Economic decision-making in psychopathy: A comparison with ventromedial prefrontal lesion patients

Abstract

Psychopathy, which is characterized by a constellation of antisocial behavioral traits, may be subdivided on the basis of etiology: "primary" (low-anxious) psychopathy is viewed as a direct consequence of some core intrinsic deficit, whereas "secondary" (high-anxious) psychopathy is viewed as an indirect consequence of environmental factors or other psychopathology. Theories on the neurobiology of psychopathy have targeted dysfunction within ventromedial prefrontal cortex (vmPFC) as a putative mechanism, yet the relationship between vmPFC function and psychopathy subtype has not been fully explored. In this study, we administered two laboratory decision-making tasks (the Ultimatum Game and the Dictator Game) to a group of prisoners (n=47) to determine whether the different subtypes of psychopathy (primary vs. secondary) are associated with characteristic patterns of economic decision-making, and furthermore, whether either subtype exhibits similar performance to patients with vmPFC lesions. Comparing primary psychopaths (n=6) to secondary psychopaths (n=6) and non-psychopaths (n=22), we found that primary psychopathy was associated with significantly lower acceptance rates of unfair Ultimatum offers and lower offer amounts in the Dictator Game. Moreover, primary psychopaths were quantitatively similar to vmPFC lesion patients in their response patterns. These results support the purported connection between psychopathy and vmPFC dysfunction, bolster the distinction between primary and secondary psychopathy, and demonstrate the utility of laboratory economic decision-making tests in differentiating clinical subgroups.

The strategy of psychopathy: primary psychopathic traits predict defection on low-value relationships

“…In an ultimatum game (UG), individuals scoring higher on the Machiavellian egocentricity subscale of the Psychopathic Personality Inventory [24] make higher offers when they face punishment for offering too little, while accepting low offers to their own benefit [22]. By contrast, clinical psychopaths do not make higher UG offers than controls, and they are especially willing to reject low offers [25]. Such results are complemented by studies of Machiavellianism, which is highly correlated with primary psychopathy [17] and may afford a similar adaptationist explanation [26].…”

Psychopathic individuals exhibit but do not avoid regret during counterfactual decision making

“…mOFC damage produces a syndrome that includes social and affective symptoms similar to those seen in psychopathy (27). Recent work suggests that the presence of such symptoms in mOFC patients may be due to lesion-induced alterations in the representation of information-including counterfactual signals-during value-based decision making (28)(29)(30). Together, these studies raise the possibility that diminished regret in psychopathy may result from a deficit in the ability to generate forward action-outcome models and/or perform retrospective counterfactual comparisons.…”

No excuses for moral realism

“…Their moral understanding of situations involving violations of norms of fairness is perfectly normal (Koenigs et al 2010), at least when their own standing has been affected by such violations. This schism in the kinds of moral knowledge they are capable of maps exactly onto their respective impaired and normally functioning affective capacities: their capacity for empathy is impaired, but their capacity for anger and outrage is not.…”