Visual complexity attenuates emotional processing in psychopathy: Implications for fear-potentiated startle deficits

A long-standing debate is the extent to which psychopathy is characterized by fundamental deficits in attention or emotion.
We tested the hypothesis that the interplay of emotional and attentional systems is critical for understanding processing
deficits in psychopathy. A group of 63 offenders were assessed using the Psychopathy Checklist: Screening Version. Event-related
brain potentials (ERPs) and fear-potentiated startle (FPS) reflexes were collected while participants viewed pictures selected
to disentangle an existing confound between perceptual complexity and emotional content in the pictures typically used to
study fear deficits in psychopathy. As predicted, picture complexity moderated the emotional processing deficits. Specifically,
the affective–interpersonal features of psychopathy were associated with greater allocation of attentional resources to processing
emotional stimuli at initial perception (visual N1), but only when the picture stimuli were visually complex. Despite this,
results for the late positive potential indicated that emotional pictures were less attentionally engaging and held less motivational
significance for individuals high in affective–interpersonal traits. This deficient negative emotional processing was observed
later in their reduced defensive fear reactivity (FPS) to high-complexity unpleasant pictures. In contrast, the impulsive–antisocial
features of psychopathy were associated with decreased sensitivity to picture complexity (visual N1) and were unrelated to
emotional processing, as assessed by both ERPs and FPS. These findings are the first to demonstrate that picture complexity
moderates FPS deficits, and they implicate the interplay of attention and emotional systems as deficient in psychopathy.