Intact prioritization of fearful faces during continuous flash suppression in psychopathy
Affective state recognition and in particular the identification of fear is known to be impaired in psychopathy. It is unclear, however, whether this reflects a deficit in basic perception (‘fear blindness’) or a deficit in later cognitive processing. To test for a perceptual deficit, 63 male incarcerated offenders, assessed with the Hare Psychopathy Checklist-Revised (PCL-R), and 59 age-matched control participants detected fearful, neutral, and happy facial expressions rendered invisible through continuous flash suppression (CFS), a strong interocular suppression technique. Consistent with previous CFS studies on children, student and community samples, fearful faces were detected faster than neutral faces, which were detected faster than happy faces. Detection of emotional faces was unimpaired in offenders, with strong evidence for a full-blown fear advantage. Moreover, the fear advantage was not reduced in the 20 offenders qualifying as psychopaths according to the PCL-R, and there was no correlation between the fear advantage and PCL-R scores in the 63 incarcerated offenders. These results show that basic visual detection of fearful faces is unimpaired in psychopathy. Deficits in the processing of fearful facial expressions in psychopathy may thus not reflect fear blindness, but impairments at later post-perceptual processing stages related to attention, memory, decision-making, or language.