................. 294
Appendix 9 ............................................................................................................................. 300
Appendix 10 ........................................................................................................................... 301
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List of Figures
Figure 1 Conceptual diagram of the Direct and Indirect Effects of Secondary
Psychopathy on Self-Reported Criminal Behaviour for Males. …………………….Page 106
Figure 2 Conceptual diagram of the Direct and Indirect Effects of Secondary
Psychopathy on Self-Reported Criminal Behaviour for Females. …………………….Page 107
Figure 3a. Conceptual diagram of the Direct and Indirect Effects of Self-Centred
Impulsivity on Tower of London Performance for Males. ……………………………. Page 178
Figure 3b. Conceptual Diagram of the Direct and Indirect effects of Self-Centred
Impulsivity on Tower of London Execution Times for Males. …………………………Page 178
Figure 4. Example trial sequences: (a) congruent emotion word trial (b) incongruent
concrete word trial. ………………………………………………………………………….Page 217
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List of Tables
Table 1 Participant Demographics (N = 523)……………………………………….Page 87
Table 2 Descriptive Statistics for Psychopathy and Criminal Attitudes for Males and
Females…………………………………………………………………………………………...Page 94
Table 3 Bivariate Correlations between Psychopathy and Criminal Attitudes
(Correlations Below the Diagonal Are for Males, Above the Diagonal for Females). Page 95
Table 4 Hierarchical Multiple Regression Predicting Criminal Attitudes from Primary
and Secondary Psychopathy Separately for Males and Females…………………………Page 97
Table 5 Hierarchical Multiple Regression Predicting Attitudes Toward Law, Courts,
and Police from Primary and Secondary Psychopathy Separately for Males and
Females…………………………………………………………………………………………..Page 99
Table 6 Hierarchical Multiple Regression Predicting Tolerance for Law Violations
from Primary and Secondary Psychopathy Presented Separately for Males and
Females……………………………………………………………………………………… Page 101
Table 7 Hierarchical Multiple Regression Predicting Identification with Criminal
Others from Primary and Secondary Psychopathy for Males and Females…………Page 103
Table 8 Hierarchical Multiple Regression Predicting Criminal Behaviour from
Primary and Secondary Psychopathy for Males and Females…………………………Page 105
Table 9 Studies Examining Behavioural Performance on Measures of Cool Executive
Function in Psychopathy……………………………………………………………………Page 146
Table 10 Descriptive Statistics for Psychopathy and Executive Function for Males and
Females………………………………………………………………………………………..Page 162
Table 11 Bivariate Correlations between Psychopathy and Executive Function for
Males and Females (Males are below the diagonal, females above) .Page 172
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Table 12 Mediated Regression Predicting Tower of London Execution Times from Self-
Centred Impulsivity and Cognitive Ability for Females. ……………………………….Page 174
Table 13 Mediated Regression Predicting Tower of London Execution Times from Self-
Centred Impulsivity and Cognitive Ability for Females…….…………………………..Page 181
Table 14 Priming effects, presented separately for each gender, for concrete, abstract
and emotion words (in milliseconds)………………………………………………………Page 220
Table 15 Correlations between Psychopathy Factors and Priming Effects for Males and
Females…………………………………………………………………………………………Page 220
Table 16 Mean word ratings for positive, negative, abstract and concrete words on
concreteness, imageability, context availability, arousal, and valence………………...Page 221
Table 17 Correlations between Psychopathy Factors and Word Ratings for Males and
Females………………………………………………………………………………………….Page 222
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Abstract
The current thesis provides an original contribution to knowledge through the examination of
psychopathy in a mixed gender community sample with a noncriminal measure of
psychopathy. Most research on psychopathy, a personality disorder characterised by
callousness, manipulativeness, deceitfulness, and a lack of emotion, has used predominately
male criminal samples and criminal measures of psychopathy. This monofocal approach
conflates psychopathy with criminality and has resulted in a dearth of knowledge regarding
the nature and presentation of psychopathy in females and in the general population. This
research tested prominent theories of psychopathy by examining criminality, executive
functioning, and emotion-processing in psychopathy in a community sample. Gender
differences were also examined. Study 1 examined the relationship between psychopathy and
criminality using a comprehensive survey; Study 2 explored executive function in
psychopathy using a series of computer-based executive function tests, and Study 3 focused
on emotion-processing in psychopathy using a lexical decision task. The results from Study 1
showed that psychopathy was a poor predictor of criminal behaviour and attitudes, for both
genders. In Study 2, while psychopathy predicted executive dysfunction in males, for
females, psychopathy predicted superior executive function. In Study 3, there were no
significant relationships between psychopathy and emotion-processing in either males or
females. However, gender differences were also observed for emotion-processing. These
findings suggest that while current theories of psychopathy explain male, criminal
psychopathy well (as would be expected given the tautology with sampling and
measurements), they do not adequately explain noncriminal psychopathy nor female
psychopathy.
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Acknowledgements
First and foremost, I would like to express my deep gratitude for the support and
mentoring provided by my primary supervisor, Renata Meuter. Renata, you have finessed the
art of postgraduate student supervision by providing me with enough support and advice to
get me through, but enough space to be an independent researcher. In addition to sharing your
exceptional content knowledge on language processing, E-prime, and virtually all aspects of
cognitive psychology, you have been a consistent advocate for me throughout the PhD
journey. I would never have finished this PhD had it not been for your support,
encouragement, and advice – thank you, thank you, thank you! I would also like to thank my
associate supervisor, Nigar Khawaja, who joined the PhD supervision team late in the
program. Nigar, thank you for reviewing drafts of my thesis and for setting expectations of
me that kept me motivated and on task.
To my husband Troy, thank you for listening to me whine about the PhD program and
for encouraging me out of my ‘imposter syndrome’ episodes. You have supported and loved
me not just through the PhD journey, but through all the wonderful and horrible life
circumstances throughout the past 8 years. A wife could not ask for a more loyal, supportive,
patient, or loving husband.
To my parents, Rick and Janine, thank you for your unwavering support for me. You
have loved me, encouraged me, nurtured me, and raised me to be the woman I am today.
Mum, you taught me to be a kind and empathetic person and you inspire me to be a better
person through the example that you set every day. Papa, thank you for raising me to be a
strong, determined, and confident woman. Your love, support, and belief in me has enabled
me to pursue my dreams and aspirations. To my siblings, Rachael and Kieran, thank you for
being my lifelong best friends and confidantes.
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Thank you to my PhD peers, Louise Starfelt, Sherrie-Ann Kaye, Shannon Edmed,
Alicia Allen, Jim Oxtoby, Vincent Tam, Ivan Chang, Cassandra Pattinson, Daniel Joyce,
Sophie Miller, and Rachel and Stuart Leske. I couldn’t have asked for a better group of
people to go to work with every day. You all made the PhD journey so much more enjoyable
and I will never forget the good times we had navigating the academic world.
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Chapter One - Thesis Overview
Chapter Overview
This chapter of the thesis provides an overview of the current program of research. In
an attempt to increase understanding on the nature and presentation of psychopathy, the
relationships between criminality, executive functioning, and emotion processing in
psychopathy were examined using a community sample. Although interest in female
psychopathy and noncriminal psychopathy has increased in recent times, the current body of
literature on psychopathy primarily reflects male, criminal psychopathy. Very little is known
about the presentation of psychopathy in females, and it is unclear whether research findings
in male psychopaths generalize to female psychopaths. Furthermore, the focus on criminal
offenders and the use of criminal scales to assess psychopathy has resulted in the conflation
of psychopathy and criminality. Thus, the primary goal was to extend psychopathy research
to female and noncriminal psychopathy using a community sample. To do this, current
theoretical models of noncriminal psychopathy were examined and their applicability to
noncriminal psychopathy and female psychopathy were assessed in the three studies
presented throughout this thesis. A brief background to the research is outlined in this
chapter, along with the presentation of the rationale and aims of the research program, the
chapter concludes with the presentation of the structure of the thesis.
Background and Context
The psychopathic personality produces considerable personal, financial and societal
burdens, including, an increased risk for domestic violence (Coid & Yang, 2011), an
increased incidence of workplace bullying (Boddy, 2011), negative impacts of corporate
psychopaths on employee well-being and productivity (Boddy, 2014), and an increased
incidence of general, violent, and sexual recidivism in criminal psychopathy (Hemphill, Hare
&Wong, 1998). Given the negative impact of psychopathy on families and society more
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broadly it is not surprising that a considerable amount of research has focused on elucidating
the etiological mechanisms that give rise to this personality, along with attempts to treat and
reform individuals with psychopathy. However, because psychopathy has long been
associated with both serious and recidivist criminal behaviour (Hemphill, Hare & Wong,
1998), the majority of research on psychopathy has focused on criminal manifestations of
psychopathy. This program of research aims to extend the research literature on psychopathy
by highlighting the limitations of previous research that have focused exclusively on criminal
offender samples. Specifically, it will be argued that the use of predominately male, criminal
offender samples and the use of measures of psychopathy that explicitly tap criminality are
problematic and interfere with the interpretation of research on psychopathy. It will be argued
that the majority of previous research on psychopathy is confounded by criminality and the
prevalent belief that criminal behaviour is central to psychopathy cannot be justified by the
existing research literature.
Purpose of Research Program
The current research program addresses a significant gap in the psychopathy literature
which has primarily focused on male, criminal psychopathy. Because previous literature has
focused on criminal psychopathy, and emphasises criminality as a key feature, the goals of
the current program of research were to (a) extend psychopathy research to a community
sample; (b) examine the relationship between psychopathy and criminality using a
community sample and noncriminal measure of psychopathy; (c) examine executive
functioning in psychopathy as a way to test current theoretical models of psychopathy and to
establish whether previous findings in criminal psychopathy also extend to noncriminal
psychopathy; (d) examine emotion processing in psychopathy and establish whether findings
of affective abnormalities in criminal psychopathy extend to noncriminal psychopathy; (e)
examine possible gender differences in psychopathy and the manifestation of criminal
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behaviour, executive functioning, and emotion processing. These research aims were
addressed by three broad studies that are described in chapters three, four, and five of this
thesis.
Thesis Structure
This thesis contains six chapters. Chapter one provides an overview of the research
program and thesis. The second chapter provides a general introduction to the current body of
literature on psychopathy, highlights potential problems with current findings, and provides a
brief rationale for the program of research presented in chapters three, four, and five.
Chapters three to five outline the background, aims, method, results and discussion of the
three studies designed to address the aforementioned aims of the current program of research.
Chapter three provides a more detailed review of the psychopathy assessment
literature, describes theories of noncriminal psychopathy, and outlines the method and results
of Study 1. Chapter four describes the background, methods and findings of the second study,
which examines whether findings of executive dysfunction in criminal psychopathy also
extend to noncriminal and female psychopathy, and whether there are differential
relationships between executive function and primary and secondary psychopathy. Chapter
five describes the background, methods and findings of the third study, which examines the
relationship between primary and secondary psychopathy and emotion processing in a
noncriminal sample, including an examination of possible gender differences. Chapter six
summarises the findings of the current program of research in the context of the current
literature, and provides some direction for future research.
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Chapter Two - General Literature Review
Chapter Overview
This chapter provides the general background of the psychopathy literature. It begins
by defining the psychopathy construct, including coverage of the controversies in the
conceptualization and assessment of psychopathy. The current theoretical perspectives on the
etiology of psychopathy are set-out, followed by discussion of the notion of noncriminal
psychopathy. Through discussion of the current theories, measures, and approaches to the
study of psychopathy, gaps in the literature between theoretical conceptualisations and the
modern approach to the study of psychopathy become apparent. Specifically, it will be
argued that the over-use of criminal samples and the mono-operationalisation of psychopathy
have resulted in the conflation of psychopathy and criminality. Furthermore, it will be argued
that the male bias in the scientific study of psychopathy hinders understanding and may result
in less effective treatments for psychopathic females. The global objective here is to
empirically test two theories of psychopathy: the successful psychopathy model and the dual
process model. There is an additional focus on examining gender differences in the
manifestation of psychopathy. The chapter concludes with a presentation of the aims and
research questions of the current program of research.
Psychopathy Defined
The psychopathic individual is characterized by an excessive sense of self-worth, a
propensity towards deception, impulsivity, and a failure to learn from previous experience.
(Cleckley, 1951; Hare, 1991; Lilienfeld & Widows, 2005). Interpersonally, they are known
for their superficial charm, manipulativeness, and exploitation of others for personal gain.
Emotionally, they lack the capacity for genuine love, fear, empathy, and remorse.
Behaviourally, psychopathic individuals have a reputation for being impulsive and
irresponsible, and controversially, some theorists claim that antisocial behaviour is a defining
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attribute (Hare, 1991). Although the early psychiatric literature describes individuals
displaying ‘manie sans délire’ (Pinel, 1801) ‘innate, preternatural moral depravity’ (Rush,
1812, p. 360), and ‘moral insanity’ (Pritchard, 1835), it was Hervey Cleckley (1941, 1948,
1951) who offered one of the first clear descriptions of the psychopathy construct with his
16-item checklist of interpersonal, affective, and behavioural symptoms. The criteria include:
1. Superficial charm and good “intelligence”
2. Absence of delusions and other signs of irrational thinking
3. Absence of “nervousness” or psychoneurotic manifestations
4. Unreliability
5. Untruthfulness and insincerity
6. Lack of remorse or shame
7. Inadequately motivated antisocial behaviour
8. Poor judgment and failure to learn by experience
9. Pathologic egocentricity and incapacity for love
10. General poverty in major affective reactions
11. Specific loss of insight
12. Unresponsiveness in general interpersonal relations
13. Fantastic and uninviting behaviour with drink and sometimes without
14. Suicide rarely carried out
15. Sex life impersonal, trivial, and poorly integrated
16. Failure to follow any life plan (Cleckley, 1941, pp. 338-339)
Cleckley’s clinical accounts have been hugely influential in the modern
conceptualisation and measurement of psychopathy. The most commonly used and
empirically validated measure of psychopathy, the Psychopathy Checklist Revised (PCL-R)
(Hare, 1991), was developed specifically from Clecklian criteria.
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Assessment of Criminal Psychopathy
Although reports of the psychopathic personality appear consistently throughout the
psychological literature (Herve & Yuille, 2007), the development of a valid empirical
measurement of psychopathy is a relatively recent addition. Hare (1980) was the first to
develop a standardised and reliable measurement of psychopathy with the Psychopathy
Checklist (PCL) (now Psychopathy Checklist-Revised [PCL-R]) (Hare, 1991). The
construction of the Psychopathy Checklist was based on Cleckley’s clinical description of
interpersonal, affective, and behavioural abnormalities. Research on the factor structure of the
PCL-R has produced varying factor structures, including two-factor (Hare, 1991), three-
factor (Cooke & Michie, 2001), and four-factor models (Hare & Neumann, 2005). Although
there is relatively little consensus amongst researchers on which factor structure best captures
PCL-R psychopathy, the two-factor structure is consistent with historical conceptualisations
of psychopathy as consisting of two distinct yet related variants (Blackburn, 1975; Karpman,
1941; Lykken, 1995). PCL-R Factor one (F1) reflects the interpersonal and affective
characteristics of psychopathy, such as superficial charm, egocentricity, deceitfulness,
blunted affect and a lack of inhibitory emotions (i.e., fear, guilt and remorse). PCL-R Factor
two (F2) reflects the behavioural and lifestyle features of psychopathy, such as impulsivity,
irresponsibility and a lack of long-term goals, and is associated with the experience of
negative affect (i.e., fear, anxiety and hostility).
The PCL-R has contributed enormously to the scientific study of psychopathy and is
considered by many to be the ‘gold standard’ of psychopathy measurement (e.g., Fulero,
1995). However, the PCL-R is not without limitations. The PCL-R consists of a 20-item
clinical rating scale completed by a trained clinician on the basis of extensive interviews and
information gathered from institutional files. As a result, the administration of the PCL-R is a
lengthy and involved process, and the reliance on institutional files makes it unsuitable for
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nonclinical populations. Furthermore, the PCL-R was developed and standardised on criminal
offender samples, and includes assessment items that specifically capture previous criminal
behaviour. This focus on criminal samples and the antisocial behavioural aspects of
psychopathy has been a topic of recent debate (Skeem & Cooke, 2010a, 2010b). Specifically,
some researchers point out that the focus on criminal behaviour in the PCL-R measurement
of psychopathy is inconsistent with the theoretical foundations on which it was originally
constructed (Blackburn, 2005; Skeem & Cooke, 2010a). Given the heavy focus on criminal
samples and criminal behaviour in the development and standardisation of the PCL-R, it
follows that the PCL-R is best viewed as a measurement of criminal psychopathy, not the
broad theoretical construct of psychopathy.
Assessment of Noncriminal Psychopathy
The study of psychopathy outside of forensic samples was hindered by the absence of
suitable assessment techniques. However, the advent of self-report measurements of
psychopathy has provided researchers with an avenue to study noncriminal psychopathy. The
two most promising self-report measures of noncriminal psychopathy are the Levenson Self-
Report Psychopathy Scale (LSRP) (Levenson, et al., 1995) and the Psychopathic Personality
Inventory-Revised (PPI-R) (Lilienfeld & Widows, 2005). The Levenson Self-Report
Psychopathy Scale (Levenson, et al., 1995) is a self-report measure of psychopathy. The
LSRP consists of two related subscales: the LSRP Primary Scale and the LSRP Secondary
Scale. Similar to the two-factor model of the PCL-R, primary psychopathy reflects the
interpersonal and affective features of psychopathy and secondary psychopathy reflects the
behavioural and lifestyle features of psychopathy. The LSRP possesses good psychometric
properties (Levenson, et al., 1995; Lynam, Whiteside, & Jones, 1999) and has been shown to
capture the same two-factor structure as the PCL-R (Levenson, et al., 1995). More
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importantly, the LSRP does not contain items that tap criminality, making it a useful measure
of noncriminal psychopathy.
The Psychopathic Personality Inventory-Revised (Lilienfeld & Widows, 2005) is
another promising self-report measure of psychopathy. The PPI-R was developed for use in
non-institutionalised samples and does not contain items that assess criminality. The PPI-R is
psychometrically reliable and captures the same two factor structure as the PCL-R (Lilienfeld
& Widows, 2005). Validity research on the PPI-R has shown that the two factors are strongly
correlated with composite scores from the Multidimensional Personality Questionnaire
(MPQ; Patrick, Curtin and Tellegen, 2002), and the factors display significant correlations
with internalising and externalising behaviours that are consistent with theoretical accounts of
psychopathy (Witt, Donnellan, Blonigen, Krueger & Conger, 2009). With the advent of
psychometrically reliable measures of noncriminal psychopathy, researchers now have the
opportunity to investigate the mechanisms underlying the range of affective and cognitive
dysfunction observed in psychopathy, without the confounding effect of criminality.
Review of Psychopathy Assessments
The measure of psychopathy utilised often reflects the researcher’s theoretical
position regarding the role of severe anti-sociality in psychopathy and/or the research sample
of interest. Typically, those who endorse the view of criminality as central to psychopathy
utilise the PCL-R measures (i.e., PCL-R, PCL-SV, PCL-YV, and P-SCAN), and those who
view criminality as an epiphenomenon utilise the LSRP or the PPI-R. Additionally,
researchers interested in criminal samples often utilise the PCL-R, whereas the LSRP and
PPI-R are more commonly used when investigating psychopathy in noncriminal populations.
However, a consistent finding across all measures of psychopathy is the emergence of two
separate, yet related aspects of psychopathy, an interpersonal and affective facet, and an
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antisocial-lifestyle facet. This finding aligns with theoretical conceptualisations of
psychopathy as consisting of two related, yet separate, variants (e.g., Karpman, 1941).
Psychopathy Variants
Karpman (1941) was the first to suggest the existence of two variants of psychopathy
that appeared phenotypically similar but were distinct in the underlying core deficits and
etiology. Karpman (1941, 1948) suggested that primary psychopathy or “idiopathic”
psychopathy was associated with a heritable deficit in affective experience, whereas
secondary psychopathy or “symptomatic” psychopathy was associated with affective
dysfunction resulting from negative environmental experiences. According to Karpman
(1941) primary psychopathy is characterized by an innate inability to experience negative
emotional states, including fear and anxiety, which interferes with socialisation. In contrast,
Karpman suggested that secondary psychopathic individuals experience increased levels of
negative affect, and have the capacity for empathy. Differentiating psychopathy variants has
important clinical implications. Although both primary and secondary variants are
phenotypically similar, if different etiological processes give rise primary and secondary
psychopathy, then it is plausible that interventions that may be effective for secondary
psychopathy may not be effective for primary psychopathy, and vice versa.
Research focused on disaggregating psychopathy variants has shown that primary
psychopathy and secondary psychopathy display distinct etiological markers and divergent
patterns of relationships with external variables (e.g., socioeconomic status (SES) variables)
(Benning, Patrick, Hicks, Blonigen, & Krueger, 2003; Morrison & Gilbert, 2001). A key
distinguishing feature of primary and secondary psychopathy is the experience of negative
affect (i.e., fear, anxiety and remorse) (Frick, Lilienfeld, Ellis, Loney, & Silverthorn, 1999;
Patrick, 1994). Numerous studies have shown that primary psychopathy is associated with a
paucity of negative emotions (K. S. Blair, Morton, Leonard, & Blair, 2006; Frick et al., 1999;
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Lykken, 1957). Specifically, primary psychopathy is associated with a lack of fear and
anxiety (Lykken, 1957; Ogloff & Wong, 1990), poor passive avoidance to punishment when
the task involves competing goals (Newman & Kosson, 1986), and decreased electrodermal
responsivity to punishment cues (Lykken, 1957). In contrast, secondary psychopathy is
associated with elevated levels of negative affect, specifically, anxiety, fear and hostility
(Hicks, Markon, Patrick, Krueger, & Newman, 2004; Vassileva, Kosson, Abramowitz, &
Conrod, 2005). The experience of negative affect is often used to distinguish between
primary and secondary psychopathy.
In addition to the affective differences between primary and secondary psychopathy, a
range of socioeconomic and behavioural differences have also been observed. Secondary
psychopathy is positively associated with lower SES factors, lower educational levels and
lower verbal intelligence (Benning et al., 2003). In contrast, primary psychopathy is
negatively associated with these factors (Benning et al., 2003). Additionally, secondary
psychopathy and primary psychopathy differ in respect to aggressive behaviour. Empirical
findings demonstrate that primary psychopathy is associated with increased rates of both
instrumental and reactive aggression (Reidy, Zeichner, Miller, & Martinez, 2007).
Conversely, secondary psychopathy is only associated with increased rates of reactive
aggression (Reidy et al., 2007).
These differences in affective, socioeconomic and behavioural functioning suggest
that although primary and secondary psychopathy share some similar behavioural features,
they are actually two separate variants in terms of dysfunction and etiology. Research using
twins has demonstrated a distinct genetic architecture for primary psychopathy and secondary
psychopathy (Blonigen, Carlson, Krueger, & Patrick, 2003; Blonigen, Hicks, Krueger,
Patrick, & Iacono, 2005). According to the dual process model, primary and secondary
psychopathy arise from distinct neurobiological deficits (Patrick & Bernat, 2009). According
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to this theory, primary psychopathy stems from dysfunctional neurobiological systems
responsible for motivation and emotion. On the other hand, secondary psychopathy is thought
to result from deficits in brain regions responsible for higher order cognitive functioning.
Taken together, the observed differences between the two variants highlights the need to
distinguish between primary and secondary psychopathy and the phenomenon of interest
when conducting psychopathy research.
It is evident that a complex pattern of both affective and behavioural anomalies have
been observed in primary and secondary psychopathy. However, the majority of previous
research has utilised criminal offender samples. The estimated prevalence of psychopathy in
prison populations (approximately 30%) (Hare, 1991) versus the estimated prevalence of
psychopathy in the general population using PCL measures (approximately 1-6%) (Coid,
Yang, Ullrich, Roberts, & Hare, 2009) makes criminal offender samples a convenient
recruitment option. However, the exclusive use of criminal offender samples provides a
relatively narrow perspective of psychopathy. The etiological mechanisms that lead to
criminal psychopathy (both primary and secondary variants) may not be the same as those in
psychopathy more broadly. Therefore, in order to gain a clearer understanding of the
biological and environmental processes that produce psychopathy, both criminal and
otherwise, research utilising more diverse populations is necessary. In addition to the lack of
generalisability of previous research to the wider population, the traditional use of criminal
offender samples has contributed to the coalescing of psychopathy with criminality and
antisocial personality disorder.
Psychopathy and Antisocial Personality Disorder
An important distinction in the psychopathy literature is that of psychopathy and
Antisocial Personality Disorder (ASPD). The original conception of psychopathy (Cleckley,
1941, 1948) emphasised interpersonal and affective abnormalities concealed by a ‘mask of
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sanity’. Cleckley’s research strongly influenced the criteria for ‘antisocial personality’ in an
early version of the diagnostic and statistical manual of mental disorders (DSM-II)
(American Psychiatric Association, 1968). However, recent editions of the DSM (e.g. DSM-
III; DSM-III-R; DSM-IV; DSM-IV-TR, DSM-V) (American Psychiatric Association, 1980,
1987, 1994, 2000) have shifted towards behaviour-based criteria instead of personality traits
and affective characteristics, because the latter are considered difficult to assess objectively
and reliably. Antisocial Personality Disorder as described in the current version of the DSM
(DSM-V) (American Psychiatric Association, 2013) emphasises “a pervasive pattern of
disregard for and violation of the rights of others, occurring since age 15 years” (section
301.7 [F60.2]) demonstrated by evidence of at least three of the following criteria:
1. Failure to conform to social norms with respect to lawful behaviours, as
indicated by repeatedly performing acts that are grounds for arrest.
2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others
for personal profit or pleasure.
3. Impulsivity or failure to plan ahead.
4. Irritability and aggressiveness, as indicated by repeated physical fights or
assaults.
5. Reckless disregard for safety of self or others.
6. Consistent irresponsibility, as indicated by repeated failure to sustain
consistent work behaviour or honour financial obligations.
7. Lack of remorse, as indicated by being indifferent to or rationalizing having
hurt, mistreated, or stolen from another. (American Psychiatric Association,
2013, section 301.7 [F60.2])
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Although ‘associated features supporting diagnosis’ describe some of the
interpersonal and affective features characteristic of psychopathy (American Psychiatric
Association, 2013), the current diagnostic criteria primarily focus on antisocial behaviour
rather than interpersonal and affective features. The emphasis in the DSM on antisocial
behaviour has drawn criticism from psychopathy researchers, who disagree with claims that
psychopathy and ASPD are synonymous constructs. This particular claim is not supported for
several reasons. Firstly, psychopathy is a personality construct that consists not only of
behavioural components, but also cognitive, interpersonal, and affective components. These
other central and perhaps more crucial aspects of psychopathy are not adequately captured in
DSM-V descriptions of ASPD which focus heavily on behavioural features. Furthermore,
there is a robust debate occurring in the psychopathy literature about the role of antisocial
behaviour, with some strong arguments against antisocial behaviour as a diagnostic feature of
psychopathy (Skeem & Cooke, 2010a). Secondly, research on the prevalence of ASPD in
forensic settings estimate that 50-80% of prisoners meet the criteria, while estimates of
psychopathy are only 15-30% (Hare, 1991). The high prevalence of ASPD in criminal
samples may be attributed to the focus on antisocial behaviour rather than personality
characteristics in the diagnosis of ASPD. Alternatively, research in a non-forensic sample
suggests that disparate cut-offs for psychopathy (stricter cut-offs) versus ASPD (lower cut-
offs) may explain the differences in prevalence rates (Rogers & Rogstad, 2010). However,
given the differences in sample characteristics in the Rogers and Rogstad study, further
research is needed before conclusions can be drawn regarding disparate cut-offs and
differences in prevalence rates for PCL-R measures of psychopathy and ASPD. Thirdly, the
predictive utility of psychopathy in forensic settings is higher than that of ASPD. Research
has shown that psychopathy is a good predictor of general recidivism, violent recidivism and
sexual recidivism (Hemphill, Hare, & Wong, 1998). Criminal psychopaths are three times
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more likely to recidivate than criminal non-psychopaths and four times more likely to
recidivate violently than criminal non-psychopaths (Hemphill et al., 1998). Therefore, the
classification of psychopathy demonstrates a predictive utility above and beyond a diagnosis
of ASPD. Lastly, ASPD diagnoses in criminal offenders capture a highly heterogeneous
population grouped together based on antisocial behaviour rather than the various etiological
factors that lead to the behaviour. Lykken (2006) emphasised this latter point:
APD is plainly a heterogeneous category in respect to etiology and also in respect to
the psychological characteristics that give rise to the varied patterns of socially
deviant behaviour that serve to meet the criteria. Identifying someone as ‘having’
APD is about as nonspecific and scientifically unhelpful as diagnosing a sick patient
as having a fever or an infectious or a neurological disorder (Lykken, 2006, p. 4).
It is commonly accepted that the causes of antisocial behaviour are multifarious, with
biological, psychological, sociological, geographic, and economic factors all implicated in
crime causation (Brown, Esbensen, & Geis, 2010). In contrast, the diagnosis of psychopathy
captures a more homogenous group of individuals who share a common pattern of
personality dysfunction. This personality dysfunction separates psychopathic individuals
from individuals with antisocial personality disorder, and there is a wealth of evidence that
demonstrates that psychopathic criminals show unique emotional and cognitive impairments
not found in nonpsychopathic criminals.
Psychopathy and Affective Deficits
Clinical accounts of psychopathy emphasized emotional impairment as a central
feature of the disorder. This position is supported by a vast body of literature that
demonstrates that psychopathy is characterized by abnormal emotion processing. Lykken
(1957) conducted one of the earliest investigations of affective dysfunction in psychopathy
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when he examined the performance of primary and secondary psychopaths (categorized using
Cleckian criteria) on a passive avoidance test. Using a sample of male and female participants
from a correctional facility, Lykken found that primary psychopaths generated lower galvanic
skin response to stimuli associated with punishment, and less avoidance of punished
responses compared to criminal controls (Lykken, 1957). Research using a startle reflex
paradigm has also revealed abnormal emotion processing in psychopathic individuals. In the
startle reflex paradigm, the startle reflex (aversive reflex) can be augmented by the
presentation of a visual prime before the startle probe (a loud noise) (Lang, Bradley, &
Cuthbert, 1990). In conditions where a positive prime (e.g., pictures of romantic couples or
babies) is presented before the startle probe, healthy participants display reduced startle
response compared to conditions using neutral primes (e.g., a book or a pair of shoes), as
measured by eye blinks using electrodes attached to the face (Lang et al., 1990). In contrast,
when negative primes (e.g., images of victims of violent death) are displayed prior to the
presentation of the startle probe, healthy participants display an increased startle response
compared to neutral primes (Lang et al., 1990). Research using the startle response paradigm
in psychopathic offenders has shown that whilst some reduction in startle reflex is observed
after the presentation of positive primes, there is significantly less augmentation of the startle
reflex following the presentation of negative primes (Patrick, 1994). These findings suggest a
reduced response to negative emotional information in psychopathic individuals compared to
controls.
Subsequent studies on emotion processing in psychopathy have produced consistent
evidence of pervasive emotional impairment in psychopathic individuals. For example, Blair
and colleagues examined skin conductance responses to visual distress cues, threat cues, and
neutral stimuli in a sample of male, psychopathic criminals and nonpsychopathic criminals
and found that psychopathic individuals compared to controls displayed hyporesponsivity to
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the distress cues but intact responsivity to the threat cues and neutral stimuli (R. J. R Blair,
Jones, Clark, & Smith, 1997). Further support for the emotional impairment of psychopathic
individuals is provided by research that demonstrates that psychopathic individuals are
selectively impaired in recognizing the fearful facial expressions of others (R. J. R Blair et
al., 2004). Furthermore, this deficit appears to extend across sensory modality. Using a male,
criminal offender sample Blair and Colleagues (2002) examined the recognition of vocal
affect (happiness, disgust, anger, fear, and sadness) in psychopathic and nonpsychopathic
participants. They found that psychopathic participants were selectively impaired in
recognizing fearful and sad vocal affect, committing significantly more recognition errors
than nonpsychopathic controls (R. J. R. Blair et al., 2002).
The accumulated evidence on emotion and psychopathy strongly supports the claims
of affective dysfunction as a core feature of psychopathy. However, like many of the modern
studies on psychopathy, the vast majority of these studies employed predominately criminal
and predominately male participants. With the exception of a few studies (e.g., Eisenbarth et
al., 2013; Iria & Barbosa, 2009; Reidy, Zeichner, & Foster, 2009), the examination of
emotion deficits in noncriminal and female psychopathic samples remains an understudied
area. Iria and Barbosa (2009) examined the ability to recognize fearful facial expressions
amongst male noncriminal psychopaths. The authors found that the deficit in recognizing
fearful facial expressions commonly reported in criminal psychopaths also occurred in
noncriminal psychopaths. Preliminary research on emotional facial recognition in female
criminal psychopaths suggests that this deficit also extends to female, criminal psychopathy
(Eisenbarth, Alpers, Segrè, Calogero, & Angrilli, 2008; Eisenbarth et al., 2013). However,
this difficulty in recognizing facial expressions may not extend to female, noncriminal
psychopathy. For example, Justus & Finn (2007) found that the abnormal startle response to
aversive images found in male criminal psychopaths also occurred for male noncriminal
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psychopaths, but that this did not extend to noncriminal female psychopaths. In fact,
noncriminal females high on psychopathy (global and primary psychopathy) demonstrated a
larger startle amplitude for negative images compared to those low on psychopathy.
Clearly, further research is needed to determine whether the findings of broad
emotional dysfunction in male, criminal psychopaths also extend to female psychopaths and
noncriminal psychopaths. Further, given that primary and secondary psychopathy display
divergent relationships with a range of external variables, it would be interesting to consider
whether similar emotion processing deficits are found in both primary and secondary
psychopathy. One task that has been used in previous research to examine implicit emotion
processing in psychopathy is the lexical decision task (LDT). The LDT is a well-known
cognitive task for studying the nature of language processing. In this task, participants are
presented with a string of letters and asked to decide as quickly as possible whether the letter
string forms a word or a nonword. The letter strings are typically presented in quick
succession on a computer screen with the response (often a key press) triggering the
presentation of the next letter string. Previous research has found that this task is useful in
tapping implicit cognitive and emotional processes related to psychological abnormality. For
example, research examining responses to appearance-related words (e.g., beautiful, ugly)
after viewing pictures of emaciated-looking women or thin women, found that participants
with Anorexia Nervosa responded faster to appearance-related words after looking at
emaciated pictures than did healthy females.
In relation to psychopathy, previous research using the LDT has shown that healthy
individuals show a speed advantage for emotion words (e.g., love, hate) relative to neutral
words (grass, candle) (Graves, Landis, & Goodglass, 1981; Landis, 2006; Strauss, 1983).
However, this speed advantage has not been observed in psychopathic individuals (Kiehl,
1999; Williamson et al., 1991). Further evidence for affective language dysfunction comes
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from research which shows that psychopathic individuals do not display the same event-
related potential (ERP) responses to emotion words that are observed in healthy individuals
(Williamson et al., 1991). Collectively, these findings suggest that different processes may be
involved in the processing of affective language in psychopathic individuals (S. Williamson,
Harpur, & Hare, 1991). However, the majority of previous research on affective language
processing in psychopathy has been conducted using male participants. There is only one
known study that has examined language processing in female psychopathy (Vitale,
Maccoon, & Newman, 2011). The lack of consideration for gender differences in affective
language processing in psychopathy is problematic. Research has consistently demonstrated
differences in emotional processing as a function of gender. For example, previous research
has demonstrated gender differences in the judgment of facial affect (Thayer & Johnsen,
2000), including increased physiological reactivity to facial affect for females over males
(Dimberg & Lundquist, 1990); gender differences in the experience of emotion (Fischer,
Rodriguez Mosquera, van Vianen, & Manstead, 2004); gender differences demonstrating
increased emotional expressiveness for females (Kring & Gordon, 1998); and gender
differences in affective priming (Gohier et al., 2011). Therefore, it stands to reason that the
findings of affective dysfunction in language processing may only be true for male
psychopaths. This is likely given that Vitale et al. (2001) failed to replicate the findings of
affective language dysfunction with a female sample. However, because this study employed
only female participants, a direct examination of gender differences was not possible.
Clearly, further research on affective language processing in female psychopathy and an
examination of possible gender differences is needed in order to address this gap in the
psychopathy literature.
In addition to the lack of research on gender differences in affective language
processing in psychopathy, there is also a lack of research examining the separate
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relationships between primary and secondary psychopathy and affective language processing.
As previously stated, research has shown that primary and secondary psychopathy are
associated with differential experiences of emotion, with primary psychopathy associated
with a paucity of negative emotion and secondary psychopathy associated with elevated
levels of negative emotion (Del Gaizo & Falkenbach, 2008). Affective priming studies have
consistently demonstrated a facilitation in response to negative stimuli amongst individuals
with elevated levels of negative affect (e.g., anxiety and depression) (B. P. Bradley, Mogg, &
Millar, 1996; B. P. Bradley, Mogg, & Williams, 1995; Ruiz-Caballero & González, 1997).
Thus, given that secondary psychopathy is associated with elevated levels of negative
emotionality (e.g., anxiety), it stands to reason that an attentional bias to negative words may
be observed. This attentional bias would result in a facilitation to negative words amongst
secondary psychopaths. However, given the paucity of emotion in primary psychopathy, it
would be expected that a lack of facilitation to both positive and negative words would be
observed. Consequently, the current findings of language processing deficits in psychopathy
may only be true for primary psychopathy and not secondary psychopathy.
There is only one known study that has investigated language processing separately
for primary and secondary psychopathy (Reidy, Zeichner, Hunnicutt-Ferguson, & Lilienfeld,
2008). Reidy and colleagues (2008) investigated response latencies to discrete affect word
categories (anger, sadness, happiness, and fear) and abstract words as a function of primary
and secondary psychopathy. Their findings provided partial evidence of a differential pattern
of response latencies to sadness and anger words between primary and secondary
psychopathy. Primary psychopathy was associated with slower responses to sadness words
and secondary psychopathy was associated with faster responses to anger words (Reidy et al.,
2008). However, a number of methodological limitations were present. An undergraduate
sample was used, but consisted of only male participants, thus affecting the generalisability
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of the findings. Furthermore, the authors did not obtain word ratings on the discrete affect
dimensions from participants. Consequently, words that healthy, normal adults rate as
‘angry’, ‘sad’ or ‘happy’, may not be rated in the same fashion by psychopathic individuals.
Reidy, et al., (2008) suggested that cognitive biases based on individual differences may have
been present. For example, words that normal, healthy adults view as fearful (e.g. murder),
may actually activate anger nodes in individuals with high levels of hostile emotion (Reidy et
al., 2008). This highlights the importance of including a word rating task when conducting
language studies in psychopathy, especially considering the elevated rates of hostility and
aggression in secondary psychopathy (Reidy et al., 2007). Reidy, et al., (2008) concluded that
future studies should incorporate a wider participant sample, including female participants,
and the inclusion of a word rating task when conducting emotional priming studies in
psychopathy.
Psychopathy and Cognitive Deficits
In addition to the impairments in affective functioning, there is now a large body of
research that suggests that psychopathy is associated with abnormal cognitive processing
(Bagshaw, Gray, & Snowden, 2014; Baskin–Sommers, Curtin, Li, & Newman, 2012; Hiatt,
Schmitt, & Newman, 2004; Jutai, Hare, & Connolly, 1987; Kosson, 1996; Newman,
Patterson, & Kosson, 1987). Studies have shown that psychopathic individuals display
attentional deficits, such as reduced interference on Stroop-like tasks (Hiatt, et al., 2004) and
reduced physiological reactivity to irrelevant auditory stimuli (Jutai, et al., 1987). There is
also some evidence of executive dysfunction in criminal psychopathic individuals, such as
poor behavioural inhibition (Newman & Brinkley, 1997) and set-shifting (Bagshaw et al.,
2014), with research suggesting this is primarily associated with elevated levels of secondary
psychopathy. Conversely, there is some research that suggests that noncriminal psychopathy
(Ishikawa, Raine, Lencz, Bihrle, & Lacasse, 2001) and/or higher levels of primary
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psychopathy are actually associated with superior executive functioning (Hansen, Johnsen,
Thornton, Waage, & Thayer, 2007; Sellbom & Verona, 2007).
Executive Functioning
The term ‘executive function’ refers to a constellation of higher order, self-regulatory
cognitive abilities, including attention, memory, planning, decision-making, response
inhibition, and cognitive flexibility (Royall et al., 2002). These self-regulatory processes are
essential for socially appropriate behaviour, prompting researchers to suggest that executive
dysfunction may underlie the range of socially inappropriate and self-defeating behaviours
observed in individuals with psychopathy. This hypothesis is bolstered by evidence of
‘acquired sociopathy’ or ‘pseudo-psychopathy’, a condition characterised by pervasive
changes in personality and socially appropriate behaviour, such as callousness, a paucity of
emotion, irresponsibility, impulsivity, and a lack of empathy, following damage to the
ventromedial prefrontal cortex, an area implicated as important for intact executive
functioning (Tranel, 2002). Individuals with acquired psychopathy display profound deficits
regulating socially inappropriate behaviour, and like psychopathic individuals, they generally
display intact intelligence, memory, and language ability.
Whilst the prefrontal cortex plays a crucial role in the ability to perform a range of
executive functions, different regions are purported to be responsible for different kinds of
executive function. A common distinction in the executive function literature is that of ‘hot’
and ‘cool’ executive functions (Zelazo & Cunningham, 2007; Zelazo & Muller, 2002). Hot
executive functions refer to cognitive functions that are recruited in situations that are
emotionally or motivationally significant because they involve reward/punishment. These
executive functions are subserved by the ventromedial prefrontal cortex and its associated
pathways (Zelazo & Muller, 2002; Zelazo, Qu, & Kesek, 2010). On the other hand, cool
executive functions are purely cognitive in nature, such as working memory, planning, set-
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shifting and attentional processes, and rely on the lateral prefrontal cortex (Zelazo & Carlson,
2012; Zelazo & Cunningham, 2007; Zelazo & Muller, 2002; Zelazo et al., 2010). Researchers
claim that similar to the individuals with ‘acquired sociopathy’, the psychopathic individuals’
executive dysfunction is characterised by ventromedial prefrontal cortex deficits, with largely
intact lateral prefrontal cortex functioning (K. S. Blair, Newman, et al., 2006; Gao, Glenn,
Schug, Yang, & Raine, 2009).
The intuitive appeal of the executive dysfunction hypothesis has led to a flurry of
research examining executive function processes in psychopathic individuals (e.g., Bagshaw
et al., 2014; De Brito, Viding, Kumari, Blackwood, & Hodgins, 2013; Dolan, 2012; Ishikawa
et al., 2001; Mahmut, Homewood, & Stevenson, 2008; Mol, Van Den Bos, Derks, & Egger,
2009; Pham, Vanderstukken, Philippot, & Vanderlinden, 2003; Ross, Benning, & Adams,
2007; Sellbom & Verona, 2007; Snowden, Gray, Pugh, & Atkinson, 2013). However,
research findings to date are contradictory and clouded by methodological inconsistencies in
the measurement of psychopathy, the types of executive function studied (e.g., cool executive
functions or hot executive functions), the measurement of executive function utilised, and
demographic differences between samples (e.g., male criminal offender samples, male
community samples, or mixed gender community samples).
Generally speaking, two streams of research on the psychopathy-executive function
relationship have emerged, a stream examining executive function in criminal psychopaths
(often referred to as unsuccessful psychopaths), and a stream examining executive function in
noncriminal psychopaths (often referred to as successful psychopaths). The common
suggestion in the psychopathy literature is that criminal psychopathy is associated with
poorer executive functioning, whilst noncriminal psychopathy is associated with superior
executive functioning (Gao & Raine, 2010). This hypothesis was generated in part by
Ishikawa et al. (2001), who examined performance on the Wisconsin Card Sorting Test
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(WCST: a common neuropsychological measure of executive function) in successful
psychopaths, unsuccessful psychopaths, and non-psychopathic controls. They found that
successful psychopaths solved more categories, and displayed less perseverative and non-
perseverative errors than the unsuccessful psychopaths and non-psychopathic controls. There
were no differences in WCST performance for the unsuccessful psychopaths and non-
psychopathic controls. This study has been consistently referred to in the literature as
evidence of superior executive functioning in successful psychopaths. However, the literature
on executive functioning in psychopathy is considerably more complex, with differential
patterns of association with executive function observed for primary (F1) versus secondary
psychopathy (F2), both within the criminal and noncriminal psychopathy literatures, and
inconsistent results across different measures of executive function (for a full review of the
executive function literature on psychopathy, see Chapter Four). For example, Sellbom and
Verona (2007) used a mixed gender undergraduate sample to examine WCST performance as
a function of PPI-R assessed psychopathy and found that whilst Factor 1 was associated with
better performance, Factor 2 was associated with worse performance. These findings suggest
a more nuanced relationship between psychopathy and executive function.
Another possible explanation for the finding of executive dysfunction in criminal
psychopathy, primarily factor 2 (which captures the antisocial features), could be due to
factors related to criminality rather than psychopathy. Dolan (2012) examined planning
ability, set-shifting, and response inhibition in a large sample of offenders with Antisocial
Personality Disorder (ASPD) with and without PCL:SV assessed psychopathy (ASPD+P and
ASPD-P) against nonpsychopathic participants from the general population. The author
found that individuals with ASPD-P performed worse on tasks of planning ability, set-
shifting, and response inhibition than controls but that the performance of ASPD+P was not
significantly different to controls (Dolan, 2012). This finding suggests that antisociality,
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rather than psychopathy, is associated with executive dysfunction on tasks reliant on the
DLPFC. When taken together with the findings by Ishikawa et al. (2001), one could infer that
successful psychopaths could well have superior executive functioning.
However, De Brito et al. (2013) conducted a similar study which examined
performance on a range of hot and cool executive functions (verbal working memory,
reversal learning, decision-making under risk, and stimulus-reinforcement-based decision
making) in a group of violent offenders diagnosed with ASPD with and without PCL-R
assessed psychopathy. The results revealed that the violent offenders (both ASPD-P and
ASPD+P) displayed poorer performance on measures of hot executive function than a
noncriminal control group but similar performance to each other. Specifically, the offenders
(ASPD-P and ASPD+P) failed to change their behaviour in response to changing task
requirements, failed to learn from punishment cues, and despite taking longer to make
decisions than the controls, they displayed more decision-making errors. However, unlike the
findings of Dolan (2012), the offenders (ASPD-P and ASPD+P) performed worse on a
measure of cool EF (working memory tasks) than controls. These findings suggest that poor
performance of psychopathic individuals recruited from forensic samples on tasks of hot
executive function may be explained by factors related to criminality (antisocial behaviour),
rather than psychopathy per se. However, the finding of poorer performance on tasks of cool
executive dysfunction in ASPD+P is in contrast to the results of Dolan (2012). Given that
these studies have not examined the unique relationships between primary psychopathy,
secondary psychopathy and executive function; it could be that differences in the levels of
primary versus secondary psychopathy between the samples is responsible for the
inconsistent findings.
The inconsistency in findings of different studies of psychopathy and executive
function may suggest different patterns of relationships for unsuccessful versus successful
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psychopathy, or superior performance for primary psychopathy and worse performance for
secondary psychopathy, or they could be an artefact of methodological differences between
studies. Specifically, research in criminal offender samples typically utilise male participants,
whereas research in community samples has utilised either male participants or mixed gender
samples without any consideration of gender as a moderating factor (e.g., Snowden et al.,
2013). The a priori assumption that the pattern of relationships between psychopathy and
measures of executive function are the same for males and females is problematic. There is
evidence of differential patterns of disease susceptibility and symptomatology in males and
females for a range of physical and psychological conditions (For a review see Beery &
Zucker, 2011). However, a male bias in health research is prolific (Beery & Zucker, 2011),
and is prevalent in psychopathy research.
In addition to this problem, the previous research on psychopathy and executive
function is difficult to interpret because gender differences between criminal and noncriminal
samples obfuscate the relationship. This problem is exacerbated by research that
demonstrates gender differences in a range of cognitive functions (Astur, Ortiz, &
Sutherland, 1998; D. W. Collins & Kimura, 1997; Herlitz & Rehnman, 2008; Thakkar et al.,
2014; Tlauka, Brolese, Pomeroy, & Hobbs, 2005). Therefore, discrepancies between studies
that employ primarily male criminal offender samples and those that employ mixed gender
community samples could be because of the impact of criminality on the psychopathy-
executive function relationship, or they could be due to gender differences. One of the aims
of this thesis is to examine executive functioning in psychopathic individuals from the
community, including an examination of possible gender differences.
Summary of Affective and Cognitive Deficits
There is evidence of both affective and cognitive processing abnormalities in
psychopathic individuals. However, theorists are divided on the etiological and explanatory
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mechanisms that underlie these abnormalities. These abnormalities are interpreted as being
either primarily affective or primarily cognitive in nature depending on the theoretical lens of
the researcher.
Theories of Psychopathy
The interaction of affective, behavioural, interpersonal, and cognitive traits of
psychopathy produce a complex personality, and whilst numerous studies have examined the
pattern of dysfunction associated with psychopathy, the underlying etiology remains unclear.
Early reports of affective dysfunction in psychopathy led to the development of theoretical
models that attempted to explain psychopathy primarily as a disorder of emotion (e.g.,
absence of fear). However, evidence of abnormalities in processing neutral stimuli (Kiehl,
1999; Newman, Schmitt, & Voss, 1997) combined with evidence of general information
processing dysfunction (Lorenz & Newman, 2002a) resulted in revisions to the ‘emotion
dysfunction’ hypotheses. Whilst there is relatively little consensus on the etiology of
psychopathy, the most prominent theories of psychopathy are Lykken’s Low Fear Hypothesis
(Lykken, 1957, 1995), Gray’s Reinforcement Sensitivity Theory (revised) (Gray, 1975; Gray
& McNaughton, 2003), The Somatic Marker Hypothesis (Bechara, Damasio, Damasio, &
Anderson, 1994; Bechara, Damasio, & Damasio, 2000; Damasio, 1994, 1995a), The
Integrated Emotions System Hypothesis (R J R. Blair, Mitchell, & Blair, 2005), and the
Response Modulation Hypothesis (Gorenstein & Newman, 1980; Lorenz & Newman, 2002a;
Newman & Lorenz, 2003).
Lykken’s Low Fear Hypothesis
In his book ‘The Antisocial Personalities’, David T. Lykken (1995) outlined his
theory on the etiological mechanisms that give rise to the various personalities that appear in
forensic institutions, including, sociopathy and psychopathy. His theory of psychopathy
demarcated the personality into two main subtypes: a primary subtype and a secondary
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subtype. Lykken (1995) proposed a ‘low-fear hypothesis’ of primary psychopathy that argues
that primary psychopathy is associated with an absence of fear to conditions or situations that
would normally elicit a fear response. He suggested that all the characteristics on Cleckley’s
(1941) checklist can be accommodated for by an innate fearlessness. For example,
‘untruthfulness and insincerity’ is accounted for by the low-fear hypothesis with the claim
that fear of being caught in a lie prevents most people from telling serious lies, and that
‘white-lies’ are told because of fear of hurting other’s feelings (Lykken, 1995). Lykken
proposed that the innate fearlessness of primary psychopaths made it difficult to socialise
them away from antisocial behaviour, because they were impervious to the fear of
punishment. Lykken (1995) borrowed from Gray’s (1987) model of affective behaviour to
differentiate the secondary psychopath from the primary psychopath. Lykken suggests that
secondary psychopathy is associated with intact or normal reactivity to fear and anxiety, but a
strong sensitivity to reward. He claims that the strong sensitivity to reward may lead the
secondary psychopath to disregard the fear or anxiety that may normally curtail his
psychopathic behaviour.
The low fear hypothesis has garnered a range of empirical support, with studies
showing that psychopathic individuals display poor fear conditioning (Lykken, 1957),
impairments in response to threat cues (Ogloff & Wong, 1990), and poor startle response to
threat scenes (Levenston, Patrick, Bradley, & Lang, 2000). Lykken’s low-fear hypothesis set
the foundation for subsequent studies on the psychopathology of psychopathy and
contributed to a greater understanding of the affective dysfunction observed in psychopathic
individuals. However, whilst the low-fear hypothesis explains some the affective deficits
observed in psychopathy, it does not explain findings which suggest that emotional
impairment is present for both negative and positive emotional stimuli (K. S. Blair, Morton,
et al., 2006). K.S. Blair et al., (2006) used the Differential Reward/Punishment task to
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demonstrate that psychopathic individuals were impaired on both punishment (as predicted
by the low-fear hypothesis) and reward trials. These findings cannot be easily accommodated
within the low-fear hypothesis, which argues that it is fearlessness, not general affective
dysfunction that characterizes the psychopathic individual. An extension of the low-fear
hypothesis that attempts to explain the broader emotion dysfunction observed in psychopathic
individuals is Gray’s Reinforcement Sensitivity Theory (now revised [RST]).
Gray’s Reinforcement Sensitivity Theory
Lykken (1995) considered aspects of the RST (Gray, 1987; Gray & McNaughton,
2003) to be consistent with his low-fear hypothesis and both theories share an emphasis on
dysfunction of fear and anxiety in psychopathic individuals. The RST is a sophisticated
neurobiological theory of individual differences in motivation and affective behaviour that
proposes three major systems of emotion: The Fight-Flight-Freeze System (FFFS), The
Behavioural Inhibition System (BIS) and, The Behavioural Approach System (BAS). The
FFFS is reactive to both conditioned and unconditioned aversive stimuli, such as innately
unpleasant or painful stimuli and mediates emotional and behavioural responses to these
stimuli (e.g., fear and subsequent escape behaviours, respectively) (Corr, 2004; Gray &
McNaughton, 2003). The BAS is reactive to both unconditioned and conditioned reward cues
and is associated with the initiation of goal-directed behaviour (e.g., approach behaviour), the
anticipation of reward, and hope (Corr, 2004). The BIS is responsible for detecting and
resolving goal conflict by acting as a mediator between the FFFS and the BAS; it is activated
when FFFS and BAS conflict and is responsible for resolving conflict between approach and
avoidance behaviours. It performs this function by momentarily suspending behaviour and
shifting attention to the environment, performing a risk assessment of the environment, and
scanning memory (Gray & McNaughton, 2003). Because the BIS is sensitive to goal conflict
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it is postulated to be responsible for the experience of anxiety, worry, and rumination (Gray
& McNaughton, 2003).
The RST model applied to psychopathy suggests that: (a) both primary and secondary
psychopathy are associated with a dysfunctional BIS, (b) primary psychopathy is associated
with an underactive FFFS, and (c) secondary psychopathy is associated with an overactive
BAS (Corr, 2010). Hughes, Moore, Morris and Corr (2012) recently tested the RST model of
psychopathy in an university sample using Carver and White’s (1994) BIS/BAS scales and
the Levenson Self-Report Psychopathy Scale (Levenson, Kiehl, & Fitzpatrick, 1995). In this
study, the BIS scale was separated into a FFFS subscale and a BIS subscale, whilst the BAS
produced scores on three subscales: Drive, Fun-seeking, and Reward Responsiveness. The
Drive subscale captured goal-directed behaviour, the Fun-seeking subscale reflected
impulsive behaviour motivated by immediate reward, and the Reward Responsiveness scale
captured motivation in anticipation of future reward. In support of Corr’s (2010) hypothesis,
Hughes et al., (2012) found that both primary and secondary psychopathy were associated
with low BIS activity. Primary psychopathy was associated with low FFFS activity,
negatively related to the Fun-seeking scale of the BAS, and positively associated with the
Drive and Reward Responsiveness subscales of the BAS. In contrast, secondary psychopathy
was not associated with the FFFS or the Drive and Reward Responsiveness subscales of the
BAS, but it was positively associated with the Fun-seeking subscale of the BAS. Whilst these
findings are consistent with characterisations of low fear, low anxiety and predatory
behaviour in primary psychopathy, the finding of a negative relationship between BIS and
secondary psychopathy is in direct contrast with both theory and research on the relationship
between anxiety and secondary psychopathy. In an attempt to clarify the relationship between
primary and secondary psychopathy and measures of FFFS, BIS and BAS, Broerman, Ross
and Corr (2014) replicated Hughes et al.,’s (2012) study with a larger university sample
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whilst controlling for shared psychopathy variance. Using partial correlations they found that
secondary psychopathy was positively associated with BIS and FFFS activity and BAS Fun-
seeking. Primary psychopathy was unrelated to BAS Reward Responsiveness, positively
associate with BAS Drive, and negatively associated with BIS and FFFS. These findings are
consistent with historical conceptualisations of a fearless, constrained primary psychopath
and an impulsive, hostile secondary psychopath. Furthermore, these findings conflict less
with research on psychopaths insensitivity to reward stimuli, a finding making the low-fear
hypothesis untenable (K. S. Blair, Morton, et al., 2006). Although research on the revised
RST model of psychopathy is in its infancy, the preliminary findings suggest that the revised
model can accommodate many of the emotion and information-processing abnormalities
observed in psychopathic individuals. Another popular theory of psychopathy with
neurobiological origins is Damasio’s (1994, 1995a) Somatic Marker Hypothesis, similar to
the RST, this model is concerned with the role of emotion in decision-making.
The Somatic Marker Hypothesis
Compared to the RST, which is focuses on individual differences in emotion
behaviour, the Somatic Marker Hypothesis is a more general theory of the role of emotion in
decision-making (Damasio, 1994, 1995a). The theory is based on observations of emotional
processing abnormalities in the documentation of the famous neuropsychological patient,
Phineas Gage, and other patients who suffered similar injuries to the ventromedial prefrontal
cortex (Damasio, 1994). Challenging the commonly held belief that decision-making is best
performed in the absence of emotion (e.g., with a ‘cool-head’), Damasio (1994, 1995a)
argued that effective decision-making involves the use of emotions and emotional
information. The Somatic Marker Hypothesis proposes that the ventromedial prefrontal
cortex is involved in storing information about past situations and the physiological (somatic)
reactions (e.g., heart rate, facial expression, blood flow, posture, hormones, and muscle
THE PSYCHOPATH NEXT DOOR 51
contractions) to these situations and the emotions that are subsequently processed in the
brain. These ‘somatic’ markers then elicit the emotional reaction that was previous associated
with that situation and influence approach or avoidance behaviour. According to Damasio
(1994, 1995) somatic markers can influence decision making in two ways: (a) via the ‘body
loop’, in which bodily changes in response to a situation activate the emotional response, and
(b) via the ‘as-if body loop’ in which representations or simulations of the bodily changes are
processed and elicit the emotional response.
The majority of research testing the Somatic Marker Hypothesis has been conducted
using the Iowa Gambling Task (Bechara et al., 1994), a card game that consists of four decks
of cards. Participants are given an imaginary loan and play the card game to win money. Two
decks of cards produce small gains but also unexpected small loses and result in an overall
net gain of $250 per 10 cards. The other two decks produce large gains but also unexpected
large losses and result in an overall net loss of $250 per 10 cards. The game begins with trial
and error until participants begin choosing the advantageous card decks, with participants
either consciously or unconsciously aware of the advantageous strategy (Bechara, Damasio,
Tranel, & Damasio, 1997). Thus, the Iowa Gambling Task simulates real life decision
making by creating circumstances which produce uncertainty, reward, and punishment. The
Somatic Marker Hypothesis predicts that individuals with intact ventromedial prefrontal
cortex functioning will begin to establish somatic markers eliciting positive and negative
emotions to the four decks of cards following the gains and losses associated with each deck.
These somatic markers bias decision-making away from the risky decks to the advantageous
decks. Damasio and colleagues found that following a trial and error process, neurologically-
intact participants were initially drawn to the risky decks before switching to the
advantageous decks. However, participants with damage to the ventromedial prefrontal
cortex, unlike controls, were unable to establish the advantageous response strategy and
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continued to sample from the risky decks (Bechara et al., 1994; Bechara , Damasio , Damasio
, & Lee 1999; Bechara et al., 1997). Observing the deficits of individuals with ‘acquired
sociopathy’ following damage to the ventromedial prefrontal cortex, Damasio (1994)
suggested that abnormal ventromedial prefrontal cortex functioning might also explain the
behaviour of individuals with developmental psychopathy.
Initial research testing the Somatic Marker Hypothesis in psychopathic individuals
failed to discriminate the performance of psychopaths compared to controls (Schmitt,
Brinkley, & Newman, 1999). However, methodological inconsistencies between Schmitt,
Brinkley and Newman’s (1999) study and that of Bechara, Damasio & Damasio’s (2000)
investigation likely explained the findings, given that subsequent research using the same
methodology as Bechara, Damasio & Damasio showed that psychopathic individuals were
impaired on the Iowa Gambling Task (Mitchell, Colledge, Leonard, & Blair, 2002). Using a
sample of psychopathic offenders assessed with the PCL-R, Mitchell, Colledge, Leonard and
Blair (2002) found that psychopaths performed worse on the Iowa Gambling Task compared
to controls, with psychopaths preferring the risky decks despite the long-term negative
consequences. However, Mitchell, Colledge, Leonard and Blair suggest that the Somatic
Marker Hypothesis cannot adequately explain the selective impairment for sad and fearful
stimuli, but intact processing of threat cues found in previous research (e.g., R. J. R Blair et
al., 1997; Patrick, Bradley, & Lang, 1993). Instead, R J R Blair and colleagues propose a
more specific model of neurobiological dysfunction in psychopathic individuals, the
Integrated Emotions System Model (R J R. Blair et al., 2005).
The Integrated Emotions Systems Model
The Integrated Emotions Systems (IES) model proposed by R J R Blair and
colleagues (2005) suggests that the deficits associated with psychopathy are a result of
genetic anomalies that lead to amygdala dysfunction. The amygdala dysfunction disrupts
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emotional learning, and as a result the normal affect representations are not made in
psychopathic individuals (R J R. Blair et al., 2005). More specifically, because the integrity
of the amygdala is crucial in the recognition of fearful and sad facial expressions, children
with psychopathic tendencies do not experience the same reaction to distress of others as
healthy children. Blair (1995) claims that the distress of others acts as an unconditioned
stimulus that results in aversive conditioning towards the behaviour that elicited the distress.
It is the inability to process sad and fearful facial expressions in children with psychopathy
that interferes with moral socialisation and the failure to inhibit antisocial behaviours that
cause harm to others. Blair and colleagues (2005) point out that whilst negative affect
representations are more severely impacted in psychopathy, these abnormalities also occur to
a lesser extent to positive affect representations. Thus explaining the findings of positive and
negative emotional dysfunction in psychopathy. Whilst amygdala dysfunction is the basic
tenet of the IES model, the model also suggests that functional interactions between the
amygdala and associated neural systems (e.g., orbitofrontal and ventrolateral prefrontal
cortex, and insula) are disrupted in psychopathic individuals (R J R. Blair et al., 2005). The
pattern of dysfunction predicted by the IES is consistent with research findings that
demonstrate that psychopathic individuals display deficits in tasks that rely on these neural
systems, for example, goal-directed behaviour (K. S. Blair, Morton, et al., 2006); the ability
to recognize fearful and sad facial expressions (R. J. R Blair et al., 2004); the ability to
recognize vocal affect (R. J. R. Blair et al., 2002); attention to emotional stimuli (Lorenz &
Newman, 2002a; Mitchell, Richell, Leonard, & Blair, 2006); and response control (Kiehl et
al., 2001).
While the IES model can accommodate the findings of emotional impairment, it
cannot account for findings that demonstrate that redirection of attention to emotional
information ameliorates the emotion impairment (Dadds, El Masry, Wimalaweera, &
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Guastella, 2008; Larson et al., 2013; Newman, Curtin, Bertsch, & Baskin-Sommers, 2010).
For example, Newman, Curtin, Bertsch and Baskin-Sommers (2010) found that deficits in
fear-potentiated startle in criminal psychopaths were ameliorated under conditions in which
the threat was the primary focus of attention. They argue that the IES model cannot explain
these findings and suggest an alternative model, the Response Modulation Hypothesis
(Newman & Lorenz, 2003; Patterson & Newman, 1993).
The Response Modulation Hypothesis
The Response Modulation Hypothesis proposed by Newman and colleagues (Lorenz
& Newman, 2002; Newman & Brinkley, 1997; Newman & Lorenz, 2003; Patterson &
Newman, 1993) suggests that the behavioural and affective impairments currently observed
in psychopathy can be attributed to dysfunctional information processing. More specifically,
they suggest that psychopathy is associated with a deficit in shifting response set to
accommodate peripheral information. This results in an over-focus of attention to the primary
or salient features of a task, to the detriment of overall task performance. The Response
Modulation Hypothesis claims that the emotional deficits observed in psychopathy are simply
a secondary symptom of a broader problem of dysfunctional information processing. Several
studies provide support for the Response Modulation Hypothesis, for example, results from a
lexical decision task revealed deficits in processing non-salient neutral information (e.g.,
word frequency cues) (Lorenz & Newman, 2002a), indicating that deficits in psychopathy are
not exclusively affective in nature; less interference to neutral, incongruent information in a
flanker-type task when the target was the prepotent focus of attention, but normal interference
when the target was no longer the prepotent focus of attention (Zeier, Maxwell, & Newman,
2009); and less interference to incongruent information on modified Stroop tasks (Hiatt et al.,
2004). Altogether, these findings suggest that the affective and cognitive deficits observed in
psychopathy are specific to situations in which important information is peripheral to the
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primary task. This ‘situation-specific’ position is in direct contrast with theories that posit
general emotional dysfunction in psychopathic individuals, such as the IES model.
Subsequent research on the Response Modulation Hypothesis suggests that an early
attentional bottleneck may underlie the attentional abnormalities observed in psychopathic
individuals (Baskin-Sommers, Curtin, & Newman, 2011). Providing further support for the
Response Modulation Hypothesis, recent research by Baskin-Sommers, Curtin, and Newman
(2015) found that cognitive remediation focused on addressing the attentional deficits in
psychopathy resulted in better performance on response modulation tasks for psychopathic
individuals.
However, the Response Modulation Hypothesis is not without criticism. Although a
recent meta-analytic and narrative analysis revealed small to medium effect sizes between
psychopathy and response modulation deficits, the results also revealed some evidence of
publication bias, with the effect sizes reported in the published literature higher than those
reported in unpublished studies (Smith & Lilienfeld, 2015).
Review of Current Theories of Psychopathy
Whilst these theories differ with respect to the specific mechanisms that underlie
psychopathy dysfunction, a common theme of many theories to posit dysfunction of one or
more regions of the brain associated with emotion processing. The point of contention
amongst theorists is whether the emotion dysfunction is exclusively affective in nature, or
whether it is an artefact of a more general information processing abnormality. However,
with the exception of the Low-Fear Hypothesis and the Revised RST model, these theories
predominately view psychopathy as a categorical construct, even in light of evidence that
suggests that psychopathy is best viewed as a dimensional construct (Edens, Marcus,
Lilienfeld, & Poythress, 2006). In fact, the majority of previous research and theory on
psychopathy has viewed psychopathy as a unitary, categorical construct. However, given
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evidence that suggests psychopathy is dimensional, and that different etiological markers and
patterns of dysfunction are observed between primary and secondary psychopathy (e.g.,
Benning et al., 2003), an updated theoretical framework of psychopathy that accommodates
these findings is important for an accurate account of the nature of psychopathy.
The arguments surrounding psychopathy subtypes and the dimensional nature of
psychopathy tie in closely with the notion of ‘noncriminal psychopathy’. Given the empirical
evidence that psychopathic individuals differ in degree, rather than kind (Edens et al., 2006;
Lilienfeld & Widows, 2005; Murrie et al., 2007; Walters et al., 2007), it stands to reason that
psychopathic traits and behaviours may not be limited to the extremes seen in criminal
offenders, and that these traits may be found in the general population. Whilst the majority of
previous research has utilized forensic or clinical samples, there is now some research
emerging on the notion of ‘noncriminal psychopathy’ (e.g., Lilienfeld & Widows, 2005).
What is Noncriminal Psychopathy?
The vast majority of research on psychopathy has been conducted using criminal
offender samples. Consequently, comparatively little is known about psychopathy outside of
forensic settings. This is problematic because theoretical conceptualization by theorists such
as Cleckley (1941) did not emphasise criminality as a central feature of the disorder. On the
contrary, there is no a priori reason for assuming that the core interpersonal and affective
features should result in increased antisocial behaviour. Whilst it is acknowledged that a lack
fear, empathy, and regard for the welfare of others might place some psychopathic
individuals at risk for antisocial behaviour, situational factors such as socioeconomic status,
peer group, level of education, and family environment likely play a role in the manifestation
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of psychopathy. Providing theoretical support for the notion of noncriminal psychopathy,
Hare remarked that:
Many psychopaths never go to prison or any other facility. They appear to function
reasonably well – as lawyers, doctors, psychiatrists, academics, mercenaries, police
officers, cult leaders, military personnel, businesspeople, writers, artists, entertainers,
and so forth – without breaking the law or at least without being caught and
convicted. These individuals are every bit as egocentric, callous, and manipulative as
the average criminal psychopath (Hare, 2011, pp. 202-203).
Recent studies of noncriminal psychopathy provide empirical support for the
existence of psychopathy in the general population (Levenson et al., 1995; Lilienfeld &
Widows, 2005). Thus, the criminal psychopathy literature must be interpreted cautiously as it
may only be reflective of a specific sub-population of psychopathy and not representative of
the construct as a whole. Studies examining psychopathy in the general population are
theoretically important because they provide insight into the nature of the disorder without
the confounding effect of criminality. Furthermore, research on psychopathy in the general
population is clinically relevant as it may identify protective factors and compensatory
mechanisms that buffer against severe antisociality and criminality (Lilienfeld, 1994).
Theoretical Perspectives of Noncriminal Psychopathy
Hall and Benning (2006) suggest that there are three common theoretical perspectives
of noncriminal psychopathy: psychopathy as a subclinical or less severe version of the full-
blown disorder; a moderated expression of psychopathy where psychopathic traits are
manifested in a positive, rather than negative way (i.e., successful psychopathy); and a dual
perspective of psychopathy that distinguishes the interpersonal features of the disorder from
the behavioural features. However, a more recent model of noncriminal psychopathy, the
Triarchic Model of Psychopathy, suggests that the varying conceptualisations of psychopathy
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can be explained by differing emphasis on the three phenotypic constructs of psychopathy by
psychopathy researchers (Patrick, Fowles, & Krueger, 2009).
Subclinical psychopathy. Proponents of the subclinical psychopathy perspective
claim that noncriminal psychopaths possess the same affective and interpersonal
characteristics as criminal psychopaths, but to a lesser degree (Ali, Amorim, & Chamorro-
Premuzic, 2009; Gustafson & Ritzer, 1995; Mahmut et al., 2008; Paulhus & Williams, 2002).
A central feature of the subclinical perspective is that it holds the interpersonal and affective
characteristics of psychopathy as the cause of anti-social behaviour. Consequently,
individuals who possess the interpersonal and affective characteristics of psychopathy at a
reduced level, will also exhibit less extreme examples of anti-social behaviour. However, the
term ‘subclinical’ implies that there is a clinical cut-off that determines whether a person is a
psychopath or a nonpsychopath (Lilienfeld, 1998). Therefore, the notion of subclinical
psychopathy cannot be sustained given research on the nature of psychopathy demonstrates
that psychopathy is dimensional not taxonic (Edens et al., 2006).
Successful psychopathy. According to proponents of the ‘successful psychopathy’
perspective, noncriminal psychopathy is viewed as an adaptive expression of psychopathy
(Hall & Benning, 2006; Hare, 2011; Widom, 1977). The central tenet of this model is the
claim that noncriminal psychopaths possess the same core characteristics, at the same level of
severity, but that compensatory factors moderate the expression of the disorder.
Compensatory factors such as high intelligence, high SES factors, level of education and
educational opportunities, parental style, and adequate vs. poor socialisation are said to result
in a successful adaption of psychopathy (Hall & Benning, 2006). Although successful
psychopaths possess the core affective and interpersonal features of the disorder, they are
expressed in noncriminal or socially accepted avenues, such as business environments, and
politics (Hall & Benning, 2006). In these environments, the core interpersonal and affective
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features of psychopathy (e.g. fearlessness and paucity of emotion) are considered
advantageous. However, critics of the successful psychopathy model claim that the notion of
‘successful’ psychopathy is an oxymoron, because a personality disorder is inherently
pathological and maladaptive (Kiehl & Lushing, 2014). Yet, as S. F. Smith, Watts, and
Lilienfeld (2014) point out psychopathology is sometimes associated with creative
temperament and achievement. For example, numerous studies have demonstrated a link
between mood disorders and creativity and achievement (Kyaga et al., 2011; MacCabe et al.,
2010; Santosa et al., 2007). Therefore, although psychological conditions are characterised by
pathological traits, they can also have adaptive manifestations.
A dual process model of psychopathy. The dual process model of psychopathy
mirrors historical conceptualisations of psychopathy as consisting of two separate
components: the interpersonal and affective component (viz. primary psychopathy), and the
anti-social behaviour component (viz. secondary psychopathy) (Patrick, 2007). According to
the dual process model, the presence of the interpersonal and affective component can occur
in absence of the anti-social behaviour component, and vice versa, as it is thought that the
two components result from distinct etiological pathways. According to the dual process
model, primary psychopathy results from a deficiency in the brain’s defensive motivational
system resulting in trait fearlessness. In contrast, secondary psychopathy is thought to stem
from impairments in brain regions responsible for higher-order processes such as planning,
behavioural inhibition, and cognitive flexibility, resulting in a vulnerability to externalising
psychopathology (e.g., behavioural deviance, substance abuse) (Patrick & Bernat, 2009).
Therefore, individuals can present with elevations on primary psychopathy or secondary
psychopathy, or both. There is empirical support for the dual processing perspective, with
studies demonstrating that the two factors show divergent patterns of relationships with
external variables (e.g. personality, temperament, anti-social behaviour, and social
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functioning) (Benning et al., 2003; Harpur, Hare, & Hakstian, 1989; Hicks et al., 2004). A
recent study also found differences between primary and secondary psychopathy in feedback-
related negativity (FRN) for positive and negative faces on a time estimation task, with
primary, but not secondary psychopathy, related to reduced FRN (Schulreich, Pfabigan,
Derntl, & Sailer, 2013). A further extension of the dual process model is the Triarchic Model
of Psychopathy, which seeks to address the discrepancies in the conceptualization of
psychopathy between criminal and noncriminal classifications (Patrick et al., 2009).
Triarchic Model of Psychopathy
The Triarchic Model of Psychopathy proposed by Patrick et al., (2009) suggests that
the reoccurring themes in the conceptualization of psychopathy can be characterized as
generally fitting into three phenotypic constructs: disinhibition, boldness, and meanness.
Disinhibition reflects issues of impulsivity, behavioural disinhibition, an inability to delay
gratification, and a lack of forethought or planning (Patrick et al., 2009). Boldness reflects a
propensity towards thrill-seeking combined with low stress reactivity, emotional resiliency,
and social dominance (Patrick et al., 2009). Meanness reflects a lack of empathetic concern,
exploitativeness, callousness, and a disregard for close interpersonal relationships (Patrick et
al., 2009). Patrick and colleagues (2009) suggest that individuals may not possess all three
components of psychopathy and that conceptualisations of noncriminal and criminal
psychopathy can be explained by differences in how the three components are emphasized.
They suggest that psychopathy can be characterized as disinhibition combined with either
meanness or boldness, or both. They suggest that the Cleckian approach (Cleckley, 1941)
emphasizes disinhibition and boldness, whilst the criminal approach that dominates the
contemporary psychopathy literature emphasizes disinhibition and meanness. However, there
is a current debate on the usefulness and appropriateness of boldness in the psychopathy
construct, with some research suggesting that boldness is not a central component of
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psychopathy (Gatner, Douglas, & Hart, 2016; Miller, Lamkin, Maples-Keller, & Lynam,
2016).
Review of Theories of ‘Noncriminal’ Psychopathy
A common theme in all theories of noncriminal psychopathy is the view that
criminality and severe anti-sociality are not central to psychopathy. Whilst this view has
recently been subject to enthusiastic debate (Hare & Neumann, 2010; Skeem & Cooke,
2010a, 2010b), very little empirical investigation has been conducted on the link between
criminality and psychopathy in the general population. This is an area of research that
warrants empirical attention as the current psychopathy literature may only apply to a small
subpopulation of psychopathy. There are two reasons for the overall lack of research on
psychopathy in the general population. Firstly, estimates of the prevalence of psychopathy in
criminal offender samples are higher (Hare, 1991) than estimates of the prevalence of
psychopathy in the general population (Coid et al., 2009). Thus, criminal offender samples
provide a convenient and easily recruited psychopathic sample. Secondly, until recently, there
were no suitable or established measures of psychopathy that could be used on noncriminal
samples.
The relative absence of research on noncriminal psychopathy can be partially
attributed to measurement limitations. The PCL-R has been hailed as the ‘gold standard’ of
psychopathy measurement (e.g. (Fulero, 1995; Paulhus & Williams, 2002; Williams &
Paulhus, 2004), generating concern that researchers may be equating PCL-R psychopathy
with the theoretical construct of psychopathy (Blackburn, 2007; Skeem & Cooke, 2010a,
2010b). Furthermore, as previously discussed, the PCL-R was designed for use in criminal
offender samples, requires access to case histories, and contains items that specifically tap
criminal behaviours. Therefore, the PCL-R should be considered a measure of criminal
psychopathy rather than the broad construct of psychopathy. The recent advent of measures
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of noncriminal psychopathy (Levenson, et al., 1995; Lilienfeld & Widows, 2005) have
provided researchers with an avenue to study the theoretical concept of psychopathy more
broadly.
The Current Research
Original Contribution to Knowledge
This program of research contributes to the existing body of literature on psychopathy
by addressing three main gaps in the current literature, each discussed in the following
sections: psychopathy and criminality; psychopathy and executive function; and psychopathy
and emotion-processing.
Psychopathy and Criminality
Because of the paucity of studies on the relationship between psychopathy and
criminality in the general population, it is not known whether criminality is a key feature of
psychopathy or simply one manifestation. Research investigating the relationship between
psychopathy and criminality in the general population may assist with answering this
question. In addition, the exclusive use of male participants means that we have a limited
understanding of the nature and presentation of female psychopathy. The first aim of the
current research project is to conduct a population study of psychopathy with the aim of
disentangling the relationship between psychopathy and criminality. Whilst several theories
of ‘noncriminal’ psychopathy have been proposed, a common perspective is that criminality
and anti-sociality are not central to psychopathy. The current theoretical models of
noncriminal psychopathy will be tested by examining the relationships between criminality,
criminal attitudes, and psychopathy in a general population sample. Additionally, an
examination of possible gender differences in the psychopathy-criminality nexus will be
included to address the male bias in previous psychopathy research.
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Executive Function
The psychopathy literature on executive function has produced confusing and
contradictory findings. This may be attributed to methodological inconsistences between
studies, including criminal versus noncriminal samples; male versus mixed gender samples;
differences in the types of executive function studied; differences in the tests used to
operationalize the different types of executive function; differences in the measurement of
psychopathy; and whether psychopathy was examined as a unitary, categorical construct, or a
continuous, dimensional construct. Therefore, one of the aims of this program of research is
to provide some clarification on the relationship between psychopathy and executive function
by examining the separate relationships between primary and secondary psychopathy and
performance on several popular measures of executive function in a community sample. An
additional aim of this program of research is to examine the relationship between
psychopathy and executive function separately for males and females. This should assist with
comparison of the findings from this program of research with previous studies and also
reveal whether gender differences exist in the psychopathy-executive function relationship.
These findings may also provide support for one or more theories of psychopathy, for
example, by revealing whether a moderated expression of psychopathy is characterised by
intact executive functioning (i.e., the successful psychopathy model).
Emotion Processing
Most previous research on emotion processing abnormalities in psychopathy has been
conducted using male, criminal offender samples. Consequently, the patterns of emotion
dysfunction currently observed in psychopathy may not generalise to other psychopathic
populations. Specifically, the current psychopathy literature may only be applicable to male
psychopathy, and not female psychopathy. In fact, given that a range of cognitive and
emotion processing differences are observed between males and females, some differences in
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cognitive and emotional processing between male and female psychopaths may be expected.
Therefore, the inclusion of gender in studies of affective dysfunction in psychopathy
(including affective language dysfunction) is warranted.
The current research project will examine emotion processing in psychopathy and will
include an examination of gender differences. The emotion literature has consistently
demonstrated differences in emotional processing as a function of gender, including
differences in the ratings of affective stimuli and affective priming. Research on psychopathy
and emotion using male participants has revealed a range of affective deficits, including
abnormal responding to affective words and affective priming abnormalities. However, it not
currently clear whether these deficits will be seen in female psychopathy.
Lastly, this program of research considers the separate contributions of primary and
secondary psychopathy on the processing of affective and semantic language and executive
function. Previous research suggests that psychopathy is a superordinate construct consisting
of two separate yet related subtypes; primary psychopathy and secondary psychopathy. As
mentioned earlier, primary and secondary psychopathy display differential patterns of
affective experience (Del Gaizo & Falkenbach, 2008). Primary psychopathy is associated
with a paucity of positive and negative emotionality, whilst secondary psychopathy is
associated with elevated levels of negative emotionality (e.g., anxiety and hostility).
Cognitive bias studies have demonstrated a facilitation to negative stimuli in individuals with
elevated levels of negative emotion (e.g., anxiety). Given the differences in emotional
experience between primary and secondary psychopathy, differences in processing affective
language may also be observed. There is only one known study that has investigated primary
and secondary psychopathy and affective language abnormalities, and a number of
methodological limitations were present (Reidy et al., 2008). Specifically, this study did not
consider differences in word ratings for psychopathic samples, or differences in word ratings
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for primary and secondary psychopathy (Reidy et al., 2008). The current research project will
examine emotion processing in primary and secondary psychopathy using a LDT and will
extend upon previous research by addressing methodological limitations found in previous
research.
Findings from previous research suggests that psychopathy consists of two subtypes
(Hare, 1991). Primary psychopathy reflects the core interpersonal and affective features of
psychopathy and is thought to be associated with emotion deficits (Karpman, 1941, 1948),
whilst secondary psychopathy reflects the anti-social and impulsive features of psychopathy
and is thought to be associated with affective dysfunction (Karpman, 1941, 1948). More
specifically, research has shown that primary psychopathy is associated with a lack of
negative affect, whilst secondary psychopathy is positively associated with elevated levels of
negative affect (Del Gaizo & Falkenbach, 2008). A consideration of these differences in
emotional experience from a cognitive bias perspective suggests that in comparison to both
non-psychopathic individuals and primary psychopaths a facilitation to negative emotion
stimuli may be observed in secondary psychopathy. Furthermore, given that primary
psychopathy is associated with a paucity of emotion, it is expected that there will be no
differences in response to emotion words in primary psychopathy.
Research Questions
Six main research questions were developed to address the aforementioned aims of
this program of research. These research questions were designed to address the gaps in the
psychopathy literature regarding the underrepresentation of female participants in the study
of psychopathy, the a priori assumption of criminality as a core feature of psychopathy, and
the tendency to consider psychopathy as a unitary construct despite evidence that it is
subsumed by two separate yet related variants.
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Research Question One: How central is criminal behaviour to the construct of
psychopathy?
This research question addresses the controversial dispute between psychopathy
researchers regarding the centrality of criminality to the psychopathy construct. This research
question is addressed by a thorough coverage of the current debate about the role of antisocial
behaviour in relation to psychopathy and empirically tested in study 1 in this program of
research. The relevant literature, the methodology and findings are discussed in chapter three
of this thesis.
Research Question Two: Is the relationship between criminality and psychopathy the
same for males and females?
This research question addresses the underrepresentation of female participants in
psychopathy research. This research question is concerned with possible gender differences
in the relationship between psychopathy and criminality and is empirically tested in study one
of this program of research. The relevant literature, the methodology and findings are
discussed in chapter three of this thesis.
Research Question Three: What is the relationship between psychopathy variants and
executive function in a community sample?
This research question empirically tests the dual process model of psychopathy and
also addresses the current confusion in the psychopathy literature regarding the relationship
between psychopathy and performance on measures of executive function. This is achieved
in study two of this program of research, which examines the relationship between primary
and secondary psychopathy and several popular measures of executive function in a
community sample. The relevant literature, methodology and findings are discussed in
chapter four of this thesis.
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Research Question Four: Is the pattern of relationships between psychopathy variants
and executive function the same for males and females?
This research question addresses the limitations of previous research on executive
functioning in noncriminal samples by including an examination of possible gender
differences. Whilst a couple of previous studies using noncriminal samples have included
female participants, they have not included an examination of possible gender differences in
the relationship between primary and secondary psychopathy and performance on measures
of executive function. This limitation is addressed in study two of this program of research
and the relevant literature and study details are set out in chapter four.
Research Question Five: What is the relationship between psychopathy variants and
emotion processing in a community sample?
This research question addresses the gap in the psychopathy literature regarding the
unique relationships between primary and secondary psychopathy and emotion processing
abnormalities. Specifically, it considers whether a differential relationship between primary
and secondary psychopathy will be observed on a task of implicit emotion processing. The
majority of previous studies have used a criminal offender sample and/or criminal measure of
psychopathy, thus inhibiting interpretation. The only study that has examined whether
differences exist used a male only sample and did not examine explicit ratings of the
emotional stimuli. This limitation is addressed in study three of this program of research,
which is outlined in chapter five of this thesis.
Research Question Six: Is the relationship between psychopathy variants and emotion
processing abnormalities the same for males and females?
Several differences in emotion processing have been observed between males and
females. However, the research on emotion processing abnormalities in psychopathy research
has failed to include an examination of possible gender differences. This limitation is
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addressed in study 3 of this program of research. The relevant literature and study details are
presented in chapter five of this thesis.
Chapter Three
Chapter Overview
This chapter of the thesis presents theoretical arguments and empirical evidence for
extending research on psychopathy to noncriminal populations. The chapter begins by
covering the ongoing debate in the psychopathy literature on the centrality of criminal and
anti-social behaviour to the psychopathy construct, and presents a rationale for extending
psychopathy research to a community sample. It was hypothesised that the relationship
between psychopathy and criminality would more nuanced than suggested by previous
research that has used criminal offender samples and criminal measures of psychopathy. As
the bulk of previous research on psychopathy has examined male participants, possible
gender differences in the relationship between psychopathy and criminality were also
examined.
Background to Research
The psychopathic personality is typified by interpersonal, affective, and behavioural
characteristics such as, manipulativeness, deceitfulness, egocentricity, superficial charm,
irresponsibility, impulsivity, a disregard for conventional norms, and reduced emotional and
empathic capacity. Whilst considerable progress has been made in regards to the
conceptualization and measurement of psychopathy in criminal offenders (Hare, 1980, 1991,
1996), relatively little is known about psychopathy in the general population. The scarcity of
research on psychopathy in noncriminal samples can be attributed to measurement limitations
and a lack of consensus on how psychopathy should be conceptualised and defined
(Lilienfeld, 1994), specifically the role of severe anti-sociality (Hare & Neumann, 2010;
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Neumann, Hare, & Newman, 2007; Skeem & Cooke, 2010a, 2010b; Skeem, Polaschek,
Patrick, & Lilienfeld, 2011).
Whilst the majority of modern research on psychopathy has focused on criminal
manifestations, earlier accounts of the psychopathic personality included both theoretical and
clinical reports of noncriminal psychopaths. In fact, the generally accepted conceptualization
of the clinical construct of psychopathy originated from Cleckley’s (1948) ‘The Mask of
Sanity’. In this collection of case studies, Cleckley highlighted various accounts of
psychopathic individuals who possessed the central features of psychopathy observed in
criminal psychopaths (e.g., egocentricity, manipulativeness, and a lack of concern for others),
but who did not commit serious anti-social or criminal acts (e.g., the business man; scientist;
psychiatrist; and the psychopath as man of the world) (Cleckley, 1948). This classic
Clecklian conceptualization is what forms the basis of modern psychopathy theory, research,
and measurement. At present, the Psychopathy Checklist Revised (PCL-R) is the most widely
used measure of psychopathy, and it was constructed specifically from Clecklian criteria.
(Hare, 1980, 1991). However, the PCL-R was developed and normed on criminal offender
samples, contains items specifically related to criminality, and requires the use of institutional
files, making it unsuitable for the assessment of psychopathy in the general population. Even
PCL-R variants designed for use in noncriminal samples are similarly constrained by the
inclusion of items that specifically assess criminality (e.g., SRP-III). This modern approach to
psychopathy measurement does not align with the theoretical and clinical accounts from
which it was originally constructed. This is problematic because a basic tenet of personality
research states that the development of psychometric assessments should be guided by a
coherent theory of the construct of interest. Without a coherent theoretical foundation for
including criminality as a key feature of the psychopathy construct, the PCL-R unjustifiably
amalgamates psychopathy and criminality. This has resulted in claims of ‘conceptual drift’
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(Blackburn, 2005) and ‘construct drift’(Skeem & Cooke, 2010a). However, this disaccord
between theoretical conceptualizations of psychopathy and the measurement of psychopathy
has been largely overlooked by researchers. As highlighted by Skeem and Cooke (2010a), the
psychopathy literature is bordering on equating the PCL-R measurement of psychopathy with
the construct itself. This mono-operationalisation is problematic not only because of the
departure from a coherent theoretical foundation, but also because previous findings using
PCL-R measures may not generalize to other psychopathic populations. The criticisms
regarding PCL-R measurement are not recent (e.g., Lilienfeld, 1994), yet the PCL-R and its
derivatives continue to be used almost exclusively in psychopathy research. Recent
theoretical discussions on the nature of psychopathy (e.g., Hare & Neumann, 2005; Hare &
Neumann, 2010; Lilienfeld, Watts, & Smith, 2015; Skeem & Cooke, 2010a, 2010b; Skeem et
al., 2011) have resulted in a renewed focus on examining alternative measures of
psychopathy and utilising noncriminal samples.
Examination of the PCL-R. As mentioned, the PCL-R is the most widely used
measure of psychopathy. Research on the factor structure of the PCL-R and its derivatives
has produced two-factor (Hare, 1991; Harpur et al., 1989), three-factor (Cooke & Michie,
2001), and four-factor models (Hare & Neumann, 2005; Hare & Neumann, 2006; Vitacco,
Neumann, Caldwell, Leistico, & Van Rybroek, 2006; Vitacco, Neumann, & Jackson, 2005;
Vitacco, Rogers, Neumann, Harrison, & Vincent, 2005). The once widely-accepted two-
factor model of the PCL-R produces two moderately correlated factors (Harpur et al., 1989).
Factor 1 reflects the interpersonal and affective features of psychopathy, including
deceitfulness, callousness, manipulativeness, superficial charm, and a lack of inhibitory
emotions. Factor 2 reflects the behavioural features of psychopathy, including criminal
antisociality, hostility, and impulsivity. Of particular relevance, criminal behaviour is
encompassed under Factor 2 of the two-factor model.
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Unsatisfied with the methodological techniques used in previous factor analyses of
the PCL-R, and the conclusions drawn from these methods, Cooke and Michie (2001)
conducted factor analysis of the PCL-R using confirmatory factor analysis (CFA) on data
obtained from large forensic samples. Their research did not support the commonly accepted
two-factor model of PCL-R psychopathy. Instead Cooke & Michie’s research indicated that a
three-factor model best described PCL-R psychopathy. The first factor, named Arrogant and
Deceitful Interpersonal Style, consists of the interpersonal features commonly identified in
the psychopathy literature, including, superficial charm, grandiosity, manipulativeness, and
deceitfulness. The second factor, named Deficient Affective Experience, reflects the affective
characteristics, including shallow affect, a lack of inhibitory emotions (i.e., guilt, empathy &
remorse), and a failure to accept responsibility for one’s own actions. The third factor, named
Impulsive and Irresponsible Behavioural style, reflects the lifestyle features of psychopathy,
including boredom proneness, impulsivity, irresponsibility, a parasitic lifestyle, and a lack of
realistic long-term goals. Notably, the severe antisocial behavioural features that appear in the
two-factor model were excluded from Cooke & Michie’s model because they were
considered to be poor indicators of psychopathy.
The four-factor model is the most recent factor-analytic model proposed of PCL-R
psychopathy (Hare, 2003; Hare & Neumann, 2005; Hare & Neumann, 2008; Neumann et al.,
2007). Because of differing theoretical positions on the centrality of severe antisocial
behaviour in psychopathy, Hare and Colleagues (Hare & Neumann, 2005; Neumann et al.,
2007) conducted CFA on the PCL-R and its progeny (e.g., Psychopathy Checklist: Screening
Version [PCL-SV], Psychopathy Checklist: Youth Version [PCL-YV], etc.) using large
forensic adult and youth samples and community samples. The authors proposed a four-factor
model which consisted of the three factors identified in Cooke & Michie’s (2001) factor
analysis and an additional factor labelled ‘antisocial’. The antisocial factor reflects poor
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behavioural controls, early behavioural problems, juvenile delinquency, revocation of
conditional release, and criminal versatility (Hare & Neumann, 2005). Hare (2003) has
suggested that the four factors can easily be converted to the two factor model with Factor 1
consisting of the interpersonal and affective factors and Factor 2 consisting of the lifestyle
and antisocial factors. However, other variations of the four-factor model exist. Cooke,
Michie & Skeem (2007) describe the many variations of the four-factor models as fitting into
three general perspectives: a two factor, four facet model (Hare, 2003), a four factor
hierarchical model (Hare, 2003), and a four-factor correlated model (Hare & Neumann,
2005).
There is currently no consensus amongst researchers on a model of PCL-R
psychopathy. Proponents of the three-factor model criticise the methodology used in previous
factor analytic studies, and the a priori assumption that criminality is a key feature of
psychopathy (Cooke et al., 2007). In turn, proponents of the four-factor models criticise the
techniques used to derive the three-factor model, and argue that early and persistent antisocial
behaviours are central to psychopathy. Whilst there is no consensus on which model of PCL-
R psychopathy is best, it is important to consider that the results of factor analyses are reliant
on the scale items entered. As such, understanding of the criminality-psychopathy nexus
cannot progress by repeatedly conducting factor analyses on the same scale items. In order to
increase understanding, future research should examine the relationship between a measure of
psychopathy that does not explicitly tap criminality, with indicators of criminality, using a
noncriminal and non-psychiatric sample. This has been consistently highlighted by
researchers (Blackburn, 1988; Cooke et al., 2007; Lilienfeld, 1994), including Skeem and
Cooke (2010a, 2010b) who emphasised the tautological nature of predicting criminality from
measures of psychopathy that consist of items and subscales that directly tap criminality. This
problem is further magnified by research which uses the PCL-R as measure of psychopathy,
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then examines the relationship between PCL-R scores and a range of indicators of criminality
(e.g., Harris, Rice, & Cormier, 1991), and then uses these findings to support the notion that
criminality is a central feature of psychopathy (e.g., Hare, 1996). In order to examine the true
relationship between psychopathy and criminality, noncriminal measures of psychopathy
need to be utilised. A few measures of psychopathy suitable for assessment in both forensic
and non-forensic populations now exist for researchers, and research suggests that these
measures possess good psychometric properties. (Levenson et al., 1995; Lilienfeld &
Widows, 2005).
Noncriminal Measures of Psychopathy. Perhaps two of the most promising self-
report measures of psychopathy are the Levenson Self-Report Psychopathy Scale (LSRP)
(Levenson et al., 1995), and the Psychopathic Personality Inventory (Now the Psychopathic
Personality Inventory- Revised) (Lilienfeld & Widows, 2005). The LSRP is a 26-item self-
report inventory designed to extend research on psychopathy to a noncriminal sample and
does not contain items that explicitly assess criminal behaviour. The scale produces a total
score and scores on two subscales that parallel the two factors consistently highlighted in the
literature: primary psychopathy and secondary psychopathy. Validation studies of the LSRP
have produced two-factor (Levenson et al., 1995; Lynam, Whiteside, & Jones, 1999) and
three factor structures (C. Brinkley, Schmitt, Smith, & Newman, 2001; Sellbom, 2011) that
display similar relations with external correlates as the PCL-R. Additionally, the LSRP has
demonstrated good concurrent validity with the PCL-R (C. Brinkley, Schmitt, Smith, &
Newman, 2001). Lynam, Whiteside and Jones (1999) found significant, yet weak correlations
(r between .15 and .32) between LSRP scores and antisocial behaviour in a large university
sample (n = 1219), they concluded that the LSRP scale was a promising self-report measure
of psychopathy.
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Another promising measure of psychopathy is the PPI, which is the most widely used
measure of psychopathy in college and community samples. Unlike the PCL-R, the PPI does
not explicitly tap criminal or anti-social behaviours. Rather, the PPI was developed to
measure the core personality traits considered by many theorists to be central to psychopathy
(Lilienfeld & Widows, 2005). The PPI produces a global psychopathy score and eight content
scale scores derived from factor analyses: Stress Immunity, Social Potency, Fearlessness,
Coldheartedness, Impulsive Nonconformity, Blame Externalisation, Machiavellian
Egocentricity, and Carefree Nonplanfulness. Factor analytic studies of the PPI have generally
produced two dominant factors (Although see, Neumann, Malterer, & Newman, 2008, who
did not replicate the two-factor structure) labelled Fearless Dominance (FD) and Self-Centred
Impulsivity (SCI). (Benning et al., 2003; Patrick, Edens, Poythress, Lilienfeld, & Benning,
2006). A third factor labelled Coldheartedness (CH) also emerged from the aforementioned
studies, but comprised mostly of items from the Coldheartedness content scale. The FD factor
reflects aspects of positive adjustment such as low anxiety and worry, and social adeptness,
combined with high levels of interpersonal dominance (Lilienfeld et al., 2012; Lilienfeld &
Widows, 2005; Patrick et al., 2006). The SCI factor reflects the more deviant personality
traits of psychopathy, including, impulsivity, manipulativeness, egocentricity, a tendency to
blame others for one’s own mistakes, and lack of concern for convention (Benning et al.,
2003; Lilienfeld & Widows, 2005). The CH factor reflects the callous and unemotional traits
of psychopathy. Research by Witt et al. (2009) has demonstrated that the FD and SCI factors
display good convergent and criterion validity. Importantly, because the PPI-R was designed
using a personality-based approach, it does not contain items that assess criminal and/or
antisocial behaviour.
It clear at this point that the measure of psychopathy utilised often reflects the
theoretical position of the researcher regarding the role of severe anti-sociality in
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psychopathy. Typically, researchers who endorse the view of criminality as central to
psychopathy utilise the PCL-R or similar measures (e.g., PCL-SV), and researchers who view
criminality as an epiphenomenon utilise the PPI or similar measures (e.g., LSRP). However, a
consistent finding across all measures of psychopathy is the emergence of two separate, yet
related aspects of psychopathy, an interpersonal and affective facet, and an antisocial-lifestyle
facet. The difference between the measures is the degree to which antisocial behaviour loads
on the antisocial-lifestyle facet, and this is a point of contention amongst psychopathy
researchers. However, in order to establish the true relationship between psychopathy and
criminality, and resolve the question of the centrality of criminality to psychopathy, it is
necessary to utilise a noncriminal measure of psychopathy.
It has been argued that it is tautological to predict criminality from measures of
psychopathy that assess criminality (e.g., Cooke et al., 2007; Skeem & Cooke, 2010a,
2010b). This logic also extends to research on the relationship between psychopathy and
criminality in criminal offender samples. It is currently difficult to assess the degree to which
criminality is central to the construct of psychopathy as previous research has been
confounded by both measurement and sample biases. In this regard, even if alternative,
noncriminal measures of psychopathy are used, understanding of the nature and presentation
of psychopathy will not evolve unless research is extended to include other populations.
Attempts to examine psychopathy using general population samples have been
hindered by measurement limitations, but also previous estimates of the prevalence of
psychopaths in the general population (e.g., estimates between 1-3%, Coid et al., 2009). With
such small estimates, large samples would be required - a task that is both timely and
expensive. However, these estimates were established using criminal measures of
psychopathy, which as pointed out earlier, are unsuitable for assessing psychopathy in the
general population. True estimates of the prevalence of psychopathy in the general population
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would require the use of noncriminal measures. In addition, the research that does exist on
the relationship between psychopathy and criminality in general population samples has
employed measures of psychopathy that directly assess criminality, thus making it difficult to
interpret findings (Coid & Yang, 2011; Coid et al., 2009; Watt & Brooks, 2011). It is likely
that the range of interpersonal and affective features (e.g., callousness, manipulativeness,
superficial charm, deceitfulness, glibness) described by Cleckley (1948, 1951) do exist in the
general population, as severe anti-sociality is not a necessary consequence of possessing
these traits. Furthermore, even within criminal offender samples, the key interpersonal and
affective features are not good predictors of criminal behaviour (Hemphill et al., 1998). In a
review paper on psychopathy measures, Lilienfeld (1998) drew upon McCrae & Costa’s
(1995) distinction between basic tendencies and characteristic adaptations to highlight that
the basic tendencies of psychopathy may be manifested in antisocial ways when psychopathy
traits interact with adverse environmental factors. Given a different set of environmental
factors the basic tendencies of psychopathy may manifest in different characteristic
adaptations (Lilienfeld, 1998). This line of reasoning has led to the development of several
theories of noncriminal psychopathy.
Theories of noncriminal psychopathy. Whilst relatively little empirical research has
been conducted on noncriminal psychopathy, a few theoretical perspectives of noncriminal
psychopathy exist in the literature. These theoretical perspectives have been identified as
reflecting three distinct models: a subclinical psychopathy model, a successful psychopathy
model, and a dual process model (Hall & Benning, 2006). According to the subclinical
account, noncriminal psychopathy and criminal psychopathy share the same etiological
processes and the same psychopathic traits and features, however, noncriminal psychopaths
possess these characteristics to a lesser degree than criminal psychopaths (Ali et al., 2009;
Gustafson & Ritzer, 1995; Mahmut et al., 2008; Paulhus & Williams, 2002). According to the
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subclinical account, criminal behaviour is a product of the core personality characteristics of
psychopathy. However, some researchers (e.g., Lilienfeld, 1994) have suggested that the term
‘subclinical’ implies a clinical cut-off and research demonstrates that psychopathy is a
dimensional construct, not a taxonic construct (Edens et al., 2006; Walters, Brinkley,
Magaletta, & Diamond, 2008). Thus the assumptions of the ‘subclinical’ account are not
supported by research on the nature of psychopathy. In contrast, the model of successful
psychopathy claims that noncriminal psychopaths possess the same traits and features as
criminal psychopaths, and to the same degree, however, compensatory mechanisms moderate
the expression of these traits (Hall & Benning, 2006; Hare, 2011; Lilienfeld, 1998; Widom,
1977). From this perspective, a criminal manifestation of psychopathy would occur in the
presence of other known criminogenic factors, such as pro-criminal attitudes, criminal
associates, substance abuse, familial history of criminal conduct, and lower educational and
financial achievement (Gendreau, Little, & Goggin, 1996). However, in the absence of these
criminogenic factors and/or the presence of compensatory mechanisms, the traits of
psychopathy may be expressed in an advantageous fashion (e.g., rational, successful business
leaders, etc.). This position is in line with the aforementioned distinction between basic
tendencies and characteristic adaptations in personality, which is widely accepted within the
domain of personality theory (McCrae & Costa Jr, 1995). Furthermore, a recent study found
that intelligence was a compensatory factor in the psychopathy-criminality relationship
(Wall, Sellbom, & Goodwin, 2013). Wall, Sellbom & Goodwin (2013) examined intelligence
as a moderating variable between PPI-R assessed psychopathy and self-reported criminal
activity in a university sample and found that individuals who scored highly on psychopathy,
and who were of higher intelligence, reported engaging in less criminal behaviour. This study
provides some support for Hall & Benning’s (2006) successful psychopathy theory and
suggests that psychopathic individuals who are intelligent may be less likely to engage in
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criminal conduct. This finding is in line with research on criminality and intelligence, which
has shown that criminal offenders possess lower levels of intelligence than non-offenders,
particularly verbal intelligence (Kratzer & Hodgins, 1999; Moffitt, 1990). Lastly, the dual
process model of psychopathy suggests that distinct etiological factors give rise to the
development of the interpersonal and affective characteristics, and the development of the
anti-social behavioural features (Hall & Benning, 2006). According to this model,
psychopathic individuals can possess the interpersonal and affective features (primary
psychopathy) in absence of the anti-social behavioural features (secondary psychopathy)
(Patrick, 2007). This position is consistent with suggestions that antisocial behaviour is a
correlate of psychopathy, rather than a core feature. Furthermore, it is possible for individuals
to score highly on one facet whilst scoring low on the other, and there is consistent evidence
of divergent relationships with external variables for individuals high on primary vs.
secondary psychopathy (Benning et al., 2003; Benning, Patrick, & Iacono, 2005; Blonigen et
al., 2003; Morrison & Gilbert, 2001) . Although these theories offer divergent explanations of
the underlying mechanisms of noncriminal psychopathy, the explanations are not mutually
exclusive and a shared feature of all models is the reduced emphasis on criminality as a
central aspect of psychopathy. As previously highlighted, the view of criminality as central to
psychopathy resulted from the popular use of a criminal measure of psychopathy (PCL-R),
and the ease of access to psychopathic individuals in forensic institutions. This modern
conceptualisation of psychopathy is at odds with the theoretical foundation from which it has
originated (e.g., Cleckley).
Whilst the need to study noncriminal samples has been recognized, and new
noncriminal scales have enabled such research, attempts to examine the relationship between
psychopathy and criminality in the general population have continued to use criminal
measures (e.g., Coid et al., 2009; DeMatteo, Heilbrun, & Marczyk, 2006; Ishikawa et al.,
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2001; Watt & Brooks, 2011). Therefore, although general population samples were utilised,
the scales used may only be capturing criminal psychopathy in a noncriminal sample. Very
few studies have examined psychopathy in noncriminal and nonclinical samples using
noncriminal measures (e.g., Lynam et al., 1999; Sellbom & Verona, 2007; Wall et al., 2013).
This is an area of research that warrants empirical attention as the current psychopathy
literature, both forensic and non-forensic, may not generalise to other psychopathic
populations. For example, Skeem & Cooke (2010a) have suggested that the current
psychopathy literature is one of ‘unsuccessful psychopathy’. Therefore, the aim of the current
study was to examine the relationship between LSRP assessed psychopathy and criminality in
a general population sample.
Crime and Criminality. Criminality is a socially constructed concept that can be
defined in various ways. Behaviour can be antisocial but not necessarily criminal and
criminal law is sometimes at odds with what is considered antisocial. For example, public
displays of affection are heavily penalised in some countries (e.g., United Arab Emirates), yet
spousal rape is not a criminal offence in many countries, although such behaviour would be
considered by many to be antisocial. Thus, it is acknowledged that criminal behaviour is
relative to the social, cultural, and political contexts in which it is performed; what is
considered ‘criminal’ varies across time and space. A recent debate on the distinction
between criminal and antisocial behaviour in regards to psychopathy (Hare & Neumann,
2010; Skeem & Cooke, 2010a, 2010b) highlights the need to provide a clear definition of
criminal behaviour for the context of the current discussion. Debates on how best to define
‘crime’ can be found in great detail within the criminology literature, with little agreement
amongst criminologists (see Brown et al., 2010 for a review). For the purposes of this
discussion, crime is defined as an act that is socially harmful, prohibited by the legal system
in the relevant state or country, and results in punishment (Sutherland, 1934). Implied in this
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definition is the view that behaviours are still deemed ‘criminal’ even if they are not officially
documented and prosecuted. Criminologists have long acknowledged the limitations of
official convictions and official records in estimating criminal activity (Erickson & Empey,
1963; Sellin, 1931; Sutherland, 1934), with research showing that criminal activity is more
prevalent than indicated by official conviction records (Erickson & Empey, 1963; Porterfield,
1943). To overcome these limitations researchers have implemented self-report delinquency
scales to estimate the prevalence of criminal activity in the general community (Krohn,
Thornberry, Gibson, & Baldwin, 2010). Therefore, the use of a self-report criminal behaviour
inventory, together with the assessment of official convictions, may provide a more
comprehensive picture of the relationship between psychopathy and criminality than
measuring official convictions alone. In this discussion the term ‘criminality’ is used as a
more general term to refer to criminal behaviour and attitudes towards criminal behaviour.
Attitudes are encompassed in this definition because research in forensic samples shows that
the endorsement of pro-criminal attitudes correlates with future criminal behaviour for both
men and women (Andrews & Bonta, 2014; Gendreau et al., 1996; Holsinger, 1999). Thus, the
assessment of criminal attitudes may provide an additional indicator of criminality in
noncriminal samples.
Attitudes. Attitudes are favourable or unfavourable evaluations of something or
someone and consist of three components: affective, cognitive and behavioural (Maio, Olson,
Bernard, & Luke, 2006). The affective component refers to feelings about the object, the
cognitive component refers to beliefs and ideas about the object, and the behavioural
component refers to past behaviours regarding the object. Although personality traits and
attitudes are both used to explain and predict behaviour, there are also distinguishing features
that separate personality traits and attitudes (Ajzen, 2005). Personality traits are viewed as
behavioural dispositions or response tendencies of an individual that occur in a range of
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circumstances, and are relatively stable over time (i.e., manipulativeness). Attitudes are
evaluations of a particular object (e.g., person, event, idea, or institution), and are more
flexible, and susceptible to change than personality traits (i.e., negative attitudes towards law
enforcement) (Ajzen, 2005). Azjen’s (1991) influential theory of planned behaviour suggests
that attitudes towards a particular behaviour, combined with subjective norms and perceived
control, can be used to predict behavioural intentions with a high degree of accuracy. It is
conceivable then that attitudes towards crime and criminal behaviour may provide an implicit
indicator of criminality in psychopathy, even in absence of actual criminal behaviour.
The Criminal Sentiments Scale- Revised (CSS-R) (Simourd, 1997) is a scale used to
assess attitudes towards criminal behaviour. The scale produces a global score and scores on
three subscales: attitudes towards the law-courts-police, identification with criminal others,
and tolerance for law violations. Thus, the CSS-M can be used to assess attitudes towards a
particular behaviour/s (criminal behaviours), which as suggested by Ajzen (1991) is one
component of predicting behavioural outcomes. Research by Simourd and Olver (2002) using
the CSS-M in a large, male offender sample found that the endorsement of criminal attitudes
was significantly related to rearrest, violent rearrest, and re-incarceration. Previous research
on the CSS-M and psychopathy in criminal offender samples has shown that secondary
psychopathy, but not primary psychopathy is moderately correlated with pro-criminal
attitudes (Simourd, 1997). Therefore, the use of the CSS-M to assess attitudes towards
criminal behaviour may be a good indicator of latent criminality in psychopathy in a
community sample. This study will examine the relationship between LSRP global
psychopathy, primary psychopathy, secondary psychopathy and criminal attitudes.
As mentioned earlier, the common theme shared by theories of noncriminal
psychopathy is the reduced role of criminality. However, these theories lead to differential
hypotheses regarding the relationship between psychopathy and criminal attitudes. According
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to the dual-model, the interpersonal and affective features can appear in absence of the anti-
social features. Thus, it might be expected that only secondary psychopathy would be
associated with pro-criminal attitudes in a general population. However, according to the
successful psychopathy model, psychopathic individuals in the community possess the same
traits and to the same degree, but moderating factors influence the expression of these traits.
From this perspective, it might be expected that both primary and secondary psychopathy
would be associated with pro-criminal attitudes. However, the influence of these attitudes on
criminal behaviour would be moderated by social influences or other criminogenic factors
known to contribute to criminal behaviour. For example, it is acknowledged that subjective
norms influence the strength of attitudes, and the attitude-behaviour relationship. Research in
support of the effect of subjective norms on the attitude-behaviour relationship has shown
that group norms influence the strength of attitudes (Visser & Mirabile, 2004), and the
relationship between attitudes and behavioural intentions, particularly when the individual
identifies strongly with the social group (Terry & Hogg, 1996; Terry, Hogg, & White, 1999).
Therefore, it is reasonable to suggest that individuals with increased levels of psychopathy in
criminal social contexts, where criminality is normalised, may display stronger criminal
attitudes and increased criminal behaviour. However, in contexts where criminal behaviour is
not acceptable and is heavily penalised, both formally and informally, the behavioural
expression of pro-criminal attitudes may be supressed. Therefore, some individuals with
psychopathy in the community may possess stronger pro-criminal attitudes, but the influence
of social context may supress the behavioural expression of these attitudes.
Gender. As previously discussed, the majority of previous research on psychopathy
has utilised male, criminal offender samples. Thus, in addition to criminal samples
dominating the psychopathy literature, research on psychopathy predominately reflects male
psychopathy. There is comparatively little research on psychopathy in females, and few
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studies have explored possible differences in the manifestation of psychopathy traits as a
function of gender. The current literature on psychopathy and gender has demonstrated that
males are more likely to possess psychopathic characteristics than females (Rogstad &
Rogers, 2008), and mean differences in psychopathy scores are consistently reported (Miller,
Watts, & Jones, 2011). Furthermore, there is some evidence that psychopathy is expressed
differently in males and females. For example, Forouzan (2003) found that the interpersonal
characteristics of male and female psychopaths varied, deceitful males were more likely to be
conning, whilst females were more likely to act flirtatiously. Behavioural differences were
also observed, while male psychopaths displayed problems with impulsivity and violent
criminal conduct, female psychopaths displayed self-harming behaviours, manipulation and
non-violent criminal conduct, such as theft or fraud (Forouzan, 2003). However, these
findings are consistent with gender differences in offending more broadly, with crime
statistics showing that males are more likely to engage in violent criminal behaviour than
females, and that when females offend it is generally theft and property crimes (Australian
Institute of Criminology, 2013; United States Department of Justice, 2014). Therefore,
female and male criminal psychopaths are engaging in gender-consistent criminal behaviours
and the gender differences observed may not be related to psychopathy per se. Forouzan &
Cooke (2005) suggest that clinicians find the interpersonal features such as superficial charm
and grandiosity to be less observable in females and suggest that this may be an artefact of
socialisation. In addition, whilst psychopathy is considered a good predictor of recidivism in
males, the predictive utility of psychopathy in females is questionable. Using the PCL-R in a
female inmate sample, Salekin, Rogers, Ustad & Sewell (1998) found that the PCL-R
performed poorly as a predictor of recidivism in females, with only 11% of the recidivists
scoring highly on psychopathy. This study also found that unlike males, Factor 1 of the PCL-
R was a better predictor of recidivism in females than factor 2 (Salekin et al., 1998). Research
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using male, criminal offender samples has consistently shown that Factor 2 of the PCL-R is a
better predictor of recidivism than Factor 1 (Hemphill et al., 1998). These findings suggest
that psychopathy factors may differentially predict criminal behaviour in males and females.
In contrast, Miller, Watts & Jones (2011) examined possible gender differences in the
relationships between psychopathy, etiological factors (e.g., parental relationships), the Five-
Factor Model of personality (FFM), measures of Gray’s (1970) behavioural inhibition and
activation systems, and a range of externalising behaviours (e.g., gambling, substance abuse,
and self-harm) in an undergraduate sample and found that the relationships between
psychopathy and these factors were similar across gender. Furthermore, research examining
the factor structure of psychopathy measures suggests that the factor structure is consistent
for both genders (Cale & Lilienfeld, 2002; Skeem, Mulvey, & Grisso, 2003; Kennealy,
Hicks, & Patrick, 2007). Whilst there appears to be similarities in the underlying structure of
psychopathy for males and females the scarcity of research on psychopathy in females,
together with some evidence of differences between males and females in the behavioural
expression of psychopathy, warrants an examination of possible gender differences in the
psychopathy-criminality nexus.
The Current Study
The aim of this study was to examine the relationship between criminality and
psychopathy in the community using a noncriminal measure of psychopathy. It was expected
that some individuals recruited from the community would score highly on the LSRP scale.
Given the theories of noncriminal psychopathy previously discussed, it was hypothesised that
individuals who scored highly on primary and secondary psychopathy would not possess the
same level of criminality as psychopaths in criminal samples. Alternatively, the dual-model
approach may suggest elevated levels of criminality only in secondary psychopathy. Given
the scarcity of research on psychopathy using female participants, and some evidence of
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gender differences in both crime (Australian Institute of Criminology, 2013; United States
Department of Justice, 2014) and the relationship between psychopathy and criminality
(Salekin et al., 1998), an additional aim of this study was to examine the psychopathy-
criminality relationship separately for males and females with the aim of elucidating any
gender differences. The examination of male and female findings separately will also aid in
the comparison of findings from the current study with previous research which has
predominately used male, criminal offender samples.
To achieve these aims, this study examined the relationship between primary and
secondary psychopathy (measured by the LSRP) and self-reported criminal convictions,
criminal behaviour, and traffic violations. To obtain a comprehensive assessment of the
relationship between psychopathy and criminality, criminal attitudes were also assessed as an
additional indicator of criminality. According to the theory of planned behaviour, attitudes
can influence behaviour, and there is some empirical support for the association between
criminal attitudes and criminal conduct (Gendreau, Andrews, Goggin & Chanteloupe, 1992;
Simourd & Andrews, 1994).
In line with theoretical accounts of noncriminal psychopathy, which emphasise the
reduced role of anti-sociality, it was hypothesised that the relationship between psychopathy
and criminality would be more nuanced than that found in previous research using criminal
offender samples. The successful psychopathy model suggests that compensatory
mechanisms (e.g., favourable environmental factors) influence the expression of psychopathy
towards adaptive rather than maladaptive expressions. Following this theory, it would be
expected that neither primary nor secondary psychopathy would be associated with criminal
convictions, self-report criminal behaviour, or traffic violations. However, because attitudes
are implicit and their expression influenced by social context, primary and secondary
psychopathy may be associated with pro-criminal attitudes, but not necessarily criminal
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conduct. An examination of possible mediating effects of group norms on the relationship
between psychopathy and criminality may provide additional support for the successful
psychopathy model. Therefore, if a significant relationship is found between psychopathy and
criminal behaviour, it could be because of a stronger identification with criminal social
groups.
In contrast, the dual process model suggests that the interpersonal and affective
features are distinct from the antisocial behaviour features. In this regard, it might be
expected that only secondary psychopathy (the antisocial-lifestyle facet) would be
significantly related to criminal attitudes, criminal convictions, self-report criminal
behaviour, and traffic violations. This hypothesis is further supported by research in forensic
samples which demonstrates that only secondary psychopathy (Factor 2) is related to pro-
criminal attitudes (Simourd, 1997), and that secondary psychopathy is better predictor of
criminal behaviour (Hemphill et al., 1998). In regards to gender differences, it is
hypothesised that if a relationship exists between psychopathy and criminality in the current
study, primary psychopathy will be a better predictor than secondary psychopathy in the
female sample only, because previous research has shown that unlike males, Factor 1 of the
PCL-R is a better predictor of criminality in female criminal offenders (Hemphill et al., 1998;
Salekin et al., 1998).
Method
Participants
The sample consisted of 523 participants (68% female) recruited from the general
population of South East Queensland via social networking sites, online news websites,
classified advertisements, and advertising flyers posted at shopping centres and university
campuses. The average age of participants was 29 years (males M = 29 years, SD = 10 years;
females M = 30 years, SD = 12 years). The sample consisted of participants who were
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students (45%), and participants who were employed full-time (35.4%), part-time (11.1%), or
on a casual basis (4.2%); self-employed (1.7%); unemployed (1%) and other (1.5%) (e.g.,
volunteers/full-time parents/retirees). The complete demographic data for participants is
presented in Table 1.
Table 1
Participant Demographics (N = 523)
Demographic Variable % Male % Female
Highest Level of Education Did Not Complete Year 10
- .60
Year 10 Certificate 1.80 2.50 Year 12 Certificate 44.40 41.20 Trade/Diploma 14.20 13.30 Undergraduate Degree 29.60 26.30 Postgraduate Degree 10.10 16.10 Country of Birth Australia 78.10 74.90 England 4.10 5.40 New Zealand 4.10 4.50 China 3.0 1.10 Other (all < 2% frequency)
10.70 14.10
Cultural Background Australian 86.20 89.70 British 3.80 6.90 Chinese 4.40 2.20 Other (all < 1% frequency)
5.60 1.20
Traffic Violation Yes 58.60 50.90 No 41.40 49.10 Criminal Conviction Yes 5.30 2.0 No 94.70 98.0 Prison Sentence Yes - .30 No 100 99.70
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Materials
Demographic questionnaire. A brief demographic questionnaire was used to
measure individual difference variables, such as age, gender, ethnicity, level of education and
employment status. In addition, there were items regarding previous criminal conduct and
lawful behaviour. Participation was anonymous, no personally identifying information was
requested from participants.
Levenson Self-Report Psychopathy Scale (LSRP) (Levenson et al., 1995). The
LSRP is a 26-item self-report questionnaire designed for use in non-institutionalised samples
(Levenson, et al., 1995). Each item consists of a statement that participants endorse on a four-
point Likert scale (the anchors are 1 = disagree strongly and 4 = agree strongly). The primary
psychopathy subscale contains 16 items that assess the core personality traits of psychopathy
described by Cleckley (1941, 1948, 1951), including manipulativeness, callousness, and lack
of empathy, guilt or remorse. A sample item is “I tell other people what they want to hear so
that they will do what I want them to do”. Scores range from 16 to 64 with higher scores
reflect higher levels of primary psychopathy. The secondary psychopathy subscale contains
10 items that assess impulsivity, anti-social behaviour and a self-defeating lifestyle. A sample
item is “I don’t plan anything very far in advance”. Scores range from 10 to 40 with higher
scores reflect higher levels of secondary psychopathy. Some items are scored in reverse order
to control for response sets. The scale has good internal reliability for the primary
psychopathy subscale with Cronbach’s alpha .84 and adequate internal reliability for the
secondary psychopathy subscale with Cronbach’s alpha .72 (Ali, et al., 2009). The scale
possesses good temporal reliability at eight weeks’ test-retest (.83) (Lynam, et al., 1999). In a
male, predominately Caucasian, undergraduate sample the mean level of primary
psychopathy (M = 32.22, SD = 6.80) and secondary psychopathy (M = 18.60, SD = 3.60)
(Reidy et al., 2008) is similar to that found in male, Caucasian, criminal offender samples for
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primary (M = 31.86, SD = 8.22) and secondary (M = 22.20, SD = 5.18) psychopathy
(Brinkley et al., 2001).
The Criminal Sentiments Scale Modified (CSS-M) (Simourd, 1997). The CSS-M
is a 41-item self-report questionnaire designed to measure attitudes, values and beliefs
towards criminality and lawful behaviour. Each item consists of a statement with which
participants agree, disagree or remain undecided (anchors are A = agree, D = disagree, U =
undecided). Endorsement of pro-criminal statements (or the rejection of pro-social
statements) attracts two points whilst the rejection of pro-criminal statements (or the
endorsement of pro-social statements) yields a point of zero. Undecided responses attract one
point. Thus, higher scores indicate greater pro-criminal attitudes. Some items are scored in
reverse to control for response sets. The CSS-M yields a total score and three subscale scores:
law-court-police (LCP), identification with criminal others (ICO), and tolerance for law
violations (TLV). The LCP subscale contains 25 items that assess attitudes towards the law
and criminal justice system. Sample items are “The police are as crooked as the people they
arrest” (police), “Almost any jury can be fixed” (courts), and “It’s our duty to obey all laws”
(law). The ICO subscale contains 6 items designed to assess personal evaluative judgments
that individuals hold toward law violators. A sample item is “People who have broken the
law have the same sorts of ideas about life as me”. The TLV subscale contains 10 items that
assess justification for criminal behaviour and law violation. Sample items are “Most people
would commit crimes if they wouldn’t get caught” and “There is never a good reason to
break the law”. The CSS-M possesses good internal reliability for the total scale (alpha = .91)
(Simourd & Olver, 2002) and LCP subscale (alpha = .87) (Simourd & Olver, 2002), and
adequate internal reliability for the TLV (alpha = .76) (Simourd & Olver, 2002) and ICO
(alpha = .73) (Simourd, 1997) subscales.
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Self-Report Criminal Activity Scale. A self-report criminal activity scale was
included to capture acts of criminal behaviour that may not have resulted in an official
conviction. The Self-Report Delinquency Scale (SRDS) (Mak, 1993) was modified so that
items relating to delinquent behaviours (such as truancy from school) were excluded or
reworded so that they were applicable to an adult population. The SRDS was designed by
Mak (1993) to capture actual delinquent behaviour rather than official convictions in young
people, and the scale demonstrates good internal consistency (Cronbach’s alpha = .88).
Unlike the SRDS, the modified scale used in the current study employed a Likert-scale
response format that assessed the frequency of a particular criminal act across the lifespan,
rather than in the previous 12-month period (the anchors are 1 = never, 2 = a couple of time,
3 = a few times, 4 = many times, 5 = all the time). The modified scale contains 28 items: 22
items that assess the frequency of a range of criminal behaviours, and six items to detect
socially desirable responding (See Appendix 1). The possible scores range from 22 to 110,
with higher scores indicating higher levels of criminal activity. The modified scale possesses
good internal consistency (Cronbach’s alpha = .85).
Instructional manipulation checks (IMC’s) (Oppenheimer, Meyvis, &
Davidenko, 2009). The two IMC’s were designed to capture satisfice responding. The IMC’s
instructed participants to select a particular response on the Likert-scale or to refrain from
responding. A sample item is “Please select ‘agree strongly’ as your answer for this
question”.
Procedure
Ethical approval for this study was obtained from the Human Research Ethics
Committee of the Queensland University of Technology and is presented in appendix 2
(approval number 1100001490). Participants were given an information letter which detailed
the nature of the research and participation requirements. The participant information letter
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contained a web link to an online survey tool (Surveymonkey.com) and participants
completed the questionnaire set electronically. Participation was anonymous and participants
were given the choice to participate in future studies by providing a unique identifier code.
The identifier code consisted of the first three letters of the participants’ mothers’ maiden
name and the last three digits of the participants’ mobile telephone number. The identifier
code was designed to link participant responses from this study with participation in
subsequent studies of this research program. Participation in this study was voluntary.
Participants first completed the demographic questionnaire and then the Levenson
Self-Report Psychopathy Scale. The Criminal Sentiments Scale-Modified and Self-Report
Criminal Activity Scale were presented last in a counterbalanced order to avoid value-laden
items from influencing responses on the other questionnaires. The IMC’s were presented
randomly throughout the questionnaire set. Participants were thanked for their participation at
the conclusion of the questionnaire set. The complete questionnaire set for this study is
presented in Appendix 1.
Design
A cross-sectional, correlational design was used to examine the relationship between
psychopathy and criminality. The predictor variables were primary psychopathy and
secondary psychopathy as measured by the Levenson Self-Report Psychopathy Scale (LSRP)
(1995). The LSRP was chosen as the measure of primary and secondary psychopathy for this
study, as this scale is a psychometrically sound, public domain test and could therefore be
used in the online questionnaire set. The outcome variables were previous criminal
convictions; traffic violations; the three criminal attitude factors (attitudes towards law-
courts-police, tolerance for law violations, and identification with criminal others) (measured
using the CSS-M); and self-reported criminal offending (measured using the SRCS).
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To prevent potential satisfice responding, a progress bar was displayed at the top of
the page to provide participants with information on their progress through the study. In
addition, four instructional manipulation checks (IMC’s) (Oppenheimer, Meyvis &
Davidenko, 2009) were used to capture satisfice responding and were randomly presented
throughout the questionnaire set. Participants who did not respond appropriately were
excluded from the sample (N = 32).
Results
Data Screening
Data was screened prior to analyses for accuracy of input, missing values, and
outliers. There were no missing data points or out of range values. All means and standard
deviations were plausible. Values that were more than 3.29 standard deviations from the
mean were considered extreme values (Tabachnick & Fidell, 2007). These cases were
addressed by replacing the original score with a value equal to the mean plus three standard
deviations. The modified data was used in all inferential analyses.
Descriptive Statistics
Descriptive statistics are displayed separately for males and females in Table 2. An
examination of the means indicated possible gender differences in global psychopathy,
primary psychopathy, tolerance for law violations, identification with criminal others, and
self-report criminality. T-tests confirmed that these differences were significant. Males
reported significantly higher levels of global psychopathy, t(521) = 2.80, p = .005, d = .26,
primary psychopathy, t(521) = 3.28, p = .001, d = .26, tolerance for law violations, t(521) =
2.96, p = .003, d = .27, possessed a stronger identification with other criminals, t(521) = 3.53,
p < .001, 𝑑𝑑 = .31, and reported engaging in more criminal behaviour, t(521) = 5.70, p <
.001, 𝑑𝑑 = .56. The small effect sizes observed for psychopathy and criminal attitudes suggest
that no meaningful differences exist between males and females. However, a medium effect
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size was observed for criminal behaviour, suggesting that there is a noticeable difference in
criminal offending as a function of gender. This finding is consistent with crime data on
gender differences in offense rates (Australian Institute of Criminology, 2013; United States
Department of Justice, 2014). Of the 523 participants only 16 reported having a criminal
conviction (< 3% of the sample), thus no further analyses were conducted in relation to
criminal offenses. The means and standard deviations for primary psychopathy and secondary
psychopathy were similar to those found in previous research using an undergraduate sample
(Reidy et al., 2008), and criminal offender sample (C. Brinkley et al., 2001) (Cohen’s d = .38,
a small-moderate effect, for the difference between the current sample and Brinkley et al.
2001). Interestingly, the means and standard deviations for the criminal sentiments subscales
were also similar to those found in previous research using male, criminal offender samples
(CSS-M Total, M = 27.10, SD = 14.80; LCP, M = 18.10, SD = 10.70; TLV, M = 6.50, SD =
3.80, ICO, M = 2.50, SD = 2.30) (Simourd, 1997). The internal reliabilities for the scales
were calculated using the whole sample and are displayed in Table 2. The internal reliabilities
of the scales ranged from good to adequate, with the exception of the ICO subscale. The poor
internal reliability of the ICO subscale could be because it contains only 6 items and
Cronbach’s alpha is sensitive to the number of items included. All inter-item correlations for
the ICO subscale were positive.
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Table 2
Descriptive Statistics for Psychopathy and Criminal Attitudes for Males and Females
Male Female Cronbach’s a Measure M SD M SD Global Psychopathy 48.49 9.48 46.05 9.14 .85 Primary psychopathy 28.48 9.14 26.37 6.28 .84 Secondary psychopathy
19.98 3.93 19.69 4.33 .70
Criminal Sentiments Scale total
25.81 12.11 24.15 9.73 .88
Law-Courts-Police 15.43 8.23 15.30 6.74 .85 Tolerance for law violations
7.15 3.69 6.17 3.42 .70
Identification with criminal others
3.18 1.68 2.67 1.51 .54
Self-report criminality
29.89 7.38 26.32 4.97 .85
Inferential Statistics
Hierarchical multiple regression analyses were conducted to predict self-report
criminal behaviour and criminal attitudes as a function of primary and secondary
psychopathy. All assumptions were met (i.e., additivity and linearity, independent errors,
homoscedasticity, and normally distributed residuals). Bivariate correlations are displayed
separately for males and females in Table 2. The pattern of relationships between
psychopathy and the criminal attitudes factors are similar for both males and females.
However, the relationship between primary psychopathy and self-report criminality is
different for males and females. Higher levels of primary psychopathy show a weak, positive,
and significant relationship with criminal behaviour in females. However, for males a weak,
negative and nonsignificant relationship is observed. The difference between these
correlations was statistically significant, Z = 2.82, p = .005. These findings are consistent
with previous research in criminal offender samples (Hemphill et al., 1998; Salekin et al.,
1998). Secondary psychopathy was significantly related to self-report criminal conduct in
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both males and females. Given the low bivariate correlations between the number of traffic
violations and primary and secondary psychopathy no further analyses were conducted.
Table 3
Bivariate Correlations between Psychopathy and Criminal Attitudes (Correlations Below the
Diagonal Are for Males, Above the Diagonal for Females)
Psych Total
Prim Psych
Secon Psych
CSS Total LCP ICO TLV SRCS NTV
Psych Total .90** .79** .39** .27** .26** .46** .25** .04
Prim Psych .92** .46** .31** .19** .20** .42** .18** .01
Secon Psych .71** .38** .37** .29** .25** .35** .27** .07
CSS Total .42** .33** .38** .92** .52** .77** .32** .07
LCP .31** .23** .30** .95** .32** .52** .22** .06
ICO .34** .27** .31** .62** .45** .41** .22** .04
TLV .48** .40** .41** .82** .63** .53** .36** .08
SRCS .06 -.01 .16* .33** .25** .37** .32** .18*
NTV -.15 -.17 -.04 -.22* -.19* -.11 -.21* .29**
Note. CSS Total = Criminal Sentiments Scale Total; LCP = Law Courts Police; ICO = Identification with Criminal Others; TLV = Tolerance for Law Violations; Psych Total = Psychopathy Total Score; Prim Psych = Primary Psychopathy; Secon Psych = Secondary Psychopathy; SRCS = Self-report Criminality Scale NTV = Number of Traffic Violations. * p < .05, **p < .01. two-tailed.
Criminal Attitudes. Hierarchical multiple regression was conducted to predict
criminal attitudes from the linear combination of primary and secondary psychopathy.
Because the literature on psychopathy suggests that secondary psychopathy is more strongly
related with antisocial behaviour, secondary psychopathy was entered in the first step, and
primary psychopathy was entered in the second step.
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Males. The results at the first step revealed that higher levels of secondary
psychopathy significantly explained 14.3% (adjusted R square) of the variance in criminal
attitudes, a moderate effect (R = .38, F [1, 167] = 29.06, p < .001). Adding primary
psychopathy to the regression model explained an additional 4% of the variation in criminal
attitudes and this change in 𝑅𝑅2 was significant, F(1, 167) = 8.10, p = .005. The linear
combination of primary and secondary psychopathy significantly predicted criminal attitudes,
R= .43, accounting for 17.8% of the variance, F(2, 166) = 19.20, p<.001. Within the
regression model higher levels of secondary psychopathy, and to a lesser extent, higher levels
of primary psychopathy significantly predicted pro-criminal attitudes. Details of the
regression are presented in Table 4.
Females. In the first step when secondary psychopathy was entered, R = .37,
accounting for 13.6% of the variation in criminal attitudes (adjusted R square), F(1, 352) =
56.59, p < .001. The addition of primary psychopathy to the regression model explained an
additional 2.5%, and this change was significant, F(1, 351) = 10.70, p < .001. The linear
combination of primary and secondary psychopathy significantly predicted criminal attitudes
in females, accounting for 15.9% of the variability in pro-criminal attitudes, R = .40, F(2,
351) = 34.42, p < .001. Within the regression model both higher levels of primary and
secondary psychopathy significantly predicted pro-criminal attitudes, with secondary
psychopathy being a better predictor. Details of the regression are presented in Table 4.
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Table 4
Hierarchical Multiple Regression Predicting Criminal Attitudes from Primary and Secondary
Psychopathy Separately for Males and Females
B SE B β t
Males
Step 1
Constant 2.09 4.48
Secondary Psychopathy 1.18 .22 .38 5.39***
Step 2
Constant -3.25 4.77
Secondary Psychopathy .76 .13 .34 5.90***
Primary Psychopathy .26 .08 .18 3.18**
Females
Step 1
Constant 7.67 2.24
Secondary Psychopathy .83 .11 .37 7.52**
Step 2
Constant 4.03 2.47
Secondary Psychopathy .64 .12 .28 5.21***
Primary Psychopathy .27 .08 .18 3.27**
Note. **p<.01 ***p<.001.
Attitudes Toward Law, Courts and Police. To further elucidate the relationship
between criminal attitudes and primary and secondary psychopathy, hierarchical multiple
regression was conducted on the criminal sentiments subscale: law, courts and police. Using
the previously mentioned rationale, secondary psychopathy was entered in the first step and
primary psychopathy was entered in the second step.
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Males. The results at the first step revealed that higher levels of secondary
psychopathy significantly explained 8.9% of the variance in negative attitudes toward the
law, courts, and police, a small effect (R = .30, F [1, 167] = 17.40, p < .001). The addition of
primary psychopathy to the regression model did not produce a significant change in 𝑅𝑅2, F(1,
166) = 3.08, p = .08. The linear combination of primary and secondary psychopathy
explained 10% of the variance, R = .33, F(2, 166) = 10.35, p<.001. However, within the
regression model only higher levels secondary psychopathy significantly predicted negative
attitudes towards the law, courts, and police. Details of the regression are presented in Table
5.
Females. In the first step, higher levels of secondary psychopathy significantly
predicted negative attitudes towards the law, courts and police, R = .29, F(1, 352) = 34.64, p
< .001, accounting for 8.7% of the variability in negative attitudes towards the law, courts
and police. The addition of primary psychopathy to the regression model did not produce a
significant change in 𝑅𝑅2, F(1, 351) = 1.24, p =.26. The linear combination of primary and
secondary psychopathy significantly predicted negative attitudes towards the law, courts and
police, explaining 9.3% of the variance, R = .30, F(2, 351) = 17.95, p<.001. However, only
higher levels of secondary psychopathy significantly predicted negative attitudes towards the
law, courts and police. The regression model is presented in Table 5.
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Table 5
Hierarchical Multiple Regression Predicting Attitudes Toward Law, Courts, and Police from
Primary and Secondary Psychopathy Separately for Males and Females
B SE B β t
Males
Step 1
Constant 2.55 3.14
Secondary Psychopathy .64 .15 .30 4.17**
Step 2
Constant .20 3.39
Secondary Psychopathy .53 .16 .25 3.20**
Primary Psychopathy .16 .09 .13 1.75
Females
Step 1
Constant 6.11 1.59
Secondary Psychopathy .46 .07 .29 5.88***
Step 2
Constant 5.22 1.78
Secondary Psychopathy .42 .09 .26 4.68***
Primary Psychopathy .06 .06 .06 1.11
Note. **p<.01 ***p<.001.
Tolerance for Law Violations. Hierarchical multiple regression was used to assess if
primary and secondary psychopathy significantly predicted a higher tolerance for law
violation. Secondary psychopathy was again entered in the first step and primary
psychopathy was entered in the second step.
Males. At the first step higher levels of secondary psychopathy significantly
explained 16.7% of the variance in tolerance for law violations, R = .41, F (1, 167) = 34.70, p
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< .001. The addition of primary psychopathy to the regression model explained an additional
7.2% of the variance in tolerance for violations of the law and this change in 𝑅𝑅2 was
significant, F(1, 166) = 15.85, p <.001. The linear combination of primary and secondary
psychopathy significantly predicted tolerance for law violations, R = .49, accounting for
23.5% of the variance, F(2, 166) = 26.82, p<.001. A higher tolerance for law violations was
significantly predicted by higher levels of primary and secondary psychopathy, with
secondary psychopathy being a better predictor. The full regression model is presented in
Table 6.
Females. The results at the first step showed that higher levels of secondary
psychopathy significantly explained 12.3% of the variation in tolerance for law violations, R
= .35, F(1, 352) = 50.46, p < .001. With primary psychopathy added to the model, an
additional 8.9% of variability was explained and this 𝑅𝑅2change was significant, F(1, 351) =
39.81, p <.001. The linear combination of primary and secondary psychopathy significantly
predicted a tolerance for law violations, explaining 21% of the variability (R = .46, F[2, 351]
= 47.92, p <.001). Higher levels of both primary and secondary psychopathy significantly
predicted a higher tolerance for law violations. However, unlike the findings for males,
higher levels of primary psychopathy better predicted a tolerance for law violations. Details
of the regression are presented in Table 6.
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Table 6
Hierarchical Multiple Regression Predicting Tolerance for Law Violations from Primary and
Secondary Psychopathy Presented Separately for Males and Females
B SE B β t
Males
Step 1
Constant -.63 1.34
Secondary Psychopathy .39 .06 .41 5.89***
Step 2
Constant -2.83 1.40
Secondary Psychopathy .28 .06 .30 4.15***
Primary Psychopathy .15 .03 .29 3.98***
Females
Step 1
Constant .65 .79
Secondary Psychopathy .28 .03 .35 7.10***
Step 2
Constant -1.73 .84
Secondary Psychopathy .15 .04 .19 3.67***
Primary Psychopathy .18 .02 .33 6.31***
Note. ***p <.001.
Identification with Criminal Others. Primary and secondary psychopathy were used
in a hierarchical regression analysis to predict identification with criminal others. Secondary
psychopathy was entered in the first step and primary psychopathy was entered in the second
step.
Males. The results at the first step revealed that secondary psychopathy significantly
explained 9.1% of the variance in identification with other criminals, R = .31, F (1, 167) =
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17.81, p < .001. The addition of primary psychopathy to the regression model explained an
additional 2.8% of the variance in identification with criminal others, and this change in 𝑅𝑅2
was significant, F(1, 166) = 5.30, p =.02. The overall prediction model was statistically
significant, R = .35, accounting for 11.4% of the variance, F (2, 166) = 11.78, p < .001.
Within the regression model higher levels of both primary and secondary psychopathy
predicted a stronger identification with criminal others, with secondary psychopathy being a
better predictor. Details of the regression are presented in Table 7.
Females. The results after the first step showed that higher levels of secondary
psychopathy significantly explained 6.1% of the variation in identification with other
criminals, R = .25, F (1, 352) = 23.76, p < .001. The addition of primary psychopathy to the
regression model did not produce a significant change in 𝑅𝑅2, F(1, 351) = 3.8, ns. The linear
combination of primary and secondary psychopathy significantly predicted a stronger sense
of identification with other criminals, explaining 6.8% of the variability (R=.27, F[2, 351] =
13.91, p < .001. Unlike the male results, only secondary psychopathy was a significant
predictor within the regression model. The full details of the prediction model are presented
in Table 7.
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Table 7
Hierarchical Multiple Regression Predicting Identification with Criminal Others from
Primary and Secondary Psychopathy for Males and Females
B SE B β t
Males
Step 1
Constant .53 .64
Secondary Psychopathy .13 .03 .31 4.22***
Step 2
Constant -.09 .68
Secondary Psychopathy .10 .03 .24 3.06**
Primary Psychopathy .04 .01 .18 2.30*
Females
Step 1
Constant .94 .36
Secondary Psychopathy .08 .01 .25 4.8***
Step 2
Constant .58 .40
Secondary Psychopathy .06 .02 .19 5.41**
Primary Psychopathy .02 .01 .14 1.96
Note. *p<.05 **p<.01 ***p<.001.
Self-Reported Criminal Behaviour. Primary and secondary psychopathy were used
in a hierarchical regression analysis to predict criminal behaviour. Secondary psychopathy
was entered in the first step and primary psychopathy was entered in the second step.
Males. After the first step when secondary psychopathy was entered, the model
significantly explained 2.2% of the variability in criminal behaviour, R = .16, F (1, 167) =
4.85, p = .02. The addition of primary psychopathy to the regression model did not result in a
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significant change to 𝑅𝑅2, F(1, 166) = 1.35, ns. The linear combination of primary and
secondary psychopathy significantly explained 2.4% of the variability in criminal behaviour
(R=.19, F[2, 166] = 3.10, p = .04). Within the regression model higher levels of secondary,
but not primary, psychopathy significantly predicted criminal behaviour. The full details of
the model are displayed in Table 8.
Females. The results at the first step revealed that higher levels of secondary
psychopathy significantly predicted higher levels of criminal behaviour, explaining 7% of the
variability, R = .27, F (1, 352) = 27.63, p < .001. The addition of primary psychopathy to the
model did not explain any additional variability in criminal behaviour, with a nonsignificant
𝑅𝑅2change, F(1, 351) = 1.69, ns. The linear combination of primary and secondary
psychopathy significantly explained 7.2% of the variability in criminal behaviour, R = .27, F
(2, 351) = 14.69, p < .001. However, within the regression model only secondary
psychopathy was a significant predictor of criminal behaviour. Details of the regression
model are presented in Table 8.
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Table 8
Hierarchical Multiple Regression Predicting Criminal Behaviour from Primary and
Secondary Psychopathy for Males and Females
B SE B β t
Males
Step 1
Constant 23.58 2.91
Secondary Psychopathy .31 .14 .16 2.20*
Step 2
Constant 25.03 3.17
Secondary Psychopathy .38 .15 .20 2.48*
Primary Psychopathy -.09 .08 -.09 1.16
Females
Step 1
Constant 20.21 1.18
Secondary Psychopathy .31 .05 .27 5.25***
Step 2
Constant 19.43 1.32
Secondary Psychopathy .26 .06 .23 4.04***
Primary Psychopathy .06 .04 .07 1.30
Note. *p<.05 **p<.01 ***p<.001.
Follow-up Mediation Analyses
Mediated regression analyses were used to follow-up the significant effect of
secondary psychopathy on self-reported criminal behaviour to determine whether this effect
was mediated by a stronger identification with other criminals.
Males. A mediated regression analysis was conducted to predict self-reported
criminal behaviour from secondary psychopathy whilst examining the possible mediating role
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of ICO. All assumptions of the analysis were met. The linear combination of secondary
psychopathy and ICO significantly predicted self-reported criminal behaviour, explaining
14.2% of the variance, R = .37, F(2, 166) = 13.73, p <.001. Within the regression model a
stronger identification with criminal others significantly predicted criminal behaviour (b
=1.55, p < .001), secondary psychopathy was not a significant predictor (b =.10, p = .44). The
results of the mediation analysis revealed a significant indirect effect of secondary
psychopathy on self-reported criminal behaviour through ICO, b = .20, BCa CI [.06, .43].
This represents a small effect, 𝜅𝜅2 = .10, 95% BCa CI [.03, .19]. There was no significant
direct effect of secondary psychopathy on self-reported criminal behaviour, b = .10, p = .44,
The results suggest that the effect of secondary psychopathy on self-reported criminal
behaviour is entirely mediated by a stronger identification with other criminals. The
mediation effect is displayed graphically in Figure 1.
Figure 1
Conceptual diagram of the Direct and Indirect Effects of Secondary Psychopathy on Self-
Reported Criminal Behaviour for Males.
Females. A mediated regression analysis was conducted to predict self-reported
criminal behaviour from secondary psychopathy whilst examining the possible mediating role
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of ICO. All assumptions were met. The linear combination of secondary psychopathy and
ICO significantly predicted self-reported criminal behaviour, explaining 10% of the variance,
R = .31, F(2, 351) = 19.62, p <.001. Within the regression model a stronger identification
with criminal others significantly predicted criminal behaviour (b =.56, p = .001), as did
higher levels of secondary psychopathy (b =.26, p <.001). The results of the mediation
analysis revealed a significant indirect effect of secondary psychopathy on self-reported
criminal behaviour through ICO, b = .04, BCa CI [.01, .09]. This represents a very small
effect, 𝜅𝜅2 = .04, 95% BCa CI [.01, .07]. Unlike males, there was also a significant direct
effect of secondary psychopathy on self-reported criminal behaviour, b = .26, p < .001. The
results suggest that the effect of secondary psychopathy on self-reported criminal behaviour
is only partially mediated by a stronger identification with other criminals, and that an effect
of secondary psychopathy on criminal behaviour exists even when controlling the effects of
identification with criminal others The conceptual model is displayed in Figure 2.
Figure 2
Conceptual diagram of the Direct and Indirect Effects of Secondary Psychopathy on Self-
Reported Criminal Behaviour for Females.
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Discussion
Overview of Research
Previous research on the relationship between psychopathy and criminality has
typically utilised male, criminal offender samples, or criminal measures of psychopathy.
Consequently, it has been difficult to interpret previous research on the relationship between
psychopathy and criminality because of sample and measurement biases. The current study
aimed to provide clarification on the relationship between psychopathy and criminality by
using a community sample and a noncriminal measure of psychopathy. An examination of
possible gender differences was also included, as research on female psychopathy is scant.
Two current theories of noncriminal psychopathy were explored, the successful
psychopathy model and the dual process model. This was achieved by examining the
relationship between primary and secondary psychopathy and indices of criminality (criminal
convictions, criminal behaviour and traffic violations, and criminal attitudes).
Key Findings
Gender. Research on psychopathy has almost exclusively examined the personality
construct in male participants. Because of this, very little is known about psychopathy in
women. The few studies that have examined psychopathy in women have found that males
generally score higher on measures of psychopathy. Consistent with previous research on
psychopathy and gender, the current study found that males possessed higher levels of
primary psychopathy than females, but that secondary psychopathy did not differ between
genders (Miller, Gaughan, & Pryor, 2008). Although the gender difference in primary
psychopathy found in the current study produced a small effect, this finding provides some
support for claims by clinicians that the interpersonal and affective features of psychopathy
are muted in women (Forouzan & Cooke, 2005). However, alternative explanations for this
difference have been proposed in detail by Forouzan and Cooke (2005), including, effects of
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gender socialisation on both the behavioural expression of psychopathy in females, and the
clinicians’ assessment of psychopathy in females; the failure of current psychopathy
assessments, designed for males, to capture female psychopathy; and genuine differences in
symptomatology for females. In addition to gender differences in mean psychopathy scores,
the current study also found a range of gender differences in the relationships between
psychopathy and criminal attitudes, and psychopathy and self-reported criminal behaviour.
These findings are discussed in detail in the proceeding sections.
Criminal convictions and traffic violations. It was hypothesised that the degree of
criminality reported in psychopathy using a community sample would be lower than that
found in criminal offender samples. The current study found no relationship between primary
and secondary psychopathy and traffic violations for males or females. Whilst the small
proportion of participants in the current sample with a criminal conviction (< 3%) prevented
analysis of the relationship between psychopathy and self-reported criminal conduct, the
means and standard deviations for global psychopathy, primary psychopathy and secondary
psychopathy were similar to those found in criminal offender samples (e.g., C. Brinkley et al.,
2001). This suggests that although psychopathic characteristics can be found equally in
criminal offender and community samples, individuals in the community with psychopathic
characteristics are far less likely to have a criminal conviction. Interpreted in isolation, this
finding would suggest that individuals with psychopathy in general community are engaging
in less criminal behaviour that individuals with psychopathy in forensic populations.
However, not all crimes are detected and even when they are detected, they do not always
lead to an official conviction. To overcome this limitation, the current study also examined
self-reported criminal behaviour, and pro-criminal attitudes.
Criminal attitudes. Following the dual process model it was hypothesised that higher
levels of secondary psychopathy, which reflect the antisocial, impulsive and interpersonally
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parasitic features, would predict pro-criminal attitudes. However, because the interpersonal
and affective features are considered distinct from the antisocial features it was hypothesised
that primary psychopathy would not be related to pro-criminal attitudes.
In contrast, the predictions following the successful psychopathy model were that
primary or secondary psychopathy could be associated with pro-criminal attitudes. However,
because attitudes are implicit and subjective norms influence their behavioural expression, it
was suggested that the behavioural expression of these attitudes may be mediated by social
factors.
The results showed that for both males and females higher levels of primary and
secondary psychopathy predicted the endorsement of pro-criminal attitudes. However, it was
higher levels of secondary psychopathy that explained most of the variance, with primary
psychopathy not contributing much to the explanation of pro-criminal attitudes. These
findings are consistent with research in male criminal offender samples which show that
elevated levels of secondary psychopathy are more strongly associated with pro-criminal
attitudes than higher levels of primary psychopathy (Simourd, 1997). The results provide
partial support both models of noncriminal psychopathy. The dual process model suggests
that primary psychopathy and secondary psychopathy arise from distinct etiological
mechanisms, and suggest that secondary psychopathy may be more strongly related with
criminality. The results provide partial support for this claim as secondary psychopathy was a
stronger predictor of pro-criminal attitudes than primary psychopathy. However, the results
also provide support for the successful psychopathy model in that both primary and
secondary psychopathy were associated with pro-criminal attitudes, but not an increase in
official convictions or traffic violations. This suggests that perhaps moderating factors are
influencing the expression of psychopathy away from criminal manifestations. This finding
was consistent for both male and female participants. However, some gender differences
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were evident in the pattern of relationships between primary and secondary psychopathy and
the criminal attitudes subscales.
For both males and females only secondary psychopathy significantly predicted
negative attitudes towards the justice system. However, gender differences were observed for
tolerance for law violations and identification with criminal others. For males, both primary
and secondary psychopathy significantly predicted a higher tolerance for law violations, with
secondary psychopathy being a better predictor. In contrast, both primary and secondary
psychopathy predicted a higher tolerance for law violations, but primary psychopathy was a
better predictor in the female sample. This suggests that the relationship between
psychopathy and beliefs about criminal behaviour are different for males and females. This
finding is consistent with previous research on gender differences in the relationship between
psychopathy and criminal recidivism, which show that factor 1 is a better predictor in females
samples only (Salekin et al., 1998).
A possible explanation for this difference is the influence of gender norms on
attitudes toward antisocial behaviour. In general, antisocial behaviour is more frowned upon,
especially violent antisocial behaviour, in females than in males because the behaviour is
inconsistent with expected female traits of passivity, empathy and sensitivity. Females with
elevated levels of primary psychopathy may have a higher tolerance for law violations
because their personality makes them less susceptible to the guilt and shame associated with
violating female stereotypes of acceptable behaviour. This is consistent with Cleckley’s
(1941) description of ‘Anna’, a female client with psychopathy who engaged in a range of
sexual behaviours considered inappropriate for the era, with an apparent lack of concern for
social opinion. However, this explanation warrants further research to establish the possible
mediating effects of gender role on the relationship between primary psychopathy and
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criminality, particularly because secondary psychopathy was generally a better predictor of
pro-criminal attitudes for both males and females in the current sample.
Self-Reported Criminal Behaviour. An examination of self-reported criminal
behaviour was included in the current study to overcome the discrepancies between estimates
of crime and official conviction records. According to the dual process model, it was
hypothesised that only secondary psychopathy would be associated with self-reported
criminal behaviour. The results supported this prediction revealing that secondary
psychopathy, but not primary psychopathy, significantly predicted self-report criminal
conduct. The results were consistent for males and females, although secondary psychopathy
explained more variance in criminal conduct in the female sample compared to the male
sample.
The successful psychopathy model proposes that external factors influence the
expression of psychopathic traits. According to this model, it was hypothesised that neither
primary nor secondary psychopathy would be associated with elevated engagement in
criminal behaviour. The results of this study did not support this hypothesis, with secondary
psychopathy a significant predictor of criminal behaviour. However, secondary psychopathy
did not explain much variance in criminal behaviour, particularly for males, suggesting that
other factors are more important than psychopathy in predicting criminal behaviour in this
sample. An alternative explanation for this finding could be that social group mediates the
relationship between psychopathy and criminal behaviour. The results of the follow-up
mediation analysis revealed that the relationship between secondary psychopathy and
criminal conduct was entirely mediated by identification with criminal peers for males, and
partially mediated by identification with criminals for females. These results suggest that
normative effects influence the relationship between psychopathy and criminality. Therefore,
it could be that criminal attitudes and behaviours are normalised in circumstances where a
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psychopathic individual identifies with a criminal group, resulting in a criminal manifestation
of psychopathy. This interpretation is consistent with the successful psychopathy model,
which suggests that other factors influence the expression of psychopathy towards adaptive
and maladaptive manifestations. This claim is bolstered by the results of the current study
which demonstrated that whilst primary psychopathy was a significant predictor of pro-
criminal attitudes, it was not a significant predictor of criminal behaviour. This suggests that
other factors are mediating and/or moderating the relationship between primary psychopathy
and criminal behaviour. Gao & Raine (2010) have proposed a neurobiological model to
explain differences between noncriminal and criminal psychopaths. The authors suggest that
the neurobiological abnormalities found in criminal psychopaths are absent in noncriminal
psychopaths, and that these abnormalities may contribute to a criminal manifestation of
psychopathy (Gao & Raine, 2010). They suggest that noncriminal psychopathy may be
characterised by superior executive function.
Research examining executive functioning in psychopathy has shown that criminal
and noncriminal psychopaths display differential patterns of performance on measures of
executive function. A study by Ishikawa and colleagues (2001) examined executive
functioning in psychopathic individuals and found that whilst criminal psychopaths displayed
dysfunctional executive processing, noncriminal psychopaths displayed superior executive
functioning compared to both criminal psychopaths and controls (Ishikawa et al., 2001).
Given the differential patterns of executive dysfunction between criminal and noncriminal
psychopaths, it is plausible that intact or superior executive functioning could be moderating
the influence of pro-criminal attitudes on the behaviour of individuals with elevated levels of
psychopathy. Processes such as response inhibition, decision-making ability, cognitive
flexibility, and planning may prevent individuals with elevated levels of psychopathy, and
pro-criminal attitudes from engaging in risky, criminal behaviours. Superior executive
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functioning could moderate the expression of criminal behaviour in individuals with
psychopathy because they are better able foresee the consequences of criminal behaviour, are
better equipped to inhibit inappropriate behaviour, and have increased cognitive flexibility to
determine superior courses of action.
However, these findings may also be explained by the dual process model, which
suggests that primary psychopathy results from deficits in the brain’s motivational systems,
whilst secondary psychopathy results from deficits in brain regions responsible for higher
order cognitive functions (Patrick & Bernat, 2009). According to this model, only secondary
psychopathy would be associated with executive dysfunction. The findings of executive
dysfunction in criminal, but not noncriminal, psychopathy may be explained by higher levels
of secondary psychopathy in the criminal sample. Support for this hypothesis comes from
research conducted by Sellbom and Verona (2007) who examined the relationships between
general executive control and response inhibition and found that whilst secondary
psychopathy was associated with deficits in response inhibition and general executive
control, primary psychopathy was related to superior general executive control, but not
associated with response inhibition. These findings may explain the results from the current
study which found that only secondary psychopathy predicted criminal behaviour, it could be
that executive dysfunction in secondary psychopathy may be related to criminal offending.
However, a recent review of the psychopathy and executive function literature found that
studies of executive function in psychopathy are obscured by methodological inconsistencies,
including differences in samples, measures of executive function, and statistical approaches
(Maes & Brazil, 2013). Therefore, further research is needed to establish whether individuals
with secondary psychopathy are at a heightened risk for criminal offending because of
executive dysfunction (dual process model), or alternatively whether executive dysfunction
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plays a role in moderating the expression of psychopathic traits (successful psychopathy
model).
Implications, Limitations, and Future Directions
Although the current study provides an important contribution to the literature on
psychopathy and criminality, a number of limitations need to be considered when interpreting
the findings. The first limitation is the use of self-report measures to capture primary and
secondary psychopathy, criminal attitudes, and criminal behaviour. The use of self-report
measures can lead to socially desirable responding and other kinds of response biases (e.g.,
conservative or liberal responding). In order to counter social desirability, the current study
was conducted anonymously online. However, online studies can be problematic as
participants can adopt satisficing response strategies, and the ability to participate multiple
times can lead to duplicate data. In order to counter these potential issues, instructional
manipulation checks were randomly presented throughout the questions to detect satisfice
responding, and the use of a unique identifier was used to prevent duplicate data.
Nevertheless, these techniques may only have reduced the abovementioned issues, rather than
eliminated them. Future research could consider the use of scale to measure socially desirable
responding and other responses biases (e.g., the Marlowe-Crowne Social Desirability Scale
[MCSDS; Reynolds, 1982]) to identify and address these issues.
Although the study possesses some methodological limitations, the current study
contributes important empirical evidence to the debate on whether criminality is a key feature
of psychopathy. The results obtained challenge the common assumption of both laypeople
and researchers that psychopathy equals criminality, and provides some support for Skeem &
Cooke’s (2010a) assertion that the current body of literature on psychopathy reflects
primarily unsuccessful psychopathy. The findings highlight the need to extend psychopathy
research to noncriminal samples, as such research may lead to the identification of protective
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factors for individuals with psychopathy who are at risk of criminal offending. One such
direction for future research could be to examine the role of social group on the relationship
between psychopathy and criminality. Although the findings of the current study suggest that
the relationship between psychopathy and criminal behaviour is mediated by identification
with criminal peers, there was no direct assessment of peer group in the current study, which
limits the conclusions that can be drawn. Another avenue for future research could be to
examine neurobiological differences in psychopathy for criminal and noncriminal samples. In
particular, research examining executive functioning and noncriminal psychopathy may shed
light on the link between psychopathy, criminal attitudes, and criminal behaviour. The
current study also found some evidence of gender differences in the relationships between
psychopathy and criminal attitudes, however, future research is needed to determine the
mechanisms underlying gender differences in psychopathy. One such direction could be to
examine the extent to which psychopathic females identify with the feminine gender role
(e.g., Bem, 1974), and the extent to which gender stereotypes influence criminal and
noncriminal female psychopaths.
Chapter Summary
Controversy around the conceptualisation and measurement of psychopathy has led to
an increased interest in noncriminal psychopathy (Hare & Neumann, 2010; Skeem & Cooke,
2010a, 2010b). Current theories of noncriminal psychopathy generally fit into the subclinical
model, the successful psychopathy model, or the dual process model. The findings from this
study provided support for both the successful and dual process models, with secondary
psychopathy being the only significant predictor of criminal behaviour, yet this was entirely
mediated by identification with criminals for males, and partially mediated for females.
Interestingly, both primary and secondary psychopathy were predictive of pro-criminal
attitudes, suggesting that other compensatory mechanisms may be moderating the expression
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of primary psychopathy in noncriminal samples. One explanation of these findings may be
that dysfunctional executive processes in secondary psychopathy leads to an increased risk
for criminal offending and that intact processes in primary psychopathy act as a protective
mechanism against criminal offending. However, this suggestion requires future research to
examine the potential role of executive function in the psychopathy-criminality nexus.
Chapter Four
Chapter Overview
The results from the previous study provided support for both the dual process and
successful models of psychopathy. Primary psychopathy did not significantly predict criminal
behaviour, however, secondary psychopathy did. Whilst secondary psychopathy was related
to criminality, the results suggest that the severe antisocial features often associated with
psychopathy are muted in psychopathic individuals living in the community. It has been
previously suggested that neurobiological differences may explain the differential
manifestation of antisocial behaviour in criminal versus noncriminal psychopaths (Gao &
Raine, 2010). For example, Gao and Raine suggest that neurobiological deficits associated
with criminal psychopathy, such as executive dysfunction, reduced grey volume, and
decreased autonomic reactivity, may be absent in noncriminal psychopathy. This hypothesis
aligns with theoretical accounts of ‘successful psychopathy’, in which compensatory
mechanisms, such as superior intelligence, are thought to moderate the expression of
psychopathy towards prosocial or socially acceptable manifestations (Hall & Benning, 2006).
Given the important role of executive processes in regulating socially acceptable behaviour, it
seems plausible that executive functioning may be differentially impaired in criminal versus
noncriminal psychopathy. From this perspective, executive function may moderate the
expression of criminal behaviour in individuals with psychopathy.
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In contrast, proponents of the dual process model claim that psychopathy is not a
unitary disorder. Instead, they suggest that deficits in two neurobiological systems produce
two distinct patterns of personality dysfunction (Patrick & Bernat, 2009). According to this
model, primary psychopathy results from a deficiency in the brain’s defensive motivational
system resulting in trait fearlessness. In contrast, secondary psychopathy is thought to stem
from impairments in brain regions responsible for higher-order processes such as planning,
behavioural inhibition, and cognitive flexibility, resulting in a vulnerability to externalising
psychopathology (e.g., behavioural deviance, substance abuse) (Patrick & Bernat, 2009).
According to the dual process model, individuals can present with elevations on both primary
and secondary psychopathy, or either primary or secondary psychopathy. From this
perspective, only individuals with elevated levels of secondary psychopathy are at risk of
behavioural deviance because of difficulties with higher order processes, vis a vis executive
dysfunction.
This chapter of the thesis describes a study that empirically tests these two theories of
psychopathy by examining relationship between noncriminal psychopathy and executive
function. The review of the literature on executive function in psychopathy will highlight that
research on executive function in both criminal and noncriminal psychopathy has produced
mixed findings. These contradictory findings may result from methodological inconsistencies
across studies of executive function in psychopathy, including differences in the
conceptualisation of psychopathy (unitary syndrome or dual process); the measurement of
both psychopathy and executive function; and demographic differences between criminal and
noncriminal samples (e.g., sex, age, level of education, and drug use).
In the current study executive function in primary and secondary psychopathy is
examined using a noncriminal sample and several commonly used measures of executive
function, whilst also controlling for the possible mediating role of intelligence. An additional
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focus was the examination of sex differences in the psychopathy-executive function
relationship. In doing so, this addresses a significant gap in the psychopathy literature on
executive function which hitherto has focused almost exclusively on males. Considering
gender differences is particularly important given that research, including the findings Study
1 of this program of research, suggest some gender differences exist in the manifestation of
psychopathy (Forouzan & Cooke, 2005; Justus & Finn, 2007). The chapter begins with a
critical review of the literature on psychopathy and executive function and highlights the
discrepancies and inconsistencies in previous research. The aims of the current study are then
described along with the methodology. The chapter concludes with a discussion of the
findings in relation to current models of psychopathy.
Background to Research
Intact self-regulatory processes are essential for socially appropriate behaviour,
leading researchers to suggest that executive dysfunction may underlie the range of socially
inappropriate and self-defeating behaviours observed in individuals with psychopathy. This
hypothesis is bolstered by evidence of ‘acquired sociopathy’ or ‘pseudo-psychopathy’, a
condition characterised by pervasive changes in personality and socially appropriate
behaviour, such as callousness, a paucity of emotion, irresponsibility, impulsivity, and a lack
of empathy, following damage to the ventromedial prefrontal cortex, an area implicated as
important for executive functioning (Tranel, 2002). Whilst these patients display profound
deficits regulating socially inappropriate behaviour, like psychopathic individuals they
generally display intact intelligence, memory, and language ability.
There is now a wealth of evidence to suggest that psychopathy is characterised by a
range of cognitive deficits. Studies have shown that psychopathic individuals display
attentional abnormalities, such as reduced interference on Stroop-like tasks (Hiatt et al.,
2004) and reduced physiological reactivity to irrelevant auditory stimuli (Jutai et al., 1987).
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In addition to the attentional abnormalities, there is also accumulating evidence of executive
dysfunction in criminal psychopathic individuals, such as poor behavioural inhibition
(Newman & Brinkley, 1997), difficulties planning a sequence of events (Lapierre, Braun, &
Hodgins, 1995; Pham et al., 2003), difficulties changing response strategies to changing
environmental contingencies (Ishikawa et al., 2001), and poor decision-making (Mitchell et
al., 2002).
Executive Function
Executive function is an umbrella term that refers to a range of cognitive functions
including: working memory, attention, response inhibition, planning, and cognitive
flexibility, all of which are necessary for the regulation of socially acceptable behaviour
(Chan, Shum, Toulopoulou, & Chen, 2008; Damasio, 1995b; Jurado & Rosselli, 2007; Royall
et al., 2002). Research suggests that the broad range of executive functions can be organised
into three correlated yet separate processes: set shifting or task-switching, inhibition, and
working memory functions such as monitoring and updating (Miyake et al., 2000). Collette et
al’s (2005) research using Positron Emission Tomography (PET) provided further support for
both the unity and diversity of executive functioning by demonstrating that whilst all three
executive processes share common neural substrates, there are also specific neural substrates
for each executive function (updating, shifting and inhibition). Although executive functions
can generally be categorised into three separate processes, research on executive function
also includes an examination of planning ability, which reflects the ability to plan a sequence
of events in order to achieve a goal. However, the planning function may fall under the
banner of ‘inhibition’, as it involves suspending behaviour and evaluating several potential
options before proceeding with a course of action.
Hofmann, Schmeichel and Baddeley (2012) suggest that all three basic executive
functions play a role in the self-regulation of behaviour. Working memory capacity (WMC)
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(monitoring and updating) is linked to self-regulation through executive attention and goal-
shielding. Executive attention and goal-shielding refer to the ability to ignore distracting
stimuli and maintain goal-directed focus. WMC is considered to be a passive form of
inhibition in self-regulation because inhibition of distracting stimuli/thoughts results from the
selective activation of goal-directed processing. Inhibition is a key component of self-
regulation and refers to the ability to inhibit impulsive responses that conflict with an
individual’s goals. Finally, task-switching or set shifting refers to cognitive flexibility and
involves overriding prepotent responses that are no longer advantageous, and adopting
alternative strategies and methods (Hofmann et al., 2012; see also Miyake et al., 2000).
Given that intact executive function processes are essential for self-regulation and
socially acceptable behaviour, it seems plausible that psychopathy may be associated with
executive dysfunction. The intuitive appeal of the executive dysfunction hypothesis has
resulted in active research on psychopathy and executive dysfunction, however results are
contradictory and clouded by methodological inconsistencies. These methodological
inconsistencies include heterogeneous samples, different measures of psychopathy, and
different measures of executive function. Generally speaking, two streams of research on the
psychopathy-executive function relationship have emerged, a stream examining executive
function in criminal psychopaths (often referred to as unsuccessful psychopaths), and a
stream examining executive function in noncriminal psychopaths (often referred to as
successful psychopaths).
Some researchers claim that unsuccessful psychopathy is associated with poorer
executive functioning, whilst successful psychopathy is associated with superior executive
functioning (Gao et al., 2009; Gao & Raine, 2010). This hypothesis was generated in part by
a study by Ishikawa, Raine, Lencz, Bihrle and Lacasse (2001). They examined performance
on the Wisconsin Card Sorting Test (WCST), a common neuropsychological measure of
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executive function, in male participants classified as successful psychopaths, unsuccessful
psychopaths, and non-psychopathic controls. The results showed that successful psychopaths
solved more categories, and displayed less perseverative and non-perseverative errors than
the unsuccessful psychopaths and non-psychopathic controls. There were no differences in
WCST performance for the unsuccessful psychopaths and non-psychopathic controls. This
study has been consistently referred to in the literature as evidence of superior executive
functioning in successful psychopaths. However, the literature on executive functioning in
psychopathy is considerably more complex, with differential patterns of association between
executive function observed for primary (F1) versus secondary psychopathy (F2), both within
the criminal and noncriminal psychopathy literatures, and inconsistent results across different
measures of executive function. This has led some researchers to propose that the inconsistent
findings may be attributed to the different types of executive function tasks tapping two kinds
of executive processes: hot executive function processes, and cool executive function
processes (e.g., Lapierre et al., 1995; Snowden et al., 2013). These two types of executive
function are discussed in the proceeding section.
Hot and Cool Executive Function
Previous research on executive function in psychopathy has often produced
inconsistent findings, with some research showing no evidence of executive dysfunction
(e.g., Hare, 1984; Hart, Forth, & Hare, 1990). This has led some researchers to suggest that
psychopathy may be marked by specific executive dysfunction, namely dysfunction on
measures of hot executive function and intact performance on measures of cool executive
function (Lapierre et al., 1995; Snowden et al., 2013). Hot executive functions refer to
cognitive functions that are recruited in situations that are emotionally or motivationally
significant because they involve reward/punishment, and are believed to be subserved by the
orbital-ventromedial prefrontal cortex and its associated pathways (Zelazo & Muller, 2002;
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Zelazo et al., 2010). In contrast, cool executive functions are purely cognitive in nature, such
as working memory, planning, set-shifting and attentional processes, and are believed to rely
on the lateral prefrontal cortex (Zelazo & Carlson, 2012; Zelazo & Cunningham, 2007;
Zelazo & Muller, 2002; Zelazo et al., 2010). Researchers claim that similar to the individuals
with ‘acquired sociopathy’, the psychopathic individuals’ executive dysfunction is
underscored by orbital-ventromedial prefrontal cortex deficits, with largely intact lateral
prefrontal cortex functioning (K. S. Blair, Newman, et al., 2006; Gao et al., 2009; Lapierre et
al., 1995; Snowden et al., 2013). However, evidence for compromised orbital-ventromedial
prefrontal cortex functioning and intact lateral frontal cortex functioning in psychopathy is
equivocal.
Snowden et al. (2013) examined performance on measures of hot and cool executive
function as a function of PPI-R assessed psychopathy in 150 undergraduate students. They
used the Porteus Maze and Object and Spatial Alternation Tasks1 to measure orbitofrontal
cortex (OFC) and dorsolateral prefrontal cortex (DLPFC) functioning, respectively. Snowden
et al. (2013) found no significant relationship between global psychopathy, fearless
dominance, or self-centred impulsivity and performance on the Spatial Alternation Task.
However, fearless dominance was weakly negatively correlated with performance on the
Object Alternation Task, and both fearless dominance and self-centred impulsivity were
associated with poorer performance on the Porteus Maze. The authors concluded that the
poor performance on the Porteus Maze reflected OFC dysfunction. However, the claim that
the Porteus Maze selectively taps orbitofrontal cortex functioning is spurious, with some
research showing that the dorsolateral cortex is also involved (Roberts & Wallis, 2000).
Furthermore, the finding of poor performance on the Porteus Maze contrasts with an earlier
study of psychopaths recruited from the general population (Widom, 1977). Here
1 In the Porteus Maze
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performance of psychopaths on the Porteus Maze was similar to that found in normal, healthy
adults.
Using a criminal sample, Pham, Vanderstrukken, Philippot and Vanderlinden (2003)
examined executive function in 36 male inmates assigned to psychopathic and non-
psychopathic groups on the basis of PCL-R classification. They found some evidence to
support selective attention abnormalities, specifically impaired maintenance of attention on
the D-II Cancellation Test (a measure of cool executive function). Psychopathic individuals
made significantly more qualitative errors on the Porteus Maze (crossed more walls), they
performed significantly more movements on misleading trials of the Tower of London, and
took longer to solve the problem after the first move. Importantly, performance on the Tower
of London has been demonstrated to rely upon the dorsolateral prefrontal cortex (Cazalis et
al., 2003), which is believed to play a role in cool executive functions.
Smith, Arnett and Newman (1992) also found deficits in cool executive function in
psychopaths. They examined performance on several measures of executive function in male
prisoners classified as low anxious psychopaths (n=18), low-anxious non-psychopaths
(n=18), high anxious psychopaths (n=19) and high anxious non-psychopaths (n=14) using the
PCL-R and the Welsh Anxiety Scale. They found that performance on two measures of cool
executive function, the Trail-Making Part B (TMT-B) and Block Design test, was impaired in
the low anxious psychopaths only, reflecting an impairment in their ability to plan a sequence
of events (TMT-B), and their ability to form and maintain a cognitive set, cognitive
flexibility, and attention (Block design). These findings and those from Pham et al. (2003)
suggest that there is some dysfunction in psychopathic individuals on tasks of cool executive
function.
Additionally, there is limited evidence of an OFC deficit even on tasks that are known
to rely upon intact OFC functioning, such as the Iowa Gambling Task (IGT), the IGT is
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purported to be sensitive to ventromedial deficits and has been widely used in testing the
Somatic Marker Hypothesis (Bechara & Damasio, 2005). For example, Hughes, Dolan,
Trueblood and Stout (2014) examined performance on this task in male offenders with
varying degrees of PCL-SV psychopathy and controls and found no difference in
performance on the IGT. In fact, higher levels of the antisocial facet of the PCL-SV predicted
better performance on the IGT. This finding is in contrast to previous research indicating
either poorer performance in psychopathic individuals (R. J. R. Blair, Colledge, & Mitchell,
2001; Mitchell et al., 2002) or intact performance in psychopathic individuals (Schmitt et al.,
1999).
Given the mixed findings on the role of the OFC in psychopathy, it is difficult to draw
any firm conclusions regarding the relationship between psychopathy and hot executive
functions, or the hypothesis that psychopathy is characterised by a specific OFC dysfunction.
The inconsistencies in results across different studies of hot executive function, may be
because different methodologies, samples and statistical analyses were used, or because the
relationship between brain pathology and psychological and behavioural functioning is
complex. E Miller (1972) in Lezak (2004) made the following insightful analogy:
“It is tempting to conclude that if by removing a particular part of the brain we can
produce a deficit in behaviour, e.g., a difficulty in verbal learning following removal
of the left temporal lobe in man, then that part of the brain must be responsible for the
impaired function…..[T]his conclusion does not necessarily follow from the evidence
as can be seen from the following analogy. If we were to remove the fuel tank from a
car we would not be surprised to find that the car was incapable of moving itself
forward. Nevertheless, it would be very misleading to infer that the function of the
fuel tank is to propel the car forward.” (pp. 19-20)
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Thus, whilst specific deficits may be associated with damage to dorsolateral prefrontal
cortical regions or orbitolateral prefrontal cortical regions, it may be misleading to assume
that these regions are solely responsible for the pattern of dysfunction observed in individuals
with psychopathy. Indeed, the variable findings in relation to the role of anxiety (S. S. Smith
et al., 1992) and degree of antisocial markers (M. A. Hughes et al., 2014) suggest greater
complexity. It is likely that complex interactions between various prefrontal and other
neuroanatomical regions underlie normal executive processing and that damage to any one of
these (or combination of) prefrontal or related neuroanatomical regions may result in deficits
on a task that relied on the complex interaction. Furthermore, the use of hot executive
function tasks to assess executive function in psychopathy may be not be suitable because
they also rely on other non-executive processes, such as feedback processing and sensitivity
to reward and punishment cues (Maes & Brazil, 2013). In contrast, the use of cool or ‘pure’
executive function tasks allow the examination of cognitive processing in the absence of
emotional processing. This distinction is important in psychopathy research because of
evidence of emotional dysfunction in psychopathy. However, the research literature on cool
executive functioning in psychopathy is also plagued by contradictory and confusing
findings.
Cool Executive Functions in Psychopathy
Gorenstein (1982) conducted one of the earliest studies on executive function in
psychopathy using a male psychiatric inpatient sample classified as psychopathic (n=20) and
nonpsychopathic (n=23) using the Socialization Scale of the California Psychological
Inventory. Psychopathic individuals displayed more perseverative errors on the Wisconsin
Card Sorting Test (a task known to rely on the dorsolateral prefrontal cortex), poorer
performance on the Sequential Matching Memory Task, and significantly more reversals on
the Necker Cube (a phenomenon observed in bilateral frontal lobe lesion patients).
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Gorenstein concluded that psychopathy was marked by frontal lobe deficits. However, the
study possessed a number of methodological weaknesses (e.g., differences in substance abuse
between the psychopathic and non-psychopathic groups, as well as the scale used to measure
psychopathy), and subsequent studies failed to replicate these findings (Hare, 1984; Sutker &
Allain, 1987; Sutker, Moan, & Allain, 1983). For example, Hare (1984) failed to find any
group differences in performance on the Wisconsin Card Sorting Test, Sequential Matching
Memory Task, or Necker Cube in a sample of male criminal offenders classified as high
(n=14), medium (n=16) or low (n=16) on psychopathy. However, more recently several
studies have reported evidence of poorer performance on measures of cool executive function
in psychopathic individuals (Bagshaw et al., 2014; Heritage & Benning, 2013;
Hoppenbrouwers et al., 2013; Kiehl, Smith, Hare, & Liddle, 2000; Kim & Jung, 2014;
Mahmut et al., 2008; Sellbom & Verona, 2007). For example, Hoppenbrouwers et al. (2013)
examined dorsolateral prefrontal cortex and working memory functioning in male
psychopathic offenders. They found that compared to controls, psychopathic offenders
displayed poorer performance on the letter-number sequencing test, a measure of working
memory, that was accompanied by inhibition deficits in the DLPFC. These findings suggest
that psychopathy is associated with DLPFC dysfunction and this dysfunction may explain the
impulse control problems that are characteristic of psychopathy. Whilst these findings
provide some evidence of executive dysfunction, studies on cool executive function in
psychopathy have also produced inconsistent findings, likely due to methodological
differences between studies of executive function in psychopathy. These demographic and
measurement differences make it difficult to determine whether executive dysfunction is
present in psychopathic individuals. Given the evidence that these differences in findings
may be attributed to the use of criminal versus noncriminal samples (Ishikawa et al., 2001),
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the extant literature on executive function in criminal and noncriminal psychopathy is
considered separately in the proceeding sections.
Cool Executive Function in Unsuccessful Psychopathy
In addition to the interpersonal, affective and lifestyle features of psychopathy,
unsuccessful psychopaths also display problematic antisocial behaviours and a failure to learn
from mistakes. This pattern of self-defeating behaviour has led some to propose that criminal
psychopathy is characterised by executive dysfunction (e.g., Gao & Raine, 2010; Gorenstein,
1982). However, evidence supporting the executive dysfunction hypothesis has been
equivocal, with different results across different executive functions (working memory,
planning, set-shifting, and response inhibition) and factors of psychopathy (Factor 1 and
Factor 2 vis a vis primary and secondary psychopathy).
Working Memory. There are only a handful of studies that have examined working
memory function in criminal psychopathy, with most research focusing on set-shifting and
response inhibition because of their putative link with problematic behaviours. However,
Hansen et al. (2007) examined working memory function in male offenders (n=53) using the
California Computerised Assessment Package Serial Pattern Matching 2 (calCAP-SPM2) and
the N-back task (2-back). Using the PCL-R to delineate psychopathy into four facets
(interpersonal, affective, lifestyle and antisocial facets) they found that only Facet 1
(interpersonal) was related to superior performance on the calCAP and the N-back, indicating
superior working memory function. No other relationships found with working memory
function. In contrast, Hoppenbrouwers et al. (2013) in a small sample of male offenders
classified as psychopathic using the PCL-R (n=13) and a small sample of age-matched,
healthy, community controls (n=15) found that psychopathic offenders performed worse than
healthy controls on the Letter-Number Sequencing test from the Weschler Adult Intelligence
Scale – Third Edition (WAIS-III), indicating deficits in working memory function. These
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contrasting findings are difficult to interpret and could be affected by a number of other
factors. For example, Hoppenbrouwers et al. (2013) noted that whilst no participants reported
drug use in the past six months, 87% of the psychopathic participants had a history of drug
use and substance use disorder. Therefore, it is plausible that their findings may be
attributable, at least in part, to neuropsychological changes caused by substance abuse, rather
than psychopathy. Another explanation for the discrepancy between these two studies is that
Hansen et al. (2007) examined working memory function and the PCL-R factors separately,
whilst Hoppenbrouwers et al. (2013) only examined the total PCL-R score. Thus, it could be
that only the interpersonal facet of the PCL-R is characterised by superior working memory
function, whilst the other factors are characterised by impairment in working memory.
Clearly further research is needed on working memory function in criminal psychopathy
before any conclusions can be drawn regarding this particular executive function.
Planning. Despite the intuitive appeal of a planning deficit in criminal psychopathy,
there is scant research in this area, with only four studies identified as having examined
planning in criminal psychopathy. Lapierre et al. (1995) was one of the first to examine
planning deficits in criminal psychopathy using the Porteus Maze in a sample of male
offenders classified using the PCL-R as psychopathic (n=30) or nonpsychopathic (n=30), and
matched on a range of demographic variables (e.g., age, education, socioeconomic status,
etc). The Porteus Maze requires participants to trace a path through a series of mazes
avoiding dead ends or ‘blind alleys’ and without back-tracking or crossing maze walls. The
test is scored for two types of errors: quantitative errors (i.e., the number of wrong entries or
blind alleys) and qualitative errors (i.e., rule-breaking errors such as back-tracking and
crossing maze walls). Lapierre et al. (1995) found no differences for the number of
quantitative errors, but a greater number of qualitative errors. These findings provide initial
support for a planning deficit in criminal psychopathy and are consistent with the findings
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Pham et al. (2003), who examined planning ability using the Porteus Maze, Trail Making
Test Part B (TMT-B), and a TOL task with three different types of problems: neutral
problems, facilitating problems and misleading problems. They found no differences in PCL-
R psychopathic or nonpsychopathic offenders for the number of quantitative errors on the
Porteus Maze, but found significant differences for the number of qualitative errors. They
also found that psychopaths displayed excessive movements on misleading trials of the TOL,
broke more rules, and displayed longer subsequent completion times than nonpsychopathic
offenders, regardless of problem type. These findings suggest that planning deficits in
psychopathy may be subtle and dependent upon task complexity. The longer subsequent
completion times may be attributed to impulsively moving the first disc without thoughtful
consideration of the sequence of moves required to complete the problem. Bagshaw et al.
(2014) found similar results when they examined planning ability using an adapted Tower of
London (TOL) task in a small sample of male offenders. They found that PCL-R
psychopathy was related to more moves on misleading trials of the TOL and that Factor 1
(interpersonal and affective) and Factor 2 (impulsive and antisocial) were negatively related
to planning times. The shorter planning times and higher number of moves on misleading
problems indicate difficulties with planning a sequence of events, possibly because of
impulsive decision-making. Altogether, the findings from these studies suggest that criminal
psychopathy is characterised by planning deficits.
Response Inhibition. Similar to research on working memory function, research on
response inhibition in psychopathy has produced mixed findings, Kiehl et al. (2000)
examined response inhibition in psychopathy using a Go/No-Go task in male offenders
classified as psychopathic (n = 13) and nonpsychopathic (n = 11) using the PCL-R. They
found no difference in performance between the two groups. However, other studies using
the same paradigm did observe difficulties in response inhibition (Lapierre et al., 1995;
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Varlamov, Khalifa, Liddle, Duggan, & Howard, 2011). For example, Varlamov et al. (2011)
compared performance in personality-disordered male forensic patients classified as
psychopathic (n = 22) or nonpsychopathic (n= 27) using the PCL-R, and a group of healthy
controls matched on age, intelligence, and parental occupation. They found that the
psychopathic patients made significantly more errors of commission than the
nonpsychopathic patients and controls. However, psychopathic patients made a similar
number of errors of omission to the healthy controls, indicating a problem with response
inhibition on No-Go trials but intact performance on Go trials.
As with working memory and planning performance, these inconsistent findings may
be explained by differential patterns of relationship with response inhibition deficits for
Factor 1 (interpersonal and affective) and Factor 2 (impulsive and antisocial). Support for this
hypothesis is provided by a recent study that examined the relationship between PCL-R
psychopathy factors and response inhibition using the Hayling Sentence Completion Test in a
sample of 29 male offenders (Bagshaw et al., 2014). The authors found that Factor 2 was
moderately associated with poorer response inhibition on the Hayling Sentence Completion
Test. However, there was no relationship between performance and Factor 1, indicating intact
response inhibition.
Set-shifting. The ability to shift between tasks is another key executive function.
Lapierre et al. (1995) examined set-shifting in a male offender sample using the WCST. They
found that psychopaths (n = 30), classified using the PCL-R, made more perseverative errors
and achieved fewer categories than the nonpsychopathic offenders (n =30), with a trend
towards significance (p = .07, p = .06, respectively). In contrast, Pham et al. (2003) found that
performance on the WCST in psychopaths (n =18) and offender controls (n = 18) was
similar, with psychopathic offenders actually making fewer perseverative errors. However,
these inconsistent findings may result from differential relationships between PCL-R
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psychopathy factors and performance on the WCST, similar to what was observed by
Bagshaw et al. (2014)
For example, Mol, Van Der Bos, Derks and Egger (2009) examined possible
differential associations between PCL-R Factor 1 and Factor 2, and performance on the
WCST in a male forensic sample (n = 53). There were no differences in performance between
psychopathic (n = 17) and nonpsychopathic individuals (n = 36) in the number of categories
achieved, or in the number of perseverative and nonperseverative errors. However, when they
examined the relationships between WCST performance and the PCL-R factors separately
they found that Factor 1 was related to better performance on the WCST, with more
categories achieved and fewer perseverative and nonperseverative errors. In contrast, Factor 2
was largely unrelated to performance, with a weak relationship with nonperseverative errors
observed. Furthermore, when they examined performance in four psychopathy subgroups
(low F1 and F2 [low-low, n = 16), high F1 and low F2 [high-low, n = 6], high F2 and low F1
[low-high, n = 8], and high F1 and high F2 [high-high, n = 16) they found no significant
differences in performance between the four groups. However, this may be because of a lack
of statistical power from the small sample sizes, as the pattern of results showed that the
high-low group had fewer perseverative and nonperseverative errors and achieved more
categories than the other groups. The low-high group performed the worst, with a greater
number of perseverative and nonperseverative errors and fewer categories achieved (See
Table 9). This pattern of results suggest that Factor 1 may be related to superior performance
and Factor 2 related to worse performance. However, given the weak correlations found,
further research is needed before strong conclusions can be drawn regarding set-shifting in
criminal psychopathy.
To recap, the lack of consistency in findings across different studies of executive
function in criminal psychopathy may be a function of the different measures of executive
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function utilized and may reflect differences task complexity. Alternatively, given that some
studies have shown a differential pattern of relationships between Factor 1 and Factor 2
psychopathy and executive dysfunction, the inconsistency in previous findings could be a
result of failing to parse psychopathy into primary and secondary factors. Based on the
preliminary evidence examining primary and secondary psychopathy and executive function,
it appears that primary psychopathy may be related to intact or superior executive
functioning, whilst secondary psychopathy may be associated with executive dysfunction.
Interestingly, secondary psychopathy reflects the antisocial features of psychopathy and there
is considerable debate about whether antisociality is a central feature of psychopathy or
simply one behavioural manifestation of the central personality characteristics. Given that
Morgan and Lilienfeld (2000) concluded from their meta-analytic review that there was a
robust and significant relationship between antisocial behaviour and executive dysfunction,
the degree to which executive dysfunction is attributable to psychopathy, or just antisociality
more broadly, is debatable.
For example, Dolan (2012) examined DLPFC dysfunction using a planning, set-
shifting and response inhibition task in male offenders with ASPD and varying degrees of
psychopathy (Low, Medium, High) with healthy controls. Results on the planning task
showed that offenders with Anti-Social Personality Disorder (ASPD) performed worse than
healthy controls but that psychopathy score was not related to performance: participants who
scored higher on psychopathy performed as well as healthy controls. This suggests that
previous research showing planning deficits in criminal samples may reflect the DLPFC
dysfunction associated with ASPD rather than psychopathy. In regards to set-shifting, Dolan
found that offenders with ASPD performed worse on the set-shifting task than healthy
controls, but again, performance did not vary with psychopathy scores. It is reasonable to
suggest that previous research that found set-shifting deficits in offenders with psychopathy
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may be due to antisocial behaviour features related to psychopathy, rather than psychopathy
per se. In regards to the response inhibition task (Go/No-Go), Dolan found that ASPD
participants with moderate levels of psychopathy performed worse than healthy controls but
that ASPD participants with high levels of psychopathy displayed intact performance on the
Go/No-Go and actually displayed longer mean reaction times than healthy controls,
suggesting a response style marked by lower levels of impulsivity.
Similarly, Zeier, Baskin–Sommers, Hiatt Racer, and Newman (2012) recently
concluded from the results of their study that response inhibition deficits are not unique to
psychopathy, but related to antisociality more broadly. Using a male offender sample they
examined the relationship between response inhibition using a flanker task, psychopathy
using the PCL-R, and antisocial personality disorder. They found that when they examined
the global psychopathy scores and performance on the flanker task that high psychopathic,
low anxious individuals performed worse. However, they further elucidated the relationship
between psychopathy and response inhibition by examining Factor 1 and Factor 2 separately,
they found that only Factor 2 was related to worse performance. Interestingly, when they
examined the data for overlapping effects of antisocial personality disorder and psychopathy,
antisocial personality disorder remained a significant predictor of response disinhibition, but
none of the PCL-R scores approached significance. This suggests that it is the antisocial
behaviour associated with, but not unique to, secondary psychopathy that is related to poor
response inhibition.
Extending this research, De Brito et al. (2013) examined performance on a range of
hot and cool executive functions (verbal working memory, reversal learning, decision-making
under risk, and stimulus-reinforcement-based decision making) in a group of violent
offenders diagnosed with ASPD with and without PCL-R assessed psychopathy. The results
revealed that the violent offenders (both ASPD-P and ASPD+P) displayed poorer
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performance on measures of hot executive function than a noncriminal control group but
similar performance to each other. Specifically, the offenders failed to change their behaviour
in response to changing task requirements, failed to learn from punishment cues, and despite
taking longer to make decisions than the controls, they displayed more decision-making
errors (De Brito et al., 2013). Furthermore, the offenders (both ASPD-P and ASPD+P)
performed worse on a measure of cool EF (working memory tasks) than controls, but similar
to each other. These findings suggest that poor performance of psychopathic individuals
recruited from forensic samples on tasks of hot and cool executive function may be explained
by factors related to criminality (antisocial behaviour) rather than psychopathy per se.
Taken together, the findings from these three studies suggest that the executive
dysfunction found in criminal psychopathy may not be unique to psychopathy, but rather
shared by other externalising disorders (e.g., ASPD), all of which place an individual at risk
for behavioural deviance. This aligns with claims of the dual process model of psychopathy,
which suggests that primary and secondary psychopathy result from distinct etiological
processes. Secondary psychopathy is considered to result from deficits in brain regions
important for higher order processes, placing these individuals at risk for externalising
problems. Interestingly, in criminal offender samples psychopathy is measured using the
PCL-R, which is oversaturated with items tapping externalising symptomatology (e.g.,
criminal versatility). Therefore, the findings of executive dysfunction in criminal offender
samples could be because PCL-R psychopathy reflects elevated levels of primary
psychopathy, but also an emphasis on externalising psychopathology in the assessment of
secondary psychopathy. From this perspective, criminal psychopathy may be related to
executive dysfunction because individuals in forensic institutions have elevated levels of
secondary psychopathy.
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However, Gao and Raine (2010) propose an alternative explanation. They suggest
that intact neurobiological functioning differentiates criminal psychopaths from noncriminal
psychopaths. This hypothesis is bolstered by research on executive function in noncriminal
(successful) psychopathy which suggests that criminal psychopaths display executive
dysfunction, but that successful psychopaths actually display superior executive function
(Ishikawa et al., 2001).
Cool Executive Function in Successful Psychopathy
Gao and Raine’s (2010) recent review on successful and unsuccessful psychopathy
highlighted the lack of research on successful psychopathy. They proposed a neurobiological
model to account for the behavioural differences between successful and unsuccessful
psychopaths in criminal offending. They suggested these differences may reflect underlying
neurobiological differences, including executive functioning, in which successful
psychopaths are hypothesised to possess intact or superior functioning, whilst unsuccessful
psychopaths possess deficits. Given the recent evidence that it is antisocial behaviour in
general, rather psychopathy that is associated with executive dysfunction (e.g., Dolan, 2012),
it seems plausible that successful psychopaths may possess intact executive functioning.
Indeed, if individuals with the interpersonal and affective features of psychopathy possess
intact or superior executive function then their tendencies towards impulsive antisocial
behaviour may be moderated by superior planning ability, response inhibition, set-shifting
and working memory.
Working Memory. Sellbom and Verona (2007) examined working memory function
using the digits backward in a sample of undergraduate university students. They found that
Factor 1 psychopathy (measured using the PPI-R) was associated with superior working
memory function, with more digits recalled on the digits backward. In contrast, Factor 2 was
unrelated to working memory function. Similarly, Sadeh and Verona (2008) examined
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performance on measures of selective attention and cognitive control in a sample of male
university students. Using the PPI to measure psychopathy, they hypothesized that primary
psychopathic traits would be associated with superior selective attention/reduced interference
of distracting stimuli on a test of selective attention, and that secondary psychopathic traits
would be associated with poorer performance on a measure of cognitive control. The results
supported their hypothesis, with primary psychopathic traits associated with faster reaction
times on the selective attention task, indicating reduced processing of distracting stimuli.
Secondary psychopathic traits were not associated with performance on the selective
attention task. However, secondary psychopathic traits, but not primary psychopathic traits,
were associated with cognitive control deficits, specifically, impaired working memory
function.
These findings suggest a differential pattern of relationships between primary and
secondary psychopathy and executive function deficits, with primary psychopathy
characterised by intact executive functioning and secondary psychopathy characterised by
poor executive functioning. Sadeh and Verona (2008) suggest that the differential pattern
may explain the contradictory findings from previous research that failed to partial
psychopathy traits into primary and secondary components.
Planning. Gao and Raine (2010) suggest that successful psychopathy may be
characterised by superior neuropsychological functioning and that this may facilitate the
achievement of personal goals, whilst avoiding detection. In order to successfully achieve
their desired goals, these individuals need the ability to foresee possible consequences of their
actions, and thus would need intact or superior planning ability. Salnaitis, Baker, Holland,
and Welsh (2011) found evidence for such relationship. They examined performance on a
computerised version of the Tower of Hanoi to assess planning ability, but also response
style, in a sample of undergraduate university students, assessed for psychopathy using the
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PPI. They found that high psychopathy scorers displayed better performance, with a response
style marked by slow and accurate responses, compared to low and medium psychopathy
scorers.
In contrast, Snowden et al. (2013) when examining planning ability in an
undergraduate university sample with the Porteus Maze test, found that PPI-R total score,
PPI-I and PPI-II were all related to qualitative errors, suggesting difficulties in planning a
sequence of events. However, Sellbom and Verona (2007) used the WISC-III Mazes to assess
planning and found no significant relationships between PPI-I and PPI-II and performance.
However, the pattern of relationships showed that PPI-I was associated with better
performance, whilst PPI-II was associated with worse performance. Further analysis revealed
that the differences in performance for the two PPI-R factors were statistically significant,
suggesting that the relationship between psychopathy and executive function is different for
the primary and secondary components. Importantly, Sellbom and Verona (2007), unlike
Snowden et al. (2013), presented partial correlations thus identifying the unique relationships
between PPI-I and PPI-II and planning ability. The pattern of findings across the three studies
of planning ability suggest that, like working memory function, primary psychopathy appears
to be related to intact or superior planning ability, whilst secondary psychopathy is associated
with poor planning ability.
Set-Shifting. In one of the first studies of set-shifting in successful psychopathy,
Ishikawa et al. (2001) examined performance on the WCST in a sample of successful
psychopaths, unsuccessful psychopaths and healthy controls. They were no differences
between unsuccessful psychopaths and healthy controls. However, they did find that the
successful psychopaths displayed superior performance on the WCST, indicating superior
set-shifting abilities. Subsequent studies have failed to consistently replicate this finding. For
example, Mahmut et al. (2008) found that high psychopathy participants recruited from a
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university student population performed similarly to low psychopathy participants on a
computerised version of the TMT-B, suggesting intact but not superior set-shifting abilities.
In contrast, Yang, Raine, Colletti, Toga, and Narr (2011) examined performance on the
WCST as a function of PCL-R psychopathy in a community sample recruited from temporary
employment agencies. They found that psychopathy was positively associated with the
number of perseverative errors, but not nonperseverative errors. Similarly, Kim and Jung
(2014) examined set-shifting using the WCST in a small sample of university students
classified as psychopathic and nonpsychopathic using the PPI-R. They found that the
psychopathic group displayed significantly more perseverative and nonperseverative errors
than the nonpsychopathic group.
The findings from these two studies (Kim & Jung, 2014; Yang et al., 2011) suggest
that noncriminal psychopathic individuals have deficient set-shifting abilities. However, both
Mahmut et al. (2008) and Yang et al. (2011) used criminal measures of psychopathy (SRP-III
and PCL-R, respectively), thus conflating psychopathy with criminality. Given that there is a
robust relationship between antisocial behaviour and executive dysfunction (Morgan &
Lilienfeld, 2000), these findings may simply reflect the relationship between antisocial
behaviour and set-shifting deficits. Although Kim and Jung (2014) found that PPI-R
psychopathy (a measure of noncriminal psychopathy) was related to more perseverative and
nonperseverative errors, they failed to parse the PPI-R into its subfactors: Fearless
Dominance (Primary) and Impulsive-Antisociality (Secondary). When Sellbom and Verona
(2007) examined the separate relationship between PPI-R factors and performance on the
WCST, they found that primary psychopathy was associated with significantly fewer
perseverative errors and secondary psychopathy was associated with more perseverative
errors. These findings suggest that it is the antisocial characteristics that are associated with
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set-shifting dysfunction, and this may explain the inconsistent findings in research on
successful psychopathy.
Response Inhibition. Unlike research on set-shifting, planning and working memory,
most of the research on response inhibition has examined the separate relationships between
primary and secondary psychopathy and response inhibition, the exception being two recent
studies conducted using undergraduate samples. Using the Psychopathic Personality
Inventory: Short Form (PPI:SF), Zimak, Suhr, and Bolinger (2014) found no differences in
response inhibition on the Stop-Signal Task between psychopathic and nonpsychopathic
participants. Similarly, Kim and Jung (2014) examined response inhibition using the Go-No-
Go task, a popular measure of response inhibition. The Go-No-Go task is a computerised task
that requires participants to respond, as quickly as possible, to ‘Go’ stimuli and to withhold
responses for ‘No-Go’ stimuli. Kim and Jung found no differences in performance between
PPI-R psychopaths and nonpsychopaths on the Go-No-Go task. These findings suggest that
successful psychopathy is characterised by normal response inhibition. However, studies that
have examined primary and secondary factors separately paint a different picture. For
example, Sellbom and Verona (2007) found that PPI-I was unrelated to response inhibition
assessed using the Controlled Word Association Test and a Flanker Task. However, PPI-II
was significantly related to response inhibition deficits, with higher levels of PPI-II
significantly related to greater errors of commission on the Flanker Task.
Providing support for Sellbom and Verona’s research, Heritage and Benning (2013)
tested the Response Modulation Hypothesis (RMH)2 in male (n = 39) and female participants
(n = 50) recruited from an emergency department. Psychopathy was assessed with the
multidimensional personality questionnaire, from which scores of Impulsive-Antisociality
2 The Response Modulation Hypothesis is described in detail in Chapter Two of this thesis.
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(e.g., SCI, PPI-II) and Fearless Dominance (e.g, PPI-I) were produced. They tested the RMH
using a stop-signal lexical decision task with words of different valence (positive, negative,
and neutral) and measured the event-related potentials (ERPs) N1 and error-related negativity
(ERN). The N1 is used as an index of attentional processing and the ERN is elicited when an
individual responds erroneously, it is used as an indicator of error monitoring. Heritage and
Benning showed that individuals with higher levels of Fearless Dominance had intact
performance on the task and normal N1 and ERN responses. However, Impulsive
Antisociality (IA) was associated with poorer performance on the task, with poorer lexical
decision accuracy, stop signal accuracy, stop signal delay and stop signal reaction times. This
did not change as a function of the valence of the word (positive, negative, or neutral). IA
was also correlated with smaller ERN peaks for the lexical decision responses and stop signal
inhibition, suggesting problems with error monitoring. Individuals higher on IA also showed
smaller N1 peaks after all stop signals, suggesting an issue with processing of the stop signal
itself. Follow-up mediation analyses showed that N1 mediated the relationship between IA
and ERN, suggesting that problems with inhibiting responses on the task may be a product of
deficient attentional processing of the stop signal cues. Altogether, these findings suggest that
in noncriminal samples, primary psychopaths possess intact response inhibition, whilst
secondary psychopaths display dysfunctional response inhibition that is underscored by
abnormal physiological reactivity to response inhibition cues. These findings suggest that the
antisocial features of psychopathy are related to response inhibition deficits, rather than the
core interpersonal features.
Although the majority of findings on response inhibition have found no relationship
between primary psychopathy and negative relationships with secondary psychopathy, there
are two studies that have found relationships between psychopathy and response inhibition.
For example, Carlson and Thai (2010) examined response inhibition using a modified version
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of the Expectancy AX-CPT in an undergraduate university sample (n = 72; 40 females and 32
males). The Expectancy AX-CPT is a computerised task where a single letter is presented on
the screen. Participants are required to respond ‘target’ to the letter ‘X’ if it follows the letter
‘A’ and ‘non-target’ to all other letters. The task is designed to create an expectation for X
following the letter A, and participants must withhold responses to other letters following A.
They found that PPI-I was related to superior response inhibition, with faster responses for
correct trials, but that PPI-II was unrelated to performance. In contrast to the previous studies,
these findings suggest that primary psychopathy is associated with superior response
inhibition, whilst secondary psychopathy is characterised by normal response inhibition.
However, Lynam, Whiteside, and Jones (1999) looked at performance on a Go-No-
Go task and a Q task with 77 male undergraduate participants. The Q task is a computerised
task that assesses behavioural inhibition to previously punished stimuli. In the conditioning
phase, participants are presented with a string of letters and asked to respond as quickly as
possible when the letter-string does not contain the letter ‘Q’. Participants are rewarded when
they respond correctly (e.g., given points when the Q is absent) and punished when they
respond incorrectly (e.g., points taken when the Q is present). In the test phase, participants
are again presented letter strings, this time with a combination of letters and number or letters
only. Participants are instructed to respond as quickly as possible to the letter-only strings.
The letter Q is presented in some of the letter-only strings and responses on this task are
again rewarded or punished. Longer reaction times to letter trials containing the Q compared
non-Q trials indicate greater inhibition to the previously punished stimuli. There were no
significant correlations between secondary psychopathy and performance on the Q task or
Go-No-Go task. However, total scores on the Levenson Self-Report Psychopathy Scale
(LSRP) were correlated with Go-No-Go commission errors, and this was primarily because
of a significant relationship between primary psychopathy and commission errors on the Go-
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No-Go task. On the surface, these findings suggest that the interpersonal features of
psychopathy are related to response inhibition. However, in this sample, primary psychopathy
was more strongly related to antisocial behaviour, as assessed by the Antisocial Behaviour
Inventory, than secondary psychopathy. Therefore, these findings provide partial support for
the link between antisocial behaviour features and response inhibition deficits in
psychopathy.
Summary of Cool Executive Functioning in Successful and Unsuccessful Psychopathy
Although results differ across studies of criminal and noncriminal samples, with some
evidence of executive dysfunction in criminal samples and superior executive function in
noncriminal samples, an emerging pattern across both samples is the divergent relationships
between primary and secondary psychopathy and executive function (see Table 9). Given
these findings, it is plausible that the differing results across the two samples may be
attributed to the different ways in which psychopathy was conceptualised, with studies using
criminal samples generally failing to parse psychopathy into its primary and secondary
factors. When psychopathy is parsed into primary and secondary factors, the findings across
both samples suggest that secondary psychopathy may be characterised by executive
dysfunction, whilst primary psychopathy may be characterised by intact or superior executive
function. However, this pattern is not consistent across different studies of psychopathy and
executive function, perhaps because of other methodological differences.
One such methodological difference relates to sample characteristics. Thus, an
alternative explanation for the conflicting findings across criminal and noncriminal studies
could be that the two samples differ in a range of demographic and socioeconomic factors
(e.g., age and gender). These factors vary across criminal and noncriminal samples and
confound any conclusions regarding the role of executive function in the psychopathy-
criminality relationship. Importantly, samples also differ according to gender. It is
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noteworthy that all of the studies on executive function in criminal psychopathy have used
male participants, in contrast, the majority of the studies on executive function in noncriminal
psychopathy have used mixed gender samples (see Table 9). Despite this obvious gender
confound and bias, only two studies of executive function in noncriminal psychopathy have
examined possible gender differences. This is problematic because there is evidence that the
manifestation of psychopathy is different for males compared to females (e.g., Forouzan,
2003; Rogstad & Rogers, 2008).
For example, Justus and Finn (2007), using a short-form of the PPI-R to examine the
influence of psychopathy on startle response to affective images in a community sample of
male and female participants, found that the augmentation of the startle response in
psychopathy was moderated by gender. Males with elevated levels of global psychopathy and
PPI-I showed decreased startle amplitude compared to males with low psychopathy for
unpleasant images, at 2ms probe. However, the opposite pattern was observed for women,
with high levels of psychopathy producing greater startle response amplitudes to unpleasant
images compared to women low on psychopathy. These findings suggest that the expression
of psychopathy is different for males and females, with different physiological reactivity to
emotional stimuli observed. Interestingly, female participants in this study had significantly
lower levels of antisocial behaviour than the male participants. This finding is consistent with
data on gender differences in antisocial behaviour, with rates of antisocial behaviour
generally lower amongst females compared to males (Australian Institute of Criminology,
2013). Importantly, antisociality is known to be related to executive dysfunction (Morgan &
Lilienfeld, 2000). This highlights a significant oversight in the current literature on
psychopathy and executive function, as the majority of previous studies using mixed gender
samples have failed to examine possible gender differences. This is problematic because the
available evidence suggests that the manifestation of psychopathy is different for males and
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females, and it is possible that the psychopathy and executive function relationship differs
depending on gender.
In addition to gender differences in criminal and noncriminal samples, the age of
participants in criminal offender and noncriminal samples also varies systematically, with
criminal offenders on average ten years older (average age 34 years) than their
undergraduate, noncriminal psychopathic counterparts (average age 23 years) (see Table 9).
This age difference is problematic because research on the developmental trajectory of
executive function suggests that executive functions peak around the age of 20, with a
gradual cognitive decline observed from the age of 30 (for a review see, De Luca & Leventer,
2010). Thus, criminal and noncriminal samples not only differ with respect to antisociality,
which is known to be related to executive dysfunction, but also age, which is also linked to
performance on executive function tests. Although samples utilising criminal offenders
usually have a matched healthy comparison group, the executive function deficits in criminal
offenders could be due to additive effects of a vulnerability to externalising psychopathology
combined with the onset of general cognitive decline. These differences in both gender and
age make comparison of findings between criminal and noncriminal samples very difficult
and cast doubt on the claims of executive dysfunction in criminal psychopathy and superior
executive functioning in ‘successful’ psychopathy. One simple solution to the demographic
inconsistencies would be to recruit participants from the community and to examine data
separately for males and females.
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Table 9 Studies Examining Behavioural Performance on Measures of Cool Executive Function in Psychopathy
Author/s Sample Females (n)
Psychopathy Measure
Control measures
Executive Function
EF measure and dependant variables
Results
Bagshaw et al. (2014)
Male offenders (n = 29, mean age = 35)
0 PCL-R parsed into F1 and F2 scores
Weschler Abbreviated Scale for Intelligence (WAIS), psychopathy was not related to IQ
Drug screening test, all screens returned negative results
Planning
Set-shifting
Response Inhibition
Adapted TOL (planning time; number of moves).
Brixton Spatial Anticipation Test: (rule detection errors and rule adherence errors)
The Hayling Sentence Completion Test (RT’s and errors)
PCL-R related to more moves (r =.45, s) Factors not examined separately.
FI and F2 negatively related to planning times (F1: r =-.57 to -.68) (F2 r = -.35).
F1 and F2 negatively related to rule detection errors (F1:r = -.33, ns) (F2 r = -.39, s) and positively related to rule adherence errors (F1 r = .33, s) (F2 r = .35, s)
F1 not related to reaction time or errors
F2 related to more errors (r = -.32, p = .051)
Carlson and Thai (2010)
Undergraduates (n = 72, mean age = 20)
44
Examination of gender differences
PPI parsed into FD, IA and CH factors
Excluded head injury/neuropsychological conditions
Response Inhibition
Expectancy AX-CPT (RT)
No gender differences. FD was associated with faster RTs. FD predicted faster RTs on correct trials (r = -.28, s). No relationship observed for IA or CH.
DeBrito et al. (2013)
Male violent offenders with ASPD with (n = 17, mean age = 40) and without psychopathy (n
0 PCL-R Total Score
Matched on age and IQ.
Alcohol and drug use recorded. Healthy controls had less
Verbal Working Memory
Nonverbal Working Memory
Digits Backward (raw score)
Spatial Alternation Task
ASPD groups recalled less digits than healthy controls but there was no difference between ASPD+P or ASPD-P participants.
There was no significant difference between groups on the spatial alternation task.
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Author/s Sample Females (n)
Psychopathy Measure
Control measures
Executive Function
EF measure and dependant variables
Results
= 28, meange age = 36)
Healthy controls (n = 21, mean age = 35)
substance use but substance use was similar amongst ASPD+P and ASPD-P groups.
Dolan (2012) Male offenders with ASPD (n = 96, mean age = 37)
Healthy controls (n = 49, mean age = 34)
0 PCL:SV Total Score divided sample into Low (LP) Medium (MP). and High (HP) scorers.
Offenders and controls matched on age and IQ
Planning
Set-shifting
Response Inhibition
Computerised TOL (planning time and percentage of problems completed)
ID/ED set-shifting task (the mean number of stage completed, and the number or errors)
Go/No-Go Task (Mean probability of response inhibition and mean RT)
No significant differences in planning time across the four groups
All ASPD groups completed less problems than the healthy controls, but only for the difficult trials. Psychopathy groups performed similarly to each other.
No group differences in ID performance but a significant group difference on ED performance, with healthy controls completing more stages than offenders. No differences between any of the psychopathy groups.
There was no significant difference in the number of errors between the four groups for the ID stages. There were significant differences between the healthy controls and the psychopathic groups on ED stages.
There was a significant difference in the probability of inhibition between the MP group and the LP group and healthy controls.
The HP group displayed longer mean reaction times than the healthy controls, indicating less impulsive responding. No other group differences were observed.
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Author/s Sample Females (n)
Psychopathy Measure
Control measures
Executive Function
EF measure and dependant variables
Results
Hansen et al. (2007)
Male offenders (n = 48, mean age = 32)
0 PCL-R parsed into Facets 1- 4.
Working Memory
calCAP/SPM2 (accuracy and RT)
N-back task (accuracy and RT
Facet 1 related to better performance on the calCAP SPM2 (r = .29, s)
Facet 1 related to better performance on the N-back task (r = .27, s)
Heritage and Benning (2013)
Emergency dept. patients (n = 89, mean age = 36)
50
No examination of gender differences
MPQ-BF to assess FD and IA
Response Inhibition
Lexical Decision Stop Signal Task (LD reaction times, LD and SS accuracy, and SSRTs)
FD was not related to performance
IA was significantly negatively related to LD and SS accuracy, SS delay (r = -.29, -.30, -.31), and significantly positively related to SSRT (r =.32) to . These findings indicate increased impulsivity and difficulty inhibiting a response.
Hoppenbrouwers et al (2013)
Male offenders (n = 13, mean age = 34)
Healthy male controls (n=15, mean age = 34)
0 PCL-R Total Score
Participants screened for MI using PAS or case notes
Participants with current substance use excluded
Working memory
Letter-number sequencing test from the WAIS-III (total score)
Psychopathic individuals performed worse than healthy controls (t[26] = 3.06, s).
Ishikawa et al. (2001)
Males classified as successful (n = 13, mean age = 30) and unsuccessful psychopaths (n = 17, mean age = 34), or
0 PCL-R Total Score
IQ measured using the WAIS-R and controlled for in all analyses
Set-shifting
WCST (CAT, PE, NPE)
Successful psychopaths solved more categories and made fewer perseverative and nonperseverative errors than both unsuccessful psychopaths and controls. Unsuccessful psychopaths and controls did not differ in performance.
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Author/s Sample Females (n)
Psychopathy Measure
Control measures
Executive Function
EF measure and dependant variables
Results
healthy controls (n = 26, mean age = 28)
Kiehl et al. (2000)
Male offenders comprised of 12 schizophrenic offenders (mean age = 33) , 24 nonpsychotic offenders classified as psychopathic (n = 13, mean age = 28)) and nonpsychopathic (n = 11, mean age = 27)
0 PCL-R Total Score
Response Inhibition
Go/No-Go (Reaction times, percentage of correct responses, and errors of commission)
Planned comparisons revealed that schizophrenic offenders made more errors of commission than non-psychopaths. There were no other significant differences in performance, with psychopathic and nonpsychopathic offenders performing similarly.
Kim and Jung (2014)
Undergraduate students (n = 30, mean age = 20)
20 No examination of gender differences
PPI-R Total Score used to classify groups as psychopathic or nonpsychopathic
Psychopathic and nonpsychopathic groups matched on age, education, IQ (WAIS) and gender.
Set-shifting
Response Inhibition
WCST (CAT, PE, NPE)
Go/No-Go Task (Accuracy and RTs for Go and No-Go trials)
T-tests revealed that psychopaths and non-psychopaths completed the same number of categories but psychopaths displayed significantly more perseverative and nonperseverative errors.
There were no significant differences in performance on any aspect of the Go/No-Go task.
Lapierre et al. (1995)
Male offenders (n = 60, mean age = 33)
0 PCL-R used to classify offenders as
Matched on age, education, socioeconomic
Planning
Porteus Maze (quantitative and qualitative errors)
No differences for number of quantitative errors, but psychopathic individuals displayed significantly more qualitative errors.
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Author/s Sample Females (n)
Psychopathy Measure
Control measures
Executive Function
EF measure and dependant variables
Results
psychoapthic (n = 30) or nonpsychopathic (n = 30)
status, and drug and alcohol consumption. No neuropsychological problems.
Set-Shifting
Response Inhibition
WCST (CAT, NPE)
Go/No-Go (commission and omission error)
A trend towards significance was observed for the number of perseverative errors (p = .07) and categories achieved (p = .06), with psychopathic individuals performing worse.
There were no differences in the number of errors of omission, but psychopathic individuals displayed significantly more errors of commission.
Lynam, Whiteside and Jones (1999)
Male undergraduate students (n = 70). Demographic details not provided
0 LSRP parsed into prim and sec psyc factors
Response Inhibition
Go/No-Go Task (errors of omission and commission)
LSRP prim was significantly correlated with errors of commission (r = .23, s), but not omission. The same pattern of results was observed for LSRP sec but the results were only marginally significant (r = .18, ns).
Mahmut et al. (2008)
Undergraduate students (n = 101, mean age = 23)
74 Examination of gender differences
SRP-III total score used to classify participants as psychopathic and nonpsychopathic
Estimated IQ using NART, no differences between males or females and no differences between psychopathic and nonpsychopathic groups.
Set-shifting
Computerised TMT-B (Completion time)
There were no gender differences in performance. No differences in completion time between psychopathic and nonpsychopathic groups for either males or females. However, the Callous-Affect facet was significantly related to longer completion times.
Mol et al. (2009) Male forensic psychiatric
0 PCL-R parsed into
Age, education and substance
Set-Shifting
WCST (CAT, PE, NPE)
T-test revealed that performance did not differ between psychopathic and nonpsychopathic
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Author/s Sample Females (n)
Psychopathy Measure
Control measures
Executive Function
EF measure and dependant variables
Results
patients (n = 53, mean age = 39)
F1 and F2 scores and four subgroups, LH, HH, LL,and HL.
abuse were included as covariates
participants. However, partial correlations revealed that F1 was positively associated with the number of categories achieved and negatively associated with both perseverative and nonperseverative errors (r = .22, -.15, -.22, respectively). F2 was unrelated to the number of categories achieved or perseverative errors but was related to nonperseverative errors (r = .17). However, these correlations were not significant at p <.01.
Performance on the task also varied across the four subgroups, LH (PE = 23.25, NPE = 26.63, CAT = 4), HH (PE = 20.81, NPE = 23.13, CAT = 4.38), LL (PE = 18.87, NPE = 19, CAT = 4.57) and HL (PE = 13.17, NPE = 12.33, CAT = 5.17), all ns.
Munro et al., (2007)
Male violent offenders (n = 15, mean age = 46)
Healthy controls (n = 15, mean age = 47)
0 PCL-R total score to classify offenders as psychopathic (n = 9) and nonpsychopathic (n = 6)
Psychotropic medications unrelated to variables of interest.
Response Inhibition
Go/No-Go (number of omission and commission errors and RTs)
Offenders made more errors than controls but that this was only for errors of commission, with the number of errors of omission the same between groups. However, the level of psychopathy within the offender group was negatively related to the number of commission errors (r = -.46).
Similarly, offenders displayed longer reaction times for Go and No-Go trials. However, the level of psychopathy within the offender group was unrelated to performance (r = -.19).
Pham et al. (2003)
Male inmates (n = 36, mean age = 30)
0 PCL-R total scores used to classify participants
Matched on age and WAIS IQ.
Planning
TOL with three different types of problems, neutral, facilitating, or
Factorial ANOVA’s revealed that psychopaths displayed excessive movements but only in misleading trials, and broke more rules and displayed longer subsequent completion times than nonpsychopathic
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Author/s Sample Females (n)
Psychopathy Measure
Control measures
Executive Function
EF measure and dependant variables
Results
as psychopathic (n = 18) and nonpsychopathic (n = 18)
Set-Shifting
misleading. (number of movements, number of broken rules, initiation time and subsequent completion time)
Porteus Maze (Quantitative and qualitative errors)
TMT-A and B (completion time and number of errors)
Modified WCST (CAT, PE, NPE, and percentage of perseverative errors)
individuals, regardless of problem type. There was no difference between groups for reaction time.
Psychopaths displayed more qualitative errors than nonpsychopaths but a similar number or quantitative errors.
There were no differences in performance between psychopathic and nonpsychopathic participants.
There were no differences in performance between psychopathic and nonpsychopathic participants.
Salnaitis et al. (2011)
Undergraduate university students (n =
60
No examination of
PPI total score used to classify participants
Working memory capacity assessed using
Planning Computerised Tower of Hanoi-revised (RT and accuracy)
High psychopathy scorers were faster and more accurate than medium and low psychopathy scorers. The results indicate superior planning abilities amongst noncriminal psychopaths.
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Author/s Sample Females (n)
Psychopathy Measure
Control measures
Executive Function
EF measure and dependant variables
Results
82, mean age = 21)
gender differences in psychopathy-executive function
as low, medium and high psychopathy
the Spatial Span Task was used as a covariate
Sellbom and Verona (2007)
Undergraduate university students (n = 95, mean age = 20)
45
No examination of gender differences
PPI parsed into PPI-I and PPI-2 factors
Estimated IQ measured using the Shipley Institute of Living Scale
Composite scores for General executive cognitive functions (ECF) and response inhibition
Digits Backward (total score)
WCST (PE)
TMT-B (Completion time)
WISC-III mazes (Completion time)
Controlled Word Association Test (number of words retrieved and number of rule breaks)
Flanker task (errors)
PPI-I was positively correlated with ECF (r =.28, s). This was primarily due to a negative relationship with the number of perseverative errors on the WCST (r = -.23, s) and better performance on the Digits Backward (r = .23, s).
PPI-II was negatively correlated with ECF (r = -.22, s). This was primarily because of longer completion times on the TMT-B and WISC-III mazes, and more perseverative errors on the WCST (r = .20, .17, .12, respectively, ns).
There was no relationship between PPI-I and the response inhibition composite or individual tasks (all ns).
PPI-II was negatively related to response inhibition (-.21, s) and this was because of greater commission errors on the Flanker task (r = .25, s)
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Author/s Sample Females (n)
Psychopathy Measure
Control measures
Executive Function
EF measure and dependant variables
Results
Snowden et al. (2013)
Undergraduate students. Experiment 1 (n = 90) and Experiment 2 (n = 60). No age or demographic details provided.
Experiment 1 (n = 46). Experiment 2 (n = 48).
No examination of gender differences
PPI-R parsed into FD, IA, and CH factors
Working Memory
Planning
Spatial and Object Alternation Tasks (number of errors)
Porteus Maze (Qualitative errors)
FD was related to more errors on the Object Alternation Task (r =.22). No other relationships were found.
FD and IA were related to more qualitative errors on the Porteus maze (r = .24 and .23, respectively). CH was unrelated to performance.
Varlamov et al. (2011)
Male personality-disordered forensic patients with (n = 22, mean age = 32) and without psychopathy (n = 27, mean age = 34).
Healthy controls (n = 19, mean age = 33)
0 PCL-R classified as psychopathic and nonpsychopathic
Healthy controls screened for psychopathy using PCL-SV
Response Inhibition
Go/No-Go (errors of omission and commission)
Psychopathic patients made significantly more errors of commission. Nonpsychopathic patients made more errors of omission than psychopathic patients and controls, with a trend observed (p = .055).
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Author/s Sample Females (n)
Psychopathy Measure
Control measures
Executive Function
EF measure and dependant variables
Results
Yang et al. (Yang et al., 2011)
Community sample recruited from temp employment agency (n= 86) demographic details not provided.
? PCL-R total score
Age and IQ controlled in analyses
Set-shifting
Computerised WCST (PE and NPE)
Partial correlations revealed a significant relationship between PCL-R scores and perseverative errors (r = .20, s). No relationship with nonperseverative errors.
Zeier et al. (2012)
Male offenders (n = 98, mean age = 28)
0 PCL-R Total score and WAS used to classify offenders as low anxious psychopathic (n = 29), high anxious psychopathic (n = 25), low anxious nonpsychopathic (n = 23) or high anxious nonpsychopathic (n = 29).
IQ
ASPD
Response Inhibition
Flanker Task (accuracy and RT)
No effect of ASPD on RT. However, ASPD resulted in significantly more errors on incongruent trials.
No effect of psychopathy, anxiety or their interaction on RT. Psychopathic participants displayed more errors on congruent and incongruent trials. High anxious individuals displayed more errors. However, a significant interaction was found where high psychopathic, low anxious individuals displayed more errors.
Analyses of individual PCL-R factors revealed that for the two-factor model, Factor 2 was related to more errors on incongruent trials. In the three factor model, only facet 3 was associated with more errors on incongruent trials.
When the overlapping effects of ASPD and psychopathy were examined together, ASPD was still related to lower accuracy, but psychopathy was no longer related to lower accuracy.
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Author/s Sample Females (n)
Psychopathy Measure
Control measures
Executive Function
EF measure and dependant variables
Results
Zimak (Zimak et al., 2014)
Male undergraduate students (n = 79, mean age = 19)
0 PPI-SF participants caterogised into high and low psychopathy
IQ. No head injury, neuropsychological or psychological conditions, no substance abuse. Word memory test to detect faking.
Response Inhibition
Stop-Signal Task (SSRT)
T-tests revealed no difference between psychopathic and nonpsychopathic participants on SSRT.
Note: PCL-R = Psychopathy Checklist Revised; MPQ = Multidimensional Personality Questionnaire – Brief form; FD = Fearless Dominance; IA = Impulsive Antisociality; CH = Coldheartedness; MI – Mental Illness;
PAS = Personality Assessment Screener; WAIS-III = Wechsler Adult Intelligence Scale Third Edition; WCST = Wisconsin Card Sorting Test; CAT = Categories Achieved; PE = Perseverative errors, NPE =
Nonperseverative Errors; ASPD = Antisocial Personality Disorder; ASPD+P = Antisocial Personality Disorder with Psychopathy; ASPD-P = Antisocial Personality Disorder without Psychopathy; PCL:SV =
Psychopathy Checklist: Screening Version; ID/ED = Intradimensional/Extradimensional; WISC-III = Wechsler Intelligence Scale for Children Third Edition; TMT-B = Trail Making Test Part B; PPI = Psychopathic
Personality Inventory; PPI-R = Psychopathic Personality Inventory-Revised; SRP-III = Self-Report Psychopathy Scale – Version Three; NART = National Adult Reading Test; RT = Reaction times; LSRP = Levenson
Self-Report Psychopathy Scale; WAS = Welsh Anxiety Scale; LH = Low Factor 1 Scores and High Factor 2 Scores; HH = High Factor 1 and Factor 2 Scores; LL = Low Factor 1 and Factor 2 Scores; HL = High Factor
1 Scores and Low Factor 2 Scores; PPI-SF = Psychopathic Personality Inventory – Short Form;
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The Current Study
The literature on executive function in psychopathy has produced inconsistent
findings in both criminal and noncriminal samples. These inconsistent findings may be
attributed to differences in the conceptualisation and measurement of psychopathy, with some
studies examining psychopathy as a unitary construct and others examining primary and
secondary factors separately. According to the dual process model, psychopathy is
conceptualised as two distinct syndromes with distinct neurobiological origins. Primary
psychopathy is thought to arise from a deficiency of the brain’s defensive motivational
system, resulting in the lack of fear and anxiety that is characteristic of the primary
psychopath (Patrick & Bernat, 2009). Secondary psychopathy is considered to result from an
impairment in brain regions that are responsible for higher order cognitive processes.
Although the pattern is somewhat inconsistent across studies, when the unique relationships
are examined between executive function and primary and secondary psychopathy, a
divergent relationship emerges. Primary psychopathy appears to be related to superior, or at
least intact, executive function, whilst secondary psychopathy appears to be related to
executive dysfunction. These findings are consistent with the claims of the dual process
model of psychopathy, which suggest that the interpersonal and affective features (primary
psychopathy [PCL-R Factor 1, PPI-FD]) are etiologically distinct from the socially deviant
and lifestyle features of psychopathy (secondary psychopathy [PCL-R Factor 2, PPI-SCI]).
Further support for the dual process model is found in research which demonstrates unique
and divergent relationship between primary and secondary psychopathy and a range of
external variables.
For example, Heinzen, Köhler, Godt, Geiger, and Huchzermeier (2011) used a large,
male forensic sample to examine the unique relationships between PCL:SV psychopathy
factors, intelligence, and conviction history. The authors found no association between Factor
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1 (primary psychopathy) and intelligence or number of convictions. However, they did find
that Factor 1 was associated with the length of conviction, perhaps indicating a relationship
between primary psychopathy and seriousness of offence. In contrast, Factor 2 (secondary
psychopathy) was negatively related with intelligence and the length of conviction, but
positively related to the number of prior convictions. These findings indicate that primary and
secondary psychopathy share opposite relationships with intelligence and conviction history.
Similar studies have found that primary psychopathy and secondary psychopathy
display distinct etiological markers and divergent patterns of relationships with external
variables (i.e., socioeconomic status variables) (Benning et al., 2003; Morrison & Gilbert,
2001). Most notably, primary and secondary psychopathy differ in the experience of negative
affect (i.e. fear, anxiety and remorse) (Frick et al., 1999; Patrick, 1994). Numerous studies
have shown that primary psychopathy is associated with a paucity of negative emotions (K.
S. Blair, Morton, et al., 2006; Frick et al., 1999; Lykken, 1957). Specifically, primary
psychopathy is associated with a lack of fear and anxiety (Lykken, 1957; Ogloff & Wong,
1990), poor passive avoidance to punishment when the task involves competing goals
(Newman & Kosson, 1986), and decreased electrodermal responsivity to punishment cues
(Lykken, 1957). In contrast, secondary psychopathy is associated with elevated levels of
negative affect, specifically, anxiety, fear and hostility (Hicks et al., 2004; Vassileva et al.,
2005).
Taken together, there is some evidence that psychopathy arises from a two distinct
processes, each resulting in different, yet sometimes related, syndromes. From this
perspective, primary psychopathy would not be related to executive dysfunction. In contrast,
a deficit in brain regions responsible for executive processes places an individual with
secondary psychopathy at risk of externalising psychopathology (e.g., behavioural deviance).
Although offering different explanations of psychopathy, the dual process and successful
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models of psychopathy are not mutually incompatible. For example, the results from study 1
provided support for both models by showing that the relationship between secondary
psychopathy and criminal behaviour was explained by identification with criminal peers. This
finding is consistent with the successful model of noncriminal psychopathy (Hall & Benning,
2006), which suggests the manifestation of psychopathy is influenced by other internal (e.g.,
intelligence, executive dysfunction) and external factors (e.g., peer group, family
environment).
Further evidence for the successful psychopathy model comes from a recent study by
Wall et al. (2013) which suggests that intelligence moderates the relationship between
psychopathy and criminal behaviour. Using a large undergraduate sample the authors
examined whether intelligence, as measured by the Shipley-2, moderated the relationship
between PPI-R psychopathy and scores on the Antisocial Behaviour Questionnaire. The
results indicated that individuals with high psychopathy scores (PPI-R and PPI-FD) were less
likely to have engaged in criminal behaviour if they had higher scores on both the verbal and
non-verbal scales of the Shipley-2. For individuals with higher levels of Self-Centred
Impulsivity, higher scores on the verbal scale of the Shipley-2 predicted a decreased
likelihood of having engaged in criminal behaviour (Wall et al., 2013). Therefore, the
increased risk for behavioural deviance in secondary psychopathy predicted by the dual
process model may be affected by other environmental factors, such as general intelligence,
education, socioeconomic status, and peer group, a finding that is consistent with the
successful psychopathy model. Following this line of reasoning, it may be that secondary
psychopathy is related to an increased risk of behavioural deviance because of executive
dysfunction, but that the degree of executive dysfunction moderates the relationship between
secondary psychopathy and antisocial behaviour. However, there are no known studies that
have explicitly tested these two neurobiological theories of noncriminal psychopathy.
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Aims and Hypotheses
The primary aim of this study is to empirically test two contemporary neurobiological
theories of psychopathy; the successful psychopathy model (Gao & Raine, 2010; Hall &
Benning, 2006) and the dual process model. Given the pattern observed in previous research
on executive function in psychopathy and the findings of Study 1, it is hypothesised that there
will be intact or superior performance on measures of executive function in primary
psychopathy. Because there is accumulating evidence that supports the dual process model, it
is hypothesised that secondary psychopathy will be related to poorer performance on
measures of executive function. However, in line with the claims of the successful
psychopathy model, it is hypothesised that the relationship between secondary psychopathy
and antisocial behaviour will be moderated by the degree of executive dysfunction.
A secondary aim of this study is to address the demographic inconsistencies between
criminal and noncriminal studies. This will be achieved by recruiting participants from the
community, as opposed to an undergraduate university sample. Furthermore, this study will
examine possible gender differences in the relationship between psychopathy and executive
function. Given that previous research has demonstrated gender differences in the expression
of psychopathy, it is hypothesised that there would be some gender differences in the
relationship between psychopathy, executive function, and criminal behaviour. Given that
there is limited research on psychopathy in women, and that the current study is exploratory,
no specific hypotheses were made in regards to gender differences.
In addition to the examination of gender, this study will also control for possible
effects of intelligence on the relationship between primary and secondary psychopathy and
executive function. There is some evidence that performance on tests of executive function
are related to performance on intelligence tests (e.g., Salthouse, 2005), and that tests of
executive function and tests of intelligence both measure general intelligence (e.g.,
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Obonsawin et al., 2002). However, more in-depth analysis of the relationship between
intelligence and executive function shows that inhibition and task switching are not related to
general intelligence, and that updating may be the only executive function that is related to
general intelligence (Miyake et al., 2000). Nevertheless, given the differential relationship
between primary psychopathy and secondary psychopathy and intelligence (Heinzen et al.,
2011; Vitacco, Neumann, et al., 2005), and preliminary evidence that intelligence moderates
the psychopathy-antisocial behaviour relationship (Wall et al., 2013), the current study will
examine possible mediating effects of intelligence on the psychopathy-executive function
relationship.
Method
Participants
Forty participants were recruited from the participant pool of Study 1 (19 males, 21
females) by contacting all participants who expressed interest in participating in future
studies.The average age of participants was 28 years (males M = 28 years, SD = 7.6 years;
females M = 27 years, SD = 10 years). The sample consisted of participants who were
students (55%), and participants who were employed full-time (25%), part-time (2.5%), or on
a casual basis (10%); self-employed (5%), or unemployed (5%). Table 10 displays the
breakdown of employment status and education level by gender. Participants with a previous
history of psychiatric or neurological illness, and/or regular use of psychiatric or neurological
medication were excluded from participating. Additionally, participants who did not speak
English as their first language were excluded from participation.
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Table 10
Employment status and education presented separately for males and females (N = 40)
Demographic Variable % Male (n = 19) % Female (n = 21)
Highest Level of Education
Year 12 Certificate 31.60 50.00
Trade/Diploma 26.30 25.00
Undergraduate Degree 36.80 20.00
Postgraduate Degree 5.30 5.00
Employment Status
Student 31.60 75.00
Full-time Employee 36.80 -
Part-time Employee - 5.0
Casual Employee 21.10 -
Self-Employed 5.30 -
Unemployed 5.30 5.00
Materials
The Psychopathic Personality Inventory-Revised (PPI-R) (Lilienfeld & Widows,
2005). The Psychopathic Personality Inventory-Revised (PPI-R) is a 154-item self-report
questionnaire commonly used to assess psychopathy in noncriminal populations (Lilienfeld &
Widows, 2005). Each item consists of a statement that participants endorse on a four-point
Likert scale (anchors are 1= false, 2= mostly false, 3= mostly true, 4= true). The PPI-R yields
a global psychopathy score, as well as eight content scale scores: Machiavellian Egocentricity
(ME), Rebellious Nonconformity (RN), Blame Externalisation (BE), Carefree
Nonplanfulness (CN), Social Influence (SOI), Fearlessness (F), Stress Immunity (STI), and
Coldheartedness (C). Factor analysis of the scale reveals a two factor solution that is
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consistent with other well-validated measures of psychopathy (Benning, et al., 2003;
Lilienfeld & Widows, 2005).
The PPI-FD factor labeled “fearless dominance” consists of scores from the SOI, STI
and F content scales and reflects higher levels of wellbeing (e.g., lower social and physical
anxiety, and lower levels of worry and tension), interpersonal dominance, narcissism, and
thrill-seeking (Benning et al., 2003; Benning et al., 2005; Lilienfeld & Widows, 2005). The
PPI-SCI factor labeled “self-centered impulsivity” consists of scores from the ME, RN, BE
and CN content scales and reflects higher levels of manipulativeness, impulsivity, a
propensity to blame others for one’s shortcomings, and a defiance of societal norms and
values (Benning et al., 2003; Benning et al., 2005; Lilienfeld & Widows, 2005). Although the
C content scale does not load highly onto either PPI-FD or PPI-SCI, the scale captures a
callous disposition, a characteristic that many clinicians consider to be central to psychopathy
(Cleckley, 1951; Lilienfeld & Widows, 2005).
The scale has good internal reliability for the global psychopathy scale with
Cronbach’s alpha .92 (Lilienfeld & Widows, 2005). The temporal reliability of the global
psychopathy scale remains high at an average test-retest interval of 19.94 days (Cronbach’s
alpha = .93) (Lilienfeld & Widows, 2005).
The Wisconsin Card Sorting Task (WCST). The WSCT is a classic test of
executive function that has been used extensively in cognitive, neuropsychological and
personality research (Eling, Derckx, & Maes, 2008). The WCST provides an index of
abstract reasoning ability, concept formation, the ability to maintain a response strategy, and
the ability to change response strategies to changing environmental contingencies (Eling et
al., 2008). The test consists of four stimulus cards and 128 response cards that depict varying
geometric figures (triangles, stars, crosses, and circles), colours (red, green, yellow, and blue)
and number of figures (one, two, three, or four). The task requires the participant to match
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each of the 128 response cards to one of the four stimulus cards and the participant is given
feedback about whether the response was correct or incorrect. Once the participant has
achieved ten consecutive correct responses the sorting principle is changed without warning.
The test yields seven different scores: number of categories completed, trials to complete first
category, percent perseverative errors, percent non-perseverative errors, failure to maintain
set, percent conceptual level responses, and learning to learn. The variables of interest for this
study were the number of categories achieved as an index of overall task performance, and
the percentage of perseverative errors as an index of task-switching ability. Computerised
administration of the WCST was used with the Wisconsin Card Sorting Test: Computer
Version Four (WCST:CV4).
The N-Back Task. The n-back task is commonly used to investigate working
memory function and uses a parametric design to vary working memory load whilst
maintaining task consistency across conditions. A single n-back task was utilized across four
levels of difficulty (0-3-back). The stimuli consisted of eight phonologically distinct
consonants (B, F, H, K, M, Q, R, X). A computerised version of the task was administered
using E-prime software.
The Tower of London. The Tower of London (TOL) requires participants to
manoeuvre a number of discs across three vertical pegs of differing sizes from a start position
to a goal configuration, under the tasks constraints that only one disc is moved at a time, and
the number of discs on each vertical peg cannot exceed what the peg can accommodate (The
first peg can only accommodate one disc, the second peg can accommodate two discs, and
the third peg can accommodate three discs). Successful completion of the task requires a
number of execution functions, including planning, response inhibition and goal-oriented
behaviour (Anderson & Douglass, 2001; Goel & Grafman, 1995). A computerised version of
the Tower of London Drexal University (TOL-DX) (Culbertson & Zillmer, 1998) was
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administered using the Psychology Experiment Building Language (PEBL) software
(Mueller, 2010). The indices of performance on the TOL-DX were the total number of
correct trials, the average planning time (time from presentation of trial to the first problem-
solving move), and the average execution time (time from first problem-solving move to
completion of trial).
The Stop-Signal Task. The stop-signal task is used to assess response inhibition
(Lappin & Erikson, 1966; Logan & Cowan, 1984; Vince, 1948). Research by Verbruggen
and Logan (2008) suggests that in contrast to other measures of response inhibition, such as
the go/no-go paradigm, the stop-signal paradigm captures controlled, top-down inhibition,
and is therefore a purer measure of executive control processes in response inhibition. A
windows executable version of the stop-signal task called ‘STOP-IT’ (SI) was used to
administer the task (Verbruggen, Logan, & Stevens, 2008). The primary task requires
participants to perform a shape judgement task by discriminating between a square and circle
as quickly and accurately as possible. However, on stop-signal trials an auditory stop signal is
presented immediately following the presentation of the primary stimulus, which signals that
participants must withhold their response. The SI software uses a horse-race model to
produce a measure of the latency of the stop process, known as the stop-signal reaction time
(SSRT) (Verbruggen et al., 2008). Greater stop signal reaction times are indicative of poorer
response inhibition.
The Raven’s Standard Progressive Matrices Plus (SPM-P). The SPM-P is a non-
verbal measure of cognitive reasoning ability that was designed to capture the educative
component of Spearman’s g. The SPM-P consists of a series of patterns or designs with a
missing section. Participants are required to select the correct missing section from a number
of possible alternatives in a multiple choice format. The SPM-P consists of 60 problems
divided into five sets with a progressive level of difficulty both among the problems in each
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set, and across sets (sets A-E). Each set consists of 12 problems. The test produces total
scores ranging from 0-60 with higher scores on the SPM-P indicating higher levels of
educative reasoning ability. The SPM-P provides a robust measure of cognitive reasoning
ability in a wide range of cultural, socioeconomic and ethnic groups and possesses adequate
test-retest reliability (>.85) for periods up to one year (Raven, Raven, & Court, 2000).
Procedure
Participants from Study 1 who indicated that they were interested in participating in
future studies were contacted. Testing was conducted individually in a quiet study room at
the Queensland University of Technology. Participants were given an information letter
which detailed the nature of the research and participation requirements (See Appendix 3 for
information letter). The executive function tasks, the SPM-P, and the PPI-R were conducted
in a counter-balanced order to control for order effects. The SPM-P and the PPI-R were
administered according to the test manual procedures for each test. Computerised versions of
the WCST, Stop-Signal, N-Back and Tower of London were used. Participants were
encouraged to take regular breaks between testing. The entire testing session lasted
approximately 120 minutes, including instructions and practice blocks.
The computerised executive function tasks. The computerised executive function
tasks were conducted on a computer connected to a flat screen monitor with a screen
resolution set at 1920x1080 pixels and a screen refresh rate of 60 Hertz. Auditory displays
were presented using the computer speakers and participants provided confirmation that the
sound was audible. A standard qwerty keyboard was used to obtain responses from
participants on the n-back and stop-signal tasks. An optical computer mouse was used to
obtain responses on the WCST and Tower of London tasks.
The WCST:CV4. The WCST:CV4 was administered to participants according to the
test manual instructions for computer mouse administration. The four stimulus cards were
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presented across the top of the screen and the response cards were presented on the bottom of
the screen one at a time. Participants were required to match the response cards to the
stimulus cards by using the computer mouse to select the stimulus card they believed
matched the response card (pressing either the left or right mouse key). After each selection
participants were given visual and auditory feedback on whether their selection was correct
or incorrect.
The N-Back. Stimuli were presented in black on a white background for 500ms with
a 2,500ms interval which consisted of a blank screen. Participants responded with the ‘target”
key which was mapped to the ‘f’ key if the target matched the stimulus presented n-items
ago, or the ‘not a target’ key which was mapped to the ‘j’ key if the target did not match the
stimulus presented, with a response window of 3,000ms. In the 0-back condition participants
were asked to respond if the stimulus presented matched a pre-specified stimulus (X). In the
1-back condition, the target was any letter that was identical to the letter immediately
preceding it (one trial back). In the 2-back and 3-back conditions, the target was any letter
that was identical to the letter presented two or three trials back, respectively.
Participants performed a practice block at the start of each level so that the task
requirements were clear. This was followed by three experimental blocks of each of the four
levels in a sequential order, resulting in 12 blocks. Each block consisted of 30 trials which
contained 10 targets and 20 non-targets presented in a pseudorandom sequence (random with
reset after complete cycle of stimuli). Full instructions for the n-back task are presented in
Appendix 4.
STOP-IT (Verbruggen et al., 2008). Stimuli consisted of a square and a circle
presented in the centre of the screen in white text on a black background. On stop-signal trials
(25% of the trials) an auditory stop signal (750 Hz for 75 ms at 80dB) was presented
immediately following the presentation of the primary task stimulus. Participants responded
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with the ‘square’ key which was mapped to the ‘z’ key if the stimulus presented was a square
and the ‘circle’ key which was mapped to the ‘/’ key if the stimulus presented was a circle.
Participants performed a practice block of 32 trials followed by three experimental
blocks of 64 trials. Each trial consisted of the presentation of a fixation sign (+) presented in
the centre of the screen for 250ms which was immediately replaced by the primary stimulus.
The primary stimulus was presented until a response was obtained or 1250ms (maximum
reaction time), with an ISI of 2,000ms that was independent of reaction time. On stop-signal
trials the stop signal was presented at varying stop-signal delays (SSDs) using a staircase
procedure. The initial SSD was 250ms and when the response was correctly inhibited the
SSD increased by 50ms; when the response inhibition failed the SSD decreased by 50ms.
There was a compulsory 10 second break between blocks in which participants were
provided with feedback on their performance on the previous block, including the number of
incorrect responses on no-signal trials, the number of missed responses on no-signal trials,
and the percentage of correctly inhibited responses (Verbruggen et al., 2008).
TOL-DX (Culbertson & Zillmer, 1998; Mueller, 2010). The task consisted of three
pile heights: the first pile could only accommodate one disc, the second pile height could
accommodate two discs and the third pile height could accommodate three discs. Participants
were instructed to move the discs to match the goal configuration within a specified number
of moves using the computer mouse. The next trial commenced once the participant was
successful or the specified number of moves had been exhausted. The task consisted of 15
trials. Full instructions for the TOL-DX task are presented in Appendix 5.
Design
A cross-sectional, correlational design was used to predict executive function from
primary and secondary psychopathy. Primary psychopathy and secondary psychopathy were
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the predictors variables and were assessed using the Psychopathic Personality Inventory-
Revised (PPI-R) (Lilienfeld & Widows, 2005). The PPI-R was chosen for this study to allow
the comparison of findings with previous reseach on psychopathy and executive function,
which has predominately used the PCL-R or PPI-R.
The executive functions of set-shifting, working memory function, planning, and
response inhibition were assessed using the Wisconsin Card Sorting Task, the N-back task,
the Tower of London task, and the Stop-Signal task, respectively and these were used as the
outcome variables. Measures of cool executive function were chosen to allow the
examination of cognitive processing in the absence of emotional processing. As previously
mentioned, this distinction is important in psychopathy research because of evidence of
emotional dysfunction in psychopathy.
Estimates of general cognitive ability were obtained using the Raven’s Standard
Progressive Matrices Plus. This measure of cognitive ability was used to examine possible
mediating effects of cognitive ability on the psychopathy-executive function relationship.
Follow-up moderation analyses were conducted to examine the influence of executive
function on the relationship between psychopathy and criminal behaviour. Criminal
behaviour was measured using the Self-Report Criminality Scale data from Study 1.
Results
Data Screening
Data were screened prior to analyses for accuracy of input and outliers. There were no
out-of-range values, and all means and standard deviations were plausible. Missing values
were not systematic and were excluded from analyses in a pairwise fashion. The PPI-R was
evaluated for inconsistent responding, and socially desirable and/or malingering response sets
according to the test manual instructions (Lilienfeld & Widows, 2005). One female
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participant scored highly on the ‘Deviant Responding’ subscale. Experimenter notes
indicated that this participant had adopted a satisfice response style throughout the
experiment despite multiple reminders about task requirements. This participant was
excluded from all analyses. One female participant scored highly on both the ‘Virtuous’ and
‘Deviant’ Responding subscales. However, there was no evidence to suggest the participant
had adopted an exiguous response style, there was no evidence of inconsistent responding,
and the PPI-R scores were within normal ranges. Therefore, in order to increase power this
participant was included in all analyses with the caveat that they may have been ‘faking bad’
and ‘faking good’ on the PPI-R.
The data was examined for univariate outliers, and values were considered
problematic if they were greater than 3.29 standard deviations from the mean. There was only
one participant (male) with extreme scores, which reflected extremely high levels of PPI-
Total, PPI-FD, PPI-SCI and PPI-C. In order to retain the extreme value whilst reducing the
impact, the value was replaced with a score that was equal to three standard deviations from
the mean. Normality was checked separately for males and females via inspection of
histograms. Due to the small samples sizes (male n = 19, females n = 19) the data displayed
slightly leptokurtic distributions, but was otherwise normally distributed. Distribution-free
tests were used where violations of normality could impact the robustness of the statistical
analyses.
Descriptive Statistics
Descriptive statistics are displayed separately for males and females in Table 11.
Because gender differences in psychopathy are often reported, an examination of mean
differences was conducted using t-tests (Mann-Whitney U analyses were consistent with the
results of the t-tests). There was a significant gender difference in PPI-R Total Scores, t(36) =
2.41, p = .021, 𝜂𝜂2= .14, which could be attributed to higher scores for males on the PPI-C,
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t=(36) = 2.95, p = .005, 𝜂𝜂2= .19, and PPI-FD subscales t(35) = 2.30, p = .027, 𝜂𝜂2=.13. There
were no significant gender differences observed for self-report criminality, PPI-SCI,
cognitive ability, or any of the executive function measures. The means and standard
deviations for the PPI-R were in line with those found in previous research using community
samples, for both the male and female samples (Lilienfeld & Widows, 2005). Additionally,
the means for the male sample were similar to those found in an Australian male prison
sample (PPI-Total M = 310.67, SD = 37.29; PPI-SCI M = 156.96, SD = 29.74; PPI-FD M =
124.69, SD = 18.20; PPI-C M = 42.96, SD = 9.52) (M. A. Hughes, Stout, & Dolan, 2013).
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Table 11
Descriptive Statistics for Psychopathy and Executive Function for Males and Females
Male (n=19) Female (n=19) Measure M SD SE Min Max M SD SE Min Max Self-Report Criminality Scale 33.00 13.78 3.45 22.00 76.00 29.18 9.27 2.25 22.00 53.00 PPI-R Total 306.89 40.32 9.25 266 424 276.47 37.36 8.57 219 354 PPI-R Self-Centred Impulsivity 148.37 23.90 5.48 118 191 139.58 18.72 4.29 110 194 PPI-R Fearless Dominance 126.00 20.73 4.89 77 177 109.89 21.74 4.98 69 152 PPI-R Coldheartedness 33.95 7.75 1.78 21 56 27.00 6.83 1.56 16 40 SPM-Plus 43.28 8.84 2.08 25 58 39.55 6.79 1.60 27 56 TOL Total 30.00 10.39 2.45 12 45 27.17 8.38 2.03 15 39 TOL Avg Planning Time (sec) 22.65 12.88 3.03 8.26 52.48 15.56 6.58 1.55 9.99 28.87 TOL Avg Execution Time (sec) 8.47 2.78 .65 4.73 15.07 9.85 4.04 .95 9.99 16.21 SSRT(ms) 279.43 39.2 9.24 225.00 365.10 273.46 46.29 10.91 198.70 373.50 WCST Categories Achieved 5.82 .73 .18 3 6 5.72 .82 .19 3 6 WCST Perseverative Errors % 8.82 3.94 .95 5.00 23.00 9.00 4.45 1.05 5.00 20.00 N-Back Zero Back Target Hits 30.00 0.00 0.00 30.00 30.00 30.00 0.00 0.00 30.00 30.00 N-Back One Back Target Hits 25.66 3.41 .80 17.00 30.00 26.39 2.91 .68 18.00 30.00 N-back Two Back Target Hits 23.27 7.22 1.70 0.00 30.00 24.39 3.93 .92 15.00 30.00 N-back Three Back Target Hits 16.06 8.05 2.01 2.00 29.00 16.76 5.72 1.39 3.00 25.00
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Inferential Statistics
The data were examined separately for males and females to elucidate any gender
differences in the psychopathy-executive function relationship. Because of breaches to the
normality assumption, Kendall’s Tau nonparametric bivariate correlations were conducted
and are displayed separately for males and females in Table 12. The results show that the
pattern of relationships between the psychopathy subscales, and psychopathy and executive
function is different for males and females. Given the differences in the psychopathy-
executive function relationship, separate regression analyses were conducted for males and
females for the executive function measures.
THE PSYCHOPATH NEXT DOOR 174 Table 12 Bivariate Correlations between Psychopathy and Executive Function for Males and Females (Males are below the diagonal, females above)
Note. *p <.05, **p < .01, # = trend towards significance. Two-tailed.
PPI-R PPI-SCI PPI-FD PPI-C SPM SRCS TOL TOL P TOL E SSRT WCST CA WCST PE One-back Two-back Three-back
PPI-R .519** .677** .673** .143 .278 .244 .214 -.155 -.391* .093 -.147 -.298 .127 .163
PPI-SCI .622** .185 .376* .294 .236 .459** .199 -.376* -.229 -.108 -.356* -.080 .149 .194
PPI-FD .695** .362* .505** .091 .400* .044 .148 .030 -.459* .217 -.124 .008 .221 .162
PPI-C .149 -.125 .180 -.031 .079 .004 .149 .-.075 -.209 .266 -.297 -.298 .127 .163
SPM -.133 -.260 -.120 .149 .378* .067 -.355# -.187 .086 -.140 .458* .598** .605**
SRCS .205 .256 .293 .026 -.100 .383# -.020 -.099 -.296 -.162 .159 .250 .125 .104
TOL -.222 -.377* -.030 .137 .430* -.142 .284 -.529* -.253 -.112 .048 .114 .292 .148
TOL P -.033 -.092 .096 .233 .253 -.020 .651** .033 -.137 .211 -.062 .140 .035 -.090
TOL E .281 .472** .214 -.207 -.558** .156 -.477** -.176 .150 -.014 -.034 -.070 -.438* -.209
SSRT .098 .026 .244 .033 .239 -.215 .383* .268 -.124 .099 .062 -.084 -.327 -.045
WCST CA -.343 -.344 -.354 -.349 .306 -.080 .331 .000 -.343 .214 -.487* .150 .210 .125
WCST PE .318# .440* .161 .008 -.462* .183 -.287 -.127 .207 -.096 -.371 .117 -.110 -.295
One-back -.129 -.137 -.054 .035 .132 .051 .280 .238 -.089 -.048 .202 -.042 .424* .254
Two-back .094 -.047 .168 -.027 .226 .281 .305 .243 .067 .121 .355 -.206 .505** .567**
Three-back -.176 -.336 -.221 .239 .281 .160 .266 .126 -.377* -.192 .367 -.104 .487* .421*
Running head: THE PSYCHOPATH NEXT DOOR 175
Psychopathic Personality Inventory – Revised
The results show that the pattern of relationships between the PPI-R subscales and the
total scale is different for males and females. Whilst PPI-C is not related to PPI-Total, PPI-
FD or PPI-SCI in males (all r <.19, ns), PPI-C is positively associated with PPI-total, PPI-FD
and PPI-SCI in females. The findings of low mean inter-item correlations for the PPI-R
factors in the male sample are consistent with previous research on the PPI-R in an Australian
male prison sample (M. A. Hughes et al., 2013). However, the results of the mean inter-item
correlations for the female sample are not in line with previous research. Chapman, Gremore,
and Farmer (2003) using a female prison sample found that PPI-C only displayed a weak
relationship (r=.11) with the PPI overall scale score. However, this study did use an earlier
version of the PPI-R (PPI).
Raven’s Standard Progressive Matrices-Plus
The SPM-P was used to examine if there was a relationship between psychopathy and
intelligence in the community. The results revealed that PPI-R, PPI-FD, PPI-SCI and PPI-C
were not significantly related to the SPM-P for either males or females (all ns). This finding
is in line with previous research in general population samples, which shows there is no
relationship between psychopathy and intelligence (Bagshaw et al., 2014). With the exception
of TOL final score (r = .37, p = .04), TOL execution time (r =-.33, p =.05), and N-back
performance (one-back, r = .42, p = .02; two-back, r = .59, p =.001; three-back, r = .60, p
=.001), there were no significant relationships between SPM-P and the executive function
measures, for females. As can be seen in Table 11, for males, higher scores on the SPM-P
were significantly negatively related to WCST perseverative errors, and TOL execution time;
and significantly positively related to TOL total score. There were no significant relationships
observed between SPM-P and SSRT, WCST categories achieved, TOL planning time, or
performance on the N-back (all ns). Whilst all relationships between the PPI-R scales and
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SPM-P were weak and non-significant, preliminary evidence suggests that intelligence may
be a compensatory mechanism in the psychopathy-criminality relationship (Wall et al., 2013).
Therefore, follow up tests were conducted to examine possible mediating effects of cognitive
ability on the psychopathy-executive function relationship for each individual task (i.e., the
TOL, Stop-signal, WCST, and N-back).
Tower of London
Tower of London -Total Score. Increased levels of PPI-SCI in males was
significantly related to poorer performance on the TOL, with a moderate, negative correlation
observed. In contrast, increased levels of PPI-SCI in females was significantly associated
with better performance on the TOL, with a moderate, positive correlation observed (see
Table 11). This difference cannot be explained by mean differences between males and
females on PPI-SCI or performance on the TOL. There were no significant relationships
observed between PPI-Total, PPI-FD, and PPI-C and performance on the TOL for either
males or females (all ns). Although non-significant, it is interesting to observe that the pattern
of relationships between PPI-Total, PPI-FD, and PPI-C and performance on the TOL was
opposite for males and females. For females, increased levels of psychopathy were positively
associated with performance on the TOL. For males, increased levels of psychopathy were
negatively associated with performance on the TOL, with exception of the PPI-C factor
which displayed a weak, positive correlation. Because of differences in the relationship
between PPI-SCI and TOL performance, separate regression analyses were conducted for
males and females.
Males. A mediated regression analysis was conducted to predict performance on the
TOL from PPI-SCI whilst examining the possible mediating role of SPM-P. All assumptions
of the analysis were met. The linear combination of PPI-SCI and SPM-P significantly
predicted performance on the TOL, explaining 51.28% of the variance, R = .71, F(2, 15) =
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7.89, p =.004. Within the regression model higher scores on the SPM-P significantly
predicted better performance on the TOL (b =.53, p = .04), whilst higher scores on the PPI-
SCI scale predicted worse performance, with a trend towards significance observed (b =-.16,
p = .07). The results of the mediation analysis revealed a significant indirect effect of PPI-
SCI on TOL through SPM-P, b = -.09, BCa CI [-.25, -.01]. This represents a medium effect,
𝜅𝜅2 = .23, 95% BCa CI [.03, .50]. There was also a direct effect of PPI-SCI on TOL
performance, b = -.17, p = .07, with a trend towards significance observed. These results
suggest a partial mediation effect of SPM-P on the relationship between PPI-SCI and TOL
performance. This indicates that PPI-SCI predicts poorer performance on the TOL through its
relationship with SPM-P, although a direct effect of PPI-SCI still exists beyond the mediating
role of SPM-P. This relationship is displayed graphically in Figure 3a.
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Figure 3a.
Conceptual diagram of the Direct and Indirect Effects of Self-
Centred Impulsivity on Tower of London Performance for Males.
Figure 3b.
Conceptual Diagram of the Direct and Indirect effects of Self-
Centred Impulsivity on Tower of London Execution Times for Males.
Running head: THE PSYCHOPATH NEXT DOOR 179
Females. A mediated regression analysis was conducted to predict performance on the TOL
from PPI-SCI whilst examining the possible mediating role of SPM-P. All assumptions were
met. Unlike males, there was no mediating role of SPM-P, b = .03, BCa CI [-.01, .23]. The
regression analysis revealed that higher levels of PPI-SCI significantly predicted better
performance on the TOL, R = .59, with 34.8% of the variance explained, F(1, 14) = 7.48, p =
.01.
Tower of London – Planning and Execution Time. For males and females, there
was no relationship observed between the PPI-R scales and planning time (all ns). However,
for males higher levels of PPI-SCI were significantly related to longer execution times, with a
moderate-strong relationship observed. In contrast, higher levels of PPI-SCI in females was
moderately, negatively related to execution time, with a trend towards significance observed
(p = .05). This differential relationship between PPI-SCI and TOL execution time cannot be
explained by mean differences between males and females on PPI-SCI or TOL execution
time. There were no significant relationships observed between PPI-Total, PPI-FD, or PPI-C
and TOL execution time for either males or females (all ns). Although non-significant, the
direction of the relationships between the PPI-R scales and TOL execution time was again
opposite for males and females. These differences in performance were followed up with
separate regression analyses for males and females.
Males. To examine possible mediating effects of SPM-P, a mediated regression
analysis was conducted to predict TOL execution times from PPI-SCI scores. All
assumptions were met. The results of the regression revealed that PPI-SCI and SPM-P
significantly predicted performance on the TOL, explaining 63.57% of the variance, R = .79,
F(2, 15) = 13.08, p <.001. Higher scores on the SPM-P significantly predicted shorter
execution times on the TOL (b = -173.43, p = .006). However, higher scores on the PPI-SCI
scale significantly predicted longer execution times (b = 44.97, p = .04). The results of the
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mediation analysis revealed a significant indirect effect of PPI-SCI on TOL execution times
through SPM-P, b = 30.04, BCa CI [1.46, 82.49]. This represents a medium effect, 𝜅𝜅2 = .29,
95% BCa CI [.03, .56]. There was also a significant direct effect of PPI-SCI on TOL
performance, b = 44.97, p = .04. The conceptual diagram is displayed in Figure 3b. These
results show a partial mediation effect of SPM-P on the relationship between PPI-SCI and
TOL execution times. However, elevated scores on the PPI-SCI significantly predict longer
execution times, even with the effects of SPM-P partialled from the regression. These longer
execution times seen for males with elevated levels of PPI-SCI could be due to impulsively
moving the first disc without considering the constraints imposed by the move limit.
Females. A mediated regression analysis was conducted to predict execution times on
the TOL from PPI-SCI scores, whilst examining any mediating effects of SPM-P. All
assumptions were met. The linear combination of SPM-P and PPI-SCI significantly predicted
execution times on the TOL, R = .48, accounting for 23.48% of the variance, F(2, 14) = 5.41,
p = .01. The details of the regression are displayed in Table 13 and show that only SPM-P
was a significant predictor, with higher scores predicting shorter execution times.
Furthermore, unlike males, there was no mediating effect of SPM-Ps on the relationship
between PPI-SCI and TOL execution times b = -15.92, BCa CI [-96.53, 4.24].
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Table 13
Mediated Regression Predicting Tower of London Execution Times from Self-Centred
Impulsivity and Cognitive Ability for Females.
B SE B β t
Constant 25142.49 5851.12
SPM-P -192.22 78.98 .-.34 2.43*
PPI-SCI -56.96 42.90 -.27 1.34
Note. *p<.05
Stop-Signal Reaction Time
There were no significant relationships observed between any of the PPI-R scales and
SSRT for males (all ns). However, the results for the female sample show that elevated levels
of PPI-R Total and PPI-FD were related to shorter SSRT times. These results were followed
up with a forced entry multiple regression analysis predicting SSRT from the linear
combination of PPI-FD, PPI-SCI and PPI-C. A forced entry multiple regression analysis was
chosen because little is known about the relationships between primary and secondary
psychopathy and executive function in females. The results revealed that the linear
combination of PPI-FD, PPI-SCI, and PPI-C did not significantly predict SSRTs, R = .52,
F(3, 13) = 1.48, p = .26. However, an examination of the individual beta-weights revealed a
trend towards significance for higher levels of PPI-FD predicting shorter SSRTs (p = .09).
Accordingly, a follow up mediated regression analysis was conducted to predict SSRT from
PPI-FD, whilst controlling for the effects of SPM-P. All assumptions of the analysis were
met. The results revealed that higher levels of PPI-FD predicted shorter SSRT’s, b = -.95, t =
1.81, explaining 19.48% of the variance, R = .44, F(1, 15) = 3.27, with a trend towards
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significance observed (p = .07). There was no mediating effect of SPM-Ps on the relationship
between PPI-FD and SSRT, b = -0.07, BCa CI [-.53, .06]. These results suggest that higher
levels of the interpersonal and affective features of psychopathy in females, such as
interpersonal dominance, narcissism, and low levels of anxiety predict superior response
inhibition, with a moderate effect observed.
Wisconsin Card Sorting Task
The bivariate correlations between PPI-R Total, PPI-SCI, PPI-FD, PPI-C and
performance on the WCST show that the pattern of relationships vary according to gender. A
similar pattern of relationships emerged, with psychopathy in males related to poorer
performance on the Wisconsin Card Sorting Test, whilst in females psychopathy was
associated with superior performance on the Wisconsin Card Sorting Test.
Categories Achieved. There were no significant relationships observed between
WCST number of categories achieved and any of the PPI-R scales for males or females (all
ns). However, consistent with the pattern of results for the other executive function measures,
the number of categories achieved was moderately and negatively related to PPI-R total, PPI-
FD, PPI-SCI and PPI-C for males, and moderately and positively related to PPI-FD and PPI-
C for females. There was no relationship between PPI-R Total and PPI-SCI in females (<
.11).
Percentage of Perseverative Errors. For males there was a significant moderate,
positive relationship between the number of perseverative errors made and PPI-SCI. There
was also a moderate, positive relationship between PPI-R Total and the number of
perseverative errors, with a trend towards significance (p = .09). There were no relationships
observed between PPI-FD, PPI-C and the number of perseverative errors made. For females,
there were no relationships between the number of perseverative errors and PPI-R Total, PPI-
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FD or PPI-C. However, there was a significant negative relationship observed between the
number of perseverative errors and PPI-SCI. These significant findings were followed up
with separate mediated regression analyses for males and females.
Males. Given that a moderate relationship was observed between PPI-R Total, PPI-
SCI, and the percentage of perseverative errors, a hierarchical multiple regression was
conducted to predict the percentage of perseverative errors from the linear combination of
PPI-SCI, PPI-FD, and PPI-C. The assumption of normally distributed residuals was not met,
therefore a logarithmic transformation was applied to PPI-SCI, PPI-FD, PPI-C, SPM-P, and
WCST percentage of perseverative errors. This transformation was successful in achieving
the assumptions of the test, and the analysis was performed using the transformed data. PPI-
SCI was entered in the first step, and PPI-FD and PPI-C were entered in the second step. At
the first step, the results revealed that higher levels of PPI-SCI significantly predicted a
higher percentage of perseverative errors, b = 1.27, t = 2.90, explaining 31.80% of the
variance, R = .60, F(1, 15) = 8.44, p = .01. The addition of PPI-FD and PPI-C to the
regression model did not produce a significant change in 𝑅𝑅2, F(2, 13) = 1.36, p = .29. The
linear combination of PPI-SCI, PPI-FD, and PPI-C explained 34.9% of the variance, R = .68,
F(2, 13) = 3.86, p = .03. However, within the regression model only higher levels PPI-SCI
significantly predicted a higher percentage of perseverative errors. To examine possible
mediating effects of intelligence, the results of the hierarchical regression analysis were
followed up with a mediated regression analysis. There was no mediating effect of SPM-P on
the relationship between PPI-SCI and the number of perseverative errors, b = .02, BCa CI
[.00, .07]. These results suggest that males with elevated levels of secondary psychopathy
have more difficulty switching strategies in response to changing task contingencies, and that
this effect is independent of intelligence.
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Females. A mediated regression analysis was used to predict the number of
perseverative errors from PPI-SCI. The assumptions of normally distributed residuals and
homoscedasticity were not met and logarithmic transformations failed to address the
violations. Therefore, PROCESS’s ‘heteroscedasticity consistent standard errors’ tool was
used to control for any deleterious effects of heteroscedasticity (Hayes, 2012). The results of
the regression analysis were not significant, R = .11, F(1, 15) < 1, p = .77. Furthermore, there
was no mediating effect of SPM-P on the relationship between PPI-SCI and the number of
perseverative errors, b = .02, BCa CI [-1.67, .09].
N-Back Task
As can be seen in Table 10, there was decrease in the number of targets correctly
identified as the task difficulty increased from zero-back to three-back. A repeated measures
ANOVA was conducted on the total sample and confirmed that this difference was
significant, F(3, 96) = 72.33, p < .001. Post-hoc pairwise comparisons using a Bonferroni
correction revealed that participants identified significantly fewer targets in the two-back
condition compared to the one-back condition, t(1, 32) = 3.00, p =.03, and significantly fewer
targets in the three-back condition compared to the two-back condition t(1, 32) = 8.1, p <
.001. These findings demonstrate that the N-back task was successfully increasing the
working memory load across difficulty level.
The bivariate correlations presented in Table 11 show that there were no significant
relationships observed between performance on the N-Back Task (at any level of difficulty)
and any of the PPI-R scores for either gender. This suggests that psychopathy is not related to
attentional deficits in either males or females. This finding is consistent with previous
research on psychopathy and attention, with studies demonstrating unusual yet superior
selective attention in psychopathic individuals.
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Self-Report Criminality Scale (SRCS)
Follow-up moderation analyses were conducted to see whether executive function
moderated the relationship between psychopathy and self-report criminality. Bivariate
correlations revealed that for males, antisocial behaviour was positively related to PPI-R,
PPI-C, PPI-FD, and PPI-SCI but the results did not reach statistical significance because of a
lack of statistical power. A similar pattern of results was found for females, with the
exception that antisocial behaviour was significantly, moderately related to PPI-FD. Because
the pattern of relationships for the male and female samples were the same, the analysis was
rerun using the combined sample. The results revealed that PPI-FD, PPI-SCI, and PPI-R were
significantly, moderately related to scores on the SRCS (r = .304, p = .01; r = .279, p = .02, r
= 295, p = .02, respectively). However, for both genders, the SRCS only displayed
nonsignificant, weak to moderate correlations with the executive function measures.
Interestingly, the pattern of relationships between the SRCS and the measures of executive
function differed across the two samples, and so the male and female data were analysed
separately.
Moderated regression analyses were conducted using the PROCESS tool (Hayes,
2012). Variables were centred prior to analysis and any potential issues with
heteroscedasticity were controlled using the heteroscedasticity-consistent standard errors
function. For males, there were no significant moderating effects of executive function on the
relationship between PPI-SCI and SRCS (all ns). Additionally, there were no significant
moderating effects of executive function on the relationship between PPI-FD and SRCS (all
ns). For females, the results of the moderation analyses revealed no significant moderation of
any of the executive function measures on the relationship between PPI-FD and SRCS (all
ns). Furthermore, there were no moderating effects of executive function on the relationship
between PPI-SCI and SRCS (all ns).
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Discussion
Overview of Research
The primary aim was to empirically test two theories of psychopathy: the dual process
model and the successful psychopathy model. Whilst both theories attempt to explain the
differential manifestation of psychopathy in criminal versus noncriminal samples, they differ
with respect to the neurobiological mechanisms that underlie criminal versus noncriminal
psychopathy. In line with the claims of the successful psychopathy model, Gao and Raine
(2010) suggest that criminal and noncriminal psychopaths are differentiated by executive
functioning. According to their hypothesis, criminal psychopaths are characterised by
executive dysfunction which places them at greater risk for overt criminal offending. In
contrast, noncriminal or ‘successful’ psychopaths possess intact or superior executive
functioning, which acts as a protective mechanism against criminal offending. From this
perspective, executive function is hypothesised to moderate the expression of antisocial
behaviour in psychopathy.
On the other hand, the dual process model claims that psychopathy cannot be
considered a unitary syndrome, but rather a confluence of two etiologically distinct
syndromes. From this perspective, primary psychopathy arises from a deficit in the brain’s
defensive motivational system, manifesting as trait fearlessness. Secondary psychopathy is
hypothesised to stem from a dysfunction in brain regions responsible for higher order
processes, placing an individual at risk for criminal offending. According to the dual process
model, individuals can present with elevated levels of primary and secondary psychopathy, or
elevated levels on only primary or secondary psychopathy. In this conceptualisation, the
criminal psychopath presents with elevated levels of both dimensions. However, the
noncriminal psychopath presents with only elevated levels of primary psychopathy, with low
or average levels of secondary psychopathy. From this perspective, primary psychopathy
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would be associated with intact executive functioning. In contrast, secondary psychopathy
would be characterised by executive dysfunction.
This study aims to examine the relationships between primary and secondary
psychopathy and executive function, whilst also testing for moderating effects of executive
function on the relationship between psychopathy and antisocial behaviour. This was
achieved by utilising several commonly used measures of executive function and examining
their relationship with psychopathy and criminal behaviour in a community sample.
Following the dual process model, it was hypothesised that primary psychopathy would be
associated with intact executive function. In contrast, it was hypothesised that secondary
psychopathy would be predictive of executive dysfunction. In line with the successful
psychopathy model, it was hypothesised that the degree of executive dysfunction would
moderate the relationship between secondary psychopathy and antisocial behaviour.
In addition to theory testing, the secondary aim of this study was to address the
demographic inconsistencies between criminal and noncriminal studies, with a particular
focus on exploring possible gender differences in the relationship between psychopathy and
executive function. Given that previous research has found some gender differences in the
expression of psychopathy, it was hypothesised that there would be gender differences in the
relationship between psychopathy, executive function, and criminality. Furthermore, because
there is some evidence that measures of executive function and measures of intelligence tap
the same underlying construct, intelligence was included as a possible mediating factor.
Key Findings
These findings provide partial support for the dual process model of psychopathy. For
both males and females, primary psychopathy was associated with intact performance on all
measures. Interesting, for females, primary psychopathy was predictive of superior response
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inhibition and this effect was independent of intelligence. However, support for the dual
process model was dependent on gender. This finding supports the hypothesis regarding
gender differences in the manifestation of psychopathy. It is interesting to note that there
were no gender differences in intelligence or performance on the measures of executive
function that could explain the differential findings for gender on the relationship between
psychopathy and executive function. Furthermore, although the majority of participants in the
female sample were students, males in current sample had higher levels of education than the
females, suggesting that level of education cannot explain the gender differences observed.
Given the gender differences, discussion of the key findings are presented separately for
males and females.
Males. For males, the results provide partial support for the dual process model, with
secondary psychopathy associated with poorer performance on some, but not all, measures of
executive function. Specifically, higher levels of secondary psychopathy were related to, or
predictive of, poorer planning ability and cognitive flexibility. However, higher levels of
secondary psychopathy were not related to working memory function or response inhibition.
The finding of intact response inhibition in secondary psychopathy is consistent with two
previous studies on response inhibition in secondary psychopathy using a noncriminal sample
(Carlson & Thái, 2010; Lynam et al., 1999).
In contrast, two other studies have found that individuals with higher levels of
secondary psychopathy displayed greater errors of commission on a Flanker task (Sellbom &
Verona, 2007) and longer stop-signal reaction times (Heritage & Benning, 2013). However,
in both these studies, the relationships observed between secondary psychopathy and
response disinhibition were weak (r = .25 - .32). Given that the sample sizes used in previous
studies were much larger than the sample used in the current study, the lack of replication in
the current study may reflect problems with statistical power. Nevertheless, given the weak
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relationships observed between secondary psychopathy and response disinhibition across all
four studies, response disinhibition may not be a hallmark feature of secondary psychopathy
in noncriminal samples.
This appears to the case for working memory function also, with the results showing
intact working memory function in secondary psychopathy. This finding is consistent with
previous research using undergraduate (Sellbom & Verona, 2007; Snowden et al., 2013) and
criminal samples (Hansen et al., 2007). Taken together, these findings suggest that secondary
psychopathy is not characterised by global executive function deficits, but rather by specific
executive function deficits. The results suggest that males with higher levels of secondary
psychopathy have more difficulty planning a sequence of events, with worse overall
performance and longer execution times on the Tower of London. Furthermore, intelligence
only partially mediated the effects of psychopathy on performance, with a direct effect
observed for overall score and execution time. These findings are consistent with previous
research in an undergraduate sample, which showed that performance on the WISC-III Mazes
was significantly different for primary versus secondary psychopathy (Sellbom & Verona,
2007). In Sellbom and Verona’s study, primary psychopathy was associated with better
planning ability, whilst secondary psychopathy was associated with poorer planning ability.
Taken together, these findings highlight the importance of examining primary and secondary
variants separately. This is particularly important given that previous research on planning
ability using global psychopathy scores has produced inconsistent findings.
Similar to other studies in both criminal and noncriminal populations, global
psychopathy was associated perseverative responding on the WCST (Kim & Jung, 2014;
Lapierre et al., 1995; Yang et al., 2011). However, other studies have generally failed to parse
psychopathy into primary and secondary variants. The results show that when the relationship
between perseverative errors and primary and secondary psychopathy is examined separately,
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only secondary psychopathy is significantly related to perseverative responding. Furthermore,
this effect is not mediated by intelligence This finding is consistent with Sellbom and Verona
(2007) findings, and highlights the importance of examining the psychopathy variants
separately. It also finding provides support for the dual process model, by showing that males
with higher levels of primary psychopathy have intact set-shifting abilities, but that those
higher on secondary psychopathy have problems with cognitive flexibility.
Taken together, the results provide partial support for the claims of the dual process
model, with primary psychopathy not related to performance on any of the measures of
executive function. In line with the claims of the dual process model, secondary psychopathy
was associated with some deficits in executive functioning. However, the results from this
study showed that support for the dual process model was specific to the male sample.
Females with elevated levels of secondary psychopathy did not display the same pattern of
executive function deficits predicted by the dual process model.
Females. While for males, secondary psychopathy was related to poorer performance
on tasks assessing planning and set-shifting abilities, for females, higher levels of secondary
psychopathy significantly predicted better performance, as shown on the Tower of London.
Furthermore, as shown by the finding that secondary psychopathy was negatively related to
execution times, higher levels of secondary psychopathy in females was related to faster
completion times. There were no mediating effects of intelligence for females. It is
interesting to observe that the pattern of relationships between secondary psychopathy and
performance on the Tower of London are opposite for males and females. This finding may
explain why previous research has produced inconsistent findings. As discussed previously,
criminal samples contain only male participants and reveal a deficit in planning for
psychopathy. On the other hand, noncriminal samples have a mix of male and female
participants and reveal intact performance on planning tasks. For example, Salnaitis et al.
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(2011) found that undergraduate participants who scored high on psychopathy performed
better on the Tower of Hanoi than low and medium psychopathy scorers. Interestingly, in
contrast to criminal offender samples, the sample was predominately female (73%).
Therefore, it is plausible that the inconsistency in findings for a planning deficit in
psychopathy across criminal and noncriminal samples is because of gender differences in the
manifestation of psychopathy.
This pattern of superior or intact performance for females with elevated levels of
secondary psychopathy was observed for all the executive function tasks. Although not
significant, secondary psychopathy was negatively related to stop-signal reaction times, and
unrelated to performance on the N-back task, indicating intact response inhibition and
working memory function. Furthermore, the bivariate correlations revealed that higher levels
of secondary psychopathy were significantly negatively related to the percentage of
perseverative errors on the WCST. This finding is in contrast to that found for males, and
indicates that females with elevated levels of secondary psychopathy have superior set-
shifting abilities. Taken together, these findings suggest that current theoretical models of
psychopathy do not adequately explain the manifestation of psychopathy in women.
A possible reason for the differences in performance for males and females with
secondary psychopathy may have to do with gender stereotypes and the role they play in the
performance of females on tests of ability and intelligence. For example, previous research
has shown that ‘stereotype threat’ negatively affects performance on tests for females and
other minority groups (Nguyen & Ryan, 2008). Stereotype threat refers to the psychological
phenomenon where negative group stereotypes negatively impact performance on ability tests
(Steele, 1997). Many social-cognitive theories have been proposed to explain how gender
stereotypes are formed and maintained, including the gender schema theory (Bem, 1981), the
social-cognitive theory (Bussey & Bandura, 1999), and the cognitive-developmental theory
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(Kohlberg, 1966). However, a central tenet of each theory is the role of socio-cultural and
cognitive influences in the formation and maintenance of gender roles.
Gender roles are defined as the roles that society assigns to men and women based
upon biological sex, and include the types of responsibilities, behaviours, attitudes,
personality traits, and skills that are appropriate for each sex. Generally speaking, masculine
stereotypes emphasise independence, competitiveness, physical strength and ability,
emotional ‘toughness’, and a natural intelligence. On the other hand, feminine stereotypes
emphasise social connectedness, empathy, compliance, physical ‘fairness’, and intellectual
inferiority. There exists a masculine hegemony where traditionally ‘male’ qualities are
superior and the male experience is the normative standard. These stereotypes are reinforced
by the media (R. Collins, 2011; Lauzen, Dozier, & Horan, 2008; Ward, 2002), parents
(Tenenbaum & Leaper, 2002; Tomasetto, Alparone, & Cadinu, 2011), teachers (Gunderson,
Ramirez, Levine, & Beilock, 2012), and peers (Kessels, 2005). This perspective of male
superiority has negatively impacted women, resulting in negative body image and negative
self-evaluations of physical ability (Hively & El-Alayli, 2014; Slater & Tiggemann, 2011);
lower participation in traditionally masculine enterprises, such as math and science (Nosek et
al., 2009; Schmader, Johns, & Barquissau, 2004); and poorer performance on a range of
ability tests (Good, Aronson, & Inzlicht, 2003; Schmader & Johns, 2003; Schmader, Johns, &
Forbes, 2008; Sekaquaptewa & Thompson, 2003).
For example, Schmader (2002) examined the influence of gender roles and stereotype
threat on math performance. Using a sample of male and female undergraduates, they
examined the moderating effects of gender identity on male and female math performance.
When females strongly identified with the feminine gender role, and their gender identity was
manipulated to be relevant to performance, their performance was worse than their male
counterparts. This effect was not observed for women with low levels of feminine gender
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identification, with these women performing similarly to men. However, when gender
identity was not linked to performance women, regardless of gender identity, performed
equally as well as the men. There were no effects of gender identity on men’s math
performance. These findings show how gender roles and stereotype threat affect women’s
performance on ability tests.
Given that the measure of secondary psychopathy used here reflects
unconventionality and a defiance of societal norms, it is plausible that a flouting of traditional
gender identity roles in females with secondary psychopathy acts as protective mechanism
against gender stereotype threat. This hypothesis may also explain the superior performance
on the stop-signal reaction task for females with higher levels of primary psychopathy. This
is because one of the ways that stereotype threat affects performance is through increased
levels of test anxiety (Osborne, 2007). Therefore, it is plausible that females with higher
levels of primary psychopathy may identify with gender stereotypes, but that this does not
impact performance because of their innate fearlessness and stress immunity. Therefore, it
may be that primary and secondary psychopathy confer some advantages for females,
particularly in relation to performance on ability tests. However, this hypothesis requires
testing in future research on psychopathy in females. One possible avenue for future research
could be to employ a measure of gender identity and examine possible moderating effects on
the relationship between psychopathy and performance on tests of executive function.
Research has shown that gender identity moderates the performance of women on tests of
mathematical ability (Schmader, 2002). It is plausible that this may also be true for
performance on tasks of executive function.
Psychopathy, Executive Function, and Self-Report Criminality
In addition to testing the dual process model of psychopathy, this study examined the
successful model of psychopathy by examining the possible moderating role of executive
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function on the relationship between criminality and self-report criminality. The results do
not provide support for the successful psychopathy model, as executive function did not
moderate the relationship between primary or secondary psychopathy and self-reported
criminal behaviour. Instead, the results suggest that the dual process model of psychopathy
may explain the differential relationships between primary and secondary psychopathy and
executive function. However, this was only true for the male participants. The results from
this study indicate that current theoretical models of psychopathy do not adequately explain
female psychopathy, with no support for the dual process or successful psychopathy model.
Limitations and Directions for Future Research
Although the aim was to make comparisons between criminal samples and this study
easier by controlling for age and gender differences, there are still other differences (e.g.,
drug use, socioeconomic status, education level, etcetera) that make comparison between the
two samples difficult. Future research may consider examining psychopathy in criminal and
noncriminal samples, including an examination of the possible mediating role of substance
use, socioeconomic status, and education level in the relationship between psychopathy and
executive function. The findings for the male participants support the pattern of relationships
observed for both criminal and noncriminal samples, with primary psychopathy related to
intact or superior functioning and secondary psychopathy related to some types of executive
dysfunction. This finding highlights the importance of examining psychopathy variants
separately. Inconsistencies across previous studies of executive dysfunction in psychopathy
may be because of the way that psychopathy was conceptualised and measured (e.g., different
measures of psychopathy, different samples, and unitary versus variant conceptualisations).
In order to gain a better understanding of the relationship between psychopathy and executive
function, future research should ensure that the psychopathy variants are examined
separately.
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Whilst the findings for males supported the dual process model, the results revealed
that this model did not adequately explain female psychopathy. Indeed, neither the dual
process nor successful model of psychopathy adequately explained the results for
psychopathic women in the current study, indicating that current theoretical models based
predominately on male psychopathy do not generalise to female psychopathy. Given that
psychopathy presents with less nefarious manifestations in females, future research should
examine female psychopathy to determine whether the mechanisms that produce this
difference could be utilised in the treatment and management of male psychopathy.
There is one final limitation to note, and that is that the sample size was small and
consequently the analyses, particularly the regression analyses, may have been
underpowered. Although the sample size here is similar to previous research (see Table 9),
future studies using larger sample sizes would be better equipped to examine the possible
moderating role of executive function in the psychopathy-criminality nexus, and the possible
moderating role of gender.
Chapter Summary
According to the dual process model, primary and secondary variants arise from two
distinct processes, with primary psychopathy characterised by emotional dysfunction and
secondary psychopathy characterised by executive dysfunction. These findings provided
partial support for the dual process model, but only males. Future research could examine the
dual process model in relation to emotion deficits, including an examination of possible
gender differences. As previously mentioned, research has consistently demonstrated
differences in emotional processing as a function of gender. For example, previous research
has demonstrated gender differences in the judgment of facial affect (Thayer & Johnsen,
2000), including increased physiological reactivity to facial affect for females over males
(Dimberg & Lundquist, 1990); gender differences in the experience of emotion (Fischer et
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al., 2004); gender differences demonstrating increased emotional expressiveness for females
(Kring & Gordon, 1998); and gender differences in affective priming (Gohier et al., 2011).
Given the gender differences observed for executive functioning in psychopathy, and the
research on gender differences in emotion processing, it would be interesting to see whether
gender differences also exist for emotion processing in psychopathy. According to the dual
process model, primary psychopathy arises from dysfunctional motivational systems,
resulting in a paucity of fear and anxiety. However, the findings from this study suggest that
models of psychopathy based on males do not generalise to females. Therefore, the final
study of this thesis tests the dual process model of psychopathy for emotion deficits, with a
particular focus on examining gender differences.
Chapter Five
Chapter Overview
The dual process model of psychopathy (Patrick & Bernat, 2009) suggests that
secondary psychopathy is the result of dysfunctional higher-order cognitive processing.
Consistent with this model, in Study 2 secondary psychopathy was related to poorer
performance on planning and set-shifting executive functions for males. However, females
with higher levels of secondary psychopathy displayed superior planning and set-shifting
abilities. In contrast, primary psychopathy was characterised by intact executive functioning
for both males and females. These findings indicate that current models of psychopathy,
developed to explain male psychopathy, do not necessarily extend to female psychopathy. A
further claim of the dual process model is that primary psychopathy is characterised by
emotional dysfunction (e.g., lack of emotional depth, and a lack of empathy, guilt or remorse
for personal transgressions) that is underscored by deficits in the brain’s motivational system.
However, as previously discussed, research to date has largely focused on criminal samples
and largely on men. Therefore, it is currently unknown not only whether the claims of the
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dual process model regarding primary psychopathy extend to noncriminal psychopathy but
also whether they extend to female psychopathy.
Clinical descriptions of psychopathy emphasise a pattern of affective and
interpersonal abnormalities, including: a paucity of inhibitory emotions (i.e., empathy,
remorse, and guilt), a lack of emotional depth, fearlessness, and interpersonal
manipulativeness (Cleckley, 1941, 1948). This pattern of affective functioning led
researchers to examine whether deficits in processing emotional information and cues may
underlie the emotional symptoms observed in psychopathic individuals. There is now a
wealth of evidence that suggests psychopathy is characterised by abnormal affective
processing and reactivity.
Implicit emotional functioning is frequently measured using the lexical decision task,
previous studies employing this task in psychopathic criminal offenders have found abnormal
affective processing (e.g., K. S. Blair, Richell, et al., 2006; S. Williamson et al., 1991).
However, they have largely focused on male criminal offenders and have viewed
psychopathy as a unitary construct (i.e., psychopath vs. nonpsychopath). Addressing this gap,
this study examines affective and semantic processing in primary and secondary psychopathy
using a noncriminal, mixed gender sample to allow the examination of gender differences.
Emotion Deficits in Psychopathy
Lykken (1957) conducted one of the earliest investigations of affective dysfunction in
psychopathy when he examined the performance of primary and secondary psychopaths on a
passive avoidance test. Using a sample of male and female participants from a correctional
facility, Lykken found that primary psychopaths generated lower galvanic skin responses to
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stimuli associated with punishment, and less avoidance of punished responses compared to
criminal controls (Lykken, 1957).
Research using a startle reflex paradigm has also revealed abnormal emotion
processing in psychopathic individuals. In the startle reflex paradigm, the startle reflex
(aversive reflex) can be augmented by the presentation of a visual prime before the startle
probe (a loud noise) (Lang et al., 1990). In healthy participants, positive primes (e.g., pictures
of romantic couples or babies) result in a reduced startle response compared to neutral primes
(e.g., a book or a pair of shoes), as measured by eye blinks using electrodes attached to the
face (Lang et al., 1990). In contrast, negative primes (e.g., images of victims of violent death)
result in an increased startle response (Lang et al., 1990). In psychopathic offenders, whilst
some reduction in startle reflex is observed after the presentation of positive primes, there is
significantly less augmentation of the startle reflex following the presentation of negative
primes (Patrick, 1994), suggesting a reduced response to negative emotional information.
Subsequent studies have produced consistent evidence of pervasive emotional
impairment in male, criminal psychopathic individuals. For example, Blair and colleagues
examined skin conductance responses to visual distress cues, threat cues, and neutral stimuli
in a sample of male criminals classified as psychopathic or nonpsychopathic (i.e.,
psychopathy as a unitary construct). They found that psychopathic individuals compared to
controls displayed hyporesponsivity to the distress cues, but intact responsivity to the threat
cues and neutral stimuli (R. J. R Blair et al., 1997). Further research suggests that this
emotional impairment may be specific to fearful or negative emotions. For example, some
research has shown that psychopathic individuals are selectively impaired in recognizing the
fearful facial expressions of others (R. J. R Blair et al., 2004), and this deficit appears to
extend across sensory modality. Using a male, criminal offender sample Blair and colleagues
(2002) examined the recognition of vocal affect (happiness, disgust, anger, fear, and sadness)
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in psychopathic and nonpsychopathic participants. Psychopathic participants were selectively
impaired in recognizing fearful and sad vocal affect, committing significantly more
recognition errors than nonpsychopathic controls (R. J. R. Blair et al., 2002).
Williamson, Harper and Hare (1991) conducted one of the earliest studies into
abnormal processing of emotional information using a lexical decision task (LDT). On the
LDT participants are asked to identify, as quickly as possible, whether a string of letters
presented briefly on a screen (e.g., < 150 milliseconds) represents a valid word or a nonword
(e.g., Blerp). The LDT is an appropriate measure of affective function in psychopathic
individuals because the task assesses automatic/implicit processes rather than
strategic/explicit processes. This distinction is important in research on psychopathy because
psychopathic individuals are known for being conning and duplicitous. Previous research
using the LDT has shown that healthy adults respond faster to emotion words compared to
neutral words (Strauss, 1983). Williamson, Harper and Hare (1991) predicted that this
phenomenon would be absent in psychopathic offenders. Using a small sample of male
criminal offenders classified as psychopathic (n=8) and nonpsychopathic (n=8) by the PCL-
R, they examined responses to positive, negative and neutral words using a lexical decision
task. Whilst nonpsychopathic offenders responded faster to positive and negative emotion
words (compared to neutral words), the psychopathic individuals responded slower to
positive and negative words. Interestingly, on a post-experimental word rating task both
psychopathic and nonpsychopathic offenders rated positive words as good, and negative
words as bad. These findings indicate that psychopathic individuals have intact objective
appraisal of emotional information, but may process this information differently.
Alternatively, it could be that psychopathic offenders were rating the emotion words
according to how they believed other people would rate them. In either case, these and
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similar observations support the use of implicit/automatic measures of emotional functioning
in psychopathic individuals.
Emotion Deficits in Primary and Secondary Psychopathy
Although most research on emotion processing in psychopathy has viewed
psychopathy has a unitary construct, some research has examined emotion processing and the
unique relationships between primary and secondary variants, revealing divergent
relationships between primary and secondary psychopathy and emotional impairment. For
example, Patrick et al. (1993) demonstrated that in criminal psychopaths the deficient startle
response was specific to high PCL-R Factor 1 scores (primary psychopathy), and was not
observed for high PCL-R Factor 2 scores (secondary psychopathy). These findings suggest
that different patterns of emotional reactivity may exist for primary and secondary
psychopathy.
Verona, Patrick, Curtin, Bradley, and Lang (2004) examined the relationships
between PCL-R assessed primary and secondary psychopathy and physiological reactions to
positive (e.g., baby laughing) and negative sounds (e.g., baby crying) sourced from the
International Affective Digitized Sounds system. The physiological measures of emotional
reactivity included skin conductance responses, heart rate reactivity, and corrugator (frown)
and zygomatic (smile) responses measured using electromyography. A sample of male
criminal offenders was classified as nonpsychopathic, high primary psychopathic (high on
F1, but low on F2), high secondary psychopathic (high on F2, but low on F1), and
psychopathic (high on both F1 and F2). Participants high in primary psychopathy displayed
lower skin conductance responses to all sounds (positive, negative, and neutral). Further,
those high in primary psychopathy did not show the expected skin conductance response
differentiation between positive, negative and neutral sounds observed in those high in
secondary psychopathy. An unusual pattern of HR was observed for the high secondary
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psychopathy group across positive, negative and neutral sounds. Participants high on
secondary psychopathy displayed a similar decrease in HR for neutral and emotion sounds
found for high primary psychopathy, but only on the first block of the experiment. On the
second and third blocks they displayed a similar pattern of heart rate reactivity to the other
two groups, indicating intact functioning. The authors suggest this may indicate a delay in the
processing of the affective significance of sounds for those with secondary psychopathy. No
effects in regards to psychopathy were observed for electromyography activity. This study
provides some evidence of differential emotion impairment, with abnormal sympathetic
reactivity to emotional stimuli in primary psychopathy and generally intact functioning in
secondary psychopathy. These findings are consistent with more recent research which has
demonstrated reduced physiological reactivity to emotional stimuli in primary, but not
secondary, psychopathy (Casey, Rogers, Burns, & Yiend, 2013).
One study, in contrast to those discussed hitherto, found enhanced (rather than
reduced) emotion perception capabilities in primary psychopathy. Del Gaizo and Falkenbach
(2008) examined the unique relationships between primary and secondary psychopathy, the
ability to identify vocal and facial affect, and the experience of positive and negative
emotions in an undergraduate sample (female = 119, male = 56). Using the PPI to assess
primary and secondary psychopathy, those scoring highly on primary psychopathy displayed
a weak, negative correlation with errors in identifying fearful facial expressions. There were
no other relationships observed between primary and secondary psychopathy and the ability
to identify facial or vocal affect. In addition, those with primary psychopathy displayed a
moderate positive relationship with the experience of positive emotions and a weak, positive
relationship with negative emotions. In contrast, those with secondary psychopathy displayed
a moderate, positive correlation with the experience of negative emotions, but not positive
emotions. This study provides support for the notion of increased experience of negative
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affect and lack of positive affect in secondary psychopathy. However, the findings suggest
that primary psychopathy is associated with superior ability to identify fearful facial
expressions, and intact experience of positive and negative emotions, at least in an
undergraduate sample. This may reflect the sample used (i.e., noncriminal) and could suggest
that the emotion deficits observed in criminal samples may not extend to noncriminal
samples. Alternatively, it could be that primary psychopathic individuals are capable of
emotion perception but lack the capacity to experience negative emotions (as indicated by the
weak relationship with negative emotionality).
Taken together, there is some evidence to suggest that primary and secondary
psychopathy present with different emotion processing capabilities and different experiences
of emotion. However, most research to date has utilized male, criminal offender samples.
Research that has used a noncriminal sample, notably Del Gazio and Falkenbach (2008),
reported divergent findings. More research is needed to establish whether psychopathy is
associated with emotional impairments and whether these impairments are uniquely related to
specific psychopathy variants (i.e., primary and secondary psychopathy), specifically outside
of a forensic environment. One promising area of emotion research is situated within the
language literature on affective and semantic language processing. The use of a language task
to assess affective deficits in psychopathy is particularly useful because it provides insight
into the emotional experiences of psychopathic individuals and their capacity to use
emotional information to make decisions.
Affective and Semantic Language Processing
The ability to use language to directly communicate our ideas and feelings with others
is perhaps one of the most fundamental traits of the human experience, and research has
shown that differences in how language is processed can provide important insights into our
psychological functioning. For example, research has shown that anxious individuals display
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an attentional bias for negative word stimuli. Using a Stroop-task, Mogg, Bradley, Williams,
and Mathews (1993) examined subliminal effects of five types of words (anxiety words,
depression words, positive words, neutral categorized words [e.g., household items], and
neutral uncategorized neutral words) in a sample of anxious individuals, depressed
individuals, and healthy controls. Anxious individuals displayed greater interference for
negative words (combined anxiety and depression words), supraliminally and subliminally,
compared to depressed individuals and healthy controls. This suggests an early attentional
bias for negative information in highly anxious individuals. Similarly, Minor et al. (2015)
found that an analysis of language use was effective in predicting schizophrenic
symptomatology, suggesting that patterns of language use are useful in capturing clinically
relevant information. One commonly used language task for assessing implicit processing is
the lexical decision task (LDT). In the LDT, participants are asked to identify whether a
string of letters represents a valid word or a nonword (e.g., Blerp). The LDT has been widely
used to capture implicit and automatic processes, including cognitive bias for eating disorder
information (D. A. Williamson, 1996), implicit attitudes and racial prejudice (Wittenbrink,
Judd, & Park, 1997), and as an implicit alcohol expectancy measure (Campos-Melady &
Smith, 2012).
Altogether, there is evidence that the LDT can capture both emotional functioning and
psychopathology. A further advantage of using the LDT, is that the activation of affective and
semantic networks occurs automatically and subconsciously (see Balota, 1983; Neely, 1977)
and this is important because psychopathic individuals have a reputation for being
manipulative and deceitful. Thus, the LDT allows the assessment of implicit emotional and
semantic processing in psychopathy. Previous research using the LDT has demonstrated that
lexical decisions on a standard LDT and go/no-go LDT are faster for both positive (e.g.,
puppy, love) and negative emotion words (e.g., murder, cancer) compared to neutral words
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(e.g., table, tissue) (Yap & Seow, 2014). The facilitation of lexical decisions to emotion
words can be explained by semantic-richness accounts which suggest that emotion words are
responded to faster because they are more familiar and meaningful (Pexman, 2012).
However, an interesting finding within the male, criminal psychopathy literature is the failure
of emotion words to facilitate lexical decisions (S. Williamson et al., 1991). Interestingly,
male criminal psychopaths display intact semantic processing (C. A. Brinkley, Schmitt, &
Newman, 2005).
Lexical Decision Task Research in Psychopathy
S. Williamson et al. (1991) was one of the first to use the LDT to assess affective and
semantic processes in psychopathic offenders. Since that time, several studies have utilised
the LDT to examine affective and semantic processing in psychopathy, with a pattern of
dysfunctional affective processing and intact semantic processing emerging (e.g., C. A.
Brinkley et al., 2005). In addition to examining reaction times for different word types, the
lexical decision task is commonly used to examine affective and semantic priming. A
consistent finding is that if word pairs are semantically related (e.g. sand/beach), then lexical
decisions to the second word (target word) are facilitated (e.g., Meyer & Schvaneveldt,
1971). That is, lexical priming is the facilitation in the detection or recognition of a word
through the use of prior information (McDonough & Trofimovich, 2009). Semantic priming
refers to the phenomenon in which the speed or accuracy in responding to a word is
facilitated when it is preceded by a semantically-related prime (e.g., butter-bread), rather than
a semantically-unrelated prime (e.g., butter-mouse) (McDonough & Trofimovich, 2009).
Affective priming refers to the phenomenon in which the speed or accuracy in responding to
an emotion-word (i.e., love) is facilitated when it is preceded by a prime with the same
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affective valence (i.e., happy), rather than a prime with the opposite affective valence (i.e.,
fear) (Klauer & Musch, 2003).
Spreading activation models are the generally accepted model of priming. Although
several spreading activation models have been proposed (e.g., Anderson, 1976, 1983; Collins
& Loftus, 1975; Quillian, 1967) the common hypothesis is that when an item is retrieved
from memory it activates its internal representation, which in turn activates related concepts
and facilitates their retrieval from memory. Spreading activation models are closely linked to
network models of semantic memory. Network models of semantic memory suggest that
memory can be viewed as a network of nodes (concepts) that are interconnected by
associative links. When a word is presented (e.g. dog), the retrieval of the concept from the
semantic network activates related concepts (e.g. cat) and facilitates subsequent response
times to related words because they are already activated in the semantic network. Spreading
activation models provide a straightforward explanation of semantic priming by suggesting
that priming effects occur because a target word has already been partially activated by a
related prime word (A. M. Collins & Loftus, 1975).
Research employing a semantic priming LDT has demonstrated intact semantic
processing in male, psychopathic offenders. C. A. Brinkley et al. (2005) classified
participants has low anxious or high anxious using the Welsh Anxiety Scale (Welsh, 1956),
and as psychopathic and nonpsychopathic using the PCL-R. All participants performed
similarly on the semantic priming LDT, with responses faster to words that were preceded by
related words. There were no group differences regarding anxiety or psychopathy. Similarly,
they found that performance on a semantic Stroop task was the same for all groups, with
significant interference on trials where color-related words (e.g., grass, lemon, fire) were
written in incongruent colours. This finding demonstrates that psychopathic offenders,
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including those low on anxiety (a hallmark of the Cleckley psychopath) possess intact
semantic processing.
Extending on this research, K. S. Blair, Richell, et al. (2006) demonstrated that male,
psychopathic offenders (n = 52) displayed intact semantic processing, but deficient affective
processing using an affective priming word categorization task and a semantic priming word
categorization task. Participants were classified as psychopathic or nonpsychopathic with the
PCL-R. The affective priming task consisted of negative emotion words, positive emotion
words, and neutral words. In congruent conditions emotion target words were preceded by an
affectively congruent word (e.g., love-song). In incongruent conditions target words were
preceded by a prime word with the opposite affective valence (e.g., hate-song). For the
neutral words, a neutral prime was paired with a positive or negative target word. Participants
were also asked to complete a word rating task in which they rated the words on a
pleasantness scale (seven-point Likert scale). The results revealed that the nonpsychopathic
offenders displayed significant facilitation in congruent conditions and significant
interference for negative targets that were preceded by positive primes. The psychopathic
individuals displayed no facilitation or interference for emotion words. However, consistent
with a previous studies (Kiehl, 1999; S. Williamson et al., 1991), psychopathic individuals
rated the positive and negative emotion words as similarly pleasant on the word rating task.
Follow-up correlational analyses revealed that both Factor 1 (primary psychopathy) and
Factor 2 (secondary psychopathy) of the PCL-R were related to longer reaction times on the
affective priming task. This could suggest that the affective and interpersonal features and the
impulsive-antisocial features of the PCL-R are related to deficient emotion processing.
Alternatively, given that partial correlations were not used, it could be that participants in the
sample who scored highly on Factor 2 also scored highly on Factor 1 and thus the findings
for Factor 2 represent shared variance.
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The semantic priming task required participants to categorise words as belonging to
the category of fruit/vegetable or the category of animal. The congruent trials consisted of
congruent animal-animal (e.g., dog-cat) and fruit-fruit (e.g., apple-orange) word pairs. The
incongruent trials consisted of pairing animal words and fruit words (e.g., dog-apple) or vice
versa (e.g., lemon-cat). Both nonpsychopathic and psychopathic participants displayed
facilitation for congruent prime-target word pairs compared to incongruent prime-target word
pairs. Correlation analyses revealed that the PCL-R total score, PCL-R Factor 1, PCL-R
Factor 2 were unrelated to semantic processing. These findings indicate that semantic
processing is intact for individuals with psychopathy.
Demonstrating a similar finding of deficient affective processing, Lorenz and
Newman (2002a) found behavioural differences between psychopathic and nonpsychopathic
offenders on an affective priming task. Participants were classified as psychopathic or
nonpsychopathic using the PCL-R and then classified as low-anxiety or high-anxiety using
the Welsh Anxiety Scale (Welsh, 1956). This resulted in four groups: low-anxious
psychopaths, high-anxious psychopaths, low-anxious nonpsychopaths, and high-anxious
nonpsychopaths. Using a LDT, they examined behavioural responses to positive, negative,
and neutral words that were matched on frequency, concreteness, pronounceability, length,
number of letters, and imagery. Additionally, they also examined appraisal of the emotion
and neutral word stimuli using a word rating task where participants were required to rate
words on a 7-point Likert scale (anchors were 0 = bad, 4 = neutral, and 7 = good). They
found no differences between any of the groups in the appraisal of the word stimuli, with all
groups rating positive words highest, followed by neutral words, and then negative words.
However, they did find that nonpsychopathic offenders showed faster responses to emotion
words than neutral words and this facilitation effect was not observed in psychopathic
offenders.
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An interesting finding is that the dysfunctional affective processing in psychopathic
offenders captured using the LDT may be underscored by abnormal physiological reactivity.
For example, Intrator et al. (1997) examined affective and semantic processing in a male
sample recruited from a substance abuse program, along with a healthy control group (who
they assumed were nonpsychopathic). The substance abuse users were classified as
psychopathic or nonpsychopathic using the PCL-R and this resulted in three groups;
psychopathic substance abuse, nonpsychopathic substance abuse, and healthy control. The
authors recorded behavioural responses (speed and accuracy) and cerebral blood flow (rCBF)
to neutral and negative emotion words using a LDT. Because this study used long stimulus
exposure times this made it unlikely that any group differences in behavioural responses
would emerge. However, the main purpose was to examine rCBF. Consistent with their
predictions, they failed to find any behavioural differences between psychopathic and
nonpsychopathic participants to neutral or negative emotion words, with all groups
performing similarly. However, they did find that psychopaths displayed increased rCBF to
the negative emotion words compared to both control groups. The authors interpreted this
finding as evidence that psychopathic individuals require additional resources to respond to
emotional information.
Similarly, Kiehl (1999) examined emotion and semantic processing in a small sample
of criminal offenders classified as psychopathic or nonpsychopathic using the PCL-R. They
found no differences between psychopathic and nonpsychopathic offenders for word
identification of positive and negative words. Furthermore, all participants regardless of
psychopathy status, responded faster to concrete words than abstract words in a LDT and
word identification task. However, the psychopathic participants displayed large negative
event-related potentials (ERPS) (N350) for all word types and this finding was absent in the
nonpsychopathic participants who displayed large positive ERPs. Kiehl (1999) interpreted
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this finding as evidence that psychopathic individuals require more cognitive resources to
perform affective and semantic language tasks than do nonpsychopathic individuals, an
interpretation that echoes Intrator et al. (1997).
Taken together, there is evidence that male psychopathic offenders display difficulties
processing emotional information but have intact semantic processing. However, these
findings may only generalise to Caucasian, male criminal offenders. For example, some
research has shown that the impairments in affective processing on the LDT do not extend to
African-American offenders, or female offenders. Lorenz and Newman (2002b) replicated
their affective and semantic processing study (Lorenz & Newman, 2002a) with a group of
male, African-American criminal offenders. In contrast to the previous findings, they found
no differences in affective or semantic processing between low-anxious psychopathic, high-
anxious psychopathic, low-anxious nonpsychopathic or high-anxious nonpsychopathic
groups. Similarly Vitale et al. (2011) failed to find any differences between low anxious
psychopathic and nonpsychopathic female offenders on an affective lexical decision task.
Female offenders were classified as psychopathic or nonpsychopathic using the PCL-R and
anxiety was scored using the WAS. Additionally, participants were diagnosed with or with
Antisocial Personality Disorder (ASPD) and this was used a covariate in the analyses. The
results revealed that participants with ASPD responded faster to emotion words than non-
ASPD participants, and no effects of regarding psychopathy. These findings suggest that the
emotion processing abnormalities observed in Caucasian, male criminal offenders may not
extend to Caucasian, female criminal offenders. The two aforementioned studies raise the
question of whether emotion processing deficits are limited to Caucasian, male, criminal
offenders.
There is only one known study that has examined lexical decisions in psychopathic
individuals recruited from a noncriminal sample. Using a male, undergraduate university
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sample, Reidy et al. (2008) examined whether LSRP primary and secondary psychopathy
predicted reaction times to neutral, anger, sadness, fear or happiness words on a LDT. They
found that higher levels of secondary psychopathy, but not primary psychopathy,
significantly predicted faster reaction times (RTs) to anger words. Furthermore, higher levels
of primary psychopathy, but not secondary psychopathy, significantly predicted slower RTs
to sadness words. There were no significant findings regarding neutral words, happiness
words, or fear words. These findings indicate that the divergent relationships for secondary
and primary psychopathy and emotional reactivity may extend to male, noncriminal samples.
Furthermore, it appears as though different categories of negative words evoke different
responses depending on psychopathy variants.
Summary of Implicit Language Tasks in Psychopathy
A table summarising the findings from studies of implicit language tasks in both
unsuccessful and successful psychopathy is presented in Appendix 6. The pattern observed
from the studies suggests that psychopathic offenders display abnormal affective processing
(i.e., lack of responsivity) but intact semantic processing. However, this finding appears to be
specific to Caucasian, male, primary psychopaths. There have been no studies to date that
have examined affective and semantic processing using an implicit language task with a
noncriminal, community sample of mixed gender. Therefore, it is unknown whether
noncriminal psychopathic women will display the emotion processing deficits observed in
Caucasian men in criminal and noncriminal samples. Furthermore, there is some evidence
that emotion processing deficits on implicit language tasks are specific to primary
psychopathy. For example, as mentioned previously, Reidy et al. (2008) found that higher
levels of secondary psychopathy were associated with faster responding for anger words,
suggesting a facilitated response for certain kinds of emotion words. Additionally, Vitale et
al. (2011) found that females with ASPD displayed increased emotional facilitation effects.
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Interestingly, ASPD is moderately correlated with Factor 2 (secondary psychopathy) of the
PCL-R (Hare, 1991). Therefore, it is plausible that intact or increased reactivity for emotion
words may be observed in females with secondary psychopathy. Furthermore, given that
there are no studies have examined the unique relationship between primary psychopathy and
affective language processing in females, it may be that the emotion deficits characteristic of
primary psychopathy in men, are absent in women. This may be because females are
socialized to be more empathetic and nurturing, thus emphasizing emotional intelligence in
females.
Another avenue for research would be to examine whether semantic processing is
intact for both abstract and concrete stimuli. Kiehl (1999) found that psychopathic individuals
displayed more errors for abstract words than nonpsychopathic individuals. K. S. Blair,
Richell, et al. (2006) suggest that this may indicate that intact semantic processing may only
be present for concrete words. Interestingly, Altarriba and Bauer (2004) conducted a word
rating task with undergraduate students and found that emotion words are considered less
concrete than abstract words. Further, emotion words were considered less imageable, more
difficult to think of a context, and less concrete than concrete words. Therefore, an interesting
extension of Blair’s rationale would be to examine how psychopathic individuals rate
emotion words in terms of characteristics known to facilitate responding, including context
availability, concreteness, and imageability. It may be that emotion processing deficits
captured by implicit language tasks actually reflect difficulties processing abstract stimuli.
The use of word rating task may also aid in the interpretation of any gender differences in
affective and semantic language processing in psychopathy. This is because previous research
has shown that females consider emotion words as having a greater emotional impact than
men and that women display a different pattern of brain activation to emotion words than
men (Bremner et al., 2000).
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Study 3
The primary aim of Study 3 is to test the dual process model by examining implicit
emotion processing in primary and secondary psychopathy in a noncriminal sample. Given
that psychopathic individuals are known for being deceitful and manipulative, lexical
decision tasks using emotion words are particularly useful as they provide an implicit
measure of emotion processing through the assessment of automatic and subconscious
processes (Balota, 1983). Therefore, this study will examine implicit emotion processing
using a lexical decision task. Specifically, the study explores whether the impairment on
affective tasks seen in Caucasian, male psychopaths extends to noncriminal psychopathic
samples, including females.
Given that previous research has suggested that secondary psychopathy is associated
with faster responses for anger words (Reidy et al., 2008), and that ASPD is associated with
faster responses for both positive and negative emotion words in females (Vitale et al., 2011),
it is predicted that higher levels of secondary psychopathy will be related to larger priming
effects for negative words on the LDT, reflecting an increased sensitivity to negative
emotional information. It is further hypothesized that secondary psychopathy will be
unrelated to priming for positive words, reflecting intact emotional processing of positive
affective stimuli. Regarding primary psychopathy, for males it is hypothesized that higher
levels of primary psychopathy will be negatively related to priming for negative emotion
words. This is hypothesized to reflect the emotional impairment that is characteristic of males
with high levels of primary psychopathy by demonstrating that those higher on primary
psychopathy have difficulty using emotional cues. Previous research has demonstrated
differences in emotional processing as a function of gender (e.g., Dimberg & Lundquist,
1990; Fischer et al., 2004; Kring & Gordon, 1998; Thayer & Johnsen, 2000), and in Study 2
it was found that the relationships between psychopathy and executive function were
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different for males and females, with higher levels of psychopathy predicting superior
executive function in females. Therefore, it is hypothesised that no relationships will be
observed between primary psychopathy and affective priming for females.
In regards to semantic priming, it is hypothesized that there will be intact semantic
processing for primary and secondary psychopathy in both males and females. However, if
semantic processing deficits appear, these are hypothesized to be specific to abstract stimuli
because, as previous mentioned, there is some evidence of abnormal processing of abstract
information in psychopathic individuals (Kiehl, 1999).
An additional aim of Study 3 is to examine explicit emotion processing in
psychopathy by using a word rating task. In male criminal offender samples, there is no
difference in word ratings for concrete, abstract or emotion words, indicating that explicit
processing of emotional information is intact. Using a word rating task, this study examines
whether this finding extends to noncriminal samples. Given that previous research has
demonstrated that psychopathic individuals appraise emotion words in the same way as
nonpsychopathic individuals, it is hypothesized that there will be no relationship between
psychopathy and word ratings. However, given that this is the first study to employ a
comprehensive word rating task for abstract, concrete and emotion words, it is unknown what
relationships might emerge regarding the ratings of concreteness, context availability,
imageability, valence and arousal in psychopathy.
Method
Participants
Thirty-five participants were recruited from the participant pool of Study 2 (18 males,
17 females). The mean age was 28 years (males M = 28 years, SD = 7.8 years; females M =
28 years, SD = 10.6 years). The sample consisted of students (51.4%), and individuals who
were employed full-time (28.6%), part-time (2.9%), or on a casual basis (8.6%); self-
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employed (2.9%), or unemployed (5.7%). Participants with a previous history of psychiatric
or neurological illness, and/or regular use of psychiatric or neurological medication were
excluded from participating, as were those who did not speak English as their first language.
Materials
Demographic questionnaire. A brief demographic questionnaire was used to
measure individual difference variables, such as age, gender, ethnicity, level of education,
employment status, and handedness (RH/LH).
The Psychopathic Personality Inventory-Revised (PPI-R) (Lilienfeld & Widows,
2005). The Psychopathic Personality Inventory-Revised (PPI-R) is a 154-item self-report
questionnaire commonly used to assess psychopathy in noncriminal populations (Lilienfeld &
Widows, 2005). Each item consists of a statement that participants endorse on a four-point
Likert scale (anchors are 1= false, 2= mostly false, 3= mostly true, 4= true). The PPI-R yields
a global psychopathy score, as well as eight content scale scores: Machiavellian Egocentricity
(ME), Rebellious Nonconformity (RN), Blame Externalisation (BE), Carefree
Nonplanfulness (CN), Social Influence (SOI), Fearlessness (F), Stress Immunity (STI), and
Coldheartedness (C). Factor analysis of the scale reveals a two factor solution that is
consistent with other well-validated measures of psychopathy (Benning, et al., 2003;
Lilienfeld & Widows, 2005). The scale has good internal reliability for the global
psychopathy scale with Cronbach’s alpha .92 (Lilienfeld & Widows, 2005). The temporal
reliability of the global psychopathy scale remains high at an average test-retest interval of
19.94 days (Cronbach’s alpha = .93) (Lilienfeld & Widows, 2005). A score for the Fearless
Dominance factor akin to primary psychopathy was obtained by combining the Fearlessness,
Social Influence, and Stress Immunity subscales. A score for Self-centered Impulsivity was
obtained by combining the Machiavellian Egocentricity, Rebellious Nonconformity, Blame
Externalisation and Carefree Nonplanfulness subscales. This was used as the measure of
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secondary psychopathy. Although factor analytic studies have found that the Coldheartedness
factor does not load onto either the FD or SCI factors, this subscale was included in the
analyses as it represents characteristics that many consider to be central to psychopathy.
Word Stimuli. A total of 240 English language words were selected as follows:
concrete words (30 primes, 30 targets) whose meaning represented objects, materials or
people (e.g., chair) and/or had high concreteness ratings in previous research (Toglia &
Battig, 1978; Wilson, 1988); abstract words (30 primes, 30 targets) whose meaning did not
represent objects, materials, or people (e.g., metaphor), were not classified as emotion words,
and/or had low concreteness ratings in previous research (Toglia & Battig, 1978; Wilson,
1988); and emotion words (60 primes and 60 targets, with an equal number of positive and
negative words that were matched on valence and arousal) selected from the ANEW database
(Bradley & Lang, 1999). This resulted in a total of 120 prime-target pairs. All word stimuli
were matched on frequency (Brysbaert & New, 2009), word type (noun/verb), and word
length (see Appendix 7). The prime-target pairs were matched on mean strength of
association across the concrete, abstract, and emotion word conditions using the University of
South Florida Free Association Norms database (Nelson, McEvoy, & Schreiber, 1998) or the
Edinburgh Associative Thesaurus (Kiss, 1975; Kiss, Armstrong, Milroy, & Piper, 1973). The
complete list of word stimuli can be found in Appendix 8.
Pseudoword stimuli. A total of 120 pronounceable non-words were generated from
the target stimuli using the Wuggy pseudoword generator (Keuleers & Brysbaert, 2010). The
pseudowords were matched to the target word stimuli on length, subsyllabic segments (2/3),
transition frequency, and orthographic Levenshtein distance (OLD20). An additional set of
concrete, abstract and emotion words (120 words in total) were used as primes for the
pseudowords. This resulted in a total of 120 prime-target pairs. The prime words used in the
pseudoword condition were matched to the primes used in the word conditions on frequency
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(Brysbaert & New, 2009), word type (noun/verb), and word length. In addition, concrete and
abstract primes were matched on concreteness and imageability to the primes used in the
word conditions (Toglia & Battig, 1978; Wilson, 1988), and emotion words were matched on
valence and arousal (M. M. Bradley & Lang, 1999). The complete list of pseudowords can be
found in Appendix 8.
Procedure
Testing was conducted individually in a quiet room. Participants were given an
information letter which detailed the nature of the research and participation requirements
(See Appendix 3 for information letter). The LDT was conducted first, followed by the word
rating task to avoid repetition priming effects. Participants then completed the demographic
questionnaire. Scores from Study 2 for the PPI-R were used in this study. The entire testing
session lasted approximately 90 minutes, including instructions and a practice block.
The Lexical Decision Task. A classic LDT (word/nonword) was used to assess
response times and error rates for concrete, abstract, and emotion word targets. The LDT was
conducted using Eprime software on a computer connected to a flat screen monitor with a
screen resolution set at 1920x1080 pixels and a screen refresh rate of 60 Hertz. Participants
were seated comfortably in a quiet room. The letter strings were presented in black lowercase
letters on a white background. A standard qwerty keyboard was used to obtain responses
from participants to the letter strings. The ‘f’ and ‘k’ keys were labelled with either ‘word’ or
‘nonword’ and were counterbalanced across participants. Participants were instructed to
identify, as quickly as possible, whether the second letter string formed a valid English word
by pressing the relevant key. The full instructions for the LDT are presented in Appendix 9.
A typical trial began with a fixation point (‘+’) presented briefly in the centre of the screen
(500ms). Next, a prime word was presented in the centre of the screen for 125ms, followed
by the presentation of a blank screen (1000ms) and then the target word which was presented
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for 100ms, participants had 1500ms to respond (see Figure 4). There was a 1900ms inter-trial
interval before the next trial began.
Figure 4. Example trial sequences: (a) congruent emotion word trial (b) incongruent
concrete word trial.
(a) 500ms 125ms 1000ms 100ms
(b) 500ms 125ms 1000ms 100ms
The LDT began with a practice phase of 20 trials, followed by the experimental
phase. In the experimental phase, each participant was given a total of 240 trials: 30 concrete,
abstract, and 60 emotion (30 positive, 30 negative) word-word trials and 30 concrete,
abstract, and 60 emotion (30 positive, 30 negative) word-pseudoword trials. There was an
equal number of word/pseudoword word trials. There was an equal number of congruent and
incongruent prime-target trials for each word type and the trials were presented in random
order. In the concrete and abstract conditions, the prime words were counterbalanced across
participants so that the same prime words were used in both the related and unrelated
conditions (McNamara, 2005). In the emotion word condition, the primes used in the
affectively congruent prime-target pairs were re-paired with a word of the opposite affective
valence to form the incongruent prime-target pair. Participants completed the trials in blocks
of 80 (a total of three blocks) and the blocks were presented in random order. Participants
were given a 2-minute rest break between blocks. The lexical decision task lasted
approximately 25 minutes.
Word rating task. A computerized word rating task was used to obtain ratings for
concrete, abstract and emotion words on concreteness, imageability and context availability
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using a 7-point Likert scale. Concreteness refers to the degree to which a word represents a
physical or perceivable entity. Imageability refers to the ease with which a word evokes
mental imagery, sound, or experience. Context availability refers to how easy it is to think of
a context for a given word. Emotion words were also rated on valence and arousal. Valence
refers to how positive or negative a word is and arousal refers to how stimulating or alerting a
word is. Concrete, abstract and emotion words were randomly presented throughout the word
rating task to control for fatigue and order effects. Participants were provided with clear
instructions for each word characteristic (e.g., context-availability) on the word rating task
and these instructions were in line with previous research (Paivio, Yuille, & Madigan, 1968)
(See Appendix 10 for complete instructions). The word rating task took approximately 40
minutes to complete.
Design
A cross-sectional, correlational design was used to examine the relationships between
primary and secondary psychopathy and priming effects for concrete, abstract, and emotion
words. The predictor variables were primary and secondary psychopathy, as measured by the
Psychopathic Personality Inventory-Revised (PPI-R) (Lilienfeld & Widows, 2005). The
outcome variables were the word ratings of concrete, abstract and emotion words; and
priming effects for concrete, abstract and emotion word targets, assessed using the LDT.
Results
Data Screening
Data for the PPI-R from Study 2 was used for the analyses for Study 3 (see Chapter 4
results for data screening of the PPI-R). The RT data was screened and incorrect responses
(4.3% error rate), or responses less than 250ms (nil) or greater than 1000ms (0.8%) were
excluded from the data. Participants whose RTs on the LDT were greater than 2.5 SDs from
the mean were excluded from the LDT analyses (n= 1). Normality was checked separately for
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males and females for the word rating and LDT data. The data for the word rating task and
LDT were not normally distributed. Therefore, nonparametric tests were used in instances
where violations of normality could affect the robustness of the statistical analyses.
Lexical Decision Data
The descriptive data for the RTs for positive, negative, abstract and emotion words on
congruent trials and incongruent trials are presented separately for males and females in
Table 14. Since analysis of variance (ANOVA) is considered robust to violations of
normality when group sizes are equal (Field, 2007), a 2 (relatedness) x 2 (gender) mixed
ANOVA was conducted for each word type to examine whether responses in congruent
conditions were faster than responses in incongruent conditions and whether this varied by
gender. For abstract words, there was no significant difference between responses for
congruent compared to incongruent conditions (F (1, 32) = 1.32, p = .25, 𝜂𝜂𝑝𝑝2 = .04) and no
interaction by gender (F (1, 32) = .41, p = .52, 𝜂𝜂𝑝𝑝2 = .01). For concrete words, there was no
significant difference between responses for congruent compared to incongruent conditions
(F (1, 32) = 2.30, p = .13, 𝜂𝜂𝑝𝑝2 = .06) and no interaction by gender (F (1, 32) = .07, p = .78, 𝜂𝜂𝑝𝑝2
= .002). This indicates that there were no priming effects for abstract or concrete words. For
positive emotion words, there was a significant difference between congruent (M = 556.90,
SD = 12.44) and incongruent conditions (M = 581.44, SD = 11.62), F (1, 32) = 19.41, p
<.001, 𝜂𝜂𝑝𝑝2 = .38, a large effect. This was the same for males and females, with no significant
interaction for word by gender (F (1, 32) = 1.09, p = .30, 𝜂𝜂𝑝𝑝2 = .03. This indicates that RTs
were faster in congruent conditions (i.e., positive, positive) compared to incongruent
conditions (i.e., negative, positive) and that this was the same for males and females. For
negative emotion words, there was a significant difference between congruent (M = 578.85,
SD = 10.56) and incongruent conditions (M = 558.85, SD = 11.36), F (1, 32) = 12.29, p =
.001, 𝜂𝜂𝑝𝑝2 = .27, a large effect. This was the same for males and females, with no significant
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interaction for word by gender (F (1, 32) = .71, p = .40, 𝜂𝜂𝑝𝑝2 = .02. This indicates that RTs
were faster in the incongruent conditions (i.e., positive, negative) compared to congruent
conditions (i.e., negative, negative) and this was regardless of gender.
Table 14 Mean RTs for lexical decision responses, presented separately for each gender, on congruent and incongruent trials (Milliseconds)
Trial Male (n=17) Female (n=17) M SD M SD Positive Congruent 568 72 546 73 Positive Incongruent 586 58 577 77 Negative Congruent 583 60 575 63 Negative Incongruent 557 62 560 70 Abstract Congruent 606 70 581 66 Abstract Incongruent 609 74 594 71 Concrete Congruent 579 50 566 75 Concrete Incongruent 568 70 558 79
Psychopathy and Priming Effects
Priming effects were obtained for concrete, abstract, and positive and negative
emotion words by subtracting the mean RTs for the congruent trials from the mean RTs for
the incongruent trials. The descriptive data is presented in Table 15, greater values indicate
greater priming effects and smaller values indicate less priming.
Table 15 Priming effects, presented separately for each gender, for concrete, abstract and emotion words (in milliseconds) Male (n=17) Female (n=17) Measure M SD SE M SD SE Priming Effect Positive Word (RT)
18.70 38.34 9.29 30.38 25.30 6.13
Priming Effect Negative Words (RT)
-25.23 36.57 8.87 -15.44 30.81 7.47
Priming Effect Abstract Words (RT)
3.84 41.43 9.46 13.76 47.70 11.57
Priming Effect Concrete Words (RT)
-10.74 43.18 10.04 -7.93 28.01 6.79
Note: RT = Reaction Time in Milliseconds
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Spearman’s Rho nonparametric correlations were conducted to examine the
relationships between psychopathy factors and priming effects for positive, negative, abstract,
and concrete word types. Table 16 displays the findings for both males and females.
Table 16 Correlations between Psychopathy Factors and Priming Effects for Males and Females
Note: * <.05, **,.01, # <.1
Regardless of gender, there were no significant relationships between the psychopathy
factors and affective priming, possibly because of a lack of statistical power given the small
sample sizes. However, a moderate negative relationship was observed between FD and
priming for positive emotion words, with a trend towards significance (p = .08). This
suggests that males with higher levels of primary psychopathy display less priming for
positive emotion words. This relationship was not observed for females, with a non-
significant positive relationship between FD and priming for positive words.
For males, SCI was strongly positively related to the concrete priming effect,
indicating that individuals with higher levels of secondary psychopathy displayed greater
priming effects for concrete words. There was also a moderate positive relationship between
FD and concrete priming effects, although this was only a trend (p =.07). These relationships
were not observed for females, but Coldheartedness was significantly positively related to the
Male (n = 18) Females (n = 17)
Measure SCI FD COLD SCI FD COLD
Positive Priming Effect
-.324 -.444# -.132
.178 .341 -.059
Negative Priming Effect
-.066 -.140 .199
-.067 .366 .137
Abstract Priming Effect
-.196 .029 .530*
.170 -.041 .362
Concrete Priming Effect
.609** .402# .032
.028 .299 .531*
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concrete priming effect in females. In males, Coldheartedness was significantly positively
related to the abstract priming effect.
Word Rating Task
Table 17 shows the descriptive statistics for the word rating task separately for males
and females. Females and males both considered concrete words to be the most concrete,
followed by negative words, positive words, and then abstract words; concrete words to be
easier to think of a context, followed by emotion words, and then abstract words; concrete
words easier to image, followed by negative words, positive words, and then abstract words;
emotion words to be moderately arousing; positive emotion words to be positive and negative
emotion words to be negative.
Table 17
Mean word ratings for positive, negative, abstract and concrete words on concreteness, imageability, context availability, arousal, and valence
Male (n=18) Female (n=17) Measure M SD SE M SD SE Concreteness
Positive words 3.83 1.02 .24 4.06 .92 .21 Negative words 4.82 .90 .21 5.08 .89 .20 Abstract words 2.68 1.01 .23 2.70 1.05 .24 Concrete words 6.85 .14 .03 6.84 .29 .06
Context Availability Positive words 6.48 .51 .12 6.26 .72 .16 Negative words 6.45 .59 .14 6.57 .58 .13 Abstract words 5.91 .86 .20 5.26 1.37 .31 Concrete words 6.63 .58 .13 6.77 .33 .07
Imageability Positive words 5.47 1.03 .24 5.60 .73 .16 Negative words 6.00 .78 .18 6.18 .55 .12 Abstract words 3.69 1.40 .33 3.20 1.11 .25 Concrete words 6.83 .28 .06 6.92 .11 .02
Arousal Positive words 4.60 .86 .20 4.97 1.08 .24 Negative words 3.80 1.25 .29 4.61 1.32 .30
Valence Positive words 5.64 .38 .09 5.81 .55 .12 Negative words 2.45 .80 .18 1.81 .46 .10
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Mann-Whitney U analyses were conducted to determine any gender differences in
word ratings (i.e., concreteness, imageability, context availability, arousal, and valence). The
only significant difference across the word rating categories was for negative words, which
were considered more negative by females (Mdn = 1.73, range = 1.87) compared to males
(Mdn = 2.15, range = 3.50), U = 61 p < .001, r = .54.
Correlations were conducted to examine whether psychopathy was related to the ways
in which the words were rated. Because the word rating data was not normally distributed,
Spearman’s Rho non-parametric correlations were conducted. The findings are presented
separately for males and females in Table 18.
Table 18. Correlations between Psychopathy Factors and Word Ratings for Males and Females
Note: *<.05, **<.01 CT = Context availability, C = Concreteness, I = Imageability, VAL = Valence, AR = Arousal, AB = Abstract, CON = concrete, POS = positive, NEG = negative.
Male (n = 18) Females (n = 17)
Measure SCI FD COLD SCI FD COLD
C-AB .106 .157 -.078 -.094 -.077 -.199
C-CON .186 .011 -.406 .160 .041 .096
C-POS .102 .313 .032 -.142 .026 -.031
C-NEG .110 .174 -.206 .103 -.065 .155
I–AB .142 .083 -.336 -.134 .026 -.305
I-CON -.010 -.016 -.486* -.170 -.015 -.172
I-POS -.044 .016 -.359 -.357 -.059 -.357
I-NEG -.107 .059 -.323 -.274 -.139 -.274
CT-AB -.004 .006 -.205 .128 .143 -.013
CT-CON .121 .322 .131 -.072 -.043 -.106
CT-POS -.229 -.046 -.149 .094 .179 -.018
CT-NEG .056 .212 -.076 .260 .058 .080
VAL-POS -.099 .008 -.601** -.039 -.346 -.173
VAL-NEG .415 .265 .494* .457* .518* .252
AR-POS .611** .775** .159 .063 .110 .010
AR-NEG .273 .385 .359 .380 -.062 .058
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For males, Coldheartedness was moderately negatively related to imageability for
concrete words, strongly negatively related to valence for positive words, and strongly
positively related to valence for negative words. These findings indicate that males with
higher levels of Coldheartedness consider concrete words to be harder to image, positive
words to be less positive, and negative words to be less negative. Both Self-Centered
Impulsivity and Fearless Dominance were strongly, positively related to arousal for positive
words. This indicates that males higher on SCI and FD consider positive words to be more
arousing. For females, a moderate-strong positive correlation was observed between the
valence rating for negative words and both SCI and FD. This indicates that females with
higher levels of SCI and FD consider negative words to be less negative.
Discussion
Overview of Research
The primary aim of this study was to empirically test the claims of emotional
impairment in primary psychopathy proposed by the dual process model of psychopathy in a
noncriminal sample. According to the dual process model, psychopathy consists of two
etiologically distinct variants: primary psychopathy and secondary psychopathy (Patrick &
Bernat, 2009). Primary psychopathy is thought to result from aberrant neurological
functioning in regions of the brain responsible for emotion processes, specifically fear and
anxiety. Secondary psychopathy is considered to stem from impairments in brain regions
responsible for higher-order cognitive processes, resulting in disorganised and impulsive
behaviour. According to the dual process model, individuals can present with elevations on
either primary or secondary psychopathy, or elevations on both primary and secondary
psychopathy.
Following the claims of the dual process model, it was hypothesized that secondary
psychopathy would be characterised by intact or increased responsivity to emotional
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information on a lexical decision task. Specifically, it was hypothesized that secondary
psychopathy would be positively associated with affective priming for negative words. In
contrast, it was hypothesized that the performance of individuals with primary psychopathy
would not be influenced by emotional information. Specifically, it was hypothesized that for
males, primary psychopathy would be associated with less priming for negative words. Given
that the results from the previous study found that the dual process model does not adequately
explain secondary psychopathy in females, it was predicted that primary psychopathy in
females would not be associated with priming effects for emotion words. A word rating task
was also included to examine whether primary and secondary psychopathy might be
associated with the ways in which emotion words, concrete words, and abstract words were
rated on attributes known to facilitate responding on lexical decision tasks.
Because some previous research has demonstrated that psychopathy may be
associated with dysfunctional semantic processing for abstract words, an examination of
word ratings and priming effects for abstract and concrete words types was included in the
study. It was hypothesized that there would be intact semantic processing for primary and
secondary psychopathy in both males and females. However, it was thought that if semantic
processing deficits were observed they would be for abstract words only.
Key Findings
Psychopathy and priming. There were gender differences observed in the
relationship between psychopathy and priming. For males there was a trend level moderate,
negative relationship observed between Fearless Dominance and priming for positive words.
The opposite relationship was observed for females with a non-significant positive
relationship found between Fearless Dominance and priming for positive words. No other
findings existed for affective stimuli.
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With regard to semantic processing, Self-Centered Impulsivity was positively related
to the priming effect for concrete words, and a trend level relationship was observed between
Fearless Dominance and the priming effect for concrete words. This suggests that there does
not appear to be a deficit in semantic processing of abstract or concrete stimuli in a
noncriminal psychopathic sample. For females, there was a positive relationship between
Coldheartedness and priming for concrete words and abstract words. This suggests that
semantic processing is intact for females with high levels of the affective features of
psychopathy.
Psychopathy and word ratings. The results from this study revealed that for males,
Coldheartedness was related to lower ratings of imageability for concrete words, lower
valence ratings for positive words and high valence ratings for negative words. This means
that males high on the affective features of psychopathy consider concrete words as harder to
bring an image to mind, positive words less positive and negative words less negative. These
findings suggest that the affective features of psychopathy, such as callousness and a lack of
empathy, are related to differential appraisal of emotional information. This may indicate that
individuals high on the callous traits of psychopathy do not respond appropriately to
emotional information because of differences in the appraisal of the information rather than a
lack of responsivity. This finding is in contrast with that found in criminal offender samples,
where psychopathic individuals rated emotional words the same as nonpsychopathic
individuals (Kiehl, 1999; S. Williamson et al., 1991). However, the current study differs in
methodology, viewing psychopathy as a continuous construct as opposed to taxonomic.
Therefore, methodological differences may account for the discrepancy in the findings
between this study and those using criminal offenders. Alternatively, it could be that
similarities between offenders in the evaluation of emotion has obfuscated the findings of
differential appraisal of the valence of emotional stimuli in psychopathy.
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Self-Centered Impulsivity and Fearless Dominance were related to arousal for
positive words. This means that males in this study with higher levels of primary and
secondary psychopathy considered positive emotion words to be more exciting than
individuals lower on primary and secondary psychopathy. These findings suggest appetitive
appraisal of positive emotion stimuli for males in both primary and secondary psychopathy.
Whilst previous research has examined valence ratings, this is the first study to examine
arousal for emotional words as a function of psychopathy.
For females, both Self-Centered Impulsivity and Fearless Dominance were positively
related to valence for negative emotion words. This means that females with higher levels of
primary and secondary psychopathy consider negative words to be less negative. This
indicates that both the interpersonal and lifestyle features of psychopathy in women are
related to differential appraisal of negative emotion information. This finding is in contrast
with the hypotheses for emotional appraisal in primary and secondary psychopathy for
women. However, given that there are no previous studies that have examined word ratings in
primary and secondary psychopathy using female participants these findings offer the first
insight into the appraisal of emotional language. The finding of differential appraisal of
negative emotion words in primary psychopathy is consistent with clinical accounts of
emotional impairment in primary psychopathy. This may suggest that the affective features of
primary psychopathy, considered by clinicians and researchers alike to be a key diagnostic
feature, are also characteristic of female psychopathy. The findings regarding secondary
psychopathy were not expected and suggest that secondary psychopathy in females is related
to differential appraisal of negative stimuli.
Summary of Findings
The findings from this study provide partial support for the hypotheses. It was
hypothesized that secondary psychopathy would be related to increased priming for negative
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words, but no relationship with priming for positive words was expected for both males and
females. Consistent with this hypothesis, secondary psychopathy was not related to priming
for either positive or negative emotion words in either males or females, indicating intact
emotion processing. It was hypothesized that primary psychopathy would be negatively
related to priming effects for negative emotion words. This hypothesis was only partially
supported by the findings of this study with primary psychopathy not related to priming for
negative words. However, primary psychopathy in males was related to less priming for
positive emotion words, indicating that males with primary psychopathy may have
difficulties using positive emotion cues and information. This provides partial support for the
dual process hypothesis, which suggests that primary psychopathy is underscored by
dysfunctional neurological processing of emotional information. Interestingly, in some
instances, the explicit appraisal of emotional stimuli in this study did not correspond with the
implicit responses. This may be because males higher on primary psychopathy are
responding dishonestly. However, given that participation in this study was anonymous, the
motivation to do so is unclear. An alternative explanation is that males higher on primary
psychopathy have intact appraisal of emotional stimuli but have difficulties processing
emotional information. In contrast to males, it was hypothesized that primary psychopathy in
females would be unrelated to priming for negative emotion words and this hypothesis was
supported. This suggests that the dual process model of psychopathy does not adequately
explain female psychopathy.
Limitations, Implications and Directions for Future Research
This study possessed some limitations that may affect interpretation of the findings.
Firstly, despite the use of methodologically robust lexical decision task, the expected priming
effects for abstract, concrete and negative emotion words that have been found in previous
research were not found in this study. This cannot be explained by the word stimuli, as
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participants in the current study rated words similarly to previous research on concreteness,
imageability, valence and arousal. However, this study did not examine the cue to target
strength for each of the prime-target pairs. It could be that the participants in this study did
not consider the prime-target pairs to be highly related. Future research could consider the
use of a discrete associate task to examine the prime to target strength of association. The
absence of clear priming effects makes interpretation of the relationship between
psychopathy and the priming effects difficult, as only one priming effect was found (i.e., for
positive words). Future studies may consider the use of an alternative implicit emotion task to
assess emotional processing in noncriminal psychopathy (e.g., affective priming using picture
stimuli). Secondly, this study was also limited by the small sample size, meaning that some of
the correlational analyses may have lacked statistical power. For example, a moderate,
negative correlation was observed between primary psychopathy and positive priming but
this did not reach statistical significance. Furthermore, given that results could change with
greater statistical power, the current findings should be interpreted with caution. The use of
larger sample size will make it easier to elucidate the relationships between psychopathy and
affective and semantic priming
Chapter Six
Chapter Summary
This program of research contributes to the current psychopathy literature by
addressing the scarcity of research on noncriminal psychopathy and female psychopathy,
whilst also examining the unique relationships between primary and secondary psychopathy
and criminality, executive function, and emotion processing. The key findings from each
study have been discussed in their respective chapters. Therefore, this chapter of the thesis
provides a summary of these key findings, along with a discussion of the implications for
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current theories of psychopathy and some practical implications. The chapter concludes with
a discussion on future directions in psychopathy research.
Psychopathy and Criminality
Because there are few studies on the relationship between noncriminal psychopathy
and criminality in the general population, it was not known whether criminality was a key
feature of psychopathy or simply one manifestation. Some theorists have claimed that
antisocial behaviour is a defining feature (e.g., Hare, 1991; Hare & Neumann, 2010).
However, there was little empirical evidence for such a claim, with the majority of research
on psychopathy conducted in criminal offender samples and with criminal measures of
psychopathy. This obfuscated any clear interpretation of the relationship between
psychopathy and criminality. Furthermore, the exclusive use of male participants limits our
understanding of the nature and presentation of female psychopathy. Therefore, Study 1
sought to answer two research questions: (1) How central is criminal behaviour to the
construct of psychopathy; and (2) Is the relationship between criminality and psychopathy the
same for males and females? This was achieved by examining the relationship between
psychopathy and criminality in the community using noncriminal measures of psychopathy
and a mixed gender sample. Additionally, an examination of possible gender differences in
the psychopathy-criminality nexus was included to address the male bias in previous
psychopathy research. To the best of our knowledge, this was the first study to examine the
relationship between psychopathy and criminality using noncriminal measures in a mixed
gender, general population sample
The findings from Study 1 challenge the common assumption of both laypeople and
researchers that psychopathy equals criminality, and provides some support for Skeem &
Cooke’s (2010a) assertion that the current body of literature on psychopathy reflects
primarily unsuccessful psychopathy. These findings highlight the need to extend psychopathy
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research to noncriminal samples, as such research may lead to the identification of protective
factors for individuals with psychopathy who are at risk of criminal offending. However,
there was evidence of gender differences between psychopathy and criminal attitudes, and
future research is needed to determine the mechanisms underlying gender differences in
psychopathy. One such direction could be to examine the extent to which psychopathic
females identify with the feminine gender role, and the extent to which gender stereotypes
influence criminal and noncriminal female psychopaths.
Executive Function
Study 2 extended theory testing of the successful and dual process models of
psychopathy by examining the relationships between primary and secondary psychopathy and
executive function in a mixed gender community sample. In line with the claims of the
successful psychopathy model, Gao and Raine (2010) suggest that criminal and noncriminal
psychopaths are differentiated by executive functioning. According to their hypothesis,
criminal psychopaths are characterised by executive dysfunction which places them at greater
risk for overt criminal offending. In contrast, noncriminal or ‘successful’ psychopaths possess
intact or superior executive functioning, which acts as a protective mechanism against
criminal offending. From this perspective, executive function is hypothesised to moderate the
expression of antisocial behaviour in psychopathy.
On the other hand, the dual process model claims that psychopathy cannot be
considered a unitary syndrome, but rather a confluence of two etiologically distinct
syndromes. From this perspective, primary psychopathy arises from a deficit in the brain’s
defensive motivational system, manifesting as trait fearlessness. Secondary psychopathy is
hypothesised to stem from a dysfunction in brain regions responsible for higher order
processes, placing an individual at risk for criminal offending. According to the dual process
model, individuals can present with elevated levels of primary and secondary psychopathy, or
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elevated levels on only primary or secondary psychopathy. In this conceptualisation, the
criminal psychopath presents with elevated levels of both dimensions. However, the
noncriminal psychopath presents with only elevated levels of primary psychopathy, with low
or average levels of secondary psychopathy. From this perspective, primary psychopathy
would be associated with intact executive functioning. In contrast, secondary psychopathy
would be characterised by executive dysfunction.
In Study 2, two main research questions were addressed: (1) What is the relationship
between psychopathy variants and executive function in a community sample; and (2) Is the
pattern of relationships between psychopathy variants and executive function the same for
males and females? This was achieved by utilising several commonly used measures of
executive function and examining their relationship with psychopathy and criminal behaviour
in a community sample, separately for males and females. Furthermore, because there is
some evidence that measures of executive function and measures of intelligence tap the same
underlying construct, intelligence was included as a possible mediating factor.
The results from Study 2 did not provide support for the successful psychopathy
model, but provided partial support for the dual process model of psychopathy. For both
males and females, primary psychopathy was associated with intact performance on all
measures. Interesting, for females, primary psychopathy was predictive of superior response
inhibition and this effect was independent of intelligence. However, support for the dual
process model was dependent on gender. For males, secondary psychopathy was predictive of
poorer planning ability and a lack of cognitive flexibility and this was not mediated by
intelligence. This suggests some deficits in executive function for psychopathic males. In
contrast, for females, it was found that secondary psychopathy predicted superior planning
ability and cognitive flexibility and this was not mediated by intelligence. These findings
suggest that whilst the dual process model of psychopathy explains male psychopathy, it does
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not adequately explain female psychopathy. Given these findings, the final study of the thesis
set out to examine the claims of the dual process model of psychopathy in relation to emotion
processing, with particular attention to gender differences.
Emotion Processing
Most previous research on emotion processing abnormalities in psychopathy has been
conducted using male, criminal offender samples. Therefore, it was suggested that the
patterns of emotion dysfunction currently observed in psychopathy may not generalise to
other psychopathic populations. Specifically, given the findings from Study 2, it was
suggested that the current psychopathy literature may not be applicable to female
psychopathy. In fact, given that a range of cognitive and emotion processing differences are
observed between males and females, it was suggested that some differences in cognitive and
emotional processing between male and female psychopaths may be expected. Therefore, the
aim of Study 3 was to test the dual process model of psychopathy, with a particular focus on
the examination of gender differences in affective dysfunction in psychopathy. Two main
research questions were addressed; (1) What is the relationship between psychopathy variants
and emotion processing in a community sample; and (2) Is the relationship between
psychopathy variants and emotion processing the same for males and females?
The results of Study 3 found some evidence of emotion processing deficits in primary
but, not secondary psychopathy, for males but not females. These findings provide partial
support for the dual process model of psychopathy for males and again highlight that current
theoretical models of psychopathy are unsuitable for female psychopathy. However, the
findings from this study should be interpreted with caution as we were unable to obtain
priming effects with the LDT, which limited our examination of emotion-processing deficits.
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Theoretical Implications, Practical Applications, and Directions for Future Research
The findings from the three studies of this thesis have implications for the current
theories of psychopathy. Firstly, the assumption that criminality is central to psychopathy is
not supported by the evidence from Study 1, which is the only study to examine psychopathy
and criminality in a community sample with a noncriminal measure of psychopathy and a
consideration of gender differences. This finding, taken together with the lack of evidence in
the literature for criminality as a key feature, suggests that accounts of psychopathy that posit
criminality as a central feature need to be revised. Furthermore, these findings bolster the
claims by Skeem and Cooke (2010) that the current body of literature primarily reflects
research on unsuccessful psychopathy. Future research on psychopathy should focus on
examining psychopathy in a range of noncriminal populations (e.g., the general community,
corporate environments, etcetera) as research in these samples may lead to the identification
of protective factors and early indicators that can inform the treatment and management of
psychopathic individuals, both criminal and otherwise.
The second broad theoretical implication from these findings is that a dual process
account of psychopathy, as suggested by Patrick and Bernat (2009), best accommodates the
contradictory and often paradoxical research findings of both emotion deficits and cognitive
deficits in psychopathy. Furthermore, these findings suggest that the IES Model and RMH
may not be mutually incompatible, but complimentary accounts of psychopathy deficits in
primary and secondary psychopathy, respectively. The findings presented here suggest that
primary psychopathy is primarily characterised by emotion deficits, as predicted by the IES
Model and secondary psychopathy is primarily characterised by cognitive deficits, namely
executive dysfunction, as suggested by the RMH. This aligns with Patrick and Bernat’s
(2009) account, which brings together these competing theories and offers a possible
explanation for the contradictory findings of emotion deficits and cognitive deficits in
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psychopathy when psychopathy is examined as a unitary construct. Taken together, this
highlights the importance of examining psychopathy variants separately in future
psychopathy research. Given these findings, it stands to reason that a broad treatment
approach for psychopathy may not be effective, and this could partially explain the failure of
previous approaches to the treatment of psychopathy. Given that primary and secondary
psychopathy are characterised by unique deficits (i.e., emotion deficits and executive
dysfunction, respectively), it seems reasonable to suggest that treatment approaches to
psychopathy should first focus on elucidating whether an individual is high on primary or
secondary psychopathy, or both, and tailor treatment approaches to address the primary
underlying dysfunction.
The final broad theoretical implication from the studies presented here is that current
theoretical models of psychopathy, designed to explain male psychopathy, do not explain
female psychopathy. The findings from Study 2, which is the first study to examine gender
differences in the executive function-psychopathy relationship, suggest that alternative
theories of female psychopathy are needed. Future research should focus on examining
female psychopathy, with the goal of elucidating possible gender differences in the
manifestation of psychopathy.
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Appendix 1
See attachment labelled ‘Appendix_Study1_Questionnaire’.
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Appendix 2
Personality and the Law
PARTICIPANT INFORMATION FOR QUT RESEARCH PROJECT
Personality and Language Processing QUT Ethics Approval Number 1100001490
RESEARCH TEAM Principal Researcher:
Emily Adam, PhD Student, QUT
Associate Researcher:
Associate Professor Renata Meuter and Associate Professor Nigar Khawaja, QUT
DESCRIPTION This project is being undertaken as part of a PhD research project for Emily Adam.
The purpose of this project is to explore the relationship between personality and attitudes towards authority and the law.
You are invited to participate in this project in order to gain a better understanding of how personality influences the ways in which individuals think about the law and authority.
PARTICIPATION The research team are looking for male and female participants between the ages of 18 and 60 years who reside in South East Queensland. Participants must speak English as their first language. The following exclusion criteria also apply: 1) no past or present history of psychiatric or neurological disorders; 2) no regular use of psychiatric or neurological medication (e.g., antiepileptic medication or antidepressants).
Your participation in this project is entirely voluntary. If you do agree to participate, you can withdraw from the project at any time without comment or penalty. Any identifiable information already obtained from you will be destroyed. Your decision to participate, or not participate, will in no way impact upon your current or future relationship with QUT.
Participation will involve completing an online survey that includes a brief demographic questionnaire, a personality questionnaire, a questionnaire on attitudes towards the law, and a questionnaire looking at any past anti-social acts. Participation will take approximately 45 minutes of your time and participation is anonymous. The questionnaires are designed to assess your feelings and beliefs, for example, “Before I do anything, I carefully consider the possible consequences” and to gain some background information (e.g. age and gender).
EXPECTED BENEFITS It is expected that this project will not directly benefit you. However, it may benefit our understanding of how personality influences the way individuals’ view authority and the law.
To recognise your contribution should you choose to participate, the research team is offering participants the chance to win an iPad mini.
RISKS There are no risks beyond normal day-to-day living associated with your participation in this project.
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PRIVACY AND CONFIDENTIALITY All comments and responses will be treated confidentially and will remain anonymous. You will be asked to provide a unique code at the start of the study to identify your responses on this study with subsequent studies, whilst maintaining your anonymity. The unique code will not identify you an any way and will only be used for the purpose of matching responses. If please provide your contact phone number when prompted at the end of the survey.
Please note that non-identifiable data collected in this project may be used as comparative data in future projects.
CONSENT TO PARTICIPATE Submitting the completed online questionnaire is accepted as an indication of your consent to participate in this project.
QUESTIONS / FURTHER INFORMATION ABOUT THE PROJECT If have any questions or require any further information about the project please contact one of the research team members.
Emily Adam, PhD Student A/Prof Renata Meuter, Supervisor
A/Prof Nigar Khawaja, Supervisor
School of Psychology and Counselling, Faculty of Health, QUT
+61 7 3138 4625 +61 7 3138 4625 +61 7 3138 4625
[email protected] [email protected] [email protected]
CONCERNS / COMPLAINTS REGARDING THE CONDUCT OF THE PROJECT QUT is committed to research integrity and the ethical conduct of research projects. However, if you do have any concerns or complaints about the ethical conduct of the project you may contact the QUT Research Ethics Unit on +61 7 3138 5123 or email [email protected]. The QUT Research Ethics Unit is not connected with the research project and can facilitate a resolution to your concern in an impartial manner.
Thank you for helping with this research project. Please keep this sheet for your information.
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Appendix 3
PARTICIPANT INFORMATION FOR QUT RESEARCH PROJECT
Personality and Language Processing
QUT Ethics Approval Number 1100001490
RESEARCH TEAM Principal Researcher:
Emily Adam, PhD Student, Queensland University of Technology (QUT)
Associate Researcher:
Associate Professor Renata Meuter and Associate Professor Nigar Khawaja, QUT
DESCRIPTION This project is being undertaken as part of a PhD research project for Emily Adam.
The purpose of this project is to explore the relationship between personality and memory, attention, problem-solving, multi-tasking, planning, and the processing of different types of words: emotion words (i.e. happy, sad), concrete words (i.e. desk), and abstract words (i.e. metaphor).
You are invited to participate in this project in order to gain a better understanding of how personality influences the processing of written language, memory, attention, and other tasks such as problem-solving and multi-tasking.
PARTICIPATION The research team are looking for male and female participants between the ages of 18 and 60 years who reside in the South East Queensland Region. Participants must speak English as their first language. The following exclusion criteria also apply: 1) no past or present history of psychiatric or neurological disorders; and 2) no regular use of psychiatric or neurological medication (e.g., antiepileptic medication or antidepressants).
Your participation in this project is entirely voluntary. If you do agree to participate, you can withdraw from the project at any time without comment or penalty. Any identifiable information already obtained from you will be destroyed. Your decision to participate, or not participate, will in no way impact upon your current or future relationship with QUT.
Participation involves attending two testing sessions scheduled on different days. Participation in one testing session will involve completing a brief demographic questionnaire, a personality questionnaire, a word rating task, and a lexical decision task. Participation in this testing session will take approximately 1 and a half hours of your time. The questionnaire is designed to assess your feelings and beliefs, for example, “Some people say that I am a ‘worry wart’” and to gain some background information (e.g. age and gender). The word rating task is designed to gain your opinion on the qualities of English language words. The lexical decision task simply asks you to decide whether a string of letters is a word or not (e.g. apple vs bram) and records your response times in making that decision.
Participation in the other testing session will involve completing a brief demographic questionnaire, four computerised problem-solving tasks and one pen-and-paper problem-solving task. Participation in this testing session will take approximately 1 and a half hours of your time. The computerised and pen-and-paper problem-solving tasks are designed to memory, attention, problem-solving, planning and multi-tasking.
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EXPECTED BENEFITS It is expected that this project will not directly benefit you. However, it may benefit our understanding of how personality influences the way individuals’ process written language.
To recognise your contribution should you choose to participate, the research team is offering participants two adult movie passes for each testing session.
RISKS
There are no risks beyond normal day-to-day living associated with your participation in this project.
PRIVACY AND CONFIDENTIALITY All comments and responses will be treated confidentially and will remain anonymous. If you are willing to participate in similar follow-up studies for this research project, please provide your contact phone number and your unique code as indicated at the end of the questionnaire. This unique code will not identify you in any way, and will only be used for the purpose of matching responses from this study and any follow-up studies.
Please note that non-identifiable data collected in this project may be used as comparative data in future projects.
CONSENT TO PARTICIPATE Submitting the completed online questionnaire is accepted as an indication of your consent to participate in this project.
QUESTIONS / FURTHER INFORMATION ABOUT THE PROJECT If have any questions or require any further information about the project please contact one of the research team members.
Emily Adam – PhD Student A/Prof Renata Meuter – Supervisor
A/Prof Nigar Khawaja – Supervisor
School of Psychology and Counsel l ing – Faculty of Health – QUT
07 3138 4625 07 3138 4625 07 3138 4625
[email protected] [email protected] [email protected]
CONCERNS / COMPLAINTS REGARDING THE CONDUCT OF THE PROJECT QUT is committed to research integrity and the ethical conduct of research projects. However, if you do have any concerns or complaints about the ethical conduct of the project you may contact the QUT Research Ethics Unit on 07 3138 5123 or email [email protected]. The QUT Research Ethics Unit is not connected with the research project and can facilitate a resolution to your concern in an impartial manner.
Thank you for helping with this research project. Please keep this sheet for your information.
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Appendix 4
Welcome to the n-back test. You will see letters on the screen, one letter at a time. When you
see the letter X press TARGET. For all other letters press NOT A TARGET. Press
SPACEBAR to continue.
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Appendix 5
You are about to perform a task called the ‘Tower of London’. Your goal is to move a pile of
disks from their original configuration to the configuration shown on the top of the screen.
You can only move one disk at a time, and you cannot move a disk onto a pile that has no
more room (as indicated by the size of the grey rectangle). To move a disk, clock on the pile
you want to move the disk off of, and it will move up above the piles. Then, click on another
pile and the disk will move down to that pile. You will only have a limited number of moves
to solve each problem. Before you make your first move, think about the problem to make
sure you can solve it within your move limit. If you do not finish the problem within the
limit, the turn will end and you will move onto the next problem.
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Appendix 6
Author/s Sample Females (n)
Psychopathy measure
Control Measures
Word Rating Task?
Stimuli Affective language task and DVs
Semantic language task and DVs
Results
K. S. Blair, Richell, et al. (2006)
Male, criminal offenders (n = 52)
0 PCL-R scores used to classify participants as psychopathic or nonpsychopathic
Raven’s advanced matrix (GI); NART (VI)
Yes; emotional words rated on pleasantness; neutral animals words rated according to the size of the animal.
Emotional words selected from ANEW database.
Neutral words selected from MRC psycholinguistic database.
Participants were required to press either ‘positive’ or ‘negative’ to the target word following a congruent or incongruent prime. Outcome measures were RT’s and errors.
Fruit and animal words used and participants had to identify whether the target word was an animal word, or in the fruit trials if the target was a fruit following either congruent or incongruent words. Outcome measures were RT’s and errors.
Affective Priming: Nonpsychopathic individuals showed significant facilitation for emotion words in congruent conditions. They also showed significant interference by negative primes for positive targets.
The psychopathic individuals displayed no facilitation or interference for the emotion words.
There were no group differences in error rates.
No group differences in semantic priming for psychopathic vs nonpsychopathic groups.
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Author/s Sample Females (n)
Psychopathy measure
Control Measures
Word Rating Task?
Stimuli Affective language task and DVs
Semantic language task and DVs
Results
Psychopathic individuals rated neutral words as more pleasant than nonpsychopathic individuals.
Correlational analyses revealed that PCL-R1 and PCLR2 were both related to longer reaction times on the affective priming task, but not the semantic priming task
C. A. Brinkley et al. (2005)
Male criminal offenders (study 1 n = 58, study 2 n = 124)
0 PCL-R scores used to classify participants as psychopathic or nonpsychopathic
SILS (for IQ)
WAS (for anxiety)
No Unknown source but matched on length, imageability, and log word frequency
Nil Study 1 LDT to examine facilitation.
Study 2 semantic Stroop task to examine interference
Study 1 No group differences between Ps and NPs. Intact semantic facilitation.
Study 2. No group difference observed. Intact interference for psychopaths.
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Author/s Sample Females (n)
Psychopathy measure
Control Measures
Word Rating Task?
Stimuli Affective language task and DVs
Semantic language task and DVs
Results
Intrator et al. (1997)
Male substance users (psychopath n = 8, nonpsychopath n – 9) and healthy controls (n = 9)
0 PCL-R scores used to classify participants as psychopathic or nonpsychopathic. Healthy controls not tested for psychopathy.
No drug use two weeks prior (recreational or medicinal)
All right-handed
No Unknown LDT decision task for neutral and emotional words.
Also looked at relative cerebral blood flow (rCBF) using a SPECT scanner.
Nil No behavioural differences in performance on the LDT.
Some differences in rCBF.
Kiehl (1999)
Male criminal offenders (n = 29)
0 PCL-R scores used to classify participants as psychopathic or nonpsychopathic (Cut scores 30)
ERP’s to word responses also recorded.
Yes, word rating task showed that Ps and NPs rated the abstract, concrete, positive and negative
Selected from Toglia & Battig’s (1978) word norms.
Task 3, participants had to decide if a word was positive or negative
Task 1 was a LDT with concrete or abstract words. No priming condition. Had to make word/nonword binary decision.
Task 1: No group differences
Task 2: Ps made more errors to abstract words than NPs
Task 3: No group differences. All participants displayed faster and
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Author/s Sample Females (n)
Psychopathy measure
Control Measures
Word Rating Task?
Stimuli Affective language task and DVs
Semantic language task and DVs
Results
words the same.
Task 2 participants had to decide if a word was concrete or abstract.
RTs and errors
more accurate responses to positive words than negative words.
ERPs: NPs showed normal ERPs in all tasks. Ps did not and displayed an N350 to all tasks.
Lorenz and Newman (2002a)
Male criminal offenders (n = 100)
0 PCL-R scores used to classify participants as psychopathic or nonpsychopathic (cut score 30)
WAS
WAIS-R
Age
Yes Emotion words selected from Rubin and Friendly’s (1986) word list.
High, Med and Low frequency
LDT, to examine RTs to the different word types (positive, negative, neutral)
Nil, but emotion words of high, medium and low frequency were chosen to examine whether an emotionally neutral secondary due would
No group differences in word ratings.
Nonpsychopaths displayed greater facilitation to emotion words than psychopaths but only for right-handed responses.
Low anxious psychopaths displayed less facilitation for
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Author/s Sample Females (n)
Psychopathy measure
Control Measures
Word Rating Task?
Stimuli Affective language task and DVs
Semantic language task and DVs
Results
words chosen.
facilitate performance.
emotion words than low anxious controls, for right handed responses only.
Planned comparison revealed that low anxious psychopaths displayed significantly less facilitation for high frequency words than low anxious controls but this was only for right handed responses, with performance intact for left handed responses.
Lorenz and Newman (2002b)
Male offenders (African-American) (n = 94)
0 PCL-R used to classify as psychopathic or nonpsychopathic (cut score 30)
IQ (SILS)
Anxiety (WAS)
Yes Emotion words selected from Rubin and Friendly’s (1986) word list.
LDT, to examine RTs to the different word types (positive, negative, neutral)
Nil, but emotion words of high, medium and low frequency were chosen to examine whether an emotionally neutral
No group differences in word ratings.
No difference between low anxious psychopaths and low anxious controls in emotion facilitation.
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Author/s Sample Females (n)
Psychopathy measure
Control Measures
Word Rating Task?
Stimuli Affective language task and DVs
Semantic language task and DVs
Results
High, Med and Low frequency words chosen
secondary due would facilitate performance.
No difference between low anxious psychopaths and low anxious controls in frequency facilitation.
No effects of response hand on emotion or frequency facilitation.
Reidy et al. (2008)
Male undergraduates (n = 60)
0 LSRP parsed into F1 and F2 scores
PANAS
IRI
BIS-11
STAI
NPI
Yes, but not by participant of the study.
Unknown source, but rated by 25 psychology students
LDT, no examination of priming. Just examination of responses to neutral, sad, anger, fear and happiness words by binary decision of word/nonword (RTs)
Nil Neither F1 nor F2 predicted RTs for fear and happiness words.
F1 did not predict RTs for anger words, but F2 significantly predicted faster reaction times to anger words.
F1 significantly predicted slower response times for sadness words. F2 did not predict response times for sadness words.
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Author/s Sample Females (n)
Psychopathy measure
Control Measures
Word Rating Task?
Stimuli Affective language task and DVs
Semantic language task and DVs
Results
Vitale et al. (2011)
Female offenders (n = 117)
117 PCL-R to classify participants as psychopathic or nonpsychopathic (cut scores 24)
IQ (SILS)
Anxiety (WAS)
ASPD
No Emotion words selected from Rubin and Friendly’s (1986) word list.
High, Med and Low frequency words chosen
LDT, to examine RTs and accuracy to the different word types (positive, negative, neutral)
2 (P or NP) x 2 (anxious or non-anxious) x 2 (left vs right) x 3 (pos, neg, neut word) ANCOVA with ASPD as a covariate.
ASPD diagnosis significantly predicted emotional facilitation for emotion words.
No other significant effects.
S. Williamson et al. (1991)
Male offenders (n = 16)
0 PCL-R to classify participants as psychopathic or nonpsychopathic cut score 33
Matched controls
Yes, participants asked to rate words from good to bad on 7-point scale
Positive, Negative and Neutral words were selected from Toglia and Battig’s (1978) word norms
LDT to make binary decision of word/non word for positive, negative and neutral words.
Nonpsychopaths responded faster to emotion words than neutral words.
Psychopaths responded slower to emotion words than neutral words (response to negative words was
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Author/s Sample Females (n)
Psychopathy measure
Control Measures
Word Rating Task?
Stimuli Affective language task and DVs
Semantic language task and DVs
Results
slowest although this was not statistically tested).
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Primes - word condition: Mean ratings for each word characteristic
Word Type
Noun/Verb Frequency Length Concreteness Imageability Valence SD Arousal SD
Positive 1.43 39.77 6.10 N/A N/A 7.36 1.51 5.09 2.53
Negative 1.33 39.84 5.83 N/A N/A 2.47 1.59 5.71 2.40
Concrete 1.11 45.75 5.48 592.95 588.93 N/A N/A N/A N/A
Abstract 1.41 42.68 6.35 306.59 344.50 N/A N/A N/A N/A
Appendix 7
Targets: Mean ratings for each word characteristic
Word Type
Noun/Verb Frequency Length Concreteness Imageability Valence SD Arousal SD
Positive 1.53 77.91 5.80 N/A N/A 7.99 1.33 6.19 2.48
Negative 1.30 71.31 5.77 N/A N/A 2.11 1.37 6.32 2.48
Concrete 1.20 72.22 5.33 595.23 597.12 N/A N/A N/A N/A
Abstract 1.46 71.14 5.96 292.84 335.81 N/A N/A N/A N/A
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Primes - nonword condition: Mean ratings for each word characteristic
Word Type
Noun/Verb Frequency Length Concreteness Imageability Valence SD Arousal SD
Positive 1.33 48.48 6.13 N/A N/A 7.73 1.46 5.47 2.61
Negative 1.30 41.09 5.97 N/A N/A 2.32 1.66 5.82 2.56
Concrete 1.30 50.89 5.41 588.49 588.57 N/A N/A N/A N/A
Abstract 1.15 51.73 6.18 310.27 334.09 N/A N/A N/A N/A
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Appendix 8
PRIME TARGET RELATEDNESS honeymoon sex related proud glad related poetry romantic related save rescue related ambition desire related angel fex beautiful glid birthday salantic bouquet redsue bunny demite traitor betray related rage anger related explosion bomb related rot cancer related disappoint failure related corpse begley debt arber fat boge alone carger alcoholic fillure vivid hurt unrelated butterfly stress unrelated treat danger unrelated lottery funeral unrelated pleasant hate unrelated cake struss christmas rander cheer huch comedy nuderat valentine hade ulcer alive unrelated punish free unrelated threat reward unrelated grave cash unrelated enemy friendly unrelated bankrupt atill despise swee divorce rewote fraud cank lost freacely elbow ankle related
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PRIME TARGET RELATEDNESS furniture apartment related oil engine related lake skiing related owl bird related canoe arshe barn anictment basement engate zoo droing bean birk reason purpose related method concept related norm rule related manner attitude related hint answer related series pursese enough concues rare rund role attinine theme arwher hallway car unrelated crane dog unrelated van doorway unrelated animal machine unrelated hill key unrelated bath lar beard doy beetle roonway card mascone zipper jey custom certain unrelated specific design unrelated value chance unrelated possible worth unrelated forever quote unrelated bland certive amateur desais definition chapes exception worps extent snote star wish related delight happy related sing joy related triumph miracle related flowers nature related diamond wesh
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PRIME TARGET RELATEDNESS elegant haddy fame jof smile suraphe fantasy narire tragedy grief related victim killer related shoot gun related noose suicide related torture pain related horror prief insane kether infection gan lie suirame maggot pame compassion jail unrelated wisdom flood unrelated adore terrorist unrelated enjoy accident unrelated dove disease unrelated gentle jame heart slood holiday tastorist cozy accigate hug diseine criminal passion unrelated famine knowledge unrelated extremist loved unrelated scar pleasure unrelated virus peace unrelated massacre dassion morgue phowlepts nightmare lorts poison frealure rejected pealm pond frog related school book related bench chair related bracelet necklace related sculpture painting related oven scog olive boak leather chacs couch neckloys duck manching mind soul related
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PRIME TARGET RELATEDNESS current event related posh refined related urge beg related belief real related inaction sool order enant intention regires motive bew normal deat building mattress unrelated bed mountain unrelated piano house unrelated suitcase rock unrelated park clothes unrelated corkscrew maldress cloud meantail chain hoose clock rost test clorked example always unrelated bias infinite unrelated eternity opinion unrelated intrinsic paradox unrelated enigma innate unrelated instance aslays logic innitute simple ocotion usual parafue grade indant honest truth related glory victory related celebrate fireworks related fun party related cute puppy related king trule luxury neccory music firegarks paradise pangy rainbow mumpy drown suffocate related hung death related hell fire related wreck crash related scared afraid related rude sutmorate
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PRIME TARGET RELATEDNESS starve deald thief fint blind crast trauma acroid trophy bully unrelated humour pollution unrelated amaze disaster unrelated comfort weapon unrelated prosper sad unrelated riches rolly thrill perrution treasure denanter warmth weison jolly sar coward win unrelated smog laughter unrelated cyclone magic unrelated deadly support unrelated lonely success unrelated burn hin vomit latchler violence pabic ugly suppame filth sudress blanket pillow related letter envelope related banana apple related coach football related egg chicken related yard mollow light envenics student adfle handle lootbale spring shacken common typical related unclear vague related represent depict related gradual slower related potential ability related length lugical moment varve need depoth phrase slaler scheme imenity boat tree unrelated
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PRIME TARGET RELATEDNESS cement water unrelated hose window unrelated curtain garden unrelated fishing plant unrelated secretary blee room laner radio wantow insect warmen market plang tired vision unrelated mirage fatigue unrelated amount fiction unrelated reality less unrelated dignity unknown unrelated proof vibean pause falived repeat loction realm lelt review unscorm
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Appendix 9
Welcome to the experiment
In this experiment, you will see a word presented very briefly in the centre of the screen.
A second word will appear immediately after the first.
This word will either be a valid English word (e.g. cup) or a non-word (e.g. kolp).
Your task is to respond as quickly as possible to the second word/non-word.
Press 'SPACEBAR' to continue for further instruction.
To decide if the second word forms a valid English word please use the keys 'F' and 'J' on the keyboard.
When a word appears press the 'J' key.
If a non-word appears press the 'F' key.
Press 'SPACEBAR' to begin the practice trials.
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Appendix 10
Please enter the unique code you generated for the previous study (personality and the law).
REMINDER: The unique code consists of the first three letter of your mother's maiden name
and the last three digits of your mobile phone number. For example, if your mother's maiden
name was 'SMITH' and your mobile phone number is 0408 891 525, your unique code would
be 'SMI525'. This unique code will not identify you in any way. The purpose of the unique
code is to enable us to match your responses across studies within this project, whilst
maintaining your anonymity.
In this section you will be asked to rate a list of words on context availability (how easy it is
to think of a context or circumstance for the word). Some words are easy to think of a context
or circumstance in which they might appear. Forexample, the word ‘sorry’ can easily be
contextualised in the sentence ‘I am sorry’. You will be asked to rate how easy it is for the
word to evoke a context for it's use (e.g. situations, circumstances, and cases). The scale
ranges from ‘very difficult to think of a context’ to ‘very easy to think of a context’.
Try to use all 7 points on the rating scale. Remember to read each word carefully before you
rateit. Make your rating on the basis of how easily you can think of a context of use for the
word, not how you think people in general would rate the word.
On the concreteness word rating task you will be asked to rate words that represent objects,
materials or people as concrete (e.g. couch), and to rate words that refer to concepts that
cannotbe perceived by the senses as abstract (e.g. justice). We want you to indicate how
concrete the meaning of each word is for you by using a 7-point rating scale going from
‘highly abstract’ to ‘highly concrete’.
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A concrete word comes with a higher rating and refers to something that exists in reality; you
can have immediate experience of it through your senses (smelling, tasting, touching,
hearing, seeing) and the actions you do. The easiest way to explain a concrete word is by
pointing to it or by demonstrating it (e.g. To explain 'couch', you could point to a couch or
show a picture of a couch).
An abstract word comes with a lower rating and refers to something you cannot experience
directly through your senses or actions. Its meaning depends on language. The easiest way to
explain it is by using other words (e.g. There is no simple way to demonstrate 'justice'; but we
can explain the meaning of the word by using other words that capture parts of its meaning).
Try to use all 7 points on the rating scale. Remember to read each word carefully before you
rate it. Make your rating on the basis of how abstract or concrete you think the word is, not
how you think people in general would rate the word.
The imagebility word rating task asks you to rate the degree of ease with which a word brings
to mind a mental image, sound, or sensory experience.
Words differ in their capacity to arouse mental images of things or events. Some words
arouse a sensory experience such as a mental picture or sound very quickly and easily,
whereas others may do so with difficulty after a long delay or not at all.
The purpose of this task is to rate a list of words as to the ease with which they arouse mental
images. For example, some words bring to mind a mental picture very easily (e.g. flower),
while others do not (e.g. enough).
Your task is to decide how much imagery each word brings to mind. The scale ranges from
‘no image comes to mind’ to ‘very clear and vivid image’. Words that arouse images quickly
and easily should be rated as 'very clear and vivid image', whilst words that do not bring to
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mind a mental image should be rated as 'no image comes to mind'. Words that are
intermediate in ease
or difficulty should be rated somewhere between the two extremes.
Try to use all 7 points on the rating scale. Remember to read each word carefully before you
rate it. Make your rating on the basis of how easily you can form an image for the word, not
how you think people in general would rate the word.
For the valence word rating task you are asked to rate words that evoke happy, positive, and
satisfied feelings as positive, and words that evoke sad, unpleasant, and negative feelings as
negative.
At one extreme of this scale, you are happy, pleased, satisfied, contented, hopeful. When you
feel completely happy you should indicate this by selecting 'highly positive'. The other end of
the scale is when you feel completely unhappy, annoyed, unsatisfied, melancholic, despaired,
or bored. You can indicate feeling completely unhappy by selecting 'highy negative'. If the
word doesn't feel extremely positive or negative you can select anywhere in between the two
extremes that reflects your feeling.
Try to use all 7 points on the rating scale. Remember to read each word carefully before you
rate it. Make your rating on the basis of how the word makes you feel, not how you think
people in general would rate the word.
For the arousal word rating task you are asked to rate the intensity of some words. You
should rate words that are calming, dull or boring with low arousal, and words that are highly
exciting or agitating with high arousal.
At one extreme of this scale you are stimulated, excited, frenzied, jittery, wide-awake, or
aroused. When you feel completely aroused you should select 'highly arousing'. When you
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feel completely relaxed, calm, sluggish, dull, sleepy, or unaroused, indicate feeling calm by
selecting 'Not at all arousing'. As with the valence word rating scale, you can represent
intermediate levels of excitedness or calmness by selecting somewhere between the two
extremes.
Try to use all 7 points on the rating scale. Remember to read each word carefully before you
rateit. Make your rating on the basis of how arousing the word is for you, not how you think
people in general would rate the word.