Matthew S. Shane, Ph.D. University of Ontario Institute of Technology, Oshawa, Ontario, Canada The...

Matthew S. Shane, Ph.D. University of Ontario Institute of Technology, Oshawa, Ontario, CanadaThe Mind Research Network, Albuquerque, New Mexico

Psychopathy: A Deficit of Ability or Motivation?

What is Psychopathy?

Myths

PCL-R Interview

• 2 hour semi-structured interview

• The individual is queried about various facets of their life: childhood, school, work, family, relationships, criminal, substance abuse, etc.

• More than the fact, the intent is to gain some sense of their interpersonal, emotional and behavioral nature

• Following the interview, the individual receives a score of 0, 1 or 2 on each of the 20 items that comprise the PCL-R

Glib and Superficial Charm

Grandiose Self-worth

Pathological Lying

Conning and Manipulative

Lack of Remorse or Guilt

Shallow Affect

Callousness or Lack of Empathy

Failure to Accept Responsibility

Many Short-term Marital Relationships

Promiscuity

Parasitic Lifestyle

Poor Behavioral Controls

Early Behavioral Problems

Lack of Realistic Long-term Goals

Need for Stimulation

Impulsivity

Irresponsibility

Juvenile Delinquency

Revocation of Conditional Release

Criminal Versatility

Psychopathy Checklist - Revised

Glib and Superficial Charm

Grandiose Self-worth

Pathological Lying

Conning and Manipulative

Lack of Remorse or Guilt

Shallow Affect

Callousness or Lack of Empathy

Failure to Accept Responsibility

Parasitic Lifestyle

Poor Behavioral Controls

Early Behavioral Problems

Lack of Realistic Long-term Goals

Need for Stimulation

Impulsivity

Irresponsibility

Juvenile Delinquency

Revocation of Conditional Release

Criminal Versatility

Psychopathy Checklist - Revised

Factor 1Affective/Interpersonal

Components

Factor 2Impulsive/Antisocial

Components

Many Short-term Marital RelationshipsPromiscuity

Psychopathy

Psychopathy versus Antisocial Personality Disorder

Factor 1Affective/Interpersonal

Components

Factor 2Impulsive/Antisocial

Components

Psychopathy

ASPD

Psychopathy versus Antisocial Personality Disorder

Factor 1Affective/Interpersonal

Components

Factor 2Impulsive/Antisocial

Components

Psychopathy

ASPDSometimes referred

to as the primary essence of

psychopathy

Psychopathy versus Antisocial Personality Disorder

Factor 1Affective/Interpersonal

Components

Factor 2Impulsive/Antisocial

Components

Relationship Between Psychopathy and ASPD

Prison Population

Antisocial Personality Disorder

Psychopathic

Prison prevalence of ASPD: ~65-85%Prison prevalence of psychopathy: ~15-25%

The hypothesis states that the psychopath does not experience

sufficient fear to promote conditioning or avoidance learning

Core Fear Processing Deficit

Low level of subjective fear

Reduced impact of aversive stimuli on emotional systems

Failure to correct dysfunctional actions

Failure to recognize other’s fear

Failure to avoid fear-provoking situations

The “Low Fear” Hypothesis

Other flavours focus on other emotions:• Low guilt• Low empathy• Low negative affect

• Patrick et al. (1993): Participants are asked to watch pictures while they are randomly given painful shocks

• Deficient fear-potentiated startle magnitude in psychopaths

Reduced Sensitivity to Aversive Stimuli

Reduced Sensitivity to Anticipation of Aversive Information

Reduced anticipatory skin conductance

Mea

n C

hang

e in

HR

Skin Conduc tance

10 9 8 7 6 5 4 3 2 1 0Seconds

P-SCL NP-SCL Hare, 1966Ogloff and Wong, 1990

• Reduced ability to identify fearful/sad faces (Blair et al., 2004)

• Reduced ability to identify fearful vocal intonations (Blair et al., 2002)

• Reduced attributions of guilt to others (Blair et al., 1995)

• Reduced sensitivity to distress cues (Blair, 1997)

Emotional Deficits in Psychopathy cont.

Disrupted Neural Processing of Emotional Information

Largely Intact Cognitive Abilities

Already noted that intact awareness of right/wrong was almost necessary for the diagnosis of the disorder

• Psychopathic individuals score normal to above average on IQ tests• Often show increased cortical response (perhaps compensatory)

• One proposed problem was in processing, and learning from, committed mistakes

S

Intact Error Monitoring

Shane et al. (2008), NeuroImage

Shane (resubmitted)

The Importance of Controlling for Substance Abuse

Shane et al. (in progress)

“Don’t” doesn’t equal “Can’t”

The fact that psychopathic indiviudals don’t show reactivity to aversive/emotional stimuli doesn’t necessarily mean they can’t.

If so, we may expect quite drastic neural abnormalities • While some evidence exists, these differences, to date, are

fairly small, and fairly transient

Another possibility is that they can, but simply don’t under the vast majority of (naturalistic) settings

3000 ms

6000 ms

2000 ms

500 ms

Jittered ITI: 2000, 3500 or 5000 ms

+ Enhance

Enhance

How strong is your emotional reaction right now? 1 2 3 4 Very weak very strong

Emotion Regulation in Psychopathy

NonPsychopathic(N = 16)

PsychopathicN = 18) t p

Age 37.37 (9.00) 33.75 (8.25) 1.19 ns IQ 102.68 (13.53) 101.75 (18.16) .17 ns Verbal IQ 39.00 (13.80) 38.94 (15.13) .02 ns Performance IQ 18.31 (4.36) 17.25 (5.74) .59 ns PCL-R Score 15.40 (4.88) 31.47 (1.34) 12.69 < .001 Factor 1 3.87 (2.72) 11.93 (1.58) 9.93 < .001 Factor 2 10.10 (3.88) 16.10 (1.83) 5.42 < .001 Substance Use Years of Alcohol Use 11.25 (7.55) 7.00 (6.48) 1.71 ns Composite Years of Substance Use 21.21 (20.63) 12.03 (12.93) 1.51 ns Comorbid Diagnoses Antisocial Personality Disorder 86.9% 100% Substance Abuse Disorder 94.4% 100% Past Mood Disorder 1 5 Other Personality Disorder 0 0

Emotion Regulation in Psychopathy - Demographics

Emotion Regulation in Psychopaths

Nonpsychopathic Psychopathic

NegWATCH vs

NeutWATCH

Shane, MS (under review)

Emotion Regulation in Psychopaths

Nonpsychopathic Psychopathic

NegWATCH vs

NeutWATCH

NegINCREASE vs

NegWATCH

Shane, MS (under review)

Emotion Regulation in Psychopaths

Nonpsychopathic Psychopathic

NegWATCH vs

NeutWATCH

Left OFC/Insula ROI

0

0.05

0.1

0.15

0.2

0.25

NegWATCH NegINCREASE

Sig

nal

Ch

an

ge (

% f

rom

N

eu

tWA

TC

H)

NonPsychopaths

Psychopaths

Right Amygdala ROI

0

0.02

0.04

0.06

0.08

0.1

0.12

0.14

0.16

NegWATCH NegINCREASE

Sig

nal

Ch

ang

e (%

fro

m

Neu

tWA

TC

H)

NonPsychopaths

Psychopaths

Shane, MS (under review)

NegINCREASE vs

NegWATCH

Empathic Deficits in Psychopathy

Quite a lot of studies over the years

However, a number of recent studies have investigated this from a

neuroscience perspective

“Imagine self” versus “imagine other” in pain

Performance Condition: Participants must press a button as quickly as possible to all ‘X’s, and stop their button press to all ‘K’s.

Observation Condition: Participants watch a video of another person performing the same task; press a button to indicate correct/error responses.

Error Performance/Observation Study Design

All participants performed the ‘Performed’ task first, followed by the ‘Observed’ task, followed by the self-report measures.

Error Performance/Observation Study Results

Performed Errors

Observed

Errors

Shane et al. (2008), NeuroImage

Error Performance/Observation Study Results

Performed Errors

Observed

Errors

Shane et al. (2008), NeuroImage

Similar dACC activity was obtained during both the performance of one’s own errors, and also the

observation of another’s errors.

Error Performance/Observation Study Results

Performed Errors

Observed

Errors

In addition, several regions showed unique activity only during processing of other’s

errors

Shane et al. (2008), NeuroImage

Error Performance/Observation Study Results

Correlations between vACC response to observed errors and Levenson Self-report Psychopathy (LSRP) scores

Shane et al. (resubmitted)

Error Performance/Observation Study Results

Correlations between vACC response to observed errors and self-reported empathic concern

Shane et al. (2009), SCAN

Thus, participants who scored higher on self-reported empathic concern showed

increased vACC activity during the observation of another person’s failures.

“Try to feel the other’s pain”

Entire Sample(N = 26)

With ASPD(N = 9)

Without ASPD(N = 15)

Age M = 33.52 (8.62) M = 35.22 (10.77) M = 34.38 (7.64)

IQ M = 104.69 (12.17) M = 101.67 (10.45) M = 105.00 (14.25)

PCL-R M = 21.12 (6.23) M = 23.59 (6.80) M = 19.42 (5.42)

PCL-R Factor 1 M = 7.24, (3.38) M = 8.51 (3.56) M = 6.35 (3.08)

PCL-R Factor 2 M = 10.57 (2.90) M = 11.02 (3.32) M = 10.26 (2.67)

Comorbid Diagnoses

Alcohol Dependence 50.00% 55.56% 46.15%

Drug Dependence 68.18% 77.78% 61.54%

Current Psychotropic Meds 13.64% 11.11% 15.38%

Anxiety 18.18% 11.11% 23.08%

Depression 31.82% 55.56% 15.38%

Psychotic Disorders 4.55% 11.11% 0.00%

“Try to increase your level of concern for the individual in pain”

Study 1: Probation/Parole sample

“Try to feel the other’s pain”

Arbuckle and Shane (resubmit)

“Try to feel the other’s pain”

Arbuckle and Shane (resubmit)

“Try to feel the other’s pain”

Z-scores of Subjective Pain Ratings and Left

Insula Response

Arbuckle and Shane (resubmit)

Study 2. Demographics

Total(N = 27)

High PCL-R(N = 14)

Low PCL-R(N = 13)

Age 32.56 (8.44) 35.27 (7.54) 30 (9.58)

IQ 104.04 (6.77) 104.00 (6.77) 102.21 (10.81)

PCL-R 23.11 (7.89) 32.18 (1.33) 15.41 (4.13)

PCL-R Factor 1 8.67 (3.76) 12.79 (1.69) 5.00 (1.88)

PCL-R Factor 2 11.26 (3.69) 15.18 (0.87) 8.06 (2.24)

Comorbid Diagnoses

Alcohol Dependence 73.53% 90.91% 50.00%

Drug Dependence 85.29% 100% 64.29%

Anxiety 23.53% 18.18% 21.43%

Depression 20.59% 18.18% 21.43%

ASPD 73.53% 90.91% 50.00%

Arbuckle and Shane (in progress)

Study 2. Results

Arbuckle and Shane (in progress)

NegWatch > NeutWatchActivity represents greater responses

in low PCL-RActivity represents greater responses

in high PCL-R

NegIncrease > NegWatch

NPW PW IC II

-0.1

-0.05

0

0.05

0.1

0.15

LowHi

PW IC II NPW0

0.02

0.04

0.06

0.08

0.1

0.12

LowHi

ACC

Left IFG

Study 2. Results

Arbuckle and Shane (in progress)

NegWatch > NeutWatchActivity represents greater responses

in low PCL-RActivity represents greater responses

in high PCL-R

NegIncrease > NegWatch

NPW PW IC II

-0.1

-0.05

0

0.05

0.1

0.15

LowHi

PW IC II NPW0

0.02

0.04

0.06

0.08

0.1

0.12

LowHi

ACC

Left IFG

Study 2. Results

Arbuckle and Shane (in progress)

NegWatch > NeutWatchActivity represents greater responses

in low PCL-RActivity represents greater responses

in high PCL-R

NegIncrease > NegWatch

Motivated Empathy?

Meffert and colleagues (2013) devised the terms “spontaneous” versus “deliberate” empathy, • Impaired in “spontaneous” empathy• Normal “deliberate” empathy

In the place of “deliberate”, I may instead suggest the term “motivated”• Received a direct instruction to feel…

Coincides with recent work by Zaki and colleagues (e.g. Zaki, 2014), in which he puts out a call for researchers to consider the extent to which empathy is, at its very nature, a motivation

Next Steps?

• Better demonstrate that increased neural response indeed represents empathy• Behavioral metrics• Functional connectivity analyses

• Manipulate motivation to feel for another person• Evaluating empathic accuracy for ingroup versus outgroup versus family

members• Constructing situations within which the psychopath may want to empathize

(to manipulate?)

• Also evaluating a variety of neuromodulation techniques• Have used rt-fMRI in the past• Considering attempting HD-tdcs to stimulate subcortical emotion regions

• For me, external stimulation is less satisfying, however

Previous Treatment Attempts

Rice, Hare and Cormier, 1991

May be considerable implications for potential therapeutic concerns• Treatable versus untreatable