Psychopathic callousness and perspective taking in pain processing: an ERP study.

Psychopathy is a multifaceted personality disorder characterized by distinct affective/interpersonal traits, including callousness-unemotionality/meanness, which are often considered the hallmarks of empathic deficits. It has been posited that the processing of others' pain could play an important role in empathy capabilities. This study aimed to investigate the influence of perspective taking on electrocortical responses during pain processing in relation to psychopathic callousness. The late positive potential (LPP) -a well-established electrophysiological indicator of sustained attention to motivationally significant stimuli- was measured while 100 female undergraduates viewed images depicting bodily injuries while adopting an imagine-self or an imagine-other perspective. Callousness factor scores -computed as regression-based component scores from EFA on three relevant self-report measures of this dimension- predicted reduced LPP amplitudes to pain pictures under the imagine-other (but not imagine-self) perspective, even after controlling for other LPP conditions. This result suggests that high-callous individuals exhibit diminished brain responsiveness to others' distress, potentially contributing to the empathic deficits observed in psychopathy. This finding highlights the usefulness of the LPP and perspective taking in studies on pain processing to refine our understanding of the low empathy characteristics of psychopathy in biobehavioral terms.

Attentional biases in abstinent patients with cocaine use disorder: rapid orienting or delayed disengagement?

Addiction-related attentional biases may play a central role in the development and maintenance of drug-seeking and drug-taking behaviors. However, evidence in cocaine dependence is limited and mixed. This study examined the time course and component processes of attentional biases for cocaine-related cues in a sample of 47 outpatients (38 men) with cocaine use disorder (CUD) with varying durations of current abstinence. Reaction times in a visual dot-probe task with two picture exposure durations -500 ms, to assess initial stages of attention, and 2,000 ms, to assess maintained attention- were recorded. We found faster responses to probes replacing cocaine-related vs. matched control pictures in the 500 ms but not in the 2,000 ms condition, indicative of early but not late attentional biases for cocaine cues in abstinent patients with CUD. Further comparisons with a neutral baseline revealed that it was not due to rapid orienting but to delayed disengagement from cocaine-related pictures, being this effect greater the longer the period of current abstinence. Consistent with the incentive-sensitization theory, these data suggest that cocaine-related stimuli maintain the capacity to hold spatial attention in abstinent patients with CUD, even after months of abstinence, highlighting the relevance of carrying out stimulus control to avoid relapses.

Low defensive cardiac reactivity as a physiological correlate of psychopathic fearlessness: Gender differences.

Affective/interpersonal features of psychopathy have been consistently associated with diverse psychophysiological indicators of low threat sensitivity, suggesting an underlying deficit in the reactivity of the brain's defensive motivational system. This study examined the Cardiac Defense Response (CDR) -a complex pattern of heart rate changes in response to an aversive, intense, and unexpected stimulus- and its second accelerative component (A2), as a new physiological indicator of the fearlessness trait component of psychopathy. The differential contribution of dispositional fearlessness, externalizing proneness, and coldheartedness to the CDR pattern elicited during a defense psychophysiological test was examined in a mixed-gender sample of 156 undergraduates (62% women) assessed by the Psychopathic Personality Inventory-Revised (PPI-R). Higher PPI-R Fearless Dominance scores were related to lower heart rate changes throughout the CDR in women, but not in men. Further analyses on scales conforming the fearless dominance factor revealed that the hypothesized reduced A2 was specifically related to higher PPI-R Fearlessness scores only in women. Our findings provide initial evidence for the utility of the A2 to better understand the physiological aspects of fearlessness tendencies and its potential distinct manifestations across genders.

Attention-affect interactions and triarchic psychopathy: New electrophysiological insights from the late positive potential.

One of the most prominent characteristics of psychopathy is a reduced processing of emotionally relevant information. However, it is still unclear how attentional mechanisms may modulate this deficit. The current study aimed to examine the impact of attentional focus on emotion processing in relation to the triarchic constructs of boldness, meanness, and disinhibition. Participants performed two tasks in which pleasant, neutral, and unpleasant framed pictures were presented. In the first task, participants were required to indicate the color of the frame (alternative-focus task), whereas in the second task they were instructed to indicate the emotional category of the image (affect-focus task). The Late Positive Potential (LPP) was used as an index of sustained engagement of attention to affective material. Confirming a successful task manipulation, we observed reduced LPP amplitudes, particularly for affective relevant material, in the alternative-focus task compared to the affect-focus task. Most interestingly, our results evidenced that trait meanness scores were associated with blunted elaborative processing of affective material (both appetitive and aversive) when this information was task-relevant (affect-focus task), but not when it was task-irrelevant (alternative-focus task). These findings indicate that high mean individuals are characterized by blunted elaborative processing of affective stimuli when their motivational relevance is determined in a top-down manner (i.e., when it is task-relevant). Our results highlight the need for further studying of the bottom-up and top-down dynamics of emotional attention in psychopathy.

Psychopathy and heart rate variability: A new physiological marker for the adaptive features of boldness.

The boldness disposition of the triarchic model of psychopathy is theorized to entail, aside from mal-adaptive proclivities (narcissism, fearless risk-taking), some adaptive features (e.g., immunity to stressful events, high self-esteem, and emotional resilience) that seem to predispose high boldness individuals to an effective emotional regulation in response to environmental demands. The high frequency band of heart rate variability -an index of parasympathetic cardiac vagal activity-is a well-validated physiological index of emotional self-regulation and mental health resilience. The aim of this study was to examine the unique predictive contributions of triarchic dispositions of boldness, meanness, and disinhibition on resting vagally mediated heart rate variability (vmHRV) in a sample of 241 undergraduates (60 men) assessed via the Triarchic Psychopathy Measure (TriPM; Patrick, 2010). A hierarchical regression analysis was conducted on vmHRV in which TriPM Boldness, Meanness, and Disinhibition scores were entered as predictors, along with gender, age, body mass index, mean resting heart rate, and respiratory activity. Results showed that only TriPM Boldness -but not Meanness or Disinhibition-scores significantly predicted vmHRV (positively), thus evidencing that adequate emotional self-regulation is one of the adaptive features encompassed by the boldness disposition. These findings encourage further use of vmHRV as a physiological marker of boldness and contribute to shedding light on the nomological network surrounding the construct of boldness in psychopathy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Latent variable modeling of item-based factor scales: Comment on Triarchic or septarchic?-Uncovering the Triarchic Psychopathy Measure's (TriPM) Structure, by Roy et al.

We critique Roy et al.'s (2020; this issue) approach to characterizing the item-level factor structure of the three scales of the Triarchic Psychopathy Measure (TriPM), in light of the manner in which the TriPM scales were developed, the purposes they were designed to serve, and the growing body of evidence supporting their construct validity. We focus on three major points: (1) The TriPM scales are item-based factor scales - i.e., item sets designed to index broad factors of larger multi-scale (parent) inventories; (2) item-level structural analysis can be useful for representing broad dimensions tapped by such scales, but it cannot be expected to provide an accurate picture of narrower subdimensions (facets) assessed by their parent inventories; and (3) it is critical to consider the nomological networks of the TriPM scales (and other triarchic scale measures) in appraising their effectiveness as operationalizations of the triarchic model constructs. We illustrate the first and second of these points by applying Roy et al.'s analytic approach to the trait scales of the NEO-FFI, which were developed to index broad personality dimensions of the multi-scale NEO-PI-R. We address the third point with reference to the growing body of literature supporting the construct validity of the TriPM scales and demonstrating their utility for advancing an integrative understanding of psychopathy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Electrocortical measures of performance monitoring from go/no-go and flanker tasks: Differential relations with trait dimensions of the triarchic model of psychopathy.

This study examined associations of performance-monitoring event-related potentials (ERPs) from go/no-go and flanker tasks with one another, and with psychopathy-related traits of disinhibition, meanness, and boldness. A task-dependent relationship was evident between the error-related negativity (ERN) and trait disinhibition, with high-disinhibited participants showing reduced no-go ERN but not flanker ERN. Disinhibition was also inversely related to variants of the P3 and the error positivity (Pe) from these two tasks. A factor analysis of the ERPs revealed two distinct factors, one reflecting shared variance among the P3 and Pe measures from the two tasks, and the other covariance among the N2 and ERN measures. Scores on the P3/Pe factor, but not the N2/ERN factor, were inversely related to disinhibition, and accounted for associations of this trait with variants of the P3 and Pe across tasks. The implication is that high trait disinhibition relates mainly to reductions in brain responses associated with later elaborative stages in the processing of motivationally significant events across different tasks. Importantly, no-go ERN predicted disinhibition scores beyond N2/ERN factor scores, indicating that high disinhibition is not generally related to diminished early preresponse conflict and error processing, but rather to processing impairments in conditions calling for inhibition of prepotent response tendencies.

Response perseveration and the triarchic model of psychopathy in an undergraduate sample.

This study aimed to extend previously reported links between distinctive configurations of traits in the psychopathic personality and maladaptive response perseveration, by examining performance in the Card Perseveration Task (CPT) within the framework of the triarchic model of psychopathy in a mixed-gender undergraduate sample. A computerized version of the CPT was administered to 222 undergraduates (142 women) assessed for triarchic psychopathy dimensions using the Triarchic Psychopathy Measure. Maladaptive response perseveration (more cards played and less money earned) was uniquely associated with trait boldness scores for both women and men. Moreover, analyses of response times following feedback indicated that poor performance on the CPT was related to lack of overall reflection. Further mediation analyses did not reveal significant effects of trait boldness on the response perseveration deficit through reflection times. Our results provide new evidence for the role of trait boldness in the failure to suspend reward-approach behavior in the face of increasing punishment contingencies, probably due to an absence of fear or insensitivity to punishment cues rather than to an unreflective response style. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Identity and expression processing during classical conditioning with faces.

In classical conditioning, conditioned responses (CRs) to aversively paired (CS+) relative to unpaired (CS-) face images are often interpreted in terms of the specific individual displayed in the CS + face image having adopted an aversive emotional connotation. This interpretation requires conditioning to rely on an association between CS + face identity and the occurrence of the aversive event (UCS). Here, we tested this requirement assuming that if an association between CS + face identity and UCS occurrence is established, CRs to originally conditioned face images should transfer to novel images of same-identity faces. Forty-eight participants underwent MultiCS conditioning with eight neutral faces as CSs and electric shock as UCS. Central, peripheral, evaluative, and behavioral CRs signaled successful emotional learning (as reported in Pastor et al., 2015). Behavioral and EEG responses of consecutive passive viewing showed enhanced reactions to novel angry and happy expressions of previously shocked CS + versus nonshocked CS- identities, indicating successful CR transfer within the dimension of face identity. Investigating the nature of CR transfer, EEG revealed an interaction of identity and expression information during face processing that followed emotional congruency (i.e., stronger reactions to congruent angry CS + and happy CS- vs. incongruent angry CS- and happy CS + compounds). While correlates of transfer appeared in late and midlatency time intervals, the congruency interaction became significant within the first 100 ms of face processing. Our results suggest conditioning to rely on an association of UCS occurrence with CS + identity and point to fast dynamic interrelations between identity and expression processing.

Deficient aversive-potentiated startle and the triarchic model of psychopathy: The role of boldness.

This study examined the contribution of the phenotypic domains of boldness, meanness, and disinhibition of the triarchic conceptualization of psychopathy (Patrick, Fowles, & Krueger, 2009) to deficient aversive-potentiated startle in a mixed-gender sample of 180 undergraduates. Eyeblink responses to noise probes were recorded during a passive picture-viewing task (erotica, neutral, threat, and mutilation). Deficient threat vs. neutral potentiation was uniquely related to increased boldness scores, thus suggesting that the diminished defensive reaction to aversive stimulation is specifically linked to the charm, social potency and venturesomeness features of psychopathy (boldness), but not to features such as callousness, coldheartedness and cruelty traits (meanness), even though both phenotypes theoretically share the same underlying low-fear disposition. Our findings provide further evidence of the differential association between distinct psychopathy components and deficits in defensive reactivity and strongly support the validity of the triarchic model of psychopathy in disentangling the etiology of this personality disorder.

Binding neutral information to emotional contexts: Brain dynamics of long-term recognition memory.

There is abundant evidence in memory research that emotional stimuli are better remembered than neutral stimuli. However, effects of an emotionally charged context on memory for associated neutral elements is also important, particularly in trauma and stress-related disorders, where strong memories are often activated by neutral cues due to their emotional associations. In the present study, we used event-related potentials (ERPs) to investigate long-term recognition memory (1-week delay) for neutral objects that had been paired with emotionally arousing or neutral scenes during encoding. Context effects were clearly evident in the ERPs: An early frontal ERP old/new difference (300-500 ms) was enhanced for objects encoded in unpleasant compared to pleasant and neutral contexts; and a late central-parietal old/new difference (400-700 ms) was observed for objects paired with both pleasant and unpleasant contexts but not for items paired with neutral backgrounds. Interestingly, objects encoded in emotional contexts (and novel objects) also prompted an enhanced frontal early (180-220 ms) positivity compared to objects paired with neutral scenes indicating early perceptual significance. The present data suggest that emotional--particularly unpleasant--backgrounds strengthen memory for items encountered within these contexts and engage automatic and explicit recognition processes. These results could help in understanding binding mechanisms involved in the activation of trauma-related memories by neutral cues.

Facing Challenges in Differential Classical Conditioning Research: Benefits of a Hybrid Design for Simultaneous Electrodermal and Electroencephalographic Recording.

Several challenges make it difficult to simultaneously investigate central and autonomous nervous system correlates of conditioned stimulus (CS) processing in classical conditioning paradigms. Such challenges include, for example, the discrepant requirements of electroencephalography (EEG) and electrodermal activity (EDA) recordings with regard to multiple repetitions of conditions and sufficient trial duration. Here, we propose a MultiCS conditioning set-up, in which we increased the number of CSs, decreased the number of learning trials, and used trials of short and long durations for meeting requirements of simultaneous EEG-EDA recording in a differential aversive conditioning task. Forty-eight participants underwent MultiCS conditioning, in which four neutral faces (CS+) were paired four times each with aversive electric stimulation (unconditioned stimulus) during acquisition, while four different neutral faces (CS-) remained unpaired. When comparing after relative to before learning measurements, EEG revealed an enhanced centro-posterior positivity to CS+ vs. CS- during 368-600 ms, and subjective ratings indicated CS+ to be less pleasant and more arousing than CS-. Furthermore, changes in CS valence and arousal were strong enough to bias subjective ratings when faces of CS+/CS- identity were displayed with different emotional expression (happy, angry) in a post-experimental behavioral task. In contrast to a persistent neural and evaluative CS+/CS- differentiation that sustained multiple unreinforced CS presentations, electrodermal differentiation was rapidly extinguished. Current results suggest that MultiCS conditioning provides a promising paradigm for investigating pre-post-learning changes under minimal influences of extinction and overlearning of simple stimulus features. Our data also revealed methodological pitfalls, such as the possibility of occurring artifacts when combining different acquisition systems for central and peripheral psychophysiological measures.

Emotional reactivity during anticipation and perception of affective pictures.

The focus of the present study was on further exploring anticipatory responses to emotional stimuli by measuring the eyeblink startle reflex in a variation of the picture-picture affective learning procedure. Participants (113 undergraduate women) were not explicitly instructed before the experiment began. Instead, they had to learn the specific relations between cues (geometrical shapes) and emotional pictures based on pairings during the first part of the task. Plausible contingency learning effects were tested afterwards, in a parallel sequence of trials including auditory probes during cues and pictures processing during the second part of the task. Results did show the typical affective startle modulation pattern during perception, linear F(1, 200) = 52.67, p < .0001, but unexpected inhibition for both pleasant and unpleasant, compared to neutral cues, during anticipation, quadratic F(1, 200) = 7.07, p < .009. All patterns of startle modulation were independent of cue-picture contingency awareness (all interactions Fs < 1). Skin conductance changes showed the predictable quadratic trend either during picture perception or anticipatory periods (greater activity for emotional vs. neutral; overall quadratic F(1, 224) = 7.04, p < .01), only for participants fully aware of the cue-picture contingency, quadratic F(1, 158) = 5.86, p < .02. Overall, our results during anticipation (cues processing) seem to suggest that more resources were allocated to highly arousing pictures that engage attention. Differences between the present results and prior research may be attributed to procedural variations in the sample, cues, or instructions. Future studies should also explore in more detail the role of the contingency awareness during anticipation.

Emotional reactivity during anticipation and perception of affective pictures

The focus of the present study was on further exploring anticipatory responses to emotional stimuli by measuring the eyeblink startle reflex in a variation of the picture-picture affective learning procedure. Participants (113 undergraduate women) were not explicitly instructed before the experiment began. Instead, they had to learn the specific relations between cues (geometrical shapes) and emotional pictures based on pairings during the first part of the task. Plausible contingency learning effects were tested afterwards, in a parallel sequence of trials including auditory probes during cues and pictures processing during the second part of the task. Results did show the typical affective startle modulation pattern during perception, linear F(1, 200) = 52.67, p < .0001, but unexpected inhibition for both pleasant and unpleasant, compared to neutral cues, during anticipation, quadratic F(1, 200) = 7.07, p < .009. All patterns of startle modulation were independent of cue-picture contingency awareness (all interactions Fs < 1). Skin conductance changes showed the predictable quadratic trend either during picture perception or anticipatory periods (greater activity for emotional vs. neutral; overall quadratic F(1, 224) = 7.04, p < .01), only for participants fully aware of the cuepicture contingency, quadratic F(1, 158) = 5.86, p < .02. Overall, our results during anticipation (cues processing) seem to suggest that more resources were allocated to highly arousing pictures that engage attention. Differences between the present results and prior research may be attributed to procedural variations in the sample, cues, or instructions. Future studies should also explore in more detail the role of the contingency awareness during anticipation (AU)

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FFM description of the triarchic conceptualization of psychopathy in men and women.

This study examined differential associations between phenotypic domains of the triarchic conceptualization of psychopathy (boldness, meanness, and disinhibition; Patrick, Fowles, & Krueger, 2009), as assessed by the Triarchic Psychopathy Measure (Patrick, 2010b), and the five-factor model (FFM) of normal personality, as indexed by the Revised NEO Personality Inventory (Costa & McCrae, 1992; Spanish version, Costa & McCrae, 1999), in 349 undergraduates (96 men). Distinctive patterns of correlations for psychopathy components did not differ significantly across gender, although relations between Meanness and Agreeableness were stronger for men than for women. Our findings are largely consistent with the conceptualization of psychopathy in terms of FFM constructs and provide discriminant evidence in support of all 3 triarchic domains. Thus, meanness is marked by low Agreeableness and some degree of low Conscientiousness, whereas disinhibition is characterized both by low Conscientiousness and low Agreeableness along with high Neuroticism and Extraversion. Notably, the constellation of low Neuroticism, high Extraversion, and high Openness, with facets of low Agreeableness, supports the idea that boldness encompasses some adaptive features of psychological adjustment while depicting the interpersonal features of psychopathy.

Adaptación española del -International Affective Picture System- (IAPS). Tercera parte / Spanish adaptation of the "International Affective Picture System" (IAPS). Third part

Este trabajo proporciona los valores normativos españoles de las 358 imágenes que forman los conjuntos 15 a 20 del International Affective Picture System (IAPS). En este estudio participaron 811 estudiantes universitarios (521 mujeres) que evaluaron las imágenes en las dimensiones emocionales de valencia, activación y dominancia. Las correlaciones entre las evaluaciones estadounidenses y las españolas en todas las dimensiones fueron altamente significativas y, como en Estados Unidos, la distribución de las imágenes en el espacio bidimensional afectivo definido por las dimensiones de valencia y activación adoptó la típica forma de boomerang. Los resultados confirmaron, asimismo, las diferencias de género encontradas en Estados Unidos en las evaluaciones de las imágenes aversivas. Estos resultados son totalmente consistentes con los obtenidos en la primera y segunda parte de la adaptación española, y demuestran que la estandarización del IAPS en nuestro país ha sido adecuada. Por último, se ratificaron las pequeñas diferencias transculturales encontradas en las evaluaciones de activación y dominancia: los españoles tendieron a asignar a las imágenes mayores puntuaciones en activación y menores en dominancia que los estadounidenses. Es-tos datos apoyan los estereotipos culturales de estos países y sugieren que el IAPS podría ser un indicador fiable de diferencias transculturales en la disposición emocional (AU)

The Spanish norms for pictures in shows 15 to 20 of the International Affective Picture System (IAPS) are reported in this paper. Participants were 811 undergraduate university students (521 women), who rated the valence, arousal, and dominance of 358 pictures. The correlations between the North-American and the Spanish ratings were all highly significant and, like in the United States, the picture distribution in the bidimensional affective space, defined by the ratings on affective valence and arousal, displayed the typical boomerang shape. Our data also corroborated gender differences in aversive pictures found in North-Americans. These results are fully consistent with those obtained in the first and second part of the Spanish adaptation, and demonstrate that the standardization of IAPS in our country has been successful. Finally, our data confirmed the cross-cultural differences found in arousal and dominance ratings: Spanish participants tended to assign higher arousal and lower dominance scores to the pictures, as a whole, than North-Americans. These data support the general cultural stereotypes that exist for these countries and suggest that the IAPS might be a reliably index of cultural differences in emotional disposition (AU)

Deficient fear conditioning and self-reported psychopathy: the role of fearless dominance.

The role of the two dimensions of psychopathy-dispositional fearlessness (theorized to reflect variations in reactivity of the brain's defensive system) and externalizing proneness (presumed to reflect variations in function of anterior regulatory systems)-in fear learning was examined in a sample of undergraduates assessed using the Psychopathic Personality Inventory-Revised (PPI-R) who participated in a differential aversive conditioning task. Only scores on self-reported "fearless dominance," irrespective of scores on "impulsive antisociality," were related to diminished acquisition of physiological fear. Consistent with dual-process accounts of psychopathy proposing divergent etiological pathways for the interpersonal/affective and the social deviance features of the disorder, our results lend support to the existence of a deficit in reactivity of the brain's defensive system underlying the fearlessness dimension of psychopathy.

Cardiac defense response as a predictor of fear learning.

Prior studies have demonstrated that differences in activation of the defensive motivational system - as indexed by cardiac responses to the CS+ during aversive conditioning - are related to differences in the acquisition of two-levels-of-learning: cognitive (contingency learning) and emotional (fear learning). Here we further explored these differences using an independent psychophysiological test to assess cardiac reactivity - Cardiac Defense Response (CDR) - prior to the aversive conditioning task. Participants were then classified as accelerators or decelerators based on the CDR second accelerative component. Both groups showed contingency learning, as indexed by greater skin conductance changes to CS+ than to CS- during acquisition and by consistent contingency awareness ratings after the conditioning task. However, only accelerators showed affective fear learning, as indexed by greater blinks to CS+ than to CS- during (acquisition) and after (extinction) aversive conditioning. These results extend evidence about differences in the two-levels-of-learning in aversive conditioning as a function of defensive reactivity, and suggest that the CDR second accelerative component could be a reliable predictor of fear learning.

Affective picture perception: emotion, context, and the late positive potential.

Event-related potentials (ERP) were measured when pleasant, neutral or unpleasant pictures were presented in the context of similarly valenced stimuli, and compared to ERPs elicited when the same pictures were viewed in an intermixed context. An early ERP component (150-300 ms) measured over occipital and fronto-central sensors was specific to viewing pleasant pictures and was not affected by presentation context. Replicating previous studies, emotional pictures prompted a larger late positive potential (LPP, 400-700 ms) and a larger positive slow wave (1-6 s) over centro-parietal sensors that also did not differ by presentation context. On the other hand, ERPs elicited when viewing neutral pictures varied as a function of context, eliciting somewhat larger LPPs when presented in blocks, and prompting smaller slow waves over occipital sensors. Taken together, the data indicate that emotional pictures prompt increased attention and orienting that is unaffected by its context of presentation, whereas neutral pictures are more vulnerable to context manipulations.

Response perseveration in psychopaths: Interpersonal/affective or social deviance traits?

In order to clarify the role of the two broad components of psychopathy (interpersonal/affective and social deviance; R. D. Hare, 2003) in explaining maladaptive response perseveration in psychopaths, as well as the role of reflection after punished responses in this deficit, the authors administered a card perseveration task to 47 Spanish male inmates assessed using the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991). Hierarchical regressions showed that psychopaths' maladaptive perseveration (more cards played and less money earned) was uniquely predicted by the social deviance features of psychopathy (PCL-R Factor 2)--particularly by its impulsive and irresponsible lifestyle facet (PCL-R Facet 3)--and not by its interpersonal/affective features (PCL-R Factor 1). Moreover, perseveration was related to a lack of reflection both after punishment and after reward feedback. The authors' results, in conjunction with previous evidence indicating perseverative deficits in several impulse control disorders, suggest that response perseveration may not be specific to psychopathy but rather is associated more generally with the externalizing dimension of psychopathology.