Sunday, February 17, 2019

Anticipating regret

I apologize, I forget who sent me this article highlighting some recent research by Joshua Buckholtz, associate professor of psychology at Harvard, and Arielle Baskin-Sommers, assistant professor of psychology and of psychiatry at Yale University. I think we've talked about at least Baskin-Sommers before. I wish there was a little bit better explanation of the nature of the experiment and how robust their findings were, but essentially what they found was that sociopaths are actually capable of feeling regret and disappointment -- essentially just a wish that things had gone differently than they actually did, perhaps because we had acted differently than we did.

This I find to be true to experience. Not just that, I see it in other sociopaths that I've met and still talk to and I think it underpines the inability of sociopaths to learn for experience. Take for instance a sociopath who has totaled on average .85 cars a year since she started driving. That's very high! But I actually know two separate sociopaths who have a driving history like this. I'm not sure if it's always true, but most of the accidents are caused not by weather conditions, etc., but by inattention to road conditions. Maybe some texting while driving, maybe some wandering mind. But totalling a car is expensive. This is something that you think people would start really trying to avoid. And the advantage of texting while driving or doing other things while driving is so low. If sociopaths were true rational actors engaged in a cost benefit analysis, you'd think that these people would have lower automobile insurance premiums. But they don't. Why?

Maybe normal people are better able to learn from their experience because they can anticipate the regret that they would feel. In fact, probably a lot of the source of normal people's anxiety and worry is really just an anticipation of regret or disappointment. Does this sound right normal people? And because those emotions are so negative and powerful, it directs the normal person to avoid the behavior that carries a high risk of regret with it. Not always, but more than sociopaths maybe.

According to the article:

“The assumption has always been that they make these bad choices because they can’t generate negative emotions like fear, or appropriately respond to emotional signals generated by other people … but we turned that idea on its head.”

Using an economic game, Buckholtz and Baskin-Sommers were able to show that while psychopaths have normal, or even enhanced, emotional responses in situations that typically elicit regret, they have trouble extracting information from the environment that would indicate that an action they’re about to take will result in the experience of regret.

“There are two components to regret,” Buckholtz explained. “There is retrospective regret, which is how we usually think about regret — the emotional experience after you learn you could have received a better outcome if you had made a different choice. But we also use signals from our environment to make predictions about which actions will or won’t result in regret. What differentiated psychopaths from other people was their inability to use those prospective regret signals, to use information about the choices they were given to anticipate how much regret they were going to experience, and adjust their decision-making accordingly.

“It’s almost like a blindness to future regret,” he added. “When something happens, they feel regret, but what they can’t do is look forward and use information that would tell them they’re going to feel regret to guide their decision-making.”

“These findings highlight that psychopathic individuals are not simply incapable of regret [or other emotions], but that there is a more nuanced dysfunction that gets in the way of their adaptive functioning,” Baskin-Sommers said. “By appreciating this complexity, we are poised to develop more accurate methods for predicting the costly behavior of psychopathic individuals.”

Using a measure of prospective regret sensitivity, Buckholtz and Baskin-Sommers were also able to predict whether and even how many times study participants had been incarcerated.

“Contrary to what you would expect based on these basic emotional-deficit models, their emotional responses to regret didn’t predict incarceration,” Buckholtz said. “We know psychopathy is one of the biggest predictors of criminal behavior, but what we found was that behavioral regret sensitivity moderated that, raising the suggestion that intact behavioral regret sensitivity could be a protective factor against incarceration in psychopathic individuals.”

While the study upends the pop-culture image of psychopaths, Buckholtz is hopeful that it will also provide a new direction for scientists who hope to understand how psychopaths make decisions.

“We actually know very little about how psychopaths make choices,” he said. “There have been all sorts of research into their emotions and emotional experience, but we know next to nothing about how they integrate information that we extract from the world as a matter of course and use it to make decisions in daily lives. Getting better insight into why psychopaths make such terrible choices, I think, is going to be very important for the next generation of psychopathy research.”


Monday, February 4, 2019

Diagnosing Logan and Jake Paul as sociopaths?

I was aware of this at the time they came out but didn't have anything to really say. But I stumbled upon this article by Self , "What Mental Health Experts Want You to Know Before Watching the Buzzy New YouTube Series ‘The Mind of Jake Paul’,: that interviewed some of our friend researchers that I thought had some good information :

Although the word pops up in everyday conversation, it is not actually a medical term, Steven Siegel, M.D., professor and chairman of psychiatry and the behavioral sciences at the Keck School of Medicine of USC, tells SELF.

“We try to avoid the term because it just doesn’t have any formal meaning. It’s a colloquial word and it’s not used consistently,” Scott Lilienfeld, Ph.D., professor of psychology at Emory University, tells SELF.

“It has no clinical content,” Ronald Schouten, M.D., J.D., director of the Law & Psychiatry Service of the Massachusetts General Hospital and associate professor of psychiatry at Harvard Medical School, tells SELF. “It’s used as an epithet.”

As Dr. Siegel explains, sociopath is generally a label that some people give someone they believe is a bad person.

Sociopathy is really an outdated, slippery term for what is known today as antisocial personality disorder (ASPD), according to the American Psychological Association (APA). As Morton notes in episode two, “The Dark Side of Jake Paul,” ASPD is the technical term most clinicians prefer to use today. (The terms are still sometimes used interchangably, according to the National Institutes of Health).

“Antisocial personality disorder is psychiatry's way of trying to classify people without using the pejorative or derogatory terms,” Dr. Siegel explains. “It’s a way of commenting on a pervasive pattern of behavior that spans someone's adult life and that may inform why they experience life the way they do.”
***
“personality disorders are notoriously difficult to diagnose,” Katherine Dixon-Gordon, Ph.D., a clinical psychologist and assistant professor in the department of Psychological and Brain Sciences at the University of Massachusetts Amherst, tells SELF. “This diagnosis is a really complex thing to undertake, and requires these long interviews.”

Even having all the relevant information doesn’t always ensure a reliable diagnosis. “They are so complicated that even among psychologists and psychiatrists, we can’t agree on how to diagnose personality disorders,” Dixon-Gordon says. “Even when we undertake these incredibly complicated interviews with people, experts don't always agree.” She explains that two well-qualified clinicians could evaluate the same person and not necessarily come away with the same assessment.

In reality, the behaviors some experts may link to ASPD span a spectrum. “All of these personality disorders describe being at an extreme end of a spectrum of normal human behaviors,” Dr. Siegel says. Dixon-Gordon adds, “By definition, [personality disorders] represent maladaptive variance of normative personality functioning. So often that line between what’s adaptive and what’s maladaptive and what’s normative and non-normative is a difficult one to find.”

In episode two, Morton cites a statistic that one in 25 people is a sociopath. (This stat is arguably outdated and was derived from several studies dating back to the ‘90s.) While there are not many reliable epidemiological studies on how prevalent ASPD is—although several experts noted that figure sounds high—Lilienfeld argues that the stat is misleading for a different reason.

“Saying ‘one in 25’ implies that [people with ASPD] are different in kind, rather than in degree, from the rest of us,” Lilienfeld says. “In my view, there’s no real distinction in nature that clearly tells you [if somebody has ASPD or not]. There’s no categorical cutoff. It’s almost like asking, ‘How many people are tall?’ Depends on where you draw the cutoff for tall.”

Dixon-Gordon makes a similar argument. “In the same way that the cutoff for whether or not you have high cholesterol changes from year to year, these [diagnostic cutoffs] change,” she explains.

These complicated, nebulous aspects of personality disorders mean that attempting to diagnose them even in a professional setting requires extreme care and caution. “All of these things are reasons why diagnosis is so, so nuanced and complex and contextual,” Dixon-Gordon says, “and really requires [...] not jumping to conclusions.”

Interestingly some of the researchers quoted worry that the webseries is trying to glamourize what they describe as a "dangerous" disorder. But maybe watching were concerned about the opposite, that it was attempting to demonize and stigmatize. So much so that Shane Dawson included an apology at the beginning of episode 3:

“I do actually want to apologize because there was some backlash from people feeling offended and feeling like I was making a horror movie out of an illness or a disorder. And I 100% understand [...] to treat a person like a scary monster is like, not cool, and I shouldn’t have done that. So I apologize for that genuinely.”

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