Clarifying the heterogeneity in psychopathic samples: Towards a new continuum of primary and secondary psychopathy

Mesocorticolimbic dopamine functioning in primary psychopathy: A source of within-group heterogeneity

“…Before discussing the role of DA in the etiology of different primary psychopathic subtypes, a necessary first step is to clarify the endophenotypes or continua on which primary psychopathic individuals show variability so that an empirically based typology may be established (see also Yildirim and Derksen, 2015). Therefore, we will start off by examining the empirically supported variability in the primary psychopathic population.…”

“…Indeed, different researchers have opposed to the initial premise that persistent criminality, impulsivity, and overtly deviant behavior are integral to the construct of psychopathy (Cooke and Michie, 2001;Cooke et al, 2004;Gao and Raine, 2010;Cooke, 2010a, 2010b;Poythress and Hall, 2011;Yildirim and Derksen, 2015). The main argument is that a significant portion of individuals who possess the core features of psychopathy may exhibit adequate self-control, foresight, and planning ability, allowing them to refrain from serious antisocial behavior and manifest their lack of conscience through controlled and calculated schemes rather than impulsive antisociality and impetuous risk-taking.…”

“…(1) Since core psychopathic traits have been generally related to measures of positive affectivity and reward sensitivity, including traits such as boldness, extraversion, risk-taking, motivational drive, behavioral activation (BAS scores), and novelty seeking (see Ross et al, 2007;Del Gaizo and Falkenbach, 2008;Patrick et al, 2009;Ross et al, 2009;Seibert et al, 2011;Anderson et al, 2014b;Yildirim and Derksen, 2015), it is hypothesized that primary psychopathy would associate with a higher tonic and population striatal DA activity regardless of subtype. (2) However, since anatomical alterations of the PFC and hippocampus or severe levels of risk-taking and dysfunctional impulsivity characterize disinhibited psychopaths more specifically (Laakso et al, 2001;Raine et al, 2004;Yang et al, 2005Yang et al, , 2009Gao and Raine, 2010;Poythress et al, 2010;Yang et al, 2010), they might show a more extreme dysregulation of striatal DA activity, whereas controlled subtypes, who evince a more healthy development of the PFC, normal hippocampal anatomy, and a more calculated and foresighted approach to life, might show elevations of DA activity that are within the confines of normal variation.…”

“…Secondly, the term controlled primary psychopathy may be used to refer to psychopathic personalities who primarily score high on the core features of psychopathy (fearlessness, callous insouciance, moral utilitarianism, and social potency) but present with functional impulsivity (i.e., deliberate risk-taking), covert/relational aggression, adequate behavioral controls, normal to high attentional sensitivity, and proper (socio)cognitive functioning (see Yildirim and Derksen, 2015). To achieve what they strive at, controlled psychopaths think and reflect in a strategic, methodical, and mathematical manner, are cunning and manipulative, and although they have strong internal drives towards coveted rewards just as their disinhibited counterparts and may even have violent tendencies and fantasies, they are able to regulate their behavior when necessary, construct and work towards long-term goals, live convincing double-lives, and evade capture for their wrongdoings for prolonged periods.…”

“…Ever since its theoretical inception as a psychiatric condition by Cleckley (1941), different scholars have argued that primary psychopathy does not necessarily culminate in overt violence, dysfunctional impulsivity, or persistent criminality (e.g., Cleckley, 1941;Lykken, 1995;Blackburn et al, 2008;Gao and Raine, 2010;Cooke, 2010a, 2010b;Poythress and Hall, 2011;Yildirim and Derksen, 2015). Characteristic attributes of the primary psychopath, including fearlessness, stress-immunity, and social insensitivity, may hold adaptive value and even facilitate success in individualistic and competitive societies, especially in the context of other protective factors such as high intelligence, good executive functioning, and a firm but authorative socialization (Lykken, 1995;Stout, 2006;Babiak and Hare, 2007;Gao and Raine, 2010;Cooke, 2010a, 2010b;Poythress and Hall, 2011;Dutton, 2012;Lilienfeld et al, 2012).…”