A reduction in the pupil’s response to affective sounds in psychopathy and related personality traits

The pupil of the eye dilates in response to affective information, even if that information is not visual. We used this affective modulation of the pupil to examine the hypothesis that individuals with high traits of psychopathy have an insensitivity to emotional stimuli. We also examined general personality traits related to psychopathy. A sample of 120 healthy young men had their pupils monitored while they listened to sound clips that conveyed either neutral emotion (e.g., rain), negative emotion (e.g., a person screaming) or positive emotion (e.g., people laughing). Psychopathy and general personality traits were measured via self-report questionnaire. As expected, both the positive and negative emotional sounds produced greater dilation in the pupil size than neutral sounds. This affective modulation of the pupil was found to be reduced for the negative sounds for people high on the “callous/affective” components of psychopathy (the Affective facet of the SRP-4 and the Meanness scale of the TriPM) and the general personality traits of Reward Dependence and Cooperativeness. The results indicate that these callous traits of psychopathy and general personality may be underpinned by a reduction in the ability to effectively process or monitor emotional stimuli

Assessing physiological sensitivity in Post-Traumatic Stress Disorder

People who have endured horrific events often bear predictable psychological harm. The symptoms of this harm can persist to produce a recognised clinical syndrome, Post-Traumatic Stress Disorder (PTSD). The lived reality of PTSD is a condition in which sufferers experience unbearable emotional reactions to traumatic reminders and exist in a persistent state of fear. Although the psychiatric and psychological construct of PTSD has been hotly contested, research and clinical opinion seem to converge around a state of enhanced sensitivity to threat, underpinned by chronic physiological hyper-arousal. This thesis has been concerned with the development of assessment measures that are sensitive to physiological hyper-arousal, including pupillometry and visual contrast sensitivity. In three experiments, a sample of 73 participants recruited from military, addiction and homelessness charity services were assessed for PTSD symptomology with the Clinician Administered PTSD Scale for DSM-V, and the self-report Impact of Event Scale-Revised. During passive viewing of emotive images, individuals with PTSD showed pupil responses that were influenced more by emotive stimuli than controls, and showed a reduced constriction of the pupil to light; revealing altered states of arousal. Due to methodological differences, a task assessing pupil responses to emotive sound clips failed to replicate this result. The assessment of visual contrast sensitivity revealed the heterogeneous nature of PTSD. Multi-dimensional assessment of symptom subscales showed that higher levels of re-experiencing symptoms were related to heightened visual sensitivity, but avoidant symptoms were related to lower sensitivity. Overall, the assessment of psychophysiological responses in PTSD demonstrated the utility of pupillometry for the assessment of PTSD, contributed to the literature on the regulation of the autonomic nervous system in PTSD, and highlighted the diversity of the clinical construct due to opposing effects of the symptom subscales

Enhanced emotional response to both negative and positive images in post-traumatic stress disorder: Evidence from pupillometry

Post-traumatic stress disorder (PTSD) is characterised by alterations in the function of the autonomic nervous system. However, it is unclear if this dysfunction is threat-related or related to arousing stimuli in general. Pupillometry offers a simple non-invasive measure of ANS activity that can separate parasympathetic and sympathetic arousal. Participants viewed images with emotional or neutral content: 20 met diagnostic criteria for PTSD, 28 were trauma-exposed (but with no PTSD), and 17 were controls. Initial pupil constriction (a marker of parasympathetic function) was reduced for the PTSD group, while dilation due to the emotional content of the image (a marker of sympathetic activity) was greater in the PTSD group. Individuals with PTSD demonstrated enhanced physiological arousal to both threat-related and positive images. The results suggest reduced parasympathetic arousal and increased sympathetic arousal in the autonomic nervous system, which has been linked to a range of adverse health outcomes in PTSD

The Aggression and Vulnerablility Scale (AVS) for the measurement of inpatient behaviors: A demonstration of reliability

Background: The accurate and consistent recording of problematic incidents for in-patient behaviour is important in monitoring patient’s treatment and needs, and for comparing behaviour across different settings. Methods: The Aggression and Vulnerability Scale (AVS) classifies individual incidents into 10 categories covering aggression (Physical Aggression against Other People, Verbal Aggression, Aggression against Property, Non-Compliant Behaviour) and vulnerabilities (Self-Harm/Suicide Attempt, Self-Neglect, Victimized/Exploited, Sexual Vulnerability, Absconding Behaviour and Accident) and rates severity of the incident. Twenty raters (10 naïve and 10 experienced) rated 28 vignettes drawn from nursing records. Results: The AVS had high reliability for both classification category and severity in both experienced and inexperienced raters. Conclusion: The AVS is a reliable scheme for the coding of problematic behavior in an in-patient setting. The AVS is available free from the authors

A reduction in the pupil’s response to affective sounds in psychopathy and related personality traits

The pupil of the eye dilates in response to affective information, even if that information is not visual. We used this affective modulation of the pupil to examine the hypothesis that individuals with high traits of psychopathy have an insensitivity to emotional stimuli. We also examined general personality traits related to psychopathy. A sample of 120 healthy young men had their pupils monitored while they listened to sound clips that conveyed either neutral emotion (e.g., rain), negative emotion (e.g., a person screaming) or positive emotion (e.g., people laughing). Psychopathy and general personality traits were measured via self-report questionnaire. As expected, both the positive and negative emotional sounds produced greater dilation in the pupil size than neutral sounds. This affective modulation of the pupil was found to be reduced for the negative sounds for people high on the “callous/affective” components of psychopathy (the Affective facet of the SRP-4 and the Meanness scale of the TriPM) and the general personality traits of Reward Dependence and Cooperativeness. The results indicate that these callous traits of psychopathy and general personality may be underpinned by a reduction in the ability to effectively process or monitor emotional stimuli

Sexual Attraction to Both Genders in Ambiphilic Men: Evidence from Implicit Cognitions

Ambiphilic (or bisexual) men describe feelings of sexual attraction to both men and women. However, physiological measures of arousal have failed to show a consistent pattern of arousal to both genders. We measured men’s automatic associations between the concept of sex (represented by words) and the concepts of men versus women (represented by images) via the Implicit Association Test (IAT) and a priming task. On the IAT, gynephilic men (N = 32) were faster for women-sex pairings, androphilic men (N = 18) were faster for men-sex pairings, while ambiphilic men (N = 20) showed no bias toward either gender. We then isolated the concepts of “men” and “women” by comparing them separately against neutral images. In contrast to both the gynephilic or androphilic men, ambiphilic men showed sexual associations to both men and women. On the priming task, ambiphilic men showed faster responses to sex words, but slower responses to not-sex words, when primed with pictures of either men or women compared to when primed by neutral images. The results from all the experimental tasks suggest that ambiphilic men have a pattern of sexual association that is different from both gynephilic and androphilic men and represents a sexual attraction to both men and women

Structured professional judgment to assist the evaluation and safety planning of suicide risk: The Risk of Suicide Protocol (RoSP)

Background: The Risk of Suicide Protocol (RoSP) is a structured professional judgment (SPJ) scheme designed in line with NICE guidelines to improve clinicians' ability to evaluate and manage suicide risk. Aims: This study aimed to evaluate the efficacy of RoSP in two settings: (1) unexpected deaths of people in the community who were known to mental health services; and (2) an inpatient hospital specializing in the assessment and treatment of patients with personality disorder. Method: In Study 1, information from a database of unexpected deaths (N = 68) within an NHS health board was used to complete a RoSP assessment (blind to cause of death) and information from the Coroner's Court was used to assign people to suicide vs. natural causes/accidental death. In Study 2, patients (N = 62) were assessed on the RoSP upon admission to hospital and their self-injurious behaviors were recorded over the first 3 months of admission. Results: (1) Evaluations using RoSP were highly reliable in both samples (ICCs 0.93–0.98); (2) professional judgment based on the RoSP was predictive of completed suicide in the community sample (AUC = 0.83) and; (3) was predictive of both suicide attempts (AUC = 0.81) and all self-injurious behaviors (AUC = 0.80) for the inpatient sample. Conclusion: RoSP is a reliable and valid instrument for the structured clinical evaluation of suicide risk for use in inpatient psychiatric services and in community mental health services. RoSP's efficacy is comparable to well-established structured professional judgment instruments designed to predict other risk behavior (e.g., HCR-20 and the prediction of violence). The use of RoSP for the clinical evaluation of suicide risk and safety-planning provides a structure for meeting NICE guidelines for suicide prevention and is now evidence-based

Pupillary Responses to Static Images of Men and Women: A Possible Measure of Sexual Interest?

The pupil dilates to images that are arousing. In Experiment 1, we examined if the pupil’s response to brief presentations (2,000 ms) of static images could be used to identify individuals’ sexual orientation. Participants were grouped according to their self-reported gender and sexual orientation (male heterosexual, N = 20; male bisexual, N = 13; male homosexual, N = 19; female heterosexual, N = 28; female bisexual, N = 21; female homosexual, N = 17). Pupil size was monitored to images of men in seminude poses, women in seminude poses, or neutral images. Every group showed the same pattern of responses, with the greatest dilation to male images, then female images, and least dilation to the neutral images. Experiment 2 used more tightly controlled stimuli and tested at two different image durations (150 and 3,000 ms). Both heterosexual men (N = 18) and women (N = 20) showed greater pupil dilation to images of nude men than to nude women. However, in Experiment 3, where we reduced the erotic content by using images of clothed models, both heterosexual men and women showed greater pupil dilation to images of women. The results showed that while the pupil does dilate strongly to sexual imagery, its response to these brief static images does not correspond to a person’s sexual orientation in a simple manne