Formulation of a measurement model for the boldness construct of psychopathy

Reliability Generalization of the Triarchic Psychopathy Measure

The extent to which psychopathy can be reliably assessed via self-report has been debated. One step in informing this debate is examining the internal consistency of self-report psychopathy measures, such as the Triarchic Psychopathy Measure (TriPM; Patrick, 2010). Reliability generalization (RG) studies apply a meta-analytic approach to examine the internal consistency of an instrument in a more robust manner by aggregating internal consistency statistics reported across the published literature. This study conducted an RG analysis to yield the average Cronbach's alpha among published studies (k = 219) that administered the TriPM. Meta-analytic alphas were high for TriPM Total (α = .88) Boldness (α = .81), Meanness (α = .87), and Disinhibition (α = .85). Moderator analyses indicated internal consistency differed minimally as a function of study characteristics, like gender, age, or the nature of the sample (i.e., forensic or community). Subsequent RG analyses were performed for McDonald's omega (k = 40), which yielded comparable internal consistency estimates. The results of this study provide strong evidence that the TriPM measures coherent, internally consistent constructs and thus could be a viable, cost-effective mechanism for measuring psychopathy across a broad range of samples.

Triarchic psychopathy and affective picture processing: An event-related potential study

Psychopathy and its precursors appear to be associated with abnormal affective response. For example, individuals high in psychopathy show reduced psychophysiological response to unpleasant stimuli, which might explain low levels of empathy in psychopathic individuals, and their pursuit of individual goals without regard for others' wellbeing. In keeping with the notion that psychopathology is best represented on a continuum, the triarchic model suggests that psychopathy is characterized by elevations on three traits: boldness, meanness and disinhibition. Understanding how these traits relate to psychophysiological response to emotional stimuli would help validate the triarchic model, while also bridging to other psychopathological spectra (e.g., internalizing psychopathology, which is characterized by low boldness). Here, N = 123 young adults passively viewed unpleasant, pleasant and neutral pictures while subjective and electrocortical response were recorded. Controlling for the other triarchic traits, individuals with higher self-reported meanness had smaller late positive potentials (LPPs) to both pleasant and unpleasant pictures, whereas individuals higher in boldness had larger LPPs to unpleasant pictures. In addition, those higher in meanness rated unpleasant pictures as more pleasant and less emotionally arousing. Disinhibition was not associated with the LPP or ratings. Meanness appears to drive blunted response to unpleasant pictures that has previously been observed among those high on psychopathy, and may also be associated with reduced engagement with generic pleasant stimuli. Moreover, results converge with prior work on other traits of transdiagnostic relevance (e.g., extraversion), as well as internalizing symptoms, providing a bridge between psychopathy and other forms of psychopathology.

Low defensive cardiac reactivity as a physiological correlate of psychopathic fearlessness: Gender differences

Affective/interpersonal features of psychopathy have been consistently associated with diverse psychophysiological indicators of low threat sensitivity, suggesting an underlying deficit in the reactivity of the brain's defensive motivational system. This study examined the Cardiac Defense Response (CDR) -a complex pattern of heart rate changes in response to an aversive, intense, and unexpected stimulus- and its second accelerative component (A2), as a new physiological indicator of the fearlessness trait component of psychopathy. The differential contribution of dispositional fearlessness, externalizing proneness, and coldheartedness to the CDR pattern elicited during a defense psychophysiological test was examined in a mixed-gender sample of 156 undergraduates (62% women) assessed by the Psychopathic Personality Inventory-Revised (PPI-R). Higher PPI-R Fearless Dominance scores were related to lower heart rate changes throughout the CDR in women, but not in men. Further analyses on scales conforming the fearless dominance factor revealed that the hypothesized reduced A2 was specifically related to higher PPI-R Fearlessness scores only in women. Our findings provide initial evidence for the utility of the A2 to better understand the physiological aspects of fearlessness tendencies and its potential distinct manifestations across genders.

Situating Psychopathy Within the DSM-5 Alternative Model of Personality Disorders (AMPD) Among Italian Community-Dwelling Adults

Given growing evidence for a joint hierarchical framework of clinical and personality symptomatology, situating triarchic traits within this model would acknowledge transdiagnostic trait-related variance and provide a basis for linking the DSM-5 Alternative Model of Personality Disorders (AMPD) domains to established indicators of these neurobehavioral traits. The current study (N = 2,041 Italian adults) sought to replicate and extend recent evidence regarding the locations of triarchic traits within the AMPD and to examine relations with criterion measures at different levels of the hierarchy. "Bass-ackwards" analyses revealed a hierarchical structure of personality pathology in which triarchic traits aligned with broad dispositional domains of the AMPD. Boldness, meanness, and disinhibition were clearly situated within the Externalizing branch of the hierarchy and helped to differentiate the Negative Affect, Antagonism, Detachment, and Disinhibition domains at lower levels. The current findings support the view of psychopathy as multidimensional and encompassing developmentally meaningful and neurobehaviorally relevant traits.

The Good, the Bad, and the Ugly? A Triarchic Perspective on Psychopathy at Work

Does psychopathy have an upside in vocational contexts? Applying the triarchic model of psychopathy, we propose that the dimensions of boldness, disinhibition, and meanness have different relations to workplace outcomes. Focusing on boldness and in line with socioanalytic personality theory, we propose that political skill moderates the relation between boldness and job performance. Using a sample of 477 target-coworker pairings, we found interaction effects of boldness and political skill on contextual and task performance, and the buffering of counterproductive work behavior. Furthermore, political skill moderated the relation between boldness and adaptive performance. Disinhibition and meanness were positively correlated with counterproductive work behaviors, thereby reflecting the dark core of psychopathy. In sum, boldness is a trait linked to career success in the absence of the other traits that make up psychopathy as a whole. Furthermore, we encourage the use of the triarchic model as an overarching framework in vocational contexts.

The effect of courage on stress: The mediating mechanism of behavioral inhibition and behavioral activation in high-risk occupations

Employees in high-risk occupations are exposed to tremendous work acute stress or prolonged stress disorders that are likely to undermine the health and organizational effectiveness. Based on positive psychology, courage which refers to behavioral approach despite the experience of fear could buffer the negative effects on stress. However, there is little known about the mechanisms by which courage decreases the risk of stress. Motivational systems may play an underlying role in this process, as behavioral inhibition system (BIS) is inhibited and behavioral activation system (BAS) is evoked by risk or threat. The current study aimed to examine the mediating effects of behavioral inhibition and activation on the relationship between courage and stress in the high-risk occupations. This study recruited 1,761 high-risk employees aged from 18 to 27 (M = 19.32; SD = 4.14) with a cluster sampling method who completed Courage Measure (CM), the BIS/BAS Scales and the Psychological Stress Evaluation Test (PSET). The correlation and mediation analyses examined the inter-variable correlations as well as the underlying mechanism between courage and stress. The results support the hypothesis and reveal that the behavioral inhibition mediates the association between courage and stress (Bindirect = −0.02, p < 0. 01, 95%CI = −0.03 to −0.003). The behavioral activation of fun seeking mediates the association between courage and stress as well (Bindirect = −0.04, p < 0. 01, 95%CI = −0.058 to −0.029). These findings suggest that behavioral inhibition and activation of fun seeking play imperative mechanism underpinning the buffering effect of courage on stress. Other theoretical and applied implications for desensitizing stress in the high-risk occupations are discussed.

Mutual synergies between reactive and active inhibitory systems of temperament in the development of children's disruptive behavior: Two longitudinal studies

Individual differences in two inhibitory temperament systems have been implicated as key in the development of early disruptive behaviors. The reactive inhibition system, behavioral inhibition (BI) entails fearfulness, shyness, timidity, and caution. The active inhibition system, or effortful control (EC) entails a capacity to deliberately suppress, modify, or regulate a predominant behavior. Lower scores in each system have been associated with more disruptive behaviors. We examined how the two systems interact, and whether one can alleviate or exacerbate risks due to the other. In two community samples (Study 1, N = 112, ages 2.5 to 4, and Study 2, N = 102, ages 2 to 6.5), we assessed early BI and EC, and future disruptive behaviors (observed disregard for rules in Study 1 and parent-rated externalizing problems in Study 2). Robustly replicated interactions revealed that for children with low BI (relatively fearless), better EC was associated with less disruptive behavior; for children with low EC, more BI was associated with less disruptive behavior. This research extends the investigation of Temperament × Temperament interactions in developmental psychology and psychopathology, and it suggests that reactive and active inhibition systems may play mutually compensatory roles. Those effects emerged after age 2.

Trait boldness and emotion regulation: An event-related potential investigation

The present study sought to extend knowledge of the role of boldness, a transdiagnostic bipolar trait dimension involving low sensitivity to threat, in emotional reactivity and regulation using physiological and report-based measures. One prior study found that boldness was associated with reduced late positive potential (LPP) while passively viewing aversive images, but not during emotion regulation; a disconnect between LPP and self-reported reactivity was also observed. Here, participants (N = 63) completed an emotion regulation task in which they either passively viewed or effortfully up- or downregulated their emotional reactivity to pleasant, unpleasant, and neutral pictures while EEG activity was recorded; they later retrospectively rated the success of their regulation efforts. ANOVAs examining the interactive effects of regulation instruction and boldness on LPP amplitude revealed that lower boldness (higher trait fearfulness) was associated with paradoxical increases in LPP to threat photos during instructed downregulation, relative to passive viewing, along with lower reported regulation success on these trials. Unexpectedly, similar LPP effects were observed for affective images overall, and especially nurturance photos. Although subject to certain limitations, these results suggest that individual differences in boldness play a role not only in general reactivity to aversive stimuli, as evidenced by prior work, but in the ability to effortfully downregulate emotional response.

Triarchic Model Traits as Predictors of Bullying and Cyberbullying in Adolescence

The triarchic model of psychopathy includes a disinhibition dimension related to externalizing outcomes, a meanness dimension pertaining to callous-unemotional traits, and a boldness dimension referring to emotional stability and high confidence in peer relationships. Some dimensions of psychopathy have been extensively investigated in samples of children and adolescents; in particular, the callous-unemotional (meanness) dimension has been associated with aggression and bullying in numerous studies. However, the other dimensions of the triarchic model have been relatively unexplored in samples of adolescents. Thus, we tested for associations between the triarchic dimensions and bullying and cyberbullying behaviors (i.e., proactive, goal-directed, and repetitive aggressive behaviors) in a sample of 580 high school students aged 14 to 19 years. Logistic regression analyses showed that (a) meanness and disinhibition scores were uniquely associated with traditional bullying, whereas only meanness was uniquely associated with cyberbullying; (b) boldness scores moderated the relationship between disinhibition and cyberbullying, such that disinhibition was related to cyberbullying only at low levels of boldness; and (c) these patterns were maintained when accounting for overall levels of conduct problems and were not moderated by the experience of victimization. Our findings suggest that the triarchic model of psychopathy can contribute to an understanding of youth engagement in bullying and cyberbullying.

Psychopathy: Current Knowledge and Future Directions

Research on psychopathy has progressed considerably in recent years against the backdrop of important advances in the broader field of clinical psychological science. My major aim in this review is to encourage integration of investigative work on dispositional, biobehavioral, and developmental aspects of psychopathy with counterpart work on general psychopathology. Using the triarchic model of psychopathy as a frame of reference, I offer perspective on long-standing debates pertaining to the conceptualization and assessment of psychopathy, discuss how dispositional facets of psychopathy relate to subdimensions of internalizing and externalizing psychopathology, and summarize findings from contemporary biobehavioral and developmental research on psychopathy. I conclude by describing a systematic strategy for coordinating biobehavioral-developmental research on psychopathy that can enable it to be informed by, and help inform, ongoing research on mental health problems more broadly. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Evaluating the validity of brief prototype-based informant ratings of triarchic psychopathy traits in prisoners

The validity of self-report psychopathy assessment has been questioned, especially in forensic settings where clinical evaluations influence critical decision-making (e.g., institutional placement, parole eligibility). Informant-based assessment offers a potentially valuable supplement to self-report but is challenging to acquire in under-resourced forensic contexts. The current study evaluated, within an incarcerated sample (n = 322), the extent to which brief prototype-based informant ratings of psychopathic traits as described by the triarchic model (boldness, meanness, disinhibition; Patrick et al., 2009) converge with self-report trait scores and show incremental validity in predicting criterion measures. Self/informant convergence was robust for traits of boldness and disinhibition, but weaker for meanness. Informant-rated traits showed incremental predictive validity over self-report traits, both within and across assessment domains. These findings indicate that simple prototype-based informant ratings of the triarchic traits can provide a useful supplement to self-report in assessing psychopathy within forensic-clinical settings.

The startle reflex as an indicator of psychopathic personality from childhood to adulthood: A systematic review

The startle reflex has been suggested to operate as a psychophysiological marker of psychopathic personality, based on findings from studies using a range of different methodologies and participant samples. The present review aims at synthesizing existing evidence of the relationship between psychopathy and the startle reflex across task paradigms, psychopathic personality subtypes and subdimensions, participant samples (i.e., incarcerated/ clinical or non-offenders), and age groups using the triarchic model of psychopathy as a frame of reference. Systematic literature searches were conducted up until the 24th of March 2020 in PubMed, PsycINFO, and Web of Science. A total of 2311 potential studies were identified, out of which 40 met relevancy and quality criteria. Results indicate that reduced aversive startle potentiation is associated with psychopathic personality in general, but clusters of traits relating to the triarchic model constructs of boldness and meanness in particular. Available evidence suggest that startle paradigms could be meaningful for differentiating individuals with and without psychopathic personality. Findings support suggestions of psychopathic personality as a multifaceted, rather than a unitary construct. Reduced aversive startle potentiation has also been found in relation to psychopathic features in child-aged samples but work of this kind is limited and more research is needed. Future studies should focus on greater consistency in task paradigms and analytic strategies to enhance the capacity to compare and integrate findings across studies.

Testing for Sex Differences in the Nomological Network of the Triarchic Model of Psychopathy in Incarcerated Individuals

The triarchic model of psychopathy conceptualizes variants of this clinical condition as expressions of three distinct biobehavioral dispositions, termed boldness, meanness, and disinhibition. As a trait-oriented model, the triarchic model situates psychopathy within a broader nomological network of personality and psychopathology, and has proven useful for characterizing how psychopathy relates to variables in these domains as well as to biological and behavioral variables. The current study was the first to examine sex differences in the external correlates of psychopathic traits as described by the triarchic model in a prison sample. Results were generally consistent with hypotheses: The triarchic traits related to measures of personality and psychopathology in patterns that were largely consistent across sex, but with some notable differences between males and females, in the correlates of disinhibition in particular. These included stronger associations for disinhibition with substance use problems, self-harm, and staff ratings of prison misbehavior among females compared to males. Findings from this study support the value of the triarchic model for understanding similarities and differences in the nomological network of psychopathy in incarcerated males and females.

Investigating the Validity Evidence of the Swedish TriPM in High Security Prisoners Using the PCL-R and NEO-FFI

The triarchic model of psychopathy was developed to bridge opposing descriptions of psychopathy by separating the core construct in three domains; boldness, meanness, and disinhibition. The Triarchic Psychopathy Measure (TriPM) operationalizes the model through a 58-item self-report questionnaire. The current study examined the psychometric properties of the Swedish translation by investigating intercorrelations and associations to expert-rated psychopathy, general personality and psychopathy-related traits in male high-security prisoners (n = 191). Psychopathy rated with TriPM and the Psychopathy Checklist Revised (PCL-R) demonstrated expected convergence, as did empathy and impulsivity measures. The Disinhibition and Meanness scales were highly correlated, indicating that the scales might not be adequately differentiated. Nevertheless, the divergent association patterns to other important variables, particularly neuroticism and empathy, also points to meaningful differences. However, the lack of association between Disinhibition and Boldness may put into question if these domains are related at all, especially since there was a lack of similarity in the association patterns with other clinical variables. The influence of antisocial behavior in the TriPM operationalization might amplify the similarities of the Meanness and Disinhibition scales, while diluting the associations between Meanness and Boldness. In conclusion, the Swedish TriPM is effective in measuring the domains of triarchic model in forensic settings, even though a revision of the scales might improve the psychometric properties of the instrument.

A Model-Based Strategy for Interfacing Traits of the DSM-5 AMPD With Neurobiology

The DSM-5 alternative model for personality disorders (AMPD) groups traits into domains based on factor analyses of self-report data. AMPD traits may need to be configured differently to interface with neurobiology. Focusing on biobehavioral risk for externalizing problems in 334 adults, the authors used structural modeling to evaluate how well alternative configurations of AMPD traits, operationalized using the Personality Inventory for DSM-5 (PID-5), interface with neural indicators of externalizing liability. A model specifying two correlated factors defined by traits within the PID-5 Disinhibition domain and brain-response indicators of externalizing proneness exhibited inadequate fit. However, a model using PID-5 traits with better coverage of biobehavioral externalizing liability evidenced good fit. Scores on this PID-5 trait factor, termed "PID-5 Externalizing Proneness," converged well with criterion measures of externalizing proneness and diverged from measures of threat sensitivity. Findings illustrate how AMPD traits can be configured for use in investigations of biobehavioral risk for psychopathology.

Quantifying Dispositional Fear as Threat Sensitivity: Development and Initial Validation of a Model-Based Scale Measure

The Research Domain Criteria initiative aims to reorient the focus of psychopathology research toward biobehavioral constructs that cut across different modalities of measurement, including self-report and neurophysiology. Constructs within the Research Domain Criteria framework are intentionally transdiagnostic, with the construct of "acute threat," for example, broadly relevant to clinical problems and associated traits involving fearfulness and stress reactivity. A potentially valuable referent for research on the construct of acute threat is a structural model of fear/fearlessness questionnaires known to predict variations in physiological threat reactivity as indexed by startle potentiation. The aim of the current work was to develop an efficient, item-based scale measure of the general factor of this structural model for use in studies of dispositional threat sensitivity and its relationship to psychopathology. A self-report scale consisting of 44 items from a conceptually relevant, nonproprietary questionnaire was first developed in a sample of 1,307 student participants, using the general factor of the fear/fearlessness model as a direct referent. This new Trait Fear scale was then evaluated for convergent and discriminant validity with measures of personality and psychopathology in a separate sample (n = 213) consisting of community adults and undergraduate students. The strong performance of the scale in this criterion-validation sample suggests that it can provide an effective means for indexing variations along a dispositional continuum of fearfulness reflecting variations in sensitivity to acute threat.

Forms, Importance, and Ineffability of Factor Interactions to Define Personality Disorders

The emergent interpersonal syndrome (EIS) approach conceptualizes personality disorders as the interaction among their constituent traits to predict important criterion variables. We detail the difficulties we have experienced finding such interactive predictors in our empirical work on psychopathy, even when using uncorrelated traits that maximize power. Rather than explaining a large absolute proportion of variance in interpersonal outcomes, EIS interactions might explain small amounts of variance relative to the main effects of each trait. Indeed, these interactions may necessitate samples of almost 1,000 observations for 80% power and a false positive rate of .05. EIS models must describe which specific traits' interactions constitute a particular EIS, as effect sizes appear to diminish as higher-order trait interactions are analyzed. Considering whether EIS interactions are ordinal with non-crossing slopes or disordinal with crossing slopes, or entail nonlinear threshold or saturation effects may help researchers design studies, sampling strategies, and analyses to model their expected effects efficiently.