Understanding the psychopathy-stress association in typical developing adults: The role of emotional deficits
Introduction
The common lay concept of psychopathy is one of coolness and control. However, the empirically-derived profile of psychopathic behavior includes indications of higher stress reactivity, irritability and anger (Cleckley, 1941/1976; Patrick, 2018). Such emotion-regulation difficulties may underpin the proactive and reactive types of aggression observed (Cima & Raine, 2009).
Emotional distress is both an antecedent and consequence of antisocial behaviour (Deschamps, Verhulp, de Castro, & Matthys, 2018; Garofalo, Neumann, & Velotti, 2018). High scores on psychopathy measures, along with elevated self-reported perceived stress, have been found to predict concomitant violence offending and victimization (Silver, Piquero, Jennings, Piquero, & Leiber, 2011). Although experimental evidence showing lower autonomic nervous system activation in stress reactivity and in stress recovery in psychopathic samples have been replicated (e.g., Beauchaine, Gatzke-Kopp, & Mead, 2007; Nederhof, Marceau, Shirtcliff, Hastings, & Oldehinkel, 2015; Sijtsema, Van Roon, Groot, & Riese, 2015), few studies have investigated the associations between psychopathy and perceptions of stress.
Before we examine what we already know about psychopathy and stress, it is important to consider work on primary and secondary variants of psychopathy. First proposed by Karpman (1941), these variants are typically defined by low anxiety/internalizing symptoms in the case of primary psychopathy, and increased anxiety and internalizing symptoms (secondary variant), often seen alongside greater levels of traumatic experiences than those presenting with the primary subtype profile (Skeem et al., 2007; Tatar et al., 2012).
Cross-sectional work that has explored the associations of psychopathic personality traits to post-traumatic stress suggests that affective deficits seen in psychopathy could have some adaptive role in dealing with stress (Pham, 2012). For this reason, psychopathic personality traits of fearlessness and stress immunity seem to better characterize the primary psychopathy profile rather than the secondary subtype (Marcus, Fulton, & Edens, 2013). Similarly, traits denoting fearlessness have been negatively associated to personal distress, suggesting that among this group of individuals (likely primary-type) with higher psychopathic personality traits, there is an attenuated experience of distress (Durand, 2018).
One further study investigating the association between antisocial personality disorder (APSD; which includes those with elevated psychopathic traits) and perceived stress found that those with APSD had higher levels of self-reported stress when compared to participants with generic antisocial behavior and to those without antisocial traits (Goldstein, Dawson, Smith, & Grant, 2012). Previous work has shown that psychopathy and perceived stress are positive, significant predictors of concomitant violence offending and victimization (Silver et al., 2011). In addition, nearly 75% of incarcerated males who scored >27 on the Psychopathy Checklist-Revised (PCL-R) reported a history of traumatic stressful events (Pham, 2012). In a further sample of psychiatric patients, Dalkner et al. (2018) employed the Psychopathic Personality Inventory-Revised (PPI-R; Lilienfeld & Widows, 2005) along with several measures of stress-related experiences, reporting that low self-reported stress levels and adaptive stress coping strategies might be explained by primary psychopathic personality traits in psychiatric settings. Recent data showed much stronger associations between secondary psychopathy and stress than between primary psychopathy and stress for both male and female participants (Eisenbarth et al., 2019).
One potential mechanism to explain increased stress responses is via impairments or differences in emotion processing. Stressful life events are certainly associated with differences in attention to and memory for emotional stimuli (Demers et al., 2018; Pollak, Cicchetti, & Klorman, 1998), and individual differences in stress responses are associated with different neural activity in areas of the brain involved in emotion processing (Henckens et al., 2015). Sethi et al. (2018) reported reduced neural responses to distress only in individuals with primary psychopathy. At present, it is not entirely clear whether emotional/social information processing deficits offer incremental utility in understanding stress in psychopathy (Crozier et al., 2008; Derefinko, 2015). Among these deficits in emotion processing, alexithymia is a strong candidate for further consideration. Defined as being an inability to describe or recognize one's own emotions, alexithymia has particular potential relevance to the study of psychopathy as both conditions entail deficiencies in empathic response (Bird & Viding, 2014; Takamatsu & Takai, 2019). Alexithymia has been negatively associated with empathic concern, one facet of affective empathy (Bird et al., 2010; Grynberg, Luminet, Corneille, Grezes, & Berthoz, 2010) and positively with psychopathy (Lander, Lutz-Zois, Rye, & Goodnight, 2012; Louth, Hare, & Linden, 1998).
Recently, Takamatsu and Takai (2019) reported that the three domains (difficulties in describing feelings [DDF], difficulties identifying feelings [DIF] and externally oriented thinking [EOT]) from the Toronto Alexithymia Scale (Bagby, Parker, & Taylor, 1994) correlated positively and with secondary psychopathy (rrange = 0.17 to 0.35, p's < 0.01), while the primary psychopathic variant was only associated with DIF and EOT (rrange = 0.26 to 0.30, p's < 0.001).
Higher scores on alexithymia measurements - especially those denoting deficits in identifying and describing feelings - have been positively linked to experiences of personal distress in adults (Grynberg, Luminet, Corneille, Grezes, & Berthoz, 2010). It is important to be able to consider the role of being able to adequately recognize and express one's own emotions in the management of stress, and the impact that these factors may have on antisocial behavior.
Psychopathy is not only linked to significant, direct harm to other individuals but also important societal costs (DeLisi, Reidy, Heirigs, Tostlebe, & Vaughn, 2018). Psychopathy is related with poorer outcomes for the individuals themselves, particularly those high on the affective component of the disorder, and is frequently associated with high rates of early stressful life experience (Dargis, Newman, & Koenigs, 2016; Dhingra, Boduszek, Palmer, & Shevlin, 2015). There is an emergent interest in studying the role that stress plays in behavior associated with psychopathy (Durand, 2018; Eisenbarth et al., 2019; Sethi et al., 2018).
The principal aim of the research was to explore the relationship between primary and secondary psychopathic personality traits and their associations with both alexithymic symptoms and with self-reported stress. Beyond the basic issue of the nature of bivariate relationships between psychopathy and stress, there are three key questions that we sought to investigate:
- 1.
How do primary and secondary variants of psychopathic personality traits relate to alexithymia? Although previous research suggests a relationship between psychopathic traits and alexithymic symptoms (Takamatsu & Takai, 2019), no other work has attempted to replicate whether this association is true for both primary and secondary variants of psychopathic personality traits.
- 2.
Is there a difference in the way that primary and secondary variants of psychopathy relate to self-reported stress? Based on previous work that used psychophysiological and self-report measures, we aimed to test the hypothesis that perceived stress would positively associate with the secondary variant of psychopathic personality traits, but negatively with the primary variant.
- 3.
What processes might mediate associations between stress and psychopathy? Arguably, various processes associated with psychopathy might contribute to higher levels of self-reported stress, but mediating mechanisms have been so far neglected in the research reviewed. Given that psychopathic personality traits can be comorbid with alexithymia, it was predicted that alexithymia would have significant indirect effects in the relationship between perceived stress and primary and secondary psychopathic personality traits. However, larger effects were expected to occur for the model exploring secondary psychopathic personality traits as a predictor of stress.
Section snippets
Participants, procedures and design
This cross-sectional study involved a convenience sample of 264 adults between the ages of 18 and 58 years-old (Mage = 21.7 years, SD = 6.92; 70% female). In addition, 97.2% were currently enrolled in universities, 96.6% lived in the United Kingdom, 91.7% were under the age of 29 years-old, and 37% were employed or self-employed. The investigation was approved by the Goldsmiths College Research Ethics Committee and followed the international guidelines on research ethics, particularly the
Results
In respect to the links between alexithymia and primary and secondary psychopathy personality traits, positive, small to moderate correlations were found for Externally Oriented Thinking, Difficulties Identifying Feelings and Difficulties Describing Feelings, although the magnitude of relationship was greater for the secondary psychopathy variant for the latter two dimensions of alexithymic symptoms and for alexithymia total score (Table 1). Even though both associations between
Discussion
The goal of the research was to test the hypothesis that psychopathic personality traits associate with behavioral, self-reported stress. In addition, the literature reviewed supported the investigation of further research questions. Firstly, we tested whether perceived stress was associated only with the secondary variant of psychopathy, or whether primary psychopathic traits were related to self-reported stress. Results showed that both psychopathic variants were positively correlated with
Declarations of interest
None.
Funding
This work was supported by CAPES Foundation (Grant number: 893713-3).
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