Knut Vohs

The influence of emotions on inhibitory functioning in borderline personality disorder

BACKGROUND Borderline personality disorder (BPD) is characterized by an emotionally unstable and impulsive cognitive and behavioral style. Inhibitory dysfunction has been hypothesized as playing a crucial role in BPD psychopathology. This study aimed to systematically investigate differential inhibitory functions in patients with BPD as compared to healthy controls, and to investigate their expected impairment in the context of aversive emotions by comparing performances in neuropsychological tasks that present both neutral and emotional material. METHOD Unmedicated female patients with BPD (n=28) were compared with age-matched healthy female controls (n=30) in the following tasks: the emotional Stroop test (inhibition of interference), directed forgetting (intentional, resource-dependent inhibition), and an emotional variant of the negative priming task (automatic, resource-independent inhibition). RESULTS In comparison with the controls, the BPD patients showed reduced inhibition of negative material in the directed forgetting task and in the negative priming task. No effect was found in the emotional Stroop test. Significant correlations with current affect as well as trait anxiety and anger (but not impulsiveness) were found in the BPD group specifically for negative stimuli, while no such correlations were found in the control group. In addition to inhibitory deficiencies, BPD patients had difficulties remembering positive words in the directed forgetting task. CONCLUSIONS Our data suggest that individuals with BPD have difficulties in actively suppressing irrelevant information when it is of an aversive nature. Inhibitory dysfunction appears to be closely related to state and trait variables of unstable affect, but not to self-reported impulsiveness.

Emotional empathy and psychopathy in offenders: an experimental study.

Previous studies associated psychopathy in adults with deficits in empathy but these studies did not directly compare cognitive and emotional facets of empathy. The present study sought to establish whether psychopathy is associated with impairments in emotional empathy among adult offenders. Participants were 90 male offenders scoring low (n = 29), medium (n = 33) or high (n = 28) on the Psychopathy Checklist-Revised (PCL-R) and n = 28 male noncriminal controls. Empathy functioning was assessed through self-report and computerized decision tasks, differentiating between perspective-taking (cognitive empathy) and compassion (emotional empathy). Against expectations, level of psychopathy among the offenders was not associated with either emotional or cognitive empathy. Offenders however had lower scores for both cognitive and emotional components of empathy functioning than controls. Both facets of empathy showed small but significant positive correlations with education level and social desirability. The methods employed to assess differences in empathy functioning may not be sensitive enough to assess differences in forensic samples.

Brain volumes differ between diagnostic groups of violent criminal offenders.

Studies on structural abnormalities in antisocial individuals have reported inconsistent results, possibly due to inhomogeneous samples, calling for an investigation of brain alterations in psychopathologically stratified subgroups. We explored structural differences between antisocial offenders with either borderline personality disorder (ASPD-BPD) or high psychopathic traits (ASPD-PP) and healthy controls (CON) using region-of-interest-based and voxel-based morphometry approaches. Besides common distinct clusters of reduced gray matter volumes within the frontal pole and occipital cortex, there was remarkably little overlap in the regional distribution of brain abnormalities in ASPD-BPD and ASPD-PP, when compared to CON. Specific alterations of ASPD-BPD were detected in orbitofrontal and ventromedial prefrontal cortex regions subserving emotion regulation and reactive aggression and the temporal pole, which is involved in the interpretation of other peoples’ motives. Volumetric reductions in ASPD-PP were most significant in midline cortical areas involved in the processing of self-referential information and self-reflection (i.e., dorsomedial prefrontal cortex, posterior cingulate/precuneus) and recognizing emotions of others (postcentral gyrus) and could reflect neural correlates of the psychopathic core features of callousness and poor moral judgment. The findings of this first exploratory study therefore may reflect correlates of prominent psychopathological differences between the two criminal offender groups, which have to be replicated in larger samples.

Effects of emotional stimuli on working memory processes in male criminal offenders with borderline and antisocial personality disorder

Abstract Objective. In the present study, we aimed to investigate the influence of concurrently presented emotional stimuli on cognitive task processing in violent criminal offenders primarily characterized by affective instability. Methods. Fifteen male criminal offenders with antisocial and borderline personality disorder (ASPD and BPD) and 17 healthy controls underwent functional magnetic resonance imaging (fMRI) while performing a working memory task with low and high working memory load. In a second experimental run, to investigate the interaction of emotion and cognition, we presented emotionally neutral, low, or high salient social scenes in the background of the task. Results. During the memory task without pictures, both groups did not differ in general task performance and neural representation of working memory processes. During the memory task with emotional background pictures, however, ASPD-BPD subjects compared to healthy controls showed delayed responses and enhanced activation of the left amygdala in the presence of emotionally high salient pictures independent of working memory load. Conclusions. These results illustrate an interaction of emotion and cognition in affective instable individuals with enhanced reactivity to emotionally salient stimuli which might be an important factor regarding the understanding of aggressive and violent behaviour in these individuals.

Neural correlates of risk taking in violent criminal offenders characterized by emotional hypo- and hyper-reactivity

Recent approaches suggest that emotional reactivity can be used to differentiate between subgroups of individuals who are at risk for showing elevated levels of aggression and violence. In this study, we examined how emotion governs decision making within two subgroups of antisocial criminal offenders with either emotional hypo- or hyper-reactivity compared with healthy, noncriminal controls. Offenders were recruited from high-security forensic treatment facilities and penal institutions and underwent functional magnetic resonance imaging during a financial decision-making task. In this task, participants were required to choose between low-risk (bonds) and high-risk alternatives (stocks). Bonds were always the safe choice; stocks could win or lose, with a varying degree of uncertainty. We found that emotionally hypo-reactive offenders differed most from healthy controls by showing diminished neural activation in the rostral anterior cingulate cortex in response to uncertainty as well as decreased activity in the prefrontal cortex when trying to regulate their behavior accordingly (i.e., when consistently choosing “safe alternatives”). Hence, the data indicate that emotionally hypo-reactive offenders (with psychopathic traits) constitute a special subgroup within antisocial offenders characterized in particular by a limited capacity to emotionally represent uncertainty and to anticipate punishment.

[Preventive detention: empirical findings concerning the detainees and the quality of forensic-psychiatric reports].

Expert testimonies and judges of 224 lawsuits of the years 1991 to 2001, who lead to the order of Preventive Detention in the German federal states of Bavaria, Brandenburg, Northrhine Westfalia and Saxony were analysed. Offenders with the order of Preventive Detention have mostly committed violent and/or sexual offences. Nearly two third of the inmates show personality traits with relevance for psychiatry or even personality disorders. Thus the discrimination between forensic psychiatric measurements and preventive detention is difficult. The quality of forensic psychiatric reports does not reflect the complexity of this task. They show diagnostic and prognostic weaknesses.

Offenders with antisocial personality disorder show attentional bias for violence-related stimuli

Offenders with antisocial personality disorder (ASPD) may be characterized by a lack in emotional functioning that manifests in irritability and a lack of remorse. The proposed link between ASPD and negative emotionality led to the question of emotional processing anomalies in ASPD. Furthermore, the effect of childhood maltreatment/abuse on emotional processing was tested in the present study. Violent and sexual offenders with ASPD (n=35), without ASPD (n=34), and healthy non-criminal controls (n=24) were compared in an Emotional Stroop Task (EST) using neutral, negative, and violence-related words. Secondary analyses focused on the effect of psychopathic traits and childhood maltreatment. Offenders with ASPD showed a stronger attentional bias to violence-related and negative words as compared to controls. Comparable results were obtained when grouping offenders to high, medium, and low psychopathic subgroups. Offenders with childhood maltreatment specifically showed stronger violence-related attentional bias than non-maltreated offenders. The data suggest that enhanced attention to violence-related stimuli in adult criminal offenders is associated with adverse developmental experiences and delinquency but to a lesser extent with antisocial or psychopathic traits.

NORMATIVE DATA FOR THE PSYCHOPATHY CHECKLIST-REVISED IN GERMAN-SPEAKING COUNTRIES A Meta-Analysis

The Psychopathy Checklist–Revised (PCL-R) is the standard assessment method for psychopathic personality traits of offenders. PCL-R norms for German-speaking countries have not yet been published. This study reviews the extant literature on the PCL-R and its screening version in Austria, Germany, and Switzerland. Based on 25 published empirical studies (total N = 4,254) overall means and standard deviations were estimated using meta-analytic methods. Assuming normality, estimates of norms (percentiles and T-scores) were derived for male offenders with respect to the standard assessment protocol (PCL-R interview plus file review), purely file-based assessments, and the screening version of the instrument. Compared with the North American normative data, estimated sample means were significantly lower for PCL-R standard assessments and for the screening instrument. The present findings may serve as provisional estimates for gauging the level of psychopathic traits of male offenders in Austria, Germany, and the German-speaking parts of Switzerland.

Psychopathy, intelligence, and impulsivity in German violent offenders

Previous studies have reported numerous correlations between psychopathy and various personality traits, behavioural tendencies or clinical characteristics. The present study examined in greater depth the relationships between the components of psychopathy as measured by the Psychopathy Checklist-Revised (PCL-R) and intelligence as well as impulsivity. A total of ninety male violent offenders were recruited from a prison and a forensic-psychiatric hospital in Germany. All of the subjects were assessed using the PCL-R, the Barratt Impulsiveness Scale (BIS-11), and a short version of the German Wechsler Adult Intelligence Scale (WIP). As expected, a canonical correlation analysis showed a negative association between spatial intelligence and the Factor 2 subtotal on the PCL-R (reckless lifestyle/antisociality). In addition, our results agreed with the assumption of an association between impulsivity and the subtotal for PCL-R Factor 2. The positive relationship between verbal intelligence and the subtotal for Factor 1 of the PCL-R (insincere, manipulative conduct/affective deficits) vanished after controlling for educational level. The results indicate that there is a relationship between the spatial components of intelligence and the concept of psychopathy as described by Hare. This result supports the spatial impairment aetiological model of antisocial behaviour.

Preventive Detention in Germany: An Overview and Empirical Data from Two Federal States

Eighty years ago, preventive detention for dangerous offenders was implemented in the German Penal Code (Section 66). In 2011, about 500 individuals were incarcerated under a preventive detention order in Germany. Through semi-structured clinical interviews and/or collateral file review, the present investigators assessed the sociobiographic, criminological, and clinical characteristics of 58 men for whom preventive detention had been ordered in two German federal states. In addition, risk assessment instruments were administered. The majority of the inmates were sexual offenders. The main mental health problems were antisocial personality disorder (APD), substance abuse/disorder, and paraphilias. Most individuals had a history of poor socialization. Structured clinical judgment as well as actuarial risk assessment instruments identified all inmates as high-risk offenders. Future development of preventive detention in Germany must emphasize treatment interventions. Given the life histories and the mental health problems of the detainees assessed in the present study, the implementation of effective treatment will prove difficult.