J Psychiatry Neurosci 2013; 38(4): E13-E20
Inti A. Brazil, MSc; Joseph H.R. Maes, PhD; Inge Scheper, MSc; Berend H. Bulten, PhD; Roy P.C. Kessels, PhD; Robbert Jan Verkes, MD, PhD; Ellen R.A. de Bruijn, PhD
Brazil, Maes, Kessels — Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, The Netherlands; Brazil, Bulten, Verkes — Pompestichting, Nijmegen, The Netherlands; Scheper, Verkes — Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Psychiatry, Nijmegen, The Netherlands; Kessels — Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Medical Psychology and Geriatrics, Nijmegen, The Netherlands; de Bruijn — Leiden University, Department of Clinical, Health, and Neuropsychology, Leiden Institute for Brain and Cognition, Leiden, The Netherlands
Background: Psychopathy is a severe personality disorder that has been linked to impaired behavioural adaptation during reinforcement learning. Recent electrophysiological studies have suggested that psychopathy is related to impairments in intentionally using information relevant for adapting behaviour, whereas these impairments remain absent for behaviour relying on automatic use of information. We sought to investigate whether previously found impairments in response reversal in individuals with psychopathy also follow this dichotomy. We expected response reversal to be intact when the automatic use of information was facilitated. In contrast, we expected impaired response reversal when intentional use of information was required.
Methods: We included offenders with psychopathy and matched healthy controls in 2 experiments with a probabilistic cued go/no-go reaction time task. The task implicated the learning and reversal of 2 predictive contingencies. In experiment 1, participants were not informed about the inclusion of a learning component, thus making cue-dependent learning automatic/ incidental. In experiment 2, the instructions required participants to actively monitor and learn predictive relationships, giving learning a controlled/intentional nature.
Results: While there were no significant group differences in acquisition learning in either experiment, the results revealed impaired response reversal in offenders with psychopathy when controlled learning was facilitated. Interestingly, this impairment was absent when automatic learning was predominant.
Limitations: Possible limitations are the use of a nonforensic control group and of self-report measures for drug use.
Conclusion: Response reversal deficits in individuals with psychopathy are modulated by the context provided by the instructions, according to the distinction between automatic and controlled processing in these individuals.
Submitted Aug. 2, 2012; Revised Jan. 17, 28, 2013; Accepted Feb. 4, 2013.
Acknowledgements: I.A. Brazil, E.R.A. de Bruijn and R.P.C. Kessels were supported by Mosaic (240-00-244), VENI (451-07-022) and VIDI (452-08-005) grants, respectively, from the Netherlands Organization for Scientific Research (NWO).
Competing interests: As above for I.A. Brazil, E.R.A. de Bruijn and R.P.C. Kessels. Otherwise, none declared.
Contributors: I.A. Brazil, B.H. Bulten, R.J. Verkes and E.R.A. de Bruijn designed the study. I.A Brazil and I. Scheper acquired and analyzed the data, which J.H.R. Maes, R.P.C. Kessels and E.R.A. de Bruijn also analyzed. I.A. Brazil, J.H.R. Maes, I. Scheper and E.R.A. de Bruijn wrote the article. I.A. Brazil, J.H.R. Maes, B.H. Bulten, R.P.C. Kessels, R.J. Verkes and E.R.A. de Bruijn reviewed the article. All authors approved its publication.
Correspondence to: I.A. Brazil, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands; I.Brazil@donders.ru.nl