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Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
1
Pupil reactivity to emotional faces among convicted violent offenders:
The role of psychopathic traits
Steven M. Gillespie1, Pia Rotshtein2, Harriet Chapman2,
Emmie Brown3, Anthony R. Beech2, Ian J. Mitchell2
1Department of Psychological Sciences, University of Liverpool, UK
2School of Psychology, University of Birmingham, UK
3School of Psychology, Newcastle University, UK
Citation: Gillespie, S. M., Rotshtein, P., Chapman, H., Brown, E., Beech, A. R., & Mitchell, I. J.
(2019, July 18). Pupil reactivity to emotional faces among convicted violent offenders: The role of
psychopathic traits. Journal of Abnormal Psychology. Advance online publication.
http://dx.doi.org/10.1037/abn0000445
Author Note
This work was funded by a grant from the Economic and Social Research Council (ESRC)
[ES/L002337/1]. The funder had no role in study design; in the collection, analysis, and interpretation
of data; in the writing of the report; and in the decision to submit the article for publication.
Ethical approval for this study was granted by the University of Birmingham Committee for
Ethical Review for Science, Technology, Engineering and Mathematics (ERN_ 15-0600P).
Hypotheses and data appearing in this manuscript have not previously been presented at a
conference, or shared on a website etc.
Correspondence concerning this article should be addressed to: Steven M. Gillespie,
Department of Psychological Sciences, University of Liverpool, UK, L69 3GB, email:
steven.gillespie@liverpool.ac.uk
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
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Abstract
Psychopathy is characteristically associated with impairments in recognizing others facial expressions
of emotion, and there is some evidence that these difficulties are specific to the callousness features of
the disorder. However, it remains unclear if these difficulties are accompanied by reductions in
autonomic reactivity when viewing others emotional expressions, and whether these impairments are
particular to expressions showing another’s distress, or are more pervasive across different emotional
expressions. In this study, 73 adult male prisoners with histories of serious sexual or violent offenses
– who ranged across the psychopathy continuum – completed a facial emotion recognition task. For
the first time in a convicted offender sample, we used pupillometry techniques to measure changes in
the pupil dilation response, a measure of sympathetic autonomic arousal to affective stimuli. We
found that the callousness features of psychopathy were related to impaired recognition of fearful
faces. Strikingly, we also showed that increasing callousness was associated with a reduction in the
pupil dilation response, and that this was pervasive across different emotional expressions. Our results
highlight a potential role of the locus coeruleus-noradrenaline system in the pathophysiology of
psychopathy, and demonstrate the potential of the pupillary response as a technique for understanding
attention-emotion interactions in psychopathy.
Key words: psychopathy, fear, facial expression, pupilometry, antisocial behaviour
General scientific summary
We found that psychopathic traits among convicted violent offenders are associated with reduced
fearful expression recognition, and reduced arousal in response to the emotional expressions of others.
This study suggests that these difficulties may represent a mechanism for the callousness features of
psychopathy.
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
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Pupil reactivity to emotional faces among convicted violent offenders:
The role of psychopathic traits
Convicted psychopaths account for more severe and more frequent acts of aggression, and
they engage in instrumental forms of aggression at a higher rate than non-psychopaths do (Skeem,
Polaschek, Patrick, & Lilienfeld, 2011). These behaviours are thought to reflect deficiencies in
emotion processing, and reduced reactivity of the autonomic nervous system [ANS] to emotional
stimuli (Blair, Leibenluft, & Pine, 2014; Fanti, 2018). Psychopathy is a multidimensional construct
that is characterized by callous/affective (e.g., lack of remorse or guilt, shallow affect), interpersonal
(e.g., manipulative, interpersonal charm), and behavioral (e.g., recklessness, impulsivity)
characteristics (Cooke & Michie, 2001; Patrick, Fowles, & Krueger, 2009). It is hypothesized that the
callousness features are related to both emotional reactivity deficits (e.g., Kyranides, Fanti, Sikki, &
Patrick, 2017), and a diminished ability to recognize and respond to other’s emotional facial
expressions (Blair et al., 2014). However, whether these difficulties are specific to expressions
signalling another’s distress, or are more generalized across different emotional expressions, has been
the subject of some debate (Brook, Brieman, & Kosson, 2013; Dawel, O'Kearney, McKone, &
Palermo, 2012). The aims of the present study were to assess the relationship of distinct psychopathic
traits with accuracy of emotion recognition and autonomic reactivity to distress (fear, sad) and non-
distress (disgust, happy) facial expressions in a sample of convicted violent offenders.
Historically, psychopathy has been conceptualized and measured according to a two-
factor/four-facet model, with Factor 1 indexing Interpersonal and Affective features, and Factor 2
indexing Lifestyle and Antisocial features (Hare, 2003). These features can be measured in forensic
samples using the interview-based Psychopathy Checklist – Revised (Hare, 2003). Alternatively, the
Triarchic Model of psychopathy conceptualizes the construct along three core dimensions, namely
Boldness, Meanness, and Disinhibition (Patrick et al., 2009). These trait dimensions have been
reliably identified and distinguished in forensic and non-forensic samples, and have been
operationalized using the Triarchic Psychopathy Measure (TriPM; Drislane, Patrick, & Arsal, 2014).
Boldness refers to venturesomeness, fearlessness, and interpersonal dominance (Patrick et al., 2009),
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
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and is positively associated with interpersonal features assessed using the Fearless Dominance
subscale of the Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996; Lilienfeld &
Widows, 2005), and with PCL-R Interpersonal and Antisocial symptoms (Patrick & Drislane, 2015).
Meanness indexes callous and affective features, and is positively related to scores on the Inventory of
Callous-Unemotional Traits (ICU; Kimonis, Branch, Hagman, Graham, & Miller, 2013), the
Coldheartedness subscale of the PPI , and with PCL-R Affective and Antisocial symptoms (see
Patrick & Drislane, 2015 for a review). Moderate associations of Meanness with PPI Fearless
Dominance and Impulsive Antisociality features have also been reported (Patrick & Drislane, 2015).
Disinhibition refers to impulse control problems, emotional reactivity, and poor behavioural restraint
(Patrick et al., 2009). Patrick and Drislane (2015) have highlighted positive associations of
Disinhibition with PPI Impulsive Antisociality, and with PCL-R Lifestyle and Antisocial symptoms.
Thus, although Boldness, Meanness, and Disinhibition appear to be preferentially associated with
interpersonal, affective, and antisocial features, respectively, all three subscales have been linked with
higher PCL-R Antisocial symptoms.
The ways in which Boldness, Meanness, and Disinhibition relate to measures of emotion
processing and ANS reactivity remain unclear. Although several prominent accounts of psychopathy
emphasize difficulties in emotional expression recognition (Blair et al., 2014; Moul, Killcross, &
Dadds, 2012), there is some debate as to whether these deficits are particular to emotions signalling
another’s distress, most notably fear and sadness, or are more generalized across the emotional
spectrum, including, for example, anger, disgust and happy (Brook & Kosson, 2013; Dawel et al.,
2012). The callousness dimension in particular appears to be linked with difficulties recognizing
others’ distress from their emotional expressions (Brislin et al., 2018; Dargis, Wolf, & Koenigs, 2018;
Gillespie, Mitchell, Satherley, Beech, & Rotshtein, 2015; Igoumenou, Harmer, Yang, Coid, & Rogers,
2017), and is associated with amygdala hypoactivity to fearful facial expressions (Jones, Laurens,
Herba, Barker, & Viding, 2009; Viding et al., 2012; White et al., 2012). In contrast, the interpersonal
dimension is associated with a pattern of reduced attention to the eyes that is generalized across
different emotional expressions (Dargis et al., 2018; Gillespie, Rotshtein, Beech, & Mitchell, 2017;
Gillespie, Rotshtein, Wells, Beech, & Mitchell, 2015). As such, there are several important questions
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
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that require further clarification, including whether psychopathy related impairments in facial affect
recognition are specific to fear and sadness, or are more generalized across the emotional spectrum;
whether these impairments are primarily related to the callousness features of the disorder; and
whether these impairments are accompanied by hypoautonomic reactivity while viewing emotional
expressions.
ANS activity can be measured at rest, or in response to emotional stimuli. In both contexts,
psychopathy is associated with attenuated ANS responses (see De Brito & Mitchell, 2018 for a
review). In studies with convicted offenders, psychopathy has been linked with low resting heart rate
(Armstrong, Keller, Franklin, & Macmillan, 2009; Arnett, Howland, Smith, & Newman, 1993;
Patrick, 2008; Pham, Philippot, & Rime, 2000), and low resting levels of electrodermal activity
(Lorber, 2004). Studies of ANS reactivity in response to emotional stimuli have also shown that
psychopathy is related to reduced cardiovascular (Arnett et al., 1993; Ishikawa, Raine, Lencz, Bihrle,
& Lacasse, 2001; Patrick, 2008; Pham et al., 2000), and electrodermal reactivity (Arnett, 1997;
Patrick, 2008; Rothemund et al., 2012), and an absence of, or reduction in, aversive startle
potentiation – that is, the augmentation of the blink startle reflex that is normally observed in response
to an aversive stimulus (e.g., an unpleasant picture) (Pastor, Molto, Vila, & Lang, 2003; Patrick,
Bradley, & Lang, 1993).
In children with conduct problems, reductions in ANS activity, both at rest, and in response to
emotionally salient stimuli, are related to the callousness dimension in particular (Fanti, 2018).
Studies with adult community and offender samples have found negative associations of estimated
scores on PPI Fearless Dominance (Benning, Patrick, & Iacono, 2005), and PCL-R Interpersonal
symptoms (Verona, Patrick, Curtin, Bradley, & Lang, 2004), with electrodermal responsivity to
negative stimuli, and PPI Fearless Dominance is negatively associated with electrodermal responses
during anticipatory stress (Dindo & Fowles, 2011). Aversive startle potentiation is also inversely
related to estimated scores on PPI Fearless Dominance (Benning et al., 2005), and PCL-R Factor 1
(Vaidyanathan, Hall, Patrick, & Bernat, 2011), but is either unrelated (Benning et al., 2005;
Vaidyanathan et al., 2011), or positively related (Vanman, Mejia, Dawson, Schell, & Raine, 2003), to
impulsive and antisocial features. Consistent with these findings, TriPM Boldness was associated with
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
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reduced cardiac reactivity to violent stimuli, while Meanness was associated with low startle
potentiation in a young adult sample (Kyranides et al., 2017). Thus, reduced ANS reactivity in
psychopathy appears to be most strongly associated with Boldness and Meanness.
Pupil dilation (pupilometry) is another marker of ANS reactivity that is sensitive to emotional
content, yet pupillary responses to emotional expressions have not been studied in convicted offender
samples. The smooth muscles involved in the pupil response are controlled by the two opposing
branches of the ANS: the dilator muscle, influenced by activity of the sympathetic nervous system
(SNS), and the sphincter muscle, influenced by activity of the parasympathetic nervous system (PNS).
Thus, pupil size reflects the relative activation of these two systems, with pupil dilation resulting from
either increased SNS activity, or reduced PNS activity.
Accumulating evidence suggests that the pupil dilation response is a robust marker of activity
in the locus coeruleus (LC) (Joshi, Li, Kalwani, & Gold, 2016; Murphy, O'Connell, O'Sullivan,
Robertson, & Balsters, 2014). LC neurons respond to the salience and biological significance of
stimuli, and give rise to the release of noradrenalin (i.e., norepinephrine), the neurotransmitter that
characterises sympathetic efferents. This release of noradrenaline is thought to facilitate the functional
integration of brain regions involved in attention (Corbetta, Patel, & Shulman, 2008; Coull, Buchel,
Friston, & Frith, 1999; Sara, 2009). Although no known anatomical pathways allow for a direct
influence of LC on the autonomic nuclei controlling pupil diameter (Nieuwenhuis, De Geus, & Aston‐
Jones, 2011), this tight relationship likely reflects parallel activation of the LC and SNS by sources of
common input. A likely candidate is the rostral ventrolateral medulla, a major excitatory input to the
LC, and a key sympathoexcitatory brain region that receives cortical and subcortical inputs
(Nieuwenhuis et al., 2011). While activation of the LC leads to noradrenergic release into the
neocortex, parallel activation of the SNS causes direct activation of the pupil dilator muscle. Thus, the
pupil dilation response represents a novel avenue of enquiry that could be revealing about a potential
role of the LC-noradrenaline system in the pathophysiology of psychopathy.
In community adult samples, increased pupil dilation has been observed in response to both
positive and negative stimuli (Bradley, Miccoli, Escrig, & Lang, 2008; Rieger et al., 2015; Snowden
et al., 2016), including emotional faces, particularly those depicting threat (i.e., fear and anger)
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
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(Schrammel, Pannasch, Graupner, Mojzisch, & Velichkovsky, 2009). Only one study has examined
pupil reactivity to emotional stimuli as a function of psychopathic tendencies in non-offenders
(Burley, Gray, & Snowden, 2017). Independent of psychopathic tendencies, this study replicated
previous reports showing that pupil dilation is increased for negative compared with neutral stimuli,
although no differences were reported for positive stimuli. More importantly, the authors did not
observe significant relationships of distinct psychopathic trait dimensions with pupillary responses to
any of the emotional stimuli (Burley et al., 2017). However, this null result may reflect the relatively
lower levels of psychopathic tendencies found in non-offender samples.
The Present Study
The aim of this study was to examine the relationship of distinct psychopathic traits with
recognition accuracy and pupillary responses to varied emotional expressions in a convicted offender
sample. We assessed three core dimensions of psychopathy, namely Boldness, Meanness, and
Disinhibition, described in the Triarchic conceptual framework (Patrick et al., 2009). Finally, we also
measured State and Trait anxiety because negative affect is an important factor regarding
heterogeneity in psychopathy (Hicks & Patrick, 2006; Kimonis, Frick, Cauffman, Goldweber, &
Skeem, 2012).
We predicted that Meanness would be negatively related to accuracy of emotional expression
recognition, and more pertinently, to autonomic reactivity indexed by the pupillary response.
Competing theories of the emotional deficits associated with psychopathy would predict that these
effects would either be specific to expressions of sadness and fear, or would be observed more
generally across the emotional spectrum (see Brook et al., 2013). Thus, as a test of both theories we
included a varied set of emotional expressions, depicting anger, disgust, fear, happy, sad, surprise, and
neutral. Expressions (excluding neutral) were presented at varying degrees of stimulus intensity to
provide more lifelike representations of emotional expressions, and to make the task more sensitive to
subtle differences in emotion processing (Adolphs & Tranel, 2004; Calder et al., 1996). Furthermore,
results suggest that psychopathy primarily affects the processing of moderate intensity expressions
(Hastings, Tangney, & Stuewig, 2008). In line with previous findings (Brook et al., 2013; Dawel et
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
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al., 2012), we hypothesized that relationships of Meanness with accuracy and pupil reactivity would
be pervasive across expressions, but with the largest effect sizes observed for fear.
Method
Ethical Approval
Ethical approval for this study was obtained from the University of Birmingham Committee
for Ethical Review and the National Offender Management Service for England and Wales. We
informed potential participants that their acceptance or refusal to take part would have no bearing
upon their sentencing, treatment, or parole decisions. All participants were informed of their right to
withdraw their data within two weeks of participation, were provided with an information sheet,
signed an informed consent form, and were debriefed following participation.
Participants
A sample of 73 adult males aged 21-72 years (M = 38.7, SD = 11.7) who were incarcerated at
one of two Category B prisons in the United Kingdom took part in the study. Individuals were eligible
to take part if they were over the age of 18, and had been convicted of a violent offense, defined as
“any criminal charge for a violent offence against persons – e.g., assault, assault causing bodily harm,
wounding, attempted homicide, homicide, kidnapping, forcible confinement, armed robbery, and all
‘hands-on’ sexual offences” (Harris, Rice, & Cormier, 2002, p. 383). Based on file information, no
participants had a diagnosis of schizophrenia, bipolar disorder or psychosis, and no participants were
currently using psychotropic medication. Three participants in the violent offender sample had a
history of post-traumatic stress disorder, three had a history of depression, and one had a history of
dissociative disorder. Recruitment in prison settings followed local procedures and included contact
with offender-supervisors, searching the prisons electronic database, and poster advertising. One
setting ran a research advisory group that consisted of expert-by-experience representatives from
eligible wings who took part in a question and answer session with two of the researchers. Wing
representatives aided recruitment on their own wings following this meeting. Most participants were
white Caucasian (86%). All participants had normal or corrected-to-normal vision.
For comparison purposes, we also recruited a sample of 25 community males. Because the
focus of this paper is on the relationship of psychopathic traits with pupil dilation responses in a
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
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convicted offender sample, we present details of the community sample and comparisons between
groups in Supplemental Materials 1.
Accuracy data for a sub-sample of the offenders (n = 30) and for the control group have
previously been reported as part of a study on eye movements (Gillespie et al., 2017).
Materials
Facial expression stimuli. We used a subset of the morphed facial stimuli developed by
Gillespie and colleagues (Gillespie, Mitchell, et al., 2015; Gillespie, Rotshtein, Satherley, Beech, &
Mitchell, 2015; Gillespie, Rotshtein, Wells, et al., 2015; Wells, Gillespie, & Rotshtein, 2016).
Original stimuli were selected from the NimStim Face Stimulus Set (Tottenham et al., 2009;
http://www.macbrain.org/resources.htm) and consisted of five male and five female Caucasian models
showing seven different expressions: neutral, angry, disgust, fear, happy, sad, and surprise. Emotional
and neutral images from the same model were morphed to create images of varying levels of
emotional intensity (for details of the morphing procedure see Gillespie, Rotshtein, Satherley, et al.,
2015). Images used in the current study consisted of each emotion, for each model, displayed at
moderate (55% expressive) and high (90% expressive) intensity. Neutral stimuli were displayed at
100% neutral (i.e., neutral stimuli did not vary in intensity). Stimuli had a resolution of 504 x 624
pixels. The positioning of each image on the canvas was manipulated such that the eyes and the
mouth appeared in the same location across all stimuli. There were no differences in contrast (F(5,
108) = .153, p = .979) or luminance (F(5, 108) = .214, p = .956) as a function of emotional
expression. Contrast values were greater for images showing higher intensity expressions (F(1, 108) =
15.161, p < .001), but there were no differences in luminance (F(1, 108) = .783, p = .378). Given that
our main aim was to examine individual differences in pupil reactivity to the stimuli, we kept the
original contrast of the stimuli to maintain more life-like expressions, and to facilitate ecological
validity.
Measures. The Triarchic Psychopathy Measure (TriPM; Drislane et al., 2014) was used for
the assessment of psychopathic traits. This 58-item self-report measure yields scores on three
subscales: Boldness, Meanness, and Disinhibition. The TriPM Boldness scale includes items
assessing interpersonal dominance, venturesomeness, and fearlessness (Patrick et al., 2009).
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
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Callousness was assessed using the Meanness scale and entails callous-aggressiveness, lack of
empathy, and a tendency toward exploiting others (Brislin et al., 2018; Drislane et al., 2014). TriPM
Disinhibition indexes impulsivity, emotional reactivity, and irresponsibility (Patrick et al., 2009).
Participants responded on a 4-point Likert scale (3 = true, 2 = somewhat true, 1 = somewhat false, 0 =
false). Internal consistencies for the Boldness, Meanness, and Disinhibition subscales in the convicted
offender sample were adequate: Cronbach’s ɑ = .68, .92, and .89, respectively. Participants in the
violent offender group also completed the State Trait Anxiety Inventory (STAI; Spielberger, 1983),
which contains both State [STAI-S] and Trait [STAI-T] subscales. Internal consistencies for the
STAI-S and STAI-T were good: Cronbach’s ɑ = .93, .93. One participant in the violent offender
group failed to complete the TriPM, and one participant failed to complete the STAI. Participants in
the community sample were also asked to complete the TriPM for comparison, although two
participants failed to complete the measure.
Pupillometry
We used an EyeLink 1000 corneal-reflection based portable eye tracking system (SR
Research Ltd.) to record participants’ pupil size. Although viewing was binocular, only pupil diameter
of the right eye was recorded. Pupil size was sampled at 1000 Hz. We used a Dell Precision laptop
computer to manage the recording of pupil diameter. Stimuli were displayed on a 19” LG colour
monitor, using SR-Research Experiment Builder software, running on a laptop computer with a
separate mouse and keyboard.
Procedure
Offender participants were tested in a private room inside the prison, whereas community
participants were tested in a dedicated eye-tracking laboratory at the university. Participants sat at a
desk with a chin rest of adjustable height to minimize head movements. Participants were positioned
approximately 68 cm from the display monitor, and images were presented at a visual angle of 21.2°.
Participants categorized the emotional expression stimuli as quickly and accurately as possible while
pupil size was being recorded. Standard EyeLink calibration and validation procedures were
performed, each using a series of nine fixation points. Facial expression stimuli were presented in a
randomized order over four blocks using the EyeLink software. At the start of each trial the
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
11
experimenter confirmed that the participant’s eye gaze fell on a fixation point presented in the centre
of the screen. A fixation cross was then presented for 1000 ms, followed by an image of an emotional
expression that was displayed for 2000 ms. Following display of the target expression, participants
categorized the facial expression using the numeric keys 0-6. Expression labels were displayed in a
vertical list alongside the relevant number key (e.g., 0. NEUTRAL).
Data Analysis
Accuracy data were analyzed as the proportion of correct responses for each stimulus
category (i.e., each emotion category at each level of intensity). To control for individual differences
in pupil size, and therefore expected differences in the degree of pupil change, we calculated within
participant percent change difference scores for each stimulus category (see Attard-Johnson, Ó
Ciardha, & Bindemann, 2018). First, for each trial we averaged pupil size across each individual
fixation for the duration of the stimulus display. We then used these values to calculate an overall
mean pupil size for each participant, across all trials. The percentage difference in pupil diameter for
each stimulus category compared to the overall mean was calculated using the following formula:
∆𝑃𝑖𝑐 =(𝑥̅𝑖𝑐 − 𝑥̅𝑒)
𝑥̅𝑒
∗100
𝑥̅𝑖𝑐 denotes the mean change for a specific category and intensity, and 𝑥̅𝑒 denotes the mean
response to all conditions, ∆𝑃𝑖𝑐 denotes the overall change in pupil diameter for a specific emotion
category (c) and intensity (i) compared to the overall mean. Thus, no change in pupil size is indicated
by zero, while positive or negative scores reflect relatively larger (dilation) or smaller (constriction)
pupil sizes in response to each stimulus category. The use of percentage change data performs as well
as other methods for the analysis of pupillary response data, including raw scores and z-scored data,
and better than pre-stimulus baseline correction where carryover effects have been observed (Attard-
Johnson et al., 2018). Second, to ensure that the observed changes in pupil size were due to changes in
the emotional content of expressions, we contrasted percentage change in pupil size for each stimulus
category with percentage change for neutral expressions (see Attard-Johnson et al., 2018). To do this,
we subtracted the percentage change in pupil size for neutral expressions from the percentage change
in pupil size for each stimulus category.
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
12
To understand the effects of the emotional content of the expression, expression intensity, and
the effects of self-reported psychopathic traits, we computed separate ANCOVAs for accuracy and
pupil reactivity. Each ANCOVA included the factors Emotion (anger, disgust, fear, happy, sad,
surprise), and Intensity (55%, 90%), with scores for Boldness, Meanness, and Disinhibition included
as covariates. Significant interactions were broken down using subsequent ANCOVAs. To test if any
effects of psychopathic traits were due to severity of antisocial behavior, ANCOVAs on accuracy and
pupil reactivity were repeated with total number of previous convictions for violence included as an
additional covariate. Supplementary ANCOVAs on accuracy and pupil reactivity were also performed
including a community control group, and with State and Trait Anxiety included separately as
covariates. Analyses including State and Trait Anxiety allowed us to test for the effects of negative
affect without controlling for important aspects of the psychopathy construct. The results of these
supplementary analyses are reported in Supplemental Materials 1 and 2, respectively. As Age was
unrelated to either accuracy of expression recognition (all r < .12 and ≥ -.23, p > .05), or pupil dilation
responses (all r < .19 and > -.07, p > .12), we did not include Age as a covariate.
Results
Table 1.
Sample description and correlations between measures in convicted violent offenders, community
non-offenders, and descriptive statistics reported by van Dongen et al. (2017) for community (N =
385), and forensic psychiatric samples (N = 296)
Variable
Bold.
Mean.
Disin.
STAI-S
STAI-T
Age
Previous
convictions
for violencea
Convicted offenders
TriPM Meanness
.206
-
TriPM Disinhibition
-.007
.616**
-
STAI-S
-.266*
-.124
-.060
-
STAI-T
-.316*
.112
.169
.729**
-
Age
-.185
-.081
-.134
-.032
-.012
-
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
13
Previous convictions
for violencea
-.072
.237*
.355*
-.050
-.020
.005
-
Range
11-44
0-50
0-54
20-66
20-73
21-72
0-14
Mean
28.5
14.2
28.4
32.3
42.7
38.7
2.3
Median
28
11
30
29
43
36
1
SD
7.9
11.3
13.3
11.0
11.8
11.7
3.3
Community controls
Range
9-47
2-38
2-42
18-69
Mean
28.9
13.4
17.7
37.9
Median
28
9
17
31
SD
9.0
9.8
10.5
18.3
Comparison scores
Community Meanb
31.1
12.3
11.5
Community SDb
8.14
7.8
7.8
Forensic Meanc
30.6
16.1
26.7
Forensic SDc
9.2
9.6
12.0
* <.05, ** <.001
Note: TriPM = Triarchic Psychopathy Measure; STAI-S = State Trait Anxiety Inventory – State;
STAI-T = State Trait Anxiety Inventory – Trait.
a Previous convictions for violence excludes index offense.
b Scores reported by van Dongen et al. (2017) for a community sample (N=496)
c Scores reported by van Dongen et al. (2017) for a forensic psychiatric sample (N=296)
Table 1 shows mean scores and standard deviations for all self-report measures completed by
violent offenders, along with the correlations between measures. For comparison, descriptive statistics
for the TriPM subscales in the community sample are also included, as well as published comparison
scores from community (N = 496), and forensic psychiatric samples (N = 296) (van Dongen, Drislane,
Nijman, Soe-Agnie, & van Marle, 2017). TriPM scores among violent offenders were similar to those
reported by van Dongen et al. (2017) for a separate sample of forensic psychiatric patients, while
Meanness and Disinhibition scores were higher compared with community controls in this study, and
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
14
community participants reported by van Dongen and colleagues. Meanness and Disinhibition were
positively correlated among violent offenders, while Boldness was unrelated to either Meanness or
Disinhibition, but was negatively correlated with measures of negative affect. Meanness and
Disinhibition were associated with a greater number of previous convictions for violence. Table 2
shows accuracy of emotion recognition and percent changes in pupil size for convicted violent
offenders as a function of Emotion and Intensity.
Table 2.
Mean task performance for violent offenders (n=73)
Accuracy
Pupil reactivity
Emotion
Intensity
M (SD)
M (SD)
Anger
55%
.86 (.12)
-.03 (2.20)
90%
.89 (.13)
-.010 (2.35)
Disgust
55%
.77 (.16)
.71 (2.01)
90%
.87 (.14)
.03 (1.86)
Fear
55%
.60 (.24)
.46 (1.96)
90%
.54 (.21)
-.28 (2.38)
Happy
55%
.83 (.20)
-.74 (2.33)
90%
.96 (.10)
-.71 (2.71)
Sad
55%
.76 (.17)
.66 (2.55)
90%
.89 (.12)
.26 (2.34)
Surprise
55%
.83 (.14)
.69 (2.33)
90%
.88 (.12)
-.48 (2.19)
Neutral
100%
.75 (.26)
-.65 (3.07)
Accuracy: Effects of Emotion and Intensity
An ANCOVA on accuracy revealed significant main effects of Emotion (F(5, 340) = 63.263,
p < .001, pη2 = .482), and Intensity (F(1, 68) = 70.727, p < .001, pη2 = .510), that were qualified by a
significant two-way interaction (F(5, 340) = 20.753, p < .001, pη2 = .234). Disgust (F(1, 68) = 57.232,
p < .001, pη2 = .457), happy (F(1, 68) = 46.491, p < .001, pη2 = .406), sad (F(1, 68) = 52.460, p <
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
15
.001, pη2 = .435), and surprise (F(1, 71) = 9.682, p = .003, pη2 = .125) were all recognized better at
high intensity, but fear was recognized better at low intensity (F(1, 68) = 11.722, p = .001, pη2 =
.147). Expressions showing anger were recognized equally well at low and high intensity (F(1, 68) =
2.866, p = .095, pη2 = .040). Bonferroni adjusted comparisons for the main effect of Emotion showed
that fear was recognized with least accuracy compared with all other expressions (all p < .001), and
happy was better recognized than disgust (p = .008), and sad (p = .006).
Accuracy: Effects of Boldness, Meanness, and Disinhibition
The main effects of Boldness (F(1, 68) = 0.270, p = .605, pη2 = .004), Meanness (F(1, 68) =
0.052, p = .820, pη2 = .001), and Disinhibition (F(1, 68) = 1.624, p = .207, pη2 = .023) were all non-
significant, but there was a significant interaction of Meanness with Emotion (F(5, 340) = 3.589, p =
.004, pη2 = .050), suggesting a relationship that was dependent on the emotional content of the
expression. All other two- and three-way interactions of Boldness, Meanness, and Disinhibition with
Emotion and Intensity were non-significant (all F < 3.12, p > .08). When including total number of
previous convictions for violence as a covariate, the interaction of Meanness with Emotion remained
significant (F(5, 335) = 3.542, p = .004, pη2 = .050), and there were no significant main effects or
interactions of previous convictions for violence (all F < 1.70, p > .19). The interaction of Meanness
with Emotion also remained significant after removing 14 participants aged over 50 years (F(5, 270)
= 3.229, p = .008, pη2 = .056).
Table 3 shows the zero-order and partial correlations of Meanness, controlling for Boldness
and Disinhibition, with accuracy of emotion recognition. Zero-order and partial correlations showed
that increasing Meanness scores were associated with poorer fear recognition. Figure 1 shows the
association of Meanness scores, controlling for Boldness and Disinhibition, with accuracy of fearful
expression recognition. Partial correlations also showed that increasing Meanness scores were
associated with better recognition of sad expressions.
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
16
Table 3.
Zero-order and partial (controlling for Boldness and Disinhibition) correlations of TriPM Meanness
scores with accuracy of emotion recognition by type of expression
Note: Bold. = Triarchic Psychopathy Measure Boldness subscale; Disin. = Triarchic Psychopathy
Measure Disinhibition subscale
Pupil Dilation Response: Effects of Emotion and Intensity
An ANCOVA on pupil dilation responses showed that pupil reactivity varied with the
emotional content of the expression (F(5, 340) = 5.167, p < .001, pη2 = .071). Bonferroni adjusted
comparisons showed that the pupil dilated more for disgust (p = .004), and sad (p = .002), compared
with happy. No other comparisons were significant. A significant main effect of Intensity showed that
pupil dilation was greatest for expressions at lower intensity (F(1, 68) = 9.965, p = .002, pη2 = .128),
but the two-way interaction of Emotion and Intensity was non-significant (F(5, 340) = 1.321, p =
.255, pη2 = .019).
Pupil Dilation Response: Effects of Boldness, Meanness, and Disinhibition
A significant two-way interaction showed that the pattern observed for Intensity was most
pronounced with increasing Boldness scores (F(1, 68) = 4.023, p = .049, pη2 = .056). The remaining
two- and three-way interactions of Boldness, Meanness and Disinhibition with Emotion and Intensity
were all non-significant (all F < 1.48, p > .19). However, a significant main effect of Meanness (F(1,
68) = 4.138, p = .046, pη2 = .057) showed that increasing Meanness scores were associated with a
Emotion
Zero-order r (p)
Partial r (p)
(Controlling for
Bold. and Disin.)
Anger
.043 (.719)
.080 (.508)
Disgust
.023 (.845)
.142 (.240)
Fear
-.256 (.030)
-.241 (.044)
Happy
-.003 (.979)
-.036 (.767)
Sad
.066 (.580)
.241 (.044)
Surprise
.012 (.918)
.082 (.501)
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
17
reduction in the pupil dilation response across Emotion and Intensity. The main effects of Boldness
(F(1, 68) = 0.023, p = .881, pη2 = .000), and Disinhibition (F(1, 68) = 0.001, p = .970, pη2 = .000),
were both non-significant. When including total number of previous convictions for violence as a
covariate, the main effect of Meanness remained significant (F(1, 67) = 4.144, p = .046, pη2 = .058),
and we also found a significant interaction of previous convictions for violence with Emotion (F(5,
335) = 2.506, p = .030, pη2 = .036). The main effect of Meanness also remained significant after
removing 14 participants aged over 50 years (F(1, 54) = 4.127, p = .047, pη2 = .071).
Table 4 shows the zero-order and partial correlations of Meanness, controlling for Boldness
and Disinhibition, with pupil reactivity for each expression type. Zero-order correlations showed that
Meanness was associated with reduced pupil dilation responses across all emotional expressions
relative to neutral, excluding anger. When controlling for Boldness and Disinhibition, the effects of
Meanness were apparent for expressions of fear, happy, and sad. Figure 1 shows the association of
Meanness scores, controlling for Boldness and Disinhibition, with the pupillary response to fearful
expressions. Although an additional analysis revealed a significant interaction of previous convictions
for violence with Emotion, all zero-order and partial correlations with the pupil dilation response were
non-significant (all p > .204).
Table 4.
Zero-order and partial (controlling for Boldness and Disinhibition) correlations of TriPM Meanness
scores with pupil dilation response by type of expression
Emotion
Zero-order r (p)
Partial r (p)
(Controlling for
Bold. and Disin.)
Anger
-.216 (.068)
-.142 (.240)
Disgust
-.249 (.035)
-.180 (.137)
Fear
-.314 (.007)
-.298 (.012)
Happy
-.305 (.009)
-.239 (.047)
Sad
-.362 (.002)
-.306 (.010)
Surprise
-.248 (.036)
-.150 (.217)
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
18
Note: Bold. = Triarchic Psychopathy Measure Boldness subscale; Disin. = Triarchic Psychopathy
Measure Disinhibition subscale
Additional Analysis
To examine if the associations of fear face accuracy and pupil dilation responses with
Meanness were separate or overlapping, we included both in a regression model as predictors of
Meanness standardized residuals, controlling for Boldness and Disinhibition. The model (F(2, 71) =
5.369, p = .007, ΔR2 = .110) showed that reduced pupil dilation responses (β = -0.080, SE = .032, p =
.015), but not accuracy (β = -1.042, SE = .535, p = .055), predicted higher Meanness scores.
Figure 1. Scatter plot showing the relationship between Meanness psychopathic traits and (A) fear
recognition accuracy, and (B) the pupillary response to fearful expressions, in violent offenders.
Meanness scores represent standardized residuals controlling for Boldness and Disinhibition.
Discussion
In this study, we examined the effects of distinct psychopathic traits on accuracy of emotion
recognition, and pupil reactivity to different emotional expressions in a sample of convicted violent
offenders. In support of our main hypotheses, we found that self-reported levels of callousness as
indexed by the Meanness scale of the TriPM were associated with reduced recognition of fearful
expressions, and reduced pupil reactivity to emotional expressions of fear, happy, and sad. These
findings suggest that although callousness is associated with a specific impairment in fearful
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
19
expression recognition, the relationship of callousness with autonomic hypoactivity is pervasive
across emotional expressions, with no specificity for fear or sadness.
Consistent with earlier findings from offenders and non-offenders, expressions of higher
intensity were typically recognized with better accuracy (Gillespie et al., 2017; Schurgin et al., 2014;
Wells et al., 2016), and fear was recognized with least accuracy compared with other expressions
(Gillespie et al., 2017; Wells et al., 2016). The finding that callousness was associated with a specific
impairment in recognizing fearful expressions is consistent with earlier studies in community adults
(Brislin et al., 2018), and convicted offenders (Gillespie, Mitchell, et al., 2015; Igoumenou et al.,
2017). Our results contrast with reports of more pervasive psychopathy related impairments in
emotion recognition that go beyond fear and sadness (Brook et al., 2013; Dawel et al., 2012), and
instead favour theoretical accounts of psychopathy that focus on impaired recognition of others
distress cues (Blair, 2013; Blair et al., 2014). However, support for these theories is tempered by an
unexpected, positive relationship of callousness, controlling for Boldness and Disinhibition, with
accuracy for sad expressions. Although others have reported positive relationships of both
interpersonal and antisocial features of psychopathy with accuracy in offender samples (Dargis et al.,
2018; Igoumenou et al., 2017), a meta-analysis showed a small, negative effect of psychopathy on
recognition of sadness (Dawel et al., 2015). These findings should be interpreted in light of mixed
reports on the emotion specific effects of psychopathy that may reflect limited discriminating power
for emotion-specific subscales (e.g., happiness is usually recognized with high accuracy), small
sample sizes, and a lack of control over confounding third variables (Olderbak, Mokros, Nitschke,
Habermeyer, & Wilhelm, 2018).
Pupil reactivity varied in response to different emotional expressions, with greater responses
for disgust and sad compared with happy. These findings are consistent with earlier studies showing
that pupil dilation responses varied with the emotional content of a stimulus (Bradley et al., 2008;
Burley et al., 2017; Snowden et al., 2016). Furthermore, we found that pupillary responses were
increased for lower intensity expressions, likely a reflection of increased task difficulty and enhanced
cognitive effort (Sara, 2009). This effect was exaggerated with increasing Boldness scores, indicating
that the effects of Boldness on pupillary responses are dependent on stimulus intensity. In an earlier
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
20
study, we reported that Boldness traits were related to differences in the processing of emotional
facial expressions (Gillespie et al., 2017), and a recent study has highlighted an association of CU
traits with fear intensity-modulated amygdala responses (Meffert et al., 2018). Future research should
clarify the association of distinct psychopathic traits with pupillary responses that are modulated by
the emotional intensity of the stimulus. Contrast differences between the moderate and high intensity
expressions may also have affected responses in these conditions.
Crucially, we also found that violent offenders’ pupil dilation responses were associated with
levels of Meanness, and that this effect was pervasive across different expressions. Our results are the
first to show a relationship between pupil reactivity and callous psychopathic traits, and are consistent
with previously reported differences in autonomic reactivity in relation to callousness (Fanti, 2018;
Kyranides et al., 2017). Although Meanness was related to lower accuracy for fearful expressions
only, reductions in the pupil dilation response were observed more generally, for expressions of fear,
happy, and sad. Our findings for pupil reactivity are consistent with more pervasive emotional and
autonomic impairments in psychopathy, while results for accuracy favour an integrated emotions
perspective (Blair, 2013). Our findings mirror those of a systematic review by Brook et al. (2013),
which showed that findings from face-morph paradigms tend to favour an integrated emotions
perspective, while studies that found reduced autonomic reactivity tend to favour a more general
deficit in emotion processing. An additional analysis predicting Meanness from accuracy and pupil
reactivity to fear face affect showed that when entered simultaneously in to the model, only pupil
reactivity was a significant predictor of Meanness, suggesting that these effects may be overlapping.
This pattern of results suggests that fear recognition may rely more heavily on autonomic responses
driven by sub-cortical structures, while recognition of other emotions can be achieved by different
mechanisms.
To better place our findings in an overall framework of brain processes in psychopathy, it is
important to consider the neural circuits underlying changes in pupil diameter. Although the pupillary
response is thought to reflect activity in the LC (Joshi et al., 2016; Murphy et al., 2014), no known
anatomical pathways allow for a direct influence of LC on the size of the pupil (Nieuwenhuis et al.,
2011). Instead, it is thought that the LC and the SNS are activated in parallel, with the rostral
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
21
ventrolateral medulla representing a source of common input. While activation of the LC leads to
noradrenergic release into the neocortex (Corbetta et al., 2008; Coull et al., 1999; Sara, 2009),
activation of the SNS causes direct activation of the pupil dilator muscle. Further, recent evidence
suggests that noradrenaline improves sensory responses, and correlates with orienting toward
behaviorally relevant stimuli (Gelbard-Sagiv, Magidov, Sharon, Hendler, & Nir, 2018). Thus, the
pupil dilation response represents a novel avenue of enquiry for understanding attention-emotion
interactions in psychopathy. Our results suggest that impaired functioning of the LC-noradrenaline
circuit may represent a mechanism for the callousness features of psychopathy.
Strengths, Limitations, and Future Directions
Our results are subject to some limitations. First, the present study was limited to the
perception of emotion from faces, and future work should employ emotional vocalizations and bodily
poses, and unconditioned fear stimuli (e.g., snakes). Further, the facial expression stimuli were static,
and although morphing procedures were used to create expressions of varying intensity, it would be
interesting to examine these effects for more dynamic facial stimuli. Second, our sample was of a
modest size and largely limited to white Caucasian participants. Future studies should seek to
replicate our effects cross-culturally, as well as with female and developmental samples, and to
examine the role of potential moderating factors, including general mental ability (Olderbak et al.,
2018). Third, although the TriPM includes a Disinhibition subscale, this does not provide a direct
measure of antisocial behavior, and the scoring of this inventory does not take in to account official
records. Nonetheless, it is promising that we found a positive correlation of scores on the Meanness
and Disinhibition subscales with total number of previous convictions for violence, and the
relationship of Meanness with fear accuracy and pupil reactivity remained unchanged after controlling
for previous convictions for violence. Strengths of this study included the dimensional approach to the
assessment of psychopathy, and the measurement of negative emotionality (State and Trait anxiety).
Analyses presented in Supplemental Materials 2 showed that State anxiety was negatively related to
accuracy for fear. There were, however, no associations of either State or Trait anxiety with pupil
reactivity. Earlier findings have shown that levels of anxiety can be used to specify discrete variants
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
22
of psychopathy (Hicks & Patrick, 2006; Kimonis et al., 2012), and so it is important that future studies
examine how the pupillary response varies in these variants.
Conclusions
We found that the trait dimension of callousness was associated with impaired fear
recognition, and reduced pupil reactivity to varied emotional expressions in a sample of convicted
violent offenders. Conversely, although Boldness was associated with pupil reactivity as a function of
emotion intensity, we found little evidence that either Boldness or Disinhibition are related to face
affect processing or autonomic responses. Our findings support the use of pupillometry as a measure
of autonomic functioning for use with clinical and forensic samples. With a growing evidence base
detailing the neural circuits underlying the pupil dilation response, pupillometry can help to inform
understanding of attention-emotion interactions in psychopathy – and other psychopathologies – and
may be revealing about the role of the LC-noradrenaline circuit.
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
23
References
Adolphs, R., & Tranel, D. (2004). Impaired judgments of sadness but not happiness following
bilateral amygdala damage. Journal of Cognitive Neuroscience, 16(3), 453-462.
doi:10.1162/089892904322926782
Armstrong, T. A., Keller, S., Franklin, T. W., & Macmillan, S. N. (2009). Low resting heart rate and
antisocial behavior: A brief review of evidence and preliminary results from a new test.
Criminal Justice and Behavior, 36(11), 1125-1140. doi:10.1177/0093854809342855
Arnett, P. A. (1997). Autonomic responsivity in psychopaths: A critical review and theoretical
proposal. Clinical Psychology Review, 17(8), 903-936.
Arnett, P. A., Howland, E. W., Smith, S. S., & Newman, J. P. (1993). Autonomic responsivity during
passive avoidance in incarcerated psychopaths. Personality and Individual Differences, 14(1),
173-184.
Attard-Johnson, J., Ó Ciardha, C., & Bindemann, M. (2018). Comparing methods for the analysis of
pupillary response. Behavior Research Methods. doi:10.3758/s13428-018-1108-6
Benning, S. D., Patrick, C. J., & Iacono, W. G. (2005). Psychopathy, startle blink modulation, and
electrodermal reactivity in twin men. Psychophysiology, 42(6), 753-762. doi:10.1111/j.1469-
8986.2005.00353.x
Blair, R. J. R. (2013). The neurobiology of psychopathic traits in youths. Nature Reviews
Neuroscience, 14(11), 786-799. doi:10.1038/nrn3577
Blair, R. J. R., Leibenluft, E., & Pine, D. S. (2014). Conduct disorder and callous-unemotional traits
in youth. New England Journal of Medicine, 371(23), 2207-2216.
doi:10.1056/NEJMra1315612
Bradley, M. M., Miccoli, L., Escrig, M. A., & Lang, P. J. (2008). The pupil as a measure of emotional
arousal and autonomic activation. Psychophysiology, 45(4), 602-607. doi:10.1111/j.1469-
8986.2008.00654.x
Brislin, S. J., Yancey, J. R., Perkins, E. R., Palumbo, I. M., Drislane, L. E., Salekin, R. T., . . . Patrick,
C. J. (2018). Callousness and affective face processing in adults: Behavioral and brain-
potential indicators. Personality Disorders-Theory Research and Treatment, 9(2), 122-132.
doi:10.1037/per0000235
Brook, M., Brieman, C. L., & Kosson, D. S. (2013). Emotion processing in Psychopathy Checklist -
assessed psychopathy: A review of the literature. Clinical Psychology Review, 33(8), 979-
995. doi:10.1016/j.cpr.2013.07.008
Brook, M., & Kosson, D. S. (2013). Impaired cognitive empathy in criminal psychopathy: Evidence
from a laboratory measure of empathic accuracy. Journal of Abnormal Psychology, 122(1),
156-166. doi:10.1037/a0030261
Burley, D. T., Gray, N. S., & Snowden, R. J. (2017). As far as the eye can see: Relationship between
psychopathic traits and pupil response to affective stimuli. Plos One, 12(1).
doi:10.1371/journal.pone.0167436
Calder, A. J., Young, A. W., Rowland, D., Perrett, D. I., Hodges, J. R., & Etcoff, N. L. (1996). Facial
emotion recognition after bilateral amygdala damage: Differentially severe impairment of
fear. Cognitive Neuropsychology, 13(5), 699-745. doi:10.1080/026432996381890
Cooke, D. J., & Michie, C. (2001). Refining the construct of psychopathy: Towards a hierarchical
model. Psychological Assessment, 13(2), 171-188. doi:10.1037//1040-3590.13.2.171
Corbetta, M., Patel, G., & Shulman, G. L. (2008). The reorienting system of the human brain: From
environment to theory of mind. Neuron, 58(3), 306-324. doi:10.1016/j.neuron.2008.04.017
Coull, J. T., Buchel, C., Friston, K. J., & Frith, C. D. (1999). Noradrenergically mediated plasticity in
a human attentional neuronal network. Neuroimage, 10(6), 705-715. doi:DOI
10.1006/nimg.1999.0513
Dargis, M., Wolf, R. C., & Koenigs, M. (2018). Psychopathic traits are associated with reduced
fixations to the eye region of fearful faces. Journal of Abnormal Psychology, 127(1), 43-50.
doi:10.1037/abn0000322
Dawel, A., O'Kearney, R., McKone, E., & Palermo, R. (2012). Not just fear and sadness: Meta-
analytic evidence of pervasive emotion recognition deficits for facial and vocal expressions in
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
24
psychopathy. Neuroscience and Biobehavioral Reviews, 36(10), 2288-2304.
doi:10.1016/j.neubiorev.2012.08.006
De Brito, S. A., & Mitchell, I. J. (2018). The neurobiological underpinnings of psychopathy. The
Wiley Blackwell Handbook of Forensic Neuroscience, 1, 189-228.
Dindo, L., & Fowles, D. (2011). Dual temperamental risk factors for psychopathic personality:
evidence from self-report and skin conductance. Journal of personality and social
psychology, 100(3), 557-566. doi:10.1037/a0021848
Drislane, L. E., Patrick, C. J., & Arsal, G. (2014). Clarifying the content coverage of differing
psychopathy inventories through reference to the Triarchic Psychopathy Measure.
Psychological Assessment, 26(2), 350-362. doi:10.1037/a0035152
Fanti, K. A. (2018). Understanding heterogeneity in conduct disorder: A review of
psychophysiological studies. Neuroscience and Biobehavioral Reviews, 91, 4-20.
doi:10.1016/j.neubiorev.2016.09.022
Gelbard-Sagiv, H., Magidov, E., Sharon, H., Hendler, T., & Nir, Y. (2018). Noradrenaline modulates
visual perception and late visually evoked activity. Current Biology, 28(14), 2239-2249.
doi:10.1016/j.cub.2018.05.051
Gillespie, S. M., Mitchell, I. J., Satherley, R. M., Beech, A. R., & Rotshtein, P. (2015). Relations of
distinct psychopathic personality traits with anxiety and fear: Findings from offenders and
non-offenders. Plos One, 10(11), e0143120. doi:10.1371/journal.pone.0143120
Gillespie, S. M., Rotshtein, P., Beech, A. R., & Mitchell, I. J. (2017). Boldness psychopathic traits
predict reduced gaze toward fearful eyes in men with a history of violence. Biological
Psychology, 128, 29-38. doi:10.1016/j.biopsycho.2017.07.003
Gillespie, S. M., Rotshtein, P., Satherley, R. M., Beech, A. R., & Mitchell, I. J. (2015). Emotional
expression recognition and attribution bias among sexual and violent offenders: a signal
detection analysis. Frontiers in Psychology, 6(595). doi:10.3389/fpsyg.2015.00595
Gillespie, S. M., Rotshtein, P., Wells, L. J., Beech, A. R., & Mitchell, I. J. (2015). Psychopathic traits
are associated with reduced attention to the eyes of emotional faces among adult male non-
offenders. Frontiers in Human Neuroscience, 9(552). doi:10.3389/fnhum.2015.00552
Hare, R. D. (2003). Manual for the revised psychopathy checklist. In. Toronto, ON, Canada: Multi-
Health Systems.
Harris, G. T., Rice, M. E., & Cormier, C. A. (2002). Prospective replication of the Violence Risk
Appraisal Guide in predicting violent recidivism among forensic patients. Law and Human
Behavior, 26(4), 377-394. doi:10.1023/A:1016347320889
Hastings, M. E., Tangney, J. P., & Stuewig, J. (2008). Psychopathy and identification of facial
expressions of emotion. Personality and Individual Differences, 44(7), 1474-1483.
doi:10.1016/j.paid.2008.01.004
Hicks, B. M., & Patrick, C. J. (2006). Psychopathy and negative emotionality: Analyses of suppressor
effects reveal distinct relations with emotional distress, fearfulness, and anger-hostility.
Journal of Abnormal Psychology, 115(2), 276-287. doi:10.1037/0021-843x.115.2.276
Igoumenou, A., Harmer, C. J., Yang, M., Coid, J. W., & Rogers, R. D. (2017). Faces and facets: The
variability of emotion recognition in psychopathy reflects its affective and antisocial features.
Journal of Abnormal Psychology, 126(8), 1066-1076. doi:10.1037/abn0000293
Ishikawa, S. S., Raine, A., Lencz, T., Bihrle, S., & Lacasse, L. (2001). Autonomic stress reactivity
and executive functions in successful and unsuccessful criminal psychopaths from the
community. Journal of Abnormal Psychology, 110(3), 423-432. doi:10.1037//0021-
843x.110.3.423
Jones, A. P., Laurens, K. R., Herba, C. M., Barker, G. J., & Viding, E. (2009). Amygdala hypoactivity
to fearful faces in boys with conduct problems and callous-unemotional traits. American
Journal of Psychiatry, 166(1), 95-102. doi:10.1176/appi.ajp.2008.07071050
Joshi, S., Li, Y., Kalwani, R. M., & Gold, J. I. (2016). Relationships between pupil diameter and
neuronal activity in the locus coeruleus, colliculi, and cingulate cortex. Neuron, 89(1), 221-
234. doi:10.1016/j.neuron.2015.11.028
Kimonis, E. R., Branch, J., Hagman, B., Graham, N., & Miller, C. (2013). The psychometric
properties of the Inventory of Callous-Unemotional Traits in an undergraduate sample.
Psychological Assessment, 25(1), 84-93. doi:10.1037/a0029024
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
25
Kimonis, E. R., Frick, P. J., Cauffman, E., Goldweber, A., & Skeem, J. (2012). Primary and
secondary variants of juvenile psychopathy differ in emotional processing. Development and
Psychopathology, 24(3), 1091-1103. doi:10.1017/S0954579412000557
Kyranides, M. N., Fanti, K. A., Sikki, M., & Patrick, C. J. (2017). Triarchic dimensions of
psychopathy in young adulthood: Associations with clinical and physiological measures after
accounting for adolescent psychopathic traits. Personality Disorders-Theory Research and
Treatment, 8(2), 140-149. doi:10.1037/per0000193
Lilienfeld, S. O., & Andrews, B. P. (1996). Development and preliminary validation of a self-report
measure of psychopathic personality traits in noncriminal populations. Journal of Personality
Assessment, 66(3), 488-524. doi:10.1207/s15327752jpa6603_3
Lilienfeld, S. O., & Widows, M. (2005). Professional manual for the Psychopathic Personality
Inventory-Revised (PPI-R). Lutz, FL: Psychological Assessment Resources.
Meffert, H., Thornton, L. C., Tyler, P. M., Botkin, M. L., Erway, A. K., Kolli, V., . . . Blair, R. J. R.
(2018). Moderation of prior exposure to trauma on the inverse relationship between callous-
unemotional traits and amygdala responses to fearful expressions: an exploratory study.
Psychological Medicine, 48(15), 2541-2549. doi:10.1017/S0033291718000156
Moul, C., Killcross, S., & Dadds, M. R. (2012). A model of differential amygdala activation in
psychopathy. Psychological Review, 119(4), 789-806. doi:10.1037/a0029342
Murphy, P. R., O'Connell, R. G., O'Sullivan, M., Robertson, I. H., & Balsters, J. H. (2014). Pupil
diameter covaries with BOLD activity in human locus coeruleus. Human Brain Mapping,
35(8), 4140-4154. doi:10.1002/hbm.22466
Nieuwenhuis, S., De Geus, E. J., & Aston‐Jones, G. (2011). The anatomical and functional
relationship between the P3 and autonomic components of the orienting response.
Psychophysiology, 48(2), 162-175.
Olderbak, S. G., Mokros, A., Nitschke, J., Habermeyer, E., & Wilhelm, O. (2018). Psychopathic men:
Deficits in general mental ability, not emotion perception. Journal of Abnormal Psychology,
127(3), 294-304. doi:10.1037/abn0000340
Pastor, M. C., Molto, J., Vila, J., & Lang, P. J. (2003). Startle reflex modulation, affective ratings and
autonomic reactivity in incarcerated Spanish psychopaths. Psychophysiology, 40(6), 934-938.
doi:10.1111/1469-8986.00111
Patrick, C. J. (2008). Psychophysiological correlates of aggression and violence: an integrative
review. Philosophical Transactions of the Royal Society of London B: Biological Sciences,
363(1503), 2543-2555. doi:10.1098/rstb.2008.0028
Patrick, C. J., Bradley, M. M., & Lang, P. J. (1993). Emotion in the criminal psychopath - startle
reflex modulation. Journal of Abnormal Psychology, 102(1), 82-92. doi:Doi 10.1037//0021-
843x.102.1.82
Patrick, C. J., & Drislane, L. E. (2015). Triarchic model of psychopathy: Origins, operationalizations,
and observed linkages with personality and general psychopathology. Journal of Personality,
83(6), 627-643. doi:10.1111/jopy.12119
Patrick, C. J., Fowles, D. C., & Krueger, R. F. (2009). Triarchic conceptualization of psychopathy:
Developmental origins of disinhibition, boldness, and meanness. Development and
Psychopathology, 21(3), 913-938. doi:10.1017/S0954579409000492
Pham, T. H., Philippot, P., & Rime, B. (2000). Subjective and autonomic responses to emotion
induction in psychopaths. Encephale, 26(1), 45-51.
Rieger, G., Cash, B. M., Merrill, S. M., Jones-Rounds, J., Dharmavaram, S. M., & Savin-Williams, R.
C. (2015). Sexual arousal: The correspondence of eyes and genitals. Biological Psychology,
104, 56-64. doi:10.1016/j.biopsycho.2014.11.009
Rothemund, Y., Ziegler, S., Hermann, C., Gruesser, S. M., Foell, J., Patrick, C. J., & Flor, H. (2012).
Fear conditioning in psychopaths: Event-related potentials and peripheral measures.
Biological Psychology, 90(1), 50-59. doi:10.1016/j.biopsycho.2012.02.011
Sara, S. J. (2009). The locus coeruleus and noradrenergic modulation of cognition. Nature Reviews
Neuroscience, 10(3), 211-223. doi:10.1038/nrn2573
Schrammel, F., Pannasch, S., Graupner, S. T., Mojzisch, A., & Velichkovsky, B. M. (2009). Virtual
friend or threat? The effects of facial expression and gaze interaction on psychophysiological
Running Head: PSYCHOPATHIC TRAITS AND PUPIL REACTIVITY
26
responses and emotional experience. Psychophysiology, 46(5), 922-931. doi:10.1111/j.1469-
8986.2009.00831.x
Schurgin, M. W., Nelson, J., Iida, S., Ohira, H., Franconeri, S. L., & Franconeri, S. L. (2014). Eye
movements during emotion recognition in faces. Journal of Vision, 14(13).
doi:10.1167/14.13.14
Skeem, J. L., Polaschek, D. L. L., Patrick, C. J., & Lilienfeld, S. O. (2011). Psychopathic personality:
Bridging the gap between scientific evidence and public policy. Psychological Science in the
Public Interest, 12(3), 95-162. doi:10.1177/1529100611426706
Snowden, R. J., O'Farrell, K. R., Burley, D., Erichsen, J. T., Newton, N. V., & Gray, N. S. (2016).
The pupil's response to affective pictures: Role of image duration, habituation, and viewing
mode. Psychophysiology, 53(8), 1217-1223. doi:10.1111/psyp.12668
Spielberger, C. D. (1983). Manual for the State-Trait Anxiety Inventory STAI (Form Y). Palo Alto:
CA: Consulting Psychologists Press.
Tottenham, N., Tanaka, J. W., Leon, A. C., McCarry, T., Nurse, M., Hare, T. A., . . . Nelson, C.
(2009). The NimStim set of facial expressions: Judgments from untrained research
participants. Psychiatry Research, 168(3), 242-249. doi:10.1016/j.psychres.2008.05.006
Vaidyanathan, U., Hall, J. R., Patrick, C. J., & Bernat, E. M. (2011). Clarifying the role of defensive
reactivity deficits in psychopathy and antisocial personality using startle reflex methodology.
Journal of Abnormal Psychology, 120(1), 253-258. doi:10.1037/a0021224
van Dongen, J. D. M., Drislane, L. E., Nijman, H., Soe-Agnie, S. E., & van Marle, H. J. C. (2017).
Further evidence for reliability and validity of the Triarchic Psychopathy Measure in a
forensic sample and a community sample. Journal of Psychopathology Behavioral
Assessment, 39(1), 58-66. doi:10.1007/s10862-016-9567-5
Vanman, E. J., Mejia, V. Y., Dawson, M. E., Schell, A. M., & Raine, A. (2003). Modification of the
startle reflex in a community sample: do one or two dimensions of psychopathy underlie
emotional processing? Personality and Individual Differences, 35(8), 2007-2021.
doi:10.1016/S0191-8869(03)00052-7
Verona, E., Patrick, C. J., Curtin, J. J., Bradley, M. M., & Lang, P. J. (2004). Psychopathy and
physiological response to emotionally evocative sounds. Journal of Abnormal Psychology,
113(1), 99-108. doi:10.1037/0021-843X.113.1.99
Viding, E., Sebastian, C. L., Dadds, M. R., Lockwood, P. L., Cecil, C. A. M., De Brito, S. A., &
McCrory, E. J. (2012). Amygdala response to preattentive masked fear in children with
conduct problems: The role of callous-unemotional traits. American Journal of Psychiatry,
169(10), 1109-1116. doi:10.1176/appi.ajp.2012.12020191
Wells, L. J., Gillespie, S. M., & Rotshtein, P. (2016). Identification of emotional facial expressions:
Effects of expression, intensity, and sex on eye gaze. Plos One, 11(12), e0168307.
doi:10.1371/journal.pone.0168307
White, S. F., Marsh, A. A., Fowler, K. A., Schechter, J. C., Adalio, C., Pope, K., . . . Blair, R. J. R.
(2012). Reduced amygdala response in youths with disruptive behavior disorders and
psychopathic traits: Decreased emotional response versus increased top-down attention to
nonemotional features. American Journal of Psychiatry, 169(7), 750-758.
doi:10.1176/appi.ajp.2012.11081270
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