Integration of emotion and cognition in patients with psychopathy

Psychopathy is a personality disorder associated with emotional characteristics like impulsivity, manipulativeness, affective shallowness, and absence of remorse or empathy. The impaired emotional responsiveness is considered to be the hallmark of the disorder. There are two theories that attempt to explain the emotional dysfunction and the poor socialization in psychopathy: (1) the low-fear model and (2) the inhibition of violence model. Both approaches are supported by several studies. Studies using aversive conditioning or the startle modulation underline the severe difficulties in processing negative stimuli in psychopaths. Studies that explore the processing of emotional expressions show a deficit of psychopathic individuals for processing sad or fearful facial expressions or vocal affect. In the cognitive domain, psychopaths show performance deficits in the interpretation of the motivational significance of stimuli. Studies investigating the impact of emotions on cognitive processes show that in psychopaths in contrast to healthy controls negative emotions drain no resources from a cognitive task. It is suggested that dysfunctions in the frontal cortex, especially the orbitofrontal cortex, the cingulate cortex and the amygdala are associated with the emotional and cognitive impairments.