Callous-unemotional, impulsive-irresponsible, and grandiose-manipulative traits: Distinct associations with heart rate, skin conductance, and startle responses to violent and erotic scenes

Psychopathy, pain, and pain empathy: A psychophysiological study

The present study examined whether people higher in psychopathy experienced less self-reported and psychophysiological nociceptive pressure than people lower in psychopathy. We also examined whether psychopathy affects empathy for others' pain via self-reported and psychophysiological measures. Three hundred and sixty-nine students (18-78 years; M = 26, SD = 9.34) were screened for psychopathic traits using the Youth Psychopathy Inventory (YPI). Stratified sampling was used to recruit 49 adults residing in the highest (n = 23) and lowest (n = 26) 20% of the psychopathy spectrum. Using skin conductance response (SCR) and self-report responses, participants responded to individually adjusted intensities of pneumatic pressure and others' pain images and completed self-reported psychopathy and empathy measures (Triarchic Psychopathy Measure, TriPm; Interpersonal Reactivity Index, IRI). People higher in psychopathy self-reported feeling less nociceptive pressure compared to people lower in psychopathy, yet we did not find any differences in SCR to nociceptive pressure. However, when viewing other people in pain, the high psychopathy group displayed lower SCR and lower self-reported empathy compared to those lower in psychopathy. Our results suggest psychopathic traits relate to problems empathising with others' pain, as well as the perception of nociceptive pressure. We also show support for the theory of dual harm which has been receiving increasing attention. Consequently, psychopathy interventions should focus both on recognising and empathising with the pain of others.

Putting the usability of wearable technology in forensic psychiatry to the test: a randomized crossover trial

Introduction

Forensic psychiatric patients receive treatment to address their violent and aggressive behavior with the aim of facilitating their safe reintegration into society. On average, these treatments are effective, but the magnitude of effect sizes tends to be small, even when considering more recent advancements in digital mental health innovations. Recent research indicates that wearable technology has positive effects on the physical and mental health of the general population, and may thus also be of use in forensic psychiatry, both for patients and staff members. Several applications and use cases of wearable technology hold promise, particularly for patients with mild intellectual disability or borderline intellectual functioning, as these devices are thought to be user-friendly and provide continuous daily feedback.

Method

In the current randomized crossover trial, we addressed several limitations from previous research and compared the (continuous) usability and acceptance of four selected wearable devices. Each device was worn for one week by staff members and patients, amounting to a total of four weeks. Two of the devices were general purpose fitness trackers, while the other two devices used custom made applications designed for bio-cueing and for providing insights into physiological reactivity to daily stressors and events.

Results

Our findings indicated significant differences in usability, acceptance and continuous use between devices. The highest usability scores were obtained for the two fitness trackers (Fitbit and Garmin) compared to the two devices employing custom made applications (Sense-IT and E4 dashboard). The results showed similar outcomes for patients and staff members.

Discussion

None of the devices obtained usability scores that would justify recommendation for future use considering international standards; a finding that raises concerns about the adaptation and uptake of wearable technology in the context of forensic psychiatry. We suggest that improvements in gamification and motivational aspects of wearable technology might be helpful to tackle several challenges related to wearable technology.

Gender differences in the effects of emotion induction on intertemporal decision-making

'Good things come to those who wait' is a popular saying, which goes along with numerous daily life decisions requiring trade-offs between immediate-small and later-larger rewards; however, some individuals have a tendency to prefer sooner rewards while discounting the value of delayed rewards, known as delay discounting. The extant literature indicates that emotions and gender can modulate intertemporal choices, but their interplay remains hitherto poorly investigated. Here, 308 participants were randomized to different conditions, inducing distinct emotions-fear, joy, a neutral state-through standardized movie clips, and then completed a computerized delay discounting task for hypothetical money rewards. Following the induction of fear, women discount the future steeper than men, thus preferring immediate-smaller rewards rather than larger-delayed ones. Also, women were more prone to choose immediate rewards when in a fearful condition than when in a positive state of joy/happiness. By contrast, men were unaffected by their emotional state when deciding on monetary rewards. Our findings provide evidence that fear can trigger different intertemporal choices according to gender, possibly reflecting the adoption of different evolutionary strategies.

Diagnosing callous-unemotional personality traits by heart rate orienting responses to images inducing threat and distress

The present study aimed at developing a rather easily applicable method of testing physiological reactions to images of threats and misery. To this end, rapid-changing, transient heart rate orienting responses were used for gaining physiologically based, objective responses to the images. Additionally, subjective ratings were obtained. A significant insensitivity to other's welfare and well-being was already demonstrated as a core feature of callous-unemotional personalities. Thus, physiologically based methods may supplement and possibly improve existing assessments and, in particular, may contribute to a multimodal assessment of psychopathic traits. Out of a non-forensic community sample of 122 men, we selected two extreme groups of 30 participants with the lowest and highest callous-unemotional traits respectively, ascertained by questionnaires. As expected, participants with higher scores of callous-unemotional traits showed smaller responses to distress cues in both heart rate responses and subjective ratings. Moreover, within the group with high callous-unemotional traits heart rate responses to threatening as well as distress cues did not significantly differ from responses to neutral pictures. The study provides further evidence for the idea that a lack of responsiveness to distress cues may be seen as a central feature of callous-unemotional personalities.

Examining the relation among callous-unemotional traits and cortisol, alpha-amylase, and testosterone reactivity in legal system involved young men

Elevated callous-unemotional (CU) traits (e.g., lack of empathy, deficient guilt/remorse, and shallow affect) are associated with increased antisociality and distinct patterns of cognitive and emotional functioning. Previous investigations have suggested that deficits in physiological stress responses may underlie these associations, yet few studies simultaneously examine the multiple physiological systems responsible for mounting a stress response. To clarify how individuals with and without elevated CU traits respond to acute stress, the current study examined the association between CU traits and hormones released by three systems: cortisol from the hypothalamic-pituitary-adrenal (HPA) axis, alpha-amylase from the sympathetic nervous system (SNS), and testosterone from hypothalamic-pituitary-gonadal (HPG) axis. Specifically, we used fixed effect regression modeling to examine within-individual changes in each biomarker across the administration of a standardized laboratory stressor (Trier Social Stress Test) in a sample of 55 justice-involved young men (Mage= 22.84). Results indicated significant within-individual changes in cortisol, alpha-amylase, and testosterone following the stressor among those with low or average CU traits. However, those with high levels of CU exhibited no significant changes in their cortisol and testosterone levels. Furthermore, individuals with high CU traits exhibit an asymmetric stress response, such that alpha-amylase and testosterone levels were not associated with changes in cortisol levels. In sum, elevated CU traits were associated with blunted cortisol and testosterone reactivity and asymmetric response to stress. Additional work is needed to determine the behavioral and treatment implications of this distinct stress response.

Blunted startle reactivity in everyday sadism and psychopathy

Two studies examined the amplitude of the startle response as a function of the Dark Tetrad of personality (narcissism, Machiavellianism, psychopathy, and sadism). We measured electromyographic activity of the orbicularis oculi muscle evoked by a startle stimulus while participants viewed images on a computer screen. Both studies revealed a negative correlation between general startle reactivity (averaged across positive, negative, and neutral images) and sadistic tendencies. In Study 2, all four dark traits were negative correlates of general startle reactivity. Study 2 also examined the personality correlates of aversive startle potentiation (ASP; indexed by greater reactivity while viewing negatively-valenced images than positive or neutral images). ASP correlated negatively with a variety of personality measures of psychopathy and sadism, their facets, and related personality tendencies (callousness, risk-taking, and restricted affect). These findings suggest that ordinary people with high levels of callousness and antagonism display physiological evidence of non-reactivity (i.e., blunted acoustic startle in general), whereas psychopathy and sadism are preferentially associated with reduced ASP.

Men's Self-Reported and Psychophysiological Affective Responses to Sexual Violence and Their Associations with Rape Myths, Personality, and Sexual Traits: A Preliminary Study

Objective: Despite alarming evidence on sexual violence against women, little is known about men's emotional responses to rape and how these may be involved in sexual violence dynamics. Accordingly, our aim was to capture how rape scenarios are emotionally appraised. Methods: The current study evaluated men's (N = 30) self-reported and psychophysiological emotional responses (facial EMG, electrodermal activity) to a rape scene, and contrasted it with their responses to stimuli depicting nonsexual violence and nonviolent male-female interactions. The associations between men's emotional responses and their endorsement of rape myths, personality, and sexual traits were also examined. Results: Findings revealed that the rape scene resulted in higher negative affect, both subjectively and indexed by increased facial EMG (corrugator activity), than the other two stimuli. Additionally, personality traits of neuroticism, lower agreeableness, lower consciousness, psychopathic tendencies, as well as lower sexual inhibition proneness, were all associated with higher subjective sexual arousal toward rape. Conclusions: Findings add to the literature on the putative emotional processes underpinning the appraisal of sexual violence against women.

The Proposed Specifiers for Conduct Disorder - Parent (PSCD-P): Convergent Validity, Incremental Validity, and Reactions to Unfamiliar Peer Confederates

Youth who experience psychopathy display multiple impairments across interpersonal (grandiose-manipulative [GM]), affective (callous-unemotional [CU]), lifestyle (daring-impulsive [DI]), and potentially antisocial and behavioral features. Recently, it has been acknowledged that the inclusion of psychopathic features can offer valuable information in relation to the etiology of Conduct Disorder (CD). Yet, prior work largely focuses on the affective component of psychopathy, namely CU. This focus creates uncertainty in the literature on the incremental value of a multicomponent approach to understanding CD-linked domains. Consequently, researchers developed the Proposed Specifiers for Conduct Disorder (PSCD; Salekin & Hare, 2016) as a multicomponent approach to assess GM, CU, and DI features in combination with CD symptoms. The notion of considering the wider set of psychopathic features for CD specification requires testing whether multiple personality dimensions predict domain-relevant criterion outcomes above-and-beyond a CU-based approach. Thus, we tested the psychometric properties of parents' reports on the PSCD (PSCD-P) in a mixed clinical/community sample of 134 adolescents (M_age = 14.49, 66.4% female). Confirmatory factor analyses resulted in a 19-item PSCD-P displaying acceptable reliability estimates and a bifactor solution consisting of GM, CU, DI, and CD factors. Findings supported the incremental validity of scores taken from the PSCD-P across multiple criterion variables, including (a) an established survey measure of parent-adolescent conflict; and (b) trained independent observers' ratings of adolescents' behavioral reactions to laboratory controlled tasks designed to simulate social interactions with unfamiliar peers. These findings have important implications for future research on the PSCD and links to adolescents' interpersonal functioning.

Psychopathic Traits and Parental Practices in Greek-Cypriot Community and Dutch Clinical Referred Samples

Parental practices are associated with psychopathic traits across several developmental stages. However, the majority of available studies focused mainly on the affective dimension of psychopathy, namely callous-unemotional traits, disregarding the grandiose-deceitful and impulsivity-need for stimulation dimensions. The current study examines the distinct associations between all three dimensions with parental practices (parental involvement, poor monitoring, inconsistent discipline, and corporal punishment) after considering the effect of conduct problems (CPs) and sex in a Greek-Cypriot primary school sample (N = 792, Mage = 6.93, SD = 0.72) and a Dutch clinical-referred sample (N = 217, Mage = 9.55, SD = 1.79) of children. In the community sample, hierarchical multiple regression analysis revealed that parents of children with high levels of callous-unemotional traits were more likely to engage in inconsistent discipline but less in positive parental practices. In contrast, high levels of impulsivity-need for stimulation were related to inconsistent discipline. In the clinical sample, callous-unemotional traits were associated with less parental involvement and grandiose-deceitful dimension with high levels of inconsistent discipline. These findings suggest that the three psychopathy dimensions have unique relations with parental practices above and beyond CPs, proposing that parental practices may be influenced more strongly by psychopathic traits than by antisocial behavior.

Parental Antisocial and Psychopathic Traits Influence Adolescent Psychopathology

The role of parental antisocial behavior in the development of adolescent psychopathology is well established in the literature. However, less is known about the role of parental psychopathic traits in offspring psychopathology. Adolescents (N = 210; boys = 107) and their parents participated in a study measuring parental antisocial behavior, psychopathic traits (i.e., callous-unemotional traits, impulsive-irresponsibility, and grandiosity), and adolescent psychopathology, including depression, anxiety, attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Results from the structural equation model suggested that maternal antisocial acts, but not anger propensity, positively predicted adolescent CD, ODD, and depressive symptoms. Paternal anger propensity mainly predicted internalizing problems, whereas paternal impulsive-irresponsibility predicted anxiety and ADHD symptoms. In addition, findings pointed to several indirect effects from maternal and paternal psychopathic traits to adolescent psychopathology, with the strongest one being between maternal impulsive-irresponsibility to maternal antisocial acts to adolescent ODD. The findings suggest that parental antisocial behaviors and psychopathic traits, and especially impulsive-irresponsibility, should be considered in interventions aiming to reduce adolescent psychopathology.

Constant installation of present orientation and safety (CIPOS) - subjective and physiological effects of an ultrashort-term intervention combining both stabilizing and confrontational elements

Objectives

Constant Installation of Present Orientation and Safety (CIPOS) is a Eye Movements Desensitization and Reprocessing (EMDR)-derived technique, which is often used to prepare for the treatment of post-traumatic stress disorder (PTSD). It differs from the latter by involving cyclically recurring exercises in reorientation to the present, interspersed between brief periods of exposure to the traumatic material.While EMDR is well established as a therapeutic method, the efficacy and mechanisms of action of CIPOS have not been investigated so far. In this pilot study, an experimental setting was used to record the subjective and physiological effects of the CIPOS intervention compared to a control condition with pure mental exposition.

Methods

The study was performed on 30 healthy volunteers aged from 20 to 30 years. Distress was induced using audio files of subjectively stressful situations. Subjective distress was measured via the Subjective Units of Distress Scale (SUD), while physiological indicators (noise-induced startle reflex, skin conductance level) were used as measures for objective stress. For each condition, pre- and post-intervention comparisons were calculated.

Results

In both groups, startle reflex potentiation and mean skin conductance level significantly decreased. In the group with CIPOS intervention, but not in the control group, a significant decrease in the SUD value was found.

Conclusion and significance

The results show that the CIPOS technique is as effective as pure mental exposition in reducing physiological stress. In addition, a superiority in reducing subjective distress (indicating a simplified reassessment of the stressful material) was found compared to pure mental exposition. Possible explanations of these effects are discussed.

Difficulties in facial emotion recognition: taking psychopathic and alexithymic traits into account

BACKGROUND

Alexithymic and psychopathic traits are closely associated, but distinct constructs. Both have been associated with facial emotion processing deficits reflecting empathy deficits, however the underlying mechanism contributing to these deficits is not well-understood.

METHODS

This study investigated facial emotion recognition performance in a non-clinical sample (N = 110) including both male and female participants, with varying levels of psychopathic and alexithymic traits. Facial emotion recognition was assessed using a computerized task, that presented different expressions depicting five emotional states (pain, fear, sadness, anger, happiness) and neutral expressions.

RESULTS

Results suggest that the high psychopathic traits group reported lower accuracy compared to the low psychopathic traits group, indicating a more generalized deficit in facial affect recognition, across all emotions. The alexithymic groups (high vs. low) on the other hand did not differ in their performance on the task for any of the emotions presented.

CONCLUSION

These findings add to the current body of research regarding face processing categorization deficits in relation to psychopathic and alexithymic traits and can inform prevention and intervention efforts that aim to facilitate facial emotion recognition in individuals with these personality traits.

Examining Links Between Infant Parasympathetic Regulation during the Still-Face Paradigm and Later Callous-Unemotional Traits

Although research suggests that callous-unemotional (CU) traits are underpinned by deficits in social affiliation and reduced sensitivity to threat, there has been little investigation of the biophysiological regulatory mechanisms underlying these processes in infancy. The current study uses data from the Durham Child Health and Development Study (DCHD; n = 206) to examine whether and how the combination of infants' behavioral reactivity and levels of respiratory sinus arrhythmia (RSA), an indicator of parasympathetic nervous system functioning, during the still-face episode of the still-face paradigm at 6 months differentiates risk for CU traits and oppositional defiant behaviors (ODD) at age 3 years, as well as whether these relations vary by children's attachment security. Results indicate that reduced negative affect during the still-face episode at 6 months predicts higher CU traits (B = -0.28, β = -0.27, p = 0.003) and ODD (B = -0.35, β = -0.24, p = 0.007) at 3 years. Results also show that comparatively lower RSA, i.e. engaged parasympathetic system, predicts higher CU traits (B = -0.10, β = -0.34, p = 0.013), but not ODD. Tests of moderation suggest the combination of blunted negative affect but comparatively lower RSA levels during a social stressor constitutes risk for later CU traits for children who are also insecurely attached (simple slope = -0.70, t = 2.88, p = 0.006 at -1 SD). Findings contribute to our understanding of the complex and interactive risk processes which precede the development of CU traits.

Fear Conditioning Deficits in Children and Adolescents with Psychopathic Traits: a Study in a Clinical Population

Deficits in fear conditioning related to psychopathy have been widely studied in adults. However, evidence in children and adolescents is scarce and inconsistent. This research aimed to expand knowledge about fear conditioning in psychopathy and its dimensions in child and early adolescent clinical populations. Participants were 45 boys (outpatients) aged 6–14 years (M = 10.59, SD = 2.04). They were assessed with the parents’ and teachers’ versions of the Child Problematic Traits Inventory (CPTI). A fear conditioning paradigm (Neumann et al., in Biological Psychology, 79(3), 337–342, 2008) for children and adolescents was used. Conditioned stimuli (CS+ and CS-) were geometric shapes and the unconditioned stimulus (US) was an unpleasant sound of metal scraping on slate (83 dB). Difference scores (CS+ minus CS-) in skin conductance responses (SCR) and self-reported cognitive and affective measures were considered as indices of fear conditioning. Results showed that: a) deficits in fear conditioning were related to some psychopathy dimensions but not to psychopathy as a unitary construct; b) the Impulsivity-Need for Stimulation dimension was a predictor of impaired fear conditioning at a cognitive level; c) the interaction of Callous-Unemotional and Impulsivity-Need for Stimulation dimensions was a significant predictor of impaired electrodermal fear conditioning; d) by contrast, the Grandiose-Deceitful dimension, was marginally associated with a greater electrodermal fear conditioning. In conclusion, psychopathy dimensions and their interactions, but not psychopathy as a whole, predicted deficits in fear conditioning as measured by SCR and cognitive indices. These findings confirm the notion that psychopathic traits are associated with deficits in fear conditioning in child and adolescent clinical populations and provide support for a multidimensional approach to youth psychopathy.

Skin Conductance Responses to a Discrete Threat in Virtual Reality: Associations with Psychopathy and Anxiety

People with high levels of psychopathic traits are often described as fearless and lacking in emotional depth, particularly when evaluating threats in their environments. Skin conductance responsivity (SCR) to negative emotional stimuli represents a robust autonomic correlate of conduct problem behavior in children (Fanti et al., in Neuroscience and Biobehavioral Reviews, 100, 98-107, 2019). However, studies that have examined threat-related processing in youth with conduct problems have tended to use a variety of negative stimuli that might induce various and unspecific negative emotions. Few studies have taken in to account the moderating effects of anxiety on the relationship of distinct psychopathic traits (e.g., narcissism, callousness, impulsivity) with SCR to a fear inducing stimulus. In this study, we examined SCR to a virtual reality rollercoaster drop - that is, a discrete fear inducing event - in a sample of 75 youths (61 males; M = 14 years, SD = 1.4) enrolled in a non-mainstream school. The rollercoaster drop was used to more clearly examine an event-related response to a discrete threat, rather than examining SCR throughout the rollercoaster ride. We used the teacher-reported Antisocial Process Screening Device (Frick & Hare, in Antisocial process screening device: APSD. Toronto: Multi-Health Systems, 2001) to examine the relations of distinct psychopathic traits with SCR and self-reported anxiety. Lower anxiety was associated with higher callousness, but only in youths with low SCR to discrete threat. These findings suggest that fear and anxiety show complex and interactive relations with distinct psychopathic traits.

Bicyclist-evoked arousal and greater attention to bicyclists independently promote safer driving

While attention has consistently been shown to be biased toward threatening objects in experimental settings, our understanding of how attention is modulated when the observer is in an anxious or aroused state and how this ultimately affects behavior is limited. In real-world environments, automobile drivers can sometimes carry negative perceptions toward bicyclists that share the road. It is unclear whether bicyclist encounters on a roadway lead to physiological changes and attentional biases that ultimately influence driving behavior. Here, we examined whether participants in a high-fidelity driving simulator exhibited an arousal response in the presence of a bicyclist and how this modulated eye movements and driving behavior. We hypothesized that bicyclists would evoke a robust arousal and orienting response, the strength of which would be associated with safer driving behavior. The results revealed that encountering a bicyclist evoked negative arousal by both self-report and physiological measures. Physiological and eye-tracking measures were themselves unrelated, however, being independently associated with safer driving behavior. Our findings offer a real-world demonstration of how arousal and attentional prioritization can lead to adaptive behavior.

Heart Rate and Skin Conductance Associations with Physical Aggression, Psychopathy, Antisocial Personality Disorder and Conduct Disorder: An Updated Meta-Analysis

The associations between physiological measures (i.e., heart rate and skin conductance) of autonomic nervous system (ANS) activity and severe antisocial spectrum behavior (AB) were meta-analyzed. We used an exhaustive partitioning of variables relevant to the ANS-AB association and investigated four highly relevant questions (on declining effect sizes, psychopathy subscales, moderators, and ANS measures) that are thought to be transformative for future research on AB. We investigated a broad spectrum of physiological measures (e.g., heart rate (variability), pre-ejection period) in relation to AB. The search date for the current meta-analysis was on January 1^st, 2020, includes 101 studies and 769 effect sizes. Results indicate that effect sizes are heterogeneous and bidirectional. The careful partitioning of variables sheds light on the complex associations that were obscured in previous meta-analyses. Effects are largest for the most violent offenders and for psychopathy and are dependent on the experimental tasks used, parameters calculated, and analyses run. Understanding the specificity of physiological reactions may be expedient for differentiating between (and within) types of AB.

Physiological reactivity in children with high callous-unemotional and autistic traits: investigating unique and interactive effects

Empathy deficits are a hallmark sign of both callous-unemotional (CU) and autistic traits. Despite these similarities, prior work did not investigate how these traits relate to physiological reactivity (heart rate and skin conductance) in response to emotional or empathy-eliciting stimuli. Understanding the physiological mechanisms associated with emotional processing deficits among individuals with autistic or CU traits is a critical step for improving both assessment and interventions. The current study was designed to investigate the unique and interactive contributions of CU and autistic traits in predicting physiological reactivity. Heart rate (HR) and skin conductance (SC) activity in response to sad, fearful and happy emotional videos were collected form young children. Participants for the current study (n = 163; M_age = 7.30, SD= 1.42; 44.2% girls) were recruited from a larger community sample of 1652 children and were selected based on their levels of empathy. Regression analysis revealed that boys, but not girls, with high levels of CU traits exhibited low SC reactivity during sad and fearful stimuli. No significant associations were revealed for autistic traits. Finally, an interesting interaction effect suggested that CU traits were associated with stronger HR reactivity to fear stimuli only when autistic traits were low. The identified differences in physiological reactivity can inform etiological hypothesis by providing evidence for the underlying physiological mechanisms related to emotional processing among children high in CU traits but not in autistic traits.

Heart-wired to be cold? Exploring cardiac markers of callous-unemotional traits in incarcerated offenders

Elevated callous-unemotional (CU) traits have been repeatedly identified in a subgroup of offenders that displays severe antisocial behavior; establishing physiological markers may help improve early identification and treatment efforts. This study examines to what extent baseline-resting heart rate (HR) and heart rate variability (HRV) can be used as markers of CU in incarcerated juvenile and adult offenders. CU traits were assessed using the Inventory of Callous-Unemotional traits. Results of the multiple hierarchical regression tests indicated that there was a small yet significant positive association between baseline HR and CU and negative association between HRV and CU in juvenile offenders with medium model effect sizes (R² = 0.115 for HR-CU; R² = 0.126 for HRV-CU). The cardiac markers were unrelated to CU in adult offenders. These findings are important because they demonstrate that impaired cardiac autonomic activity is related to CU traits in juveniles, suggesting that socioemotional processing difficulties should be considered in understanding these deficits. Future research should be conducted in large samples, under reactive and static conditions, while including cardiac covariates, to get more clarity on the interplay between biological systems and behavioral expression.

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.

Callous-unemotional traits and fearlessness: A cardiovascular psychophysiological perspective in two adolescent samples using virtual reality

There has been a longstanding debate about the link between callous-unemotional traits and fearlessness. However, biological evidence for a relationship in adolescents is lacking. Using two adolescent samples, we measured emotional reactivity and cardiac measures of sympathetic (pre-ejection period) and parasympathetic (respiratory sinus arrhythmia) reactivity during 3D TV and virtual reality fear induction. Study 1 included 62 community adolescents from a stratified sample. Study 2 included 60 adolescents from Emotional and Behavioral Difficulties schools. Results were consistent across both studies. Adolescents with high callous-unemotional traits showed coactivation of the sympathetic and parasympathetic nervous system. Consistent with these results, youths with callous-unemotional traits self-reported that they felt more in control after the fear induction. Thus, in both samples, youth with callous-unemotional traits displayed a physiological and emotional profile suggesting they maintained control during fear induction. Therefore, it is proposed here that a shift in thinking of youth with callous-unemotional traits as fearless to youth with callous-unemotional traits are better able to manage fearful situations, may be more appropriate.

Mapping neural activity patterns to contextualized fearful facial expressions onto callous-unemotional (CU) traits: intersubject representational similarity analysis reveals less variation among high-CU adolescents

Callous-unemotional (CU) traits are early-emerging personality features characterized by deficits in empathy, concern for others, and remorse following social transgressions. One of the interpersonal deficits most consistently associated with CU traits is impaired behavioral and neurophysiological responsiveness to fearful facial expressions. However, the facial expression paradigms traditionally employed in neuroimaging are often ambiguous with respect to the nature of threat (i.e., is the perceiver the threat, or is something else in the environment?). In the present study, 30 adolescents with varying CU traits viewed fearful facial expressions cued to three different contexts ("afraid for you," "afraid of you," "afraid for self") while undergoing functional magnetic resonance imaging (fMRI). Univariate analyses found that mean right amygdala activity during the "afraid for self" context was negatively associated with CU traits. With the goal of disentangling idiosyncratic stimulus-driven neural responses, we employed intersubject representational similarity analysis to link intersubject similarities in multivoxel neural response patterns to contextualized fearful expressions with differential intersubject models of CU traits. Among low-CU adolescents, neural response patterns while viewing fearful faces were most consistently similar early in the visual processing stream and among regions implicated in affective responding, but were more idiosyncratic as emotional face information moved up the cortical processing hierarchy. By contrast, high-CU adolescents' neural response patterns consistently aligned along the entire cortical hierarchy (but diverged among low-CU youths). Observed patterns varied across contexts, suggesting that interpretations of fearful expressions depend to an extent on neural response patterns and are further shaped by levels of CU traits.

EEG gamma activity to emotional movies in individuals with high traits of primary "successful" psychopathy

This study aimed to investigate emotional alterations in a community sample with primary psychopathic traits. Sixty males selected from a larger sample and divided in two groups, High (HP) and Low (LP) primary Psychopathy, watched 15 validated emotional movies divided in five categories (Erotic, Neutral, Fear, and the new Scenery and Compassion). Subjective responses and cortical activity in the EEG Gamma band (30-49 Hz) were recorded. Concerning self-reports, HP participants felt less anxious and anguished in response to Fear clips and less sad, touched and anguished by Compassion excerpts. Negative clips induced larger EEG Gamma activity in both groups compared to neutral and erotic movies, but Gamma activity to Fear movies was reduced in HP. This group showed also a small cortical response to positive Scenery movies, at the level of the Neutral ones. Source analysis showed in HP participants a reduced cortical activation to Fear in a large brain network, comprising the right prefrontal and temporal cortices and bilateral inferior parietal cortex. Results showed that primary psychopathy, in addition to the impaired response to Fear, was associated with a reduced response also to other specific categories of emotional stimuli, suggesting an altered affect on a broader scale.

Factorial Structure and Nomological Network of the Inventory of Callous-Unemotional Traits Accounting for Item Keying Variance

The factorial structure of the Inventory of Callous Unemotional Traits (ICU) is currently under dispute. The present study aims to test the factorial structure of a Greek adaptation of the ICU by considering item keying variance and examining alternative theoretical and empirically derived models. Additionally, it aims to investigate the nomological network of the ICU subscales, after controlling for item keying variance. The sample consisted of 1536 Greek-Cypriot adolescents, who completed a battery of questionnaires, including the ICU. Results showed that the consideration of item keying variance improved the overall fit of all the examined models and led to significant changes in the predictive validity of the subscales, while method factors presented distinct patterns of associations with external variables. Overall, results suggest that ICU is contaminated by item keying variance, which can be filtered out to provide clinically useful insight into the factorial structure of the ICU.

Somatic Marker Production Deficits do not Explain the Relationship between Psychopathic Traits and Utilitarian Moral Decision Making

In moral dilemma tasks, high levels of psychopathic traits often predict increased utilitarian responding-specifically, endorsing sacrificing one person to save many. Research suggests that increased arousal (i.e., somatic marker production) underlies lower rates of utilitarian responding during moral dilemmas. Though deficient somatic marker production is characteristic of psychopathy, how this deficit affects the psychopathy-utilitarian connection remains unknown. We assessed psychopathic traits in undergraduates, as well as behavioral performance and skin conductance level reactivity (SCL-R; a measure of somatic marker production) during a moral dilemma task. High psychopathic traits and low SCL-R were associated with increased utilitarian decisions in dilemmas involving direct personal harm. Psychopathic traits were unrelated to SCL-R, nor did SCL-R mediate the relationship between psychopathy and utilitarianism. The present study did not find evidence that somatic marker production explains the connection between utilitarianism and psychopathy in a college population. Further research is necessary to identify the neural mechanisms relating psychopathy and moral decision-making in nonclinical samples.

Affective startle modulation and psychopathology: Implications for appetitive and defensive brain systems

Startle reflex potentiation versus startle attenuation to unpleasant versus pleasant stimuli likely reflect priming of the defensive versus appetitive motivational systems, respectively. This review summarizes and systemizes the literature on affective startle modulation related to psychopathologies with the aim to reveal underlying mechanisms across psychopathologies. We found evidence for psychopathologies characterized by increased startle potentiation to unpleasant stimuli (anxiety disorders), decreased startle potentiation to unpleasant stimuli (psychopathy), decreased startle attenuation to pleasant stimuli (ADHD), as well as a general hyporeactivity to affective stimuli (depression). Increased versus decreased startle responses to disorder-specific stimuli characterize specific phobia and drug dependence. No psychopathology is characterized by increased startle attenuation to standard pleasant stimuli or a general hyperreactivity to affective stimuli. This review indicates that the defensive and the appetitive systems operate independently mostly in accordance with the motivational priming hypothesis and that affective startle modulation is a highly valuable paradigm to unraveling dysfunctions of the defensive and appetitive systems in psychopathologies as requested by the Research Domain Criteria initiative.

N2 amplitude modulation across the antisocial spectrum: a meta-analysis

Despite the accumulated knowledge on antisocial behavior and the positive event-related potential peaking around 300 ms (P3), less is known about the preceding negative electrophysiological response around 200 ms (N2). A systematic search of the literature was conducted to analyze the N2 modulation across the antisocial spectrum. Thirty-seven studies (n = 1199) were retrieved to the quantitative analysis. Reduced N2 amplitudes were found in the more severe antisocial manifestations (violent behavior and antisocial personality disorder), which is consistent with previous findings on P3 alterations and N2 reduced amplitudes in externalizing disorders. Findings on psychopathy were mixed, also in accordance with previous P3 results. From a dimensional lens, this supports the heterogeneity of the psychopathic personality structure: impulsivity features are a closer attribute of antisocial behavior and thus may be associated with N2 reduction, while adaptive psychopathic traits may be associated with intact (or even increased) N2 amplitude. The increased N2 amplitudes observed in impulsive behavior challenge, however, the previous meta-analytic findings. As most of the studies on impulsivity include subclinical samples, it leads to the hypothesis that some compensatory mechanisms can still occur at a subclinical level, reflecting the need for heightened allocation of brain resources to yield similar performances. Importantly, inhibition was the core deficit to explain N2 blunted amplitudes, alongside with deficits in the frontal brain region. From our findings, the reduction in P3 amplitude across the antisocial spectrum may be detected in the previous N2 time window.

Adolescent psychopathy, heart rate, and skin conductance

Researchers have advocated for a greater focus on measuring neurobiological underpinnings of serious psychological conditions such as psychopathy. This has become particularly important to investigate early in the life span, when intervention efforts for psychopathy-related behavior like conduct disorder (CD) are more successful. Given that psychopathy is a complex syndrome, it is also important to investigate physiological processes at a dimensional level. Using a sample of 56 adolescent male offenders (M_age = 15.92; SD = 1.31), this study explored the relationship between the Psychopathy Checklist-Youth Version (Forth, Kosson, & Hare, 2003), heart rate (HR), and skin conductance (SC). A white noise countdown task was used to measure autonomic activity across a baseline, anticipatory (prenoise), and reactivity (postnoise) period. Findings revealed no significant associations between psychopathy and HR activity across the time intervals. However, results revealed a positive association between grandiose-manipulative traits and SC activity and a negative association between callous-unemotional traits and SC activity. The results indicate that autonomic processes may contribute to distinct psychopathic traits in different ways, implicating slightly differential brain functioning. The findings suggest that, in order to better understand and treat youth with CD, future research should continue to examine the biological correlates of psychopathy at the broader construct level but perhaps especially at the component level.

Using the research domain criteria (RDoC) to conceptualize impulsivity and compulsivity in relation to addiction

Nomenclature for mental disorder was updated in 2013 with the publication of the fifth edition of the Diagnostic and Statistical Manual (DSM-5). In DSM-5, substance use disorders are framed as more dimensional. First, the distinction between abuse and dependence is replaced by substance use. Second, the addictions section now covers both substances and behavioral addictions. This contemporary move toward dimensionality and transdiagnosis in the addictions and other disorders embrace accumulating cognitive-affective neurobiological evidence that is reflected in the United States' National Institutes of Health Research Domain Criteria (NIH RDoC). The RDoC calls for the further development of transdiagnostic approaches to psychopathy and includes five domains to improve research. Additionally, the RDoC suggests that these domains can be measured in terms of specific units of analysis. In line with these suggestions, recent publications have stimulated updated neurobiological conceptualizations of two transdiagnostic concepts, namely impulsivity and compulsivity and their interactions that are applicable to addictive disorders. However, there has not yet been a review to examine the constructs of impulsivity and compulsivity in relation to addiction in light of the research-oriented RDoC. By doing so it may become clearer as to whether impulsivity and compulsivity function antagonistically, complementarily or in some other way at the behavioral, cognitive, and neural level and how this relationship underpins addiction. Thus, here we consider research into impulsivity and compulsivity in light of the transdiagnostic RDoC to help better understand these concepts and their application to evidence-based clinical intervention for addiction.