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

Psychopathy and Impairments in Emotion Regulation: A systematic review and Meta-analysis

Considering the sparse but rapidly growing literature concerning the relationship between psychopathy and emotion regulation, taking stock of accumulating knowledge in a systematic review and meta-analysis of the existing results is needed. We performed a systematic search (up to May 30, 2024) following PRISMA guidelines of five scientific databases (PsycINFO, PsycARTICLES, MEDLINE, PubMed, Scopus and Web of Science). Also, gray literature was searched. After removing the duplicates, a total of 8.786 records were screened, and 73 articles were selected based on the inclusion criteria used for systematic review. The meta-analytic procedure was performed on 55 identified studies consistent with the criteria adopted, which overall comprised 29.856 individuals. The current systematic and meta-analysis review has clarified the association between impairments of emotional regulation abilities and facets of psychopathy. More specifically, analyses indicated that emotional dysregulation is associated with overall levels of psychopathic traits, as well as with both the lifestyle and affective components of psychopathy, which suggests the utility of assessing these features when designing interventions focused on modulating negative emotional states and enhancing regulation of impulsive behaviors.

An examination of autonomic and facial responses to prototypical facial emotion expressions in psychopathy

Meta-analyses have found that people high in psychopathy categorize (or “recognize”) others’ prototypical facial emotion expressions with reduced accuracy. However, these have been contested with remaining questions regarding the strength, specificity, and mechanisms of this ability in psychopathy. In addition, few studies have tested holistically whether psychopathy is related to reduced facial mimicry or autonomic arousal in response to others’ dynamic facial expressions. Therefore, the current study presented 6 s videos of a target person making prototypical emotion expressions (anger, fear, disgust, sadness, joy, and neutral) to N = 88 incarcerated adult males while recording facial electromyography, skin conductance response (SCR), and heart rate. Participants identified the emotion category and rated the valence and intensity of the target person’s emotion. Psychopathy was assessed via the Psychopathy Checklist-Revised (PCL-R). We predicted that overall PCL-R scores and scores for the interpersonal/affective traits, in particular, would be related to reduced emotion categorization accuracy, valence ratings, intensity ratings, facial mimicry, SCR amplitude, and cardiac deceleration in response to the prototypical facial emotion expressions. In contrast to our hypotheses, PCL-R scores were unrelated to emotion categorization accuracy, valence ratings, and intensity ratings. Stimuli failed to elicit facial mimicry from the full sample, which does not allow drawing conclusions about the relationship between psychopathy and facial mimicry. However, participants displayed general autonomic arousal responses, but not to prototypical emotion expressions per se. PCL-R scores were also unrelated to SCR and cardiac deceleration. These findings failed to identify aberrant behavioral and physiological responses to prototypical facial emotion expressions in relation to psychopathy.

Do High Psychopaths Care More about Moral Consequences than Low Psychopaths in Chinese Culture? An Exploration Using the CNI Model

Purpose: Fewer studies are about the influence of psychopath traits on moral judgment and the underlying psychological mechanism in Chinese cultural background. In this paper, we use the creative CNI (Consequences, Norms, Inaction versus action) model to quantify the subject’s reaction to moral dilemmas. Method: In this research, the Chinese version of the Levenson Psychopathic Scale, CNI model materials, and a multinomial model to further analyze the associations among the psychopathy characteristics and utilitarian moral judgment are applied. The CNI model is proposed by Gawronski et al., which can quantify the subjects’ sensitivity to moral consequence, sensitivity to moral norms, and the general preference for inaction or action in moral dilemmas. Result: This study finds that there were significant differences in the utilitarian moral judgment between the groups, t (360) = 3.24, p = 0.001, and Cohen’s d = 0.36. The analysis results of the CNI model show that the high psychopathy group on the N parameter was significantly lower than the group of low psychopathy, ΔG² (2) = 79.70, p = 0.001. In terms of the C parameter, we found no significant distinctions between the two groups, ΔG² (2) = 1.356, p = 0.244. For the I parameter, the two groups also have no significant differences, ΔG² (2) = 0.093, p = 0.76. Conclusion: Persons with high psychopathy traits prefer to make more utilitarian moral judgments and have a weak sensitivity to moral norms (N). The sensitivity to consequences (C) of the two groups is no significant difference. The general preference for inaction versus action (I) also has no significant differences between those two groups. Moreover, the CNI model fits well in Chinese subjects.

Psychopathy and emotion dysregulation: More than meets the eye

Emotional dysfunctions have long been associated with psychopathy. Yet, the extent to which these dysfunctions include problems in emotion regulation (ER) has only recently become clearer. In this study, we first reviewed theoretical and empirical literature on psychopathy and ER, and then examined associations between ER and psychopathy in four diverse samples from two countries (MTurk, college, community, and offender samples from the United States and Italy; total N = 1940). We employed Structural Equation Modeling (SEM) to examine latent associations between ER and measures of psychopathy and the dark triad, respectively. Results revealed a consistent pattern of moderate associations between psychopathy and poorer ER. These patterns were replicated across samples and psychopathy assessment, and held when including Machiavellianism and narcissism in the models. Replicating and extending recent studies, these findings provide incremental evidence that the emotional dysfunctions associated with psychopathy include problems in ER. Thus, we contend that prevention efforts in the general community, as well as clinical risk assessment and treatment planning in clinical (forensic) populations should include an emphasis on ER, as it may represent an important factor explaining some of the maladaptive correlates of psychopathic personality.

Capacity for upregulation of emotional processing in psychopathy: all you have to do is ask

Historically, psychopathic individuals have been described as suffering a chronic hyporesponsivity to negatively valent stimuli. However, while a wide body of empirical work indicates that the psychopath does not manifest normal reactivity to emotional stimuli, it does not similarly indicate that they cannot do so. To attempt to differentiate these alternatives, the current functional magnetic resonance imaging (fMRI) study evaluated the extent to which offenders with varying PCL-R scores could up- (or down-) regulate their neural response to negatively valent stimuli. Participants were asked to either watch negatively- and neutrally-valent images naturally (passive-processing), or to try to increase or decrease their emotional response to the images (instructed-processing). During passive processing, high-psychopathy offenders showed reduced activity compared to both low- and mid-psychopathic offenders through a majority of emotion-relevant regions. However, when participants were instructed to try to increase their emotional response all groups showing increased activity throughout relevant regions, including left insula, orbitofrontal cortex and anterior cingulate/medial frontal cortex (ACC/mFC). Comparison of participants' subjective emotion ratings indicated that all groups showed symmetry between their neural/subjective emotion metrics, and the high-psychopathy group may have showed the greatest such symmetry. These findings suggest that psychopathic individuals may be capable of manifesting emotional reactivity to negatively valent stimuli, at least under certain conditions. Relevance for traditional and developing models of psychopathy is discussed in turn.

Emotional reactivity and regulation in individuals with psychopathic traits: Evidence for a disconnect between neurophysiology and self-report

Individuals with psychopathic traits often demonstrate blunted reactivity to negative emotional stimuli. However, it is not yet clear whether these individuals also have difficulty regulating their emotional responses to negative stimuli. To address this question, participants with varying levels of psychopathic traits (indexed by the Triarchic Measure of Psychopathy; Patrick, 2010) completed a task in which they passively viewed, increased, or decreased their emotions to negative picture stimuli while electrocortical activity was recorded. During passive viewing of negative images, higher boldness, but not higher disinhibition or meanness, was associated with reduced amplitude of the late positive potential (LPP), an ERP that indexes reactivity to emotionally relevant stimuli. However, all participants demonstrated expected enhancement of the LPP when asked to increase their emotional response. Participants did not show expected suppression of the LPP when asked to decrease their emotional response. Contrary to the electrophysiological data, individuals with higher boldness did not self-report experiencing blunted emotional response during passive viewing trials, and they reported experiencing greater emotional reactivity relative to other participants when regulating (e.g., both increasing and decreasing) their emotions. Results suggest inconsistency between physiological and self-report indices of emotion among high-bold individuals during both affective processing and regulation.

Implicit vs. explicit dimensions of guilt and dominance in criminal psychopathy

The current study investigated the relationship between psychopathy and two concepts that hold a central position in conceptualizations of this disorder, being guilt and dominance. Both constructs were measured using explicit measures (i.e., self-report), as well as indirect assessment (i.e., the Single Category Implicit Association Test; Sc-IAT). Our sample consisted of 43 psychopathic offenders, 42 nonpsychopathic offenders, and 26 nonoffender controls. Although no overall group differences emerged, the lifestyle/antisocial traits of psychopathy (Factor 2) predicted reduced self-reported guilt on a dimensional level. As hypothesized, such a relationship was absent for the interpersonal/affective dimension of psychopathy (Factor 1). Psychopathy was unrelated to implicit self-guilt associations. Regarding dominance, psychopathy was not significantly associated with indirectly or explicitly assessed dominance. These findings are interpreted in the light of empirical knowledge on moral emotions, insight and response distortion in highly antisocial offenders.