Attention moderates the fearlessness of psychopathic offenders

Biol Psychiatry. 2010 Jan 1;67(1):66-70. doi: 10.1016/j.biopsych.2009.07.035.


Background: Psychopathic behavior is generally attributed to a fundamental, amygdala-mediated deficit in fearlessness that undermines social conformity. An alternative view is that psychopathy involves an attention-related deficit that undermines the processing of peripheral information, including fear stimuli.

Methods: We evaluated these alternative hypotheses by measuring fear-potentiated startle (FPS) in a group of 125 prisoners under experimental conditions that 1) focused attention directly on fear-relevant information or 2) established an alternative attentional focus. Psychopathy was assessed using Hare's Psychopathy Checklist-Revised (PCL-R).

Results: Psychopathic individuals displayed normal FPS under threat-focused conditions but manifested a significant deficit in FPS under alternative-focus conditions. Moreover, these findings were essentially unchanged when analyses employed the interpersonal/affective factor of the PCL-R instead of PCL-R total scores.

Conclusions: The results provide unprecedented evidence that higher-order cognitive processes moderate the fear deficits of psychopathic individuals. These findings suggest that psychopaths' diminished reactivity to fear stimuli, and emotion-related cues more generally, reflect idiosyncrasies in attention that limit their processing of peripheral information. Although psychopathic individuals are commonly described as cold-blooded predators who are unmotivated to change, the attentional dysfunction identified in this study supports an alternative interpretation of their chronic disinhibition and insensitive interpersonal style.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acoustic Stimulation
  • Adolescent
  • Adult
  • Antisocial Personality Disorder / physiopathology*
  • Antisocial Personality Disorder / psychology*
  • Attention / physiology*
  • Criminals / psychology*
  • Electroshock / adverse effects
  • Fear / psychology*
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Photic Stimulation
  • Reflex, Startle / physiology
  • Young Adult