Advertisement

Psychopathic Personality Traits as Protective Factors against the Development of Post-Traumatic Stress Disorder Symptoms in a Sample of National Guard Combat Veterans

  • Joye C. Anestis
  • Tiffany M. Harrop
  • Bradley A. Green
  • Michael D. Anestis
Article

Abstract

Military personnel often experience post-traumatic stress symptoms following exposure to combat. Personality traits have been identified as possible protective and risk factors in the development of post-traumatic stress disorder (PTSD), and examination of the association between PTSD and personality characteristics provides further insight into this heterogeneous disorder. Psychopathy, frequently conceptualized as collection of pathological personality disturbances relating to deficits in emotionality, empathy, and inhibitory control, includes within its defining features components that may be adaptive in certain situations. In the current study, we sought to expand upon the literature related to personality and PTSD by exploring psychopathic traits as resiliency factors in a military sample. Specifically, facets of psychopathy were analyzed as moderators of the association between combat experience and symptoms of post-traumatic stress disorder within a sample of 292 combat-exposed National Guard and Reserve (NGR) service members. Results indicated that the relationship of combat exposure with PTSD decreased as rates of interpersonal-affective psychopathic traits increased. Impulsive-antisocial traits were also found to moderate the association between combat experience and PTSD, though interestingly there was a similar decrease in magnitude with higher levels of these traits. These findings suggest that particular components of psychopathy may serve as protective factors against the development of PTSD symptomatology within this population.

Keywords

Psychopathy Post-traumatic stress disorder Protective factors Military personnel Combat 

Notes

Acknowledgments

This work was in part supported by the Military Suicide Research Consortium (MSRC), an effort supported by the Office of the Assistant Secretary of Defense for Health Affairs under Award No. (W81XWH-10-2-0181). This award was received by authors Michael D. Anestis and Bradley A. Green. Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the MSRC or the Department of Defense.

Compliance with Ethical Standards

Conflict of Interest

All authors declare they have no conflict of interest.

Experiment participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Admon, R., Milad, M. R., & Hendler, T. (2013). A causal model of post-traumatic stress disorder: disentangling predisposed from acquired neural abnormalities. Trends in Cognitive Science, 17(7), 337–347. doi: 10.1016/j.tics.2013.05.005.CrossRefGoogle Scholar
  2. Anestis, J. C., Anestis, M. D., Rufino, K. A., Cramer, R. J., Miller, H. A., Khazem, L. R., & Joiner, T. E. (2016). Understanding the relationship between suicidality and psychopathy: an examination of the interpersonal-psychological theory of suicidal behavior. Archives of Suicide Research. Advanced online publication. doi: 10.1080/13811118.2015.1048399.Google Scholar
  3. Anestis, J. C., Green, B. A., Arnau, R. C., & Anestis, M. D. (n.d.). Validation of Levenson Psychopathy Scales in a military sample. Manuscript submitted for publication.Google Scholar
  4. Babiak, P., Neumann, C. S., & Hare, R. D. (2010) Corporate psychopathy: Talking the walk. Behavioral Sciences & the Law, 28(2), 174–193.Google Scholar
  5. Bare, R. L., Hopko, D. R., & Armento, M. E. A. (2004). The relation of psychopathic characteristics and anxiety in noncriminals: physiological and cognitive responses to guided imagery. Journal of Psychopathology and Behavioral Assessment, 26(4), 225–232. doi: 10.1023/B:JOBA.0000045338.30129.17.CrossRefGoogle Scholar
  6. Benning, S. D., Patrick, C. J., Blonigen, D. M., Hicks, B. M., & Iacono, W. G. (2005). Estimating facets of psychopathy from normal personality traits a step toward community epidemiological investigations. Assessment, 12(1), 3–18.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Blair, R.J.R. (2006). Subcortical brain systems in psychopathy: The amygdala and associated structures. In C.J. Patrick (Ed.), Handbook of Psychopathy (pp. 296–312).  New York: Guilford.Google Scholar
  8. Blair, R. J. R. (2008). The amygdala and ventromedial prefrontal cotrex: functional contributions and dysfunction in psychopathy. Philosophical Transactions of the Royal Society B, 363, 2557–2565. doi: 10.1098/rstb.2008.0027.CrossRefGoogle Scholar
  9. Blair, R. J. R., Colledge, E., Murray, L., & Mitchell, D. G. V. (2001). A selective impairment in the processing of sad and fearful expressions in children with psychopathic tendencies. Journal of Abnormal Child Psychology, 29(6), 491–498. doi: 10.1023/A:1012225108281.CrossRefPubMedGoogle Scholar
  10. Blonigen, D. M., Patrick, C. J., Douglas, K. S., Poythress, N. G., Skeem, J. L., Lilienfeld, S. O., et al. (2010). Multimethod assessment of psychopathy in relation to factors of internalizing and externalizing from the personality assessment inventory: the impact of method variance and suppressor effects. Psychological Assessment, 22(1), 96–107.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Blonigen, D. M., Sullivan, E. A., Hicks, B. M., & Patrick, C. J. (2012). Facets of psychopathy in relation to potentially traumatic events and posttraumatic stress disorder among female prisoners: the mediating role of borderline personality disorder traits. Personality Disorders: Theory, Research, and Treatment, 3(4), 406–414. doi: 10.1037/a0026184.CrossRefGoogle Scholar
  12. Borja, K., & Ostrosky, F. (2013). Early traumatic events in psychopaths. Journal of Forensic Science, 58(4), 927–931.CrossRefGoogle Scholar
  13. Brinkley, C. A., Schmitt, W. A., Smith, S. S., & Newman, J. P. (2001) Construct validation of a self-report psychopathy scale: does Levenson’s self-report psychopathy scale measure the same constructs as Hare’s psychopathy checklist-revised?. Personality and Individual Differences, 31(7), 1021–1038Google Scholar
  14. Brinkley, C. A., Diamond, P. M., Magaletta, P. R., & Heigel, C. P. (2008). Cross-validation of Levenson’s psychopathy scale in a sample of Federal Female Inmates. Assessment, 15(4), 464–482. doi: 10.1177/1073191108319043.CrossRefPubMedGoogle Scholar
  15. Campbell, S. B., Renshaw, K. D., & Righter, J. B. (2015). The role of personality traits and profiles in Posttrauma comorbidity. Journal of Trauma & Dissociation, 16(2), 197–210.CrossRefGoogle Scholar
  16. Caska, C. M., & Renshaw, K. D. (2013). Personality traits as moderators of the associations between deployment experiences and PTSD symptoms in OEF/OIF service members. Anxiety, Stress & Coping: An International Journal, 26(1), 36–51. doi: 10.1080/10615806.2011.638053.CrossRefGoogle Scholar
  17. Christian, E., & Sellbom, M. (2016). Development and validation of an expanded version of the three-factor Levenson self-report psychopathy scale. Journal of Personality Assessment, 98(2), 155–168.CrossRefPubMedGoogle Scholar
  18. Cleckley, H. (1976). The Mask of Sanity. St. Louis: Mosby.Google Scholar
  19. Douglas, K. S., Herbozo, S., Poythress, N. G., Belfrage, H., & Edens, J. F. (2006). Psychopathy and suicide: a multisample investigation. Psychological Services, 3(2), 97–116. doi: 10.1037/1541-1559.3.2.97.CrossRefGoogle Scholar
  20. Drislane, L. E., Patrick, C. J., & Arsal, G. (2014). Clarifying the content coverage of differing psychopathy inventories through reference to the Triarchic psychopathy measure. Psychological Assessment, 26(2), 350–362.CrossRefPubMedGoogle Scholar
  21. Graham, N., Kimonis, E. R., Wasserman, A. L., & Kline, S. M. (2012). Associations among childhood abuse and psychopathy facets in male sexual offenders. Personality Disorders: Theory, Research, & Treatment, 3(1), 66–75.CrossRefGoogle Scholar
  22. Hall, J. R., & Benning, S. D. (2006). The “successful” psychopath: adaptive and subclinical manifestations of psychopathy in the general population. In C. J. Patrick (Ed.), Handbook of psychopathy (pp. 459–478). New York: Guilford Press.Google Scholar
  23. Harpur, T. J., Hare, R. D., & Hakstian, A. R. (1989). Two-factor conceptualization of psychopathy: construct validity and assessment implications. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 1(1), 6–17. doi: 10.1037/1040-3590.1.1.6.CrossRefGoogle Scholar
  24. Hayes, A. F. (2013). An introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York: Guilford Press.Google Scholar
  25. Hicks, B. M., & Patrick, C. J. (2006). Psychopathy and negative emotionality: analyses of suppressor effects reveals distinct relations with emotional distress, fearfulness, and anger-hostility. Journal of Abnormal Psychology, 115(2), 276–287.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351(1), 13–22.CrossRefPubMedGoogle Scholar
  27. Hotopf, M., Hull, L., Fear, N. T., Browne, T., Horn, O., Iversen, A., Jones, M., Murphy, D., Bland, D., Earnshaw, M., Greenberg, N., Hacker Hughes, J., Tate, A. R., Dandeker, C., Rona, R., & Wessely, S. (2006). The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study. The Lancet, 367(9524), 1731–1741.CrossRefGoogle Scholar
  28. Hyde, L. W., Byrd, A. L., Votruba-Drzal, E., Hariri, A. R., & Manuck, S. B. (2014). Amygdala reactivity and negative emotionality: divergent correlates of antisocial personality and psychopathy traits in a community sample. Journal of Abnormal Psychology, 123(1), 214–224.CrossRefPubMedPubMedCentralGoogle Scholar
  29. Iversen, A. C., van Staden, L., Hughes, J. H., Browne, T., Hull, L., Hall, J., Greenberg, N., Rona, R. J., Hotopf, M., Wessely, S., & Fear, N. T. (2009). The prevalence of common mental disorders and PTSD in the UK military: using data from a clinical interview-based study. BMC Psychiatry, 9(1), 68.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52(12), 1048–1060.CrossRefPubMedGoogle Scholar
  31. King, D. W., King, L. A., & Vogt, D. S. (2003). Manual for the deployment risk and resilience inventory (DRRI): A collection of measures for studying deployment-related experiences of military veterans. Boston, MA: National Center for PTSD.Google Scholar
  32. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602. doi: 10.1001/archpsyc.62.6.593.CrossRefPubMedGoogle Scholar
  33. Levenson, M. R., Kiehl, K. A., & Fitzpatrick, C. M. (1995). Assessing psychopathic attributes in a noninstitutionalized population. Journal of Personality and Social Psychology, 68(1), 151.CrossRefPubMedGoogle Scholar
  34. Lilienfeld, S. O., & Andrews, B. P. (1996). Development and preliminary validation of a self-report measure of psychopathic personality traits in noncriminal population. Journal of Personality Assessment, 66(3), 488–524. doi: 10.1207/s15327752jpa6603_3.CrossRefPubMedGoogle Scholar
  35. Lilienfeld, S. O., Latzman, R. D., Watts, A. L., Smith, S. F., & Dutton, K. (2014). Correlates of psychopathic personality traits in everyday life: Results from a large community survey. Frontiers in Psychology, 5, 1–11. doi: 10.3389/2Ffpsyg.2014.00740.CrossRefGoogle Scholar
  36. Lilienfeld, S. O., Watts, A. L., & Smith, S. F. (2015). Successful psychopathy: a scientific status report. Current Directions in Psychological Science, 24(4), 298–303. doi: 10.1177/0963721415580297.CrossRefGoogle Scholar
  37. Lykken, D. T. (1996). Psychopathy, sociopathy, and crime. Society, 34, 29–38.CrossRefGoogle Scholar
  38. Marshall, G. N., Miles, J. N., & Stewart, S. H. (2010). Anxiety sensitivity and PTSD symptom severity are reciprocally related: evidence from a longitudinal study of physical trauma survivors. Journal of Abnormal Psychology, 119(1), 143.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Milliken, C. S., Auchterlonie, J. L., & Hoge, C. W. (2007). Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. JAMA, 298(18), 2141–2148.CrossRefPubMedGoogle Scholar
  40. Patrick, C. J., Bradley, M. M., & Lang, P. J. (1993). Emotion in the criminal psychopath: startle reflex modulation. Journal of Abnormal Psychology, 102(1), 82–92. doi: 10.1037/0021-843X.102.1.82.CrossRefPubMedGoogle Scholar
  41. Patrick, C. J., Fowles, D. C., & Krueger, R. F. (2009). Triarchic conceptualization of psychopathy: developmental origins of disinhibition, boldness, and meanness. Development and Psychopathology, 21(3), 913–938.CrossRefPubMedGoogle Scholar
  42. Pham, T. H. (2012). Psychopathy and traumatic stress. Journal of Personality Disorders, 26(2), 213–225.CrossRefPubMedGoogle Scholar
  43. Pietrzak, R. H., Goldstein, R. B., Southwick, S. M., & Grant, B. F. (2011). Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: results from wave 2 of the National Epidemiologic Survey on alcohol and related conditions. Journal of Anxiety Disorders, 25(3), 456–465.CrossRefPubMedGoogle Scholar
  44. Polusny, M. A., Erbes, C. R., Murdoch, M., Arbisi, P. A., Thuras, P., & Rath, M. B. (2011). Prospective risk factors for new-onset post-traumatic stress disorder in National Guard soldiers deployed to Iraq. Psychological Medicine, 41(4), 687–698. doi: 10.1017/S0033291710002047.CrossRefPubMedGoogle Scholar
  45. Rademaker, A. R., van Zuiden, M., Vermetten, E., & Geuze, E. (2011). Type D personality and the development of PTSD symptoms: a prospective study. Journal of Abnormal Psychology, 120(2), 299.CrossRefPubMedGoogle Scholar
  46. Riddle, J. R., Smith, T. C., Smith, B., Corbeil, T. E., Engel, C. C., Wells, T. S., Hoge, C. W., Adkins, J., Zamorski, M., & Blazer, D. (2007). Millennium cohort: the 2001–2003 baseline prevalence of mental disorders in the U.S. military. Journal of Clinical Epidemiology, 60(2), 192–201. doi: 10.1016/j.jclinepi.2006.04.008.CrossRefPubMedGoogle Scholar
  47. Salekin, R. T., Chen, D. R., Sellbom, M., Lester, W. S., & MacDougall, E. (2014). Examining the factor structure and convergent and discriminant validity of the Levenson self-report psychopathy scale: is the two-factor rmodel the best fitting model? Personality Disorders: Theory, Research, and Treatment, 5(3), 289–304.CrossRefGoogle Scholar
  48. Sandvik, A. M., Hansen, A. L., Hystad, S. W., Johnsen, B. H., & Bartone, P. T. (2015). Psychopathy, anxiety, and resiliency—psychological hardiness as a mediator of the psychopathy–anxiety relationship in a prison setting. Personality and Individual Differences, 72, 30–34. doi: 10.1016/j.paid.2014.08.009.CrossRefGoogle Scholar
  49. Sellbom, M. (2011). Elaborating on the construct validity of the Levenson self-report psychopathy scale in incarcerated and non-incarcerated samples. Law and Human Behavior, 35(6), 440–451. doi: 10.1007/s10979-010-9249-x.CrossRefPubMedGoogle Scholar
  50. Sellbom, M. (2015). Elucidating the complex associations between psychopathy and post-traumatic stress disorder from the perspective of trait negative affectivity. International Journal of Forensic Mental Health, 14, 85–92. doi: 10.1080/14999013.2015.1048392.CrossRefGoogle Scholar
  51. Sellbom, M., Lilienfeld, S.O., Fowler, K., & McCrary, K.L. (2017). The self-report assessment of psychopathy: Challenges, pitfalls, and promises. In C.J. Patrick (Ed.), Handbook of Psychopathy (2nd edition). (in press)Google Scholar
  52. Smith, T. C., Ryan, M. A. K., Wingard, D. L., Slymen, D. J., Sallis, J. F., & Kritz-Silverstein, D. (2008). New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures: prospective population based US military cohort study. British Medical Journal, 336(7640), 366–371. doi: 10.1136/bmj.39430.638241.AE.CrossRefPubMedPubMedCentralGoogle Scholar
  53. Solomon, Z., Ginzburg, K., Neira, Y., & Ohry, A. (1995). Coping with war captivity: the role of sensation seeking. European Journal of Personality, 9, 57–70.CrossRefGoogle Scholar
  54. van Zuiden, M., Kavelaars, A., Rademaker, A. R., Vermetten, E., Heijnen, C. J., & Geuze, E. (2011). A prospective study on personality and the cortisol awakening response to predict posttraumatic stress symptoms in response to military deployment. Journal of Psychiatric Research, 45(6), 713–719.CrossRefPubMedGoogle Scholar
  55. Verona, E., Patrick, C. J., & Joiner, T. E. (2001). Psychopathy, antisocial personality, and suicide risk. Journal of Abnormal Psychology, 110(3), 462–470. doi: 10.1037/0021-843X.110.3.462.CrossRefPubMedGoogle Scholar
  56. Vujanovic, A. A., Bonn-Miller, M. O., Potter, C. M., Marshall, E. C., & Zvolensky, M. J. (2011) An evaluation of the relation between distress tolerance and posttraumatic stress within a trauma-exposed sample. Journal of Psychopathology and Behavioral Assessment, 33(1), 129–135Google Scholar
  57. Weathers, F., Litz, B., Herman, D., Huska, J., & Keane, T. (1993). The PTSD checklist (PCL): Reliability, validity, and diagnostic utility. Paper presented at the annual convention of the international society for traumatic stress studies, San Antonio, TX.Google Scholar
  58. Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. (2013). The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Interview available from the National Center for PTSD at www.ptsd.va.gov
  59. White, B. A. (2014). Who cares when nobody is watching? Psychopathic traits and empathy in prosocial behaviors. Personality and Individual Differences, 56, 116–121. doi: 10.1016/j.paid.2013.08.033.CrossRefGoogle Scholar
  60. Widom, C. S. (1977). A methodology for studying noninstitutionalized psychopaths. Journal of Consulting and Clinical Psychology, 45(4), 674–683. doi: 10.1037/0022-006X.45.4.674.CrossRefPubMedGoogle Scholar
  61. Willemson, J., & Verhaeghe, P. (2012). Psychopathy and internalizing psychopathology. International Journal of Law & Psychiatry, 35, 269–275.CrossRefGoogle Scholar
  62. Willemson, J., De Ganck, J., & Verhaeghe, P. (2012). Psychopathy, traumatic exposure, and lifetime posttraumatic stress. International Journal of Offender Therapy and Comparative Criminology, 56, 505–514.CrossRefGoogle Scholar
  63. Yang, Y., & Raine, A. (2008). Functional neuroanatomy of psychopathy. Psychiatry, 7(3), 133–136. doi: 10.1016/j.mppsy.2008.01.001.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Joye C. Anestis
    • 1
  • Tiffany M. Harrop
    • 1
  • Bradley A. Green
    • 1
  • Michael D. Anestis
    • 1
  1. 1.Department of PsychologyUniversity of Southern MississippiHattiesburgUSA

Personalised recommendations