The psychoticism-psychopathy continuum: A model of core neuropsychological deficits

A neuropsychological model of a proposed psychoticism–psychopathy continuum is sketched, which postulates that the core deficits seen both in the personality trait of psychoticism and the clinical condition of psychopathy result from a dysfunction in a behavioural inhibition system (BIS; concerned with detecting and resolving goal-conflicts and associated with the emotion of anxiety) which leads to cognitive inflexibility, inattentiveness and response modulation deficit. Furthermore, differences in activity in a fight-flight-freeze system (FFFS; concerned with avoidance/escape and associated with the emotion of fear) are postulated to differentiate primary (low fearful) and secondary (adequately fearful) psychopaths, with the latter type also experiencing increased activity in a behavioural approach system (BAS; concerned with approach behaviour and associated with the emotion of hopeful anticipation) resulting in dysfunctional impulsiveness. Sub-clinical levels of psychoticism are postulated to result from a defective FFFS and BIS, coupled with an over-active BAS (specifically the fun-seeking, impulsivity facet) – this postulation raises the possibility that psychoticism may be a conflation of these separate influences and may differentiate into two types similar to those found in psychopathy. This model reconciles previously inconsistent findings relating the BIS to psychopathy and points to new avenues of research.