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Transcript of Matthew S. Shane, Ph.D. University of Ontario Institute of Technology, Oshawa, Ontario, Canada The...
Matthew S. Shane, Ph.D. University of Ontario Institute of Technology, Oshawa, Ontario, CanadaThe Mind Research Network, Albuquerque, New Mexico
Psychopathy: A Deficit of Ability or Motivation?
What is Psychopathy?
Myths
PCL-R Interview
• 2 hour semi-structured interview
• The individual is queried about various facets of their life: childhood, school, work, family, relationships, criminal, substance abuse, etc.
• More than the fact, the intent is to gain some sense of their interpersonal, emotional and behavioral nature
• Following the interview, the individual receives a score of 0, 1 or 2 on each of the 20 items that comprise the PCL-R
Glib and Superficial Charm
Grandiose Self-worth
Pathological Lying
Conning and Manipulative
Lack of Remorse or Guilt
Shallow Affect
Callousness or Lack of Empathy
Failure to Accept Responsibility
Many Short-term Marital Relationships
Promiscuity
Parasitic Lifestyle
Poor Behavioral Controls
Early Behavioral Problems
Lack of Realistic Long-term Goals
Need for Stimulation
Impulsivity
Irresponsibility
Juvenile Delinquency
Revocation of Conditional Release
Criminal Versatility
Psychopathy Checklist - Revised
Glib and Superficial Charm
Grandiose Self-worth
Pathological Lying
Conning and Manipulative
Lack of Remorse or Guilt
Shallow Affect
Callousness or Lack of Empathy
Failure to Accept Responsibility
Parasitic Lifestyle
Poor Behavioral Controls
Early Behavioral Problems
Lack of Realistic Long-term Goals
Need for Stimulation
Impulsivity
Irresponsibility
Juvenile Delinquency
Revocation of Conditional Release
Criminal Versatility
Psychopathy Checklist - Revised
Factor 1Affective/Interpersonal
Components
Factor 2Impulsive/Antisocial
Components
Many Short-term Marital RelationshipsPromiscuity
Psychopathy
Psychopathy versus Antisocial Personality Disorder
Factor 1Affective/Interpersonal
Components
Factor 2Impulsive/Antisocial
Components
Psychopathy
ASPD
Psychopathy versus Antisocial Personality Disorder
Factor 1Affective/Interpersonal
Components
Factor 2Impulsive/Antisocial
Components
Psychopathy
ASPDSometimes referred
to as the primary essence of
psychopathy
Psychopathy versus Antisocial Personality Disorder
Factor 1Affective/Interpersonal
Components
Factor 2Impulsive/Antisocial
Components
Relationship Between Psychopathy and ASPD
Prison Population
Antisocial Personality Disorder
Psychopathic
Prison prevalence of ASPD: ~65-85%Prison prevalence of psychopathy: ~15-25%
The hypothesis states that the psychopath does not experience
sufficient fear to promote conditioning or avoidance learning
Core Fear Processing Deficit
Low level of subjective fear
Reduced impact of aversive stimuli on emotional systems
Failure to correct dysfunctional actions
Failure to recognize other’s fear
Failure to avoid fear-provoking situations
The “Low Fear” Hypothesis
Other flavours focus on other emotions:• Low guilt• Low empathy• Low negative affect
• Patrick et al. (1993): Participants are asked to watch pictures while they are randomly given painful shocks
• Deficient fear-potentiated startle magnitude in psychopaths
Reduced Sensitivity to Aversive Stimuli
Reduced Sensitivity to Anticipation of Aversive Information
Reduced anticipatory skin conductance
Mea
n C
hang
e in
HR
Skin Conduc tance
10 9 8 7 6 5 4 3 2 1 0Seconds
P-SCL NP-SCL Hare, 1966Ogloff and Wong, 1990
• Reduced ability to identify fearful/sad faces (Blair et al., 2004)
• Reduced ability to identify fearful vocal intonations (Blair et al., 2002)
• Reduced attributions of guilt to others (Blair et al., 1995)
• Reduced sensitivity to distress cues (Blair, 1997)
Emotional Deficits in Psychopathy cont.
Disrupted Neural Processing of Emotional Information
Largely Intact Cognitive Abilities
Already noted that intact awareness of right/wrong was almost necessary for the diagnosis of the disorder
• Psychopathic individuals score normal to above average on IQ tests• Often show increased cortical response (perhaps compensatory)
• One proposed problem was in processing, and learning from, committed mistakes
S
Intact Error Monitoring
Shane et al. (2008), NeuroImage
Shane (resubmitted)
The Importance of Controlling for Substance Abuse
Shane et al. (in progress)
“Don’t” doesn’t equal “Can’t”
The fact that psychopathic indiviudals don’t show reactivity to aversive/emotional stimuli doesn’t necessarily mean they can’t.
If so, we may expect quite drastic neural abnormalities • While some evidence exists, these differences, to date, are
fairly small, and fairly transient
Another possibility is that they can, but simply don’t under the vast majority of (naturalistic) settings
3000 ms
6000 ms
2000 ms
500 ms
Jittered ITI: 2000, 3500 or 5000 ms
+ Enhance
Enhance
How strong is your emotional reaction right now? 1 2 3 4 Very weak very strong
Emotion Regulation in Psychopathy
NonPsychopathic(N = 16)
PsychopathicN = 18) t p
Age 37.37 (9.00) 33.75 (8.25) 1.19 ns IQ 102.68 (13.53) 101.75 (18.16) .17 ns Verbal IQ 39.00 (13.80) 38.94 (15.13) .02 ns Performance IQ 18.31 (4.36) 17.25 (5.74) .59 ns PCL-R Score 15.40 (4.88) 31.47 (1.34) 12.69 < .001 Factor 1 3.87 (2.72) 11.93 (1.58) 9.93 < .001 Factor 2 10.10 (3.88) 16.10 (1.83) 5.42 < .001 Substance Use Years of Alcohol Use 11.25 (7.55) 7.00 (6.48) 1.71 ns Composite Years of Substance Use 21.21 (20.63) 12.03 (12.93) 1.51 ns Comorbid Diagnoses Antisocial Personality Disorder 86.9% 100% Substance Abuse Disorder 94.4% 100% Past Mood Disorder 1 5 Other Personality Disorder 0 0
Emotion Regulation in Psychopathy - Demographics
Emotion Regulation in Psychopaths
Nonpsychopathic Psychopathic
NegWATCH vs
NeutWATCH
Shane, MS (under review)
Emotion Regulation in Psychopaths
Nonpsychopathic Psychopathic
NegWATCH vs
NeutWATCH
NegINCREASE vs
NegWATCH
Shane, MS (under review)
Emotion Regulation in Psychopaths
Nonpsychopathic Psychopathic
NegWATCH vs
NeutWATCH
Left OFC/Insula ROI
0
0.05
0.1
0.15
0.2
0.25
NegWATCH NegINCREASE
Sig
nal
Ch
an
ge (
% f
rom
N
eu
tWA
TC
H)
NonPsychopaths
Psychopaths
Right Amygdala ROI
0
0.02
0.04
0.06
0.08
0.1
0.12
0.14
0.16
NegWATCH NegINCREASE
Sig
nal
Ch
ang
e (%
fro
m
Neu
tWA
TC
H)
NonPsychopaths
Psychopaths
Shane, MS (under review)
NegINCREASE vs
NegWATCH
Empathic Deficits in Psychopathy
Quite a lot of studies over the years
However, a number of recent studies have investigated this from a
neuroscience perspective
“Imagine self” versus “imagine other” in pain
Performance Condition: Participants must press a button as quickly as possible to all ‘X’s, and stop their button press to all ‘K’s.
Observation Condition: Participants watch a video of another person performing the same task; press a button to indicate correct/error responses.
Error Performance/Observation Study Design
All participants performed the ‘Performed’ task first, followed by the ‘Observed’ task, followed by the self-report measures.
Error Performance/Observation Study Results
Performed Errors
Observed
Errors
Shane et al. (2008), NeuroImage
Error Performance/Observation Study Results
Performed Errors
Observed
Errors
Shane et al. (2008), NeuroImage
Similar dACC activity was obtained during both the performance of one’s own errors, and also the
observation of another’s errors.
Error Performance/Observation Study Results
Performed Errors
Observed
Errors
In addition, several regions showed unique activity only during processing of other’s
errors
Shane et al. (2008), NeuroImage
Error Performance/Observation Study Results
Correlations between vACC response to observed errors and Levenson Self-report Psychopathy (LSRP) scores
Shane et al. (resubmitted)
Error Performance/Observation Study Results
Correlations between vACC response to observed errors and self-reported empathic concern
Shane et al. (2009), SCAN
Thus, participants who scored higher on self-reported empathic concern showed
increased vACC activity during the observation of another person’s failures.
“Try to feel the other’s pain”
Entire Sample(N = 26)
With ASPD(N = 9)
Without ASPD(N = 15)
Age M = 33.52 (8.62) M = 35.22 (10.77) M = 34.38 (7.64)
IQ M = 104.69 (12.17) M = 101.67 (10.45) M = 105.00 (14.25)
PCL-R M = 21.12 (6.23) M = 23.59 (6.80) M = 19.42 (5.42)
PCL-R Factor 1 M = 7.24, (3.38) M = 8.51 (3.56) M = 6.35 (3.08)
PCL-R Factor 2 M = 10.57 (2.90) M = 11.02 (3.32) M = 10.26 (2.67)
Comorbid Diagnoses
Alcohol Dependence 50.00% 55.56% 46.15%
Drug Dependence 68.18% 77.78% 61.54%
Current Psychotropic Meds 13.64% 11.11% 15.38%
Anxiety 18.18% 11.11% 23.08%
Depression 31.82% 55.56% 15.38%
Psychotic Disorders 4.55% 11.11% 0.00%
“Try to increase your level of concern for the individual in pain”
Study 1: Probation/Parole sample
“Try to feel the other’s pain”
Arbuckle and Shane (resubmit)
“Try to feel the other’s pain”
Arbuckle and Shane (resubmit)
“Try to feel the other’s pain”
Z-scores of Subjective Pain Ratings and Left
Insula Response
Arbuckle and Shane (resubmit)
Study 2. Demographics
Total(N = 27)
High PCL-R(N = 14)
Low PCL-R(N = 13)
Age 32.56 (8.44) 35.27 (7.54) 30 (9.58)
IQ 104.04 (6.77) 104.00 (6.77) 102.21 (10.81)
PCL-R 23.11 (7.89) 32.18 (1.33) 15.41 (4.13)
PCL-R Factor 1 8.67 (3.76) 12.79 (1.69) 5.00 (1.88)
PCL-R Factor 2 11.26 (3.69) 15.18 (0.87) 8.06 (2.24)
Comorbid Diagnoses
Alcohol Dependence 73.53% 90.91% 50.00%
Drug Dependence 85.29% 100% 64.29%
Anxiety 23.53% 18.18% 21.43%
Depression 20.59% 18.18% 21.43%
ASPD 73.53% 90.91% 50.00%
Arbuckle and Shane (in progress)
Study 2. Results
Arbuckle and Shane (in progress)
NegWatch > NeutWatchActivity represents greater responses
in low PCL-RActivity represents greater responses
in high PCL-R
NegIncrease > NegWatch
NPW PW IC II
-0.1
-0.05
0
0.05
0.1
0.15
LowHi
PW IC II NPW0
0.02
0.04
0.06
0.08
0.1
0.12
LowHi
ACC
Left IFG
Study 2. Results
Arbuckle and Shane (in progress)
NegWatch > NeutWatchActivity represents greater responses
in low PCL-RActivity represents greater responses
in high PCL-R
NegIncrease > NegWatch
NPW PW IC II
-0.1
-0.05
0
0.05
0.1
0.15
LowHi
PW IC II NPW0
0.02
0.04
0.06
0.08
0.1
0.12
LowHi
ACC
Left IFG
Study 2. Results
Arbuckle and Shane (in progress)
NegWatch > NeutWatchActivity represents greater responses
in low PCL-RActivity represents greater responses
in high PCL-R
NegIncrease > NegWatch
Motivated Empathy?
Meffert and colleagues (2013) devised the terms “spontaneous” versus “deliberate” empathy, • Impaired in “spontaneous” empathy• Normal “deliberate” empathy
In the place of “deliberate”, I may instead suggest the term “motivated”• Received a direct instruction to feel…
Coincides with recent work by Zaki and colleagues (e.g. Zaki, 2014), in which he puts out a call for researchers to consider the extent to which empathy is, at its very nature, a motivation
Next Steps?
• Better demonstrate that increased neural response indeed represents empathy• Behavioral metrics• Functional connectivity analyses
• Manipulate motivation to feel for another person• Evaluating empathic accuracy for ingroup versus outgroup versus family
members• Constructing situations within which the psychopath may want to empathize
(to manipulate?)
• Also evaluating a variety of neuromodulation techniques• Have used rt-fMRI in the past• Considering attempting HD-tdcs to stimulate subcortical emotion regions
• For me, external stimulation is less satisfying, however
Previous Treatment Attempts
Rice, Hare and Cormier, 1991
May be considerable implications for potential therapeutic concerns• Treatable versus untreatable