Social cognition in antisocial populations
Introduction: Impairments in facial affect recognition have been linked to the development of various disorders. The aim of the current work is to conduct a systematic review and meta-analysis of studies examining whether this ability is impaired in males with psychopathy or antisocial traits, when compared to healthy individuals. Method: Studies were eligible for inclusion if they compared facial affect recognition in either a) psychopathic vs. antisocial males, b) psychopathic vs. healthy controls and c) antisocial vs. healthy controls. Primary outcomes were group differences in overall emotion recognition, fear recognition, and sadness recognition. Secondary outcomes were differences in recognition of disgust, happiness, surprise and anger. Results: Fifteen papers comprising 214 psychopathic males, 491 antisocial males and 386 healthy community controls were identified. In psychopathy, limited evidence suggested impairments in fear (k=2), sadness (k=1) and surprise (k=1) recognition relative to healthy individuals, but overall affect recognition ability was not affected (k=2). Findings were inconclusive for antisocial (k=4-6), although impairments in surprise (k=4) and disgust (k=5) recognition were observed. Psychopathic and antisocial samples did not differ in their ability to detect sadness (k=4), but psychopaths were less able to recognise happiness (k=4) and surprise (k=3). Conclusion: Limited evidence suggests psychopathic and antisocial personality traits are associated with small to moderate deficits in specific aspects of emotion recognition. However considerable heterogeneity was identified, and study quality was often poor. Adequately powered studies using validated assessment measures, rater masking and a priori public registration of hypotheses and methods are required.