Researchers from Vrije Universiteit Amsterdam and Radboud University Nijmegen found proof that psychopathic individuals can feel fear, but have trouble in the automatic detection and responsivity to threat. For many decades fear has been put forth as a hallmark feature of psychopathy, the impairments in which would lead to bold risk-taking behavior. Sylco Hoppenbrouwers (VU Amsterdam), Erik Bulten and Inti Brazil (Radboud University) reviewed theoretical and empirical brain and behavioral data pertaining to fear and psychopathy and found that psychopathic individuals have trouble detecting threats. There was however little evidence that the conscious experience of fear was affected, indicating that the experience of fear may not be completely impaired in psychopathy. It's the first study to provide empirical evidence that the automatic and conscious processes can be independently affected within one psychiatric disorder. The results are published in Psychological Bulletin.

In their systematic review and meta-analysis, Hoppenbrouwers, Bulten and Brazil reviewed the available evidence for the potential existence of the relationship between fear and psychopathy in adult individuals. Importantly, their definition of fear was based on state of the art knowledge of the neurobiological and cognitive underpinnings of this emotion. They used this knowledge to generate a model that separates brain mechanisms involved in automatic detection and responding to threats from those involved in the conscious experience of fear as an emotion. Using this model as reference, they first performed a conceptual analysis of the work of earlier theorists, going back to as early as 1806. They found that only one theorist incorporated the construct of fear into an etiological model of psychopathy.

Fear isn't absent in psychopathic individuals

The evidence for impairments in brain areas involved in the experience of fear was less consistent than is often assumed, indicating that the experience of fear may not be completely impaired in psychopathy. The researchers then conclusively showed that psychopathic individuals have trouble in the automatic detection and responsivity to threat but may in fact feel fear, providing direct empirical support for the claim that the conscious experience of fear may not be impaired in these individuals. An additional meta-analysis examining the five other basic emotions found that there may also be impairments in the experience of happiness and anger, but the lack of consistency in the current literature precluded the generation of strong claims.

New model also applies to mood and anxiety disorders

The research by Hoppenbrouwers, Bulten and Brazil is the first to provide empirical evidence that the automatic and conscious processes can be separated. Furthermore, the proposed model not only applies to psychopathy, but can also be used to further increase conceptual precision and generate new hypotheses for research on mood and anxiety disorders. Inti Brazil: "While psychopathic individuals may suffer from a dysfunctional threat system, people with posttraumatic stress disorder may have a hyperactive threat system, which later leads to them feeling fearful." Sylco Hoppenbrouwers agrees: "As a consequence of our research, some very influential theories that assign prominent roles to fearlessness in the aetiology of psychopathy will need to be reconsidered and made consistent with current neuroscientific evidence. Such re-evaluations of key concepts will lead to increased precision in research and clinical practice which should ultimately pave the way toward more targeted and more effective treatment interventions."