The exploration of subclinical psychopathic subtypes and the relationship with types of aggression

Abstract

The psychopathy literature includes inconsistencies with regard to correlates, etiology, and treatment, suggesting heterogeneity within the construct. This paper used measures of psychopathy (the LPS primary and secondary), temperament (the BIS and BAS scales), and anxiety (STAI), in a model-based cluster analysis, and identified prototypes that somewhat resembled subclinical primary and secondary psychopathy in a college population. Variants matched theory in terms of psychopathy factors and anxiety, but there were some inconsistencies in terms of BIS and BAS. Despite these discrepancies, the current study found a theoretically consistent relationship between the clusters and types of aggression generally supporting the construct validity of the subclinical psychopathic clusters that emerged in this study; the primary psychopathic-like traits cluster utilized more instrumental/mixed aggression and the secondary psychopathic-like traits cluster reported more hostile/reactive aggression.

Introduction

Contemporary conceptualizations of psychopathy reflect the Cleckley (1941) initial operationalization of deficits in affective and interpersonal functioning. Psychopathic individuals are superficially charming, insincere and have difficulty with meaningful attachments to others. They lack range and depth of emotions and tend to be narcissistic, deceitful and manipulative (Lykken, 1995). Since Cleckley’s seminal work, clinical, theoretical, and empirical evidence has accumulated supporting of the notion that psychopathy is a heterogeneous construct, with discrete subtypes (for review see Skeem, Poythress, Edens, Lilienfeld, & Cale, 2003).

Karpman (1941), distinguished between primary psychopaths, whose features originated in an unspecified but presumably constitutional deficit, and secondary psychopaths, whose behavior resulted from environmental insult (e.g., parental rejection, harsh punishment, parental overindulgence). Whereas primary psychopaths are seen as callous, self-serving, nonanxious and less affective, secondary psychopaths are capable of experiencing, on at least a transient basis, anxiety and emotion. Karpman also differentiated the two subtypes in terms of impulsivity:

... paradoxical as it may seem, the true [primary] psychopath is in a sense the least impulsive of them all... Rather than being hasty, the psychopath often coolly and deliberately plans his actions...there is no hotheadedness here at all of the type we are accustomed to seeing in neurotics and psychotics (pp. 523–524).

Similarly, Mealey (1995) proposes an evolutionary based theory indicating that Primaries are a result of genetic factors that predispose them against the experience of social emotions (e.g., anxiety), autonomic hypoarousal, and temperament which leave them unresponsive to typical teachings of moral responsibility. This combination leaves them without empathy and indicates that their behavior is driven by instrumental purposes, rather than emotional reactions. Secondaries act in antisocial ways due to exposure to risk factors in the environment, and are more prone to emotional reactions.

The Lykken (1995) typology theory uses Gray, 1975, Gray, 1987, Fowles, 1980 concepts of the behavioral inhibition system (BIS) and behavioral activation system (BAS) to distinguish the temperament deficits of primary and secondary psychopathy. The BIS is triggered by cues of punishment and aversive stimuli, and inhibits ongoing behaviors (Gray, 1982). BIS activation produces anxiety and/or fear in response to potential harm or nonreward, which serves to deter individuals from persisting in risky behavior. A weak BIS results in a relatively fearless temperament and less sensitivity, or responsiveness, to signs of punishment or nonreward. Given the role of punishment in socialization, individuals born with a fearless temperament are more difficult to socialize. In contrast, the BAS is related to impulsivity, engaged when reward opportunities are presented, and shifts attention to goal-directed behavior (Fowles, 1980).

Theory suggests that a deficit in either system may contribute to antisocial behavior. Specifically, a weak BIS is postulated as the constitutional deficit of the primary psychopath and an overactive BAS is postulated as a deficit of the secondary psychopath. When a desired, but prohibited, goal is encountered, the BIS and BAS are both activated resulting in either an avoidance approach (BAS), or a dilemma (BIS). In a well-socialized individual, the fear of consequences overrides the drive and this internal control deters the antisocial behavior. However, the person with a weak BIS (primary psychopathy) does not experience sufficient anxiety regarding the consequences of the antisocial behavior, therefore the behavior continues. However, the secondary psychopath, whose strong appetitive urge (overactive BAS) overrides inhibitions associated with a normal BIS, may also behave in an antisocial manner. Newman, MacCoon, Vaughn, and Sadeh (2005) found empirical support for this theory.

Empirical studies, using mainly the two factor definition of psychopathy defined by Hare’s Psychopathy Checklist-Revised (PCL-R; Hare, 1991) with offender samples, mirror clinical and theoretical characterizations of primary and secondary psychopathy (Karpman, 1941). A number of studies have reported divergent correlates for PCL-R Factor 1, which assesses core affective and interpersonal features (e.g., superficial charm, callousness, lack of remorse or guilt) and Factor 2, which captures features associated with a socially deviant lifestyle (e.g., impulsivity, poor behavior controls). As summarized by Hicks, Markon, and Patrick (2004), Factor 1 correlates positively with narcissism, and negatively with neuroticism and negative emotionality. In contrast, Factor 2 correlates positively with neuroticism, negative emotionality, impulsivity, and sensation seeking.

Despite the theory regarding psychopathy subtypes, there have been relatively few systematic empirical investigations. Further, those that have employed cluster analysis to identify subtypes, have either lacked a theoretical perspective (Vassileva, Kosson, Abramowitz, & Conrod, 2005), used inadequate samples (Haapasalo & Pulkkinen, 1992), or failed to employ a sufficiently broad array of clustering variables to adequately inform the debate (Herve, Yong hui Ling, & Hare, 2000). An exception is the recent work of Hicks et al. (2004), where 96 psychopathic prisoners (PCL-R Total ⩾ 30) were clustered on a general personality measure. Two groups emerged from the cluster analysis: Emotionally Stable Psychopaths and Aggressive Psychopaths, whose profiles in terms of personality variables (e.g., stress reactivity, anxiety, negative emotionality, control) and life history variables (e.g., childhood and adult fights, self-report alcohol problems) paralleled descriptions of primary and secondary psychopathy, respectively. However, while this was the first empirical support for psychopathy subtypes, it did not specifically cluster using psychopathy factor scores or temperament variables associated with Lykken and Karpman’s theories.

The majority of the research on psychopathy uses the PCL-R. However, the PCL-R cannot be utilized in non-institutionalized samples for which collateral files are lacking. Additionally, the antisocial/aggressive behavior features of Factor 2 were not part of Cleckley’s original conceptualization of psychopathy and make the PCL-R ill-equipped to identify successful psychopaths lacking a criminal history (Lilienfeld & Andrews, 1996). Research with non-institutionalized populations has found that despite lower base-rates, there is evidence for diverse expressions of psychopathic traits across the population; that psychopathy is a dimensional construct (Skeem et al., 2003). Consequently, research on non-institutionalized samples is important for investigating the subclinical levels of psychopathic traits, to determine if results are generalizable to more individuals (Lilienfeld, 1998). Additionally, because base rates for aggression and psychopathy are higher in males (Nicholls, Ogloff, Brink, & Spidel, 2005), the use of male only samples increase the likelihood of finding these traits.