Phantom phone signals are benign, not an indication of a messed-up mind

Phantom phone signals and other hallucinatory-like experiences: investigation of similarities and differences. Adrianna Aleksandrowicz, Joachim Kowalski, Łukasz Gawęda. Psychiatry Research, November 19 2022, 114964. https://doi.org/10.1016/j.psychres.2022.114964

Abstract: Phantom Phone Signals (PPS) and other hallucinatory-like experiences (HLEs) are perceptual anomalies that are commonly reported in the general population. Both phenomena concern the same sensory modality, but PPS are restricted to smartphone use. The current study aimed to assess similarities and differences between these types of anomalies in relation to general psychopathology, metacognitive beliefs about perception, smartphone dependence, and susceptibility to top-down influences on perception. We analyzed data from a Polish community sample (N = 236, aged 18–69). We used questions pertaining to PPS, a questionnaire pertaining to HLEs (Multi-Modality Unusual Sensory Experiences Questionnaire), and other variables of interest (Symptom Checklist-27-plus, Mobile Phone Problematic Use Scale, and the Beliefs about Perception Questionnaire). Additionally, a false-perception task manipulating cognitive expectancy (i.e., a visual cue associated with auditory stimuli vs. no visual cue) was devised to measure top-down influences on perception. Regression analyses showed that only top-down beliefs about perception predicted both PPS and HLEs. Smartphone dependency proved to be a stronger predictor of PPS than other measured variables, whereas for HLEs, general psychopathology was the strongest predictor. Current results suggest that despite sharing some mechanisms, PPS and HLEs may have independent underlying factors.

Introduction

Hallucinations are a key symptom in the diagnosis of schizophrenia spectrum disorders. It is estimated that hallucinations occur in approximately 80% of patients with schizophrenia spectrum disorders, with the most common being auditory hallucinations (Toh et al., 2022). According to the continuum hypothesis, hallucinations in the clinical context are considered as an extreme manifestation of phenomena that range from vivid daydreams, through infrequent experiences of different sounds (e.g., mistakenly hearing one's name being called) to full-blown hallucinations (e.g., hearing distressing voices). Yet, a significant body of work has shown that hallucinatory-like experiences (HLEs), which lie on the hallucination continuum, are frequently reported in the non-clinical population (Linszen et al., 2022). It has been suggested that auditory hallucinations occur in 13.2% of the general population (Beavan et al., 2011). These data suggest that HLEs and hallucinations also occur outside the clinical context. Investigation of HLEs in the general population is important, as it helps us better understand the mechanisms underlying hallucinations and other perceptual anomalies (Barkus et al., 2007; Daalman et al., 2010).

Recently, in addition to studies on general HLEs, Phantom Phone Signals (PPS) are being increasingly studied as perceptual phenomena (Drouin et al., 2012; Horga & Abi-Dargham, 2020; Lin, et al., 2013a,b; Lin et al., 2020; Pisano et al., 2019; Tanis et al., 2015). PPS are perceptual anomalies wherein feedback from phones is experienced without having occurred, such as the sensation of a phone ringing, an incoming message, or a notification coming from various applications. PPS are experienced in auditory (as a ringing phone), visual (a blinking notification displayed on a smartphone screen), and tactile (phantom vibration) modalities (Tanis et al., 2015). It is estimated that between 27.4% and 89% of people from the general population experience PPS (Deb, 2015; Pisano et al., 2021). This relatively high prevalence suggests that PPS are a common experience and may be associated with the growing usage of smartphones (Pisano et al., 2021). Indeed, it is estimated that about 3.5 billion people worldwide use smartphones (O'Dea, 2020). In 2018 in Poland, almost 80% of the population used smartphones (Mobirank, 2020), and 74.8% of all cell-phone users did so on a daily basis. Importantly, cellphone addiction is rising alongside smartphone usage (Olson et al., 2022). Thus, PPS and associated phenomena are becoming an important field of research.

Previous studies have shown that some characteristics of smartphone usage are predictors of experiencing PPS (Rothberg et al., 2010; Subba, 2013; Tanis et al., 2015). A study conducted by Al-Ani et al. (2009) showed that PPS experiences were very common among participants who rated themselves as “mobile addicted.” Moreover, another study also provided evidence of a significant relationship between PPS and excessive smartphone usage, smartphone addiction, and phone importance (Tanis et al., 2015). Still, some studies found that characteristics of smartphone usage are not related to PPS (Catchings et al., 2010). It should be noted that conclusions from studies that link PPS to characteristics of smartphone usage are limited by the low number of studies. For this reason, further studies on the mechanisms of PPS are needed.

With regard to the mechanisms of PPS, some studies reported that contextual factors, such as expecting a call or being in a noisy environment, are important in reinforcing the experience of PPS (Sauer et al., 2015). For instance, being in a workplace where smartphones are essential for communicating with co-workers has been shown to reinforce the occurrence of PPS. A study on medical students showed a substantial change in experiences of PPS during a medical internship. For instance, at baseline, 78.1% students reported phantom vibrations and 27.4% reported phantom ringing. At follow-up, these rates increased to 95.9% and 87.7% respectively (Lin, et al., 2013b). Although the evidence indicates a high prevalence of PPS among medical students, more research on the general population is still needed (Pisano et al., 2021).

Importantly, although PPS have been found to correlate with high stress levels, anxiety, and depressive symptoms (Lin, et al., 2013a,b; Lin et al., 2020), few studies have focused on the relationships between PPS and psychopathology (Pisano et al., 2021). One study among adolescents found a relationship between experiencing PPS and both emotional problems and temper tantrums (Pisano et al., 2019). At the same time, the association between a wide range of HLEs and psychopathology is well documented (Allen et al., 2005; Gaweda et al., 2012; Johns, 2005). Additionally, the cognitive mechanisms of HLEs have been investigated in a rich line of research. For instance, attentional processes, cognitive control (Conn & Posey, 2000; Hugdahl et al., 2013), as well as different cognitive biases have been found to be important factors related to HLEs. With regard to PPS, there is much less research on cognitive mechanisms associated with this phenomenon.

One of the leading theoretical accounts suggests that perceptual anomalies are the result of an imbalance between top-down processes (i.e., priors or cognitive expectancy) and bottom-up processes. The role of top-down processes in shaping percepts is particularly emphasized in situations of perceptual uncertainty, where cognitive expectancy can influence the final percept (Corlett et al., 2019; Horga & Abi-Dargham, 2020; Powers et al., 2016). Cognitive expectancy may be considered as a prior that impacts perception (Corlett et al., 2019). It has been shown that priors have a stronger impact on perception in people who hallucinate than those without hallucinations (Powers et al., 2016). Thus, this suggests that cognitive expectancy (i.e., priors) may have an important impact on perception. Similarly, regarding PPS, it has been proposed that these experiences may emerge from the anticipation of phone signals through expectations (Rothberg et al., 2010). For instance, PPS may emerge in the context of a belief that the phone should ring because one is waiting on an important phone call. A limited number of studies have investigated this account in the context of semantic expectancy and its relationship to HLEs (Vercammen & Aleman, 2010). More recently, a study by Gawęda & Moritz (2021) suggested that audiovisual integration might play an essential role in the formation of false percepts in patients with schizophrenia. Participants performed a task in which they were asked to detect a target word in a noisy background (the word was audible in 60% of cases and absent in 40%). Conditions consisted of three levels of expectancy (1. low – no cue prior to the stimulus; 2. medium – semantic priming; 3. high – semantic priming accompanied by a video of a man mouthing the word). The results indicated that higher expectancy significantly increased the likelihood of false auditory perceptions among schizophrenia patients only. This gives preliminary evidence that the visual modality might play an important role in the complex mechanisms of auditory perceptual anomalies. Nonetheless, more research on visual and auditory modalities in the context of hallucinations and the hallucination continuum is needed.

To date, PPS and other HLEs have been studied independently. A growing line of research investigates PPS as an isolated type of experience without comparison to other HLEs. Therefore, the main aim of our study was to compare PPS and other types of HLEs with general psychopathology, smartphone dependence, and attentional control to investigate their similarities and differences in the non-clinical population. Furthermore, we also considered the relationships of both PPS and HLEs with priors (i.e., top-down factors, such as knowledge and beliefs), which have been linked to perceptual anomalies (Corlett et al., 2019; Horga & Abi-Dargham, 2020; Powers et al., 2016). In our study, we conceptualized priors as meta-cognitive beliefs about perception (Gawęda et al., in preparation). We hypothesized that meta-cognitive beliefs about perception and interpretations of perceptual experiences may tentatively influence how perception operates, and conversely actual perceptual experiences may shape individuals’ beliefs about perceptions. Hence, we expected that there would be a relationship between false perceptions and meta-cognitive beliefs about perception. Moreover, despite some existing research investigating the potential predictors of PPS (Drouin et al., 2012; Horga & Abi-Dargham, 2020; Lin et al., 2013a,b; Lin et al., 2020; Pisano et al., 2019; Tanis et al., 2015), to our knowledge, there are no studies that explore in-depth the mechanisms of this phenomenon using an experimental approach. Therefore, the objective of our study was to experimentally verify the effect of top-down processes on false auditory perceptions using a False Perception Task design (Gawęda & Moritz, 2021). Our experimental task was tailored to examine perceptual experiences that are contextually related to smartphone use (e.g., the moment of an incoming smartphone notification on the screen) with two conditions of expectancy: low (no visual cue associated with an auditory stimuli) and high (a visual cue associated with an auditory stimulus). We hypothesize that more false recognitions will occur in the high expectancy condition than in the low expectancy condition. To our knowledge, this is the first study to investigate experimentally-induced false perceptions that are contextually connected to PPS. Moreover, we aimed to investigate whether there is a relationship between experimentally-induced false perceptions in the context of social media use and PPS alongside other HLEs.

Men and women in same-sex marriages exhibited a greater risk of psychiatric disorders than men and women in opposite-sex marriages, effect largely UNexplained by family upbringing

Same-Sex Marriage and Common Mental Health Diagnoses: A Sibling Comparison and Adoption Approach. Yin Xu et al. The Journal of Sex Research, Nov 18 2022. https://doi.org/10.1080/00224499.2022.2120597

Abstract: We aimed to test whether the association between same-sex marriage and common mental health diagnoses was explained by shared genetic and environmental familial influences using sibling comparison and adoption analyses. For the sibling comparison analysis, participants (1,177,712 men and 1,266,917 women) were individuals born in Sweden between 1932 and 1994 and had ever been recorded as married (in opposite-sex or same-sex marriages). For the adoption analysis, participants were 147,164 and 1,298 female–female full sibling and adoptive sibling pairs, respectively. Based on medical records, prescribed medication, and death certificates, depression, substance abuse, and suicide (completed and attempted) from age 18 years were identified. For both sexes, being in a same-sex marriage was associated with greater risk of depression, substance abuse, and suicide, compared with being in an opposite-sex marriage. Controlling for shared familial confounding reduced this difference by less than 20% in magnitude, but overall mental health disparities for individuals in same-sex marriages remained statistically significant. Among women, only the genetic correlation between same-sex marriage and depression was statistically significant (r = .33). Same-sex marriage, as a proxy for sexual orientation, was associated with increased risk of certain mental health diagnoses and shared familial confounding explained a small component of this association, depending on the diagnosis. The findings indicate that sexual orientation disparities in mental health outcomes may involve unmeasured factors, and a relatively small proportion should be considered that may be due to shared familial confounding relevant to both sexual orientation and psychopathology.

Should bads be inflicted all at once, like Machiavelli said? Evidence from life-satisfaction data

Should bads be inflicted all at once, like Machiavelli said? Evidence from life-satisfaction data. Paul Frijters et al. Journal of Economic Behavior & Organization, Volume 205, January 2023, Pages 1-27. https://doi.org/10.1016/j.jebo.2022.10.047

Abstract: Is wellbeing, measured by life satisfaction, higher if the same number of negative events is spread out rather than bunched in time? Is it better if positive events are spread out or bunched? We answer these questions empirically, exploiting biannual data on six positive and twelve negative life events in the Household, Income and Labour Dynamics in Australia panel. Accounting for selection, anticipation, and adaptation, we find a tipping point when it comes to negative events: once people experience about two negative events, their wellbeing depreciates disproportionally as more and more events occur in a given period of time. For positive events, effects are weakly decreasing in size. So for a person's wellbeing it is better if both the good and the bad is spread out rather than bunched in time. This corresponds better with the classic economic presumption of diminishing marginal effects rather than Machiavelli's prescript of inflicting all injuries at once, further motivating the use of life satisfaction as a suitable proxy for utility. Yet, differences are small, with complete smoothing of all negative events over all people and periods calculated to yield no more than a 12% reduction in the total negative wellbeing impact of negative events.

Introduction

“Injuries, therefore, should be inflicted all at once, that their ill savor being less lasting may the less offend; whereas, benefits should be conferred little by little, that so they may be more fully relished.” – Niccolò Machiavelli, The Prince

Ceteris paribus, would one inflict bad things all at once or spread them out? And would one do the same or the opposite with positive events? Machiavelli urges us to bunch the bad and space the good. We address this question empirically by looking at the non-linearity in the effects of positive and negative events on self-reported life satisfaction in a large panel of Australians observed since 2002, to shed light on the shape of the utility function. If our empirical life-satisfaction function turns out to be in line with classic economic assumptions on the shape of the utility function, life satisfaction could be interpreted as a suitable proxy for utility, which would further motivate its use for policy analysis.

In classic economic parlance, Machiavelli's reasoning assumes an S-shaped utility function that is concave in positive and convex in negative shocks, much like the shape of the value function by Kahneman and Tversky (1979). Then, the average absolute impact of negative shocks would decrease in their size (or number), with the same holding for positive effects. Under classic economic assumptions, on the other hand, there is concavity everywhere (diminishing marginal utility), which means that the average absolute impact of negative shocks would increase in their size. Fig. 1 illustrates the shapes of these different functions.

Implicit in Machiavelli's argument is adaptation to shocks: when he suggests inflicting all injuries at once rather than conferring them little by little, Machiavelli argues that, in doing so, “their ill savor [would be] less lasting”, which implies that these different strategies would exhibit different adaptation profiles over time. The same holds, in the opposite direction, for benefits.

The notion of ‘hedonic adaptation’ has a long tradition in psychology, dating back at least as far as Brickman's and Campbell's Hedonic Relativism and Planning the Good Society (Brickman and Campbell, 1971). There is now an established body of evidence on adaptation to various positive or negative life events in the psychology and applied economics literature, most of which uses individuals’ self-reported life satisfaction as outcome. It covers changes in marital status (Lucas, 2005; Lucas and Clark, 2006; Oswald and Gardner, 2006; Stutzer and Frey, 2006), disability (Menzel et al., 2002; Oswald and Powdthavee, 2008), income (Di Tella et al., 2010; Kuhn et al., 2011), or unemployment (Clark et al., 2008), as well as studies using measures of life satisfaction to look at anticipation and adaptation to life shocks in relative comparison (Clark et al., 2008; Frijters et al., 2011; Clark and Georgellis, 2013). Adaptation is also central to the idea of a set point of life satisfaction around which individuals fluctuate, and often thought to be one reason (besides relative comparisons) behind the lack of a strong relation between GDP and life satisfaction in rich countries over time.1 If we want to study Machiavelli's prescript empirically by looking at non-linearity in the effects of positive and negative life events on life satisfaction, we must, therefore, pay attention to the phenomenon of hedonic adaptation in order to separate that issue from the issue of non-linearity that determines the optimal spacing of events.

Apart from these studies, which have a particular focus on hedonic adaptation, there is a large literature on how individuals’ life satisfaction (or subjective wellbeing more generally) reacts to various positive or negative life shocks, including, for example, shocks to income and wealth (Gardner and Oswald, 2007; Adda et al., 2009; Schwandt, 2018), war time experiences (Johnston et al., 2016), crime victimization (Johnston et al., 2018), own criminal behavior (Corman et al., 2011), homelessness (Curtis et al., 2013), and various other life shocks (Lindeboom et al., 2002). However, despite the large interest in this topic, the question of optimal spacing of events has never been posed, to our knowledge. This reflects, in part, the inherent difficulty in finding random variation in enough life events simultaneously to be certain about their cumulative effect. Researchers, therefore, have typically restricted themselves to look at single events in isolation, such as unemployment or marital breakdown, or else have been interested in particular psychological mechanisms that hold for many events, such as adaptation or the relation between decisions and experiences (Kahneman et al., 1997).

Yet, the question of spacing, in particular its optimality, is important: to the extent that individuals may have control over certain life events (for example, getting married or divorced, retiring, or going for promotion), they may make ‘clean breaks’ (all at once), ‘bite the bullet’ (all at once), ‘take it one at a time’ (one by one), and so on. Often, policy-makers must decide when to implement certain reforms with negative or positive wellbeing consequences over the legislative period. Is it better to implement all reforms at once, or rather spread them out? Hence, it would be insightful for such deliberations to know whether – as Machiavelli's puts it – it is better if ‘injuries’ or ‘benefits’ are bunched or spread out, ceteris paribus.

We use the analogy of life events and test Machiavelli's prescript empirically, by specifying and estimating various life-satisfaction functions with life events as arguments. We find evidence that life satisfaction is concave in both positive and negative domains: accounting for selection, anticipation, and adaptation, and holding the number of negative events constant over an individual's life, we show that overall life satisfaction decreases when negative events occur all at once as opposed to being spread out. For positive events, the same holds, meaning that – from a welfare perspective – it is better if both the good and the bad are spread out. The findings from our empirical life-satisfaction functions, therefore, reject Machiavelli's prescript. If data on life satisfaction are anything to go by (an issue discussed more later on), our findings are suggestive of a utility function that is globally concave, in line with classic economic assumptions.

We use data on six positive and twelve negative life events in the Household, Income and Labour Dynamics in Australia (HILDA) panel. HILDA has several advantages over comparable datasets: it uniquely tracks the 18 life shocks we use for the entire duration of the panel (2002-now), has a large numbers of individuals (about 20,000), consistently measures life satisfaction in every survey year, and records life events on a quarterly basis. The panel dimension allows us to look at within-person variation in life events and life satisfaction, reducing some of the bias resulting from selection into particular events. The availability of quarterly event information allows us to account for the adaptation profile of each event on a precise level.

In our most simple specification, we pool all positive life events into a single count variable and all negative events into another, finding clear evidence of a non-linear effect of life events on life satisfaction. This specification assumes that all events have equal magnitude and the same temporal effect profile, which are both unlikely. So in our extended specification, where each event has its own anticipation and adaptation profile, we use empirical indices of negative and positive events, finding the same overall pattern.

Another legitimate worry is that events might arise from choice behavior rather than befalling individuals randomly. In sensitivity analyses, we show that the results remain qualitatively the same when following the literature and looking only at a specific subset of more exogenous and unanticipated events in our data (like winning the lottery, experiencing the death of a close friend, or being a victim of crime). Further robustness checks, including tests for selective attrition, respondents’ fidelity and engagement with the survey questions, and alternative estimation procedures, are all in line with our main findings.

We then ask: how much does the non-linearity in life events matter when it comes to overall welfare, measured as the sum of life satisfaction over the population over time? We find that if losses were spread evenly in a given period of time, the overall welfare loss from these losses would reduce by about 10%. If gains were spread evenly, the overall welfare gain would rise by about 2%. In sum, this would yield an overall net welfare gain of about 12% relative to the status quo. Note that this is 12% of the status quo effects of all positive and negative events, not 12% of welfare or life-satisfaction variation.

Our findings add to two streams of literature: first, there is a literature in applied economics and psychology that exploits data on subjective wellbeing (in particular on self-reported life satisfaction) focussed on the non-linearity around the reference point. A general finding is that financial worsening looms larger for life satisfaction than financial improvement of the same absolute size, which would be in line with prospect theory and the kink at the reference point of value functions experimentally identified by Kahneman and Tversky (1979). Using nationally representative longitudinal household data from the British Household Panel Survey (BHPS) and the SOEP panel, Boyce et al. (2013) find that, over a relatively long time horizon, positive changes in income from one year to another yield a lower absolute change in life satisfaction than negative changes. A similar asymmetry is found by De Neve et al. (2018) at the macro level when it comes to positive and negative fluctuations in economic growth. Likewise, Vendrik and Woltjer (2007) provide evidence of a globally concave life-satisfaction function in the context of relative income, with a (slight) kink at a zero relative income gap. Gonza and Burger (2017) also claim an S-shaped function in some of their estimates for the effects of the economic downturn of 2008 on life satisfaction.

Second, there is an established literature studying anticipation and adaptation in self-reported life satisfaction to various life events, both positive and negative. Clark et al. (2008) use annual data on four negative (unemployment, divorce, widowhood, and lay-off) and two positive life events (marriage and childbirth) from the German Socio-Economic Panel Study (SOEP), showing that respondents anticipate and later fully adapt to most life events when it comes to their life satisfaction. Frijters et al. (2011) extend this analysis by studying life satisfaction dynamics around changes in employment status (being promoted and being laid off), changes in family life (births, deaths, and divorce), and changes related to the physical person (victimization and health) in the HILDA panel. The authors confirm that respondents hedonically adapt to most changes in life circumstances. Dore and Bolger (2018) extend that methodology to allow for heterogeneous response patterns to negative shocks they call ‘stressors’.

We join both streams of literatures, allowing for a non-linearity at the reference point while focussing primarily on non-linearities further away from it. Most importantly, we account for the dynamics of life events by explicitly modeling anticipation and adaptation regarding each life event at a precise quarterly level.

The rest of this paper is organised as follows: Section 2 gives an overview of the data we use and provides summary statistics on the life events we study. Section 3 introduces the empirical strategy, including different types of estimation and different ways to operationalise the occurrence of life events in a given period of time. Section 4 presents our main findings and scrutinises their robustness regarding alternative operationalisations and explanations. Section 5 calculates overall welfare counterfactuals. Finally, Section 6 concludes and discusses potential implications for individual and policy choices.

Meta-analysis: Psychopaths do not achieve larger gains in social economic decision-making games – unless their opponents lack the option to retaliate

Social Economic Decision-Making and Psychopathy: A Systematic Review and Meta-Analysis. Gunschera, L. J., Brazil I. A. and Driessen, J. M. A. Neuroscience & Biobehavioral Reviews, November 18 2022, 104966. https://doi.org/10.1016/j.neubiorev.2022.104966

Highlights

• Psychopathy is associated with reduced cooperation

• Psychopathy is associated with smaller offering behaviour

• No support for link of psychopathy with higher total gains

• Adaptiveness of psychopathic traits is dependent on context

• Advanced approaches enable examination of more refined motivations

Abstract: Psychopathy is a personality construct that encompasses a constellation of traits reflecting emotional dysfunction and antisocial behavior. This constellation has consistently been linked to poor decision-making, often focused on personal and monetary gains at the others’ expense. However, there remains a lack of a systematic examination of how psychopathy is related to the prospect of obtaining monetary gains as a function of social context. Therefore, we conducted a series of meta-analyses to elucidate these relationships. Our findings indicated that elevated levels of psychopathy are related to a reduced tendency to cooperate with others, and no difference in the extent to which knowledge of others’ retaliation possibilities informs decision-making. However, the type of social economic decision-making game employed moderated the association between psychopathic traits and total gain obtained, suggesting that context plays a key role in moderating the link between psychopathic features and decision-making. These findings advance our understanding of psychopathy and open new avenues for research on adaptive and maladaptive social behavior in individuals with high levels of psychopathic traits.

Keywords: psychopathycooperationdecision-makingantisocial behaviorneuroeconomics

4. Discussion

The present meta-analysis shows that increased levels of psychopathic traits are associated with less cooperative behavior and lower offers across social economic decision-making paradigms. Moreover, our findings suggest that individuals with high levels of psychopathic traits ignore the potential retaliative acts of opponents in their behavioral choices challenge. Finally, these individuals obtain higher gains in games where opponents lack the option to retaliate, compared to reciprocal games. In the following sections we will discuss these findings in more detail.

4.1. Cooperation

The results indicated that increasing levels of psychopathic traits co-occurred with reduced cooperation across social economic decision-making contexts. The manifestation of uncooperative behavior varies across paradigms. In a Trust Game, for instance, defection takes the form of lower reciprocal actions when offered the opportunity to reward the investor for their investment. In contrast, defection in an Ultimatum or Dictator Game relates to the individual’s posed offers. The finding that individuals with high levels of psychopathic traits are inclined to behave less cooperative across a range of social economic decision-making contexts aligns with our primary hypothesis and emphasizes the interpersonal component of psychopathic traits. More generally, the finding supports contemporary theories of psychopathy which postulate that psychopathy encompasses interpersonal deficits and antisocial tendencies. Yet, these theories insinuate different motivations for reduced cooperative behavior.

Prevailing theories of psychopathy tend to emphasize affective deficits. One prominent account is Lykken’s low-fear hypothesis, which suggests that psychopathy is underpinned by an impairment of fear processing (Lykken, 1957, Lykken, 1995). Psychopathic individuals are thought to experience the emotion of fear to a lesser extent. Hypothesized mechanisms underlying this lack of fear are deficits in passive avoidance learning (i.e., learning to avoid an aversive stimulus by inhibiting a previously punished response) and fear conditioning (i.e., learning to associate a particular neutral stimulus with an aversive stimulus) (Birbaumer et al., 2005; R. J. R. Blair et al., 2004; Oba et al., 2019; Veit et al., 2013). Punishing responses are inherent to learning appropriate behavior in social situations, and many parenting methods rely on punishment of undesirable behaviors. Consequently, individuals scoring high on psychopathic traits may be more inclined to engage in deviant behaviors due to the lack of fear associated with undesirable outcomes. Since noncooperative behavior tends to yield the highest reward for the individual, there are few reasons not to act in socially deviant manners if fear of social or monetary punishment is disregarded.

In contrast to previously discussed emotion-focused theories, attention-based models suggest broad and nonspecific attention deficits to underpin psychopathy. The Response Modulation Hypothesis (RMH; Gorenstein & Newman, 1980; Newman & Baskin-Sommers, 2016) concerns individuals’ ability to modulate a dominant response set in the presence of nondominant response cues. Psychopathic individuals are thought to focus on immediate, motivationally salient cues while disregarding peripheral information. The attentional bottleneck model (Baskin-Sommers & Brazil, 2022) elaborates on the underlying mechanism, suggesting an exaggerated attention bottleneck that restricts parallel processing of peripheral cues. Such an overactive attention bottleneck in psychopathy filters out too much information and forces serial processing instead. Evidence in favor of the attentional bottleneck comes from studies investigating information processing in dual-task conditions. These studies showed that psychopathy-related deficits are most apparent in tasks that required participants to learn and track multiple sets or types of contingencies (e.g., Brazil et al., 2013; Von Borries et al., 2010; Newman & Kosson, 1986). It has been demonstrated that increasing levels of psychopathic traits are associated with reduced interference to response incongruent information when this information is presented outside the focus of attention (Scheeff et al., 2021, Zeier and Newman, 2013). Regarding cooperation, the attention-based models of psychopathy suggest that a disregard of contextual information, as a consequence of an exaggerated attention bottleneck, explains the negative relationship between psychopathic traits and cooperation. For instance, when in pursuit of monetary reward, individuals with elevated levels of psychopathy may be less likely to incorporate affective cues of the social interaction in their decision-making. This is limited to instances where cooperation cues remain outside the central focus of attention. As such, one may expect these individuals to consider contextual social cues when amply encouraged to do so.

Taken together, conceptualizations of psychopathy tend to converge in their predictions on cooperative behavior, while their proposed underlying motivations diverge. To effectively differentiate between said theories, we need to address the boundary conditions of the suggested deficits. For instance, absence of fear-related deficits when fear-related cues are the focus of attention challenge contemporary affective theories of psychopathy (Lykken, 1995, Newman et al., 2010). Instead, it is important to consider the situational specificity of dysfunctions associated with psychopathy, something that has become clear from researchers extending upon overly simplistic social economic decision-making studies in recent years and considering variables that go beyond the binary cooperation-defection distinction (e.g., Driessen et al., 2021; Gong et al., 2019; Osumi & Ohira, 2017; Testori et al., 2019). Throughout the following paragraph we will address the moderating variables of interest to the relationship of psychopathic traits and cooperation.

Our findings indicated that the negative relationship between psychopathic traits and cooperation is not moderated by any of the included moderators. Whereas scholars have suggested that the behavior that is associated with F1 and F2 subtypes may be driven by different motivations (Karpman, 1941, Mealey, 1995), our findings indicated no moderating effect of factor on the observed association of psychopathy and cooperation. Our analysis of the factor structure is limited as aggregate findings of studies using a wide range of psychopathy measures, only some of which strictly adhere to the F1/F2 distinction. The PPI F1, for instance, incorporates adaptive aspects. whereas F1 of the PCL-R is strictly limited to maladaptive characteristics of the disorder (Benning et al., 2003, Miller and Lynam, 2012). While findings seem to indicate that primary and secondary psychopathy are associated with the F1/F2 distinction (Levenson et al., 1995), future studies may analyze a more homogenous sample of psychopathy measures or look for an interaction between the psychopathy scales and their factor structures (Malterer et al., 2010, Poythress et al., 2010).

Two additional moderators pertain to the measurements used to assess psychopathic traits levels. The clinical utility and factor structure of the different psychopathy measures have been compared extensively (Cooke and Michie, 2001, Drislane et al., 2014, Flórez et al., 2020, Hare, 1985, Hare, 1996, Hare, 2003; Hare & Neumann, 2006; Tsang et al., 2018), but there is little insight as to the relevance of these differences for cooperative behavior. Our findings suggest that differences in psychopathy measures do not differentially account for the relationship between psychopathy and cooperation and conflicts with the limited evidence of psychopathy measures contributing to differences in findings of cooperation in psychopathic individuals (Rilling et al., 2007). We observed the same null effect for the moderator splitting psychopathy scales into those neglecting and those incorporating positive aspects of psychopathy. This finding goes against the notion that scales incorporating positive aspects of psychopathy may do better at accounting for positive behavioral outcomes, such as cooperation.

At last, our analysis revealed no significant differences in the association of psychopathic traits and cooperative behavior in the Ultimatum and the Dictator game. The non-significant moderating effect of game suggests that individuals with elevated psychopathic traits tend to disregard important differences between paradigms in their pursuit to obtain valuable outcomes. Individuals low on psychopathic traits are thought to incorporate the knowledge of potential retaliative actions in their decision-making. As such, paradigms where participants may be punished motivate cooperative behavior. The finding that individuals with elevated psychopathic traits tend not to incorporate that knowledge can be explained by affective and cognitive accounts of psychopathy. The former may argue that a lower experience of fear alters motivational contingencies in individuals with elevated psychopathic traits (Lykken, 1995). Attentional accounts, on the other hand, account for the finding by suggesting that peripheral cues, in this case the affective reactions of the other agent, tend to be disregarded by individuals high on psychopathic traits (R. K. B. Hamilton et al., 2015).

4.2. Offer Size

Results for the analysis of offer sizes in social economic decision-making games indicate a significant negative association with psychopathic traits. As such, individuals with elevated levels of psychopathy tend to propose lower offers. It should be noted that results from the file drawer analyses give reason to question the robustness of the effect and suggest that the effect may be susceptible to publication bias. Therefore, we are cautious with drawing firm conclusions. Our observation aligns with the extant literature documenting violations of social norms and reduced concern for the welfare of others in individuals with psychopathic tendencies (Chang et al., 2011, *Gillespie et al., 2013, Hare, 1996, Hare, 1998, Harpur et al., 1989, *Mokros et al., 2008). Interestingly, some studies suggested that individuals with high levels of psychopathic traits have a different sense of fairness and proposed that this could explain antisocial choices in social economic games (e.g., Driessen et al., 2021; Osumi & Ohira, 2010). This notion is supported by findings showing that individuals with elevated levels of psychopathic traits not only pose lower offers but also accepted more unfair offers and perceived unfair offers as being less unfair (*Osumi and Ohira, 2010, *Vieira et al., 2014). A first study that investigated the role of fairness considerations in social economic decision-making and compared it with potential other motivations combined a new social economic game with computational modeling and showed that psychopathy was indeed negatively associated with inequity-aversion (Driessen et al., 2021). Competing theories have been suggested as to why psychopathic traits are associated with reduced cooperative and general moral behavior (Chang et al., 2011, *Driessen et al., 2021, Glenn et al., 2009, *Gong et al., 2019, van Baar et al., 2020). While our present results fail to differentiate between guilt-aversion and inequity-aversion motives of offering behavior, recent methodological advancements have made it possible to differentiate between distinct moral decision strategies by combining new experimental tasks with computational modeling (*Driessen et al., 2021, *Gong et al., 2019, van Baar et al., 2019). The approach of computational modelling to the behavioral strategy proves a promising way of discerning between different strategies and obtaining more detailed insight into the motivations for cooperative or defective behavior.

Regarding the moderation analysis, none of the moderators showed a significant effect. The moderator ‘game’ is particularly interesting, as it captures the trade-off between immediate and delayed reward. This follows from the fundamental difference between the UG and DG, the latter of which allows for reciprocal actions of the opponent. As such, individuals can maximize immediate rewards in the DG without sacrificing long-term gains, a strategy that is bound to fail in a UG, where the opponent may punish offers that are perceived to be unfair. Our findings indicate that individuals scoring high on psychopathic traits make small offers in general. This suggests that these individuals do strive for immediate reward and do not, or to a lesser extent, incorporate the potential retaliating acts of the other player in their behavioral choices. A potential explanation for this finding could be that individuals scoring high on psychopathy are not sensitive to the reciprocal nature of the social economic interaction. However, previous studies suggested that these individuals are aware of the social context and understand other’s expectations, but just don’t utilize this knowledge in their social decision-making (e.g., Gong et al., 2019). An alternative explanation for our finding could be that a high sensitivity to reward in these individuals drives risky and antisocial decision-making. Previous studies have suggested that individuals with high levels of psychopathic traits are characterized by a tendency to excessively pursue appetitive stimuli, and proposed that this excessive behavioral activation could be a key component underlying antisocial behavior in these individuals (R. J. R. Blair et al., 2004; Buckholtz et al., 2010; Foulkes et al., 2014; Gorenstein & Newman, 1980; Hare, 1972; Pujara et al., 2013). This excessive pursuit of rewards may render individuals with psychopathic tendencies less likely to process peripheral information, such as the presence or absence of potential punishment. This could explain the observed absence of differences in offering behaviour across paradigms. Yet, the differences between paradigms imply that similar behavioral choices may yield different outcomes. To address the outcome of social economic decision-making games more directly, we turn toward an examination of the total gains obtained.

4.3. Total gain

The results for the analysis of total gain in social economic decision-making indicated that psychopathic traits are unrelated to the total gain obtained in social economic decision-making games. Yet, our findings lack scope to draw comprehensive conclusions about the adaptive value of particular psychopathic traits (Bronchain et al., 2020, Meloy et al., 2018). Whereas our findings preclude conclusions about the sensitivity to reward itself, they are relevant to the efficacy in achieving desired gains. Arguably, one would expect increased effort in obtaining rewards that are highly valued. However, this does not necessarily translate to increased efficacy in obtaining said rewards, and our findings indicate that psychopathic individuals are not more successful at achieving monetary rewards (R. J. R. Blair, 2008; Buckholtz et al., 2010; Cleckley, 1941; Everitt et al., 2008; Fowles, 1980; Gorenstein & Newman, 1980; Lykken, 1957; Pujara et al., 2013). However, findings of the moderator analyses demonstrated that the type of game significantly moderated the effect of psychopathy on total gain. More specifically, individuals with elevated levels of psychopathic traits appeared to obtain a higher outcome in games that exclude the possibility of an opponent retaliating on the current or later trials. This is in line with our other finding showing that psychopathic traits are linked to lower offers across all games and provides further insight into the efficacy of such a strategy. Posing a low offer in the Dictator game results in a higher gain, while posing a low offer in the Ultimatum or Prisoner Game increases the risk of retaliation by the opponent and therefore potentially results in a lower gain. Thus, the significant moderator effect of game on the relation between psychopathy and total gain could be explained by the risk of retaliation in the social economic decision-making games. Based on the current findings we could not conclude whether individuals scoring low on psychopathic traits, or community-dwelling individuals in general, do not adapt at all or do adapt to a lesser extent.

The question whether psychopathy scales that incorporate positive aspects of the personality construct are better at accounting for positive outcomes, such as cooperation, was addressed in the moderation analysis. Our findings indicate no significant moderation effect of scales including or discarding positive aspects of psychopathy. However, it is worth noting, that we did observe a negative trend in said moderation. Nevertheless, the moderation did not reach significance, and we conclude that although some scales do incorporate positive aspects of psychopathy, they demonstrate no greater utility at predicting the total gain of psychopathic individuals.

Finally, we should note that the proportion of the variance in study estimates concerning total gain that is due to heterogeneity was high (Deeks, 2011). Accordingly, any interpretation of these results should be taken with care. Several explanations can be devised for this observation. It is possible that total gain in social economic decision-making games vary greatly across the studies. This seems plausible, given that we observe many differences in social economic decision-making paradigms, some of which are more generous in the allocation of rewards, whereas others are more restricted. Alternatively, it is possible that results are biased, and the resulting conclusions are flawed. Whereas we consider the former to be more plausible, the following conclusions should be taken with care and further research into the amount of total gain in social economic decision-making games is warranted (Deeks, 2011).

Overall, the pattern of results indicated that individuals scoring high on psychopathy are less likely to engage in cooperative behavior and have the tendency to pose low offers regardless of the risk of retaliation by the opponent. The latter finding suggests that these individuals fail to consider potential retaliative acts of others. In line with these findings, while there was no overall effect of psychopathy on the total gain, we did find that individuals scoring high on psychopathy are more likely to end up with large gains in games where opponents do not get a chance to retaliate. Taken together, the results demonstrate that the social economic behavior of psychopaths is a result of many interacting factors.

4.4. Quality assessment and limitations

Note, however, that there is substantial heterogeneity amid study findings and the degree to which cooperative behavior can be explained by psychopathic traits is inconsistent between experiments. Another limitation follows from the relatively small set of studies on social economic decision-making of psychopathic individuals. More research is required to separate the effects of psychopathy across different economic games, as well as investigate differences in social economic decision making in clinical and pre-clinical data. These nuanced effects are of great interest and future research may utilize recent methodological developments outlined in the present review.

Our quality assessment showed 81.25% of the included studies to be of moderate quality, with another 12.5% and 6.25% being of good or poor quality, respectively. Several methodological weaknesses were common across all studies and may negatively influence the reliability of observed findings. First, most studies failed to report any form of sample size justification. Said ad-hoc justifications relate to the probability of correctly rejecting a null hypothesis, given a particular effect size, alpha level, and sample size (Tressoldi, 2012). Failure to consider these factors can result in inflated type one error rates, incidences where the null hypothesis is incorrectly rejected. Considering that the importance of power analyses has been stressed for over half a decade, it is troubling to see it being disregarded in many of the included papers (Cohen, 1969, Cohen, 1992). Another frequent issue are missing specifications of exclusion criteria. Exclusion criteria allow for judgments of external validity and comparisons of samples across studies. Moreover, it has been suggested that more theory-driven exclusion criteria are needed to solve the false-positive problem in psychopathy (Rosenberg Larsen, 2018). Although the mere specification of exclusion criteria in itself does not equate more theory-driven decisions, it is a move in the right direction and allows for comparisons across studies. In the present analysis, frequent failure to report exclusion criteria generally reduces the quality of observed evidence and may have contributed to the high rates of heterogeneity that we have observed across studies (Patino & Ferreira, 2018).

4.5. General Summary and Discussion

Marked interpersonal deficits are considered fundamental to the construct psychopathy. Several studies have documented the social behavior in relation to psychopathic traits across a variety of social economic decision-making games and aimed to obtain insight into the drives and motivations of social behavior of individuals who demonstrate elevated psychopathic traits. The present meta-analysis offers the first comprehensive review of psychopaths’ choice behavior in social economic games. In doing so, we were able to incorporate a larger variety of factors that are relevant to the social economic choices of individuals and allow for more meaningful assessments of behavior and behavioral motives. Our findings demonstrated that elevated psychopathic traits are associated with less cooperative behavior and lower offers across social economic paradigms. Both effects are reflected in our contemporary understanding of psychopathy as being characterized by marked social deficits and disregard for others. Moreover, our findings suggest that psychopathic individuals ignore the potential retaliative acts of opponents in their behavioral choices challenge. This might be explained by their engagement in risky decision-making to obtain a high reward. At last, our findings concerning the gains in social economic decision-making games indicate that, overall, individuals with elevated psychopathic traits are no better at obtaining them. However, when we make a distinction based on the type of game, our findings demonstrate that individuals scoring high on psychopathy obtain higher gains in games where opponents lack the option to retaliate. Taken together, we could argue that the risky and antisocial strategy adopted by individuals scoring high on psychopathic traits is successful in situations where one has full control over the outcome, but not in situations where reciprocity plays a role. Thus, as psychopathic traits turn out to benefit the level of success only in certain situations, our findings challenge the idea of successful psychopathy (Lasko and Chester, 2021, Palmen et al., 2018, Persson and Lilienfeld, 2019). Our findings summarize existing research on social economic decision-making in psychopathy and supports the idea that personality traits have substantial predictive power in the field of economics and can help us better understand economic behavior across strategic contexts (Borghans et al., 2008, Engelmann et al., 2019). It further demonstrates directions for future research, which should devote attention to more refined behavioral drives and consider the complexity of social economic environments.

Competing theories have been suggested as to why psychopathic traits are associated with reduced cooperative behavior in social economic contexts (Chang et al., 2011, *Driessen et al., 2021, Glenn et al., 2009, *Gong et al., 2019, van Baar et al., 2020). One prominent line of thinking incorporates the idea that people typically generate beliefs about what others expect from us and suggests that people are motivated to cooperate to avoid feelings of guilt for not living up to another’s expectations. Studies showed that psychopathy is negatively associated with such a guilt-averse motivation (K. S. Blair et al., 2006; Cleckley, 1964; Seara-Cardoso et al., 2016, Gong et al., 2019). An alternative theory proposes that fairness considerations motivate cooperative behavior in humans. According to this theory, people value the equity in outcome between themselves and another person and are often willing to sacrifice some of their own payout to ensure more equitable outcomes with others. Studies on the role of fairness considerations during social economic decision-making in psychopathy have yielded mixed results. Until recently, there were no direct comparisons between these two hypotheses as traditional social economic decision-making paradigms do not allow us to differentiate between guilt and fairness considerations. That is, the two motivations typically result in similar behavioral patterns in such paradigms. However, there have been some promising developments in this direction and studies have gone beyond the general characteristics of social environments to gather insight into the drives and motives of cooperative behavior as a function of psychopathic traits (*Driessen et al., 2021, *Gervais et al., 2013, *Gong et al., 2019, van Baar et al., 2019). Recent methodological advancements have made it possible to differentiate between distinct moral decision strategies by combining new experimental tasks with computational modeling (*Driessen et al., 2021, *Gong et al., 2019, van Baar et al., 2019). The approach of computational modelling to the behavioral strategy proves a promising way of discerning between different strategies and obtaining more detailed insight into the motivations for cooperative or defective behavior.

Following the same trend of increasing the specificity at which different strategies can be detected, different approaches have been utilized to discern reward learning from social decision-making (e.g., Martins et al., 2022; Sul et al., 2015). Sul and colleagues (2015) developed a new instrumental learning task (i.e., prosocial learning task) that helps disentangle prosocial from self-oriented learning. By splitting participants in conditions where obtaining points would benefit the self or another individual, the researchers were able to investigate individual differences in prosociality specifically. Several studies have demonstrated that self- and other-regarding choices are critically involved in determining prosocial behavior (Cutler et al., 2021, Lockwood et al., 2017, Piva et al., 2019, Sul et al., 2015). These findings emphasize the importance of adopting more rigorous scientific methods in order to better understand human decision-making.

It is important to acknowledge a potential limitation when considering the results of the present review. The studies included differed in samples (forensic vs. non-forensic), conceptualization of the construct of psychopathy, and used social economic decision-making games. In general, social economic decision-making games are designed to resemble real-life behavior in social situations. Therefore, it is essential that individuals believe in the legitimacy of these interactions and attach value to the potential outcomes, both social and economic. Hypothetical scenarios lack the consequences for actual social and economic outcomes that real social economic decisions have. Therefore, an expected increase in social desirability may cause an inflation in effect sizes of studies using hypothetical rather than behavior-contingent designs (Moshagen et al., 2011, Thielmann et al., 2016). Games during which participants are aware that their decisions will not influence their monetary payout encourage a shift toward more cooperative behavior as it comes at no actual cost to the individual. This effect is even stronger for selfish individuals (e.g., Hilbig et al., 2015). Therefore, under the assumption that psychopathic individuals tend to cooperate less across social economic decision-making games, it may be reasonable to assume that hypothetical games diminish the negative association and lead to a decline in observed effect sizes. The same is true for studies where participants are not made aware of the hypothetical nature of the task. The extent to which experimenters manage to convince participants of the legitimacy of the social economic interaction may similarly affect the willingness to cooperate. Nevertheless, Thielmann et al. (2020) concluded that perception does not confound the results on personality and prosocial behavior, reporting merely a small effect of deception on study outcomes. Accordingly, this limitation does not necessarily warrant concern, considering that a small minority of participants was aware of the hypothetical nature.

4.6. Conclusion

The current study presents meta-analytical findings concerning the relationship of psychopathic traits and social economic decision-making. The results show that psychopathy is associated with reduced cooperative behavior across social economic decision-making paradigms, while such behavior leads to high gains only in situations that do not require reciprocal interactions. While these findings improve our understanding of how variations in psychopathy scores are linked to the ability to adapt to task characteristics, we also emphasize the need for studies that go beyond the general characteristics of social environments to gather insight into the underlying motivations of cooperative behavior as a function of psychopathic traits.