Psychopathology and Emotion

It has been claimed that cognitive therapists endorse sets of uplifting beliefs BECAUSE the client feels better believing them: not because they lead towards greater verisimilitude, a purported cognitivists’ hallmark of rational choice. Since standard cognitive therapists sometimes ask us to choose sets of beliefs that interpret evidence on the basis of greater individual happiness (all other things being equal), this suggests that the basis of choice goes beyond rationality. I contend that the case against the rationality of cognitive therapy (...) is not made if one allows a broadening of what to count as rational cognitive therapy. The rationality of therapy consists in how well it achieves its goal. My claim is that at least one goal is, or ought to be, greater information value of the client’ dialogues. Among other things, information values encode affect. Understanding reason in this way effectively transforms our understanding of rationality in a way that may be incommensurable with the standard view. If these radically divergent approaches to cognitive therapy are incommensurable, there is no way to discover that we are still talking about the same thing. So, a challenge for this competing view is to say on what basis the term cognitive therapy may be projectable. I identify some constraints on this project and sketch a possible solution. (shrink)

In order to uncover the inner workings of our capacities, we look to ‘effects’. Most of us have the capacity to distinguish between spoken ‘ba’ and ‘fa’ sounds. One thought is that this is achieved through aural sensitivities that detect changes in vibration picked up by the eardrum. But the McGurk Effect suggests that there is more to the story. Without changing the incoming vibrations, sound experience can be modulated by showing a video of a mouth making a ‘ba’ sound (...) or a ‘fa’ sound with a consistent sound overlaid. We learn that our overall auditory experiences are at least in part determined by visual cues in addition to what’s first picked up by our eardrums. The McGurk Effect gives us a hint into the inner workings of audition and helps us better understand the capacity to discriminate sounds of a certain sort. -/- In the present paper, the focus is on emotional capacities and a well known effect – recalcitrance. Recalcitrant emotions, such as fearing the dog even though one knows that the dog is harmless or being angry with one’s partner even when one realises it was only in a dream that the partner was nasty, have played the role of effect in much theorising about emotions. But in my view, we’ve stayed a bit too close to home, aiming to fit the effect into a paradigm – the representationalist paradigm – that isn’t fit for purpose. I will use this criticism as a launching off point to introduce a different way of thinking about emotions that is better suited to making sense of recalcitrance. I will argue that emotions are transitions between representational states rather than being representational states themselves. The view is better suited to make sense of recalcitrance and, at the end of the paper, I will offer reasons for thinking that main points that speak in favour of a representationalist approach to emotion can be recaptured or explained away by the transitions view. (shrink)

Recently, there have been calls to develop a more contextual approach to phenomenological psychopathology—an approach that attends to the socio-cultural as well as personal and biographical factors that shape experiences of mental illness. In this Perspective article, we argue that to develop this contextual approach, phenomenological psychopathology should adopt a new paradigm case. For decades, schizophrenia has served as the paradigmatic example of a condition that can be better understood through phenomenological investigation. And recent calls for a contextual approach continue (...) to use schizophrenia as their primary example. We argue, in contrast, that substance misuse provides a better paradigm case around which to develop a contextually sensitive phenomenological psychopathology. After providing a brief vignette and analysis of a case of substance misuse, we explain why this kind of condition requires considerable sensitivity and attention to context, better motivating the incorporation and development of new contextually sensitive approaches. (shrink)

Affordances are action-possibilities, ways of relating to and acting on things in our world. They help us understand how these things mean what they do and how we have bodily access to our world more generally. But what happens when this access is ruptured or impeded? I consider this question in the context of psychopathology and reports that describe this experience. I argue that thinking about the bodily consequences of losing access to everyday affordances can help us better understand these (...) reports. An affordance-based approach to psychopathology can illuminate some of the causes, as well as the experiential character and consequences, of affective disorders and diminished spatial agency in self-world disturbances. It also highlights some under-explored ethical and political dimensions of these issues that need further attention. (shrink)

In this comparative study, we examine experiential disruptions of embodiment and affectivity in Moebius Syndrome and schizophrenia. We suggest that using phenomenological resources to explore these experiences may help us better understand what it’s like to live with these conditions, and that such an understanding may have significant therapeutic value. Additionally, we suggest that this sort of phenomenologically-informed comparative analysis can shed light on the importance of embodiment and affectivity for the constitution of a sense of self and interpersonal relatedness (...) in normal conditions. (shrink)

We argue that a phenomenological approach to social space, as well as its relation to embodiment and affectivity, is crucial for understanding how the social world shows up as social in the first place—that is, as affording different forms of sharing, connection, and relatedness. We explore this idea by considering two cases where social space is experientially disrupted: Moebius Syndrome and schizophrenia. We show how this altered sense of social space emerges from subtle disruptions of embodiment and affectivity characteristic of (...) these conditions. These disruptions are instructive, we suggest, in that they highlight the foundational role that body and affect play in organizing social space—the lived context in which we first encounter one another as social agents. (shrink)

Body checking, characterized by the repeated visual or physical inspection of particular parts of one’s own body (e.g. thighs, waist, or upper arms) is one of the most prominent behaviors associated with eating disorders, particularly Anorexia Nervosa (AN). In this paper, we explore the explanatory potential of the Recalcitrant Fear Model of AN (RFM) in relation to body checking. We argue that RFM, when combined with certain plausible auxiliary hypotheses about the cognitive and epistemic roles of emotions, is able to (...) explain key characteristics of body checking, including how body checking behavior becomes habitual and compulsive. (shrink)

It is widely agreed that obsessive-compulsive disorder involves irrationality. But where in the complex of states and processes that constitutes OCD should this irrationality be located? A pervasive assumption in both the psychiatric and philosophical literature is that the seat of irrationality is located in the obsessive thoughts characteristic of OCD. Building on a puzzle about insight into OCD (Taylor 2022), we challenge this pervasive assumption, and argue instead that the irrationality of OCD is located in the emotions that are (...) characteristic of OCD, such as anxiety or fear. In particular, we propose to understand the irrationality of OCD as a matter of harboring recalcitrant emotions. We argue that this account not only solves the puzzle about insight, but also makes better sense of how OCD sufferers experience and describe their condition and helps explain some otherwise puzzling features of compulsive behavior. (shrink)

Psychopaths exhibit diminished ability to grieve. Here I address whether this inability can be explained by the trademark feature of psychopaths, namely, their diminished capacity for interpersonal empathy. I argue that this hypothesis turns out to be correct, but requires that we conceptualize empathy not merely as an ability to relate (emotionally and ethically) to other individuals but also as an ability to relate to past and present iterations of ourselves. This reconceptualization accords well with evidence regarding psychopaths’ intense focus (...) on the temporal present and difficulties in engaging in mental time travel, as well as with the essentially egocentric and identity-based nature of grief. -/- . (shrink)

Study of Batman´s villain Scarecrow through the lens of ancient Stoicism, particularly according to the Stoic theory of passions.

The DSM‐5 highlights two essential psychological features of anorexia nervosa (AN): recalcitrant fear of gaining weight and body image disturbance. Prominent accounts grant false beliefs about body weight and shape a central role in the explanation of AN behavior. In this article, we propose a stronger emphasis on recalcitrant fear. We show that such fear can explain AN behavior without the intermediary of a false belief, and thus without the associated explanatory burdens and conceptual difficulties. We illustrate how shifting the (...) emphasis from false belief to recalcitrant fear can supplement a number of different non‐doxastic models of AN. (shrink)

If I see, hear, or touch a sparrow, the sparrow seems real to me. Unlike Bigfoot or Santa Claus, it seems to exist; I will therefore judge that it does indeed exist. The “sense of existence” refers to the kind of awareness that typically grounds such ordinary judgments of existence or “reality.” The sense of existence has been invoked by Humeans, Kantians, Ideologists, and the phenomenological tradition to make substantial philosophical claims. However, it is extremely controversial; its very existence has (...) been called into question. This paper aims to clarify the nature and reality of the sense of existence by studying a psychiatric condition in which the sense appears to be disrupted: depersonalization disorder (DPD). (shrink)

Affordances are action-possibilities, ways of relating to and acting on our world. A theory of affordances helps us understand how we have bodily access to our world and what it means to enjoy such access. But what happens to bodies when this access is somehow ruptured or impeded? This question is relevant to psychopathology. People with psychiatric disorders often describe feeling as though they’ve lost access to affordances that others take for granted. Focusing on schizophrenia, depression, and autistic spectrum disorder, (...) I argue that thinking about the bodily consequences of losing access to everyday affordances can help us better understand these reports. An affordance-based approach to psychopathology can illuminate some of the causes, as well as the experiential character and content, of affective disorders in psychopathology. It can also draw our attention to some under-explored ethical and political dimensions of these issues needing further consideration. (shrink)

Grief is, and has always been, technologically supported. From memorials and shrines to photos and saved voicemail messages, we engage with the dead through the technologies available to us. As our technologies evolve, so does how we grieve. In this paper, we consider the role chatbots might play in our grieving practices. Influenced by recent phenomenological work, we begin by thinking about the character of grief. Next, we consider work on developing “continuing bonds” with the dead. We argue that for (...) some, chatbots may play an important role in establishing these continuing bonds by helping us develop what we term “habits of intimacy”. We then turn to the “ick factor” some may feel about this prospect, focusing especially on ethical concerns raised by Patrick Stokes and Adam Buben about the risk of replacing our dead with chatbots. We argue that replacement worries are not as pressing as Stokes and Buben suggest. We resist these replacement worries by appealing to the “thin reciprocity”, as we refer to it, that such bots offer, as well as the fictionalist stance that we think users of the bots adopt when engaging with them. We conclude by briefly raising some additional concerns and highlighting future research questions. (shrink)

Checking is one of the most common compulsive actions performed by patients with Obsessive- compulsive disorder (OCD) (APA, 2013; Abramowitz, McKay, Taylor, 2008). Incessant checking is undeniably problematic from a practical point of view. But what is epistemically wrong with checking again (and again)? The starting assumption for this paper is that establishing what goes wrong when individuals check their stove ten times in a row requires understanding the nature of the doxastic attitude that compulsive re-checkers are in, as they (...) go back to perform another check. Does the re-checker know that the stove is off, and is thus looking for more of what she already has? Or is she an inquirer who repeatedly loses her knowledge and finds herself inquiring again and again into the same question? In this paper I present and discuss what I see as the three main hypotheses currently available on the market, and I suggest a refinement. (shrink)

A family of recent externalist approaches in philosophy of mind argues that our psychological capacities are synchronically and diachronically “scaffolded” by external resources. I consider how these “scaffolded” approaches might inform debates in phenomenological psychopathology. I first introduce the idea of “affective scaffolding” and make some taxonomic distinctions. Next, I use schizophrenia as a case study to argue—along with others in phenomenological psychopathology—that schizophrenia is fundamentally a self-disturbance. However, I offer a subtle reconfiguration of these approaches. I argue that schizophrenia (...) is not simply a disruption of ipseity or minimal self-consciousness but rather a disruption of the scaffolded self, established and regulated via its ongoing engagement with the world and others. I conclude by considering how this scaffolded framework indicates the need to consider new forms of intervention and treatment. (shrink)

In certain startling neurological and psychiatric conditions, what is ordinarily most intimate and familiar to us—our own body—can feel alien. For instance, in cases of somatoparaphrenia subjects misattribute their body parts to others, while in cases of depersonalization subjects feel estranged from their bodies. These ownership disorders thus appear to consist in a loss of any feeling of bodily ownership, the felt sense we have of our bodies as our own. Against this interpretation of ownership disorders, I defend Sufficiency, the (...) thesis that every experience of bodily awareness suffices for a feeling of bodily ownership. Since Sufficiency conflicts with a face‐value interpretation of these ownership disorders, the burden is on me to explain away the apparent tension. To do so, I identify and correct what I believe to be the fundamental mistake in the extant literature on the feeling of bodily ownership, namely the tendency to treat the notion of a feeling of bodily ownership as a single psychological construct. Instead, I distinguish the feeling of minimal ownership, the first‐personal character of bodily awareness, from the feeling of affective ownership, the distinctive type of felt concern we have for our bodies. I motivate this distinction by raising the disownership puzzle, the fact that subjects suffering from ownership disorders display an ambiguous set of symptoms, arguing the distinction I draw between minimal and affective ownership is just what is required to resolve the puzzle. (shrink)

Recent literature has suggested that generics can harbor and propagate worrying ideologies in a manner which is often not appreciated by speakers. In this article, I argue that the use of generics to convey information about mental illness is unhelpful, whether the knowledge structure conveyed by the generic is 'accurate' or not. Inaccurate generics contribute to insidious forms of social stereotyping and stigma by encouraging us to simplistically generalize characteristics found in very few category members to other members of that (...) kind.Yet, even where the knowledge structure underlying the generic is accurate, generics remain an unhelpful way of talking about mental illness. This is because... (shrink)

Philosophers and psychologists often claim that moral agency is connected with the ability to feel, understand, and deploy moral emotions. In this chapter, I investigate the nature of these emotions and their connection with moral agency. First, I examine the degree to which these emotional capacities are innate and/or ‘basic’ in a philosophically important sense. I examine three senses in which an emotion might be basic: developmental, compositional, and phylogenetic. After considering the evidence for basic emotion, I conclude that emotions (...) are not basic in a philosophically important sense. Emotions, I argue, are best understood as socially constructed concepts. I then investigate whether these emotions are necessary for moral agency. In order to do this I examine the philosophical and psychological literature on psychopathy and autism (two conditions defined in terms of empathic and emotional deficits). Persons with psychopathy appear incapable of distinguishing moral from non-moral norms. Additionally, while persons with autism often struggle to develop their empathic capacities, they are capable of understanding and deploying moral emotions like guilt and shame. I conclude that, in line with the conceptual act theories of emotion, that only contagion-based empathy is necessary for the acquisition of moral concepts. (shrink)

The network approach to psychopathology posits that mental disorders can be conceptualized and studied as causal systems of mutually reinforcing symptoms. This approach, first posited in 2008, has grown substantially over the past decade and is now a full-fledged area of psychiatric research. In this article, we provide an overview and critical analysis of 363 articles produced in the first decade of this research program, with a focus on key theoretical, methodological, and empirical contributions. In addition, we turn our attention (...) to the next decade of the network approach and propose critical avenues for future research in each of these domains. We argue that this program of research will be best served by working toward two overarching aims: (a) the identification of robust empirical phenomena and (b) the development of formal theories that can explain those phenomena. We recommend specific steps forward within this broad framework and argue that these steps are necessary if the network approach is to develop into a progressive program of research capable of producing a cumulative body of knowledge about how specific mental disorders operate as causal systems. (shrink)

The purpose of this paper is twofold. First, I defend and expand the Fortificationist Theory of Punishment. Second, I argue that this theory implies that non-consensual neurointerventions – interventions that act directly on one’s brain – are permissible. According to the FTP, punishment is justified as a way of ensuring that citizens who infringe their duty to demonstrate the reliability of their moral powers will thereafter be able to comply with it. I claim that the FTP ought to be expanded (...) to include citizens’ interest in developing their moral powers. Thus, states must ensure that their citizens develop their moral reliability, not only because they must enforce their citizens’ compliance with certain duties, but also because states have the duty to maintain the conditions for stability and satisfy their citizens’ interest in developing their moral powers. According to this account of the FTP, if neurointerventions are the only or best way of ensuring that offenders can discharge their fortificational duties, states have strong reasons to provide these interventions. (shrink)

So far, the value dimension underlying affectivity disorders has remained out of focus in phenomenological psychopathology. As early as at the beginning of the 20th century, however, German phenomenologist Max Scheler examined in depth the relationship between affectivity and value dimension through the concept of valueception (Wertnehmung). In this sense, a recent noteworthy contribution has been provided by John Cutting, who has drawn attention to the importance of Scheler’s analyses for psychiatry. In this work I take into consideration only two (...) aspects of Cutting’s proposal: 1) the relationship between the impairments of valueception and the perception of certain value classes; and 2) the interpretation of Scheler’s phenomenological reduction and its juxtaposition with the modus vivendi of schizophrenia. According to Cutting, in the modus vivendi of schizophrenia the valueception impairment entails putting vital values in brackets and focusing on personal values, with a process that recalls Scheler’s phenomenological reduction. Regarding the first aspect, I share Cutting’s starting point, but then shift the focus on how important the valueception is for the intersubjective dimension. In particular, I maintain that rather than compromising the perception of vital values, valueception impairments in the modus vivendi of schizophrenia interfere with the intersubjective dimension and are interwoven with a process of disembodiment. My thesis is that the modus vivendi of schizophrenia involves a disturbance of the intersubjective dimension that arises from the level of valueception and that determines the person’s self-referential closure. With regard to the second point, by analyzing Scheler’s phenomenological reduction, I sustain that its main objective is to increase both the interaction with otherness and the openness to the world (Weltoffenheit). As a consequence, the modus vivendi of schizophrenia, in my opinion, is not comparable, as Cutting claims, with Scheler’s phenomenological reduction, but goes in a different direction. (shrink)

Self-disorders in depression and schizophrenia have been the focus of much recent work in phenomenological psychopathology. But little has been said about the role the material environment plays in shaping the affective character of these disorders. In this paper, we argue that enjoying reliable (i.e., trustworthy) access to the things and spaces around us — the constituents of our material environment — is crucial for our ability to stabilize and regulate our affective life on a day-today basis. These things and (...) spaces often play an ineliminable role in shaping what we feel and how we feel it; when we interact with them, they contribute ongoing feedback that " scaffolds " the character and temporal development of our affective experiences. However, in some psychopathological conditions, the ability to access to these things and spaces becomes disturbed. Individuals not only lose certain forms of access to the practical significance of the built environment but also to its ​ regulative​ significance, too — and the stability and organization of their affective life is compromised. In developing this view, we discuss core concepts like " affordance spaces " , " scaffolding " , and " incorporation ". We apply these concepts to two case studies, severe depression and schizophrenia, and we show why these cases support our main claim. We conclude by briefly considering implications of this view for developing intervention and treatment strategies. (shrink)

Les termes que nous utilisons pour décrire notre vie affective ont changé au fil des siècles. Un changement notoire est celui qui a mené d’une conception de l’affectivité centrée autour des “passions” à un discours basé sur l' “émotion” comme catégorie psychologique centrale (Dixon 2003, Rorty 1982). Ainsi, alors que la référence à des désordres émotionnels est omniprésente dans les manuels de psychopathologie, le concept de passion a largement disparu du glossaire psychiatrique. Certains auteurs défendent pourtant l’idée selon laquelle ces (...) deux concepts auraient chacun une place à part entière dans la psychopathologie contemporaine. Dans ce qui suit, nous tenterons à travers de nombreux exemples de montrer comment l'étude des états affectifs peut contribuer à la compréhension et à la catégorisation des troubles psychiques... (shrink)

Psychopathological delusions have a number of features that are curiously difficult to explain. Delusions are resistant to counterevidence and impervious to counterargument. Delusions are theoretically, affectively, and behaviorally circumscribed: delusional individuals often do not act on their delusions and often do not update beliefs on the basis of their delusions. Delusional individuals are occasionally able to distinguish their delusions from other beliefs, sometimes speaking of their “delusional reality.” To explain these features, I offer a model according to which, contrary to (...) appearances, delusions are not beliefs at all. Delusions are acceptances that are generated by pathologically powerful cognitive feelings. This model has implications for the way that we should think about non-pathological doxastic states and emotions. (shrink)

Ryan Darby, Judith Edersheim, and Bruce Price (DEP) argue that patients with Behavioral-Variant Frontotemporal Dementia have intact moral knowledge. In effect, they assume a motivational externalist understanding of moral knowledge. We question this by probing the cases they present as evidence for their position.

While some of mental disorders due to emotional distress occur cross-culturally, others seem to be much more bound to particular cultures. In this paper, I propose that many of these “cultural syndromes” are culturally sanctioned responses to overwhelming negative emotions. I show how tools from cultural evolution theory can be employed for understanding how the syndromes are relatively confined to and retained within particular cultures. Finally, I argue that such an account allows for some cultural syndromes to be or become (...) mental disorders and also steers clear of some of the anti-realist trappings associated with a social constructivism of cultural syndromes. (shrink)

I argue that deep brain stimulation (DBS) is a bad approach for incarcerated psychopaths for two reasons. First, given what we know about psychopathy, empathy, and DBS, it is unlikely to function as an effective treatment for the moral problems that characterize psychopathy. Second, considerations of neurodiversity speak against seeing psychopathy as a mental illness in the first place.

Many contemporary accounts of moral status consider an individual's status to be grounded in some cognitive capacity, e.g. the capacity to experience certain states, to reason morally, etc. One proposed cognitive capacity significant particularly to killing, i.e. having a status that precludes being killed absent cause, is the capacity to value one's own life. I argue that considering this a condition for moral status is a mistake, as it would lead to the exclusion of some individuals with mental health problems (...) who are generally considered clear cases. -/- While a cognitive capacities approach may turn out to be generally feasible, that particular cognitive capacity is not. In the course of this discussion I address two conceptual issues, the first regarding what it means to 'value ones life' and the second regarding what conditions must obtain for something to count as a capacity. These conceptual issues, when resolved pursuant to this account of moral status, lead the account to exclude individuals with major depressive disorder, i.e. deny that it is morally wrong to kill such individuals based on their moral status. I then argue that this is a decisive reason to reject this particular cognitive capacity as implicated in moral status. (shrink)

Dietmar Hübner and Lucie White question the ethical justification of employing risky neurosurgical interventions to treat imprisoned psychopaths. They argue that (1) such interventions would confer no medical benefit on the psychopath as there is no “subjective suffering” involved in psychopathy and (2) psychopaths could not voluntarily consent to such procedures because they could have no “internal motivation” for doing so. In the course of their discussion, the authors insightfully show that certain aspects of the psychopath’s personality structure are especially (...) relevant to assessing the ethics of risky treatment options. As I argue, however, the particular conclusions that the authors draw are too strong. A deeper look at the psychopathic profile casts doubt on (1) and (2). In some cases, psychopaths can be plausibly construed as experiencing subjective suffering on account of their disorder and as appropriately motivated to voluntarily consent to neurosurgical treatment. After arguing for this view, I suggest that the psychopath’s consent to neurosurgical intervention might nonetheless be problematic, as their emotional incapacities might preclude their abilities to adequately appreciate the relevant risks. (shrink)

This article introduces a novel theoretical framework for psychopathy that bridges dominant affective and cognitive models. According to the proposed impaired integration (II) framework of psychopathic dysfunction, topographical irregularities and abnormalities in neural connectivity in psychopathy hinder the complex process of information integration. Central to the II theory is the notion that psychopathic individuals are “‘wired up’ differently” (Hare, Williamson, & Harpur, 1988, p. 87). Specific theoretical assumptions include decreased functioning of the Salience and Default Mode Networks, normal functioning in (...) executive control networks, and less coordination and flexible switching between networks. Following a review of dominant models of psychopathy, we introduce our II theory as a parsimonious account of behavioral and brain irregularities in psychopathy. The II theory provides a unified theoretical framework for understanding psychopathic dysfunction and integrates principle tenets of affective and cognitive perspectives. Moreover, it accommodates evidence regarding connectivity abnormalities in psychopathy through its network theoretical perspective. (shrink)

This chapter considers two systems that are fundamental to human behavior: learning and the allocation of attention. We review the evidence to suggest that there may be deficits in these systems in a subset of children with antisocial behavior problems-those with high levels of callous-unemotional traits-and explore how altered function of these systems might contribute to the development of immoral behavior.

Psychopathy is a personality disorder characterized by callous antisocial behavior and criminal recidivism. Here we examine whether psychopathy is associated with alterations in functional connectivity in three large-scale cortical networks. Using fMRI in 142 adult male prison inmates, we computed resting-state functional connectivity using seeds from the default mode network, frontoparietal network, and cingulo-opercular network. To determine the specificity of our findings to these cortical networks, we also calculated functional connectivity using seeds from two comparison primary sensory networks: visual and (...) auditory networks. Regression analyses related network connectivity to overall psychopathy scores and to subscores for the “factors” and “facets” of psychopathy: Factor 1, interpersonal/affective traits; Factor 2, lifestyle/antisocial traits; Facet 1, interpersonal; Facet 2, affective; Facet 3, lifestyle; Facet 4, antisocial. Overall psychopathy severity was associated with reduced functional connectivity between lateral parietal cortex and dorsal anterior cingulate cortex. The two factor scores exhibited contrasting relationships with functional connectivity: Factor 1 scores were associated with reduced functional connectivity in the three cortical networks, whereas Factor 2 scores were associated with heightened connectivity in the same networks. This dissociation was evident particularly in the functional connectivity between anterior insula and dorsal anterior cingulate cortex. The facet scores also demonstrated distinct patterns of connectivity. We found no associations between psychopathy scores and functional connectivity within visual or auditory networks. These findings provide novel evidence on the neural correlates of psychopathy and suggest that connectivity between cortical association hubs, such as the dorsal anterior cingulate cortex, may be a neurobiological marker of the disorder. (shrink)

In this chapter we explore the different ways that morality has been studied and measured as well as the ways that it has been found to be deficient in psychopathy and antisocial personality disorder.

The last two decades have seen tremendous growth in biological research on psychopathy, a mental disorder distinguished by traits including a lack of empathy or emotional response, egocentricity, impulsivity, and stimulation seeking. But how does a psychopath’s brain work? What makes a psychopath? Psychopathy provides a concise, non-technical overview of the research in the areas of genetics, hormones, brain imaging, neuropsychology, environmental influences, and more, focusing on explaining what we currently know about the biological foundations for this disorder and offering (...) insights into prediction, intervention, and prevention. It also offers a nuanced discussion of the ethical and legal implications associated with biological research on psychopathy. How much of this disorder is biologically based? Should offenders with psychopathic traits be punished for their crimes if we can show that biological factors contribute? The text clearly assesses the conclusions that can and cannot be drawn from existing biological research, and highlights the pressing considerations this research demands. (shrink)

Neuroimaging studies have found that adult male psychopaths show reduced engagement of limbic and paralimbic circuitry while making moral judgments. The goal of this study was to investigate whether these findings extend to adolescent males with psychopathic traits. Functional MRI was used to record hemodynamic activity in 111 incarcerated male adolescents while they viewed unpleasant pictures that did or did not depict moral transgressions and rated each on “moral violation severity”. Adolescents were assessed for psychopathic traits using the Psychopathy Checklist-Youth (...) Version (PCL-YV), Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (KSADS-PL) Conduct Disorder supplement, and Inventory of Callous and Unemotional Traits-Youth Version (ICU-Y). While viewing pictures depicting moral transgressions, CD scores were negatively correlated with hemodynamic responses in the anterior temporal cortex. Adolescents scoring low on the ICU-Y showed a positive correlation between right amygdala responses and severity of violation ratings; those with high ICU-Y scores showed a negative correlation. While viewing unpleasant pictures with and without moral transgressions, PCL-YV scores were negatively correlated with hemodynamic responses in the left amygdala. Overall, the results are consistent with those previously found in adult male psychopaths, but vary depending on the type of psychopathy assessment. (shrink)

Emotion processing is known to be impaired in psychopathy, but less is known about the cognitive mechanisms that drive this. Our study examined experiencing and suppression of emotion processing in psychopathy. Participants, violent offenders with varying levels of psychopathy, viewed positive and negative images under conditions of passive viewing, experiencing and suppressing. Higher scoring psychopathics were more cardiovascularly responsive when processing negative information than positive, possibly reflecting an anomalously rewarding aspect of processing normally unpleasant material. When required to experience emotional (...) response, by ‘getting into the feeling’ of the emotion conveyed by a negative image, higher factor 1 psychopathic individuals showed reduced responsiveness, suggesting that they were less able to do this. These data, together with the absence of corresponding differences in subjective self-report might be used to inform clinical strategies for normalising emotion processing in psychopathic offenders to improve treatment outcome, and reduce risk amongst this client group. (shrink)

Purpose: Although psychopathy is characterized by amoral behavior, literature on the association between psychopathy and moral judgment pattern is mixed. Recent evidence suggests that this may be due to the moderation effect of anxiety (Koenigs, Kruepke, Zeier, & Newman, 2011). The current study aims to examine the psychopathy-utilitarian judgment association in college students. Method: In this study, a group of 302 college students completed a moral judgment test involving hypothetical dilemmas. Their psychopathic traits were assessed by the Psychopathic Personality Inventory (...) – Short Form (PPI-SF) (Lilienfeld & Andrews, 1996). Results: Individuals with higher psychopathic traits were more likely to make utilitarian responses to moral dilemmas. Furthermore, the association between utilitarian responses and psychopathy was more salient for the behavioral factor of psychopathy (PPI-II), and this association was mediated by self-reported aggression. However, the moderating effect of anxiety was not found. Conclusions: These results build upon work on utilitarian moral judgment in psychopathic individuals in a non-incarcerated, non-institutionalized sample, and have important implications for the behavioral correc- tion system. (shrink)

Common psychopathy rating instrument sdistinguish between an interpersonal-affective and an antisocial dimension.The suggestion that the interpersonal-affective dimension,often considered to be the core feature of psychopathy,is positively associated with executive functioning is occasionally made in the literature, without reporting objective empirical data. The primary aim of thep resent paper was to search for empirical studies reporting relevant data, focussing on four aspects of 'cold' executive functioning: inhibition, attentional shifting, working memory, and planning. Eleven published articles wereidentified, reporting data of 721 individuals (...) from incarcerated and non-incarcerated,male and female,and adult and non-adult samples. Using a heterogeneous set of tests and dependent measures across studies, the inhibition and attentional shifting components were assessed in eight and five studies, respectively; the working memory and planning components each in two studies. A small majority of the studies found positive associations with the different executive functions, although the associations were mostly non-significant. Given the scarcity of studies and the use of heterogeneous populations,tests and statistical analyses, no robust conclusions can be drawn at this stage. Therefore,caution is needed when claiming a positive association between the interpersonal-affective features of psychopathy and executive functioning. Clearly more research is needed to further validate and specify the suggested association. (shrink)

A response to two commentaries by Gwen Adshead and Shaun Gallagher on my feature article "Internalism, Emotionism, and the Psychopathy Challenge".

The phenomenon of psychopathy has been regarded as a putative challenge to motivational internalism, which asserts a necessary connection between moral judgment and motivation. An increasingly popular internalist response to the psychopathy challenge is to argue that psychopaths do not make genuine moral judgments because they lack moral emotions (e.g., sympathy and guilt), which are alleged to be causally constitutive of moral judgments. In this paper, I attempt to reject the emotion-based internalist response by appeal to most recent empirical research (...) on psychopathy, moral cognition, and moral dilemmas. I argue that emotion is not causally responsible for even normal people’s moral judgment (although emotion may titrate the severity of moral judgment). (shrink)

It has been argued that schizophrenic delusions are “behaviourally inert.” This is evidence for the phenomenon of “double bookkeeping,” according to which people are not consistent in their commitment to the content of their delusions. The traditional explanation for the phenomenon is that people do not genuinely believe the content of their delusions. In the article, we resist the traditional explanation and offer an alternative hypothesis: people with delusions often fail to acquire or to maintain the motivation to act on (...) their delusional beliefs. This may be due to avolition, to emotional disturbances, or to the fact that, given the peculiar content of some delusions, the surrounding environment does not support the agent’s motivation to act. (shrink)

This paper addresses the phenomenology of bodily feeling in depersonalization disorder. We argue that not all bodily feelings are intentional states that have the body or part of it as their object. We distinguish three broad categories of bodily feeling: noematic feeling, noetic feeling, and existential feeling. Then we show how an appreciation of the differences between them can contribute to an understanding of the depersonalization experience.

Background— Although one of the main characteristics of psychopaths is a deficit in emotion, it is unknown whether they show a fundamental impairment in appropriately recognizing their own body sensations during an emotion-inducing task. Method— Skin conductance and heart rate were recorded in 138 males during a social stressor together with subjective reports of body sensations. Psychopathic traits were assessed using the Psychopathy Checklist – Revised (PCL-R) 2nd edition (Hare, 2003). Results— Nonpsychopathic controls who reported higher body sensations showed higher (...) heart rate reactivity, but this verbal-autonomic consistency was not found in psychopathic individuals. This mind-body disconnection is particularly associated with the interpersonal-affective factor of psychopathy. Conclusions— Findings are the first to document this body sensations– autonomic mismatch in psychopaths, and suggest that somatic aphasia the inaccurate identification and recognition of one‘s own somatic states may partly underlie the interpersonal-affective features of psychopaths. (shrink)

This study compares the performance, when identifying negative emotions on facial expression, of male offenders (n = 62) with a high level of psychopathy (n = 25) with other criminals with a low level of psychopathy (n = 37), as well as other ‘‘successful psychopaths’’(n = 12) and non-criminals with a low level of psychopathy (n = 39) in order to clarify the negative emotional processing of offenders and nonoffenders that are either high or low in psychopathy. The participants were (...) assessed on a Go/No-Go paradigm in which subjects had to respond to the facial expressions of fear, sadness, and anger. The psychopathy level was obtained by Factor 1 of Hare’s PCL:SV. Both psychopathic groups, criminal and non-criminal, showed worse performance than their non-psychopathic counterparts on the identification of fear and sadness. An overresponsivity to both anger and fear was common to criminals, psychopaths, and non-psychopaths. These results reinforce the idea that psychopathy is related to a poor ability to identify fear and sadness in facial expressions independently of its manifestation in criminal behavior. In turn, a misidentified response pattern, characterized by an overresponsiveness for fear and anger, is common to both psychopaths and the criminal groups, and it appears to be the characteristic that distinguishes the three groups under study from non-criminal non-psychopath controls. (shrink)

Youths with disruptive behavior disorders and psychopathic traits showed reduced amygdala responses to fearful expressions under low attentional load but no indications of increased recruitment of regions implicated in top- down attentional control. These findings suggest that the emotional deficit observed in youths with disruptive behavior disorders and psychopathic traits is primary and not secondary to increased top- down attention to nonemotional stimulus features.

In my short commentary, I dwell on the distinction between basic and complex empathy, and suggest that a basic perception-based form of empathy might point to the existence of a type of social understanding that is more direct and more fundamental than the types of social cognition normally addressed by simulation theory and theory theory.