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

Altered representation of peripersonal and interpersonal space in psychopathology

The space surrounding the body, and the regulation of this buffer zone play a central role in adaptive behavior, with direct implications for psychopathology. The physical distance that we choose to maintain between ourselves and others for social comfort is known as Interpersonal Distance (IPD), whereas the action space that marks the perceptual border between the self and the external world is known as Peripersonal Space (PPS ). While both IPD and PPS represent personal space, they are distinct constructs, each associated with different methodologies. Here we review the existing literature on IPD and PPS to elucidate their distinct and common contributions to psychiatric conditions including schizophrenia, autism, anxiety, and others. Altered representation and regulation of IPD and PPS were associated with clinical symptoms and social impairments across a wide range of psychiatric disorders, underscoring the important role of the self-other boundary and personal space regulation in adaptive social behavior. Future research should clarify the relationship between IPD and PPS and specify risk factors for self-other boundary dysregulation and associated psychopathologies.

The risks of unconcern: low sensitivity to threat can have unfortunate consequences

Each one of us is confronted with warnings of danger or threats to wellbeing in our everyday life, whether in the form of certain road signs, Public Service Announcements, ominous changes in bodily functioning, or cautionary tales heard from family or friends. There is great inter-individual variation in how people respond to such threats, with some people habitually tending to ignore or dismiss them, often to their peril. The first purpose of the present paper is to review several studies showing that individuals-most often men-who score very low on measures of trait anxiety are more likely to engage in behaviors that could jeopardize their physical wellbeing. The general hypothesis that is derived from that review is that when attention to everyday threats is chronically muted by way of a dispositional trait, the likelihood of proceeding down some dangerous path is increased. Those findings are then discussed within the broader context of personality theory to highlight the importance of recognizing the bipolarity of common traits. Here the case is made for replacing the term trait anxiety with the term threat sensitivity in order to capture the full breadth of this basic personality variable. A discussion of the neurobiological underpinnings of threat sensitivity is then presented with an emphasis on individual and sex differences in the workings of the defensive survival circuitry. Taken together, this paper has implications for two subfields within psychology. For the area of personality theory, this paper provides support for the adaptationist view with the argument that low threat sensitivity has both adaptive and maladaptive potential. For the area of health psychology, it is argued that some individuals who demonstrate a habitual tendency to neglect their physical wellbeing may be acting-at least in part-in accordance with their innate neurobiological constitution.

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.

Instruments of Child-to-Parent Violence: Systematic Review and Meta-Analysis

This systematic review and reliability generalization meta-analysis synthesized psychometric literature on instrumentation assessing child-to-parent violence published through September 2023 across four databases. In the screening, we identified studies reporting Cronbach's alpha internal consistency estimates for the child-to-parent violence scales. The eligible reliability coefficients ranged from 0.610 to 0.930, mostly exceeding the minimum threshold of 0.700. Random-effects models calculated pooled Cronbach's alphas separately for global, father-specific, and mother-specific subscales. The results demonstrated cumulative values of 0.83 (global: standard error = 0.0129), 0.800 (fathers: standard error = 0.0203), and 0.81 (mothers: standard error = 0.0179), denoting largely adequate reliability. However, significant between-study heterogeneity was observed. While the mean alpha levels seem acceptable for most tools, substantial variability coupled with the possibility of some studies violating reliability assumptions indicates that a conservative interpretation is warranted. Ongoing scale refinement and additional psychometric evaluations will strengthen the rigor methodology in this developing research domain. However, these results should be interpreted with caution, as there is a high level of heterogeneity, and it is possible that some studies have not verified the assumptions underlying Cronbach's alpha.

The novel narrative technique uncovers emotional scripts in individuals with psychopathy and high trait anxiety

Mental representations are of great importance for understanding human behaviour. The aim of this article is to present an innovative way to assess emotional scripts, which are a form of mental representations of emotional events, based on an analysis of narratives and their contents. Theoretical background on emotional schemas and scripts is provided along with information about types of related measures. Then, a rationale is presented for introducing an assessment of scripts related to specific emotions such as love, hate, and anxiety in a psychopathological context. This is followed by a perspective explaining the procedure of the relevant technique based on narrative data analysis. The technique has been successfully applied in two studies [I study (n- 200), II study (n- 280)]. A total of 1440 narratives about specific emotions have been analyzed to identify the indicators of scripts. The psychometric properties of the proposed technique have been established such as reliability, inter-rater agreement, and accuracy. The results show the value of the assessment of emotional script in individuals, particularly with high psychopathy and high trait anxiety. The contents of love and hate scripts are an illustration of cognitive distortions and deficits in the emotional information processing in individuals with psychopathy. The method enables the collection of informative data on romantic love, hate, and anxiety scripts which provides insight into how people may perceive and experience emotions and how they behave emotionally. Future research should focus on verification of the technique in other types of psychopathology and on the improvement of computer software dedicated to the narrative technique described in this paper.

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.

Promoting a Safe Environment in Our Cities: Towards a Theoretical Model of "Moral Deficit" for Appropriate Psychopathic Therapy

The increasing reported incidents of knife crime in cities and the release on parole of “rehabilitated” violent criminals are creating an unsafe urban environment. Such occurrences suggest that measures taken to address psychopathic-oriented behaviour may have been ineffective because the individual’s degree of “moral deficit” is not fully accounted for in the application of specific therapies. This study developed a theoretical model of “moral deficit” that is aligned with the appropriateness of therapy, ranging from the extreme “classical approach” of total confinement justified by a belief in the incurability of psychopaths to the modern therapy that aims to reintegrate the psychopath with society using “moralizing therapy”. Analysis of secondary data from extant literature was used to develop the theoretical model of “moral deficit”. Secondary data analysis suggests that the extent of psychopathic “moral deficit” may be an important factor in the selection of appropriate therapeutic measures for psychopathy treatment and the rehabilitation of psychopaths as law-abiding members of society. We conclude that a specific type of psychopathic moral deficit may have an important bearing on the appropriateness of treatment. It is recommended that the treatment of psychopathy makes greater provision for the extent and type of psychopathic “moral deficit” in assessing the most appropriate applications for the treatment of psychopathy and promoting the safety of urban environments.