Emotion

2002, Vol. 2, No. 2, 91104

Copyright 2002 by the American Psychological Association, Inc.

1528-3542/02/$5.00 DOI: 10.1037//1528-3542.2.2.091

Deficient Response Modulation and Emotion Processing

in Low-Anxious Caucasian Psychopathic Offenders:
Results From a Lexical Decision Task
Amanda R. Lorenz and Joseph P. Newman

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University of WisconsinMadison
The clinical and research literatures on psychopathy have identified an emotion
paradox: Psychopaths display normal appraisal but impaired use of emotion cues.
Using R. D. Hares (1991) Psychopathy ChecklistRevised and the G. S. Welsh
Anxiety Scale (1956), the authors identified low-anxious psychopaths and controls
and examined predictions concerning their performance on a lexical-decision task.
Results supported all the predictions: (a) low-anxious psychopaths appraised emotion cues as well as controls; (b) their lexical decisions were relatively unaffected
by emotion cues; (c) their lexical decisions were relatively unaffected by affectively
neutral word-frequency cues; and (d) their performance deficits were specific to
conditions involving right-handed responses. The authors propose that deficient
response modulation may underlie both the emotional and cognitive deficits associated with low-anxious psychopaths.

On the basis of Cleckleys (1976) classic portrayal

of psychopathy, investigators have attributed psychopaths disinhibited and antisocial lifestyle to an emotion deficit (Blair, 1995; Hare, 1998; Lykken, 1957,
1995; McCord & McCord, 1964; Patrick, 1994). Consistent with this interpretation, psychopaths display
less reactivity to threat cues (Lykken, 1957), anomalous performance in an emotion-modulated startle
paradigm (Patrick, Bradley, & Lang, 1993), less autonomic arousal in response to interpersonal distress
cues (Blair, Jones, Clark, & Smith, 1997), and less

pronounced attention and memory effects associated

with emotional cues relative to nonpsychopathic controls (Christiansen et al., 1996; Day & Wong, 1996;
Kiehl, Hare, McDonald, & Brink, 1999). Together,
these findings provide compelling evidence that emotion cues are less likely to influence the behavior of
psychopaths.
Though investigators have focused their attention
on psychopaths emotion deficit, Cleckleys (1976)
writings also highlighted an emotion paradox between
the psychopaths ability to appraise emotion cues and
their inability to use emotion cues. That is, psychopaths demonstrate normal appraisal of emotional cues
and situations in the abstract (i.e., verbal discussion),
but they are deficient in using emotion cues to guide
their judgments and behavior in the process of living.
Williamson, Harpur, and Hare (1991) found empirical support for the emotion paradox in psychopathy by using a lexical-decision task. The lexicaldecision task requires participants to determine if a
briefly presented letter string is a word or a nonword.
Paralleling results for controls (Challis & Krane,
1988; Graves, Landis, & Goodglass, 1981; Strauss,
1983), nonpsychopathic offenders responded faster to
emotion words than to neutral words. Psychopaths,
however, did not demonstrate this emotion facilitation
in response to positive or negative words although,
similar to controls, they were more accurate at identifying the emotional words. Thus, in contrast to the

Amanda R. Lorenz and Joseph P. Newman, Department

of Psychology, University of WisconsinMadison.
This research was supported by a research grant from the
National Institute of Mental Health. We gratefully acknowledge the assistance of Cathy Farrey, Jeff Endicott, Jim
Boorman, Janet Walsh, Jeffrey Wydeven, Bernice Conner,
Bev Mars, Deb March and the staff at the Oakhill Correctional Institution, the staff at the Columbia Correctional
Institution, and the cooperation of the Wisconsin Department of Corrections. We thank Bill Schmitt, Chad Brinkley,
and Jennifer Vitale for interviewing and diagnosing participants.
Correspondence concerning this article should be addressed to Joseph P. Newman or Amanda R. Lorenz,
Department of Psychology, University of Wisconsin
Madison, 1202 West Johnson Street, Madison, Wisconsin
53706. E-mail: jpnewman@facstaff.wisc.edu

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92

LORENZ AND NEWMAN

observed group differences in using emotion cues to

facilitate task performance, Williamson and colleagues found no group differences in participants
word ratings. Similarly, Patrick et al. (1993) assessed
startle responses while participants viewed slides that
varied in affective valence, and Patrick, Cuthbert, and
Lang (1994) assessed electrodermal activity in response to tones that were cues for threat-related or
neutral situations. In both studies, Patrick and colleagues observed significant differences in the physiological indices of emotion processing, but psychopaths and nonpsychopaths performed similarly in
rating the pleasantness, arousal, and dominance of the
fear-related situations and slide stimuli. Furthermore,
in an investigation of children with psychopathic tendencies, this group demonstrated smaller electrodermal responses to distress cues than nonpsychopathic
children, but the two groups did not differ when rating
the valence of the cues (Blair, 1999; see also Blair et
al., 1997). Taken together, these findings provide
good empirical support for the emotion paradox: psychopaths can appraise emotion cues but such cues
have little measurable influence on their behavior.
Although existing theories address emotion deficits
in psychopaths, it is unclear how they account for the
paradox. One potential explanation for these phenomena is the response modulation hypothesis (RMH; Gorenstein & Newman, 1980; Newman, 1998; Newman
& Lorenz, in press; Patterson & Newman, 1993). The
RMH relates to Cleckleys (1976) concept of psychopathy, which holds that genuine psychopaths are
characterized by low levels of neurotic anxiety, absence of psychotic thinking, and good intelligence.
Indeed, response modulation deficits have been found
to be relatively specific to low-anxious psychopaths
(see Newman & Brinkley, 1997). Response modulation is defined as a brief and highly automatic shift of
attention that enables individuals to monitor and, if
relevant, use information that is peripheral to their
dominant response set (i.e., deliberate focus of attention). According to the RMH, the impulsivity, poor
passive avoidance, and emotion-processing deficits of
psychopathic individuals may all be understood as a
failure to process the meaning of information that is
peripheral or incidental to their deliberate focus of
attention (Newman & Lorenz, in press). Consistent
with the RMH, psychopathic individuals display adequate passive avoidance when avoiding punishment
is their primary (i.e., sole) task but manifest performance deficits when avoidance requires them to process nondominant (i.e., secondary or latent) information (e.g., Lykken, 1957; Newman & Kosson, 1986).

Moreover, there is evidence that psychopaths are insensitive to secondary neutral as well as secondary
emotional cues (Newman, Schmitt, & Voss, 1997).
Given the similarities between their emotional and
more general information-processing deficits, it is
possible that psychopaths emotion deficits, like their
self-regulatory deficits, involve a deficiency in processing incidental cues. Indeed, Newman and Lorenz
(in press) recently proposed that psychopaths deficits
in emotion processing may be understood as a failure
to process the associative networks primed by secondary emotion cues. Although emotion processing may
operate effortlessly and automatically to influence the
behavior of most individuals (e.g., Bower, 1981), we
proposed that emotions are less likely to influence the
behavior of low-anxious psychopaths because their
emotion processing is more dependent on deliberate
processing (i.e., less automatic). Restated, psychopaths may be less likely to activate and/or use the
associative networks primed by peripheral emotional
cues that other individuals use automatically.
With regard to the emotion paradox, then, the RMH
is consistent with the hypothesis that psychopathic
individuals (a) display normal emotion processing
when instructed to attend to emotion stimuli and (b)
are less influenced by emotion cues that are peripheral
to their dominant response set (i.e., directed attention). Regarding emotion facilitation in a lexicaldecision task, we presume that emotion words prime
associational networks on the basis of their emotional
valence (Balota & Chumbley, 1984; Bower, 1981)
and, then, activate emotional characteristics that facilitate responding by rapidly indicating the presence
of the stimuli in the mental lexicon. For instance, the
word sunset may prime positive emotions that activate
numerous words associated with happy, peaceful, and
contented feelings. This rapid activation of a positive
emotion makes it easier for the participant to identify
the stimulus as a word. However, to the extent that
psychopaths are deficient in processing incidental information as suggested by the RMH, they are less
influenced by a words affective connotations.
Conceptualizing facilitation on the lexical-decision
task in terms of response modulation, we used a modified version of the lexical-decision task employed by
Williamson and her colleagues (1991) to replicate and
extend their findings. On the basis of Cleckleys
(1976) conceptualization of psychopathy and past investigations of the RMH (see Newman & Brinkley,
1997; Schmitt & Newman, 1999b), planned comparisons focus on the performance of low-anxious (i.e.,

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DEFICIENT RESPONSE MODULATION

primary) psychopaths and controls.1 Nevertheless, we

include the data for high-anxious groups in the overall
analyses so that investigators interested in Hares
(1991) psychopathy construct (high Psychopathy
ChecklistRevised [PCLR] scorers without regard
for anxiety) can interpret out findings. Because separate planned comparisons (i.e., t tests) were conducted
to test hypotheses using low-anxious groups only,
they are unaffected by the inclusion of the highanxious groups.
Given prior work demonstrating an emotion deficit
in psychopaths, our first prediction was that lowanxious psychopaths would demonstrate less emotion
facilitation than low-anxious controls. This prediction
is consistent with the RMH and Williamson et al.s
(1991) findings that psychopaths demonstrated less
emotion facilitation than controls in a lexical-decision
task. In addition, based on prior work demonstrating
comparable appraisal of emotion stimuli, we predicted that low-anxious psychopaths would not differ
from low-anxious controls in rating the emotional valence of the words used in the lexical-decision task.
Support for these two predictions would replicate earlier work demonstrating the emotion paradox in lowanxious psychopaths.
One interpretation of the psychopaths deficient
emotion facilitation is that they fail to access or elaborate the semantic and affective associations or networks primed by the stimulus words (Hare, 1998;
Newman & Lorenz, in press). To the extent that this
failure to process associative networks relates to response modulation as opposed to deficient emotion
processing per se, psychopaths should be less influenced by emotionally neutral as well as emotional
aspects of a words meaning. To test this third prediction, we examined the ability of low-anxious psychopaths to use an emotionally neutral secondary cue
(i.e., word frequency) to facilitate performance on the
primary lexical-decision task. Paralleling our prediction involving weaker emotion facilitation, we predicted that low-anxious psychopaths would demonstrate less frequency facilitation than controls.
Recent research by Kosson (1996, 1998) and colleagues (Howland, Kosson, Patterson, & Newman,
1993; Kosson & Harpur, 1997) suggests that psychopaths demonstrate performance anomalies on measures of attention when using their right hand as opposed to their left hand to respond. Although the more
general literature on cerebral asymmetries in psychopaths is inconsistent (Hare, 1979; Hare & Forth, 1985;
Hare & Jutai, 1988; Hare & McPherson, 1984; Hiatt,
Lorenz, & Newman, in press; Jutai, Hare, & Con-

nolly, 1987; Smith, Arnett, & Newman, 1992), Kosson speculated that psychopaths deficits on tasks requiring right-handed responses might be because of
inefficient processing in the left hemisphere. Consistent with this speculation, Bernstein, Newman, Wallace, and Luh (2000) found that psychopaths performed more poorly than did controls in using
information presented to their right-visual field. Notably, however, this deficit was specific to the processing of incidental cues. Thus, evidence for inefficient left hemisphere processing in psychopaths may
be specific to incidental cues and/or the integration of
primary and secondary aspects of a stimulus as specified by the RMH.
To the extent that lexical decisions normally involve integrating incidental information (i.e., the automatic associations primed by a word) with ones
directed inspection of the word, it follows that psychopaths insensitivity to primed, secondary associations, like their insensitivity to peripheral cues in the
Bernstein et al. (2000) study, may be specific to conditions that activate the left hemisphere primarily. Although such theorizing is still speculative, we designed the lexical-decision task to explore this
hypothesis. In particular, we divided the task into
eight blocks of experimental trials and instructed participants to switch the hand used to respond after each
trial block. If low-anxious psychopaths benefit less
than controls from primed associations when the left
hemisphere is differentially activated, then the predicted group differences in facilitation should be specific to right-hand trial blocks.

Method
Participants
The participants in this study were 100 Caucasian
male inmates residing at either a minimum or maximum security prison in southern Wisconsin. Inmates

Schmitt and Newman (1999a) demonstrated that individuals with high scores on the Psychopath Checklist
Revised (PCLR) are as likely to earn high scores on the
Welsh Anxiety Scale (WAS; Welsh, 1956) and other measures of anxiety-negative affect as they are to earn low
scores (i.e., psychopathy and anxiety are statistically independent). Thus, investigators wishing to exclude secondary
or neurotic psychopaths from analyses (Cleckley, 1976;
Hare, 1970) must use a measure of anxiety-negative affect
in conjunction with the PCLR. To this end, we use the
WAS to assign participants to low- and high-anxiety groups.

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94

LORENZ AND NEWMAN

were excluded from participation if they were age 40

or older, currently taking psychotropic medication, or
left-handed (total scores on Chapman Handedness
Scale > 21; Chapman & Chapman, 1987). In addition,
inmates were excluded from analyses if they scored
below the 4th-grade level on prison achievement tests
or had earned estimated Wechsler Adult Intelligence
ScaleRevised (WAISR; Wechsler, 1981) scores
that were less than 70 on the Shipley Institute of Living Scale (Zachary, 1986). Psychopathic and nonpsychopathic participants did not differ significantly on
age or WAISR scores (low-anxious psychopaths: M
100.82, SE 11.54; low-anxious controls: M
99.63, SE 11.87; high-anxious psychopaths: M
98.04, SE 11.01; high-anxious controls: M
96.49, SE 12.70). Inmates were paid $3.00 for their
participation in this study.
Psychopathy was assessed with the PCLR (Hare,
1991), which has demonstrated good reliability and
validity in Caucasian samples (Hare, 1996; Hare et
al., 1990; Harpur, Hare, & Hakstian, 1989; Kosson,
Smith, & Newman, 1990; Lorenz, Smith, Bolt,
Schmitt, & Newman, 2001). In the current study, we
evaluated the interrater reliability of PCLR ratings
with a subset of 31 participants. To provide a conservative estimate of the reliability, we calculated an
intraclass correlation (ICC) using absolute rather than
consistency agreement and treated both raters and participants as random effects (McGraw & Wong, 1996).
This analysis yielded an ICC of .96.
Consistent with Hare (1991) and previous reports
from our laboratory, participants with PCLR scores
greater than or equal to 30 were rated as psychopaths
and those with PCLR scores less than or equal to 20
were rated as nonpsychopathic controls. Anxiety was
measured by the Welsh Anxiety Scale (Welsh, 1956).
Individuals scoring above the median (11) were rated
as high-anxious and individuals scoring below the
median were rated as low-anxious. This median split
resulted in 37 high-anxious (17 psychopaths and 20
controls) and 37 low-anxious (11 psychopaths and 26
controls) participants.2

tion, a practice block consisted of 12 neutral words

and 12 nonwords that differed from the words used
for the test trials.
The positive, negative, and neutral words for the
experimental trials were selected from Rubin and
Friendlys (1986) word list. On scales that ranged
from 1 (negative) to 7 (positive), the neutral words fell
between 3.25 and 4.75 on the Goodness scale and
under 2.0 on the Emotionality scale. Examples of neutral words were bowl, event, and vacuum. The
positive and negative words were rated above 4.0 on
the Emotionality scale and above 5.25 or below 2.75
on the Goodness scale, respectively. Examples of
positive words were kiss, sunset, and heaven.
Examples of negative words were tomb, devil,
and hostage. As expected, the positive and negative
words differed significantly from the neutral words on
emotionality, F(2, 47) 135.70, p < .001. The positive, negative, and neutral words differed significantly
from each other on goodness, F(2, 47) 333.06, p <
.001. The words for the experimental trials were
matched on frequency, pronounceability, length,
number of letters, number of syllables, concreteness,
and imagery (Kucera & Francis, 1967; Pavio, Yuille,
& Madigan, 1968). Changing two letters for each of
the words used in the experiment resulted in the 48
pronounceable nonwords.
For the word frequency analysis, the stimulus
words for the four experimental blocks were regrouped into high-, medium-, and low-frequency
word groups (Kucera & Francis, 1967). The three
word groups differed significantly on frequency,
F(2, 47) 12.88, p < .001. Examples of the highfrequency words included heaven, injury, and piano;
examples of the medium-frequency words included
bowl, devil, and sunset; and examples of lowfrequency words included dove, gore, and salute.
These words were matched on length, pronounceability, number of letters, number of syllables, imagery,

Stimulus Material
The stimuli in the lexical-decision task consisted of
48 wordnonword pairs for the experimental trials.
These stimuli consisted of 12 positive words, 12 negative words, 24 neutral words, and 48 nonwords and
were grouped into four experimental blocks: A, B, C,
and D. Each experimental block consisted of 3 positive, 3 negative, 6 neutral, and 12 nonwords. In addi-

Because the median split resulted in more high-anxious

than low-anxious psychopaths and more low-anxious than
high-anxious controls, we also computed separate median
anxiety scores for each group and reran all analyses with the
separate medians. This procedure resulted in 22 lowanxious and 21 high-anxious controls and 15 low-anxious
and 16 high-anxious controls. In all cases, the planned comparisons generated by these analyses yielded the same results. Although the cells in the latter analyses are better
balanced, we report the a priori analyses because we believe
that they are more readily interpreted.

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DEFICIENT RESPONSE MODULATION

concreteness, goodness, and emotionality (Kucera &

Francis, 1967; Pavio et al., 1968; Rubin & Friendly,
1986).
A fixation point, *, was presented in a central
position on the computer screen for 500 ms. The
stimuli were then presented in a central position on a
computer screen for 100 ms. The participants responded by pressing either the D and F keys or
the J and K keys on a standard keyboard. The D
and F keys were used for left-hand responses and
the J and K keys were used for right-hand responses. Participants used their index fingers to indicate if the presented stimulus was a word and their
middle finger to indicate if the presented stimulus was
a nonword. The F and J keys were covered with
a small blue sticker and indicated that the presented
stimulus was a word. The D and K keys were
covered with a small white sticker and indicated that
the presented stimulus was a nonword.

Procedures
A tester, who was unaware of group membership of
the participants, was in the room with the participants
running the computer program and administering the
questionnaires. Participants were seated in front of a
computer monitor and read the task instructions on the
computer screen.
This experiment involves focusing on a fixation point
and then viewing a group of letters. Half of the time the
letters will spell a word, and half of the time they will
not. Your job is to press the blue dot if the letters spell
a word or press the white dot if they do not spell a word.
Respond as quickly as you can without making mistakes.
Remember: Press the blue dot for words, the white dot
for non-words. For this block, please use your right
hand.

All participants began the experiment with the practice block and responded with their right hand. The
experimental blocks were presented in the following
order: A, B, C, D, B, A, D, C, so that each stimulus
word was presented twice. Participants alternated
their response hand after each block so that each experimental block was completed once with the right
hand and once with the left hand. Between each block,
participants had a 10-s rest period. After the rest period, participants were instructed to prepare for the
next block and were reminded of which hand to use
for their responses. After completing the fourth block
of experimental trials, the participants were given a
30-s break. The entire task lasted approximately 20
min.

After completing the lexical-design task, participants rated the stimulus words on a 07 scale, where
0 indicated bad, 4 indicated neutral, and 7 indicated
good. (One participant did not complete the wordrating task.)

Results
Preliminary Analyses
Prior to analyzing emotion and frequency facilitation, we examined the data for group differences in
overall reaction time (RT) and accuracy with two 2
(psychopathic, nonpsychopathic) 2 (low-anxious,
high-anxious) 2 (left hand, right hand) mixed-model
analysis of variance (ANOVA), with psychopathy and
anxiety as the between-participants factors and response hand as the within-participants factor. An additional set of 2 2 2 ANOVAs tested for RT or
accuracy group differences in pseudowords. None of
these analyses yielded significant main effects or interactions involving psychopathy. The raw RT data
for emotion and frequency are provided in Table 1
and Table 2.

Lexical-Decision Task: Emotion Analyses

Using only RT values from correct responses, emotion facilitation on this task was computed by subtracting the RT for the emotional words from the RT
for the neutral words. Higher RTs indicate greater
facilitation on the task. We conducted a 2 (psychopathic, nonpsychopathic) 2 (low-anxious, highanxious) 2 (left hand, right hand) 2 (positive
words, negative words) mixed-model ANOVA with
psychopathy and anxiety as the between-participants
factors and response hand and valence as the withinparticipants factors. This analysis yielded a significant
Response Hand Psychopathy interaction, F(1, 70)
4.27, p < .05. Whereas nonpsychopaths displayed
greater facilitation (M 35.36, SE 5.44) than
psychopaths (M 8.62, SE 6.65) when responding with their right hand, nonpsychopaths (M
25.55, SE 6.99) and psychopaths (M 26.79, SE
8.41) displayed similar levels of facilitation when
responding with their left hand. Owing to the large
number of analyses conducted, we have focused on
our a priori hypotheses in reporting the results. In
addition, we report all the significant findings from
the overall analyses that involve the psychopathy variable.
To test our first hypothesis, we compared the emotion facilitation of low-anxious psychopaths and controls. As predicted, low-anxious psychopaths dis-

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LORENZ AND NEWMAN

Table 1
Means and (Standard Deviations) of the Reaction Time Raw Data for Emotional Stimuli
Stimuli type
Neutral

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Variable
Low-anxious
Psychopaths
(n 11)
Controls
(n 26)
High-anxious
Psychopaths
(n 17)
Controls
(n 20)

Positive

Negative

Nonwords

Left hand

Right hand

Left hand

Right hand

Left hand

Right hand

Left hand

Right hand

512.09
(27.56)
558.42
(17.92)

500.73
(29.48)
565.34
(19.18)

496.36
(28.48)
526.15
(17.62)

494.46
(29.06)
532.46
(18.25)

487.73
(27.35)
532.85
(17.79)

516.27
(28.56)
522.92
(18.58)

587.73
(31.68)
633.81
(20.60)

605.00
(37.79)
645.50
(24.58)

545.35
(20.43)
533.89
(22.17)

537.20
(21.87)
532.41
(23.72)

511.75
(20.09)
517.00
(21.79)

505.20
(20.81)
505.65
(22.57)

511.90
(20.28)
506.41
(22.00)

525.45
(21.18)
493.06
(22.97)

631.80
(23.49)
644.89
(25.48)

631.40
(28.03)
609.12
(30.40)

main effect nor any of the interactions involving psychopathy approached statistical significance. The
planned comparison between the ratings of the negative and neutral words for the low-anxious psychopaths and controls yielded t(69) < 1.0, ns; similarly,
the ratings of the positive and neutral words for the
low-anxious psychopaths and controls yielded t(69) <
1.0, ns.

played significantly less facilitation than controls,

t(70) 3.09, p < .001. (Low-anxious psychopaths: M
7.71, SE 8.75; low-anxious controls: M
33.29, SE 5.69.) This result is shown in Figure 1.

Word Ratings
To test for differences in word ratings, we conducted a 2 (psychopathic, nonpsychopathic) 2 (lowanxious, high-anxious) 3 (positive words, negative
words, neutral words) mixed-model ANOVA with
psychopathy and anxiety as the between-participants
factors and word type as the within-participants factor. This ANOVA yielded a significant main effect for
word type, F(1, 69) 194.76, p < .001 (positive
words: M 5.37, SE 1.00; neutral words: M
4.26, SE .72; negative words: M 2.37, SE
1.04). Across groups, participants rated the positive
words higher than the neutral words, which in turn
were rated higher than the negative words. Neither the

Lexical-Decision Task: Frequency Analyses

Frequency facilitation on this task was computed
by subtracting the RT for the high-frequency words
from the RT for the low-frequency words. Higher
values indicate greater facilitation on the task. A 2
(psychopathic, nonpsychopathic) 2 (low-anxious,
high-anxious) 2 (left hand, right hand) mixed-model
ANOVA with psychopathy and anxiety as the between-participants factors and response hand as the
within-participants factor yielded no significant main

Table 2
Means and (Standard Deviations) of the Reaction Time Raw Data for Frequency Stimuli
High frequency
Variable
Low-anxious
Psychopaths
(n 11)
Controls
(n 26)
High-anxious
Psychopaths
(n 17)
Controls
(n 20)

Low frequency

Left hand

Right hand

Left hand

Right hand

479.93
(25.65)
520.30
(16.68)

517.58
(29.09)
527.97
(18.92)

526.96
(27.75)
575.63
(17.93)

503.50
(32.44)
574.63
(21.10)

509.91
(19.02)
500.00
(20.63)

505.86
(21.57)
507.35
(23.40)

553.36
(20.45)
556.94
(22.18)

549.32
(24.06)
539.17
(26.09)

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DEFICIENT RESPONSE MODULATION

97

Figure 1. Lexical-decision task emotion facilitation for right- and left-handed responses for
low-anxious psychopathic individuals and controls. RT reaction time.

effects or interactions involving psychopathy. The

planned comparison indicated that low-anxious psychopaths showed significantly less facilitation to the
high-frequency words than did controls, t(70) 2.35,
p < .05. (Low-anxious psychopaths: M 18.37, SE
12.46; low-anxious controls: M 51.82, SE
8.10.) This result is shown in Figure 2.

Lexical-Decision Task: Response

Hand Analysis
The significant Response Hand Psychopathy interaction found in the overall ANOVA indicated that
all psychopaths, regardless of anxiety group, demonstrated less emotion facilitation when responding with

Figure 2. Lexical-decision task frequency facilitation for right- and left-handed responses
for low-anxious psychopathic individuals and controls. RT reaction time.

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98

LORENZ AND NEWMAN

their right hand, but did not address our a priori hypotheses directly. Toward this end, we conducted two
planned comparisons to examine whether the weaker
emotion and frequency facilitation displayed by lowanxious psychopaths was specific to the right hand.
As predicted, low-anxious psychopaths displayed significantly less emotion facilitation than controls when
responding with their right hand, t(70) 2.87, p <
.01, (low-anxious psychopaths: M 4.64, SE
10.51; low-anxious controls: M 37.65, SE 6.84),
though the groups did not differ when responding
with their left hand (ts < 1.0). In addition, low-anxious
psychopaths demonstrated significantly less frequency facilitation than controls when responding
with their right hand, t(70) 2.84, p < .01, (lowanxious psychopaths: M 14.01, SE 18.39; lowanxious controls: M 46.66, SE 11.96), though
the groups did not differ when responding with their
left hand (ts < 1.0). These findings are shown in Figures 1 and 2.

Supplemental Analyses
The PCLR has been found to have a reliable twofactor structure (Hare, 1991; Harpur et al., 1989). Because previous studies identifying anomalous emotion
processing in psychopaths have examined the relationship between emotion deficits and the factor
scores of the PCLR (Patrick et al., 1993; Patrick et
al., 1994), we conducted supplementary analyses to
examine the associations among PCLR Factor 1,
PCLR Factor 2, and aberrant emotion processing.3
The results of these analyses are reported in Footnote
3 because they are peripheral to the primary hypotheses addressed in this study.

Discussion
The results of this study provide good support for
all four experimental hypotheses. Clinical observation
(Cleckley, 1976) and experimental research (e.g.,
Williamson et al., 1991) have highlighted a distinction
between the psychopaths ability to appraise versus to
use emotion cues, which we have referred to as the
emotion paradox. Consistent with previous research
demonstrating the emotion paradox, low-anxious controls showed significantly greater emotion facilitation
than low-anxious psychopaths (i.e., better utilization)
on a lexical-decision task even though the two groups
provided comparable appraisal of the emotion words.
The fact that we replicated the Williamson et al. findings in an independent sample, despite using different
experimental stimuli and other procedural changes,

provides good support for our first two hypotheses

and further demonstrates the situational specificity of
the low-anxious psychopaths deficits in emotion processing (i.e., emotion paradox).
Paralleling our findings for the emotion analyses,
and extending previous research, the results also supported our third hypothesis that word frequency
would have a significantly greater effect on lowanxious controls than on low-anxious psychopaths.
The basis of this prediction was a study reported by
Newman et al. (1997) that involved a Stroop-like,
picture-word task. Whereas the incongruent, affectively neutral, peripheral stimuli automatically influenced responding in low-anxious controls, they had
virtually no effect on low-anxious psychopaths. Thus,
the present findings provide a conceptual replication
of this earlier finding and, in conjunction with these
results, provide further evidence that psychopaths
failure to use incidentalperipheral information is not
limited to emotion cues.
The results of this study were also consistent with
our fourth hypothesis that psychopaths weak facilitation would be specific to trial blocks performed with
their right hand. This finding provides a conceptual
replication of previous results indicating that psychopaths poor processing of incidental cues is specific to
conditions that activate the left hemisphere primarily
(Bernstein et al., 2000; cf. Kosson, 1996, 1998). To
our knowledge, however, this study represents the
first a priori test of the hypothesis that psychopaths

Supporting previous research demonstrating an association between PCLR Factor 1 and emotion processing,
Factor 1 scores, unlike Factor 2 scores, were significantly
correlated with deficits in processing emotion cues. The
zero-order correlations between Factor 1 and Factor 2 with
the reaction time emotion facilitation score were .27, p <
.01 and .00, ns, respectively. When Factor 1 was entered at
the first step of a regression analysis, it accounted for 7% of
the variance of emotion facilitation (R2 .07), F(1, 99)
7.82, p < .01. Factor 2 scores entered at Step 2 and the
interaction of Factor 1 and Factor 2 entered at Step 3 did not
account for significant increases in variance. When we conducted another analysis entering Factor 1 scores at Step 2
after entering Factor 2 scores, Factor 1 scores accounted for
a significant 9% of the variance in emotion facilitation (R2
.09), F(1, 98) 10.00, p < .01, whereas the effects of
Factor 2 and the interaction were again not significant. For
the sake of completeness, we repeated the same analyses
using frequency facilitation as the dependent variable.
These analyses yielded no significant results.

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DEFICIENT RESPONSE MODULATION

deficits in response modulation relate to differential

activation of the cerebral hemispheres.
The results of the current study contribute to the
growing literature demonstrating an array of processing deficits in psychopathic individuals. This literature indicates that psychopaths (a) are less sensitive to
incidentalsecondary threat cues (e.g., Lykken, 1957;
Newman & Kosson, 1986); (b) have emotion processing deficits (e.g., Patrick et al., 1993; Williamson et
al., 1991); (c) display unusual cerebral asymmetries
(see Hare, 1998); (d) are less sensitive to incongruent
contextual cues that interfere with primary task performance in others (e.g., Newman et al., 1997); and
(e) demonstrate language production and reception
anomalies (see Hare, 1998). However, in all cases,
there is evidence that these anomalies are situation
specific. That is, psychopaths often display adequate
sensitivity to threat and other emotion cues, normal
asymmetries, interference in response to incongruent
contextual cues, and comparable language skills (see
Hare, 1998; Newman & Lorenz, in press, for reviews). We have referred to the situational specificity
of the psychopaths information-processing deficit in
the emotion domain as the emotion paradox. To the
extent that this paradox and the other situationspecific findings reflect a core feature of psychopathy,
understanding the nature of such effects should clarify
emotion and processing deficits seen in psychopaths.
We believe that there is increasing evidence that the
RMH offers a compelling explanation for such discrepancies. The RMH predicts that psychopaths will
perform normally when deliberately attending to relevant task dimensions but appear oblivious to incidental cues that rely on automatic shifts of attention.
Consequently, the situational specificity of their information-processing deficits is fundamental to the
RMH (Gorenstein & Newman, 1980; Patterson &
Newman, 1993). Moreover, as demonstrated in the
current study, we believe that the RMH provides a
means of integrating psychopaths affective anomalies with their anomalous cerebral asymmetries and
other information-processing deficits.
Applying the RMH to the emotion paradox, we
proposed that psychopaths perform as well as controls
when they are deliberately attending to aspects of a
situation, but have difficulty processing and integrating information that is incidental to their primary focus of attention. This proposal is consistent with
Hares (1998) characterization of linguistic processing in psychopaths. Using a combination of evoked
potential and imaging data to clarify the processes
underlying their lexical decisions, Hare concluded

99

that psychopaths did little more than make a lexical

decision, whereas the nonpsychopaths continued to
process and mentally activate or elaborate the semantic and affective associations or networks of the
word they had just seen (p. 113). Such characterizations of psychopaths processing anomalies suggest
that they could resemble nonpsychopaths when they
are processing simple information but they are likely
to differ from controls on tasks involving more complex or multidimensional information.
In discussing the psychopaths difficulties in processing affective and deep semantic information, Hare
(1998) proposed that neurobiological basis of these
difficulties may involve anomalies in the integration
of activities within and between hemispheres (p.
124). Moreover, he noted that as language tasks increased in complexity, nonpsychopaths relied more
and more on the left hemisphere to process the information, while psychopaths relied more on the right
hemisphere (p. 125). Assuming that complexity involves processing and integrating multiple sources of
information (i.e., response modulation), psychopaths
response modulation deficits should be most apparent
when they are required to process and integrate multiple sources of information using left hemisphere resources primarily. The same analogy suggests that
psychopaths would display normal response modulation when using right hemisphere resources primarily.
Returning to the present findings, to the extent that
performing blocks of trials with the right hand differentially activates the left hemisphere, psychopaths
would be expected to have more difficulty than controls with semantically complex features (e.g., emotionality, frequency) to facilitate lexical decisions in
the right-hand condition. Conversely, psychopaths
would be expected to use the semantically complex
features of words as well as controls on trial blocks
performed with the left hand. Thus, the present findings are not only consistent with our hypotheses, but
also support recent speculation linking psychopaths
unusual cerebral asymmetries to their response modulation deficits (Bernstein et al., 2000; Hare, 1998; Hiatt et al., in press; Kosson, 1996, 1998).
One question that arises with regard to this explanation is whether word frequency effects may, like
emotion facilitation, be accurately understood as involving semantic complexity? Although researchers
are not in complete agreement as to how lexical decisions are performed (Balota, 1994; Balota &
Chumbley, 1984; Pugh, Rexer, Peter, & Katz, 1994;
Seidenberg & McClelland, 1989), many theorists
agree that lexical decisions are performed by serial,

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100

LORENZ AND NEWMAN

frequency-based searches. Consistent with this view,

controls show faster recognition of high-frequency
words compared with low-frequency words (Parkin,
1985; Rajaram & Neely, 1992). Given a target stimulus (e.g., assault), other words that share orthographic
features with the target are also activated (e.g., assume, vault, etc.). To the extent that the alternative
words are higher in frequency than the target, lexical
decisions will be slower than if the reverse was true.
Restated, the RTs of controls are slower for the lowfrequency words than for high-frequency words because their attention is directed automatically to
competing words in their mental lexicon (Balota,
1994). When examining RT data, this effect in the
controls appears as frequency facilitation to the highfrequency words relative to the low-frequency words.
Thus, consistent with the RMH, it follows that the
lexical decision of psychopaths are less influenced by
word frequency cues than those of controls when they
are performing the task with their right, though not
their left, hand.
The RMH specifies a possible mechanism for integrating the diverse, and often contradictory, findings
that characterize psychopaths laboratory performance and clinical symptoms. Given the speculative
nature of this integration, however, it is relevant to
consider whether existing models, such as Lykkens
(1995) low-fear hypothesis or Fowles (1980) weak
behavioral inhibition system analogy, can account
for the current findings. According to Lykkens lowfear hypothesis, psychopaths aberrant performance
on experimental tasks should be specific to fearful
and, some have argued, negative affect stimuli (Day
& Wong, 1996; Lykken, 1957; Patrick et al., 1993,
1994). However, consistent with the a priori predictions, our analyses yielded no significant interactions
involving word valence and psychopathy, suggesting
that low-anxious psychopaths demonstrated a lack of
emotion facilitation to both positive and negative
words. Moreover, it is difficult for the low-fear hypothesis or related proposals involving negative affect
to explain the fact that low-anxious psychopaths demonstrated performance deficits processing neutral cues
(e.g., word frequency). Similarly, the fact that psychopaths emotion-processing deficit was specific to
trial blocks performed with the right hand is difficult
to reconcile with proposals postulating a general insensitivity to threat or negative affect cues.
With regard to Fowles (1980) model, the behavioral inhibition system is activated by cues for punishment and novel stimuli. Once activated, the system
increases nonspecific arousal, interrupts ongoing be-

havior, and directs attention toward environmental

stimuli (see Gray, 1987). Although much of the evidence supporting the RMH may also be explained
with the weak-behavioral-inhibition system hypothesis (see Patterson & Newman, 1993), the current
experiment examines the extent to which secondary
cues facilitate, rather than interrupt, ongoing behavior. Because the behavioral inhibition system entails
interruption or inhibition of behavior in response to
secondary cues, explanations invoking this construct
cannot easily explain the current findings.
Although the current study made use of wellmatched, carefully diagnosed groups and a variety of
methodological refinements (e.g., larger sample size,
larger word list, less word repetition, alternation of
response hand) to improve upon prior research on
emotion processing in psychopaths (Williamson et al.,
1991), there are potential limitations that require discussion. First, it should be noted that our hypotheses
were limited to low-anxious Caucasian male offenders based on a priori, theoretical and empirical justifications. Because the RMH applies to Cleckleys
(1976) characterization of psychopathy, our planned
comparisons focused on a subgroup of participants
with high PCLR scores who also meet Cleckleys
exclusion criteria (i.e., absence of psychosis, good
intelligence, and low levels of neurotic anxiety). We
have elaborated on the rationale for this procedure in
numerous publications (Newman & Brinkley, 1997;
Newman, Widom, & Nathan, 1985; Schmitt & Newman, 1999a). Moreover, the current study was not
designed to test hypotheses about the moderating effects of anxiety. We believe that such tests require
more statistical power than was necessary to test the
present hypotheses and are most appropriately examined in the context of experimental manipulations designed to reveal such differences. These issues notwithstanding, it is notable that the Psychopathy
Anxiety interactions from the omnibus analyses approached statistical significance for both emotion and
frequency facilitation.
Because we neither designed this study to address
the effects of anxiety on performance nor tested
hypotheses about such differences, we are reluctant
to speculate concerning the effects of anxiety on
psychopathic and nonpsychopathic offenders. One
possibility that may merit future investigation is that
response modulation and anxiety both relate to regulation of attention but exert such effects via different
mechanisms. Whereas response modulation involves
relatively automatic shifts of attention that affect a
persons processing of peripheral cues, the association

101

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DEFICIENT RESPONSE MODULATION

between anxiety and avoidance motivation raises the

possibility that anxiety motivates the deliberate processing of peripheral cues. Thus, depending on experimental circumstances, high anxiety might be expected to mitigate the consequences of a response
modulation deficit.
Furthermore, despite the a priori nature of our
planned comparisons and the fact that our lab has
routinely focused hypothesis testing on low-anxious
Caucasian male offenders, we acknowledge that these
selection criteria limit the generalizability of our findings. That is, such findings may not generalize to
high-anxious, non-Caucasian, female, or nonoffender
samples (see Lorenz & Newman, in press; MacCoon,
Lorenz, & Newman, 2001). Although specific, the
support for our hypotheses should not be regarded as
weak or unreliable. Indeed, the effect size for emotion
facilitation (.72) and frequency facilitation (.83)
would be considered large (Cohen & Cohen, 1983).
Moreover, our use of selection criteria for the purposes of identifying individuals who are relatively
homogeneous with regard to the etiological processes
of interest (e.g., deficient response modulation) is
consistent with recommendations by Gorenstein
(1992) and others (e.g., Blashfield, 1984).
Another potential limitation of this study is that
each word was presented twice. Multiple presentations of words in a lexical-decision task can engender
repetition priming, which may obscure or otherwise
obfuscate individual differences in lexical-decision
performance. We chose to present each word twice in
order to match words presented during the left- and
right-hand conditions. That is, each word was responded to once with each hand to ensure that group
differences in response hand could not be attributed to
the word lists presented during the left- and right-hand
conditions. Given that the predicted group differences
were specific to right-hand responses for both emotion and frequency facilitation, the observed effects
cannot be attributed to repetition priming or to word
list effects.
Finally, thus study does not explain how lowanxious psychopaths performed the lexical decisions
as quickly and accurately as controls without using
multiple aspects of the word stimuli. It is possible that
the psychopaths performed the task in a more superficial manner than controls by using dimensions of the
word stimuli such as orthographic, phonological, or
even semantic features. Though not statistically significant, inspection of Tables 1 and 2 reveals that the
low-anxious psychopathic group responded slightly
faster and less accurately than the low-anxious con-

trols. Given these data, it may be tempting to propose

that the psychopaths failure to use emotion and frequency cues reflects the fact that they deliberately
processed the words less thoroughly or were not motivated to perform well on the task. However, the fact
that psychopaths weak facilitation was specific to
right-hand trial blocks is difficult to reconcile with a
general motivational deficit.
In conclusion, this study highlighted the emotion
paradox in psychopathy and provided further evidence for the distinction between appraisal and use of
emotional cues that is familiar to emotion theorists
(see Clore, 1996; Salovey & Mayer, 1990). We believe that this distinction proves helpful to researchers
as they attempt to clarify the psychopaths mask of
sanity, which includes their unimpaired (sometimes
excellent) judgment in appraising theoretical situations despite their extraordinarily poor judgment
demonstrated in behavior (Cleckley, 1976, p. 346).
Furthermore, working with the assumption that emotional stimuli are secondary cues that influence peoples thoughts and behavior, clinicians may develop
cognitive-based interventions to reduce the callousness (i.e., emotional) and self-regulatory (i.e., response modulation) deficits contributing to the antisocial behavior of psychopaths.

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Received November 30, 2000

Revision received December 31, 2001
Accepted December 31, 2001