Investigation of the hostile attribution bias toward ambiguous facial cues in antisocial violent offenders

Large-scale meta-analyses and network analyses of neural substrates underlying human escalated aggression

Escalated aggression represents a frequent and severe form of violence, sometimes manifesting as antisocial behavior. Driven by the pressures of modern life, escalated aggression is of particular concern due to its rising prevalence and its destructive impact on both individual well-being and socioeconomic stability. However, a consistent neural circuitry underpinning it remains to be definitively identified. Here, we addressed this issue by comparing brain alterations between individuals with escalated aggression and those without such behavioral manifestations. We first conducted a meta-analysis to synthesize previous neuroimaging studies on functional and structural alterations of escalated aggression (325 experiments, 2997 foci, 16,529 subjects). Following-up network and functional decoding analyses were conducted to provide quantitative characterizations of the identified brain regions. Our results revealed that brain regions constantly involved in escalated aggression were localized in the subcortical network (amygdala and lateral orbitofrontal cortex) associated with emotion processing, the default mode network (dorsal medial prefrontal cortex and middle temporal gyrus) associated with mentalizing, and the salience network (anterior cingulate cortex and anterior insula) associated with cognitive control. These findings were further supported by additional meta-analyses on emotion processing, mentalizing, and cognitive control, all of which showed conjunction with the brain regions identified in the escalated aggression. Together, these findings advance the understanding of the risk biomarkers of escalated aggressive populations and refine theoretical models of human aggression.

Perception of emotional facial expressions in aggression and psychopathy

BACKGROUND

Altered affective state recognition is assumed to be a root cause of aggressive behavior, a hallmark of psychopathologies such as psychopathy and antisocial personality disorder. However, the two most influential models make markedly different predictions regarding the underlying mechanism. According to the integrated emotion system theory (IES), aggression reflects impaired processing of social distress cues such as fearful faces. In contrast, the hostile attribution bias (HAB) model explains aggression with a bias to interpret ambiguous expressions as angry.

METHODS

In a set of four experiments, we measured processing of fearful and angry facial expressions (compared to neutral and other expressions) in a sample of 65 male imprisoned violent offenders rated using the Hare Psychopathy Checklist-Revised (PCL-R, Hare, R. D. (1991). The psychopathy checklist-revised. Toronto, ON: Multi-Health Systems) and in 60 age-matched control participants.

RESULTS

There was no evidence for a fear deficit in violent offenders or for an association of psychopathy or aggression with impaired processing of fearful faces. Similarly, there was no evidence for a perceptual bias for angry faces linked to psychopathy or aggression. However, using highly ambiguous stimuli and requiring explicit labeling of emotions, violent offenders showed a categorization bias for anger and this anger bias correlated with self-reported trait aggression (but not with psychopathy).

CONCLUSIONS

These results add to a growing literature casting doubt on the notion that fear processing is impaired in aggressive individuals and in psychopathy and provide support for the idea that aggression is related to a hostile attribution bias that emerges from later cognitive, post-perceptual processing stages.

Network analysis of trait aggression among community youths and juvenile offenders

OBJECTIVE

The mainstream view in trait aggression research has regarded the structure as representing the latent cause of the cognitions, emotions, and behaviors that supposedly reflect its nature. Under network perspective, trait aggression is not a latent cause of its features but a dynamic system of interacting elements. The current study uses network theory to explain the structure of relationships between trait aggression features in juvenile offenders and their peers.

METHODS

Network analysis was applied to investigate the dynamic system of trait aggression operationalized by the Buss-Perry Aggression Questionnaire in a sample of community youths (Mage = 17.46, N = 715) and juvenile offenders (Mage = 18.36, N = 834).

RESULTS

The facet level networks showed that anger is a particularly effective mechanism for activating all other traits. In addition, anger was more strongly associated with physical aggression and the overall network strength was greater in juvenile delinquency networks than in their peers. The item level networks revealed that A4 and A6 exhibited the highest predictability and strength centrality in both samples. Also, the Bayesian network indicated that these two items were positioned at the highest level in the model. There are similarities and differences between juvenile delinquents and community adolescents in trait aggression.

CONCLUSION

Trait aggression was primarily activated by difficulty controlling one's temper and feeling like a powder keg.

Perception and memory-based representations of facial emotions: Associations with personality functioning, affective states and recognition abilities

Personality traits and affective states are associated with biases in facial emotion perception. However, the precise personality impairments and affective states that underlie these biases remain largely unknown. To investigate how relevant factors influence facial emotion perception and recollection, Experiment 1 employed an image reconstruction approach in which community-dwelling adults (N = 89) rated the similarity of pairs of facial expressions, including those recalled from memory. Subsequently, perception- and memory-based expression representations derived from such ratings were assessed across participants and related to measures of personality impairment, state affect, and visual recognition abilities. Impairment in self-direction and level of positive affect accounted for the largest components of individual variability in perception and memory representations, respectively. Additionally, individual differences in these representations were impacted by face recognition ability. In Experiment 2, adult participants (N = 81) rated facial image reconstructions derived in Experiment 1, revealing that individual variability was associated with specific visual face properties, such as expressiveness, representation accuracy, and positivity/negativity. These findings highlight and clarify the influence of personality, affective state, and recognition abilities on individual differences in the perception and recollection of facial expressions.

The impact of patients' hostile attribution bias on aggression in doctor-patient interactions

Background

Doctor-patient conflict is trending in social attention research. However, the existing literature rarely explores whether a patient's hostile attribution bias (HAB) in the doctor-patient interaction affects the aggression level against doctors.

Objective

This study aimed to explore the relationship and mechanism between different types of HAB and aggression in patients.

Method

In Study 1, 80 patients completed the word sentence association paradigm for hostility (WSAP-Hostility), and their explicit and implicit aggression levels were measured using the hot sauce paradigm and the single-category implicit association test (SC-IAT), respectively. In Study 2, 63 patients were randomly divided into an experimental (rejection) and a control group. Their state hostile attribution bias (SHAB) was activated through social rejection materials. They completed the SHAB questionnaire and anger expression inventory, and their explicit and implicit aggression levels were measured as in Study 1.

Results

In both studies, results indicated that patients' trait and state HAB were significantly related to explicit aggression but not implicit aggression. Hostile interpretation positively predicted explicit aggression, whereas benign interpretation had a negative predictive effect on explicit aggression. Patients' anger played a mediating role between SHAB and explicit aggression.

Conclusions

These findings suggest that patients' HAB affects explicit aggression toward doctors and anger plays a mediating role.

Aggressive and psychopathic traits are linked to the acquisition of stable but imprecise hostile expectations

Individuals with hostile expectations (HEX) anticipate harm from seemingly neutral or ambiguous stimuli. However, it is unclear how HEX are acquired, and whether specific components of HEX learning can predict antisocial thought, conduct, and personality. In an online sample of healthy young individuals (n = 256, 69% women), we administered a virtual shooting task and applied computational modelling of behaviour to investigate HEX learning and its constellation of correlates. HEX acquisition was best explained by a hierarchical reinforcement learning mechanism. Crucially, we found that individuals with relatively higher self-reported aggressiveness and psychopathy developed stronger and less accurate hostile beliefs as well as larger prediction errors. Moreover, aggressive and psychopathic traits were associated with more temporally stable hostility representations. Our study thus shows that aggressiveness and psychopathy are linked with the acquisition of robust yet imprecise hostile beliefs through reinforcement learning.

Pathways to antisocial behavior: a framework to improve diagnostics and tailor therapeutic interventions

The Antisocial Personality Disorder (ASPD), and antisocial behavior (ASB) in general, is associated with significant impact on individuals themselves, their environment, and society. Although various interventions show promising results, no evidence-based treatments are available for individuals with ASPD. Therefore, making informed choices about which treatment can be applied to an individual patient is complicated. Furthermore, contradictory findings on therapy effectiveness and underlying factors of ASB, such as cognitive impairments and personality traits, fuel the debate whether the conceptualization of ASPD in the DSM-5 is accurate and whether this population can be seen as homogeneous. A conceptual framework, based on the reciprocal altruism theory, is presented in which we propose different pathways to ASB. These pathways suggest underlying dynamics of ASB and provide an explanation for previous contradictory research outcomes. This framework is intended to serve as a clinically relevant model that provides directions for improving diagnostics and matching treatments to underlying dynamics in the antisocial population.

The Eyes Have It: Psychotherapy in the Era of Masks

Nonverbal communication is integral to the success of psychotherapy and facial expression is an important component of nonverbal communication. The SARS CoV-2 pandemic has caused alterations in how psychotherapy services are provided. In this paper, potential issues that may arise from conducting psychotherapy when both the patient and therapist are wearing masks are explored. These include higher likelihood of misidentifying facial expression, especially when expression is incongruent with body language, and when the lower face is more important for correct identification of emotion. These issues may be particularly problematic for patient populations for whom emotion recognition may be a problem at baseline, or for those more prone to biases in emotional recognition. Suggestions are made for therapists to consider when seeing patients in-person when masks are necessary.

Hostility bias or sadness bias in excluded individuals: does anodal transcranial direct current stimulation of right VLPFC vs. left DLPFC have a mitigating effect?

Exclusion has multiple adverse effects on individual's well-being. It induces anger and hostile cognitions leading to aggressive behavior. The purpose of this study was to test whether exclusion would affect recognition of anger on ambivalent faces of the excluders. We hypothesized that exclusion would elicit more anger encoding (hostility bias) than inclusion, but this effect would be mitigated by anodal tDCS of right VLPFC or left DLPFC-regions engaged in negative affect regulation. Participants (N = 96) were recognizing emotions (anger, sadness, happiness) on ambiguous faces of individuals who-as they were told-liked them or not. Results showed that exclusion induced more sadness bias. tDCS to VLPFC decreased anger and increased sadness recognition on excluders' faces compared with includers' faces, expressing a mixture of these two emotions. Additionally, stimulation to VLPFC and DLPFC decreased latencies for faces expressing sadness (sad-angry and happy-sad) but increased for happy-angry faces. Stimulation to VLPFC also increased reaction time to excluders faces while stimulation of DLPFC decreased reaction latency to includers faces. Results were discussed with the reference to the form of exclusion, motivational mechanism affected by disliking but also to lateralization (valence vs. arousal theory) and cortical regions engaged in encoding sadness after a threat to belonging.

Sex Differences in Inmates: Anger, Sensitivity to Provocation and Family History of Imprisonment

Little research has explored the role of aggression, anger, and family history of incarceration as they relate to female offenders. The current study aimed to address this gap in the literature by investigating these possible risk factors for incarceration among both men and women. The survey involved 123 (61 female and 62 male) prisoners convicted for violent crimes and a comparison group of 118 (60 female and 58 male) adults from the community. We found that women (convicted and non-convicted) were more sensitive to provocation than men, while community adults showed higher levels of trait anger than prisoners. Detainees were more likely than community adults to have a relative in prison. Although male and female inmates were equally likely to have a relative in prison, they differed in their relation to the imprisoned relative. Male and female prisoners showed increased risk for incarceration of same sex, first degree relatives (father and brothers for men, and mothers for women). These results may contribute to improved understanding of incarcerated populations. As such, this represents a critical first step in creating recovery programs that are more gender appropriate.

Facial Emotion Perceptual Tendency in Violent and Non-violent Offenders

All three authors share equal authorship in this paper.Emotion perception has a vital influence on social interaction. Previous studies discussed mainly the relationship between facial emotion perception and aggressive behavior from the perspective of hostile attributional bias and the impaired violence inhibition mechanism. The present study aims to provide new evidence of different emotion perception patterns between the violent and non-violent criminal samples through a new indicator of the facial emotion recognition test, Facial Emotion Perception Tendency (FEPT), calculated by counting the times a participant recognizes a set of emotional stimuli as a particular specific emotion, and to further examine the association between aggressive behaviors and FEPT. 101 violent and 171 non-violent offenders, as well as 81 non-offending control participants, were recruited to complete the emotion recognition task with morphed stimuli (Study 1). We further recruited 62 non-offending healthy male participants to finish the Buss -Perry Aggression Questionnaire (BPAQ) after the emotion recognition task in Study 2. Both non-violent and violent offenders were significantly lower in overall accuracy of emotion recognition and disgust FEPT, but higher in happy FEPT, than non-offending healthy controls. Non-violent offenders had significantly lower fear FEPT than violent offenders, and had higher anger FEPT than non-offending controls. The results also revealed that the level of physical aggression was positively correlated with fear FEPT, while negatively correlated with anger FEPT. The current study demonstrated that FEPT was associated with aggressive behavior and implies the importance of improving the emotion decoding ability of offenders. Also, the concept "FEPT" proposed in this study is of significance for further exploration of how individuals' tendency to perceiving a particular emotion can be correlated with social behaviors.

Monitoring the emotional facial reactions of individuals with antisocial personality disorder during the retrieval of self-defining memories

While a deficit in the recognition of facial expression has been demonstrated in persons with antisocial personality disorder (ASPD), few studies have investigated how individuals with ASPD produce their own emotional facial expressions. This study examines the production of facial emotional expressions of male inpatients with ASPD in a forensic hospital compared with a control group as they retrieve autobiographical memories. This design constitutes a specific ecological experimental approach fostering the evocation of personal feelings. Two indicators characterizing the activation of facial expression were used: activation of emotional action units and emotional dominance. The results showed that individuals with ASPD 1) activated angrier facial expressions than control participants for both indicators, 2) displayed a higher dominance of angry facial expressions during the retrieval of positive self-defining memories than control participants and 3) recalled significant memories that were less associated with neutral facial states than the control sample, regardless of the valence of their memories. These findings highlight the core role of anger in ASPD and the possible development of pathological anger, which would distinguish trajectories toward anxious or mood disorders and trajectories characterized by external disorders.

Non-invasive neuromodulation can reduce aggressive behaviors in humans: A critical perspective

Containing aggressive behavior is an ongoing challenge in modern society. Aggressiveness is a multi-level construct that can be driven by emotions (reactive aggression) or can be "cold-blooded" and goal-directed (proactive). Aggressive behavior could arise because of a misjudgment of others' intentions or can follow frontal brain lesions leading to a reduction of impulse control and emotion regulation. In the last few years, interventional and basic research studies adopting Non-Invasive Brain Stimulation (NIBS) have significantly risen. Those techniques have been used both in healthy people, to better understand the role of certain brain regions in psychological processes, and in aggressive subjects to improve their symptoms. From an overview of the literature, focusing on the paper that uses transcranial direct current stimulation (tDCS) to reduce aggressiveness, it emerges that tDCS can (i) enhance facial emotion expression recognition, (ii) improve impulses control, and (iii) affect approach/withdrawal motivation. The current work shows the strengths and weaknesses of tDCS intervention on aggressive individuals, suggesting that this instrument could be adopted on violent people, and paves the way for intervention in some applied settings such as prison.

A Single-Session Combined Cognitive Bias Modification Training Targeting Attention and Interpretation Biases in Aggression

Experimental studies applying cognitive bias modification of attention (CBM-A) and interpretation (CBM-I) to reduce aggression have examined the effect of modifying each cognitive bias in isolation. In order to maximise the potential impact on both biases and symptom reduction, we examined whether a combined bias training procedure targeting both attention and interpretation biases (CBM-AI) in combination would be more effective than targeting interpretation bias (CBM-I) alone. University students (17–35 years) were randomly assigned to either a single session of CBM-AI training (n = 40), CBM-I training (n = 40), or a control condition (n = 40). Contrary to our expectations, participants showed an increase in adaptive attention and pro-social interpretation bias in all training conditions. Additionally, in none of the conditions, we found a significant change on self-reported or behavioural aggression. These findings suggest: (1) that the combined training did not have added effect over single interpretation bias training, (2) that training interpretation bias may lead to changes in attention bias, (3) that elements of the control condition unexpectedly, but interestingly, also affected attention and interpretation biases, and (4) single-session CBM procedures do not produce robust effects on self-report or behavioural measures of aggression in unselected samples.

Cognitive Empathy in Subtypes of Antisocial Individuals

Cognitive empathy allows individuals to recognize and infer how others think and feel in social situations and provides a foundation for the formation and maintenance of mutually constructive relationships. It may seem intuitive to assume that individuals who engage in antisocial behavior, who disregard the rights of others, might have problems with cognitive empathy. However, careful examination of the literature suggests that any dysfunction in cognitive empathy associated with antisociality varies by subtype of antisocial individual and is specific to subcomponents of cognitive empathy. In this review, we (1) briefly define subtypes of antisocial individuals ("psychopathic" vs. "antisocial-only"), (2) summarize specific components of cognitive empathy; (3) review existing literature examining cognitive empathy through questionnaires, behavioral tasks, and neuroimaging within different antisocial subtypes; and (4) discuss the limitations of the current research and potential future directions. Individuals in the psychopathic subtype fail to implicitly engage in cognitive empathy, and potentially lack insight into this issue reflected in no self-reported problems with cognitive empathy, but show an ability to engage in cognitive empathy when explicitly required. Individuals in the antisocial-only subtype appear able to engage in cognitive empathy, showing no differences on questionnaire or behavioral tasks that tap explicit cognitive empathy, but may display subtle difficulties accurately inferring (affective theory of mind) the emotions of others. We end the review by noting areas for future research, including the need to: (1) document the patterns of equifinality that exist across levels of analysis for these antisocial subtypes; (2) examine the temporality of empathy and antisociality development; (3) carefully consider and label subcomponents of cognitive empathy in research on antisocial behavior; and (4) investigate the intersection among environmental experiences, cognitive empathy, and antisocial behavior.

Attention orienting to the eyes in violent female and male offenders: An eye-tracking study

Attention to the eyes and eye contact form an important basis for the development of empathy and social competences including prosocial behavior. Thus, impairments in attention to the eyes of an interaction partner might play a role in the etiology of antisocial behavior and violence. For the first time, the present study extends investigations of eye gaze to a large sample (N = 173) including not only male but also female violent offenders and a control group. We assessed viewing patterns during the categorization of emotional faces via eye tracking. Our results indicate a reduced frequency of initial attention shifts to the eyes in female and male offenders compared to controls, while there were no general group differences in overall attention to the eye region (i.e., relative dwell time). Thus, we conclude that violent offenders might be able to compensate for deficits in spontaneous attention orienting during later stages of information processing.

Aggression differentially modulates neural correlates of social intention attribution to benevolent, tickling and taunting laughter: An fMRI study in children and adolescents

Human laughter is a powerful means of communicating social intention, ranging from welcoming and friendly to hostile and ridiculing. To be communicated accurately, the recipient must correctly identify the laugher's underlying social intention. Regular misattribution of the social intention of others has been associated with maladaptive psychosocial development, in particular with aggressive behavior. We investigated the relationship between self-reported aggressive behavior and the neural correlates of social intention attributions to different audiovisual laughter types in 50 healthy children and adolescents (29 female, 10-18 years, M 15.5, SD 2.2) using functional magnetic resonance imaging. Trial-by-trial associations of neural response and behavioral attributions were distinctly modulated by aggression for benevolent versus taunting and tickling laughter. With increasing aggression, hostile misattributions of benevolent laughter were associated with decreased dorsolateral prefrontal and anterior insular cortex activation. In contrast, hostile attributions of taunting and tickling laughter were associated with increased superior frontal, superior temporal, medial prefrontal, supplementary motor, and anterior and mid-cingulate cortex activation. We argue that aggression may be associated with down-regulated emotional saliency of benevolent laughter, whereas up-regulated neural responses to taunting laughter may underlie a heightened sensitivity to hostility or acceptance of taunting behavior in more aggressive individuals.

Women With Borderline Personality Disorder Show Reduced Identification of Emotional Facial Expressions and a Heightened Negativity Bias

Individuals with borderline personality disorder (BPD) frequently display impairments in the identification of emotional facial expressions paralleled by a negativity bias. However, it remains unclear whether misperception of facial expressions is a key psychopathological marker of BPD. To address this question, the authors examined 43 women diagnosed with BPD and 56 healthy female controls using an emotion face identification task and a face dot-probe task together with measures on psychopathology. Compared to controls, women with BPD showed impaired identification of disgusted and angry faces concurrent with a bias to misclassify faces as angry, and a faster preconscious vigilance for fearful relative to happy facial expressions. Increased severity of borderline symptoms and global psychopathology in BPD patients were associated with reduced ability to identify angry facial expressions and a stronger negativity bias to anger. The findings indicate that BPD patients who misperceive face emotions have the greatest mental health issues.

Aggressive Realism: More Efficient Processing of Anger in Physically Aggressive Individuals

Physically aggressive individuals' heightened tendency to decide that ambiguous faces are angry is thought to contribute to their destructive interpersonal behavior. Although this tendency is commonly attributed to bias, other cognitive processes could account for the emotion-identification patterns observed in physical aggression. Diffusion modeling is a valuable tool for parsing the contributions of several cognitive processes known to influence decision-making, including bias, drift rate (efficiency of information accumulation), and threshold separation (extent of information accumulation). In a sample of 90 incarcerated men, we applied diffusion modeling to an emotion-identification task. Physical aggression was positively associated with drift rate (i.e., more efficient information accumulation) for anger, and drift rate mediated the association between physical aggression and heightened anger identification. Physical aggression was not, however, associated with bias or threshold separation. These findings implicate processing efficiency for anger-related information as a potential mechanism driving aberrant emotion identification in physical aggression.

Neural activity during the viewing of emotional pictures in veterans with pathological anger and aggression

Anger and aggression are common mental health problems after military deployment. Anger and aggression have been associated with abnormalities in subcortical and cortical levels of the brain and their connectivity. Here, we tested brain activation during the processing of emotional stimuli in military veterans with and without anger and aggression problems. Thirty military veterans with anger and aggression problems and 29 veterans without a psychiatric diagnosis (all males) participated in this study. During an fMRI scan 32 negative, 32 positive and 32 neutral pictures from the International Affective Picture System were presented in intermixed order. The Aggression group showed heightened activity in brain areas including the supplementary motor area, the cingulum and the parietal cortex, in response to stimuli, regardless of category. Furthermore, the Aggression group showed stronger connectivity between the dorsal anterior cingulate cortex (dACC) and the amygdala during the viewing of negative stimuli, and weaker connectivity between dACC and medial prefrontal cortex during the viewing of positive stimuli. Veterans with anger and aggression problems showed enhanced brain response to all stimuli during the task, irrespective of valence and they rated the pictures more likely as negative. We take this to indicate enhanced preparation for action and attention to the presentation of stimuli that could prove to be threatening. Further, group differences in functional connectivity involving the dACC reveal abnormal processing of stimuli with negative and positive valence. In sum, the results point towards a bias towards an enhanced sensitivity to perceived or potential threat in aggression.

Interpretation of ambiguous facial affect in adults with attention-deficit/hyperactivity disorder

In addition to impairments in cognitive functioning, attention-deficit/hyperactivity disorder (ADHD) is associated with deficits in interpersonal functioning as well which are assumed to stem from a distorted perception or interpretation of affective information. While previous research suggests that the decoding of negatively valenced facial stimuli is impaired, less is known about the potential interpretation biases in ADHD which are linked to other externalizing psychopathologies. The present study investigated interpretation biases in adults with ADHD (N = 65) and controls (N = 49) using ambiguous facial stimuli (angry/happy, angry/fearful, fearful/happy blends) with different proportions of each emotion. Participants indicated the dominant emotion and rated the perceived intensity of each image. While impaired processing of fearful expressions was evident in the ADHD group, the results of the current study do not provide support for an interpretation bias in adults with ADHD. These findings suggest that interpretation biases may be restricted to aggressive psychopathology and cannot be generalized to individuals with ADHD.

Recognition of Facial Emotion and Affective Prosody in Children at High Risk of Criminal Behavior

OBJECTIVE

Emotion recognition is an important aspect of emotion processing, which is needed for appropriate social behavior and normal socialization. Previous studies in adults with antisocial personality disorder or psychopathy, in those convicted of criminal behavior, or in children with conduct disorder show impairments in negative emotion recognition. The present study investigated affective facial and prosody recognition in a sample of children at high risk of developing future criminal behavior.

METHODS

Participants were 8- to 12-year-old children at high risk of developing criminal behavior (N=219, 83.1% boys) and typically developing controls (N=43, 72.1% boys). The high-risk children were recruited through an ongoing early intervention project of the city of Amsterdam, that focuses on the underage siblings or children of delinquents, and those failing to attend school. Facial and vocal recognition of happy, sad, angry, and fear was measured with the Facial Emotion Recognition (FER) test and the prosody test of the Amsterdam Neuropsychological Tasks (ANT), respectively.

RESULTS

The high-risk group was significantly worse in facial affect recognition and had particular problems with fear and sadness recognition. No hostile attribution bias was found. The high-risk group did not differ from controls in affective prosody recognition but needed significantly more time to recognize emotions.

CONCLUSIONS

The emotion-specific deficits found in forensic and clinical populations are already present in a sample of children at high risk of developing future criminal behavior. These findings help us understand a possible underlying mechanism of antisocial behavior that could provide directions for tailored interventions. (JINS, 2019, 25, 57-64).

It is Written in Your Eyes: Hostile Attributions and Self-Directed Gaze Perception in Incarcerated Violent Adolescent Male Offenders

To date, we have frugal knowledge about the hostile attribution bias (HAB) and the biased gaze perception in violent adolescent offenders. This however is a major contributing factor in understanding delinquent behavior. Using a computer-based approach, presenting faces modulated in gaze direction (0°, 2°, 4°, 6°, 8°) and valence (angry, fearful, happy, neutral), the present study examined the impact of HAB of the feeling of being stared at in a sample of 27 adolescent offenders (aged 17-24 years). The study was conducted institution-intern in the Department for Social Therapy of a German correctional facility. Results showed that in comparison with faces with negative expressions, happy faces were more likely to be perceived as self-directed. Interestingly, emotion showed significant influence of the gaze perception in only two viewing angles (2° and 6°), revealing the role of the facial expression in highly ambiguous conditions. Furthermore, hostility did not modulate the relationship between the self-referential gaze perception and (negative) facial expression. Possible frameworks and limitations of the study are discussed.

Associations Between Neurocognitive Characteristics, Treatment Outcome, and Dropout Among Aggressive Forensic Psychiatric Outpatients

Aggression Replacement Training (ART) is widely used to reduce aggression and is considered to be effective although there are also inconsistent results. Studies investigating the effectiveness of ART do not focus on neurocognitive characteristics. Focusing on these aspects would result in enhanced understanding of underlying mechanisms of ART. The current open uncontrolled treatment study assessed whether neurocognitive characteristics were associated with change in aggression during the social skills and anger control modules of ART among forensic psychiatric outpatients. Furthermore, differences between treatment dropouts and completers and change in these characteristics during ART were examined. A reduction of trait aggression, cognitive distortions, and social anxiety was observed. Neurocognitive characteristics were not associated with change in aggression, could not distinguish treatment completers from dropouts, and did not change after ART. It is suggested that new paradigms should be developed which take into account the social context in which these impairments appear.

Correlates of Aggression in Personality Disorders: an Update

PURPOSE OF REVIEW

This review article aims at giving an update on studies investigating correlates of aggression in personality disorders during the last 5 years.

RECENT FINDINGS

Most data refer to borderline personality disorder (BPD) and antisocial personality disorder (ASPD). In BPD, emotion dysregulation, hypersensitivity to interpersonal rejection/threat, increased rumination, increased negative urgency, aggression-related knowledge structures, and invalidation were either corroborated or emerged as psychological correlates of aggression, while reduced ambiguity sensitivity, hyposensitivity to interpersonal threat, and reduced mindfulness were associated with aggression in ASPD. Neurobiologically, alterations of the monoaminooxidase-A-, the oxytocinergic-, and the prefrontal-limbic-system as well as increases of the thyroid hormone T3, γ-aminobutyric acid and several inflammatory markers were associated with increased aggression across various personality disorders. Our understanding of correlates of aggression in personality disorders has increased over the last 5 years. More efforts in improving the conceptualization of personality disorders and aggression are needed to develop innovative treatments for those affected.

Categorical perception of facial expressions in individuals with non-clinical social anxiety

BACKGROUND AND OBJECTIVES

According to the well-established categorical perception (CP) of facial expressions, we decode complicated expression signals into simplified categories to facilitate expression processing. Expression processing deficits have been widely described in social anxiety (SA), but it remains to be investigated whether CP of expressions are affected by SA. The present study examined whether individuals with SA had an interpretation bias when processing ambiguous expressions and whether the sensitivity of their CP was affected by their SA.

METHODS

Sixty-four participants (high SA, 30; low SA, 34) were selected from 658 undergraduates using the Interaction Anxiousness Scale (IAS). With the CP paradigm, specifically with the analysis method of the logistic function model, we derived the categorical boundaries (reflecting interpretation bias) and slopes (reflecting sensitivity of CP) of both high- and low-SA groups while recognizing angry-fearful, happy-angry, and happy-fearful expression continua.

RESULTS

Based on a comparison of the categorical boundaries and slopes between the high- and low-SA groups, the results showed that the categorical boundaries between the two groups were not different for any of the three continua, which means that the SA does not affect the interpretation bias for any of the three continua. The slopes for the high-SA group were flatter than those for the low-SA group for both the angry-fearful and happy-angry continua, indicating that the high-SA group is insensitive to the subtle changes that occur from angry to fearful faces and from happy to angry faces.

LIMITATIONS

Since participants were selected from a sample of undergraduates based on their IAS scores, the results cannot be directly generalized to individuals with clinical SA disorder.

CONCLUSIONS

The study indicates that SA does not affect interpretation biases in the processing of anger, fear, and happiness, but does modulate the sensitivity of individuals' CP when anger appears. High-SA individuals perceive angry expressions in a less categorical manner than the low-SA group, but no such difference was found in the perception of happy or fearful expressions.

Personality dimensions emerging during adolescence and young adulthood are underpinned by a single latent trait indexing impairment in social functioning

BACKGROUND

Personality with stable behavioural traits emerges in the adolescent and young adult years. Models of putatively distinct, but correlated, personality traits have been developed to describe behavioural styles including schizotypal, narcissistic, callous-unemotional, negative emotionality, antisocial and impulsivity traits. These traits have influenced the classification of their related personality disorders. We tested if a bifactor model fits the data better than correlated-factor and orthogonal-factor models and subsequently validated the obtained factors with mental health measures and treatment history.

METHOD

A set of self-report questionnaires measuring the above traits together with measures of mental health and service use were collected from a volunteer community sample of adolescents and young adults aged 14 to 25 years (N = 2443).

RESULTS

The bifactor model with one general and four specific factors emerged in exploratory analysis, which fit data better than models with correlated or orthogonal factors. The general factor showed high reliability and validity.

CONCLUSIONS

The findings suggest that a selected range of putatively distinct personality traits is underpinned by a general latent personality trait that may be interpreted as a severity factor, with higher scores indexing more impairment in social functioning. The results are in line with ICD-11, which suggest an explicit link between personality disorders and compromised interpersonal or social function. The obtained general factor was akin to the overarching dimension of personality functioning (describing one's relation to the self and others) proposed by DSM-5 Section III.

Recommendations for applying a multi-dimensional model of impulsive personality to diagnosis and treatment

The UPPS-P Model of Impulsive Personality, a prominent model of impulsive personality derived from the Five Factor Model of Personality, is a multi-dimensional model of impulsive personality that consists of negative urgency, lack of premeditation, lack of perseveration, sensation seeking, and positive urgency. The UPPS-P model has highlighted the importance of separating multidimensional traits due to the specificity of these traits corresponding to different risk behaviors. The goal of the current review paper is to make recommendations on how to apply the UPPS-P Model of Impulsive Personality, to diagnosis of and treatment for psychopathology. However, despite impulsivity being one of the most frequently used criteria for a number of clinical disorders, our review of the Diagnostic and Statistical Manual for Mental Disorders-5 found that the UPPS-P traits are not well represented in the diagnostic criteria, which we propose limits inferences about etiology and treatment targets. Additionally, research has largely focused on the importance of these traits for risk models; our review of the literature applying the UPPS-P traits to treatment processes and outcomes concluded that this area is not yet well studied. Here, we propose the specific application of the UPPS-P model to improve diagnosis and increase treatment effectiveness.

Neuropsychology and emotion processing in violent individuals with antisocial personality disorder or schizophrenia: The same or different? A systematic review and meta-analysis

OBJECTIVES

To assess whether there are shared or divergent (a) cognitive and (b) emotion processing characteristics among violent individuals with antisocial personality disorder and/or schizophrenia, diagnoses which are commonly encountered at the interface of mental disorder and violence. Cognition and emotion processing are incorporated into models of violence, and thus an understanding of these characteristics within and between disorder groups may help inform future models and therapeutic targets.

METHODS

Relevant databases (OVID, Embase, PsycINFO) were searched to identify suitable literature. Meta-analyses comparing cognitive function in violent schizophrenia and antisocial personality disorder to healthy controls were conducted. Neuropsychological studies not comparing these groups to healthy controls, and emotion processing studies, were evaluated qualitatively.

RESULTS

Meta-analyses indicated lower IQ, memory and executive function in both violent schizophrenia and antisocial personality disorder groups compared to healthy controls. The degree of deficit was consistently larger in violent schizophrenia. Both antisocial personality disorder and violent schizophrenia groups had difficulties in aspects of facial affect recognition, although theory of mind results were less conclusive. Psychopathic traits related positively to experiential emotion deficits across the two disorders. Very few studies explored comorbid violent schizophrenia and antisocial personality disorder despite this being common in clinical practice.

CONCLUSION

There are qualitatively similar, but quantitatively different, neuropsychological and emotion processing deficits in violent individuals with schizophrenia and antisocial personality disorder which could be developed into transdiagnostic treatment targets for violent behaviour. Future research should aim to characterise specific subgroups of violent offenders, including those with comorbid diagnoses.

Recognition of peer emotions in children with ADHD: Evidence from an animated facial expressions task

A growing body of literature suggests that ADHD is associated with emotion recognition impairments that may be linked to deficient interpersonal functioning. However, our understanding of the mechanisms underlying these recognition impairments is extremely limited. Here, we used dynamic stimuli to investigate whether impaired emotion recognition in children with ADHD may be associated with impairments in perceptual sensitivity. Participants (ADHD: N = 26; Controls: N = 26) viewed video sequences of neutral faces slowly developing into one of the six basic emotional expressions (angry, happy, fearful, sad, disgusted and surprised) and were instructed to indicate via a button press the precise moment at which they were able to correctly recognize the emotional expression. The results showed that compared to controls, children with ADHD exhibited lower accuracy rates across all emotional expressions while there was no evidence for impaired perceptual sensitivity. Thus, the study provides evidence for a generalized categorization impairment across all emotional categories and is consistent with developmental delay accounts of ADHD. Future studies are needed in order to further investigate the developmental course of social cognition deficits in ADHD.

Perceiving the evil eye: Investigating hostile interpretation of ambiguous facial emotional expression in violent and non-violent offenders

Research into the causal and perpetuating factors influencing aggression has partly focused on the general tendency of aggression-prone individuals to infer hostile intent in others, even in ambiguous circumstances. This is referred to as the ‘hostile interpretation bias’. Whether this hostile interpretation bias also exists in basal information processing, such as perception of facial emotion, is not yet known, especially with respect to the perception of ambiguous expressions. In addition, little is known about how this potential bias in facial emotion perception is related to specific characteristics of aggression. In the present study, conducted in a penitentiary setting with detained male adults, we investigated if violent offenders (n = 71) show a stronger tendency to interpret ambiguous facial expressions on a computer task as angry rather than happy, compared to non-violent offenders (n = 14) and to a control group of healthy volunteers (n = 32). We also investigated if hostile perception of facial expressions is related to specific characteristics of aggression, such as proactive and reactive aggression. No clear statistical evidence was found that violent offenders perceived facial emotional expressions as more angry than non-violent offenders or healthy volunteers. A regression analysis in the violent offender group showed that only age and a self-report measure of hostility predicted outcome on the emotion perception task. Other traits, such as psychopathic traits, intelligence, attention and a tendency to jump to conclusions were not associated with interpretation of anger in facial emotional expressions. We discuss the possible impact of the study design and population studied on our results, as well as implications for future studies.

Emotional facial recognition in proactive and reactive violent offenders

The purpose of this study is to analyse individual differences in the ability of emotional facial recognition in violent offenders, who were characterised as either reactive or proactive in relation to their offending. In accordance with findings of our previous study, we expected higher impairments in facial recognition in reactive than proactive violent offenders. To assess the ability to recognize facial expressions, the computer-based Facial Emotional Expression Labeling Test (FEEL) was performed. Group allocation of reactive und proactive violent offenders and assessment of psychopathic traits were performed by an independent forensic expert using rating scales (PROREA, PCL-SV). Compared to proactive violent offenders and controls, the performance of emotion recognition in the reactive offender group was significantly lower, both in total and especially in recognition of negative emotions such as anxiety (d = -1.29), sadness (d = -1.54), and disgust (d = -1.11). Furthermore, reactive violent offenders showed a tendency to interpret non-anger emotions as anger. In contrast, proactive violent offenders performed as well as controls. General and specific deficits in reactive violent offenders are in line with the results of our previous study and correspond to predictions of the Integrated Emotion System (IES, 7) and the hostile attribution processes (21). Due to the different error pattern in the FEEL test, the theoretical distinction between proactive and reactive aggression can be supported based on emotion recognition, even though aggression itself is always a heterogeneous act rather than a distinct one-dimensional concept.

Generalized hostile interpretation bias regarding facial expressions: Characteristic of pathological aggressive behavior

Individuals with aggression regulation disorders tend to attribute hostility to others in socially ambiguous situations. Previous research suggests that this "hostile attribution bias" is a powerful cause of aggression. Facial expressions form important cues in the appreciation of others' intentions. Furthermore, accurate processing of facial expressions is fundamental to normal socialization. However, research on interpretation biases in facial affect is limited. It is asserted that a hostile interpretation bias (HIB) is likely to be displayed by individuals with an antisocial (ASPD) and borderline personality disorder (BPD) and probably also with an intermittent explosive disorder (IED). However, there is little knowledge to what extent this bias is displayed by each of these patient groups. The present study investigated whether a HIB regarding emotional facial expressions was displayed by forensic psychiatric outpatients (FPOs) and whether it was associated with ASPD and BPD in general or, more specifically, with a disposition to react with pathological aggression. Participants of five different groups were recruited: FPOs with ASPD, BPD, or IED, non-forensic patients with BPD (nFPOs-BPD), and healthy, non-aggressive controls (HCs). Results suggest that solely FPOs with ASPD, BPD, or IED exhibit a HIB regarding emotional facial expressions. Moreover, this bias was associated with type and severity of aggression, trait aggression, and cognitive distortions. The results suggest that a HIB regarding facial expressions is an important characteristic of pathological aggressive behavior. Interventions that modify the HIB might help to reduce the recurrence of aggression. Aggr. Behav. 43:386-397, 2017. © 2017 Wiley Periodicals, Inc.

Biased Facial-Emotion Perception in Mental Health Disorders: A Possible Target for Psychological Intervention?

Our perception of emotion in the faces of others affects our own behavior and mood. Indeed, individuals with mood disorders such as depression and aggression often show biases in facial-emotion perception. Here, we review recent and ongoing research suggesting that biased emotion perception may be on the causal pathway of the onset and maintenance of mood disorders, and hence a potential target for intervention. Simple cognitive-bias modification tasks that change participants’ perception of facial expressions of emotion have shown some promise as a therapeutic technique. We outline further directions for continued research investigating the robustness and clinical impact of emotion-bias modification in real-world settings.

In your face: the biased judgement of fear-anger expressions in violent offenders

BACKGROUND

Why is it that certain violent criminals repeatedly find themselves engaged in brawls? Many inmates report having felt provoked or threatened by their victims, which might be due to a tendency to ascribe malicious intentions when faced with ambiguous social signals, termed hostile attribution bias.

METHODS

The present study presented morphed fear-anger faces to prison inmates with a history of violent crimes, a history of child sexual abuse, and to matched controls form the general population. Participants performed a fear-anger decision task. Analyses compared both response frequencies and measures derived from psychophysical functions fitted to the data. In addition, a test to distinguish basic facial expressions and questionnaires for aggression, psychopathy and personality disorders were administered.

RESULTS

Violent offenders present with a reliable hostile attribution bias, in that they rate ambiguous fear-anger expressions as more angry, compared to both the control population and perpetrators of child sexual abuse. Psychometric functions show a lowered threshold to detect anger in violent offenders compared to the general population. This effect is especially pronounced for male faces, correlates with self-reported aggression and presents in absence of a general emotion recognition impairment.

CONCLUSIONS

The results indicate that a hostile attribution, related to individual level of aggression and pronounced for male faces, might be one mechanism mediating physical violence.

State anxiety and emotional face recognition in healthy volunteers

High trait anxiety has been associated with detriments in emotional face processing. By contrast, relatively little is known about the effects of state anxiety on emotional face processing. We investigated the effects of state anxiety on recognition of emotional expressions (anger, sadness, surprise, disgust, fear and happiness) experimentally, using the 7.5% carbon dioxide (CO2) model to induce state anxiety, and in a large observational study. The experimental studies indicated reduced global (rather than emotion-specific) emotion recognition accuracy and increased interpretation bias (a tendency to perceive anger over happiness) when state anxiety was heightened. The observational study confirmed that higher state anxiety is associated with poorer emotion recognition, and indicated that negative effects of trait anxiety are negated when controlling for state anxiety, suggesting a mediating effect of state anxiety. These findings may have implications for anxiety disorders, which are characterized by increased frequency, intensity or duration of state anxious episodes.

Impaired social cognition in violent offenders: perceptual deficit or cognitive bias?

Aggressive behavior is assumed to be associated with certain patterns of social information processing. While some theories link aggression to a tendency to interpret ambiguous stimuli as hostile (i.e., enhanced sensitivity to anger), others assume an insufficient ability to perceive emotional expressions, particularly fear. Despite compelling evidence to support both theories, no previous study has directly investigated the predictions made by these two accounts in aggressive populations. The aim of the current study was to test processing patterns for angry and fearful facial expressions in violent offenders (VOs) and healthy controls (CTLs) and their association with self-reported aggression and psychopathy scores. In Experiment 1, we assessed perceptual sensitivity to neutral-emotional (angry, fearful, happy) blends in a task which did not require categorization, but an indication whether the stimulus is neutral or emotional. In Experiment 2, we assessed categorization performance for ambiguous fearful-happy and angry-happy blends. No group differences were revealed in Experiment 1, while Experiment 2 indicated a deficit in the categorization of ambiguous fearful blends in the VO group. Importantly, this deficit was associated with both self-reported psychopathy and aggression in the VO, but not the CTL group. The current study provides evidence for a deficient categorization of fearful expressions and its association with self-reported aggression and psychopathy in VOs, but no support for heightened sensitivity to anger. Furthermore, the current findings indicate that the deficit is tied to categorization but not detection stages of social information processing.

The clinical utility of social information processing theory in assessing and treating offenders with autism spectrum disorder

Purpose

Social deficits are central within conceptualisations of autism spectrum disorder (ASD), and separately linked to offending behaviour. Social problem-solving interventions are often used with offenders, but little research has examined the social information processing (SIP) skills of individuals with ASD and a history of criminal offending behaviours. The paper aims to discuss this issue.

Design/methodology/approach

This conceptual paper will introduce the SIP model, review SIP research as applied to those with ASD and in forensic populations, and further consider the relevance to the assessment and treatment of offenders with ASD.

Findings

Difficulties in all areas of the SIP model are noted in ASD and research suggests these difficulties may be directly linked to behaviour.

Practical implications

It is possible that identifying SIP abilities and deficits could improve the effectiveness of rehabilitation programmes for this group.

Originality/value

This paper reviews the utility of social information models in the offending behaviour of people with ASD.

Facial Affect Recognition in Violent and Nonviolent Antisocial Behavior Subtypes

Prior studies provide evidence for impaired recognition of distress cues in individuals exhibiting antisocial behavior. However, it remains unclear whether this deficit is generally associated with antisociality or may be specific to violent behavior only. To examine whether there are meaningful differences between the two behavioral dimensions rule-breaking and aggression, violent and nonviolent incarcerated offenders as well as control participants were presented with an animated face recognition task in which a video sequence of a neutral face changed into an expression of one of the six basic emotions. The participants were instructed to press a button as soon as they were able to identify the emotional expression, allowing for an assessment of the perceived emotion onset. Both aggressive and nonaggressive offenders demonstrated a delayed perception of primarily fearful facial cues as compared to controls. These results suggest the importance of targeting impaired emotional processing in both types of antisocial behavior.

Does comorbid anxiety counteract emotion recognition deficits in conduct disorder?

BACKGROUND

Previous research has reported altered emotion recognition in both conduct disorder (CD) and anxiety disorders (ADs) - but these effects appear to be of different kinds. Adolescents with CD often show a generalised pattern of deficits, while those with ADs show hypersensitivity to specific negative emotions. Although these conditions often cooccur, little is known regarding emotion recognition performance in comorbid CD+ADs. Here, we test the hypothesis that in the comorbid case, anxiety-related emotion hypersensitivity counteracts the emotion recognition deficits typically observed in CD.

METHOD

We compared facial emotion recognition across four groups of adolescents aged 12-18 years: those with CD alone (n = 28), ADs alone (n = 23), cooccurring CD+ADs (n = 20) and typically developing controls (n = 28). The emotion recognition task we used systematically manipulated the emotional intensity of facial expressions as well as fixation location (eye, nose or mouth region).

RESULTS

Conduct disorder was associated with a generalised impairment in emotion recognition; however, this may have been modulated by group differences in IQ. AD was associated with increased sensitivity to low-intensity happiness, disgust and sadness. In general, the comorbid CD+ADs group performed similarly to typically developing controls.

CONCLUSIONS

Although CD alone was associated with emotion recognition impairments, ADs and comorbid CD+ADs were associated with normal or enhanced emotion recognition performance. The presence of comorbid ADs appeared to counteract the effects of CD, suggesting a potentially protective role, although future research should examine the contribution of IQ and gender to these effects.

Seeing More Than Others

Abstract. Researchers have long argued that aggressive individuals automatically tend to perceive hostile intent in others, even when it is in fact absent (hostile attribution bias). Wilkowski and Robinson (2012) recently showed, however, that aggressive individuals were particularly accurate in the identification of subtle cues of facial anger, indicating greater perceptual sensitivity to anger information rather than a biased perception or interpretation. We tested the generality of this finding in four paradigms with different stimuli. As predicted by Wilkowski and Robinson, the more aggressive participants were, the more accurately they identified subtle aggressive information, whereas accuracy in the identification of nonaggressive emotional information was not a function of self-reported aggressiveness. The discussion focuses on the generality and limitations of the findings.