Carlo Garofalo, PhD, is an assistant professor in the Department of Developmental Psychology at Tilburg University (The Netherlands). His research interests lie at the intersection of emotion, aggression, and personality pathology. More specifically, he is is interested in the development and manifestation of psychopathy and antagonistic personality traits. He is a full member of the Society for the Scientific Study of Psychopathy, and together with Dr. Luna Centifanti, he is founding member and co-chair of the Section for the study and treatment of antisocial personality disorder and psychopathy within the European Society for the Study of Personality Disorders.
- How did you get involved in psychopathy research?
Before studying psychology, I wanted to become a screenwriter, and true crime was the genre I was most into. A few years later, I was taking a psychopathology course during my undergraduate studies, and the lecture on psychopathy made me realize that I could connect my two passions. I found it fascinating to understand behaviors that appear as cold, callous, even cruel, through the lens of such a rich psychological construct. Later during my graduate studies, I had the privilege to conduct research in prisons and to spend 6 months in Chicago visiting Dave Kosson’s lab, which helped strengthen my research and clinical interest and my passion for this area.
- What role does emotion dysregulation play in psychopathy?
The layperson’s understanding of psychopathic individuals is that they are born with an inability to experience any emotion, and, as a result, their behavior is not influenced by their emotional experiences but rather by the absence of emotions. Similar views have long been predominant in the scientific literature on psychopathy. Against this background, I find it is intriguing and potentially important that, in the past decade or so, more and more research is reporting positive associations between psychopathic traits and scores on tests designed to measure emotion dysregulation. This research suggests not only that psychopathic individuals can, and do feel emotions, but also that they struggle with understanding, accepting, and managing their emotional experience.
It is still premature to speculate about the how emotion regulation problems develop in psychopathy. Yet, I find it persuasive and worth investigating the idea that emotion regulation processes may partly explain the development of psychopathic traits, and, in particular, the callousness that is typical of psychopathy. In addition, in some recent work, my colleagues and I have proposed that emotion dysregulation may also help to explain the link between psychopathy and aggression. That is, at least some of the aggression displayed by psychopathic individuals is driven by emotion dysregulation.
A cautionary note that is worth stressing is that psychopathy is likely not a unitary syndrome. therefore different variants (or subtypes) of psychopathy may be differently characterized by emotion dysregulation. Yet, my reading of the literature is that most of the evidence suggests that “prototypical” psychopathic individuals (those with high levels of psychopathic traits across the interpersonal, affective, and behavioral domains) do have problems with emotion regulation.
- Does the role of emotion dysregulation in psychopathy have any implications for interventions with psychopathic violent offenders?
It is too early for definitive answers to this question, but my sense is that, yes, the difficulties with regulating emotion can and should have implications for interventions. Before research on psychopathy and emotion (which could include research on psychopathy and emotion regulation) broadened in fairly recent times, the lion’s share of studies have focused on studying the kinds of emotions that were deficient in psychopathy. The logical clinical recommendations that followed this view discouraged studying emotion regulation in treatments for psychopathic offenders because that would allegedly not help improve their condition or influence their maladaptive behaviors (including aggression and violence).
Now there is evidence that psychopathic individuals do feel some emotions, and may feel some emotions (e.g., anger, contempt) more frequently and more intensely than most other people. On top of these findings, the evidence that psychopathic individuals have difficulties regulating emotions should make us reconsider such recommendations. In this context, it is important to emphasize that I am using the term emotion dysregulation quite broadly. The way I am using it includes awareness, understanding, and acceptance of emotions; the ability to manage (that is, modify) one’s emotional experience in desired directions; and the ability to control behavior when experiencing strong (often negative) emotions. All these areas appear to be impaired in psychopathic individuals, and all of these areas are common targets in many treatment approaches. I believe that these treatment approaches should be adapted for effective interventions with psychopathic offenders, but may also help us to someday prevent the development of psychopathic traits.
- Do community individuals with higher levels of psychopathic traits also show emotion regulation deficits?
The research I was referring to on psychopathy and emotion regulation has been focused on both offender and community samples, and the comparability of the findings across samples is striking. After all, as for almost all forms of psychopathology, psychopathy is a matter of degree in the sense that psychopathic traits exist on a continuum that goes from normative to pathological. This means that although the severity of psychopathy is lower – on average – in community samples compared to offender samples, the associations with other factors are similar. This is true also for emotion dysregulation; as the degree of psychopathic traits increases, so does the severity of the difficulties in emotion regulation in several important domains. This extends the implications mentioned above to the impact of psychopathy outside prison or forensic contexts.
- Considering research is generally ahead of application in the field, what is one improvement in the field of psychopathy that you hope to see take place over the next five to ten years?
On the research side, I hope research will continue to help us to identify more specific emotion regulation processes that play a role in the development and manifestation of psychopathic traits throughout the lifespan. I mean both, in terms of adopting multiple assessment methods, and in terms of focusing on the regulation of specific emotions, rather than examining emotion dysregulation broadly. An example of one area that I find fascinating is investigating whether psychopathic individuals have a positive appraisal of some emotional experiences typically considered to be unpleasant (such as fear or anger). In addition, I do hope that the field will develop a greater integration of knowledge across different areas of functioning that are too often investigated in isolation as they relate to psychopathy (such as emotion, cognition, and motivation).
Finally, my main hope is not for an improvement of knowledge within the field, but for an improvement in knowledge moving from the field, I hope that knowledge transfer will continue to increase so that societal stakeholders (such as the mental health care and the criminal justice system) and the general public can be better informed about the importance of psychopathy and be up to date with scientific progress. This would help to contrast the many common misconceptions that still exist about psychopathy.
