Contrary to conventional wisdom, psychopaths are able to tap into the feelings of others, a process essential in forming human bonds, but it takes work, new research suggests.
Investigators studied inmates at a maximum-security prison who played a computer game in which they were asked to perform a task either from their own perspective or from that of an avatar on the screen.
When asked to do so, participants were able to place themselves in the perspective of the avatar.
Participants who scored highest on measures of psychopathic traits showed less ability do adopt the avatar’s perspective than those with lower scores. They were also more likely to have been convicted of crimes involving assault.
“Most people automatically take in cues from others regarding their feelings — for example, if I am teaching and I notice someone yawning or laughing, it seeps into my thinking and informs my reactions without even being aware of it,” senior author Arielle Baskin-Sommers, PhD, assistant professor of psychology, Yale University, New Haven, Connecticut, told Medscape Medical News.
“Psychopaths do not take in these cues automatically, but this study shows that they can do so deliberately, which can enable them to develop compensatory strategies that force them to take the perspective of others into account,” she said.
The study was published online March 12 in the Proceedings of the National Academy of Sciences.
Standing in Another’s Shoes
Successful social interaction requires the ability, known as the theory of mind (ToM), “to understand what other people are thinking,” the authors write.
Previous research “surprisingly” has suggested that ToM deficits are not “typically characteristic” of psychopathy.
Instead, the “callous and manipulative behavior” and “chronic and flagrant disregard for the perspective of others” displayed by psychopaths have “been thought to result from deficits in social-affective processing.”
Nevertheless, “there has been very clearly replicated previous research showing that individuals who scored high on psychopathy measures are able to take the perspective of others cognitively, although their behavior in the real world seems to run contrary to normal perspective-taking,” Baskin-Sommers said.
To explore the contrast between automatic and deliberate ToM processing, the researchers studied 116 incarcerated men (aged 18 to 75 years) in a maximum-security prison.
“Participants were told that they were taking part in a study of life experiences and decision-making patterns by people who have trouble with the law, but we did not tell them explicitly what the study was for,” said Baskin-Sommers.
Participants were shown computerized images of a humanlike avatar in a room with dots on the walls and were asked to report either the number dots they see or the number of dots the avatar sees. The responses represent automatic ToM processing and controlled ToM processing, respectively.
Psychopathy was assessed through the participants’ completion of a life history interview that used the Psychopathy Checklist–Revised (PCL-R).
The researchers also inventoried participants’ real-world criminal behavior using self-reports and official records.
Participants were required to score ≤70 on a brief measure of IQ and to read at a level higher than that of the fourth grade.
Inmates with psychotic disorders, those who used psychotropic medications, or those who had medical conditions that could affect comprehension of the materials were excluded.
The skin color of the avatar was matched to each participant’s race, and all avatars wore prison uniforms similar to those worn by participants.
The avatar always appeared on the screen in profile, facing either the right or the left wall of the room. Up to three red dots were depicted on the walls of the room.
Depending on the avatar’s orientation and the positioning of the dots, the avatar was either able or unable to see all of the dots in the room.
On each trial, participants were asked to judge either their own visual perspective or the visual perspective of the avatar — self-trials (automatic ToM processing) and avatar trials (controlled ToM processing), respectively.
Sometimes the participant and the avatar could see the same number of dots, and sometimes they could see different numbers of dots, representing consistent and inconsistent trials, respectively.
Participants were given 2000 milliseconds to indicate whether or not a picture matched a given perspective and content.
Learning New Skills
The researchers found a significant main effect of both perspective (F(1,105) = 5.467; P = .021 95% confidence interval [CI], .001 – 0.148) and consistency (F(1,105) = 248.51; P < .001; 95% CI, .607 – .765).
Participants more quickly verified the content of their perspective than that of the avatar and were also faster in verifying the perspective content when both perspectives were consistent than when they were inconsistent.
To examine differences in interference across conditions, the researchers compared interference type (altercentric vs egocentric) as a within-subjects factor and found a significant effect of interference type.
Participants displayed less interference when asked to take their own perspective vs that of the avatar.
On self-perspective trials and avatar-perspective trials, participants were significantly slower to respond to inconsistent vs consistent trials.
“Thus, as a group, participants experienced both altercentric and egocentric interference, and showed more interference on the avatar perspective trials,” the authors write.
There was no relationship between PCL-R total score and egocentric interference, “which replicated previous research that psychopathy was unrelated to performance on controlled ToM,” they add.
The main effect of PCL-R total score was “significantly and positively” related to the number of assault charges.
Notably, the interaction between psychopathy and altercentric interference was a significant predictor of assault charges, “indicating that the greatest number of assault charges results from a combination of high psychopathy scores and low automatic ToM processing,” the authors note.
Additionally, the interaction between psychopathy and egocentric interference significantly predicted assault charges.
“It is not surprising that someone with lower levels of controlled ToM (ie, egocentric interference) and high levels of psychopathy would show higher levels of antisocial behavior,” the authors write.
“The practical implications are that individuals with psychopathy don’t have the total inability to take the perspective of others into account, and they can learn to do so,” Baskin-Sommers said.
“Cognitive-behavioral strategies are used to teach new skills to people with other conditions such as depression and can be adapted to this population,” she added.
New skills can also be taught through training games, which treat the neural mechanisms responsible for cognitive processes, she said.
No Emotional Capacity
Commenting on the study for Medscape Medical News, David Kosson, PhD, professor of psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, who was not involved with the study, said that it “provides additional evidence of cognitive or attentional dysfunction in psychopathic offenders.”
However, “although the authors’ principle conclusion is justified, there is some overclaiming,” because the study appears to deemphasize the “dominant perspective that clinicians have, which is still that psychopaths have a basic incapacity for emotion,” he said.
Nevertheless, the study has important take-home messages.
“This work has really shown that situational cues and immediate goals play a big role in what psychopathic people do, and don’t, pay attention to,” said Kosson, who is president-elect of the Society for the Scientific Study of Psychopathy and the founder of Aftermath: Surviving Psychopathy Foundation.
“As we understand their priorities and short-term immediate goals, we can better predict what kind of information they will have and when they’ll show these social interaction problems,” he said.
Baskin-Sommers added that by emphasizing the psychopath’s goals, such as avoiding prison in the future, “we can teach them to build new habits, which is no different than how we engage in therapy with other individuals.”
The study was funded by the Harry Frank Guggenheim Foundation. Dr Baskin-Sommers and coauthors have disclosed no relevant financial relationships. Dr Kosson receives royalties from the Psychopathy Checklist Youth Version Technical Manual.
Proc Natl Acad Sci. Published online March 12, 2018. Abstract
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