Understanding the cause of the emotional deficits and/or dysregulation in psychopathy is essential not only for managing the disorder and developing treatment protocols but this also aides in the understanding of how healthy individuals process emotion and can lead to a better of understanding of emotion, personality and personality disorder (Malterer et al. 2008).
In healthy a participant, that is individuals not suspected to have psychopathy or a preponderance of psychopathic traits, research suggests that attention may be modulated by emotion. Specifically visual awareness and attention may be modified by emotionally valenced stimuli (Blair and Mitchell 2009). More specifically, attention can be captured and dominated by unpleasant stimuli, to the exclusion of other forms of emotionally valenced stimuli (Sheth and Pham 2008). Research conducted with individuals who experience higher than average anxiety and fear, such as those with anxiety disorders and Obsessive Compulsive Disorder (OCD), participants again will over-attend to stimuli that is aversive in nature (Olatunjui et al. 2007). Conversely the expectation would be that those who exhibit a preponderance of psychopathic traits would not experience these deficits because they are not encumbered by the emotion associated with the stimuli. And for those that have a preponderance of Factor 1 traits associated with psychopathy or primary psychopathy, there is research to support this (Mitchell et al. 2006). Paradoxically, a lack of emotion actually provides an advantage to the individual with a preponderance of psychopathic traits when confronted with
Page | 5-132 certain forms of decision making. Specifically, Osumi and Ohira (2010) found that those with a preponderance of psychopathic traits were able to make more rational decisions, even if they were deemed ‘unfair’ financially to the participants. Participants’ decisions to accept an unfair or fair offer financial incentive was positively moderated by psychopathy levels. Not only did those who score high on psychopathy respond more rationally, they did not seem to experience an adverse physiological response to unfair offers that the participants with low scores experienced. The emotional detachment demonstrated by some with a preponderance of psychopathic traits seems to provide an advantage when it comes to decision making if there is generally an emotional investment of some kind involved, as the individuals with more psychopathic traits may be able to make these decisions without experiencing the emotional interference low scorers seem to.
Research conducted by Yamasaki and La Bar (2005) with healthy participants suggests that attention and emotion are regulated by the prefrontal cortex. Specifically they found that the dorsolateral prefrontal cortex is implicated in attention and the ventrolateral prefrontal cortex may be involved in emotional arousal. It also appears that specific regions can be deactivated or inhibited depending on the stimuli a participant is exposed to with emotional stimuli overriding attentional stimuli and depending upon the complexity of the cognitive task, attentional stimuli reducing neural responses to emotional stimuli. Yamasaki and La Bar (2005) hypothesise that there is a reciprocal relationship between the dorsolateral and ventral prefrontal cortex that provides a basis for neural activity for cognitive/emotional interactions and that this may help to explain dysregulation in various mental disorders that have an affective component to them. Mitchell et al. (2006) found that in healthy controls, responses to emotional stimuli resulted in response latencies far greater than psychopathic counterparts whose attention was unaffected by emotionally valenced stimuli in an Emotional Interrupt Task experiment. They hypothesised that this was
Page | 5-133 the result of dysfunction in emotional processing by those with affective disorders who do not attend to emotionally valenced stimuli in the same way as healthy controls. They hypothesise that the amygdala is responsible for the regulation of attention including biasing attention towards that which is emotionally salient to the individual and via conditioning/learning. The amygdala seems to responsible for ‘biasing’ attention to the emotional at the expense of the neutral even if the emotional stimuli is peripheral, in healthy subjects. However it could be argued that psychopathy, where emotion is said to be deficient in some subtypes, attending to and appreciating emotionally valenced stimuli has not be learned therefore is neglected as the amygdala does not function in the typical fashion. Interestingly, Shamay-Tsooryet al. (2009) have found that empathy seems to have a double disassociation system that engages the prefrontal cortex differentially, with the ventromedial prefrontal cortex responsible for cognitive empathy (perspective taking) and inferior frontal gyrus responsible for emotional empathy and emotion recognition. In psychopaths, cognitive empathy is believed to be in tact, however emotional empathy appears to be lacking (Blair 2008). Furthermore, Blair (2008) posits that the dysfunction of the amygdala, in particular the ability to learn via stimulus reinforcement through conditioning prevents psychopaths from experiencing, attending to and processing emotions correctly; this includes aversive stimuli as well as emotional empathy. This research supports the notion that psychopathy is a consequence of neurocognitive deficits, in particular global dysfunction of the paralimbic system which is responsible for emotion regulation/experience, and attention. This in turn has informed theory that suggests that emotional and neurocognitive deficits result in attenuated morality and moral reasoning in psychopaths (Blair 2009).
Page | 5-134 While not often addressed, there is research to suggest that emotional dysregulation may also be a consequence of atypical hemispheric functioning as well as dysfunction at the inter-hemispheric level. The valence hypothesis suggests that during normal functioning the hemispheres of the brain are responsible for attending to and processing different emotions and/or different aspects of emotion with the left hemisphere responsible for positive emotion and the right responsible for negative emotion (Borod et al., 2001; cited by Rueckert and Naybar, 2008). In lesion and neurodegenerative disease studies, participants who exhibited deficits in empathy demonstrated greater deterioration in the right hemisphere of the brain, for example (Rueckert and Naybar 2008). Borkenau and Mauer (2006) and tested this theory using a lateralised emotional Stroop with healthy subjects and found that negatively valenced words resulted in greater latencies and interference when negatively valenced words were presented to the LVF (left visual field), and greater latencies and interference when positively valenced words were presented to RVF (right visual field), which provides support that, at least for semantic processing of words, the right hemisphere seems to be responsible for processing negatively valenced words, and the left for positively valenced words. According to Van Strien and Van Kampen (2009) lateralised emotional Stroop research conducted with males who scored high on positive schizotypal traits, resulted in over-attending to negative valenced emotional stimuli presented to the left visual field (LFV) demonstrating differential functioning at the hemispheric level with the right hemisphere responding in an exaggerated fashion to negative stimuli due the presence of the positive schizotypal traits. The implications of this are two-fold, first that the hemispheres seem to process emotion differentially and secondly that for individuals with emotional disorders and/or lesions/disease, emotional deficits or exaggerated attendance to specific emotional stimuli seem to occur when the hemispheres either dysfunction or become damaged.
Page | 5-135 Interestingly, there is research that suggests that not only do the hemispheres function differently but for psychopathic individuals there are contradictory findings indicating that inter-hemispheric interactions via the corpus callosum may either be enhanced or diminished by the presence of psychopathic traits. Research is equivocal on the matter, with Raine (2003) cited by Hiatt and Newman (2007) suggesting that increases in collosal volume result in more efficient functioning of the corpus callosum and the work of Hiatt and Newman (2007) suggesting the opposite that for offending psychopaths demonstrated deficits in performance when compared to controls. However, this study did not explore the psychopathic subtypes beyond examining anxiety levels and assumed that the non-offending sample did not exhibit psychopathic traits.