Myth Busted: Psychopaths Do Feel Regret

Megan Brooks

November 30, 2016

New research discounts the widely held belief that psychopaths are incapable of feeling emotion and regret, and may point to a new direction in psychopathy research and treatment.

In a novel experiment, researchers from Yale University in New Haven, Connecticut, and Harvard University in Boston, Massachusetts, found that individuals in the community who scored high on a measure of psychopathy did experience regret when they made bad decisions. However, they did not use that experience to help them make better decisions in the future.

"One of the cardinal symptoms of psychopathy seems to be that they appear to lack remorse and regret. It's one of the items that we actually rate when we do clinical interviews with psychopathic individuals. But there really had never been a study that tried to operationalize that and look at it in a more controlled way," study investigator and Yale psychologist Arielle Baskin-Sommers, PhD, told Medscape Medical News.

The study was published online November 28 in the Proceedings of the National Academy of Sciences.

Paradigm Shift

The study included a community-based sample of 62 men aged 18 to 55 years who were "enriched for antisocial behavior," which included crime, drug use, gambling, impulsive behavior, and bullying. For their participation, they earned $10 per hour. The Self-Report Psychopathy–III scale was used to measure levels of psychopathy.

Prior incarcerations served as a marker of "real-world" antisocial behavior. The researchers measured affective responses to a regret-inducing "counterfactual decision-making paradigm."

Two key findings emerged, said Dr Baskin-Sommers.

"We showed that when psychopaths find out information and are asked to say how they feel about it, they are not incapable of expressing emotion. They actually rated their emotions more intensely, or as intensely, as individuals lower on psychopathy," she said. "But they didn't use that experience or information to inform future decisions. So though they might feel emotion strongly in the moment, it doesn't help adjust behavior moving forward," she said.

Diminished regret – the inability to learn from their past mistakes – was associated with a higher number of prior incarcerations.

"The most dominant paradigm, and the way most people think about psychopaths, is that they behave in very antisocial ways because they can't feel," coinvestigator Joshua Buckholtz, PhD, from Harvard, told Medscape Medical News. "But what this work shows is that perhaps it's not a deficit in the ability to generate feelings but rather an inability to appropriately use the information that they could extract from their environment to make better choices.

"This really shifts the focus in psychopathy from the idea that they are just these cold-blooded, emotionless individuals to people who may have normal emotional experiences or are capable of having normal emotional experiences, but they do bad things because the mechanisms that we use to make better choices, good decisions are broken in these folks," Dr Buckholtz said.

He emphasized that this study did not address therapeutic interventions.

"It's also foolhardy to make inferences about potential treatments from one study. Our hope is that this will point to a new direction in psychopathy research.

"Because the therapeutic options in psychopathy have been so impoverished up until this point, shedding light on a new set of deficits that haven't previously been looked at could prove useful down the line. But for today, no one is going to be basing any treatments off of this study," Dr Buckholtz said.

If psychopaths do possess a sense of regret, it might be possible to tap into that with existing therapies and perhaps reduce recidivism among psychopathic criminals, who make up a disproportionate percentage of repeat offenders, said Dr Baskin-Sommers.

"Since it's not something they absolutely lack ― it's not a capability issue ― it suggests it may be possible to intervene, maybe by trying to link their current experience with future behavior in several different clinical ways. Targeted cognitive training is one possibility," she said.

This research was supported in part by grants through the American Psychological Foundation, the American Psychology–Law Society, the Harry Frank Guggenheim Foundation, the Massachusetts General Hospital Center for Law, Brain, and Behavior, the Brain and Behavior Research Fund, and the Alfred P. Sloan Foundation. The authors have disclosed no relevant financial relationships.

Proc Natl Acad Sci. Published online November 28, 2016. Full text


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