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Article

Attention Moderates the


Relationship Between
Primary Psychopathy and
Affective Empathy in
Undergraduate Students

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DOI: 10.1177/0033294116667699
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Ayame Tamura
Graduate School of Integrated Arts and Sciences, Hiroshima University, Japan; Japan
Society for the Promotion of Science, Japan

Yoshinori Sugiura
Graduate School of Integrated Arts and Sciences, Hiroshima University, Japan

Tomoko Sugiura
Japan Society for the Promotion of Science, Japan

Jun Moriya
Graduate School of Sociology, Kansai University, Japan

Abstract
Psychopathy is personality traits, which is consisted of primary psychopathy characterized by affective and interpersonal problems and secondary psychopathy characterized
by behavioral problems. Prior researchers have suggested that people with psychopathy
have peculiar attention, which prevents them from detecting information peripheral to
their concern, and we hypothesized that this explains their low empathy. Based on these
reasoning, the present study assessed whether attention moderates the relationship
between psychopathy and affective empathy. Eighty-five undergraduates (40 men and 45
women; mean age 19.8 years; SD 1.6) completed the Levenson Self-Report
Psychopathy Scale, the Interpersonal Reactivity Index, and a perceptual load task.
Hierarchical regression showed that a significant moderation effect was found: primary
psychopathy was negatively associated with affective empathy, among those with
reduced interference from task-irrelevant stimuli under a medium level of perceptual
load. Future study should need to replicate this finding with clinical population.
Keywords
Psychopathy, empathy, attention
Corresponding Author:
Ayame Tamura, Graduate School of Integrated Arts and Sciences, Hiroshima University,
Higashi-Hiroshima City, Hiroshima Prefecture, Japan.
Email: d146256@hiroshima-u.ac.jp

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Introduction
Psychopathy is a personality trait that is represented by two components of the
Psychopathy ChecklistRevised (PCLR; Hare et al., 1990). Whereas primary
psychopathy is characterized by aective and interpersonal features, represented
by cruelty, manipulativeness, low fear, and low empathy, secondary psychopathy is characterized by behavioral features, such as an impulsive and antisocial
lifestyle. A number of studies have explored the latent structure of psychopathy
with criminal samples by using a taxometric approach with the results suggesting
that psychopathy has a continuous dimensional, rather than a taxonic structure
(e.g., Edens, Marcus, & Vaughn, 2011; Walters, 2014). In addition, the major
characteristics of psychopathy (i.e., low empathy and worse performance on a
task that measures executive function) were shown to manifest in noncriminal
groups, which are similar to those of the ndings with criminal groups (e.g.,
Mahmut, Homewood, & Stevenson, 2008). Recently, researchers have begun
focusing on cases of successful psychopaths who could adequately display characteristics of psychopathy but were adapted to social life (Lilienfeld, Watts,
& Smith, 2015). Therefore, studies of psychopathy with nonclinical samples
have become popular because it is informative to investigate the common
correlates and/or mechanisms in both noncriminal and criminal samples (e.g.,
Ali & Chamorro-Premuzic, 2010; Mahmut et al., 2008; Sadeh & Verona, 2008).
This study aimed to clarify the mechanism of low empathy, which is an
important feature of psychopathy, in a nonclinical undergraduate sample.
Empathy is the ability to feel or understand others feelings or emotions and
plays an important role in components of social behaviors, such as moral reasoning, inhibition of aggression, and other-oriented social emotions (Decety &
Lamm, 2006). Empathy is a multidimensional construct, and many studies have
distinguished cognitive from aective empathy (Cox, Uddin, Di Martino,
Castellanos, Milham, & Kelly, 2012; Davis, 1983; Shamay-Tsoory, 2011).
Cognitive empathy is the ability to comprehend other peoples emotional
states, while aective empathy is the ability to vicariously experience others
emotional states. The traditional view suggests that the low empathy in psychopathy is due to aective empathy because people who exhibit psychopathy are
characterized by dysfunctions in general emotion arousal. In fact, a number of
previous studies with both criminal (Blair et al., 2004; Kosson, Suchy, Mayer,
& Libby, 2002) and noncriminal (Ali, Amorim, & Chamorro-Premuzic, 2009)
samples have revealed that people who exhibit psychopathy have diculty with
aective responses and emotion recognition. These studies support the suggestion of an amygdala dysfunction in psychopathy (Blair, 2005). On the other
hand, it is thought that some people diagnosed with psychopathy have no
problems with cognitive empathy, especially as it relates to the theory of mind
(Blair et al., 1996; Richell et al., 2003), although some recent studies have
reported poor performance on some theory of mind tasks in psychopathy
(Ali & Chamorro-Premuzic, 2010 for undergraduates; Dolan & Fullam, 2004

Tamura et al.

for oenders). Therefore, it is possible that psychopathy is related to problems


with both aective and cognitive empathy (Reniers et al., 2012); however, the
mechanism underlying this low empathy remains unclear.
Empirical studies have examined the mechanism by which people who exhibit
criminal psychopathy experience low levels of fear. A response modulation
theory has been proposed as one such mechanism (e.g., Newman, Curtin,
Bertsch, & Baskin-Sommers, 2010). We expected that this theory will expand
to include low empathy from the original low fear. This is partly because empathy shares mechanisms with emotion, in general, and with attention (Decety &
Lamm, 2006). On the basis of the response modulation theory, people who
exhibit psychopathy tend to be insensitive to threat cues due to their exclusively
goal-directed focus of attention (Zeier, Maxwell, & Newman, 2009). That is,
people with high scores in the measures of psychopathy would display a
normal response to fear information in situations when attention is focused
on fear-relevant information. For example, Newman et al. (2010) examined
the response modulation theory with 125 prisoners and measured fear-potentiated startle (FPS) by asking participants to focus their attention on either
threat-relevant (i.e., red or green color, where red was accompanied by electric
shocks) or threat-irrelevant (i.e., upper or lower case letters) stimuli. The results
of the general linear model showed that attentional focus had a moderating
eect on the relationship between psychopathy and FPS, F(1, 123) 5.28,
B 5.8, p < .05, among prisoners with high psychopathy scores. A follow-up
simple eects test indicated that there was no signicant association between
psychopathy and FPS when participants were instructed to direct their attention
toward threat-relevant stimuli (B .70, p .800) and that there was a negative
association between psychopathy and FPS when participants focused on threatirrelevant stimuli condition (B .52, p < .001). These ndings indicate that
overfocused attention moderates the relationship between psychopathy and
fear response.
These attention characteristics in criminal psychopathy have also been
observed using other attention tasks related to response conict, such as the
Stroop test (Hiatt, Schmitt, & Newman, 2004; Vitale, Brinkley, Hiatt, &
Newman, 2007) and modied anker task (Zeier et al., 2009). Furthermore,
this particular attentional mechanism might provide a more thorough explanation of the broad aective problems associated with psychopathy. For example,
Dawel, OKearney, McKone, and Palermo (2012) reviewed the emotion recognition skills in both criminal and noncriminal psychopathy and indicated that
attention underlies the observed diculties with general emotion recognition
(not only fear recognition) in psychopathy. That is, people with high psychopathy scores tend to pay less attention to socially relevant cues, such as other
peoples eyes, when they are required to recognize others emotion (e.g., Dadds,
Masry, Wimalaweera, & Guastella, 2008 for nonclinical adolescents; Dadds,
Jambrak, Pasalich, Hawes, & Brennan, 2011 for children diagnosed with

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conduct problems using the criteria in the Diagnostic and Statistical Manual of
Mental, Fourth Edition by the American Psychiatric Association, 1994).
We expected that response modulation theory would also explain the
observed low empathy in individuals exhibiting psychopathy because goaloriented attention can provide a plausible explanation for the general emotional
problems that are associated with psychopathy. More specically, the general
emotional problems associated with psychopathy are linked to aective empathy, which is regarded as an emotional response to others, whereas cognitive
empathy is indicative of the understanding of others mental condition (Davis,
1983). Overall, we hypothesized that the association between psychopathy and
aective empathy may be moderated by attentional characteristics, which prevent people from detecting peripheral information that is outside of their goal.
However, no study has yet examined whether attention moderates the relationship between psychopathy and empathy. Therefore, in this study, we addressed
this gap in the literature by measuring self-reported psychopathy and empathy
and measured attention using an interference of task-irrelevant stimuli via an
experimental paradigm.
To assess the magnitude of interference of task-irrelevant stimuli, we used the
perceptual load task modied by Maylor and Lavie (1998) because the inherent
feature-based attention in psychopathy is considered to reduce attention to taskirrelevant stimuli. According to Lavie (2005), when people process a number of
task-relevant stimuli (i.e., perceptual load is high), they lack the capacity to
perceive task-irrelevant stimuli; however, when perceptual load is low, they
have spare capacity to process such stimuli. In relation to this point, Sadeh
and Verona (2008) examined the relationship between psychopathy and perceptual load task with a sample of 100 individuals, 26 of whom were community
and 74 subject samples. They reported that psychopathy was negatively associated with the processing of task-irrelevant stimuli at a medium level of perceptual load, based on correlation analysis (r .25, p < .05) and follow-up
analysis of analysis of variance, F(1, 93) 5.63, p < .05, 2p .06. In this way,
as psychopathy showed reduced interference when under a medium level of
perceptual load (Sadeh & Verona, 2008), a signicant moderation eect of attention on the relationship between psychopathy and empathy should be found at a
medium level of perceptual load. Further, we focused on the dierences between
primary and secondary psychopathy. Prior studies using the response modulation theory have reported that attention moderates the relationship between
primary psychopathy and fear response, and but not between secondary psychopathy and fear response (Baskin-Sommers, Curtin, & Newman, 2011; Newman
et al., 2010). Therefore, we expected that the moderation eect would only occur
for the relationship between primary psychopathy and aective empathy.
Hypothesis. The magnitude of interference from task-irrelevant stimuli at a medium
level of perceptual load task will moderate the relationship between primary

Tamura et al.

psychopathy and aective empathy. That is, primary psychopathy will be negatively associated with aective empathy when people with high primary psychopathy show reduced interference from task-irrelevant stimuli at a medium level of
perceptual load.

Method
Participants
Ninety-eight Japanese undergraduate students (45 men and 53 women;
M age 19.7 years, SD 1.5) participated in this study. All participants had
normal or corrected-to-normal vision; thus, they were able to complete the perceptual load task.
Due to time limitations, three participants completed only the perceptual load
task and not the questionnaires. The data from two, four, and three participants
from the high-, medium-, and low-load conditions, respectively, were excluded
from the statistical analyses due to technical problems during data collection.
After questionnaires with missing data were excluded, then, 85 participants data
(40 men and 45 women; mean age 19.78 years, SD 1.58) were used for
analysis.

Measures
The Levenson Self-Report Psychopathy Scale. The Levenson Self-Report Psychopathy
Scale (LSRP; Levenson, Kiehl, & Fitzpatrick, 1995) is a 26-item self-report
measure with two subscales that are designed to assess psychopathic attributes
in a noninstitutionalized population. The primary psychopathy subscale consists
of 16 items assessing aective and interpersonal features (sample items are
Success is based on survival of the ttest and I am not concerned about
losers), whereas the secondary psychopathy subscale consists of 10 items assessing behavioral and impulsivity features (a sample item is I nd myself in the
same kinds of trouble, time after time). Items are rated on a four-point scale
ranging from 1 (Strongly disagree) to 4 (Strongly agree). Levenson et al. (1995)
developed and initially validated the LSRP with a sample of 487 undergraduate
students. Further evidence for the scales acceptable psychometric properties
was provided by Lynam, Whiteside, and Jones (1999), who found a strong replication level for the two-factor structure, satisfactory testretest reliability
(N 70, r .83), and additional validity using a large sample of 1958 undergraduates. The taxometric analysis of the LSRP also provided evidence for a
dimensional structure in relation to the distribution of psychopathy in a criminal
sample (Walters, Brinkley, Magaletta, & Diamond, 2008). Sugiura and Sato
(2005) developed the Japanese version of the LSRP through back-translation

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of each item, and Osumi, Kanayama, Sugiura, and Ohira (2007) reported further
psychometric evidence supporting its construct validity, adequate testretest
reliability (N 77, rs .72.81), and factor structure using a sample of 475
undergraduate students. The alpha coecient of the original version was .82
for the primary psychopathy subscale and .63 for the secondary psychopathy
subscale (Levenson et al., 1995). Coecient omegas in the current sample were
.77 for the LSRP total scale, .77 for the primary psychopathy subscale, and
.61 for the secondary psychopathy subscale. Although the internal consistency
reliability of the secondary psychopathy is low, previous reports have supported
its acceptability (e.g., Levenson et al., 1995; Sugiura & Sugiura, 2011).
The Interpersonal Reactivity Index. The Interpersonal Reactivity Index (IRI; Davis,
1983) is a 28-item self-report scale that assesses multidimensional empathy via
the following four subscales: perspective taking, fantasy, empathic concern, and
personal distress. Both perspective taking, which assesses the tendency to spontaneously adopt the psychological view of others (a sample item is I sometimes
try to understand my friends better by imagining how things look from their
perspective), and fantasy, which assesses the tendency to identify with ctitious
characters (a sample item is I really get involved with the feelings of the characters in a novel), are facets of cognitive empathy. The other two subscales are
facets of aective empathy, where empathic concern assesses other-oriented
feelings of sympathy and concern for others (a sample item is I often have
tender, concerned feelings for people less fortunate than me), and personal
distress assesses personal responses to others emergencies (a sample item is
Being in a tense emotional situation scares me). Recent studies suggest that
the fantasy and personal distress scales of the IRI have validity problems
because the denition of empathy used was too broad (Jollie & Farrington,
2006; Reniers, Corcoran, Drake, Shryane, & Vollm, 2011). However, the
perspective taking and empathic concern subscales have demonstrated more
construct validity as indices of cognitive empathy and aective empathy
(Davis, 1983), and most studies used only these two subscales (Cox et al.,
2012; Shane, Stevens, Harenski, & Kiehl, 2009). For these reasons, we used
only the perspective taking and empathic concern subscales. Davis (1980)
reported that in a sample of 1161 undergraduate students, each of the four
subscales of the IRI displayed satisfactory temporal stability (N 109,
rs .61.81) and internal consistency reliability (as .70.78). Evidence of adequate convergent and discriminant validity has also been provided (Davis,
1983). Sakurai (1988) translated the IRI into Japanese and later (Sakurai,
1994) found adequate validity for this Japanese version. Items are rated on a
four-point scale ranging from 1 (Strongly disagree) to 4 (Strongly agree).
Coecient omegas in the current sample were .76 for the former subscale
and .43 for the latter. The low internal consistency reliability for the empathic
concern subscale may be because the Japanese version of the IRI has not been

Tamura et al.

back-translated (Sakurai, 1988), and prior factor analyses have revealed that
some items have low factor loadings (Sakurai, 1994). Therefore, we conducted
a conrmatory factor analysis using the 14 items of the empathic concern and
perspective taking subscales. Results revealed some items with low factor loadings for the empathic concern subscale. Therefore, we conducted all analyses
using only four items for empathic concern, after excluding the three items with
factor loadings <.30). After excluding the items, the coecient omega for the
empathic concern subscale improved to .65.
Perceptual load task. To assess attention, we administered a modied version of
the perceptual load task employed by Maylor and Lavie (1998). All stimuli were
presented on an Epson Endeavor AY301 computer with a 19-inch Sharp
LL-T19D1-H screen. The experimental task was controlled by MATLAB
using Psychophysics Toolbox extensions (Brainard, 1997; Pelli, 1997). The participants response times (RTs) and accuracy scores were obtained from their
keyboard responses.
In the perceptual load task, each trial started with a xation cross that
appeared for 8001200 ms, after which a circle of six letters appeared that consisted of one target letter (X or N) with zero, three, or ve perceptual load items,
constituting each of three load conditions (low, medium, and high). The taskirrelevant stimuli (X, N, or P), which were compatible, incompatible, or neutral
with the target, also appeared to the right or left outside the circle. This distractor letter was irrelevant to task completion but was the same as the target letter
for the compatible condition (e.g., distractor letter X for target X) of dierent
from the target letter for the incompatible condition (e.g., distractor letter N for
target X). The circle of letters and distractors were presented for 100 ms, then the
xation cross was presented until the participant responded. Participants were
instructed to press the left arrow key if they saw X in the circle and to press the
right arrow key if they saw N in the circle, as quickly as possible. They were also
instructed to ignore the perceptual load letters and task-irrelevant stimuli and to
focus on the xation point at the center of circle.
Each participant completed 12 practice trials, comprising one stimulus block,
and 192 experimental trials, consisting of three blocks of stimuli (one low-load,
one medium-load, and one high-load block). Feedback regarding accuracy was
only provided during the practice block. The participants completed the blocks
of stimuli for the three load conditions in a random order. Combinations of
target and task-irrelevant stimuli, distractor letters, and locations were counterbalanced within each load condition.
The compatibility eect (CE) is an index of the degree of interference from the
task-irrelevant stimuli. This was calculated separately for the three load conditions by subtracting the RT in the compatible trials from the RT in the incompatible trials. A larger CE represents greater interference from task-irrelevant
stimuli.

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Procedure
The participants were recruited voluntarily from psychology classes at
Hiroshima University by completing a brief address form. In the experiment,
the participants were tested individually in a light diminished room and
were seated in front of a monitor. They completed the perceptual load task
before completing the questionnaires. The experiment lasted approximately
90 minutes, and participants were given a prepaid card valued at 500 yen
as a reward for taking part. The nature and purpose of the study were
explained and participants were asked to sign a written informed consent
form prior to participation. This study was approved by the institutional
review board at Hiroshima University Graduate School of Integrated Arts
and Sciences.

Data analysis
In order to conrm that our manipulation of the load conditions and combination of target and task-irrelevant stimuli worked as expected, we analyzed the
RT and accuracy data using analysis of variance with a 3 (load: high, medium,
and low)  3 (compatibility: compatible, neutral, and incompatible) withinsubjects design. For each participant, we excluded all incorrect responses and
RT that fell outside 3 SD from the individual participants mean. Accuracy data
were calculated and we conducted arcsine transformation according to the procedure of Maylor and Lavie (1998). After the manipulation check was complete,
descriptive statistics and correlation were calculated for all indices in this study.
Finally, we used hierarchical regression analysis. This analysis was performed to
test our hypothesis that the CE at a medium level of perceptual load task will
moderate the relationship between primary psychopathy and aective empathy:
primary psychopathy will be negatively associated with aective empathy
when CE at a medium level of perceptual load is low. In the analysis, the predictors (subscale scores on the LSRP and CE) were mean centered and entered
simultaneously in Step 1 (main eect). An interaction eect was entered in Step
2. Separate analyses were conducted for each subscale of the IRI (perspective
taking and empathic concern) and LSRP (primary and secondary psychopathy).
As people who on scores highly on measure of psychopathy indicated that they
experienced reduced interference from task-irrelevant stimuli during the perceptual load task in the medium-load condition, F(1, 93) 5.63, p < .05, 2p .06
(Sadeh & Verona, 2008), we used CE for the medium-load condition for analysis
in this study. For signicant interactions in Step 2, simple slopes tests
were conducted at 1 SD above and below the mean CE for the medium-load
condition, in order to examine the association with psychopathy and empathy
at dierent levels of CE. The statistical procedures were performed with
R 3.1.2 (http://www.r-project.org/).

Tamura et al.

Table 1. Mean reaction time (in ms) and accuracy (proportion correct) by load and
distractor compatibility for the perceptual load task.
Low
RT
Incompatible
Neutral
Compatible

661 (198)
612 (145)
612 (159)

Medium

Accuracy
.90
.93
.95

(.11)
(.08)
(.07)

RT
746 (155)
706 (118)
711 (137)

High

Accuracy
.89
.94
.95

(.12)
(.07)
(.07)

RT
810 (158)
790 (141)
794 (164)

Accuracy
.88
.92
.93

(.13)
(.07)
(.08)

Note. RT reaction time; SD are presented in parentheses.

Results
First, we conducted a manipulation check of the perceptual load task. Table 1
shows mean RT and accuracy by load and by compatibility with task-irrelevant
stimuli. There was a main eect of load for RT, F(2, 83) 100.07, p < .001,
2p .54, and for accuracy, F(2, 83) 8.10, p < .001, 2p .09. As expected, the
participants responded more slowly as the perceptual load increased (p < .001).
Accuracy was lower in the high than the low- and medium-load conditions
(p < .01). A main eect of compatibility was also found for RT, F(2,
83) 17.42, p < .001, 2p .17, and for accuracy, F(2, 83) 25.72, p < .001,
2p .23. As expected, the participants responded more slowly in the incompatible than the compatible and neutral conditions (p < .001). Accuracy was lower
in the incompatible than compatible and neutral conditions (p < .001) and in the
neutral, compared to compatible, condition (p < .001). The interaction between
load and compatibility was also signicant for RT, F(4, 81) 3.87, p < .01,
2p .04, but not for accuracy, F(4, 81) 1.21, p .30, 2p .01, which was consistent with Sadeh and Verona (2008). Follow-up analysis indicated signicant
RT dierences between the neutral and incompatible conditions under high load
(p < .01) and between the neutral and incompatible conditions and between the
compatible and incompatible conditions under medium and low loads
(ps < .001). In the present study, neutral conditions were introduced in order
to investigate whether compatible or incompatible conditions aected the RT
dierences. With regard to the manipulation check, there were no signicant RT
dierences between the compatible and neutral conditions. Therefore, as in previous studies (Sadeh & Verona, 2008), CE was calculated using the compatible
and incompatible conditions. Taken together, we concluded that our manipulation worked mostly as hypothesized, although there was no signicant RT difference between compatible and neutral conditions. We used only RT data for
the perceptual load task for the main analysis because previous studies have
reported that there is a signicant association between psychopathy and RT
data for this task (Sadeh & Verona, 2008).

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Table 2. Descriptive statistics among LSRP, IRI, and CE by load condition.

LSRP total
Primary psychopathy
Secondary psychopathy
Perspective taking
Empathic concern
CE for high load
CE for medium load
CE for low load

SD

Min

Max

54.01
32.81
21.20
19.84
12.68
0.02
0.03
0.05

8.11
6.01
3.85
3.40
1.64
0.08
0.08
0.11

33
19
10
13
9
0.19
0.14
0.18

74
49
32
28
16
0.32
0.49
0.91

Note. LSRP total total scores on the Levenson Self-Report Psychopathy Scale; IRI Interpersonal
Reactivity Index; CE compatibility effect.

Table 3. Descriptive statistics and correlations for the LSRP, IRI, and CE by load
condition.

1.
2.
3.
4.
5.
6.
7.
8.

LSRP total
Primary psychopathy
Secondary psychopathy
Perspective taking
Empathic concern
CE for high load
CE for medium load
CE for low load

.89***

.71***
.32**

.41***
.25*
.47***

.22*
.34*
.08
.27*

.03
.02
.03
.18
.17

.05
.05
.19
.02
.22*
.39***

.06
.03
.09
.03
.15
.43***
.71***

Note. LSRP total total scores on the Levenson Self-Report Psychopathy Scale; IRI Interpersonal
Reactivity Index; CE compatibility effect.
*p < .05, **p < .01, ***p < .001.

Descriptive statistics and correlations among the study variables are presented in Tables 2 and 3. There were low to moderate negative correlations
between the primary psychopathy subscale of the LSRP and the two subscales
of the IRI (perspective taking: r .25, empathic concern: r .27). The secondary psychopathy subscale of the LSRP negatively correlated with only the
perspective taking subscale of the IRI (r .47).
To test our hypothesis, hierarchical regression analysis was performed.
A psychopathy subscale and CE for the medium load condition were entered
in Step 1 and interaction between psychopathy subscale and CE for the medium
load was entered in Step 2. Regression analysis revealed the signicant

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11

interaction between primary psychopathy subscale scores and CE under


a medium level of perceptual load on empathic concern subscale scores
(Table 4). In order to further examine interaction term, we conducted a
simple slopes test.1 There was a signicant negative association between primary
psychopathy subscale scores and empathic concern subscale scores at low
(b .19, SE .04, t 4.44, p < .001) but not high (b .05, SE .06,
t .87, p .39) levels of CE under medium perceptual load. The interaction is
depicted in Figure 1.
The interaction of scores on the secondary psychopathy subscale and CE
under a medium level of perceptual load on empathic concern subscale scores
was not signicant2 (Table 5). There was also no signicant interaction predicting scores on the perspective taking subscale of the IRI (Tables 6 and 7).

Discussion
This study tested the attentional mechanism underlying the low levels of empathy observed in psychopathy, using an undergraduate sample. Our results
showed that the relationship between primary psychopathy and empathic concern, which includes aective empathy, was moderated by attention, as measured with a perceptual load task. Specically, noncriminal people who scored
higher on measures of primary psychopathy tended to have signicantly lower
scores for empathic concern when they showed reduced interference from taskirrelevant stimuli under a medium level of perceptual load. Given that the results
of the current study revealed attentional modulation of primary psychopathy
and aective empathy under medium perceptual load, apparently a medium
level of perceptual demand is required for individual dierences in attention
characterized by psychopathy to emerge (Sadeh & Verona, 2008). Although
the relationship between primary psychopathy and interference from task-irrelevant stimuli under medium perceptual load did not strongly explain the variance in aective empathy in Step 1 (Adj. R2 .14), the increased variance
explained in Step 2 was signicant (Adj. R2 .21, R2 .08, p < .01). Further,
this interaction eect was clear and supported our hypothesis regardless of the
fact that we used a small, nonclinical sample. The ndings reported herein might
provide support for the notion that aective problems occur in people with high
levels of psychopathy traits because of their reduced attention to task-irrelevant
information.
As pointed out by a number of studies, people who score highly on measures
of psychopathy have diculties with general emotional processing. For example,
people exhibiting psychopathy who have a history of criminal oence showed
disrupted neural processing of emotional facial expressions (ContrerasRodr guez et al., 2014). Further, emotional stimuli, which are potential distractors of cognitive processing, interfered less with cognitive task performance in
criminal people with high scores on PCLR than those with low scores

12

2.25

4.41

SE

.03

.10

Note. CE compatibility effect.


**p < .01, ***p < .001.

Primary
psychopathy
CE for medium load
Primary psychopathy 
CE for medium load
R2
Adj. R2
SE
F(dfn,dfd)
R2

Variable

.16
.14
.93
7.66 (2,82)***

.20

.33

Step 1

1.96

3.28***

.00, .40

.20, .20

95%CI

6.15
1.54

.07

2.24
.53

.03

SE

.24
.21
.89
8.40 (3,81)***
.08**

.28
.42

.24

Step 2

2.75**
2.91

2.40**

Table 4. Hierarchical regression analysis predicting empathic concern by primary psychopathy and CE for medium load.

.08, .48
.13, .70

.44, .04

95%CI

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13

Figure 1. Interactive effects of primary psychopathy and CE-Medium on empathic


concern. CE-Medium compatibility effect under medium perceptual load.

Table 5. Hierarchical regression analysis predicting empathic concern by secondary psychopathy and CE for medium load.
Step 1
Variable

SE

Step 2
t

95%CI

SE

95%CI

Secondary
.02 .05
.04
.38 .18, .26 .04 .05
.08
.71 .14, .30
psychopathy
CE for
4.63 2.43
.21
1.90 .01, .43 2.67 2.72
.12
.98 .12, .36
medium load
1.21 .77
.21
1.57 .06, .47
Secondary
psychopathy 
CE for
medium load
R2
.05
.08
Adj. R2
.03
.04
SE
.99
.98
F(dfn,dfd)
2.10 (2,82)
2.25 (3,81)
R2
.03
Note. CE compatibility effect.

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Table 6. Hierarchical regression analysis predicting perspective taking by primary psychopathy and CE for medium load.
Step 1
Variable
Primary
psychopathy
CE for
medium load

SE

.14 .06

.25

.20 4.56

.00

Primary
psychopathy 
CE for
medium load

Step 2
t

95%CI

SE

2.38* .47, .04 .14 .06


.05

.21, .22


.25

.10

.21, .23

.25 1.13

.04

.22

.28, .35

.06

.07

.04

.03

.98

.98

2.84 (2,82)

1.89 (3,81)

R2

2.19* .47, .02

.01

Adj. R2
F(dfn,dfd)

95%CI

.49 4.76

R2
SE

.00

Note. CE compatibility effect.


*p < .05.

(Mitchell, Richell, Leonard, & Blair, 2006). The ndings in this study also support those studies that suggested a link between psychopathy and emotional and
cognitive processing. However, Maes and Brazil (2015) reported that noncriminal psychopathy was related to less interference of cognitive processing on
emotional distraction in relation to the interaction between high aectiveinterpersonal traits (i.e., primary psychopathy) and low impulsive-antisocial
traits (i.e., secondary psychopathy), and that it was not directly correlated
with emotional distraction. In this case, the authors considered that the disinhibition feature of impulsive-antisocial traits aects task performance, which is
associated with executive function. On the other hand, the observed signicant
moderation eect in the current study was specic to primary psychopathy,
although secondary psychopathy was also correlated with aective empathy.
The perceptual load task measures more perceptual and spatial attention;
thus, our result was interpreted not to be related to secondary psychopathy.
In this way, the attentional mechanism of low aective empathy in secondary
psychopathy may be dierent from that in primary psychopathy.
In keeping with response moderation theory, attentional mechanisms may
explain not only low fear but also reduced aective empathy in psychopathy.
However, there was an important divergence between our study, in which
we examined the moderating eect by focusing on individual dierences,

15

Note. CE compatibility effect.


***p < .001.

Secondary psychopathy
CE for medium load
Secondary psychopathy 
CE for medium load
2
R
Adj. R2
SE
F(dfn,dfd)
R2

Variable

.43
4.83

.09
4.21

SE

.23
.21
.89
12.42 (2,82)***

.49
.11

Step 1

4.98***
1.15

t
.69, .29
.08, .31

95%CI
.42
3.45
.85

B
.09
4.75
1.34

SE

.24
.21
.89
8.35 (3,81)***
.00

.48
.08
.08

Step 2

4.70***
.73
.64

Table 7. Hierarchical regression analysis predicting perspective taking by secondary psychopathy and CE for medium load.

.68, .27
.14, .30
.16, .32

95%CI

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and previous studies, which followed response modulation theory to measure


both fear and attention in one experiential paradigm (e.g., Newman et al., 2010).
In order to provide further evidence, it is necessary to use an experimental
paradigm that assesses empathic abilities to understand the vicarious emotional
expressions of others or aective responses by biological and neurocognitive
indices during processing of task-irrelevant stimuli, which is dicult to assess
by using self-report questionnaires. Additionally, our ndings in the current
study may support the possibility of training people with high scores on measures of psychopathy to improve their emotion recognition. Recent research
(Schonenberg et al., 2013) has reported that criminal oenders showed improved
emotion recognition after training to encourage them to attend more to social
stimuli, such as facial expressions. Therefore, explorations of the links between
emotional processing and cognitive processing in psychopathy may be able to be
linked to such an intervention approach.
However, in contrast to the result of Sadeh and Verona (2008), there was no
correlation between scores for psychopathy and CE under medium perceptual
load, even though both studies used the same task and load conditions. There
are several possible explanations for these contrasting results. The rst concerns
the use of the psychopathy scale. Sadeh and Verona (2008) used the
Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996), which
is another popular self-reported measure of psychopathy that consists of 187
items and 8 subscales. The factor structure of psychopathy is still under discussion, although the PCLR denes psychopathy as having two components (Hare
et al., 1990). Sadeh and Verona (2008) reported those who on score highly on
PPICallousUnemotional, which was created by them in order to map the PPI
to the PCLR construct (see, Sadeh & Verona, 2008), showed reduced interference from task-irrelevant stimuli at medium perceptual load. Therefore, there
might be dierences in the construct (e.g., Brinkley, Schmitt, Smith, & Newman,
2001; Lilienfeld et al., 2012) that might result in no correlation being observed
between primary psychopathy and CE under medium perceptual load, in contrast to previous study ndings.
The second explanation concerns the perceptual load task, which we used to
assess interference from task-irrelevant stimuli. This task may have been aected
by manipulation of perceptual load conditions, as discussed by Benoni and Tsal
(2010). Therefore, there would not have been a signicant association between
LSRP scores and CE under medium perceptual load because of the possibility
that perceptual load is simply equivalent to dilution due to the presence of letters
that are visually similar to the distractor, which prevents the precise interference
from task-irrelevant stimuli. Thus, as few have used this perceptual load task to
investigate psychopathy, evidence from more studies is needed to supplement
our present results.
Another limitation of this study is the reliability of the Japanese version of the
IRI. The interactions observed herein predicted only scores on the empathic

Tamura et al.

17

concern subscale of the IRI. These results suggest that aective empathy, as
represented by concern and sympathy for another person, might be lower in
people with high scores on psychopathy when they have reduced attentional
focus on task-irrelevant stimuli. However, the measure of empathic concern
did not show adequate reliability in the present study and, therefore, may be
insucient to appropriately measure the original concept. Despite this, the signicant results based on the current data imply even stronger interaction eects;
as low reliability can attenuate the strength of a correlation, interaction eects
tend not to be signicant. Likewise, another Japanese study supported the reliability of the empathic concern subscale of the Japanese version (Kono,
Okamoto, & Kondo, 2013), conducting a factor analysis of the IRI and reporting satisfactory reliability (alpha .76) after excluding the same three items with
low factor loadings that we removed in the current study. To a certain extent,
therefore, our results regarding the measure of empathic concern after excluding
these items were reliable. However, it is dicult to make international comparisons with the revised four-item version, which is another limitation to use of the
Japanese version of the IRI.
Additionally, in the current study, the mechanism of low cognitive empathy
in psychopathy remains unclear. Whereas cognitive empathy is thought to be
modulated by higher order processing stages, such as executive function, aective empathy is thought to be modulated by lower order processing stages that
involve more rapid and automatic processes, such as perception (ShamayTsoory, 2011). There is abundant evidence to support the idea that the two
aspects of empathy are dissociable and dierent neural processes have
been implicated (Shamay-Tsoory, 2011). There is no consistent evidence for
the relationship between psychopathy and cognitive empathy; we posit that
this relationship might depend on individual executive function skills. Future
studies should, therefore, use executive function tasks because cognitive
empathy includes complex processes involving the ability to make inferences
regarding other peoples beliefs or emotions.
Finally, this study used a sample of noncriminal, undergraduate participants
because psychopathy occurs on a continuum and has a dimensional construction;
thus, many other studies have also used noninstitutionalized samples. This limits
the generalizability of our results in the present study. Previous studies applying
the response modulation theory used samples of oenders (Baskin-Sommers et al.,
2011; Newman et al., 2010); therefore, we cannot deny the possibility that our
result regarding the moderation eect was caused by dierences between criminal
and noncriminal populations. An important future task is to replicate our results
with samples that are both larger and drawn from criminal populations.
Declaration of Conflicting Interests
The author(s) declared no potential conicts of interest with respect to the research,
authorship, and/or publication of this article.

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Funding
The author(s) disclosed receipt of the following nancial support for the research, authorship, and/or publication of this article: This study was supported by a JSPS Grant-in-Aid
for Scientic Research (C) to the second author (No.: 26380929) and a JSPS Grant-in-Aid
for JSPS Fellows to the third author (No.: 13J40120).

Notes
1. We also examined the confidence bands to confirm the CE values under medium load,
for which the simple slope is statistically significant. The significance of the moderator
(centered CE under medium load) ranges from 0.01 to 0.20, which indicates that the
simple slope outside this range is statistically significant. Specifically, the association
between primary psychopathy and empathic concern was negatively significant when
centered CE under medium load was lower than 0.01, but positively significant when
CE under medium load was greater than 0.20. Given that centered CE under medium
load ranged from 0.14 to 0.49 (see Table 2), a significant association between primary psychopathy and empathic concern emerged for both relatively high and low
centered CE under medium load.
2. The supplemental regression analysis was completed in order to confirm that the significant interaction effect shown in Figure 1 was unique to primary psychopathy,
rather than also applying to secondary psychopathy. In this analysis, primary psychopathy, secondary psychopathy, and CE for the medium load were entered in Step 1.
Then, in Step 2, we entered the two interactions between primary psychopathy and CE
for the medium load and between secondary psychopathy and CE for the medium
load. An additional significant amount of the variance was explained in Step 2
(R2 .09, p < .01) and the former interaction remained significant (B 1.44,
SE .53,  .39, t 2.71, 95%CI .10, .68), but the latter did not (B .70,
SE .70,  .12, t 1.00, 95%CI .12, .36). This is consistent with the separate
hierarchical regression analysis results shown in Tables 3 and 4. Therefore, the interaction effect of primary psychopathy with CE for the medium load on empathic concern still emerged after controlling for secondary psychopathy. Additionally, although
repeated regression analysis increased the likelihood of Type I error occurring, use of
simultaneous analysis might reduce the chance that the emerged interaction of the
separate analyses was caused by this type of error.

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Author Biographies
Ayame Tamura is a PhD student in the Graduate School of Integrated Arts and
Sciences, Hiroshima University. She is Research Fellow of the Japan Society for
the Promotion of Science. Her principal research interest is antisocial personality
such as psychopathy and Dark Triad.
Yoshinori Sugiura is an associate professor at Hiroshima University. He was a
recipient of Kido Research Prize from Japanese Association for Educational
Psychology in 2000. The focus of his work is on cognitive behavior therapy
for anxiety disorder, mindfulness, and psychopathy and publishes many articles
related to these themes.
Tomoko Sugiura was fellow of the Japan Society tor the Promotion of Science.
She won Naruse Jollzo Memorial Prize in 2003 from Japan Womans
University. The current research interest includes metacognitive approach to
emotional disorders and measurement of cognitive control skills. Her representative book is Cognitive Control of Emotional Distress (Tokyo: Kazama
Shobo, 2014).
Jun Moriya is an associate professor at Kansai University. The focus of his work
is on interactive effects between visual attention and working memory on social
anxiety.

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