Specifying the attentional selection that moderates the fearlessness of psychopathic offenders

Subjective and objective assessments of executive functions are independently predictive of aggressive tendencies in patients with substance use disorder

BACKGROUND AND AIMS

Impairments in executive functions have been found to influence violent behavior. Executive functions are crucial in the treatment of patients with substance use disorders because substance use generally impairs cognitive processes and is therefore detrimental for executive functions thereby reducing control of behavior and thus of consumption impulses. We studied correlations between subjective, i.e. self-report, and objective, i.e. behavior-based, assessment of executive functions and the predictive validity of these measures for aggression in patients with substance use disorder.

METHODS

The study included 64 patients with a diagnosed substance use disorder who were convicted according to the German Criminal Code for crimes they committed in the context of their disorder and were therefore in treatment in forensic psychiatric departments in Germany. Multiple self-report and behavior-based instruments were used to assess executive functions, appetitive and facilitative aggression as well as clinical and sociodemographic variables.

RESULTS

Participants showed impaired executive functions, and measures of executive functions predicted aggressive tendencies and violent offenses. Despite ecological validity of the findings, the subjective and objective assessments of executive functions did not correlate with each other, which corroborates studies in other clinical settings.

CONCLUSIONS

We discuss that this finding may be due to the conceptual differences between subjective and objective measures. Therefore, self-report and behavior-based measures should not be used as proxies of each other but as complementary measures that are useful for comprehensive diagnostics of cognitive impairments and assessment of risks for violent behavior.

Psychopathy and gaze cueing

BACKGROUND AND OBJECTIVES

Psychopathic traits - and especially callous affective features - have been linked to altered processing of others' emotional expressions, and to reduced attention to the eyes. Despite the importance of gaze cueing (i.e., the tendency to orient attention toward where someone else is looking) for social functioning, few studies have investigated relationships between psychopathic traits and gaze cueing, and whether facial emotional expression influence these relationships, obtaining mixed results. To address this gap, the present study aimed to evaluate associations between psychopathic traits and gaze cueing for emotional and neutral expressions.

METHODS

65 non-clinical male participants (Mage = 27.3 years) completed two self-report measures of psychopathy and performed laboratory tasks to assess gaze-cueing for emotional vs. neutral faces and an arrow-cueing task as a comparison.

RESULTS

Linear mixed models showed no significant associations of emotional (versus neutral) expressions, or psychopathy trait dimensions, with either gaze cueing or arrow cueing.

LIMITATIONS

Reliance on a convenience sample of non-clinical men, assessed with self-reports measures of psychopathy, and using static emotional stimuli limit the generalizability of our findings.

CONCLUSIONS

Findings suggest that psychopathic traits are not associated with individual differences in following others' gaze to direct attention, and that there was no advantage for affective relative to neutral expressions.

Alcohol attention bias modulates neural engagement during moral processing

The neurobiology of typical moral cognition involves the interaction of frontal, limbic, and temporoparietal networks. There is still much to be understood mechanistically about how moral processing is disrupted; such understanding is key to combating antisociality. Neuroscientific models suggest a key role for attention mechanisms in atypical moral processing. We hypothesized that attention-bias toward alcohol cues in alcohol use disorder (AUD) leads to a failure to properly engage with morally relevant stimuli, reducing moral processing. We recruited patients with AUD (n = 30) and controls (n = 30). During functional magnetic resonance imaging, participants viewed pairs of images consisting of a moral or neutral cue and an alcohol or neutral distractor. When viewing moral cues paired with alcohol distractors, individuals with AUD had lower medial prefrontal cortex engagement; this pattern was also seen for left amygdala in younger iAUDs. Across groups, individuals had less engagement of middle/superior temporal gyri. These findings provide initial support for AUD-related attention bias interference in sociomoral processing. If supported in future longitudinal and causal study designs, this finding carries potential societal and clinical benefits by suggesting a novel, leverageable mechanism and in providing a cognitive explanation that may help combat persistent stigma.

The joy of being frightened: Fear experience in psychopathy

OBJECTIVE

Psychopathic traits are associated with abnormalities in fear processing. While traditional theories focus on a lack of fear, Hosker-Field et al. (2016) provided a new perspective. They suggested that individuals with elevated psychopathic traits may experience threatening situations with appreciation or positivity, resulting in reduced negative fear responses and heightened positive responses (fear enjoyment hypothesis, FEH).

METHOD

Our study aimed to refine Hosker-Field et al.'s (2016) study design, addressing methodological limitations and improving the inconsistent operationalization of fear experience in the literature. In an online sample of 353 participants from the general population, we examined the relationship between the FEH and relevant psychopathic traits, specifically those derived from the PCL-R framework (i.e., SRP 4 Factor 1), and from a more trait-based approach to psychopathy with assumed links to fearlessness (i.e., TriPM Boldness).

RESULTS

By employing linear mixed effect models, we extended Hosker-Field et al.'s correlational analysis and provided further evidence for the FEH, particularly in relation to psychopathic traits measured using the PCL-R framework. The results regarding Boldness, however, are somewhat inconclusive.

CONCLUSION

The present study enhances existing research on fear deficits in psychopathy by assessing the subjective experience of individuals facing threat.

Brain Anatomy in Boys with Conduct Disorder: Differences Among Aggression Subtypes

Aggression is a core feature of conduct disorder (CD), but the motivation, execution of aggression may vary. A deeper understanding of the neural substrates of aggressive behaviours is critical for effective clinical intervention. Seventy-six Boys with CD (50 with impulsive aggression (I-CD) and 26 with premeditated aggression (P-CD)) and 69 healthy controls (HCs) underwent a structural MRI scan and behavioural assessments. Whole-brain analyses revealed that, compared to HCs, the I-CD group showed significant cortical thinning in the right frontal cortex, while the P-CD group demonstrated significant folding deficits in the bilateral superior parietal cortex. Both types of aggression negatively correlated with the left amygdala volume, albeit in different ways. The present results demonstrated that the complex nature of aggression relies on differentiated anatomical substrates, highlighting the importance of exploring differential circuit-targeted interventions for CD patients.

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.

Impaired salience network switching in psychopathy

Growing evidence suggests that psychopathy is related to altered connectivity within and between three large-scale brain networks that support core cognitive functions, including allocation of attention. In healthy individuals, default mode network (DMN) is involved in internally-focused attention and cognition such as self-reference. Frontoparietal network (FPN) is anticorrelated with DMN and is involved in externally-focused attention to cognitively demanding tasks. A third network, salience network (SN), is involved in detecting salient cues and, crucially, appears to play a role in switching between the two anticorrelated networks, DMN and FPN, to efficiently allocate attentional resources. Psychopathy has been related to reduced anticorrelation between DMN and FPN, suggesting SN's role in switching between these two networks may be diminished in the disorder. To test this hypothesis, we used independent component analysis to derive DMN, FPN, and SN activity in resting-state fMRI data in a sample of incarcerated men (N = 148). We entered the activity of the three networks into dynamic causal modeling to test SN's switching role. The previously established switching effect of SN among young, healthy adults was replicated in a group of low psychopathy participants (posterior model probability = 0.38). As predicted, SN's switching role was significantly diminished in high psychopathy participants (t(145) = 26.39, p < .001). These findings corroborate a novel theory of brain function in psychopathy. Future studies may use this model to test whether disrupted SN switching is related to high psychopathy individuals' abnormal allocation of attention.

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.

Attention-affect interactions and triarchic psychopathy: New electrophysiological insights from the late positive potential

One of the most prominent characteristics of psychopathy is a reduced processing of emotionally relevant information. However, it is still unclear how attentional mechanisms may modulate this deficit. The current study aimed to examine the impact of attentional focus on emotion processing in relation to the triarchic constructs of boldness, meanness, and disinhibition. Participants performed two tasks in which pleasant, neutral, and unpleasant framed pictures were presented. In the first task, participants were required to indicate the color of the frame (alternative-focus task), whereas in the second task they were instructed to indicate the emotional category of the image (affect-focus task). The Late Positive Potential (LPP) was used as an index of sustained engagement of attention to affective material. Confirming a successful task manipulation, we observed reduced LPP amplitudes, particularly for affective relevant material, in the alternative-focus task compared to the affect-focus task. Most interestingly, our results evidenced that trait meanness scores were associated with blunted elaborative processing of affective material (both appetitive and aversive) when this information was task-relevant (affect-focus task), but not when it was task-irrelevant (alternative-focus task). These findings indicate that high mean individuals are characterized by blunted elaborative processing of affective stimuli when their motivational relevance is determined in a top-down manner (i.e., when it is task-relevant). Our results highlight the need for further studying of the bottom-up and top-down dynamics of emotional attention in psychopathy.

Wider and Stronger Inhibitory Ring of the Attentional Focus in Schizophrenia

Anomalies of attentional selection have been repeatedly described in individuals with schizophrenia spectrum disorders. However, a precise analysis of their ability to inhibit irrelevant visual information during attentional selection is not documented. Recent behavioral as well as neurophysiological and computational evidence showed that attentional search among different competing stimuli elicits an area of suppression in the immediate surrounding of the attentional focus. In the present study, the strength and spatial extension of this surround suppression were tested in individuals with schizophrenia and neurotypical controls. Participants were asked to report the orientation of a visual "pop-out" target, which appeared in different positions within a peripheral array of non-target stimuli. In half of the trials, after the target appeared, a probe circle circumscribed a non-target stimulus at various target-to-probe distances; in this case, participants were asked to report the probe orientation instead. Results suggest that, as compared to neurotypical controls, individuals with schizophrenia showed stronger and spatially more extended filtering of visual information in the areas surrounding their attentional focus. This increased filtering of visual information outside the focus of attention might potentially hamper their ability to integrate different elements into coherent percepts and influence higher order behavioral, affective, and cognitive domains.

The Societal Response to Psychopathy in the Community

The harm usually associated with psychopathy requires therapeutically, legally, and ethically satisfactory solutions. Scholars from different fields have, thus, examined whether empirical evidence shows that individuals with psychopathic traits satisfy concepts, such as responsibility, mental disorder, or disability, that have specific legal or ethical implications. The present paper considers the less discussed issue of whether psychopathy is a disability. As it has been shown for the cases of the responsibility and mental disorder status of psychopathic individuals, we argue that it is undecided whether psychopathy is a disability. Nonetheless, based on insights from disability studies and legislations, we propose that interventions to directly modify the propensities of individuals with psychopathic tendencies should be balanced with modifications of the social and physical environments to accommodate their peculiarities. We also suggest how this social approach in some practical contexts that involve non-offender populations might be effective in addressing some of the negative effects of psychopathy.

Mirror neurons and empathy-related regions in psychopathy: systematic review, meta-analysis, and a working model

Mirror neurons have been associated with empathy. People with psychopathic traits present low levels of empathy. To analyze this, a systematic review of fMRI studies of people with psychopathic traits during an emotional facial expression processing task was performed. The regions of interest were structures associated with the mirror neuron system: ventromedial prefrontal cortex (vmPFC), inferior parietal lobe (IPL), inferior frontal gyrus and superior temporal sulcus. The analysis was also extended to structures related to affective empathy (insula, amygdala and anterior cingulate cortex) and to two more emotional processing areas (orbitofrontal cortex and fusiform gyrus). Hypoactivation was more frequently observed in regions of the mirror neuron system from people with high psychopathic traits, as well as in the emotional processing structures, and those associated with affective empathy, except for the insula, where it presented higher activity. Differences were observed for all types of emotions. The results suggest that the mirror neuron system is altered in psychopathy and their relationship with affective empathy deficits is discussed.

Is it good to be bad? An evolutionary analysis of the adaptive potential of psychopathic traits

Although psychopathy is widely conceptualised as a mental disorder, some researchers question the maladaptive nature of psychopathy, and argue that it might be advantageous from an evolutionary point of view. According to this view, psychopathy can be seen as an evolutionary adaptative strategy that relies on deception and manipulation to gain short-term reproductive benefits. Psychopathy is also identified as a fast life strategy in response to early life stress and an adaptation to harsh environments. This paper investigates the evidence that psychopathic traits are adaptive, while also addressing the limitations of current evolutionary models of psychopathy based on frequency-dependent selection and life history theory. We review recent studies on the fitness correlates of psychopathy and find that psychopathic traits present potential adaptive trade-offs between fertility and mortality, and offspring quantity and quality. On a proximate level, individual differences in stress reactivity and environmental risk factors in early development predispose to psychopathy through gene-environment interactions. We propose that environmental, developmental, social and cultural factors can mediate the relationship between psychopathic traits and fitness and therefore should be considered to make accurate predictions on the adaptive potential of psychopathy. We end by outlining gaps in the literature and making recommendations for future evolutionary research on psychopathy.

The importance of an exaggerated attention bottleneck for understanding psychopathy

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

The past, present, and future of selection history

The last ten years of attention research have witnessed a revolution, replacing a theoretical dichotomy (top-down vs. bottom-up control) with a trichotomy (biased by current goals, physical salience, and selection history). This third new mechanism of attentional control, selection history, is multifaceted. Some aspects of selection history must be learned over time whereas others reflect much more transient influences. A variety of different learning experiences can shape the attention system, including reward, aversive outcomes, past experience searching for a target, target‒non-target relations, and more. In this review, we provide an overview of the historical forces that led to the proposal of selection history as a distinct mechanism of attentional control. We then propose a formal definition of selection history, with concrete criteria, and identify different components of experience-driven attention that fit within this definition. The bulk of the review is devoted to exploring how these different components relate to one another. We conclude by proposing an integrative account of selection history centered on underlying themes that emerge from our review.

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.

Rational, emotional, or both? Subcomponents of psychopathy predict opposing moral decisions

Recent research has documented a small but significant correlation between psychopathic capacities and utilitarian moral judgment, although the findings are generally inconsistent and unclear. We propose that one way to make sense of mixed findings is to consider variation in perspective-taking capacities of psychopathic individuals. With this in mind, we had criminal offenders (n = 60), who varied in their psychopathy levels according to the Psychopathy Checklist-Revised (PCL-R), respond to common sacrificial moral dilemmas (e.g., trolley dilemmas) under different conditions. In a baseline condition, participants simply responded to the sacrificial moral dilemmas as is typically done in previous research. In an "emotion-salient" condition, participants had to reason about the emotions of another person after solving moral dilemmas (deliberative processing). In the "emotion-ambiguous" condition, participants saw images of people in distress, after solving moral dilemmas, but did not have to explicitly reason about such emotions (spontaneous processing). The four PCL-R facets predicted distinct interference effects depending on spontaneous versus deliberative processing of hypothetical victim's emotions. The findings suggest that the use of a multi-faceted approach to account for cognitive and moral correlates of psychopathy may help address previously mixed results. Implications and future directions for theory and research are discussed.

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.

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

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

Psychopathic traits, inhibition, and positive and negative emotion: Results from an emotional Go/No-Go task

Difficulty stopping unwanted or inappropriate actions (i.e., inhibitory control) is implicated in antisocial behaviors, which are common in people high in psychopathic traits. Recent research indicates that, for those with antisocial personality, inhibitory control is impaired under negative emotional contexts; however, it is unclear whether this impairment extends to persons with psychopathic traits and to impairments under positive emotional contexts. Identifying some of these distinctions can point to therapeutics that target negative emotion specifically or emotion dysregulation broadly. We sought to identify unique relationships between distinct facets of psychopathy and inhibitory control in the context of positive, negative, and neutral stimuli. Using a community sample (N = 117), event-related potentials were recorded during an emotional-linguistic Go/No-Go task. Results indicated distinct cognition-emotion relationships for each psychopathy facet. Higher interpersonal facet scores related to reciprocal interference between cognition and emotion. Higher callous affect facet scores related to reduced inhibitory and emotional processing, except when stimuli were most engaging (emotional No-Go trials). Higher erratic lifestyle facet scores related to increased effort required to process both emotion and inhibition cues. Finally, higher antisocial facet scores related to poorer behavioral inhibition overall. This research challenges the theoretical accounts of psychopathy focused on specific deficits in negative emotion, such as fearlessness, while offering some support for theories related to attentional dysfunction. Results also highlight the importance of facet-level theorizing, as results varied by facet. This study may inform efforts to reduce disinhibited behaviors, particularly in emotional contexts, among those high in certain psychopathic traits.

Frontal alpha asymmetry and emotional processing in youth with psychopathic traits

Emotional processing deficits are often considered central to psychopathy. There is evidence that those high in psychopathy pay less attention to emotional stimuli, and it is possible that these individuals experience diminished withdrawal motivation or heightened approach motivation in response to emotional stimuli. Studying emotional processing abnormalities, especially among youth, may be essential for better understanding psychopathy's development and for informing interventions. However, few studies on psychopathy have experimentally manipulated emotional processing, and despite the growing literature on neuroscience and psychopathy, there are aspects of neural activity that have yet to be investigated. The current study used a sample of 52 justice-involved youth to examine how psychopathy, as measured by the Proposed Specifiers for Conduct Disorder scale, relates to frontal alpha asymmetry (FAA), a neural correlate of approach and withdrawal motivation. Alpha asymmetry was first measured at rest and then while youth were asked to process emotional stimuli spontaneously as well as to increase and decrease their responses to emotional stimuli. Results indicated that total psychopathy was not related to FAA at rest or during task performance. However, youth higher in callous-unemotional traits demonstrated similar patterns of neural activity to youth lower in callous-unemotional traits when instructed to increase their response to emotional stimuli. These findings were not evident for grandiose-manipulative or daring-impulsive traits. These findings may indicate that youth high in callous-unemotional traits are capable of modulating their emotional responding, which could in turn have treatment implications for youth high in psychopathic traits.

Emotional modulation of the pupil in psychopathy: A test of the Response Modulation Hypothesis

Some aspects of psychopathy may be underpinned by a deficit in processing emotional information, although there is evidence that this impairment only emerges when the affective cues are not central to ongoing goal-directed behaviour. However, this hypothesis has not been explored previously in relation to autonomic reactivity to emotional stimuli. The current study investigated this in a large (N = 174) community sample by examining changes in pupil diameter, a measure of autonomic nervous system activity, while participants viewed images that were either neutral in content or contained highly arousing/emotional content. Participants' attentional focus was manipulated across two tasks, such that participants either focused on whether the image contained emotional content (emotion-focus) or whether there were people present in the image (alternate-focus). Psychopathy was conceptualised via the Triarchic model of boldness, meanness and disinhibition. As expected, the arousing images caused greater pupil dilation compared to neutral images. However, the magnitude of this dilation was not moderated by any aspect of psychopathy regardless of the participant's attentional focus. It may be that reduced pupil reactivity to emotional stimuli is only expressed at high levels of psychopathy not normally found in community samples, or that participants with high traits of psychopathy in the community were still able to sufficiently attend to the emotional components of the images to overcome any autonomic deficits regardless of their attentional focus. Further research is needed to explore these possibilities.

Functional neural correlates of psychopathy: a meta-analysis of MRI data

Neuroimaging studies over the last two decades have begun to specify the neurobiological correlates of psychopathy, a personality disorder that is strongly related to criminal offending and recidivism. Despite the accumulation of neuroimaging studies of psychopathy, a clear and comprehensive picture of the disorder's neural correlates has yet to emerge. The current study is a meta-analysis of functional MRI studies of psychopathy. Multilevel kernel density analysis was used to identify consistent findings across 25 studies (460 foci) of task-related brain activity. Psychopathy was associated with increased task-related activity predominantly in midline cortical regions overlapping with the default mode network (dorsomedial prefrontal cortex, posterior cingulate, and precuneus) as well as medial temporal lobe (including amygdala). Psychopathy was related to decreased task-related activity in a region of the dorsal anterior cingulate cortex overlapping with the salience network. These findings challenge predominant theories of amygdala hypoactivity and highlight the potential role of hyperactivity in medial default mode network regions and hypoactivity in a key node of the salience network during task performance in psychopathy.

The Empathic Brain of Psychopaths: From Social Science to Neuroscience in Empathy

Empathy is a crucial human ability, because of its importance to prosocial behavior, and for moral development. A deficit in empathic abilities, especially affective empathy, is thought to play an important role in psychopathic personality. Empathic abilities have traditionally been studied within the social and behavioral sciences using behavioral methods, but recent work in neuroscience has begun to elucidate the neural underpinnings of empathic processing in relation to psychopathy. In this review, current knowledge in the social neuroscience of empathy is discussed and a comprehensive view of the neuronal mechanisms that underlie empathy in psychopathic personality is provided. Furthermore, it will be argued that using classification based on overt behavior, we risk failing to identify important mechanisms involved in the psychopathology of psychopathy. In the last decade, there is a growing attention in combining knowledge from (neuro)biological research areas with psychology and psychiatry, to form a new basis for categorizing individuals. Recently, a converging framework has been put forward that applies such approach to antisocial individuals, including psychopathy. In this bio-cognitive approach, it is suggested to use information from different levels, to form latent categories on which individuals are grouped, that may better reflect underlying (neurobiological) dysfunctions. Subsequently, these newly defined latent categories may be more effective in guiding interventions and treatment. In conclusion, in my view, the future understanding of the social brain of psychopaths lies in studying the complex networks in the brain in combination with the use of other levels of information (e.g., genetics and cognition). Based on that, profiles of individuals can be formed that can be used to guide neurophysiological informed personalized treatment interventions that ultimately reduce violent transgressions in individuals with psychopathic traits.

A Motivational Framework for Psychopathy: Toward a Reconceptualization of the Disorder

Abstract. The link between psychopathy and violence has been well documented. Estimates suggest psychopathic offenders are responsible for as much as 40% of violence-related crime, and that they show rates of violent recidivism up to five times higher than non-psychopathic offenders. Existing theories of the disorder argue that this violence stems from a core insensitivity to emotional/aversive information, or from a core inability to optimally allocate processing resources in complex environments. However, some newer findings have been difficult for existing theories to assimilate; moreover, successful treatment programs based off current conceptualizations have been slow to develop. With this in mind, the current paper proposes a new motivational framework for psychopathy, within which the disorder is conceptualized as stemming from more strategic, motivated processes. The paper begins by reviewing traditional theories of psychopathy and highlighting their explanatory strengths and limitations. The proposed motivational framework is then outlined, and a supportive rationale for the framework provided. Next, the paper undertakes a selective review of some of the most empirically supported features of the disorder, to highlight how these features may be productively reformulated within a motivational framework. Finally, the paper suggests several methods through which an empirical evaluation of the proposed ideas may be undertaken, and explores potential implications of a motivational framework for next-generation rehabilitation and treatment opportunities.

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

•

Psychopathy is linked to disruptions in neural information processing.

•

Graph analysis revealed that psychopathy impacts neural network organization.

•

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

•

Subcortical structures are less central to neural communication in psychopathy.

•

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

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

Impaired processing of threat in psychopathy: A systematic review and meta-analysis of factorial data in male offender populations

Background

Psychopathy is a personality disorder characterised by two underlying factors. Factor 1 (affective and interpersonal deficits) captures affective deficits, whilst Factor 2 (antisocial and impulsive/disorganised behaviours) captures life course persistent antisocial behaviours. Impaired processing of threat has been proposed as an aetiologically salient factor in the development of psychopathy, but the relationship of this impairment to the factorial structure of the disorder in adult male offenders is unclear.

Objectives

To investigate whether threat processing deficits are characteristic of psychopathy as a unitary construct or whether such deficits are specifically linked to higher scores on individual factors.

Data sources

A systematic review of the literature was conducted by searching PubMed, Web of Science and PsycINFO.

Methods

Studies were included if they (1) reported physiological measures of threat response as the primary outcome measure (2) indexed psychopathy using a well-validated clinician rated instrument such as the PCL-R (3) investigated male offenders between 18 and 60 years of age (4) reported threat processing analyses using both Factor 1 and Factor 2 scores (5) provided sufficient data to calculate effect sizes and (6) were published in English-language peer-reviewed journals. We identified twelve studies with data on 1112 participants for the meta-analysis of the relationship with Factor 1 scores, and nine studies with data on 801 participants for the meta-analysis of the relationship with Factor 2 scores. We conducted the meta-analyses to calculate correlations using random-effects models.

Results

PCL-R/SV Factor 1 scores were significantly and negatively related to threat processing indices (r = -0.22, (95%CI [-0.28, -.017]). Neither PCL-R/SV Factor 2 scores (r = -0.005, 95%CI [-0.10, 0.09]), nor PCL-R total score (r = -0.05, (95%CI [-0.15, -0.04]) were related to threat processing indices. No significant heterogeneity was detected for the Factor score results.

Conclusions

The meta-analyses of the distinct psychopathy factors suggest that the threat processing deficits observed in male offenders with psychopathy are significantly associated with higher scores on Factor 1. A similar relationship does not exist with Factor 2 scores. Our findings highlight the importance of investigating the potentially discrete relationships between aetiological variables and the two factor constructs in the disorder.

Psychopathic traits associated with abnormal hemodynamic activity in salience and default mode networks during auditory oddball task

Psychopathy is a personality disorder accompanied by abnormalities in emotional processing and attention. Recent theoretical applications of network-based models of cognition have been used to explain the diverse range of abnormalities apparent in psychopathy. Still, the physiological basis for these abnormalities is not well understood. A significant body of work has examined psychopathy-related abnormalities in simple attention-based tasks, but these studies have largely been performed using electrocortical measures, such as event-related potentials (ERPs), and they often have been carried out among individuals with low levels of psychopathic traits. In this study, we examined neural activity during an auditory oddball task using functional magnetic resonance imaging (fMRI) during a simple auditory target detection (oddball) task among 168 incarcerated adult males, with psychopathic traits assessed via the Hare Psychopathy Checklist-Revised (PCL-R). Event-related contrasts demonstrated that the largest psychopathy-related effects were apparent between the frequent standard stimulus condition and a task-off, implicit baseline. Negative correlations with interpersonal-affective dimensions (Factor 1) of the PCL-R were apparent in regions comprising default mode and salience networks. These findings support models of psychopathy describing impaired integration across functional networks. They additionally corroborate reports which have implicated failures of efficient transition between default mode and task-positive networks. Finally, they demonstrate a neurophysiological basis for abnormal mobilization of attention and reduced engagement with stimuli that have little motivational significance among those with high psychopathic traits.

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.

Psychopaths fail to automatically take the perspective of others

Psychopathic individuals display a chronic and flagrant disregard for the welfare of others through their callous and manipulative behavior. Historically, this behavior is thought to result from deficits in social-affective processing. However, we show that at least some psychopathic behaviors may be rooted in a cognitive deficit, specifically an inability to automatically take another person's perspective. Unlike prior studies that rely solely on controlled theory of mind (ToM) tasks, we employ a task that taps into automatic ToM processing. Controlled ToM processes are engaged when an individual intentionally considers the perspective of another person, whereas automatic ToM processes are engaged when an individual unintentionally represents the perspective of another person. In a sample of incarcerated offenders, we find that psychopathic individuals are equally likely to show response interference under conditions of controlled ToM, but lack a common signature of automatic ToM known as altercentric interference. We also demonstrate that the magnitude of this dysfunction in altercentric interference is correlated with real-world callous behaviors (i.e., number of assault charges). These findings suggest that psychopathic individuals have a diminished propensity to automatically think from another's perspective, which may be the cognitive root of their deficits in social functioning and moral behavior.

Autonomic conditioning to monetary and social stimuli and aggression in children

Poor conditioning to punishment, such as loud tones or electric shock, has been proposed as an important factor involved in the etiology of aggressive and psychopathic behavior. However, it is not known whether the association holds when monetary or social stimulus is used as the unconditioned stimulus, and if aggressive individuals also have impaired conditioning to rewards. In this study, skin conductance responses in a conditioning task involving both monetary/social reward and punishment as unconditioned stimuli were assessed in 340 male and female 8- to 9-year-old children from the community. Children reported their reactive and proactive aggression using the Reactive and Proactive Aggression Questionnaire (RPQ; Raine et al., 2006). Results showed that monetary/social reward and punishment were effective in eliciting physiological classical conditioning in children, and that reduced reward conditioning was associated with high levels of proactive aggression in particular. Findings highlight the importance of distinguishing between reactive and proactive aggression when examining antisocial behavior in children, and suggest that reward-oriented treatment programs may not be effective for children with more proactive, instrumental aggressive behavior.

Facial responsiveness of psychopaths to the emotional expressions of others

Psychopathic individuals show selfish, manipulative, and antisocial behavior in addition to emotional detachment and reduced empathy. Their empathic deficits are thought to be associated with a reduced responsiveness to emotional stimuli. Immediate facial muscle responses to the emotional expressions of others reflect the expressive part of emotional responsiveness and are positively related to trait empathy. Empirical evidence for reduced facial muscle responses in adult psychopathic individuals to the emotional expressions of others is rare. In the present study, 261 male criminal offenders and non-offenders categorized dynamically presented facial emotion expressions (angry, happy, sad, and neutral) during facial electromyography recording of their corrugator muscle activity. We replicated a measurement model of facial muscle activity, which controls for general facial responsiveness to face stimuli, and modeled three correlated emotion-specific factors (i.e., anger, happiness, and sadness) representing emotion specific activity. In a multi-group confirmatory factor analysis, we compared the means of the anger, happiness, and sadness latent factors between three groups: 1) non-offenders, 2) low, and 3) high psychopathic offenders. There were no significant mean differences between groups. Our results challenge current theories that focus on deficits in emotional responsiveness as leading to the development of psychopathy and encourage further theoretical development on deviant emotional processes in psychopathic individuals.

Selective Fair Behavior as a Function of Psychopathic Traits in a Subclinical Population

Psychopathy is a group of personality traits that are associated with violations of social norms. Previous studies have suggested that people with psychopathic traits in subclinical populations do not necessarily display antisocial, self-defeating behaviors, and instead may strategically show adaptive behaviors in response to cues during reciprocal social interactions. Therefore, in the present study, we examined whether the association between psychopathic traits and unfair behavior can be moderated by a potential for punishment and social distance (anonymity), which are known to facilitate fair behavior. We focused on two psychopathic traits: primary and secondary psychopathy. Primary psychopathy is characterized by callousness, shallow affect, manipulation, and superficial charm. In contrast, secondary psychopathy is associated with impulsivity and lack of long-term goals, and is related to hostile behavior. A total of 348 undergraduate students determined the amounts of money that they would offer to strangers or friends at their university in hypothetical scenarios of the ultimatum game (UG) and the dictator game (DG). While gender affected decisions in the hypothetical scenarios of the DG, it did not interact with psychopathic traits. The score for primary psychopathy on the Levenson self-report psychopathy scale predicted unfair monetary offers to strangers in the DG, where participants could not be punished. However, compared with their offers in the DG, individuals with higher scores for primary psychopathy made larger offers in the UG, where low offers could trigger punishment from the recipient. Moreover, primary psychopathy did not decrease the amounts of offers in either game when the participant considered the recipient to be a friend. On the other hand, secondary psychopathy was not associated with differences in behavioral fairness depending on a potential for punishment or social distance. Based on these findings, we discuss strategic social skills as a function of primary psychopathy.

Differentiating emotional processing and attention in psychopathy with functional neuroimaging

Individuals with psychopathy are often characterized by emotional processing deficits, and recent research has examined the specific contexts and cognitive mechanisms that underlie these abnormalities. Some evidence suggests that abnormal features of attention are fundamental to emotional deficits in persons with psychopathy, but few studies have demonstrated the neural underpinnings responsible for such effects. Here, we use functional neuroimaging to examine attention-emotion interactions among incarcerated individuals (n = 120) evaluated for psychopathic traits using the Hare Psychopathy Checklist-Revised (PCL-R). Using a task designed to manipulate attention to emotional features of visual stimuli, we demonstrate effects representing implicit emotional processing, explicit emotional processing, attention-facilitated emotional processing, and vigilance for emotional content. Results confirm the importance of considering mechanisms of attention when evaluating emotional processing differences related to psychopathic traits. The affective-interpersonal features of psychopathy (PCL-R Factor 1) were associated with relatively lower emotion-dependent augmentation of activity in visual processing areas during implicit emotional processing, while antisocial-lifestyle features (PCL-R Factor 2) were associated with elevated activity in the amygdala and related salience network regions. During explicit emotional processing, psychopathic traits were associated with upregulation in the medial prefrontal cortex, insula, and superior frontal regions. Isolating the impact of explicit attention to emotional content, only Factor 1 was related to upregulation of activity in the visual processing stream, which was accompanied by increased activity in the angular gyrus. These effects highlight some important mechanisms underlying abnormal features of attention and emotional processing that accompany psychopathic traits.

Visual attention in violent offenders: Susceptibility to distraction

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

Amygdala reactivity predicts adolescent antisocial behavior but not callous-unemotional traits

•

Greater amygdala reactivity to angry faces predicted youth antisocial behavior.

•

Callous-unemotional traits were not related to amygdala reactivity.

•

Findings were similar across sex, ethnicity, and pubertal stage.

Recent neuroimaging studies have suggested divergent relationships between antisocial behavior (AB) and callous-unemotional (CU) traits and amygdala reactivity to fearful and angry facial expressions in adolescents. However, little work has examined if these findings extend to dimensional measures of behavior in ethnically diverse, non-clinical samples, or if participant sex, ethnicity, pubertal stage, and age moderate associations. We examined links between amygdala reactivity and dimensions of AB and CU traits in 220 Hispanic and non-Hispanic Caucasian adolescents (age 11–15; 49.5% female; 38.2% Hispanic), half of whom had a family history for depression and thus were at relatively elevated risk for late starting, emotionally dysregulated AB. We found that AB was significantly related to increased right amygdala reactivity to angry facial expressions independent of sex, ethnicity, pubertal stage, age, and familial risk status for depression. CU traits were not related to fear- or anger-related amygdala reactivity. The present study further demonstrates that AB is related to increased amygdala reactivity to interpersonal threat cues in adolescents, and that this relationship generalizes across sex, ethnicity, pubertal stage, age, and familial risk status for depression.

As Far as the Eye Can See: Relationship between Psychopathic Traits and Pupil Response to Affective Stimuli

Psychopathic individuals show a range of affective processing deficits, typically associated with the interpersonal/affective component of psychopathy. However, previous research has been inconsistent as to whether psychopathy, within both offender and community populations, is associated with deficient autonomic responses to the simple presentation of affective stimuli. Changes in pupil diameter occur in response to emotionally arousing stimuli and can be used as an objective indicator of physiological reactivity to emotion. This study used pupillometry to explore whether psychopathic traits within a community sample were associated with hypo-responsivity to the affective content of stimuli. Pupil activity was recorded for 102 adult (52 female) community participants in response to affective (both negative and positive affect) and affectively neutral stimuli, that included images of scenes, static facial expressions, dynamic facial expressions and sound-clips. Psychopathic traits were measured using the Triarchic Psychopathy Measure. Pupil diameter was larger in response to negative stimuli, but comparable pupil size was demonstrated across pleasant and neutral stimuli. A linear relationship between subjective arousal and pupil diameter was found in response to sound-clips, but was not evident in response to scenes. Contrary to predictions, psychopathy was unrelated to emotional modulation of pupil diameter across all stimuli. The findings were the same when participant gender was considered. This suggests that psychopathy within a community sample is not associated with autonomic hypo-responsivity to affective stimuli, and this effect is discussed in relation to later defensive/appetitive mobilisation deficits.

Affective startle potentiation differentiates primary and secondary variants of juvenile psychopathy

Individuals with psychopathic traits show an attenuated emotional response to aversive stimuli. However, recent evidence suggests heterogeneity in emotional reactivity among individuals with psychopathic or callous–unemotional (CU) traits in the identification of primary and secondary subtypes, or variants. We hypothesized that primary CU variants will respond with blunted affect to negatively valenced stimuli, whereas individuals with a history of childhood maltreatment, fitting with theoretical conceptualizations of secondary psychopathy, will display heightened emotional reactivity. To test this hypothesis, we examined fear-potentiated startle between CU variants while viewing aversive, pleasant, and neutral scenes. Two hundred thirty-eight incarcerated adolescent (M age = 16.8 years, SD = 1.11 years) boys completed a picture-startle paradigm and self-report questionnaires assessing CU traits, aggressive behavior, and maltreatment. Latent profile analysis of CU trait, aggression, and maltreatment scores identified four classes: primary psychopathy variants (high CU traits, high aggression, low maltreatment; n = 46), secondary psychopathy variants (high CU traits, high aggression, high maltreatment; n = 42), and two nonpsychopathic groups differentiated on maltreatment experience (n = 148). Primary CU variants displayed reduced startle potentiation to aversive images relative to control, maltreated, and also secondary variants that exhibited greater startle modulation. Findings add to a rapidly growing body of literature supporting the possibility of multiple developmental pathways to psychopathic traits (i.e., equifinality), and extend it by finding support for divergent potential biomarkers between primary and secondary CU variants.

The Mask of Sanity: Facial Expressive, Self-Reported, and Physiological Consequences of Emotion Regulation in Psychopathic Offenders

This study investigated the physiological, self-reported, and facial correlates of emotion regulation in psychopathy. Specifically, we compared psychopathic offenders (n = 42), nonpsychopathic offenders (n = 42), and nonoffender controls (n = 26) in their ability to inhibit and express emotion while watching affective films (fear, happy, and sad). Results showed that all participants were capable of drastically diminishing facial emotions under inhibition instructions. Contrary to expectation, psychopaths were not superior in adopting such a "poker face." Further, the inhibition of emotion was associated with cardiovascular changes, an effect that was also not dependent on psychopathy (or its factors), suggesting emotion inhibition to be an effortful process in psychopaths as well. Interestingly, psychopathic offenders did not differ from nonpsychopaths in the capacity to show content-appropriate facial emotions during the expression condition. Taken together, these data challenge the view that psychopathy is associated with either superior emotional inhibitory capacities or a generalized impairment in showing facial affect.

Information processing capacity in psychopathy: Effects of anomalous attention

Hamilton and colleagues (2015) recently proposed that an integrative deficit in psychopathy restricts simultaneous processing, thereby leaving fewer resources available for information encoding, narrowing the scope of attention, and undermining associative processing. The current study evaluated this parallel processing deficit proposal using the Simultaneous-Sequential paradigm. This investigation marks the first a priori test of the Hamilton et al.'s theoretical framework. We predicted that psychopathy would be associated with inferior performance (as indexed by lower accuracy and longer response time) on trials requiring simultaneous processing of visual information relative to trials necessitating sequential processing. Results were consistent with these predictions, supporting the proposal that psychopathy is characterized by a reduced capacity to process multicomponent perceptual information concurrently. We discuss the potential implications of impaired simultaneous processing for the conceptualization of the psychopathic deficit. (PsycINFO Database Record

Attention Moderates the Relationship Between Primary Psychopathy and Affective Empathy in Undergraduate Students

Psychopathy is personality traits, which is consisted of primary psychopathy characterized by affective and interpersonal problems and secondary psychopathy characterized by behavioral problems. Prior researchers have suggested that people with psychopathy have peculiar attention, which prevents them from detecting information peripheral to their concern, and we hypothesized that this explains their low empathy. Based on these reasoning, the present study assessed whether attention moderates the relationship between psychopathy and affective empathy. Eighty-five undergraduates (40 men and 45 women; mean age = 19.8 years; SD = 1.6) completed the Levenson Self-Report Psychopathy Scale, the Interpersonal Reactivity Index, and a perceptual load task. Hierarchical regression showed that a significant moderation effect was found: primary psychopathy was negatively associated with affective empathy, among those with reduced interference from task-irrelevant stimuli under a medium level of perceptual load. Future study should need to replicate this finding with clinical population.