Theory of mind and mentalizing ability in antisocial personality disorders with and without psychopathy

Reduced late positive potentials to distress in individuals with high psychopathic traits during pain judgment tasks

This study examined the empathic processing of individuals with psychopathic traits and healthy controls in response to pain, applying affective perspective-taking (Self vs. Other). Twenty subjects with high psychopathic traits and twenty control subjects performed pain judgment tasks in the study. During the tasks, late positive potentials (LPPs) of the participants were measured to assess emotional processing in reaction to visual stimuli depicting painful or non-painful situations. In early LPP time stage (500-700 ms), the control group and the psychopathic trait group exhibited comparable levels of empathic processing regarding pain. However, in late LPP time window (700-1100 ms), the control group showed a greater LPP amplitude to Pain stimuli than No-pain stimuli, whereas the psychopathic trait group exhibited non-significant amplitude differences between Pain and No-pain stimuli. These findings imply that individuals with high psychopathic traits may swiftly terminate the processing and encounter difficulties in reappraising distress cues, especially in the late stage, providing psychophysiological support for distinctive empathic processing with temporal aspects.

Mentalization based treatment for a broad range of personality disorders: a naturalistic study

BACKGROUND

Several studies have observed that mentalization-based treatment (MBT) is an effective treatment for borderline personality disorder (BPD), but its effectiveness for other personality disorders (PDs) has hardly been examined. Additionally, the evidence supporting the claim that MBT improves mentalizing capacity is scarce. The present study examined whether (i) patients with a broad range of PDs enrolled in an MBT program would improve on several outcome measures (ii) mentalizing capacity would improve over time; (iii) patients with BPD would improve more than those with non-borderline PDs.

METHOD

Personality disorders, psychiatric symptoms, social functioning, maladaptive personality functioning and mentalizing capacity were measured in a group of individuals with various PDs (n = 46) that received MBT. Assessments were made at baseline and after 6, 12, and 18 months of treatment. The severity of psychiatric symptoms, measured using the Outcome Questionnaire 45, was the primary outcome variable.

RESULTS

Overall, enrollment in the MBT program was associated with a decrease in psychiatric symptoms and an improvement of personality functioning, social functioning for a mixed group of PDs (all p's ≤ .01). Bigger effect sizes were observed for BPD patients (n = 25) than for patients with non-BPD (n = 21), but the difference failed to reach statistical significance (p = 0.06). A primary analysis showed that the decrease in psychiatric symptoms was significant in BPD patients (p = 0.01), not in non-BPD (p = 0.19) patients. However, a sufficiently powered secondary analysis with imputed data showed that non-BPD patients reported a significant decrease in psychiatric symptoms too (p = 0.01). Mentalizing capacity of the whole group improved over time (d = .68 on the Toronto Alexithymia Scale and 1.46 on the Social Cognition and Object Relations System).

DISCUSSION

These results suggest that MBT coincides with symptomatic and functional improvement across a broad range of PDs and shows that MBT is associated with improvements in mentalizing capacity. As the study is not experimental in design, we cannot make causal claims.

CONCLUSION

Mentalization-based treatment may be an effective treatment for patients with a broad range of PDs.

TRIAL REGISTRATION

The study design was approved by the Leiden University Ethical Committee.

The dark side of personality functioning: associations between antisocial cognitions, personality functioning (AMPD), empathy and mentalisation

Introduction

With the introduction of the new psychiatric diagnostic manuals, personality functioning has gained new prominence. Several studies have reported consistent findings that individual showing high levels of antisocial features are associated with alterations in interpersonal functioning domains such as empathy and mentalisation. The focus of the current study (N = 198) is to examine antisocial cognitions, as measured by the Scrambled Sentences Task (SST), and to what extent this approach can help to better understand the relationship between antisocial traits and personality functioning/empathy.

Method

We implemented a hypothesis-driven approach using logistic regression and a data-driven approach using machine learning to examine distinct but related measures of personality functioning as predictors of antisocial cognitions.

Results

Antisocial cognitions were associated with low interpersonal functioning as expected, but only when not adjusting for antisocial traits, which accounted for almost all the association. The data-driven analysis revealed that individual items assessing empathic concern in personality functioning scales (as opposed to the whole scores) explained low antisocial cognitions even when adjusting for antisocial traits.

Discussion

Antisocial cognitions appear to be associated to two distinct traits, the antisocial and a specific type of personality functioning. This finding is discussed in terms of the possible distinction between two motivational forces: to harm others/prioritize one's advantage, and to help suffering others.

Antisocial personality disorder and therapeutic pessimism - how can mentalization-based treatment contribute to an increased therapeutic optimism among health professionals?

Antisocial personality disorder (ASPD) is associated with therapeutic pessimism among health professionals. Several variables are associated with obstacles in therapist's willingness to treat ASPD. Variables that are relevant are (i) confusion associated with the term ASPD, (ii) characteristics of the disorder, (iii) attitudes, experiences, and knowledge clinicians possess, and (iv) insufficient management of countertransference. We assume that therapeutic pessimism is related to the lack of evidence-based, effective treatment for individuals with ASPD. This is problematic because ASPD is associated with large socio-economic costs and considerable suffering for the individual and the society. Mentalization-based treatment (MBT) was developed in treating borderline personality disorder (BPD) and is now considered an effective treatment for this group. Mentalization is defined as the process by which individuals make sense of themselves and others in terms of subjective states and mental processes. This ability affects an individual's psychological functioning, mental health, self-organization, and interpersonal relationships. The overall goal of MBT is to strengthen the individual's mentalizing abilities and facilitate more adaptive handling of problematic, internal states. Recently, a version of MBT tailored for individuals with ASPD (MBT-ASPD) has been developed. The purpose of this review is to investigate how MBT-ASPD relates to the major obstacles that contribute to the therapeutic pessimism toward this group. Despite a limited evidence base, preliminary studies indicate promising results for MBT-ASPD. More research is still required, this review suggests MBT-ASPD can contribute to increased therapeutic optimism and demonstrate specific characteristics of MBT-ASPD that contribute to management of therapeutic pessimism.

Examining the Association between Psychopathic Traits and Fearlessness among Maximum-Security Incarcerated Male Adolescents

Studies have reported positive associations between youth psychopathy scores and measures of 'fearlessness'. However, prior studies modified fearlessness items to be age appropriate, shifting from assessing hypothetical, extreme forms of physical risk-taking (e.g., flying an airplane) to normative risk-taking (e.g., riding bicycles downhill). We hypothesize that associations between youth psychopathy scores and alternative forms of sensation seeking (i.e., Disinhibition) have been conflated under a false fearlessness label. We tested this hypothesis among incarcerated male adolescents, investigating whether youth psychopathy scores were significantly associated with two different forms of sensation seeking: Disinhibition and Thrill and Adventure Seeking (TAS). Youth psychopathic traits were assessed using the Psychopathy Checklist: Youth Version (PCL:YV), Antisocial Process Screening Device (APSD), Child Psychopathy Scale (CPS), Inventory of Callous and Unemotional Traits (ICU), and Youth Psychopathic Traits Inventory (YPI). Disinhibition and fearlessness (i.e., TAS) were assessed using an unmodified version of the Zuckerman Sensation Seeking Scales (SSS). Consistent with hypotheses, youth psychopathy scores were associated with higher Disinhibition and lower TAS scores. Our results contribute to a growing body of literature suggesting that psychopathic traits, including among adolescents, are not concomitant with physical risk-taking and descriptions of psychopathy including fearlessness distort a precise understanding of psychopathy's core features.

Empathy and Violence in Schizophrenia and Antisocial Personality Disorder

A paucity of cognitive and affective features of empathy can be correlated with violent behavior. We aimed to identify differences in empathy among four groups in a sample of 100 male participants: (1) 27 violent offenders with schizophrenia, (2) 23 nonviolent patients with schizophrenia, (3) 25 patients with antisocial personality disorder, and (4) 25 subjects from the general population, who formed the control group. Schizophrenia symptoms were quantified with the Positive and Negative Syndrome Scale. Empathy was measured with the empathy quotient. Theory of mind was evaluated using (a) the first-order false-belief task, (b) the hinting task, (c) the faux pas recognition test and (d) the "reading the mind in the eyes" test (revised). Differences noted among the groups were age (controls were younger) and educational status (antisocials were less educated). The empathy quotient scoring (p < 0.001) and theory-of-mind tests (p < 0.001) were distinct between the control group and the three other groups of participants, but not among the three patient groups. Patients with antisocial personality disorder, violent psychotic offenders and psychotic nonviolent patients show no remarkable differences in affective or cognitive empathy tests, but they all present deficits in empathy and theory of mind when compared to controls.

The moderation effect of mentalization in the relationship between impulsiveness and aggressive behavior

Aggressive behavior is a growing problem across many contexts. Thus, searching for its predictors is important. The aim of the current study was to analyze the moderator effect of mentalization in the relationship between impulsiveness and both verbal and physical aggressive behavior, using a sample of 583 participants gathered from the general Spanish population (MAge  = 34.60, SDAge  = 12.99). In our sample, 182 were male and 401 were female. The results showed significant bivariate relationships among aggression, impulsiveness, and mentalization. Moderation structural equation modeling (MSEM) showed a significant moderation effect, so whereas the value of mentalization is not relevant in cases of people with low impulsiveness, high mentalization abilities allow those people with high impulsiveness to behave less aggressively than people with high impulsiveness and low mentalization abilities. Practical implications and limitations of the study are discussed.

Impaired social concept processing in persons with autistic-like traits

Situated models suggest that social concepts are grounded in interpersonal experience. However, few studies have tested this notion experimentally, and none has targeted individuals with reduced social interaction. Here, we assessed comprehension of text-level social and non-social concepts in persons with and without autistic-like traits. Participants read a social and a non-social text and answered questionnaires targeting social and non-social concepts, respectively. We compared behavioral outcomes, gauged their contribution to subject-level classification, and examined their association with validated measures of autism. Persons with autistic-like traits showed selective deficits in grasping text-level social concepts, even adjusting for intelligence, memory, and vocabulary. Also, social concept comprehension was the only variable that significantly classified between groups. Finally, social concept outcomes correlated negatively with measures of autism, including social interaction. Our results suggest that reduced interpersonal experience selectively compromises text-level social concept processing, offering empirical constraints for situated models of social semantics.

Contrasting social knowledge and theory of mind patterns in adults with personality disorders, schizophrenia spectrum disorders, and healthy controls

INTRODUCTION

Personality disorders (PD) and schizophrenia spectrum disorders (SSD) are distinct conditions displaying common symptoms, like impairments in social cognition, that make them hard to distinguish, especially in severe cases. To date, few studies have compared theory of mind skills in these two disorders, and none have compared social knowledge skills. This study aims to compare the social cognitive abilities of patients with these conditions.

METHOD

Non-parametric analyses of covariance were used to compare severe PD patients (n = 37), SSD patients (n = 44), and healthy controls (HC; n = 49) on the Social Knowledge Test and two measures of theory of mind: the Reading the Mind in the Eyes Test and the Combined Stories Test, which incorporates items from various widely used tests.

RESULTS

While no significant group differences were found on the Social Knowledge Test, SSD patients performed lower than the HC group on both theory of mind tests. PD patients only had lower performance than the HC group on specific items from the Combined Stories Test.

CONCLUSIONS

PD and SSD patients demonstrated distinctive patterns of social cognitive impairments, with items of greater complexity or with an affective orientation being the most discriminant for PD.

Designing a neuroclinical assessment of empathy deficits in psychopathy based on the Zipper Model of Empathy

Ho, M.H., Kemp, B.T., Eisenbarth, H. & Rijnders, R.J.P. Designing a neuroclinical assessment of empathy deficits in psychopathy based on the Zipper Model of Empathy. NEUROSCI BIOBEHAV REV YY(Y) XXX-XXX, 2023. The heterogeneity of the literature on empathy highlights its multidimensional and dynamic nature and affects unclear descriptions of empathy in the context of psychopathology. The Zipper Model of Empathy integrates current theories of empathy and proposes that empathy maturity is dependent on whether contextual and personal factors push affective and cognitive processes together or apart. This concept paper therefore proposes a comprehensive battery of physiological and behavioral measures to empirically assess empathy processing according to this model with an application for psychopathic personality. We propose using the following measures to assess each component of this model: (1) facial electromyography; (2) the Emotion Recognition Task; (3) the Empathy Accuracy task and physiological measures (e.g., heart rate); (4) a selection of Theory of Mind tasks and an adapted Dot Perspective Task, and; (5) an adjusted Charity Task. Ultimately, we hope this paper serves as a starting point for discussion and debate on defining and assessing empathy processing, to encourage research to falsify and update this model to improve our understanding of empathy.

Psychopathic Traits and Theory of Mind Task Performance: A Systematic Review and Meta-analysis

This meta-analysis aims to examine the relationship between psychopathic traits and theory of mind (ToM), which is classically and broadly defined as competency in representing and attributing mental states such as emotions, intentions, and beliefs to others. Our search strategy gathered 142 effect sizes, from 42 studies, with a total sample size of 7463 participants. Random effects models were used to analyze the data. Our findings suggested that psychopathic traits are associated with impaired ToM task performance. This relationship was not moderated by age, population, psychopathy measurement (self-report versus clinical checklist) or conceptualization, or ToM task type (cognitive versus affective). The effect also remained significant after excluding tasks that did not require the participant to 1) mentalize or 2) differentiate self and other perspectives. However, interpersonal/affective traits were associated with a more pronounced impairment in ToM task performance compared to lifestyle/antisocial traits. Future research should investigate the effects of distinct psychopathy facets that will allow for a more precise understanding of the social-cognitive bases of relevant clinical presentations in psychopathy.

Dissociating neural sensitivity to target identity and mental state content type during inferences about other minds

Predicting and inferring what other people think and feel (mentalizing) is central to social interaction. Since the discovery of the brain's "mentalizing network", fMRI studies have probed the lines along which the activity of different regions in this network converges and dissociates. Here, we use fMRI meta-analysis to aggregate across the stimuli, paradigms, and contrasts from past studies in order to definitively test two sources of possible sensitivity among brain regions of this network with particular theoretical relevance. First, it has been proposed that mentalizing processes depend on aspects of target identity (whose mind is considered), with self-projection or simulation strategies engaging disproportionately for psychologically close targets. Second, it has been proposed that mentalizing processes depend on content type (what the inference is), with inferences about epistemic mental states (e.g. beliefs and knowledge) engaging different processes than mentalizing about other types of content (e.g. emotions or preferences). Overall, evidence supports the conclusion that different mentalizing regions are sensitive to target identity and content type, respectively, but with some points of divergence from previous claims. Results point to fruitful directions for future studies, with implications for theories of mentalizing.

A stenography of empathy: Toward a consensual model of the empathic process

Empathy has gained popularity in the general population and the scientific world during the past decade. Recently, several researchers found a significant decrease in empathy scores of healthcare students (notably medical students) and recommend promoting empathy skills in several fields of education. The current paper presents a new model of the empathic process: a stenography of empathy compelling scientific data and contemporary conceptions. Indeed, we combined all pioneer researchers' conceptions of empathy (Davis, Decety, Batson, Preston & de Waal) into an integrative model. This model is centered on the empathizer (i.e., a person observing a target experiencing emotions) and displays how all empathy components are articulated, explaining the individuals' general functioning and how the process might become dysfunctional. We illustrated applications of the model with three clinical examples (i.e., burnout, psychopathy, and borderline personality disorders) to display how empathy is related to psychopathological symptoms. We believe this new dynamic and sequential model would be helpful in explaining how empathy works, which is of great interest to healthcare students, clinicians, researchers, and academics.

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.

Psychopathic tendencies are selectively associated with reduced emotional awareness in the context of early adversity

It is unclear at present whether psychopathic tendencies are associated with lower or higher levels of emotional awareness (EA). Given that psychopathy includes a proficiency for manipulating others, one might expect an elevated ability to identify and use information about others' emotions. On the other hand, empathic deficits in psychopathy could arise from reduced emotional awareness. Further, heterogeneity in psychopathy may also play a role, wherein 'secondary' psychopathy is associated with early adversity and high negative affect, while 'primary' psychopathy is not. In this paper, we tested the relationship between EA and psychopathic tendencies in 177 undergraduate students (40 males) who completed the levels of emotional awareness scale (LEAS), the triarchic psychopathy measure (TPM), the affective (empathy-related) subscales of the interpersonal reactivity index (IRI), and two measures of early adversity: the childhood experiences of care and abuse questionnaire (CECA) and the childhood trauma questionnaire (CTQ). We found that lower LEAS scores were associated with higher TPM and lower IRI empathy scores, but these relationships were primarily present in those with early adversity and high negative affect. This suggests that lower EA may be selectively associated with higher levels of secondary psychopathy, while those with higher levels of primary psychopathy remain capable of higher EA.

Theory of Mind in Offending: A Systematic Review

Theory of mind (ToM) impairment is associated with poor social functioning in some psychological disorders (e.g., autism and schizophrenia). ToM deficits have also been linked with offending behavior in the theoretical literature. However, no review has examined the empirical evidence for such a link. We carried out a systematic review to provide a critical overview of studies involving ToM ability in offenders. We included studies published in English that used an instrument to measure at least one aspect of ToM. Twenty-eight eligible studies were identified and coded. Our findings reveal a generally mixed literature. Taking study quality into account, our findings suggest that offenders and nonoffenders do not differ in their first-order ToM. For second-order ToM, findings are mixed, even when only the highest quality studies are examined. Studies exploring advanced ToM showed mixed results overall, though the highest quality research appeared to indicate that offenders have impairments in advanced ToM which means that they may have difficulty understanding various mental states such as pretense, white lies, irony, double bluffs, and sarcasm. We suggest that well-controlled future studies, which also measure other facets of ToM (e.g., distinguishing between cognitive and affective ToM or examining ToM content), are needed to fully understand the role of ToM in offending.

Can we rewire criminal mind via non-invasive brain stimulation of prefrontal cortex? Insights from clinical, forensic and social cognition studies

Non-compliance with social and legal norms and regulations represents a high burden for society. Social cognition deficits are frequently called into question to explain criminal violence and rule violations in individuals diagnosed with antisocial personality disorder (APD), borderline personality disorder (BPD), and psychopathy. In this article, we proposed to consider the potential benefits of non-invasive brain stimulation (NIBS) to rehabilitate forensic population. We focused on the effects of NIBS of the prefrontal cortex, which is central in social cognition, in modulating aggression and impulsivity in clinical disorders, as well as in forensic population. We also addressed the effect of NIBS on empathy, and theory of mind in non-clinical and/or prison population. The reviewed data provide promising evidence on the beneficial effect of NIBS on aggression/impulsivity dyscontrol and social cognitive functions, suggesting its relevance in promoting reintegration of criminals into society.

THE IMPLICATIONS OF FRONTOTEMPORAL DEMENTIA FOR BRAIN DYSFUNCTION IN PSYCHOPATHY

Understanding how psychopathy compares with brain disease can help clarify its underlying mechanisms. This literature review is a broad overview of the neurobiology of psychopathic traits in comparison to behavioral variant frontotemporal dementia (bvFTD), a disorder uniquely associated with criminal behavior. In addition to violation of social norms, both psychopathy and bvFTD result in impaired socioemotional perception and empathy, impulsivity, and altered moral judgment. Despite wide areas of decreased function in psychopathy, structural changes are primarily evident in amygdala and, to a lesser extent, anterior insula, whereas in bvFTD neuropathology involves a wider paralimbic region. In psychopathy, relatively intact medial prefrontal and anterior cingulate cortices facilitate theory of mind and psychopathic traits such as deceitfulness and manipulation, bold fearlessness, and risk-taking behavior. In conclusion, many frontotemporal areas are hypoactive in psychopathy and bvFTD, but differences in dysfunctional connectivity in psychopathy vs. direct involvement in bvFTD potentially explain similarities and differences between these two conditions.

Gender Differences in Theory of Mind, Empathic Understanding, and Moral Reasoning in an Offending and a Matched Non-Offending Population

Previous research suggests that a lack of pro-social skills is characteristic of an offending personality. Two hundred male and female offenders and matched controls completed measures to assess: Theory of Mind, empathic understanding, and moral reasoning. Significant differences between the offenders and the control group, as well as between the male and female participants, were detected in theory of mind, empathic understanding and moral reasoning with offenders scoring lower than the control group, and with males scoring lower than females on most tests. The ability to assess Theory of Mind, empathic understanding, and moral reasoning, and subsequently to identify reduced ability, is not only useful for researchers but will also allow practitioners to tailor existing (or develop new) interventions specific to the needs of individuals. This could be particularly useful in terms of recidivism when applied to those involved in anti-social or offending behavior.

Relationship between psychopathic traits and performance on the Mini Social Cognition and Emotional Assessment in incarcerated males

Psychopathy is a constellation of personality traits such as callousness, manipulativeness, and impulsivity, and these traits often co-occur with antisocial behavior. Researchers and clinicians have posited that these traits may be associated with impairments in orbitofrontal cortex functioning, but researchers have rarely assessed this using clinical neuropsychological assessments. In a sample of 87 male inmates in a county jail, this study examined the relationship between psychopathic traits and performance on the Mini Social Cognition and Emotional Assessment (Mini-SEA), an assessment of orbitofrontal cortex functioning. Psychopathy scores (total or factor) were not correlated with Mini-SEA performance. Potential reasons for our null findings and study limitations are discussed. PRACTITIONER POINTS: Psychopathic traits were not associated with performance on a neuropsychological measure assessing orbitofrontal cortex functioning. Deficits in OFC functioning observed in psychopathy may be different in nature, or less severe, than those observed in patients with frontotemporal dementia, who perform poorly on this measure.

Unzipping empathy in psychopathy: Empathy and facial affect processing in psychopaths

Psychopathy is a neurodevelopmental disorder that has a highly deleterious effect upon both individuals and society at large. Psychopaths grossly neglect and disrespect the interests of others. Their antisocial behavior is thought to originate from a lack of empathy. However, empathy is multidimensional in nature, as evidenced by the considerable heterogeneity in extant theorizing on the subject. Here, we present the "Zipper model of empathy" that reconsiders how both its affective and cognitive components converge in mature empathic behavior. Furthermore, the Zipper model of empathy is expedient for explaining the empathy deficits in psychopathy, insofar as it brings together current theories on the dysfunctional affective components of empathy, violence inhibition, and automatic versus goal-directed attention. According to the literature, the neurobiological underpinnings of these theories are amygdala-centered; however, this article traces this specifically to the basolateral and central amygdala subregions. When viewed together, the cognitive and affective components of empathy are zipped together in a natural fashion in healthy empathic behavior, whereas psychopaths leave the zipper substantially unzipped in pursuit of their purely self-centered goals.

Impaired Perception of Unintentional Transgression of Social Norms after Prefrontal Cortex Damage: Relationship to Decision Making, Emotion Recognition, and Executive Functions

OBJECTIVE

Patients with prefrontal cortex damage often transgress social rules and show lower accuracy in identifying and explaining inappropriate social behavior. The objective of this study was to examine the relationship between the ability to perceive other unintentional transgressions of social norms and both decision making and emotion recognition as these abilities are critical for appropriate social behavior.

METHOD

We examined a group of patients with focal prefrontal cortex damage (N = 28) and a group of matched control participants (N = 28) for their abilities to detect unintentional transgression of social norms using the "Faux-Pas" task of theory of mind, to make advantageous decisions on the Iowa gambling task, and to recognize basic emotions on the Ekman facial affect test.

RESULTS

The group of patients with frontal lobe damage was impaired in all of these tasks compared with control participants. Moreover, all the "Faux-Pas", Iowa gambling, and emotion recognition tasks were significantly associated and predicted by executive measures of inhibition, flexibility, or planning. However, only measures from the Iowa gambling task were associated and predicted performance on the "Faux-Pas" task. These tasks were not associated with performance in recognition of basic emotions. These findings suggest that theory of mind, executive functions, and decision-making abilities act in an interdependent way for appropriate social behavior. However, theory of mind and emotion recognition seem to have distinct but additive effects upon social behavior. Results from VLSM analysis also corroborate these data by showing a partially overlapped prefrontal circuitry underlying these cognitive domains.

Psychological factors affecting COVID-19 vaccine hesitancy

Background

Vaccine hesitancy is an important public health problem.

Aims

Identifying and understanding COVID-19 vaccine hesitancy may aid future public health messaging. This study, in which we planned to study the determinants of COVID-19 vaccine hesitancy, aims to reveal the relationship between “intolerance of uncertainty,” “belief in conspiracy theories,” and “COVID-19 phobia” with vaccine hesitancy.

Methods

This is a cross-sectional study conducted during a COVID-19 outbreak. Participants were reached via various social media platforms and e-mailing lists for convenience. Data were collected with an online survey using SurveyMonkey application. “Intolerance of Uncertainty Scale (IUS-12),” “Conspiracy Mentality Scale (CMS),” and “COVID-19 Phobia Scale” were applied to 488 participants. Statistical significance level was considered p < 0.05.

Results

Four hundred eighty-eight people between the ages of 18 and 65 participated. Twenty-one participants were excluded from the analysis due to random marking and unreasonable filling times (< 10 min). In this way, analyzes were made with 467 people. We found a positive correlation between the belief in conspiracy theories and vaccine hesitancy (p < 0.05). And also found that individuals with low fear of COVID-19 would hesitate about vaccination (p < 0.05).

Conclusions

Vaccine hesitancy is an important public health problem, and it puts public health at risk, especially during the epidemic period we live in. Therefore, it is important to understand the psychological factors involved in vaccine hesitancy. It would be useful to look for ways to spread accurate information about the vaccine in a healthier way in this case.

Neuroanatomy of complex social emotion dysregulation in adolescent offenders

Social emotions require the correct integration of emotional, cognitive, and social processes and are critical for complex social interactions. Adolescent criminal offenders (AOs) show abnormalities in the experience of basic emotions. However, most research has focused solely on basic emotions, neglecting complex social emotions that could be critical for social reintegration. The purpose of this study was to investigate the behavioral and neural correlates of social emotions (envy and Schadenfreude) in AOs. We explored the experience of complex social emotions, as well as their anatomical correlates, in AOs (n = 19) and a nonoffenders control group (NOs, n = 20). Additionally, we assessed the relationship between social emotions, executive functions (EFs), and fluid intelligence (FI). Structural brain imaging was obtained in all participants. The results showed that AOs had significantly lower envy and Schadenfreude ratings and exhibited lower performance in EFs compared with NOs. The measurement of EFs relied on the INECO frontal screening (IFS). Experiencing fewer social emotions was associated with diminished EFs but not with FI. Moreover, in AOs, reduced levels of envy and Schadenfreude were linked with reduced gray matter volumes in regions subserving mentalizing abilities (inferior parietal lobe and precuneus) and socioemotional processing (inferior and middle temporal regions), as well as key hubs of the executive frontoparietal network (inferior parietal lobule, orbital and rectus gyri). Additional analysis on the AOs revealed no associations between the type of crime and our variables of interest (EFs, FI and social emotions). Our findings are the first to provide evidence on abnormalities in the experience of social emotions in AOs that are associated with neurocognitive markers of social cognition and EFs. Understanding social emotions and their abnormalities (under-experience) as complex intertwined processes may have important future translational implications, including risk prediction for social adaptation/reintegration, sociocognitive targeted interventions, and skill training for social emotions in vulnerable populations.

Patterns of Contagious Yawning and Itching Differ Amongst Adults With Autistic Traits vs. Psychopathic Traits

Both individuals with diagnosed with Autism Spectrum Disorder (ASD) and individuals high in psychopathic traits show reduced susceptibility to contagious yawning; that is, yawning after seeing or hearing another person yawn. Yet it is unclear whether the same underlying processes (e.g., reduced eye gaze) are responsible for the relationship between reduced contagion and these very different types of clinical traits. College Students (n = 97) watched videos of individuals yawning or scratching (a form of contagion not reliant on eye gaze for transmission) while their eye movements were tracked. They completed the Interpersonal Reactivity Index (IRI), the Autism-Spectrum Quotient (AQ), the Psychopathy Personality Inventory-Revised (PPI-R), and the Adolescent and Adult Sensory Processing Disorder Checklist. Both psychopathic traits and autistic traits showed an inverse relationship to contagious yawning, consistent with previous research. However, the relationship between autistic (but not psychopathic) traits and contagious yawning was moderated by eye gaze. Furthermore, participants high in autistic traits showed typical levels of contagious itching whereas adults high in psychopathic traits showed diminished itch contagion. Finally, only psychopathic traits were associated with lower overall levels of empathy. The findings imply that the underlying processes contributing to the disruptions in contagious yawning amongst individuals high in autistic vs. psychopathic traits are distinct. In contrast to adults high in psychopathic traits, diminished contagion may appear amongst people with high levels of autistic traits secondary to diminished attention to the faces of others, and in the absence of a background deficit in emotional empathy.

Transcranial direct current stimulation for empathy: A systematic review and meta-analysis

Transcranial Direct Current Stimulation (tDCS) has been used to modulate empathy, but no studies have meta-analyzed the evidence base for its efficacy. This study aimed to determine the efficacy of tDCS at modulating empathy. We conducted a systematic review and meta-analysis of randomized controlled trials involving anodal or cathodal versus sham tDCS to modulate empathy in healthy adults and clinical populations. Random-effects modelling was applied to pooling overall efficacy estimates using standardized mean differences (Hedge's g) and 95% confidence intervals. Outcome measures for tasks designed to measure empathy were reaction time and accuracy. Anodal tDCS appears to improve lab-based computerized measures of cognitive empathy in healthy adult volunteers. While the evidence provided by this review may be of relevance to individuals with impaired empathic capabilities, the generalizability of our findings is geared towards nonclinical populations given the preponderance of healthy volunteers in our review. Hence, it is not clear if moderate improvements in speed and accuracy on lab-based computerized empathy measures would lead to meaningful clinical improvements. Future studies should consider the use of tDCS to modulate empathy in clinical populations.

The Affiliative Role of Empathy in Everyday Interpersonal Interactions

Empathy theoretically serves an affiliative interpersonal function by satisfying motives for intimacy and union with others. Accordingly, empathy is expected to vary depending on the situation. Inconsistent empirical support for empathy's affiliative role may be because of methodology focused on individual differences in empathy or differences between controlled experimental conditions, which fail to capture its dynamic and interpersonal nature. To address these shortcomings, we used ecological momentary assessment to establish typical patterns of empathy across everyday interactions. Associations among empathy, affect, and interpersonal behaviour of self and interaction partner were examined in a student sample (N = 330), then replicated in a preregistered community sample (N = 279). Multilevel structural equation modelling was used to distinguish individual differences in empathy from interaction-level effects. Results show that people are more empathetic during positively valenced interactions with others perceived as warm and when expressing warmth. By confirming the typically affiliative role of empathy, existing research to the contrary can be best understood as exceptions to the norm.

Self and Other Mentalizing Polarities and Dimensions of Mental Health: Association With Types of Symptoms, Functioning and Well-Being

Research suggests that the ability to understand one's own and others' minds, or mentalizing, is a key factor for mental health. Most studies have focused the attention on the association between global measures of mentalizing and specific disorders. In contrast, very few studies have analyzed the association between specific mentalizing polarities and global measures of mental health. This study aimed to evaluate whether self and other polarities of mentalizing are associated with a multidimensional notion of mental health, which considers symptoms, functioning, and well-being. Additionally, the level or depth of mentalizing within each polarity was also analyzed. A sample of 214 adolescents (12-18 years old, M = 14.7, and SD = 1.7; 53.3% female) was evaluated on measures of self- (Trait Meta-Mood Scale or TMMS-24) and other- mentalizing (Adolescent Mentalizing Interview or AMI), multi-informed measures of psychopathology and functioning based on Achenbach's system, and measures of psychological well-being (self-esteem, happiness, and motivation to life goals). Results revealed no association between mentalizing polarities and higher-order symptom factors (internalizing, externalizing, and global symptoms or "p" factor). Self-mentalizing was associated with self-esteem (B = 0.076, p < 0.0005) and motivation to life goals (B = 0.209, p = 0.002), and other-mentalizing was associated to general, social and role functioning (B = 0.475, p < 0.0005; B = 0.380, p = 0.005; and B = 0.364, p = 0.004). This association between aspects of self-other mentalizing and self-other function has important implications for treatment and prevention. Deeper mentalizing within each polarity (i.e., comprehension beyond simple attention to one's own mental states, and mentalizing referred to attachment figures vs. mentalizing referred to the characters of a story) revealed stronger associations with functioning and well-being. Because mentalizing polarities are associated with functioning and well-being but not with symptoms, a new hypothesis is developed: mentalizing does not contribute to resiliency by preventing symptoms, but by helping to deal with them, thus improving functioning and well-being independently of psychopathology. These findings support that promoting mentalizing across development may improve mental health, even in non-clinical population.

Social Inferences as Mediators of Wellbeing in Depression

BACKGROUND

Depression is an increasingly prevalent chronic mental health condition that involves a range of potentially negative implications, in the long term. Theory of Mind (ToM) serves to form and maintain social relationships, by accurately identifying thoughts and emotions in others. Defective ToM abilities have been noted in people with a history of clinical depression.

PURPOSE

To identify whether impairments of emotion recognition are correlated with a lower subjective feeling of wellbeing in people diagnosed with a chronic depressive illness.

PATIENTS AND METHODS

In a cross-sectional analysis of a recurrent depressive disorder (RDD, as per WHO ICD-10 nosology) cohort (n=57), the BECK depression scale and the "Reading the mind in the eyes" test were employed for the diagnosis of clinical symptoms, and for the evaluation of individual ToM skills, respectively. Wellbeing was quantified using the FANLCT scale.

RESULTS

The wellbeing of service-users decreased significantly, in correlation with their defective emotion recognition abilities. Additionally, a low capacity for the correct perception of emotions in other people appears to significantly influence the social relationships status, with scores of 14.00 (10.00-18.50) at low capacity vs 23.00 (17.58-24.75) at normal capacity (Mann-Whitney U-test, p < 0.001). Our study findings indicate that a normal ability for a correct recognition of emotions in others is significantly and strongly correlated with adequate social relationships (Spearman r = 0.757, p < 0.05).

CONCLUSION

Wellbeing is significantly correlated with the individual ability for a correct recognition of emotions in others.

Schizotypy and psychopathic tendencies interactively improve misattribution of affect in boys with conduct problems

Psychopathic tendencies are associated with difficulties in affective theory of mind (ToM), that is, in recognizing others affective mental states. In clinical and non-clinical adult samples, it has been shown that where psychopathic tendencies co-occur with schizophrenia spectrum disorders, the impairing effects of psychopathic tendencies on ToM are attenuated. These effects are yet to be examined in adolescents. We examined if the impairing effect of psychopathic tendencies on affective ToM was attenuated with increasing severity of schizotypal personality disorder (PD) in a sample of 80 incarcerated adolescent boys. We showed that the impairing effect of psychopathic tendencies on the recognition of neutral mental states, but not positive or negative mental states, was evident when the relative severity of schizotypal PD was low. However, with higher scores on both measures, we observed better performance in judging neutral mental states. The preservation of affective ToM in adolescents who show elevations in psychopathic tendencies and schizotypal PD may enable them to manipulate and extort their victims for personal gain. Our results emphasize the need to consider comorbidity in clinical case formulation when working with adolescents with conduct problems and psychopathic tendencies. More broadly, our results also suggest that the pattern of social cognitive abilities associated with co-occurring psychopathology does not always conform to an often-theorized double-dose of deficit hypothesis.

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.

An Investigation of Behavioural and Self-Reported Cognitive Empathy Deficits in Adolescents With Autism Spectrum Disorders and Adolescents With Behavioural Difficulties

Deficits in empathy have been considered hallmarks in individuals with autism spectrum disorders (ASD) but are also considered to underlie antisocial behaviour associated with individuals with callous unemotional traits (CU). Research has suggested that individuals with autism spectrum disorders show more difficulties with cognitive empathy, and that individuals diagnosed with behaviours difficulties, characterised by CU traits and antisocial behaviour, demonstrate low affective empathy. In the current manuscript we present findings of two studies. The first study describes the validation of a new stimulus set developed for the empathic accuracy task, focused on its cognitive component. The second study compares the performance of 27 adolescents with ASD, 27 age matched typically developing adolescents and 17 adolescents with behavioural difficulties on the empathic accuracy task and a self-report measure of empathy. While, no differences were observed between the three groups across the empathy accuracy task, the adolescents with ASD and CD showed deficits in their cognitive empathy across the self-report measure. Adolescents with ASD showed lower scores in particularly their perspective taking abilities, whereas the adolescences with behavioural difficulties showed more difficulties with their online simulation. No differences in self-reported affective empathy across the three groups were observed. Clinical implications of the findings are discussed.

Mentalization for Offending Adult Males (MOAM): study protocol for a randomized controlled trial to evaluate mentalization-based treatment for antisocial personality disorder in male offenders on community probation

Background

Antisocial personality disorder (ASPD), although associated with very significant health and social burden, is an under-researched mental disorder for which clinically effective and cost-effective treatment methods are urgently needed. No intervention has been established for prevention or as the treatment of choice for this disorder. Mentalization-based treatment (MBT) is a psychotherapeutic treatment that has shown some promising preliminary results for reducing personality disorder symptomatology by specifically targeting the ability to recognize and understand the mental states of oneself and others, an ability that is compromised in people with ASPD. This paper describes the protocol of a multi-site RCT designed to test the effectiveness and cost-effectiveness of MBT for reducing aggression and alleviating the wider symptoms of ASPD in male offenders subject to probation supervision who fulfil diagnostic criteria for ASPD.

Methods

Three hundred and two participants recruited from a pool of offenders subject to statutory supervision by the National Probation Service at 13 sites across the UK will be randomized on a 1:1 basis to 12 months of probation plus MBT or standard probation as usual, with follow-up to 24 months post-randomization. The primary outcome is frequency of aggressive antisocial behaviour as assessed by the Overt Aggression Scale – Modified. Secondary outcomes include violence, offending rates, alcohol use, drug use, mental health status, quality of life, and total service use costs. Data will be gathered from police and criminal justice databases, NHS record linkage, and interviews and self-report measures administered to participants. Primary analysis will be on an intent-to-treat basis; per-protocol analysis will be undertaken as secondary analysis. The primary outcome will be analysed using hierarchical mixed-effects linear regression. Secondary outcomes will be analysed using mixed-effects linear regression, mixed-effects logistic regression, and mixed-effects Poisson models for secondary outcomes depending on whether the outcome is continuous, binary, or count data. A cost-effectiveness and cost-utility analysis will be undertaken.

Discussion

This definitive, national, multi-site trial is of sufficient size to evaluate MBT to inform policymakers, service commissioners, clinicians, and service users about its potential to treat offenders with ASPD and the likely impact on the population at risk.

Trial registration

ISRCTN 32309003. Registered on 8 April 2016.

Agreeableness is related to social‐cognitive, but not social‐perceptual, theory of mind

We hypothesise on a number of grounds that the personality dimension of Agreeableness may be associated with inter‐individual differences in theory of mind (ToM) functioning. However, it is important to distinguish social‐perceptual from social‐cognitive ToM. Previous findings on ToM in psychopathic individuals, sex differences in ToM and the associations between ToM and social relationships, all suggest that social‐cognitive ToM is more likely than social‐perceptual ToM to relate to Agreeableness. In separate empirical studies, we find that Agreeableness is substantially correlated with social‐cognitive ToM performance, but uncorrelated with social‐perceptual ToM performance. We suggest that the propensity or motivation to attend to the mental states of others may be central to the personality dimension of Agreeableness. Copyright © 2008 John Wiley & Sons, Ltd.

Lack of association of common polymorphisms linked to empathic behavior with self-reported trait empathy in healthy volunteers

BACKGROUND

In a previously specified sample of 421 healthy subjects, we found associations of a common oxytocin receptor (OXTR) polymorphism with self-reported trait empathy. In this study, we used this sample to explore polymorphisms in other genes which have been frequently linked to empathic behavior for associations with self-reported trait empathy: CD38 (CD38), involved in oxytocin secretion, the serotonin transporter (SLC6A4), the Catechol-O-Methyltransferase (COMT) and the corticotropin releasing hormone receptor 1 (CRHR1).

METHODS

We genotyped our sample for the following common polymorphisms: rs3796863 in the CD38 gene, 5-HTTLPR in the SLC6A4 gene, rs4680 in the COMT gene and rs242924 in the CRHR1 gene. Dispositional empathy was tested using Davis' Interpersonal Reactivity Index (IRI). We used a Bonferroni corrected alpha level of p = 0.002 to adjust for multiple comparisons.

RESULTS

None of the genotypes were associated with any of the IRI scales for the complete sample (n = 421) or for the sub-groups of male (n = 213) and female (n = 190) participants. Our sample of 421 participants achieved 95% power to detect effects greater than r = ±0.18. For smaller effects, however, false negatives could not be rejected with equal confidence as false positives.

CONCLUSIONS

We conclude that an association between the four polymorphisms with trait empathy measured by the IRI may not be present. We propose that the associations that have been found in other studies can be largely explained by differences in empathy-related constructs and measurements.

How the Good Lives Model Can Complement Mentalization-Based Treatments for Individuals Who Have Offended With Anti-Social Personality Disorder and General Forensic Mental Health Needs: Practice Update

Limited research to date has focused on strengths-based rehabilitative approaches, such as the Good Lives Model (GLM) and the additive benefits such approaches have in ameliorating mental health needs of those in contact with forensic services. Mentalization-based therapies (MBTs) may be an effective treatment in forensic settings. This article aims to provide an overview of how GLM theory can integrate MBT within forensic settings. The review provides a conceptual overview of the many commonalities between GLM and MBT principles and provides information about how MBT can be embedded within forensic communities adhering to GLM principles. The article closes by offering an overview of the evidence of MBT approaches for individuals with anti-social personality disorder (ASPD) and those in contact with forensic services.

Intersections and Divergences Between Empathizing and Mentalizing: Development, Recent Advancements by Neuroimaging and the Future of Animal Modeling

Both mentalization and empathy allow humans to understand others, through the representation of their mental states or their mood, respectively. The present review aims to explain those characteristics which are shared between empathy and the Theory of Mind. Research in neuroscience, based on naturalistic paradigms, has shown that abilities to mentalize and to empathize are associated with the activation of different neuro-cognitive circuits. As far as mirror-neuron processes are concerned, some structures (like Anterior Insula, AI; Anterior Cingulate Cortex, ACC) play a role both in the representation of one's own affective states and in comprehension of the same affective state when experienced by others. As for mentalization, the temporal parietal junction (TPj) and temporal poles (TP), the upper posterior temporal sulcus (pSTS) and the medial prefrontal cortex (mPFC) are greatly involved: the latter appears involved in the attribution of one's own and others' temperaments. Interestingly, the ventral/orbital portion of the PFC (orbito-frontal cortex, OFC) is involved in subserving shared affective experience during cognitive mentalizing. This brain region represents a point of overlap, from a psycho-biological point of view, where emotional mirroring and affective cognition meet up. As for animal models, laboratory rodents can well be tested for prosocial behavior. Some examples include deliberate actions, allowing another conspecific the possibility to feed ("giving food"): this willingness can vary across donors, depending on how the recipient is perceived. Other examples include the possibility to let a trapped conspecific come out ("giving help"). The state-of-the-art knowledge about this theme can inform the programming of specific clinical interventions, based on the reinforcement of empathic and/or mentalization abilities.

Thinking about other's mistakes: contrasting patterns of performance in groups high or low in autistic or psychopathic traits

Introduction: Counterfactual thinking refers to thoughts such as, "What if … ?" or "If only … " that hypothesise about how past events might have turned out differently. It is a functional process, allowing us to reflect upon and solve problems, and to evoke appropriate responses. It is thought to involve both cognitive and emotional processes, and is linked to the development of false belief and moral emotions. Methods: The present study compared responses to a novel task, "Counterfactual Judgments", in students who scored high or low on self-report measures of autistic or psychopathic traits, two conditions putatively associated with deficits in empathy. Results: Contrasting patterns of performance were revealed: those with high versus low autistic traits gave harsher ratings of blame for others' mistakes and showed reduced sensitivity to punitive counterfactual alternatives, whereas those with high versus low psychopathic traits gave lower ratings for moral judgments of regret and guilt. A self-report questionnaire measure of empathy also provided some evidence of reduced empathic processing in both the high trait groups. Conclusions: The findings are considered in the light of the possible contributions of cognitive versus emotional processes to counterfactual thinking. The possible implications for managing social dysfunction in clinical populations are also discussed.

To know or not to know? Mentalization as protection from somatic complaints

Somatization processes are usually associated with a lack of insight or with emotional unawareness, especially in adolescents where the ability for self-reflection is beginning to mature. However, the extent to which different levels of insight explain variations in somatization remains understudied. This study aimed to evaluate whether high-level emotional awareness (comprehension) but not low-level awareness (only attention) is needed to psychologically cope with suffering, thus leading to lower somatization. Specific predictions were: 1) High attention along with High comprehension will be associated with significantly lower frequency of somatic complaints than other combinations (Low attention and Low comprehension, or High attention but Low comprehension); 2) In absence of comprehension, no attention will be more optimal than attention only, because only-attention might work as an amplificatory of suffering without the possibility of processing it. Self-reports of meta-cognitive processes, somatization, and control variables were obtained from 264 adolescents from a non-clinical population (54.5% female; aged 12-18, M = 14.7, SD = 1.7). In line with expectations, results revealed significant differences in the effects of insight positions on somatization: Attention+Comprehension (M = 4.9, SE = 0.9) < Nothing (M = 7.1, SE = 0.3) < Only attention (M = 8.9, SE = 0.7). Compared to Nothing, Attention+comprehension was associated with significantly reduced somatic complaints (B = -2.2, p = 0.03, 95% CI -4,1 to 0.2). However, Only attention was associated with increased somatic complaints compared to the other two conditions (B = 1.8, p = 0.03, 95% CI 0.2 to 3.4; B = 4, CI 95% 1.6-6.3, p = 0.001, respectively). This highlights the role of higher-order awareness (i.e., comprehension or clarity) in the processing of suffering and stresses its value in the adaptive coping of emotional distress.

Towards understanding atypical social affiliation in psychopathy

One distinctive feature of individuals with psychopathy is their reduced motivation and capacity to develop authentic social relationships, which are founded on an enjoyment of prosocial interactions or concern for others. Surprisingly, potential neurocognitive vulnerabilities contributing to atypical social affiliation, and lack of prosocial behaviours in psychopathy, have yet to be systematically investigated. Research efforts have largely focused on how individuals with psychopathy process negative emotions, and how this might affect their capacity to feel guilt or empathise with others' distress. Here, we propose a framework for understanding the development of atypical social affiliation and attachment in psychopathy, and outline several key processes and neural systems speculated to underpin them. We then describe present neurocognitive findings that suggest that these processes and neural systems are compromised in individuals with, or at risk of developing, psychopathy. Finally, we consider several research directions that would help with the understanding of the origin and development of social affiliation in individuals with psychopathy. This work has the potential to inform and enhance prevention and treatment strategies.

A New Test for Irony Detection: The Influence of Schizotypal, Borderline, and Autistic Personality Traits

Irony has repeatedly been suggested as a language based social cognition task. It has been argued to show specific variances in psychiatric disorders and healthy adults with certain personality traits. Above that, irony comprehension is based on a complex interplay of the informational context, the relationship of the conversational partners, and the personality of the recipient. The present study developed a video-based German language test for a systematic examination of irony detection accuracy (Tuerony). The test includes (i) a stereotypical conversation partner (doctor, actor) in (ii) different perspectives (direct interaction, neutral observer) and (iii) a bilateral chat history on a conventional messenger service interface with ironic criticism, ironic praise, literal criticism, and literal praise. Based on the continuous approach of psychiatric symptoms, schizotypal, borderline, and autistic personality traits were associated with irony detection accuracy in a healthy sample. Given the often reported role of mentalization in irony detection, these associations were also investigated. First, a broad variance of irony comprehension in our healthy sample could be shown. Second, schizotypal and borderline, but not autistic traits were significantly negatively associated with irony detection accuracy. Finally, in the current healthy sample, neither variation of the conversational context nor mentalization characteristics were significantly associated with performance beyond personality traits. The current results therefore highlight two aspects for future research in irony comprehension: the importance of ecological valid tests and the role of the individual personality of the recipient.

Beyond diagnosis: Mentalization and mental health from a transdiagnostic point of view in adolescents from non-clinical population

An increasing volume of evidence suggests that mentalization (MZ) can be an important factor in the transition from mental health to mental illness and vice versa. However, most studies are focused on the role of MZ in specific disorders. This study aims to evaluate the relationship between MZ and mental health as a trans-diagnostic process. A sample of 172 adolescents aged 12 to 18 years old (M = 14.6, SD = 1.7; 56.4% of girls) was assessed on measures of MZ, psychopathology and psychological functioning from a multimethod and multi-informant perspective. Contrary to predictions, MZ was not associated with general psychopathology and comorbidity, even when explored from a broad, trans-diagnostic perspective. However, we observed a robust association linking MZ to functioning and well-being across many dimensions, involving social, role and several psychological indicators of adjustment and mental health. These results suggest that MZ may contribute to mental health beyond symptoms, not so much associated with psychopathology, but rather resilience and well-being.

Does Affective Theory of Mind Contribute to Proactive Aggression in Boys with Conduct Problems and Psychopathic Tendencies?

Adolescent psychopathic tendencies are associated with phenotypic increases in proactive aggression. However, the extent to which an understanding of others' affective mental states, or affective theory of mind (ToM), contributes to proactive aggression remains unknown. We examined how performance on a well-known test of affective ToM, based on cropped images of the eye region, contributes to reactive and proactive types of aggression in a mixed ethnicity sample of 80 incarcerated adolescent boys. A hierarchical regression model showed that affective ToM predicted proactive aggression over and above the influence of clinically rated psychopathic tendencies. Importantly, affective ToM was unrelated to reactive aggression. Our results suggest that being able to recognize others' affective mental states may be an important factor in aggressing against others for personal gain. These findings have implications for interventions designed to enhance ToM in youth with conduct problems.

Empathy and altruistic behavior in antisocial violent offenders with psychopathic traits

Deficiencies in empathic functioning are considered a core characteristic of violent behavior. Enhancing empathy in aggressive populations may thus represent a promising intervention target. Hence, the aims of the present work were two-fold: First, we wanted to thoroughly assess empathic competencies and second, we aimed to investigate effects of an empathy induction on experienced empathy levels and prosocial behavior in a sample of violent offenders relative to matched controls. Empathy was assessed using both self-report as well as objective measures. For the empathy induction, participants were presented with empathy inducing and control videos. To assess the effects of the empathy induction on behavior, participants played a dictator game indicative of prosocial behavior after every video. Violent offenders showed no systematic impairment in empathy measures. Despite lower shares in the dictator game across conditions, the empathy induction led to a substantial increase in prosocial behavior in both groups. Importantly, high psychopathy scores were distinctively associated with lower self-reported empathy levels, an attenuated affective responsiveness to the empathy induction, and less altruistic behavior. Treatment programs aiming to improve empathy should take individual characteristics into account and may be applied to distinctive subgroups rather than to violent offenders per se.

Interpersonal and intrapersonal emotional processes in individuals treated for alcohol use disorder and non-addicted healthy individuals

INTRODUCTION

Prior work largely confirms the presence of various emotional processing deficits among individuals with an alcohol use disorder (AUD); however, their specificity and relevance still warrant investigation. The aim of the current study was to compare selected aspects of emotional processing (i.e., mental state recognition, alexithymia, and emotional intelligence) between individuals treated for an AUD and healthy individuals.

METHODS

The AUD sample consisted of 92 abstinent men with AUD who were participating in an 8-week inpatient abstinence-based treatment program in Warsaw, Poland. The healthy control (HC) group consisted of 86 men recruited from the Medical University of Warsaw and the Nowowiejski Hospital administrative staff. Baseline information about demographics, psychopathological symptoms, and severity of alcohol problems was obtained. Mental states recognition was assessed using the Reading the Mind in the Eyes Test (RMET). Alexithymia was measured with the Toronto Alexithymia Scale (TAS-20). The Schutte Self-Report Emotional Intelligence Test (SSEIT) was used to measure emotional intelligence (EI).

RESULTS AND CONCLUSIONS

After accounting for potentially confounding variables (demographics, severity of depression, anxiety symptoms) in MANCOVA models, patients with AUD presented deficits in identification and description of their own emotional states, as well as lower emotion regulation skills when compared to HCs. No between-group differences were observed in self-reported recognition of other people's emotions, social skills, and a behavioral measure of mental states recognition. Specific rather than general emotion-processing deficits in participants with AUD were identified, suggesting problems with processing of intrapersonal emotional signals.