Psychopathy and depression: mutually exclusive constructs?

https://doi.org/10.1016/S0005-7916(99)00022-1Get rights and content

Abstract

The present study was designed to evaluate the nature of the differences between psychopathy and depression. Based on previously articulated theoretical models, we hypothesized an inverse relationship between the two clinical constructs. Archival data were retrieved from 231 outpatient clients who had completed measures of depression and psychopathy. Correlational analyses and ANOVA's based on extreme groups supported the hypothesis. Implications for assessment, treatment, and research methodology are discussed.

Introduction

The present research was designed in the context of evaluating the hypothesis that depression and psychopathy represent opposing anchors of cognitive/behavioral, affective, and biological dimensions. Previous theoretical models provide a tentative, but logically consistent, rationale. The theoretical and empirical development of the relevant biological dimension is found in the work of Jeffrey Gray, 1976, Gray, 1982a, Gray, 1982b and Donald Fowles, 1980, Fowles, 1988. In researching the effects of anxiety-reducing drugs on learning, Gray (1976) described a neural model composed of two mutually antagonistic systems which he proposes determine the activation and inhibition of behavior. The behavioral inhibition system (BIS) is responsible for the inhibition of behavior in punishment and extinction situations. The behavioral activation system (BAS) responds to incentives and rewards and mediates active escape and avoidance. Gray's early work focused on the effects of anti-anxiety drugs on learning. Since he viewed the BIS as the neural substrate of anxiety, Gray's initial theoretical formulations emphasized the BIS rather than the relationship between the BIS and the BAS.

Relating his, essentially biological, model to personality, Gray (1982a) noted parallels with Eysenck's introversion and neuroticism dimensions. Tellegen (1985) reviewed these arguments and concluded that the BIS and BAS more closely correspond to his trait factors of Positive Emotionality and Negative Emotionality. State measures of these traits have been developed and subjected to rigorous psychometric criteria (Watson, Clark & Tellegen, 1988). Subsequent research has consistently supported the view that anxiety is associated with high levels of Negative Affect (NA) but is unrelated to Positive Affect (PA) while depression is associated with both high levels of NA and low levels of PA (Gannon, Vaux, Rhodes & Luchetta, 1992; Watson, Clark & Carey, 1988). Incorporating Tellegen's argument that the BAS is the neural substrate for PA and the BIS the neural substrate of NA, depression may then be described as an overactive BIS combined with an underactive BAS. Fowles (1988) reached a conclusion similar to that of Tellegen but with a somewhat different emphasis when he described an inactive BAS as a primary etiological factor in depression but acceded that there may be an increase in aversive motivation (BIS) as well.

Also inspired by Gray's work, Fowles, 1980, Fowles, 1988 developed a model of psychopathy that integrated physiological and behavioral phenomena. Fowles suggested that various clinical features of psychopathy — the lack of anxiety when faced with threatening stimuli, an inability to inhibit behavior when faced with punishment or the absence of reward, an inability to learn from previously punished or non-rewarded situations, and a lower tolerance for alcohol — may be due to a deficient BIS. Although implied in Gray's work, Fowles made explicit the reciprocal antagonism between the two motivational systems. He suggested that the diminished activity of the BIS, said to characterize psychopathy, upset the BAS-BIS balance allowing the BAS fuller expression; disinhibition combined with enhanced reward-seeking is consistent with the clinical picture of the psychopath as one who, not only lacks anxiety, guilt, and remorse, but also one who actively, and without conscience, seeks excitement and pleasure.

Various research findings in the areas of psychophysiology and learning are consistent with this model of psychopathy. For example, psychopaths, compared to normal samples, have been found to experience lower levels of anxiety as measured by skin conductance in anticipation of aversive stimuli in laboratory situations (Hare, Frazelle & Cox, 1978; Hare & Craigen, 1974; Tharp, Maltzman, Syndulko & Ziskind, 1980). Lidberg, Levander, Schalling and Lidberg (1978) noted similar physiological differences in urinary catecholamines between psychopaths and nonpsychopaths awaiting trial. Newman and colleagues (Newman, Patterson, Howland & Nichols, 1990) have reported psychopaths to be poor learners in passive-avoidance tasks which is consistent with a deficient BIS. Newman (1987) suggests this learning deficit may be limited to situations that involve both reward and punishment which is consistent with the additional involvement of an enhanced BAS.

On a cognitive/behavioral level, depressed persons may experience slowed thinking and activity and difficulty making decisions while psychopaths are described as reckless, careless, and impulsive. Depressed persons are characterized as having excessive feelings of guilt, remorse, and empathy while psychopaths are seen as lacking in empathy and remorse and as experiencing shallow affect.

The integration of Gray's biological motivation systems, Fowles’ model of psychopathy, and Tellegen's and Watson's emotionality and affect models provide the theoretical justification for proposing that psychopathy and depression may be conceptualized as representing mutually exclusive syndromes due to their occupying opposing extremes on common dimensions. The present study represents an initial exploration of this hypothesis.

Section snippets

Participants

Archival data from an outpatient clinical center associated with a large midwestern university were utilized in the present study. The clinic serves students, faculty, and staff at the university as well as persons from the community. The data consisted of all outpatient intake evaluations completed between June, 1988 and December, 1991 which contained completed and valid scores on the two inventories described below. Both inventories were given routinely to all new outpatients. This retrieval

Results

The means and standard deviations of all dependent variables are presented in Table 1. The relationship between depression and psychopathy was examined in two ways. First, correlation coefficients (N=231) were computed. The correlation between the Antisocial scale and the Dysthymia scale was (r=−0.21, p<0.01), between the Antisocial scale and the Psychotic Depression scale (r=−0.01, NS), and between the Antisocial scale and the BDI (r=−0.13, p<0.05).

An alternative set of analyses was performed

Discussion

Based on previous theoretical and empirical research by Gray, 1976, Gray, 1982aFowles, 1980, Fowles, 1988Tellegen (1985), and Watson, Clark and Carey (1988), we hypothesized that depression and psychopathy would bear an inverse relationship to one another. We evaluated this hypothesis in an outpatient sample. The correlational analyses and the ANOVAS comparing extreme groups supported this hypothesis. One might question the clinical significance of these results since the large sample size

Acknowledgements

The authors would like to thank Alan Vaux and Ron Schmeck for suggestions on previous drafts of this manuscript. A portion of this research served as the master's thesis for the first author under the direction of the second author.

References (28)

  • Gray, J. A. (1982b). The neuropsychology of anxiety. New York: Oxford University...
  • R. Hare

    Comparison of procedures for the assessment of psychopathy

    Journal of Consulting and Clinical Psychology

    (1985)
  • R.D. Hare et al.

    Psychopathy and physiological activity in a mixed-motive game situation

    Psychophysiology

    (1974)
  • R.D. Hare et al.

    Psychopathy and physiological responses to threat of an aversive stimulus

    Psychophysiology

    (1978)
  • Cited by (34)

    • Callous-Unemotional Traits as an Intervention Target and Moderator of Parent–Child Interaction Therapy—Emotion Development Treatment for Preschool Depression and Conduct Problems

      2021, Journal of the American Academy of Child and Adolescent Psychiatry
      Citation Excerpt :

      In fact, compared with the large literature on CU traits and conduct problems, fewer studies have examined relations between CU traits and internalizing problems. The dearth of research on this topic may in part be explained by the theory that psychopathy is characterized by fearlessness and shallow affect and is therefore incompatible with anxiety and depression.25,26 Despite this perspective, empirical evidence increasingly supports the existence of 2 CU subtypes—primary CU, marked by low levels of anxiety, and secondary CU, marked by high levels of anxiety.27,28

    • Clarifying the association between psychopathy dimensions and internalizing symptoms in two community samples: The role of general personality

      2019, Personality and Individual Differences
      Citation Excerpt :

      Traditionally, psychopathy and internalizing disorders have been regarded as negatively correlated, or even “mutually exclusive” (Lovelace & Gannon, 1999, p. 171).

    • Interpersonal Guilt and the Dark Triad

      2015, Personality and Individual Differences
      Citation Excerpt :

      Second, as previously mentioned the present study found some surprising associations between Machiavellianism, psychopathy, and self-hate guilt. Previous researchers have found that self-hate guilt is highly correlated with depression and anxiety (Meehan, O’Connor, Berry, & Weiss, 1996; O’Connor, Berry, & Weiss, 1999), whereas traditionally Machiavellianism and psychopathy have not (Lovelace & Gannon, 1999; Skinner, 1982). As such, the positive association between these Dark Triad traits and self-hate guilt is particularly puzzling.

    • An inter-hemispheric imbalance in the psychopath's brain

      2011, Personality and Individual Differences
      Citation Excerpt :

      Thus, from a neurobiological perspective, it seems that psychopathy and depression reflect opposite patterns of imbalanced hemispheric interactions. A similar view was proposed by Lovelace and Gannon (1999) based on the BIS/BAS dichotomy, as depression manifests a strong BIS and a weak BAS, while psychopathy reflects a weak BIS and/or a strong BAS. A meta-analysis of five large population-representative samples (consisting of 23,557 participants) on the relationships among multiple mental disorders co-occurring in high frequencies have yielded a model of ‘internalizing disorders’ (mood and anxiety disorders) and ‘externalizing disorders’ (e.g., conduct disorder, antisocial personality disorder), predicting that depression and anxiety are likely to occur together, but not with antisocial personality disorder (Krueger & Markon, 2006).

    View all citing articles on Scopus
    View full text