Maaike Cima

Psychopaths know right from wrong but don’t care

Adult psychopaths have deficits in emotional processing and inhibitory control, engage in morally inappropriate behavior, and generally fail to distinguish moral from conventional violations. These observations, together with a dominant tradition in the discipline which sees emotional processes as causally necessary for moral judgment, have led to the conclusion that psychopaths lack an understanding of moral rights and wrongs. We test an alternative explanation: psychopaths have normal understanding of right and wrong, but abnormal regulation of morally appropriate behavior. We presented psychopaths with moral dilemmas, contrasting their judgments with age- and sex-matched (i) healthy subjects and (ii) non-psychopathic, delinquents. Subjects in each group judged cases of personal harms (i.e. requiring physical contact) as less permissible than impersonal harms, even though both types of harms led to utilitarian gains. Importantly, however, psychopaths pattern of judgments on different dilemmas was the same as those of the other subjects. These results force a rejection of the strong hypothesis that emotional processes are causally necessary for judgments of moral dilemmas, suggesting instead that psychopaths understand the distinction between right and wrong, but do not care about such knowledge, or the consequences that ensue from their morally inappropriate behavior.

Self-reported trauma, cortisol levels, and aggression in psychopathic and non-psychopathic prison inmates

The relationship between self-reported traumatic childhood experiences, cortisol levels, aggression, and psychopathy was investigated in prison inmates (n=47) and healthy controls (n=27). Besides questionnaires, a brief salivary diurnal profile was measured. Results show that criminals (both psychopaths and non-psychopaths) demonstrate more traumatic childhood experiences than the control group. Within the group of criminals, psychopaths showed the lowest diurnal cortisol concentrations, whereas the non-psychopaths demonstrated highest daily average cortisol (DAC) scores. High levels of aggression were related to traumatic childhood experiences in non-psychopaths and control participants, but not in psychopaths. Although psychopathic offenders demonstrated low levels of cortisol, high levels of childhood traumatic experiences and high levels of aggression, cortisol was not a mediating factor between childhood traumatic experiences and aggression. Implications of the finding that psychopathic offenders displayed lower and non-psychopaths showed higher daily cortisol levels are discussed.

Assessing callous-unemotional traits across different groups of youths: Further cross-cultural validation of the Inventory of Callous-Unemotional Traits

The Inventory of Callous-Unemotional (CU) Traits (ICU) is a self-report questionnaire which was developed to measure the affective features of psychopathy in children and adolescents. Previous studies reported both support and difficulties with this promising new measure. The present study investigated the psychometric and discriminating qualities of the Dutch questionnaire across different groups by examining its structure, distribution and correlates. The ICU was administered to young clinical offenders (detained, N=127), healthy controls (community, N=172), non-clinical offenders (not detained, N=42) and an externalizing non-offender group (under treatment for behavioral problems, N=42). The age range for all groups was 13-20years. Since confirmatory factor analysis of models from earlier research did not yield an acceptable fit, exploratory factor analysis was conducted. Five factors were extracted: Lack of Conscience, Uncaring, Unemotional, Callousness and Lack of Empathy. The results indicated moderate to good test-retest stability and adequate internal consistency. CU traits correlated well with measures of conduct problems and aggression, indicating a good criterion and convergent validity. Results indicate weak associations with expert (Psychopathy Checklist: Youth Version, PCL:YV) and informant (Antisocial Process Screening Device, APSD) measures of psychopathic traits. Although groups could be differentiated on a statistical basis, no meaningful distinction based on CU traits alone was possible. Results of this study cast doubt on the validity of the current ICU. Suggestions are made for improvement.

Validation of the Dutch Reactive Proactive Questionnaire (RPQ): Differential Correlates of Reactive and Proactive Aggression From Childhood to Adulthood

This study reports reliability and validity of the Dutch Reactive-Proactive Aggression Questionnaire (RPQ). In total, 845 participants completed the RPQ along with other measures of aggression. Groups consisted of non-offender participants, criminal offenders, youngsters (age 6-18), and adults (age above 18). Test-retest stability in a subsample of 324 childhood arrestees was good (all ICCs > 0.41). A confirmatory factor analysis supported the same two-factor structure as in the original RPQ. Convergent validity was adequate (all rs > 0.16). Moreover, results demonstrated that the proactive and reactive subscales were differentially related to measurements of callousness and impulsiveness, respectively. Criterion validity was shown in that non-offender subjects demonstrated significantly lower RPQ scores than offender samples. Finally, construct validity was demonstrated in that violent offenders showed higher aggression scores than non-violent offenders. Proactive aggression showed different developmental trajectories within non-offender versus criminal samples, indicating that this form of aggression may be more pathological.

Effects of induced anger in patients with antisocial personality disorder

BACKGROUNDnAnger is the main deregulated emotion in patients with antisocial personality disorder (ASPD). The aim of this study was to examine emotional, cognitive and physiological correlates of anger and compare these between ASPD patients with varying degree of psychopathy (PP) and control groups.nnnMETHODnAssessment of the effect of anger induction on self-reported emotions and schema modes, psychophysiology and implicit reaction-time tasks measuring self-anger and aggressor-swearword associations. Participants (n=147) were patients with DSM-IV antisocial (n=21), borderline (n=45) and cluster C personality disorder (n=46) and non-patient controls (n=35).nnnRESULTSnGroups did not differ in self-reported anger. ASPD patients displayed a decrease in heart rate and systolic blood pressure (SBP) and stronger implicit self-anger associations. ASPD patients scoring low on affective PP reported less negative emotions and displayed a greater decrease in diastolic blood pressure (DBP).nnnCONCLUSIONSnASPD patients did not display a deviant self-reported anger but physiological hyporesponsivity and cognitive hyper-responsivity. This ASPD anger response might reflect a controlled predatory-like fight preparation.

The relationship between adult reactive and proactive aggression, hostile interpretation bias, and antisocial personality disorder

Reactive aggression (RA) refers to angry responses to provocation or frustration, while proactive aggression (PA) denotes nonemotional, instrumental, and unprovoked aggression. The current study examined personality-related and cognitive correlates of both aggressive types. Respectively, the predictive values of antisocial personality disorder (ASPD), and of hostile interpretation bias, which is the tendency to interpret ambiguous stimuli in a hostile manner, were studied. The sample consisted of n = 37 male adult patients with mixed diagnoses and n = 29 male nonpatients that responded to vignettes and pictures of ambiguous situations, using both open and closed answer formats. ASPD was assessed by means of the Structured Clinical Interview for DSM-IV Axis II disorders (SCID-II), and the Reactive Proactive Questionnaire (RPQ) measured RA and PA. Results showed that although both RA and PA types were predicted by ASPD traits, RA was additionally predicted by a hostile interpretation bias. These findings suggest that reducing hostile bias is a promising avenue for clinical treatment of ASPD-patients high in RA.

Review of Risk Assessment Instruments for Juvenile Sex Offenders What is Next

Risk assessment is considered to be a key element in the prevention of recidivism among juvenile sex offenders (JSOs), often by imposing long-term consequences based on that assessment. The authors reviewed the literature on the predictive accuracy of six well-known risk assessment instruments used to appraise risk among JSOs: the Juvenile Sex Offender Assessment Protocol-II (J-SOAP-II), Juvenile Sexual Offence Recidivism Risk Assessment Tool-II (J-SORRAT-II), Estimate of Risk of Adolescent Sexual Offence Recidivism (ERASOR), Juvenile Risk Assessment Scale (JRAS), Structured Assessment of Violent Risk in Youth (SAVRY), and Hare Psychopathy Checklist:Youth Version (PCL:YV). Through a systematic search, 19 studies were reviewed. Studies showed differences in the predictive accuracies for general, violent, and sexual recidivism, and none of the instruments showed unequivocal positive results in predicting future offending. Not unexpectedly, the accuracy of the SAVRY and PCL:YV appeared to be weaker for sexual recidivism compared with specialized tools such as the J-SOAP-II or the ERASOR. Because of the rapid development of juveniles, it is questionable to impose long-term restrictions based on a risk assessment only. New challenges in improving risk assessment are discussed.

Youth psychopathy: Differential correlates of callous-unemotional traits, narcissism, and impulsivity

Research supports the validity of the dimensional approach to psychopathy in both children and adults. The occurrence of severe aggressive and antisocial behavior in combination with callous-unemotional traits (CU traits) designates a group of children that is particularly at risk to develop psychopathy. However, most studies did not investigate the role of the remaining psychopathy dimensions (i.e. narcissism and impulsivity) in comparison. The present text reviews the newest developments in the dimensional study of psychopathy in relation to cognition, behavior and affect in clinical and detained child and adolescent samples. Findings support the role of the callous-unemotional dimension (CU traits) in the development of psychopathy. Additionally, they also underscore the importance of the narcissistic and impulsive dimensions for the understanding of psychopathy in children and adolescents and for the identification of different psychopathy profiles. Understanding differential correlates of the underlying dimensions of psychopathy is an important step in formulating interventions for those most at risk.

Did I say that word or did you? Executive dysfunctions in schizophrenic patients affect memory efficiency, but not source attributions.

Introduction. Schizophrenic patients have difficulties in recognising previously presented verbal information and identifying its sources. The antecedents of these recognition and source misattributions are, however, largely unknown. The current study examined to what extent schizophrenic patients’ lack of memory efficiency, their memory errors, and their source misattributions are related to neurocognitive deficits (i.e., executive dysfunctions). Methods. 23 schizophrenic patients and 20 healthy controls were administered an adapted version of the Deese/Roediger-McDermott (DRM) task from which parameters of memory efficiency, memory errors, source misattributions, and two-high threshold measures were derived. Furthermore, two neurocognitive tasks tapping executive functions were administered: the Wisconsin Card Sorting Test (WCST) and the Behavioural Assessment of the Dysexecutive Syndrome (BADS). Using multiple linear regression analyses, we examined whether these neurocognitive measures predicted various memory parameters. Results. Patients with schizophrenia showed poorer memory efficiency and were more prone to make internal-external source misattributions with high confidence. However, they did not more often falsely recognise critical lure words than controls. Executive dysfunctions predicted memory efficiency, but not source misattribution performance. Conclusion. Our findings provide further evidence that schizophrenic patients’ memory impairments are intimately related to fundamental neurocognitive deficits.

Differential Associations Between Psychopathy Dimensions, Types of Aggression, and Response Inhibition

Findings on executive functioning in psychopathy are inconsistent. Different associations between psychopathy dimensions and executive functioning might explain contradicting findings. This study examined the role of psychopathy dimensions and types of aggression in response inhibition among 117 male adolescents (53 antisocial delinquents and 64 controls). Participants completed a self-report measure of aggression and a GoNoGo task. Psychopathy dimensions were assessed using the Psychopathy Checklist: Youth Version. Although high scores on the antisocial dimension and reactive aggression were associated with poor response inhibition, the affective-interpersonal dimension, proactive aggression, and verbal intelligence (IQ) were related to better response inhibition (two-factor model). Associations with the affective-interpersonal dimensions did not reach significance. Exploratory analyses showed that affective and antisocial facets accounted for the obtained opposing associations of the affective-interpersonal and antisocial psychopathy dimensions with response inhibition. The interpersonal and lifestyle facets (four-facet model) were unrelated to response inhibition. Results could not be explained by Attention Deficit Hyperactivity Disorder (ADHD). Findings suggest differential associations between the psychopathy dimensions, types of aggression, and response inhibition. Therefore, a dimensional approach to psychopathy and related concepts, such as aggression, might strongly improve diagnostic procedures. Global scores could mask important differential associations.