Disentangling attentional deficits in psychopathy using visual search: Failures in the use of contextual information

The importance of an exaggerated attention bottleneck for understanding psychopathy

The psychopath has long captured the imagination. A name such as Ted Bundy evokes a morbid curiosity. The crimes committed by Bundy are so cruel that it is hard to imagine how someone could do such things. In this review we discuss evidence that exaggeration in an attention bottleneck is one mechanism that makes it possible for psychopathic individuals to be adept at focusing on a single stimulus feature or goal but struggle to process multiple streams of information simultaneously. This exaggeration may partly explain the behavioral, affective, and social deficits that are apparent among psychopathic individuals. Further research on this attentional mechanism may promote a science that adequately captures the complexity of psychopathic behavior and offers new avenues for intervention.

Psychopathy

Psychopathy is a personality disorder characterized by a constellation of affective, interpersonal, lifestyle and antisocial features whose antecedents can be identified in a subgroup of young people showing severe antisocial behaviour. The prevalence of psychopathy in the general population is thought to be ~1%, but is up to 25% in prisoners. The aetiology of psychopathy is complex, with contributions of both genetic and environmental risk factors, and gene-environment interactions and correlations. Psychopathy is characterized by structural and functional brain abnormalities in cortical (such as the prefrontal and insular cortices) and subcortical (for example, the amygdala and striatum) regions leading to neurocognitive disruption in emotional responsiveness, reinforcement-based decision-making and attention. Although no effective treatment exists for adults with psychopathy, preliminary intervention studies targeting key neurocognitive disturbances have shown promising results. Given that psychopathy is often comorbid with other psychiatric disorders and increases the risk of physical health problems, educational and employment failure, accidents and criminality, the identification of children and young people at risk for this personality disorder and preventative work are important. Indeed, interventions that target the antecedents of psychopathic features in children and adolescents have been found to be effective.

Psychopathy is associated with an exaggerated attention bottleneck: EEG and behavioral evidence from a dual-task paradigm

Psychopathy is a personality disorder associated with a chronic disregard for the welfare of others. The attention bottleneck model of psychopathy asserts that the behavior of individuals higher on psychopathy is due to an exaggerated attention bottleneck that constrains all information processing, regardless of the information's potential goal-relevance. To date, the majority of research on the attention bottleneck model of psychopathy conceptually applied the tenets of the model but did not implement methods that directly test an exaggeration of the bottleneck in psychopathy. Accordingly, the presence of an exaggerated bottleneck, the exact expression of that bottleneck, and its potential mechanistic relevance for behavior in individuals higher on psychopathy remains untested. To address these gaps, a sample of 78 male community members, evaluated for psychopathic traits using the Self-Report Psychopathy-III scale, completed an EEG-based dual-task paradigm examining short stimulus onset asynchrony (SOA; 300 ms), long SOA (1,100 ms), and single-task baseline conditions. Additionally, participants were asked about their frequency of real-world risky, impulsive, and antisocial behaviors. Psychopathy was associated with slower reaction times to second targets (T2s) presented during the dual-task conditions, relative to the baseline condition. Psychopathy also was associated with blunted P300 responses, a neural index of stimulus evaluation, across all types of T2 events. Finally, bottleneck-related interference during the short SOA events mediated the relationship between psychopathy and real-world behavior. These findings suggested that individuals higher on psychopathy exhibit an exaggerated bottleneck which produces intense and long-lasting interference, impacting all information processing and partially contributing to their maladaptive behavior.

Connections that characterize callousness: Affective features of psychopathy are associated with personalized patterns of resting-state network connectivity

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There was significant heterogeneity in participants’ neural networks.

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Psychopathy associated with default mode-central executive network connectivity.

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Associations were specific to affective psychopathic traits.

Background

Psychopathic traits are hypothesized to be associated with dysfunction across three resting-state networks: the default mode (DMN), salience (SN), and central executive (CEN). Past work has not considered heterogeneity in the neural networks of individuals who display psychopathic traits, which is likely critical in understanding the etiology of psychopathy and could underlie different symptom presentations. Thus, this study maps person-specific resting state networks and links connectivity patterns to features of psychopathy.

Methods

We examined resting-state functional connectivity among eight regions of interest in the DMN, SN, and CEN using a person-specific, sparse network mapping approach (Group Iterative Multiple Model Estimation) in a community sample of 22-year-old men from low-income, urban families (N = 123). Associations were examined between a dimensional measure of psychopathic traits and network density (i.e., number of connections within and between networks).

Results

There was significant heterogeneity in neural networks of participants, which were characterized by person-specific connections and no common connections across the sample. Psychopathic traits, particularly affective traits, were associated with connection density between the DMN and CEN, such that greater density was associated with elevated psychopathic traits.

Discussion

Findings emphasize that neural networks underlying psychopathy are highly individualized. However, individuals with high levels of psychopathic traits had increased density in connections between the DMN and CEN, networks that have been linked with self-referential thinking and executive functioning. Taken together, the results highlight the utility of person-specific approaches in modeling neural networks underlying psychopathic traits, which could ultimately inform personalized prevention and intervention strategies.

Psychopathy is associated with shifts in the organization of neural networks in a large incarcerated male sample

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Psychopathy is linked to disruptions in neural information processing.

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Graph analysis revealed that psychopathy impacts neural network organization.

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Psychopathy is linked to a hyper-efficiently organized dorsal attention network.

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Subcortical structures are less central to neural communication in psychopathy.

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No psychopathy differences were found in default or salience network graph metrics.

Psychopathy is a personality disorder defined by antisocial behavior paired with callousness, low empathy, and low interpersonal emotions. Psychopathic individuals reliably display complex atypicalities in emotion and attention processing that are evident when examining task performance, activation within specific neural regions, and connections between regions. Recent advances in neuroimaging methods, namely graph analysis, attempt to unpack this type of processing complexity by evaluating the overall organization of neural networks. Graph analysis has been used to better understand neural functioning in several clinical disorders but has not yet been used in the study of psychopathy. The present study applies a minimum spanning tree graph analysis to resting-state fMRI data collected from male inmates assessed for psychopathy with the Hare Psychopathy Checklist-Revised (n = 847). Minimum spanning tree analysis provides several metrics of neural organization optimality (i.e., the effectiveness, efficiency, and robustness of neural network organization). Results show that inmates higher in psychopathy exhibit a more efficiently organized dorsal attention network (β = =0.101, p_corrected = =0.018). Additionally, subcortical structures (e.g., amygdala, caudate, and hippocampus) act as less of a central hub in the global flow of information in inmates higher in psychopathy (β = =−0.104, p_corrected = =0.048). There were no significant effects of psychopathy on neural network organization in the default or salience networks. Together, these shifts in neural organization suggest that the brains of inmates higher in psychopathy are organized in a fundamentally different way than other individuals.

Executive function, attention, and memory deficits in antisocial personality disorder and psychopathy

Antisocial personality disorder (ASPD) and psychopathy attempt to represent individuals demonstrating callousness and disregard for others. ASPD has been criticized for capturing a heterogeneous population whilst missing the essence of the diagnosis by neglecting interpersonal/affective deficits which measures of psychopathy include. This heterogeneity in operationalizations has led to diverse findings without clear understanding of what characterizes this broader population. This study sought to clarify the neuropsychological profiles of ASPD and psychopathy. The Cambridge Neuropsychological Test Assessment Battery was administered to 85 adult male offenders in a personality disorder secure service and to 20 healthy controls. Of patients with ASPD, 46% met criteria for psychopathy. Of those with psychopathy, 89% met criteria for ASPD. There were two sets of comparisons: ASPD versus other personality disorders versus controls and psychopathy versus other personality disorders versus controls. ASPD showed deficits across executive functions, visual short-term and working memory, and attention (compared with controls). Psychopathy showed deficits limited to attention, complex planning, inhibitory control, and response reversal. Response reversal and visual search deficits appeared specific to ASPD and psychopathy versus other personality disorders and may underpin antisocial traits. Additional deficits in inhibitory control and working memory appeared to distinguish ASPD from other personality disorders.

Fearful Faces do Not Lead to Faster Attentional Deployment in Individuals with Elevated Psychopathic Traits

In the current study, a gaze-cueing experiment (similar to Dawel et al. 2015) was conducted in which the predictivity of a gaze-cue was manipulated (non-predictive vs highly predictive). This was done to assess the degree to which individuals with elevated psychopathic traits can use contextual information (i.e., the predictivity of the cue). Psychopathic traits were measured with the Self-Report Psychopathy Scale-Short Form (SRP-SF) in a mixed sample (undergraduate students and community members). Results showed no group difference in reaction times between high and non-predictive cueing blocks, suggesting that individuals with elevated psychopathic traits can indeed use contextual information when it is relevant. In addition, we observed that fearful facial expressions did not lead to a change in reaction times in individuals with elevated psychopathic traits, whereas individuals with low psychopathic traits showed speeded responses when confronted with a fearful face, compared to a neutral face. This suggests that fearful faces do not lead to faster attentional deployment in individuals with elevated psychopathic traits.

Visual attention in violent offenders: Susceptibility to distraction

Impairments in executive functioning give rise to reduced control of behavior and impulses, and are therefore a risk factor for violence and criminal behavior. However, the contribution of specific underlying processes remains unclear. A crucial element of executive functioning, and essential for cognitive control and goal-directed behavior, is visual attention. To further elucidate the importance of attentional functioning in the general offender population, we employed an attentional capture task to measure visual attention. We expected offenders to have impaired visual attention, as revealed by increased attentional capture, compared to healthy controls. When comparing the performance of 62 offenders to 69 healthy community controls, we found our hypothesis to be partly confirmed. Offenders were more accurate overall, more accurate in the absence of distracting information, suggesting superior attention. In the presence of distracting information offenders were significantly less accurate compared to when no distracting information was present. Together, these findings indicate that violent offenders may have superior attention, yet worse control over attention. As such, violent offenders may have trouble adjusting to unexpected, irrelevant stimuli, which may relate to failures in self-regulation and inhibitory control.

Representational Uncertainty in the Brain During Threat Conditioning and the Link With Psychopathic Traits

BACKGROUND

Psychopathy has repeatedly been linked to disturbed associative learning from aversive events (i.e., threat conditioning). Optimal threat conditioning requires the generation of internal representations of stimulus-outcome contingencies and the rate with which these may change. Because mental representations are imperfect, there will always be uncertainty about the accuracy of representations in the brain (i.e., representational uncertainty). However, it remains unclear 1) to what extent threat conditioning is susceptible to different types of uncertainty in representations about contingencies during the acquisition phase and 2) how representational uncertainty relates to psychopathic features.

METHODS

A computational model was applied to functional neuroimaging data to estimate uncertainty in representations of contingencies (CoUn) and the rate of change of contingencies (RUn), respectively, from brain activation during the acquisition phase of threat conditioning in 132 adolescents at risk of developing antisocial personality profiles. Next, the associations between these two types of representational uncertainty and psychopathy-related dimensions were examined.

RESULTS

The left and right amygdala activations were associated with CoUn, while the bilateral insula and the right amygdala were associated with RUn. Different patterns of relationships were found between psychopathic features and each type of uncertainty. Callous-unemotional traits and impulsive-irresponsible traits uniquely predicted increased CoUn, while only impulsive-irresponsible traits predicted increased RUn.

CONCLUSIONS

The findings suggest that 1) the insula and amygdala differ in how these regions are affected by different types of representational uncertainty during threat conditioning and 2) CoUn and RUn have different patterns of relationships with psychopathy-related dimensions.

Endogenous attention modulates early selective attention in psychopathy: An ERP investigation

Psychopathic individuals are prone to act on urges without adequate consideration of future consequences or the rights of other individuals. One interpretation of this behavior is that it reflects abnormal selective attention (i.e., a failure to process information that is incongruent with their primary focus of attention; Hiatt, Schmitt, & Newman, Neuropsychology, 18, 50-59, 2004). Unfortunately, it is unclear whether this selective attention abnormality reflects top-down endogenous influences, such as the strength or specificity of attention focus (i.e., top-down set) apart from other, more exogenous (bottom-up), effects on attention. To explore this question, we used an early visual event-related potential (N2pc) in combination with a modified visual search task designed to assess the effect of early endogenous (i.e., top-down) attention on the processing of set-congruent information. The task was administered to a sample of 70 incarcerated adult males, who were assigned to high, intermediate, and low psychopathy groups using Hare's Psychopathy Checklist-Revised (Hare, 2003). Based on the assumption that their failure to process set-incongruent information reflects the exaggerated effects of endogenous attention, we predicted that participants with high psychopathy scores would show an exaggerated N2pc response to set-congruent information. The results supported the hypothesis and provide novel electrophysiological evidence that psychopathy is associated with exaggerated endogenous attention effects during early stages of processing. Further research is needed to examine the implications of this finding for the well-established failure of psychopathic individuals to process set-incongruent information and inhibit inappropriate responses.

Theta phase coherence in affective picture processing reveals dysfunctional sensory integration in psychopathic offenders

Psychopathic offenders are described as emotionally cold, displaying deficits in affective responding. However, research demonstrates that many of the psychopathy-related deficits are moderated by attention, such that under conditions of high attentional and perceptual load psychopathic offenders display deficits in affective responses, but do not in conditions of low load. To date, most studies use measures of defensive reflex (i.e., startle) and conditioning manipulations to examine the impact of load on psychopathy-related processing, but have not examined more direct measures of attention processing. In a sample of adult male offenders, the present study examined time-frequency EEG phase coherence in response to a picture-viewing paradigm that manipulated picture familiarity to assess neural changes in processing based on perceptual demands. Results indicated psychopathy-related differences in the theta response, an index of readiness to perceive and integrate sensory information. These data provide further evidence that psychopathic offenders have disrupted integration of sensory information.