Psychopathy and decision making: the need for instant gratification

Psychopathy is a personality disorder characterized by antisocial behavior and affective and interpersonal detachment (Benning, Patrick, Blonigen, Hicks, & Iacono, 2005). Diagnosis is generally based on the assessment of two main dimensions: emotional detachment and antisocial behavior.

Eleonora Poli – OPEN SCHOOL Cognitive Psychotherapy and Research, Venice Mestre

The first dimension of psychopathy includes personality traits such as a sense of grandiosity and self-centeredness, affective superficiality, lack of empathylack of remorse or feelings of guilt, superficial charm, tendency to lie and manipulate others. The antisocial component is manifested instead with impulsive behaviors and violent, conduct problems at an early age, juvenile delinquency, predisposition to get bored easily and consequent search for extreme experiences, poor ability to organize and plan one’s future actions, irresponsibility. The disorder affects approximately 1% of the general population and 15-20% of convicted criminals (Hare, 1991).

Psychopathy: what is it

The current conceptualization of psychopathy it was influenced by the studies of Cleckley (The Mask of Sanity, 1976), who listed 16 diagnostic criteria that could be used to identify people with the disorder. Particular emphasis was placed on the poor affective and interpersonal skills of the psychopath (superficiality, inability to to lovelack of remorse, pathological lying) and his antisocial behavior (poor impulse control, lack of planning, inability to learn from past experiences, delinquency, parasitic lifestyle). This notion of psychopathy it was then operationalized in the following years with the development of the Psychopathy Checklist (Hare, 1991), which includes 20 items designed to measure these two dimensions of the disorder.

The psychopaths they show no concern about the effects their bad deeds may have on others, or even on themselves. They often commit impulsive and unplanned crimes, even when the likelihood of being caught and punished is high. Underlying such behaviors would appear to be an inability to learn information associated with punishments and to respond appropriately to them. For example, deficits have been found in aversive conditioning tasks (Flor, Birbaumer, Hermann, Ziegler, & Patrick, 2002) and in passive avoidance learning tasks (Blair et al., 2004; Newman & Kosson, 1986), a reduced ability to recognize negative facial expressions (Blair et al., 2004) and impaired electrodermal response in response to negative vocal expressions (Verona, Patrick, Curtin, Bradley, & Lang, 2004).

Being unable to learn from punishments, the people with psychopathy they often exhibit impulsive behavior, perseverance and a substantial inability to inhibit the choice of previously successful options when a change in the situation makes them disadvantageous (Whiteside & Lynam, 2001).

The tasks of decision making they are generally used to investigate the individual’s ability to select the optimal choice among a variety of possible options, to predict positive or negative events and to learn to regulate one’s behavior based on the receipt of rewards and punishments. These processes are influenced by cognitive reasoning, which requires an assessment of the risks and benefits associated with a certain choice, but also by emotional processing, which evaluates affective activation in response to different possibilities and can guide our decisions in a more or less aware (Seguin, Arseneault, & Tremblay, 2007). From these premises it can be deduced that a task of decision making may prove to be a useful tool for investigating maladaptive or perseverative responses in psychopaths.

Psychopathy and decision making

There are several tests built with the purpose of investigating the capabilities of decision making of individuals. A valid and quite widespread tool is theIowa Gambling Taskspecifically designed to examine sensitivity to rewards and punishments in everyday life and focused on the emotional aspects of economic decision making (Bechara, Damasio, Damasio, & Anderson, 1994). During the task the individual is asked to draw playing cards from two possible decks: one deck of cards leads to earning large sums of money, but even higher losses (disadvantageous deck), while a second deck allows to win small sums of money, but even smaller losses. In the long run it therefore becomes evident that it is convenient to draw from the deck which leads to the accumulation of small sums of money.

Van Honk, Hermans, Putnam, Montagne, and Schutter (2002) examined participants with high and low psychopathy, the performances at the Iowa Gambling Task. The results demonstrated how participants with high psychopathy did not learn from the negative feedback (loss of money) they received during the task and therefore exhibited maladaptive behaviors, compared with non-psychopaths.

Newman, Patterson and Kosson (1987) asked psychopaths and incarcerated non-psychopaths to perform a very analogous monetary task in Iowa with the aim of examining their perseverative responses. Again the psychopaths they made unprofitable choices and lost larger sums of money in the process. Blair, Morton, Leonard & Blair (2006) investigated the ability to decision making in people with psychopathy using the Differential Reward/Punishment learning task, in which participants had to choose between two objects that were associated with different levels of reward or punishment. The data, also in this case, revealed a significant difficulty, in the psychopaths, in choosing between objects with different levels of reward or punishment.

Psychopathy and inability to postpone reward

Advertisement Koenigs, Kruepke and Newman (2010) administered the Ultimatum Game and the Dictator Game to a group of psychopaths and to a control group. In the Ultimatum Game, a first player decides how to divide a sum of money between himself and a second player, while the latter can decide whether or not to accept the proposed division. In case he refuses the offer, both players will not receive the amount of money. In the Dictator Game, on the other hand, the first player decides how to divide the sum of money, while the second player simply receives the part of the money decided by the first. The results showed how the psychopaths accepted to a lesser extent the offers evaluated as unfair and unfair in these two games, effectively obtaining at the end of the game a smaller sum of money than the non-psychopaths. Mahmut, Homewood, and Stevenson (2008) analyzed the performance at the Iowa Gambling Task in male college students with high traits of psychopathy (compared to students with low traits) and they also observed how the psychopaths performed significantly worse on the task. In an older study Blanchard, Bassett and Koshland (1977) investigated the sensitivity to prizes and rewards in a group of psychopaths incarcerated, compared to a control group, who were asked to make a choice between receiving an immediate reward, albeit small, or receiving a three times greater reward but with a delay of a few hours or a few days. The psychopaths they showed less ability to delay gratification than the control group.

The data found in these various studies allow us to draw some observations and reflections on such a complex and multifaceted disorder. The impulsive, irresponsible, unplanned behaviors could be partly explained by the substantial inability of the psychopath to curb the need to reward and immediate gratification, to resist the temptation to try emotions and strong experiences, and by its insensitivity in the face of negative feedback or punishments, as could be seen in the various studies with tasks of decision making. The negative consequences, in the short and long term, that the implementation of these behaviors can bring have a significant impact not only on the life of the psychopath, but also of the people around him and in the society in which he lives.

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Psychopathy and decision making: the need for instant gratification