مجرمان با اختلال شخصیت ضد اجتماعی نشان دهنده تعصب توجه نسبت برای محرک های مربوط به خشونت
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|37397||2013||7 صفحه PDF||سفارش دهید||محاسبه نشده|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Psychiatry Research, Volume 209, Issue 1, 30 August 2013, Pages 78–84
Abstract Offenders with antisocial personality disorder (ASPD) may be characterized by a lack in emotional functioning that manifests in irritability and a lack of remorse. The proposed link between ASPD and negative emotionality led to the question of emotional processing anomalies in ASPD. Furthermore, the effect of childhood maltreatment/abuse on emotional processing was tested in the present study. Violent and sexual offenders with ASPD (n=35), without ASPD (n=34), and healthy non-criminal controls (n=24) were compared in an Emotional Stroop Task (EST) using neutral, negative, and violence-related words. Secondary analyses focused on the effect of psychopathic traits and childhood maltreatment. Offenders with ASPD showed a stronger attentional bias to violence-related and negative words as compared to controls. Comparable results were obtained when grouping offenders to high, medium, and low psychopathic subgroups. Offenders with childhood maltreatment specifically showed stronger violence-related attentional bias than non-maltreated offenders. The data suggest that enhanced attention to violence-related stimuli in adult criminal offenders is associated with adverse developmental experiences and delinquency but to a lesser extent with antisocial or psychopathic traits.
Introduction Individuals with antisocial personality disorder (ASPD) exhibit a stable tendency towards antisocial behavior and are characterized by increased irritability, impulsiveness, deception, and a failure to conform to social norms (American Psychological Association, 1994 and Wittchen et al., 1997). Psychopathy is a construct related to ASPD, and there is an ongoing debate on the relationship between the two constructs. While the diagnosis of ASPD is mainly based on behavior, the diagnosis of psychopathy according to the Psychopathy Checklist (Hare, 2003) also includes interpersonal and affective facets of personality (Ogloff, 2006). In particular, psychopathy has been related to a general lack of empathy and remorse, decreased emotional responding, and increased proneness to antisocial and criminal behaviors (Leistico et al., 2008). Thus, some researchers have argued that psychopathy and ASPD are distinct disorders with a different pathogenesis (Cooke et al., 2004), while others regard psychopathy as a severe form of ASPD (Coid and Ullrich, 2010). However, both ASPD and psychopathy are often diagnosed in forensic samples, with ASPD being diagnosed in up to 50–80% of prison inmates, while only about 10% meet criteria for psychopathy (Hare, 2003). It has been proposed that negative emotionality, i.e. a disposition to experience negative affective states together with attenuated inhibition of the expression of negative affect might be crucial factors for the development of ASPD (Krueger, 1999). In addition, there is also evidence that the personality facets of psychopathy are negatively associated with negative emotionality (Hicks and Patrick, 2006). However, to date, there are only few studies on the association of ASPD and psychopathy in criminal offenders with altered emotion processing in lexical decision tasks. In one study, offenders with both, ASPD and psychopathy were less sensitive for affective stimuli in a lexical decision task. In contrast, antisocial individuals without psychopathy and delinquent controls showed emotional facilitation ( Kosson et al., 2006). Affective processing in psychopaths has also been studied using lexical decision tasks ( Intrator et al., 1997, Kiehl et al., 1999 and Williamson et al., 1991). One of these studies reported reduced acceleration of reaction times to affective words in psychopaths and reduced amplitudes of late event-related brain potentials associated with the processing of affective words ( Williamson et al., 1991)—a result that was confirmed by subsequent observations ( Kiehl et al., 1999). Interestingly, a recent study showed differential modulation of processing of negative emotion words in offenders with psychopaths versus offenders with ASPD: psychopaths showed blunted responding to negative emotion words, while offenders with ASPD showed enhanced processing of negative words and showed decreased behavioral inhibition ( Verona et al., 2012). Biased attention towards specific stimuli can be investigated with the Emotional Stroop Task (EST). In this task the processing of the affective meaning of a word interferes with the process of naming the color of ink in which the word is printed. Enhanced interference (increased reaction times in color naming) and thus increased executive attention for a specific word category is supposed to reflect the individual strength of the concepts and representations associated with these stimuli. Accordingly, most of the studies in clinical samples so far have shown that patients exhibit enhanced attention for stimuli related to their clinical condition (for a review: Williams et al., 1996). Enhanced salience and attentional bias for specific stimuli is thus regarded as a significant factor in the pathogenesis or maintenance of mental disorders (Mineka and Sutton, 1992 and Williams et al., 1996). Recent studies used the EST to investigate biased attention for emotional stimuli in personality disorders (Arntz et al., 2000, Portella et al., 2011 and Wingenfeld et al., 2009). Studies using this paradigm in a forensic context reported mixed results. In one study, violent offenders exhibited a significant attentional bias for violence-related words compared to non-criminal controls (Smith and Waterman, 2003). Similarly, in another study violent offenders and violent sexual offenders showed enhanced attention to violence-related stimuli, which was not found in non-violent sexual offenders (Smith and Waterman, 2004). However, these findings were not replicated in a study comparing pedophiles, rapists, violent and non-violent offenders, and controls from the general population: there were no group differences in attention for violence-related words (Price and Hanson, 2007). It has been put forward, that in particular offenders with psychopathy and antisocial tendencies show reduced amygdala-dependent emotional arousal to affective stimuli and thus show reduced attentional bias for affective stimuli (Blair and Mitchell, 2009). Accordingly, Mitchell et al. reported reduced attentional distraction in psychopaths compared to non-psychopaths by affective pictures (Mitchell et al., 2006). It is still an open question whether ASPD and psychopathic traits are associated with attentional biases towards affective stimuli in general or are restricted to negative or even more specifically to violence-related stimuli. In the present study, we thus included violence-related words as stimuli to further investigate the specificity of the previously reported attentional bias to negative stimuli reported in criminal offenders. In particular, the present study investigated attentional biases for violence-related and unspecific negative stimuli in violent offenders with ASPD and offenders without ASPD. Based on the literature reviewed above, we hypothesized that offenders with ASPD would show increased emotional distraction by violence-related stimuli in the EST compared to offenders without ASPD. In contrast, psychopathy was expected to be negatively associated with emotional responding and thus a reduced attentional bias towards negative and violence-related stimuli in the EST was expected. A significant number of sexual and violent offenders report having been abused sexually or physically maltreated as a child (Coxe and Holmes, 2001, McCormack et al., 2002 and McMackin et al., 2002)—for a meta-analysis see Jespersen et al. (2009). In non-forensic populations, specific attentional bias for intimacy-related and abuse-related stimuli has been reported repeatedly in adult survivors of sexual abuse and childhood maltreatment (Blake and Weinberger, 2006, Coleman et al., 2008 and Field et al., 2001). A recent meta-analysis suggests that the trauma itself rather than a subsequent posttraumatic stress disorder predicts attentional biases towards trauma-related stimuli and that this effect is significantly pronounced in assaultive traumas (Cisler et al., 2011). Thus, in terms of an exploratory analysis, we investigated whether childhood maltreatment might modulate the proposed attentional bias for violence-related words in criminal offenders. In particular, we hypothesized that childhood maltreatment would be associated with increased attention in violence-related stimuli.
نتیجه گیری انگلیسی
. Results 3.1. Demographic and clinical group characteristics Table 1 presents demographic, clinical, and offense-related characteristics of the study groups. Age and IQ were comparable across groups, although the controls reported a significantly higher educational level than the two offender groups (χ28=38.75, p<0.001). The three groups differed with regard to GAF (p<0.001) which was highest in the control group. Substance misuse and/or dependence (χ22=23.90, p<0.001) was highest in the ASPD group. With regard to the index offense, the two offender groups were comparable (χ24=7.02, p=0.14). The ASPD group exhibited significantly higher PCL-R scores (PCL-R factor 2, PCL-R sum: p<0.001) than the no-ASPD group. Table 1. Demographic, clinical, and criminological characteristics. ASPD group (n=35) no-ASPD group (n=34) Controls (n=24) Statistics M S.D. M S.D. M S.D. F d.f. p Age 49.57 10.80 49.90 13.18 51.78 10.81 0.28 2, 90 0.76 HAWIE total 101.74 12.96 101.97 10.86 99.96 8.72 0.26 2, 90 0.77 HAWIE verbal 102.06 14.83 101.50 10.97 101.67 7.71 0.02 2, 90 0.98 GAF 62.46 9.72 67.06 11.78 88.00 5.73 52.71 2, 90 <0.001 PCL-R factor 1 8.00 3.41 6.41 3.38 3,77 1,67 0.056 PCL-R factor 2 12.06 3.72 6.44 3.32 43,68 1,67 <0.001 PCL-R sum 21.66 5.90 14.38 5.22 29,37 1,67 <0.001 n (%) n (%) n % χ2 d.f. p Educational level 38.8 8 <0.001 No graduation 6 (17) 2 (6) School for handicapped 4 (11) 1 (3) Secondary school 20 (58) 21 (61) 3 (12) Junior high school 4 (11) 8 (24) 16 (67) High school 1 (3) 2 (6) 5 (21) Substance abuse/dependency 23.9 2 <0.001 22 (63) 15 (44) 13 (37) 19 (56) Index offense 7.02 4 0.135 Child molester 7 (20) 13 (38) Rape 10 (29) 4 (12) Manslaughter 9 (26) 4 (12) Murder 5 (14) 7 (21) Robbery 4 (11) 6 (17) Note: HAWIE, Hamburg-Wechsler Intelligence Test for Adults; GAF, Global Assessment of Functioning; PCL-R, Psychopathy Checklist Revised. Table options 3.2. Group comparison regarding ASPD In the cognitive comparison task, incongruent trials were performed significantly slower than congruent trials (F1,90=139.10, p<0.001, ηpar2=0.61). This cognitive Stroop effect was comparable for the ASPD, no-ASPD, and control group (main effect of group, group-by-condition interaction: n.s.). In the EST, incongruent trials were also performed significantly slower than congruent trials in general (F1,90=122.39, p<0.001, ηpar2=0.58) indicating the classical Stroop effect of color–word-interference. Averaged raw reaction times for congruent and incongruent trials (Table 2, upper part) were subject to a repeated measure ANOVA. Although offenders seemed to show increased RTs compared to controls, this difference was not statistically significant (F2,90=1.19, p=0.31, ηpar2=0.026). Table 2. Reaction times (averaged for congruent and incongruent trials) and bias scores in the Emotional Stroop Task. ASPD group (n=35) no-ASPD group (n=34) Controls (n=24) M S.D. M S.D. M S.D. I: RT violence-related words 705.44 154.79 695.21 131.28 641.48 130.57 II: RT negative words 695.63 145.48 680.55 125.09 635.24 128.47 III: RT neutral words 699.24 135.57 697.29 127.76 667.20 133.83 I–III: violence-neutral words 6.20 54.33 −2.08 46.94 −25.72 36.12 II–III: negative-neutral words −3.61 51.50 −16.75 43.14 −31.96 49.86 I–II: violence-negative words 9.81 46.58 14.67 42.59 6.24 45.95 Mean reaction time (RT) in milliseconds to violence-related (I), negative (II), and neutral (III) words. A positive difference to neutral (I–III; II–III) or negative (I–II) words indicates an effect of word valence. Table options Bias scores (see Table 2, lower part) were analyzed using univariate ANOVAs. A significant group difference emerged with regard to the violence-related bias score (I–III; F2,90=3.32, p<0.05, ηpar2=0.069) and a trend with regard to the negative bias score (II–III; F2,90=2.48, p=0.09, ηpar2=0.052). The content-specific bias score (I–II) was comparable between groups. Post hoc tests revealed that the significant effect as well as the trend was attributable to the difference between offenders with ASPD and controls (violence-neutral: pcorr=0.039; negative-neutral: pcorr=0.087)—see supplementary Table S1. On average, the control group showed the shortest RTs whereas the ASPD group had the longest RTs. Contrary to expectation, RTs were in general shorter for negative than for neutral words (F2,180=6.31; p<0.005; ηpar2=0.065). In order to investigate the effect of word valence more closely, repeated measures ANOVAs were used to compare both experimental conditions (i.e., for congruent and incongruent trials) with regard to violence-related and negative bias scores. A significant main effect of experimental condition emerged (F1,90=8.42, p<0.01, ηpar2=0.086) indicating that enhanced interference was found with congruent trials only. The significant effect of group status (F2,90=3.64, p<0.05, ηpar2=0.075) was subjected to further analyses (see Fig. 1 for details). Violence-related and negative bias scores of offender groups (with and without ... Fig. 1. Violence-related and negative bias scores of offender groups (with and without ASPD) and controls for congruent and incongruent trials. Figure options Groups differed significantly in terms of congruent violence-related (F2,90=3.70, p<0.05, ηpar2=0.076) and negative bias scores (F2,90=4.86, p<0.05, ηpar2=0.097). Post hoc tests showed that the ASPD group displayed significantly more attention to violence-related (pcorr=0.031) and negative stimuli (pcorr=0.007) than controls with regard to congruent trials, whereas offenders without ASPD took an intermediate position—see supplementary Table S2. Contrary to controls, both offender groups showed a different response pattern to congruent compared to incongruent trials. Neither raw reaction times nor bias scores of the added buffer trials differed significantly between groups. In general, RTs to incongruent buffer trials were longer than to congruent trials (F1,90=94.24, p<0.001, ηpar2=0.51) and buffer trials following violence-related words elicited longer RTs (M=730.82 ms, S.D.=159.38) than those following negative (M=697.23 ms, S.D.=148.97) or neutral words (M=697.35 ms, S.D.=144.89), F2,180=13.41, p<0.001, ηpar2=0.13. 3.3. Group comparison based on PCL-R scores Comparable results were obtained when participants were grouped according to their PCL-R scores. The group differences found for congruent trials (violence-related bias: F3,89=3.15, p<0.05, ηpar2=0.096; negative bias: F3,89=3.29, p<0.05, ηpar2=0.10) were mainly driven by significant differences between the high PCL-R group and controls for violence-related words (post hoc: pcorr=0.031) as well as between the medium PCL-R group and controls in negative bias (post hoc: pcorr=0.039)—see supplementary Table S3. Fig. 2 shows that congruent violence-related bias of offenders with high psychopathic traits (M=40.59 ms, S.D.=55.79) was about twice as high as that of the ASPD group (M=20.01 ms, S.D.=56.96; Cohen's d=0.38). Violence-related and negative bias scores of PCL-R groups and controls for ... Fig. 2. Violence-related and negative bias scores of PCL-R groups and controls for congruent and incongruent trials. Figure options 3.4. Group comparison regarding childhood maltreatment Twenty-five of the offenders were identified as victims of childhood abuse, maltreatment or neglect (maltreated group). Multivariate ANOVAs revealed that the maltreated group showed a trend towards an increased violence-related bias (F1,67=3.92, p=0.052, ηpar2=0.055) as well as significantly stronger content-specific bias (F1,67=6.06, p<0.05, ηpar2=0.083) than the non-maltreated offenders. The groups of maltreated and non-maltreated participants did not differ significantly with respect to negative bias (see Fig. 3). Violence-related, content-specific, and negative bias scores of the maltreated ... Fig. 3. Violence-related, content-specific, and negative bias scores of the maltreated and non-maltreated offender groups. vio=RT to violence-related words, neu=RT to neutral words, and neg=RT to negative words. Figure options When analyzing congruent and incongruent trials separately, we found that group differences in violence-related and content-specific bias scores were attributable to the incongruent condition (violence-related: F1,67=4.46, p<0.05, ηpar2=0.062; content-specific: F1,67=8.36, p<0.01, ηpar2=0.11). With regard to the buffer trials, no significant group differences emerged. In the cognitive comparison task (classical Stroop task), groups did not differ either (group versus condition interaction: n.s.).