Social Rank, Shame and Anger in Primary and Secondary Psychopaths

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Social rank, shame and anger in primary and secondary psychopaths

David Morrison; Paul Gilbert
To cite this Article Morrison, David and Gilbert, Paul(2001) 'Social rank, shame and anger in primary and secondary
psychopaths', Journal of Forensic Psychiatry & Psychology, 12: 2, 330 — 356
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The Journal of Forensic Psychiatry Vol 12 No 2 September 2001 330–356
Social rank, shame and anger in

primary and secondary
psychopaths
Downloaded By: [University of Derby] At: 10:50 9 July 2010
D AV I D M O R R I S O N and PAU L G I L B E RT
ABSTRACT This study compared primary and secondary psychopaths

(Blackburn, 1975 and Blackburn, 1998) in their perceptions of social rank, internal
shame, angriness and intensity of anger in response to provocation. Fifty male
mentally disordered offenders with the legal classi cation ‘psychopathic disorder’
were randomly sampled from a high-security (Special) hospital population and at
interview a set of questionnaires was administered to each. Primary psychopaths
perceived themselves to be signi cantly higher in social rank than secondary
psychopaths, lower in shame, and lower in ratings of angriness, self-blame and
anger towards others. A signicant association was found between social rank and
anger in response to provocation and an inverse relationship between social rank
and both shame and angriness. Regression analyses revealed that social rank and
self-esteem best predicted variance in anger intensity to provocation, controlling
for antisocial personality deviation. Primary and secondary psychopaths differed
signicantly, therefore, in their self-evaluative and social evaluative processes. The
key differences lay in social rank evaluations and shame. Primary psychopaths
assume dominance and threaten others who challenge them, while secondary
psychopaths assume defensive, subordinate positions within a psychopathy
hierarchy, seek dominance, but are sensitive to attacks from above and below.
Findings provide preliminary support for an evolutionary perspective on the role
of social hierarchies in psychopathic behaviour.
Keywords: primary psychopaths, secondary psychopaths, social rank

theory, shame, humiliation, anger in response to provocation, impression
management
The Journal of Forensic Psychiatry

ISSN 0958-5184 print/ISSN 1469-9478 online © 2001 Taylor & Francis Ltd
http://www.tandf.co.uk/journals
DOI: 10.1080/0958518011005686 7
S H AM E A N D RA N K IN P SY CH O PAT HY 331
The self-conscious emotion of shame is regarded as a powerful affective

experience related to negative self-evaluations (self as inadequate, awed, bad
and inferior), beliefs that others see the self unfavourably, and strong desires
to hide and conceal the self (Gilbert, 1998a; Tangney and Fischer, 1995). There
has been increasing speculation and evidence that shame is associated with a
variety of psychopathologies including alcoholism (Bradshaw, 1988; Brown,
1991; Cook, 1993), depression (Andrews, 1995; Cook, 1993; Gilbert, Pehl and
Allan, 1994; Allan, Gilbert and Goss, 1994; Tangney, Wagner and Gramzow,
1992a), hostility (Retzinger, 1995; Tangney, Wagner, Fletcher and Gramzow,
1992b), domestic violence (Dutton, van Ginkel and Starzomski, 1995; Lansky,
1987, 1992), social anxiety (Gilbert and Trower, 1990), suicide (Mokros, 1995)
and personality disorders, especially narcissism (Kinston, 1987; Wurmser,
1987). To date, however, there is less research on the role of shame in psycho-
pathic disorders. To advance our understanding of the role of self-conscious
emotions in psychopathic and antisocial disorders a distinction between
shame and humiliation is useful (Gilbert, 1997).1 While both shame and humil-
iation are focused on self-presentational concerns, and a sensitivity to criti-
cism and social put-down, humiliation alone is accompanied by cognitions of
the ‘other’ as being at fault or unjust and by a strong desire to retaliate (Gilbert,
1997, 1998a, 1998b; Miller, 1988). As Klein (1991) notes, people often feel
responsible for and deserving of their shame whereas they do not feel their
humiliations are justi ed. Although some researchers believe that shame and
humiliation are similar it is important to note that major differences in their
affects and cognitions have been suggested (Gilbert, 1997, 1998b; Klein, 1991).
It is the sense of injustice, unfairness and desire to retaliate against the humil-
iator that can fuel aggression. Moreover, the way aggression is used and justi-
ed to defend against an insult or personal attack varies cross-culturally
(Cohen and Nisbett, 1994; Cohen, Nisbett, Bowdle and Schwartz, 1996).
TERMS USED IN THE STUDY
Shame and humiliation

Using an evolutionary model based on the origins and functions of social
hierarchies in primate and human social behaviour, various researchers have
noted that in a con ict situation contestants can either ee, submit, or ght
(Gilbert, 1992). Shame has been associated with the submissive defensive
strategy (Gilbert and McGuire, 1998; Keltner and Harker, 1998) associated,
in turn, with a sense of personal inferiority (being subordinate), concealment,
avoidance and inhibition. Signs of interpersonal rejection, criticism and/or
attack commonly trigger these responses. Humiliated anger, however, is
related to ‘ ght strategies’ and is manifest in desires to retaliate, seek revenge,
332 J O U RN A L O F F O RE N SI C P SY C H IAT RY Vol. 12 No. 2
dominate the other and avoid being in a subordinate position. Shame and
humiliation have similar triggers; for example, attacks on self-presentations
(attractiveness, prestige). Indeed, some suggest that attacks on rank, status
and self-presentations are crucial for aggression (Baumeister, Smart and
Boden, 1996; Berkowitz, 1993; Tedeschi and Felson, 1994; Tedeschi and
Quigley, 1996). Recent social interactionist perspectives (e.g. Tedeschi and
Felson, 1994) emphasize the role of impression management or ‘saving face’
in aggression. They identify two motives for aggression: to assert a desired
social identity (a desired level of social standing) and to protect a desired social
identity (see Gilbert, 1994; Goffman, 1968; Schlenker, 1980). Humiliated
aggression suggests that the individual has experienced an attack on his or her
ability to create a desired identity in the eyes of the other (self seen as unat-
tractive, weak, or pathetic). Under such attack, the individual blames the
other and seeks to protect and reassert his or her identity by a display of
aggression and intimidation. Indeed, the speed and vigour of retaliation may
form part of the valued identity (e.g. ‘Nobody messes with me and gets away
with it’) whereas to hide and submit (show shame) would indicate subordi-
nate status (Keltner and Harker, 1998).
Status attack and personality disorders

There have been relatively few investigations of the role of shame, humilia-
tion, self-presentations and status attacks in relation to anger and aggression
in the DSM-IV Axis-II personality disorders such as antisocial personality
disorder or in ‘psychopathy’ per se. It is likely, however, that individuals with
antisocial personality disorder are especially sensitive to rank and prestige
threats and, therefore, vulnerable to experiencing shame and humiliation.
Blackburn, for example, proposes that ‘concerns about power and status in
social hierarchies (agency) in the context of rejection or avoidance of inti-
macy (communion) would therefore be expected to be central to psycho-
pathy’ (1998: 293–4).
Primary and secondary psychopathy

Blackburn and colleagues have undertaken extensive research on personality
and social cognition in psychopaths (e.g. Blackburn, 1975, 1996; Blackburn
and Coid, 1999; Blackburn and Lee-Evans, 1985). Using self-report measures
of personality with patients in the British legal category of psychopathic dis-
order, Blackburn (1975) and others (Henderson, 1982; Kuriychuk, 1990;
McGurk and McGurk, 1979; O’Kane, Fawcett and Blackburn, 1996; Willner
and Blackburn, 1988) have described two types of psychopath, referred to as
‘Primary’ and ‘Secondary’ types. As described by Blackburn2 (Blackburn,
1996, 1998), the two types are both signi ed by under-controlled, hostile,
impulsive and aggressive tendencies. Both types have weak inhibitions
against aggression compared with ‘non-psychopath’ mentally disordered
offenders. However, they can be distinguished from one another principally
by their social competence and sociability (Blackburn, 1998). Primary psy-
chopaths are described as extroverted and self-con dent with low to average
anxiety. Secondary psychopaths are characterized by social anxiety, moodi-
ness, low self-esteem and social withdrawal (e.g. Blackburn, 1993a, 1998). In
one study (Blackburn and Renwick, 1996) which investigated the two groups
of psychopaths in terms of expectations of and responses to various attack
and frustration scenarios, both types were found to describe themselves as
dominant in both threatening and af liative settings and each expected others
to be yielding. However, while primary psychopaths did not expect to be

challenged and anticipated attentive and compliant responses from others, the
reverse was true of secondary psychopaths (Blackburn, 1998). In a related
study, Blackburn and Lee-Evans (1985) found that both groups of psy-
chopaths experienced more intense anger to attack scenarios compared with
non-psychopaths. Contrary to the ‘de cient affective response’ theory of
psychopathy (Cleckley, 1976; Hare, 1980), psychopaths were found to be
more not less reactive to threats, some of which could be construed as ‘social
punishments’ (Thomas-Peter, 1992).
These data suggest that there are a number of processes involved in
psychopathic aggression. First, in regard to rank, both primary and second-
ary psychopaths are sensitive to threats on their social standing (i.e. whether
they are in subordinate positions). However, primary and secondary psy-
chopaths appear to differ in one fundamental way. Primary psychopaths
assume that they are dominant and expect others to treat them as such.
Secondary psychopaths, on the other hand, feel subordinate but seek to
become dominant. Primary psychopaths are sensitive therefore to threats
upon their rank and to control over subordinates who are not sufficiently
deferential. Secondary psychopaths appear instead to be uncertain about
their rank; they may feel themselves to be low rank but if so are deeply
resentful of this and are vigilant to threats both from above and from below.
Hence, primary psychopaths are likely to perceive themselves as relatively
high-ranking in social comparative terms and to make favourable social
comparisons, whereas secondary psychopaths are likely to have low,
negative social comparisons of rank status and low self-esteem. This is
consistent with recent research findings (Blackburn, 1998; Blackburn and
Coid, 1999).
Second, neither type of psychopath seems able to respond to con icts
without their being construed as threats to self-presentation (rank) and
control. Moreover, neither seems able to use a subordinate defence by
acknowledging shame and using social avoidance or apologies. Instead, they

appear to be shame-intolerant (Lewis, 1971; Scheff, 1988; Schore, 1994) or
disabled in coping with shame and in assuming responsibility, and they are
‘other’-blaming (Thomas-Peter, 1996). As a result, they will often seek to
harm the would-be shamer, reassert their control/power over him/her and
deter further attacks, criticism or non-compliance from the other (Baumeis-
ter et al., 1996; Meloy, 1988; Tedeschi and Felson, 1994).
AIMS
This study sought to extend previous research on personality and social cog-
nition in the two types of psychopath (Blackburn, 1998) by embedding

speci c questions within the context of social rank theory (Gilbert, 1992;
Gilbert and McGuire, 1998). First, we sought to explore how a group of
incarcerated, high-security (special) hospital primary and secondary psy-
chopaths compare themselves with others in terms of social rank status.
Second, we sought to explore if primary and secondary psychopaths differ in
their internal shame sensitivity (e.g. do secondary psychopaths tend to see
themselves as inadequate and awed?). Third, we sought to examine in the
two psychopath groups the ratings of a range of social rank variables in
relation to other key variables relevant to the disorder such as anger in
response to provocation, direction of anger towards self and others, impul-
sivity, put-downs, helplessness, and self-blame.
METHOD
Participants were randomly sampled from a population of male offenders

detained in a high-security (special) hospital under the 1983 Mental Health
Act legal classi cation ‘psychopathic disorder’. All participants had approval
of their suitability for inclusion in the study by the respective responsible
medical of cer. Participants from a variety of wards across the hospital,
including admissions wards and villas, were included.
Selection criteria were as follows. Participants had: (1) to have the legal
classi cation ‘psychopathic disorder’ (9 participants had the mixed classi -
cation ‘PD/MI’ with one classi ed ‘PD/MIMP’); (2) to be aged between 18
and 65; (3) to have no known organic brain damage; (4) to be free of any
psychotic symptomatology at the time of interview; (5) to demonstrate the
intellectual capacity to respond appropriately to the test materials; and (6)
to give their informed consent to participate in the study. A hospital records
list of all participants who met criteria 1–5 was obtained. All male offenders
randomly sampled from this list and who gave their informed consent to
participate were included in the study. Of 73 individuals subsequently

approached to participate in the study, 20 refused; 3 other patients withdrew
after having commenced the interview.
Participants had a mean age of 38.26 years (SD = 11.50), with a mean 7.24
recorded prior offences (SD = 5.30), and 11.22 years mean length of stay (SD
= 8.63). Non-participants (n = 23) had a mean age of 42.25 years (SD =
11.36), with a mean 9.85 recorded prior offences (SD = 6.25), and 11.95 years
mean length of stay (SD = 9.41). None of the non-participating group’s
scores on these variables signi cantly differed from those obtained for the
sample.
MEASURES
At interview the following series of self-report measures were administered

to all participants.
1 The Antisocial Personality Questionnaire (APQ; Blackburn and

Fawcett, 1996)
The APQ is a 125-item multi-trait self-report inventory measuring cognitive,
affective and behavioural dispositions relevant to offender populations
(Blackburn and Fawcett, 1996). The psychometric properties of the 10 sub-
scales of the measure are well established with reliabilities ranging from 0.77
to 0.87 for the total sample (0.79–0.88 for patients). Further evidence for
validity is provided by the generally high correlations of APQ scales with
MCMI-1 (Millon Clinical Multiaxial Inventory) personality disorder scales
supporting the validity of all APQ scales as measures of personality deviation
(Blackburn, 1996).
2 The Social Comparison Scale – as ‘rank’ estimate (Allan and Gilbert,

1995)
Estimates of social standing and rank can be taken from measures of social
comparison (Gilbert, Price and Allan, 1995). The measure used here was an
11-item scale that employs a semantic differential methodology to assess
three principal dimensions of social comparison: relative inferiority-general
rank; attractiveness; and group- t. Participants are asked to consider the
statement: ‘In relation to others I generally feel’ and then to circle a number,
from 1 to 10, on a dimensional scale of bi-polar constructs including: in-
ferior–superior, untalented–talented, undesirable–desirable, different–same,
and uncondent–more condent. The scale has good psychometric properties
(Allan and Gilbert, 1995).
To provide a measure of social comparisons of angriness, three other con-

structs were added to this measure. These were: ‘Compared to others I feel’:
‘more vs less angry’; ‘more vs less angry with self’; ‘more vs less angry with
others’.
3 The Internalized Shame Scale (ISS; Cook, 1993, 1996)

This 30-item self-report questionnaire developed by Cook (1993, 1996) is
derived from Kaufman’s (1989) construct of ‘Internalized Shame’. Twenty-
four of the items form the Shame Scale. The remainder consist of positive
items from Rosenberg’s Self-Esteem Scale (Rosenberg, 1965). Items
explore negative global evaluations of the self. Respondents are asked to
rate on a 5-point scale how often they experience particular thoughts or

feelings. Examples include: ‘I feel like I am never quite good enough’, ‘I
scold myself and put myself down’, ‘I feel intensely inadequate and full of
self-doubt’.
The ISS was constructed using a large clinical (n = 370) and student (n =
645) population. It has high internal consistency with a Cronbach alpha co-
ef cient for the Shame Scale of 0.96 and for the Self-esteem Scale of 0.95. For
student samples, the test-retest reliability for shame items was 0.84 at 7 weeks
(Cook, 1993) and 0.94 at 5 weeks (Goss, Gilbert and Allan, 1994).
4 The Revised Novaco Anger Scale (Revised NAS; Novaco, 1994)

This 73-item scale is constructed in two parts. Part A has 48 items that sample
three components of anger (cognitive, arousal and behavioural). It was not
included for current use. The 25-item Part B, which is an abbreviated version
of the Novaco Provocation Inventory (NPI; Novaco, 1975, 1985), provides
an index of anger intensity and generality across ve categories of provoca-
tive situations. The ve subscales are: (a) disrespectful treatment, (b) unfair-
ness/injustice, (c) frustration/interruption , (d) annoying traits and (e)
irritations. The psychometric properties of the NAS are well established. Part
B had an internal reliability of 0.95 with a patient sample (n = 126) and a
2-week test-retest reliability of 0.86 (n = 126). Concurrent validity coef -
cients for the NAS against other scales, e.g. Spielberger Trait Anger (Spiel-
berger et al., 1983), Buss–Durkee Hostility (Buss and Durkee, 1957), Caprara
Irritability (Caprara et al., 1985), range between 0.78 and 0.84.
An additional set of 10 items was added to the NAS based upon Gilbert’s
(1993) concept of interpersonal ‘control interactions’. These items sought to
provide a basic measure of two important constructs: ‘humiliated anger’ to
put-down (Lewis, 1987b) and ‘anger at rejection/withdrawal of investments’
(Gilbert, 1993). Items were drawn from theoretical descriptions and dis-
cussion with practising clinicians and included the following illustrative
items: ‘Because you can’t nd the right words to say what you think, someone
calls you in front of others “a stupid bastard” ’ and ‘Someone tells a joke which
the others get apart from you and so the others tease you’ (humiliating put-
down); ‘The person you usually sit with at dinner asks you to go sit some place
else’ and ‘Getting ignored by someone after asking him for a hand’ (rejec-
tion/withdrawal of investments). No claims are made about the psychomet-
ric properties of these two constructs, which are as yet untested.
PROCEDURE
The self-report questionnaires were administered during assessment inter-

view to all patients who consented to participate in the study. The order of
presentation of the four self-report scales was counterbalanced to control for
response bias. Formal instructions for each scale were adhered to. Partici-
pants were given a copy of all scales to refer to, except for the APQ scale,
while the trained assessor simultaneously read aloud and scored each
response. Some participants preferred to record their responses themselves.
With respect to the APQ, all 125 items were read aloud to participants who
then lled in their respective responses on the form provided. All participants
were accompanied at all times during the interview to ensure more reliable
and valid data collection. Interviews lasted on average 90 minutes.
RESULTS
Self-report measures
Preliminary analyses of normality, kurtosis and skewness were satisfactory
with regard to all measures. Statistical analyses adopted an alpha level of 0.05.
Table 1 displays the means and standard deviations of the self-report
measures for the sample.
APQ selection criteria for group assignment (Blackburn and Fawcett,
1996) were applied to the sample. This produced the following classi cation:
23 participants were classi ed as ‘Primary psychopaths’, 17 as ‘Secondary
psychopaths’, 5 as ‘Controlled’, and 5 as ‘Inhibited’. Controlled and Inhib-
ited groups were combined to form a ‘Non-psychopaths’ group.
Social comparisons as a measure of rank estimates

Scattergram inspection of social comparison variables for the presence of out-
liers and normality showed that the data were satisfactory. Means, standard
deviations and independent t-tests of the social comparison evaluations for
338
Table 1 Means and standard deviations of the self-report measures
(n = 50) (n = 23) (n = 17) (n = 10)

‘Legal’ Primary Secondary Non-psychopaths
psychopaths
Scales: M SD M SD M SD M SD
APQ Scale
Impulsivity 21.60 (6.52) 23.70 (4.55) 24.18 (5.10) 12.40 (4.09)
Withdrawal 11.30 (5.19) 7.74 (2.73) 15.76 (2.95) 11.90 (6.51)
Low self-esteem 10.22 (4.14) 9.48 (3.78) 11.82 (3.54) 9.20 (5.35)
Self-control 8.06 (3.90) 7.78 (3.07) 7.00 (4.14) 10.50 (4.53)
Avoidance 8.68 (4.25) 6.17 (3.11) 12.12 (2.00) 8.60 (5.42)
Paranoid 8.34 (4.42) 7.65 (3.07) 10.88 (4.12) 5.60 (5.58)
Resentment 12.72 (4.03) 13.65 (3.04) 14.12 (3.31) 8.20 (4.18)
Aggression 12.94 (3.54) 13.48 (2.91) 14.18 (3.30) 9.60 (3.50)
Deviance 13.36 (3.35) 13.26 (2.58) 14.71 (3.04) 11.30 (4.50)
J O U RN A L O F F O RE N SI C P SY C H IAT RY
Extraversion 11.42 (4.13) 13.96 (2.99) 9.12 (3.30) 9.50 (4.58)
Social Comparison Scale

Rank status 68.04 (16.59) 74.39 (14.83) 58.35 (15.54) 69.90 (15.73)
ISS Scale
Internalized shame 46.50 (19.76) 44.70 (16.32) 55.82 (20.28) 34.80 (20.45)
NAS Scale
Provoked anger 66.72 (14.40) 67.74 (13.86) 69.41 (13.75) 59.80 (15.94)
Vol. 12 No. 2
the sample classi ed by psychopathy typology are presented in Table 2. All

t-tests were justi ed on the basis of (1) level of data, (2) normality of distri-
bution, and (3) the homogeneity of variance requirement where, despite
uneven group numbers, all appropriate F-Tests were non-signi cant. Where
a priori hypotheses were made, 1-tailed tests were applied; otherwise, all tests
were 2-tailed.
The independent t-test for total social comparison con rmed that the
primary psychopaths group perceived themselves to have signi cantly higher
social rank comparisons than the secondary psychopaths group (t(38) = 3.31,
p < 0.001; 1-tailed). Separate t-test comparisons of each of the social com-
parison subscales – rank, social attractiveness, group- t – revealed further
signi cant differences between primary and secondary groups in the direc-
tion predicted.
Internalized shame (shame-proneness)

Means and standard deviations of internalized shame for the total sample, for
primary, secondary and non-psychopaths and for comparative normative
samples (from Cook, 1993), are presented in Table 3. The total sample’s mean
shame score (46.50; SD = 20) is signi cantly greater than Cook’s (1993) male
norm (30.00; SD = 15) and is comparable with mean shame levels found in
clinical samples (respectively male alcoholic and mixed-sex affectively dis-
ordered samples).
Table 2 Means, standard deviations and t-tests of social comparison evaluations
Group Means Comparisons
(n = 23) (n = 17) (n = 10) P P and S

P S Non-P vs vs
S Non-P
M M M t, df (38) t, df (48)
Total SC 74.39 58.35 69.90 3.31*** n.s.

Rank 33.87 27.82 31.70 2.44** n.s.
(7.86) (7.55) (8.82)
Attractiveness 20.91 15.47 19.60 3.29*** n.s.
(5.04) (5.34) (6.88)
Group- t 19.61 15.06 18.60 2.88** n.s.
(4.83) (5.07) (3.86)
Key ** p < 0.01, ***p < 0.001; all t-tests 1-tailed; standard deviations in brackets.
Note Non-P = non-psychopath; P = Primary psychopath; S = Secondary psychopath; SC =
Social Comparison
Analyses of group differences in shame showed that secondary psy-

chopaths have signi cantly greater levels of internalized shame than primary
psychopaths (t(38) = 1.92, p < 0.05; 1-tailed), and greatest levels of shame
overall (F(2,47) = 4.24, p < 0.05; 2-tailed). A Scheffe post-hoc test comparing
secondary psychopaths with non-psychopaths was signi cant at p < 0.05;
2-tailed. Primary and non-psychopath groups did not signi cantly differ in
shame ratings. Non-psychopaths reported signi cantly lower levels of
internalized shame than psychopaths (primary and secondary groups) (t(48)
= 2.17, p < 0.05; 2-tailed).
Secondary analyses
Allan and Gilbert (1995) found that a semantic differential methodology was
a valid way to measure social comparison estimates. This method was
adopted here where measures of anger (angriness, anger with self, anger with
others), helplessness, put-down, and self-blame were developed. Means and
standard deviations for each are presented in Table 4.
Differences between groups on the social rank relevant variables were
examined. Compared with the secondary group, primary psychopaths were
found to have signi cantly lower ratings of angriness (t (38) = 2.81, p < 0.01;
1-tailed) and lower ratings of anger with others (t (38) = 2.26, p < 0.05;
1-tailed). The secondary psychopath group have signi cantly higher ratings
of feeling put-down (t (38) = 1.85, p < 0.05; 1-tailed) and make signi cantly
higher internal attributions of blame than the primary psychopath group
(t (38) = 1.74, p < 0.05; 1-tailed).
Table 3 Means and standard deviations for shame in ‘legal’, ‘primary’ (P), ‘second-
ary’ (S) and ‘non-’ (Non-P) psychopaths and in normative samples
Groups Norms
Legal P S Non-P Male* Male** Affective***

psychopaths norm alc. disorder
M M M M M M M
ISS
Total score: 46.50 44.70 55.82 34.80 30.00 47.00 50.00
SD 20 16 20 20 15 17 21
Note * = Male Non-Clinical sample (n = 382); ** = Male alcoholic sample (n = 142); *** = Affec-
tive disorder sample (n = 180), from Cook (1993); ISS= Internalized Shame Scale
Table 4 Means and standard deviations for social comparisons of angriness, put-
down, self-blame and helplessness
Groups
(n = 23) (n = 17) (n = 10)

Primary Secondary Non-psychopaths
Social Comparisons M M M
Angriness 4.39 6.53 4.60

(2.56) (2.71) (2.56)
Anger with self 5.00 6.12 4.90
(2.56) (2.71) (2.56)
Anger with others 4.52 6.47 5.50
(2.81) (2.53) (3.44)

Put-down 5.22 6.71 5.80
(2.59) (2.39) (3.43)
Helplessness 5.17 5.24 4.90
(2.48) (2.61) (2.18)
Self-blame 4.43 5.71 4.70
(2.17) (2.42) (3.27)
Note: Standard deviations (SD) in parentheses
Anger in response to provocation

To examine differences between psychopath groups in ratings of intensity of
anger in response to provocation, a series of analyses was carried out using
appropriate t-tests and one-way analyses of variance (see Table 5). The total
anger rating to provocation was signi cantly higher in psychopaths com-
pared with non-psychopaths (t (48) = 1.73, p < 0.05; 1-tailed). There were no
signi cant differences in levels of intensity of anger to provocation between
primary and secondary groups in each of the seven domains of provocation.
Correlational analyses
Table 6 presents the inter-correlation coef cients of the measures of social
rank, shame, anger in response to provocation and angriness for the total
sample. Signi cant inverse correlations were observed between social rank
and, respectively, shame and angriness. Thus, as found previously (Allan,
Gilbert and Goss, 1994), perceptions of high rank status correlate with low
internalized shame.
Interestingly, social rank ratings (as measured by social comparison
Table 5 Comparisons of intensity of anger to provocation in primary (P), secondary

(S) and non- (Non-P) psychopath groups
Group means Comparisons
Primary
P S Non-P vs P and S
(n = 23) (n = 17) (n = 10) Secondary vs Non-P
Scales M M M t, df (38) t, df (48)
NAS:
Total 67.74 69.41 59.80 n.s. 1.73*
Disrespect 12.65 13.47 12.20 n.s. n.s.
Fairness 15.00 13.88 13.10 n.s. n.s.

Frustration 13.48 14.06 12.10 n.s. n.s.
Irritation 12.43 12.53 11.10 n.s. n.s.
Annoying traits 13.00 13.59 9.50 n.s. 3.16**
Humiliation 13.84 12.55 11.83 n.s. n.s.

Rejection 10.98 10.29 11.13 n.s. n.s.
Key * p < 0.05; ** p < 0.01; all t-tests 1-tailed
ratings) correlate positively with ratings of intensity of anger in response to

provocation. Thus, as expected, those psychopaths who view themselves as
more highly dominant, attractive and superior compared with others tend
also to react with more intense anger to rank-based attacks, albeit moderately
(r = 0.30, p < 0.01; 2-tailed). Consistent with this association, social rank
Table 6 Correlations of social rank comparisons and shame with anger in response to
provocation (total and subscales) and with angriness
Total < Anger to provocation subscales >

provo. angriness
Shame anger 1 2 3 4 5 6 7
Rank –0.37** 0.30** –0.54*** 0.18 0.21 0.23 0.35* 0.06 0.35* 0.43*
Shame 0.19 0.41*** 0.16 –0.06 0.17 0.22 0.30* 0.10 0.14
Key * p < 0.05; ** p < 0.01; *** p < 0.001; all tests 2-tailed
Note Anger to provocation subscales: 1 = disrespect, 2 = fairness, 3 = frustration, 4 = irritation,
5 = annoying traits, 6 = rejection, 7 = humiliation
ratings were signi cantly highly correlated with the anger provocation sub-
scales of humiliation, rejection and irritation.
Shame, social rank and antisocial personality

Table 7 presents the correlation coefficients for respectively social rank and
shame with Blackburn’s antisocial personality questionnaire (APQ) scales
(Blackburn and Fawcett, 1996). These data show that shame is strongly
associated with antisocial personality. The ISS shame ratings are signifi-
cantly correlated with low self-esteem (0.68), deviant history (0.67), avoid-
ance (0.56), paranoid suspicion (0.55), social withdrawal (0.48), and
resentment/externalizing blame (0.45). Interestingly, ISS shame ratings
correlate significantly with the ‘acting-out’ variables measured by the

APQ, namely, impulsivity (0.43), aggression (0.31) and low self-control
(–0.33).
With respect to the correlations of social rank with APQ scales, fewer sig-
ni cant associations are observed. The social rank measure is signi cantly
correlated with extraversion (or ‘social dominance’) and negatively with
social withdrawal (r = –0.51) and avoidance (r = –0.39) as one would expect.
Interestingly, these data also suggest that those psychopaths who tend to view
themselves as more high-ranking and dominant compared with others
describe signi cantly less deviant histories (r = –0.39).
DISCUSSION
The present study suggests that primary and secondary psychopaths (Black-
burn, 1975, 1993a, 1998) differ signi cantly in their self- and social evaluative
processes. The key domains of these differences lie in social rank (as measured
by social comparison) and shame. Primary psychopaths were found to rate
themselves as signi cantly higher in social rank compared with secondary
psychopaths, and to have signi cantly lower levels of internalized shame.
Secondary psychopaths see themselves as occupying a generally lower rank
(i.e. have more negative self-evaluation). Interestingly in an earlier study by
Gudjonsson and Roberts (1983), it was found that secondary psychopaths
had higher levels of guilt than normals. However, the Morality-Conscience
sub-scale of the Mosher Guilt Inventory (Mosher, 1966) used in their study
is believed to be heavily biased toward negative self-judgements and self-
punishment (Jones et al., 1995), which is closer to a measure of shame in this
study. The primary psychopath, on the contrary, is more socially adept, more
self-con dent, displays little overt anxiety and perceives himself to be socially
dominant. He may be buoyed by a ‘presumption’ of higher rank and thus
buffered against feelings of self-doubt and uncertainty.
344
Table 7 Correlations of social rank and shame with antisocial personality scales
Antisocial Personality Scales

Scales AGG AV DEV EX PA RES SC SE F1 F2
social –0.12 –0.39** –0.39** 0.68*** –0.09 –0.01 0.11 –0.26 –0.14 –0.51***
rank
shame 0.31* 0.56*** 0.67*** –0.09 0.55*** 0.45** –0.33* 0.68*** 0.43** 0.48***
J O U RN A L O F F O RE N SI C P SY C H IAT RY
Key * p < 0.05; ** p < 0.01; *** p < 0.001; all tests 2-tailed
Note AGG = aggression, AV = avoidance, DEV = deviant history, EX = social dominance, PA = paranoid suspicion, RES = resentment/externalizing
blame, SC = self-control, SE = low self-esteem, F1 = impulsivity, F2 = withdrawal
Vol. 12 No. 2
Rank and anger
In regard to anger, primary psychopaths rate themselves as signi cantly less

angry per se (lower ratings of angriness), less angry with others and signi -
cantly less put-down, and make more external attributions of blame com-
pared with secondary psychopaths. Current ndings replicate previous
research, which found that psychopaths react with signi cantly more intense
anger than non-psychopaths to interpersonally threatening provocation
(Blackburn and Lee-Evans, 1985; Thomas-Peter, 1992; Willner and Black-
burn, 1988). No signi cant differences were found between primary and
secondary psychopaths in their ratings of anger intensity under each of the
categories of provocation. The two groups are equally angered by inter-
personally provocative status attacks.

These ndings are consistent with previous research that has found differ-
ences between psychopath groups on a number of behavioural, cognitive and
affective indices (e.g. Blackburn, 1998; Thomas-Peter, 1992). Viewed through
the lens of an evolutionary perspective on the role of social hierarchies in
behaviour (Gilbert, 1992), these ndings may suggest that primary psy-
chopaths assume dominance and threaten others who challenge them, while
secondary psychopaths assume defensive, subordinate positions, would like
to be dominant, but are highly sensitive to attacks from above and below. The
primary psychopath appears adept at directing and eliciting positive social
attention in order to control what others see of him. Primary psychopaths
more effectively create a positive ‘looking-glass self’ (Cooley, 1902): an image
in the minds of others communicating an unimpeachable dominance that can
turn hostile if threatened. The image they project seeks to foster submissive
and subordinate reactions from others. Secondary psychopaths are less able
to experience, project, or create this con dent, dominant image and suffer
attendant feelings of shame, anger and seething resentment (Blackburn, 1996,
1998). Thus, the secondary psychopath struggles against protracted feelings
of low rank and harbours doubts about his capacity to cope (Thomas-Peter,
1996).
The signi cantly lower ratings of angriness in primary psychopaths may
re ect one or more of the following. First, primary or high-ranking psy-
chopaths may subjectively experience less anger compared with secondary or
lower-ranking psychopaths; that is, they are content with their position.
Second, they may be unwilling to report (conceal or deny) these forms of
anger. Finally, they may be unaware of and less able to acknowledge (may
‘bypass’ or have repressed) these forms of anger. We are inclined toward the
view that primary psychopaths generally experience less subjective anger
arousal compared with secondary psychopaths and non-psychopaths. What
distinguishes the psychopath from the non-psychopath is the speed of
arousal to anger when suf ciently provoked and/or threatened (Blackburn,
1998) which carries the psychopath beyond an aggression threshold. Recent

research on psychopathy and the ‘violence inhibition mechanism’ (VIM) sup-
ports this view (Blair, 1995). That is, the psychopath can be distinguished
from the non-psychopath by having a weak, poorly developed, or absent
VIM. Future research might address the question of which factors, if any,
moderate the link between perceived rank attack and violence enactment.
Key among these would in our view be empathy, entitlement and self-
consistency.
Rank and impression management

There was a moderate, positive relationship between social rank and anger
intensity to provocation yet an inverse relationship between rank and per-

ceived angriness. These ndings are perhaps best understood by reference to
social interactionist perspectives on the role of impression management in
aggression and violence (Baumeister, Smart and Boden, 1996; Horowitz,
1981; Katz, 1988; Meloy, 1988; Nisbett, 1993; Tedeschi and Felson, 1994;
Toch, 1993). Meloy (1988), for example, proposes that the psychopath
engages in violence to ward off unwanted emotions that re ect unfavourably
on the self. Recent empirical ndings (e.g. Bushman and Baumeister, 1998)
from a social interactionist perspective (Baumeister et al., 1996) are consist-
ent with our own. Bushman and Baumeister (1998) contradict the popular
view that low self-esteem causes aggression and violence. Instead, they found
that amongst subjects given the opportunity to show aggression against
someone who had insulted them, the highest levels of being aggressive were
found in subjects scoring highest in narcissism and not self-esteem. They con-
clude that aggression by narcissists who are, by de nition, preoccupied with
issues of rank and self-aggrandizement (Beck et al., 1990; Gilbert, 1994;
Stevens and Price, 1996) is an interpersonally meaningful and speci c
response to ego threat. Current ndings con rm this association between
perceptions of social dominance and reactions to down-rank provocations.
Psychopaths who perceive themselves as high rank likewise manage an
impression of self-control and dominance over others by self-presenting as
lacking in angry feelings consistent with a socially dominant stance.
However, when speci cally provoked by rank-based threats or attacks their
anger levels rise accordingly. Thus, those psychopaths with high personal
ratings of social rank maintain a view of themselves as dominant, controlling,
gregarious and lacking in angry feelings per se. They feel assured of their
dominance. However, when threatened or attacked they respond angrily and
switch swiftly to counter-attack. The key role of social rank in interpersonal
anger is further suggested by the multiple regression analysis which found
that social rank working together with self-esteem made the most signi cant
contribution to provoked anger variance. This contribution held even after

controlling for Blackburn’s (1998) two principal factors, namely, impulsive
belligerence and social avoidance. Further research is needed to clarify which
factors contribute to social rank ratings and to examine the relation of social
rank to actual, recorded incidents of aggression and violence. This would lend
greater validity to current ndings that remain tentative subject to further
research.
Rank and shame

The results regarding shame proved interesting in that comparatively high
levels of internalized shame were found in both primary and secondary psy-
chopaths. Findings suggest more acknowledgement of shame than was

expected in primary psychopaths whose shame levels parallel those for male
alcoholics (Cook, 1993). It may well be that both primary and secondary psy-
chopaths have an inner sense of shame such that ‘there is a feeling that, in
truth, there is something awed, bad or worthless about oneself’ (Gilbert,
1997). Gilbert (1997, 1998a) has argued that there is a need to distinguish
internal shame (what one thinks about oneself) from external shame (what
one thinks others think about oneself). External shame was not measured
here and the ISS measures only internal shame. Why would the primary psy-
chopath feel internal shame while seeing himself as relatively superior to
others? One reason may be that the institutionalized psychopath has clearly
been ‘caught’ and may feel ashamed in his own eyes for having lost his
freedom and some pride (e.g. Meissner, 1986; Tedeschi and Felson, 1994;
Vaillant, 1975). Another may be that while one can feel personally inadequate
one may see others as even more so: ‘I may not be that good myself but I am
still better than others.’ Primary psychopaths may be concerned most by
what they think of themselves and about matching their own internal stan-
dards, and concerned less by what others think about them, partly because
they assume they are better (e.g. ‘smarter’; capable of detecting and using
deception) than others (Morrison, 1997). Only future research can answer
this question. But as Blackburn and Coid note, primary psychopaths are
described as ‘the most dominant and the least troubled by interpersonal sensi-
tivities’ (1999: 30) while secondary psychopaths have a ‘hostile-detached’
style and signi cantly greater susceptibility to affective, anxious and psy-
chotic disorders. The key domains of these differences may lie in perceptions
of social rank.
Although the results of this study are promising there are a number of
limitations. First, the instruments used in this study might be criticized on
several counts. While aiming to explore the conceptualization of psy-
chopathy offered by Blackburn and associates (Blackburn and Lee-Evans,
1985; Blackburn and Fawcett, 1996; Blackburn and Renwick, 1996), no

analogous measure was obtained of ‘psychopathy’. The most notable
research instrument for this task is the psychopathy checklist or PCL-R
(Hare, 1998). Had measures of PCL-R psychopathy been obtained, greater
confidence in the reliability and validity of current findings would have
been possible. Such measurement, however, was beyond current resources.
Future research exploration of the issues raised here would fruitfully use
simultaneous file-based PCL-R assessment (Hare et al., 1990; Hart, Cox
and Hare, 1995).
Second, findings might have been strengthened had multiple measures
been obtained of some constructs (e.g. Andrews, 1995; Robson, 1995). For
example, a more appropriate measure of shame that captures external
shame is the ‘Other As Shamer’ Scale (OAS; Goss et al., 1994). Its inclu-
sion might have helped to clarify the meaning of the shame results by pro-
viding a measure of publicly focused or external shame to be contrasted
with internal. Indeed, the measurement of shame is a key issue in research
(Andrews, 1998). Future research could also include measures of guilt and
empathy to correlate against ratings of rank, shame and anger. A key ques-
tion in this area is to what extent, if any, the psychopath has an awareness
of empathic concerns but does not care for the other, or whether he is
simply deficient in such qualities. Exploration of this issue would clarify
the role of shame and social rank in the interpersonal processing of psy-
chopaths. In conclusion, it would appear that conceptualizing psycho-
pathic interpersonal behaviour as (evolved) strategies for rank defence and
maintenance, where it matters if one feels oneself to be low rank and ‘fight-
ing upwards’ or high rank and ‘defending downwards’, could in itself be a
useful paradigm for future research. Preliminary findings in this ex-
ploratory investigation confirm the usefulness and validity of this line of
enquiry.
ACKNOWLEDGEMENTS
This study was conducted at Rampton High-Security (Special) Hospital

while the rst author was under the supervision of Dr Gareth V. Hughes,
consultant clinical psychologist, and Mr Alan Dabbs, University of Leeds.
David Glasgow (Calderstones NHS Trust) assisted in providing comments
on earlier drafts of this paper. Thanks are due also to all RMOs and nursing
staff at Rampton whose co-operation made this study possible.
Dr David Morrison, MA (Hons), PhD, PGCE, ClinPsyD, clinical psychologist, Department of
Clinical Psychology, South Derbyshire Mental Health NHS Trust, Kingsway Hospital, Derby
DE22 3LZ, UK
Professor Paul Gilbert, BSc, CPsychol, PhD, FBPsS, consultant clinical psychologist, Mental
Health Research Unit, South Derbyshire Mental Health NHS Trust, Kingsway Hospital, Derby
DE22 3LZ and University of Derby, DE3 5GX, UK
Correspondence to Dr Morrison
NOTES
1 A distinction between shame and guilt is an interesting and useful one to make. Like
shame, the conceptualization and measurement of guilt is a key research issue (e.g.
Gilbert, 1997; Tangney, 1995). Brie y, some theorists (e.g. Baumeister, Stillwell and
Heatherton, 1994; Tangney, 1995) propose that shame focuses on global self-evalu-
ations whereas guilt focuses on specic behaviour-evaluations. Others (e.g. Gilbert,
1997; Hoffman, 1991) argue that they relate to different cognitive-emotional

systems: guilt to caring and co-operative behaviour (e.g. empathy) and shame to
rank and social standing.
2 Alternative conceptualizations of primary and secondary psychopaths have been
documented in the literature (e.g. Lykken, 1957, 1995; Mealey, 1995). In this study,
we focused on the Blackburn (e.g. 1975, 1996) distinction.
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Social Rank, Shame and Anger in Primary and Secondary Psychopaths

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Social Rank, Shame and Anger in Primary and Secondary Psychopaths

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Journal of Forensic Psychiatry & Psychology

Social rank, shame and anger in primary and secondary psychopaths

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Social rank, shame and anger in

ABSTRACT This study compared primary and secondary psychopaths

Keywords: primary psychopaths, secondary psychopaths, social rank

The Journal of Forensic Psychiatry

The self-conscious emotion of shame is regarded as a powerful affective

TERMS USED IN THE STUDY

Shame and humiliation

Status attack and personality disorders

Primary and secondary psychopathy

to be yielding. However, while primary psychopaths did not expect to be

acknowledging shame and using social avoidance or apologies. Instead, they

nition in the two types of psychopath (Blackburn, 1998) by embedding

Participants were randomly sampled from a population of male offenders

participate were included in the study. Of 73 individuals subsequently

At interview the following series of self-report measures were administered

1 The Antisocial Personality Questionnaire (APQ; Blackburn and

2 The Social Comparison Scale – as ‘rank’ estimate (Allan and Gilbert,

To provide a measure of social comparisons of angriness, three other con-

3 The Internalized Shame Scale (ISS; Cook, 1993, 1996)

rate on a 5-point scale how often they experience particular thoughts or

4 The Revised Novaco Anger Scale (Revised NAS; Novaco, 1994)

The self-report questionnaires were administered during assessment inter-

Social comparisons as a measure of rank estimates

Table 1 Means and standard deviations of the self-report measures

(n = 50) (n = 23) (n = 17) (n = 10)

Extraversion 11.42 (4.13) 13.96 (2.99) 9.12 (3.30) 9.50 (4.58)

Social Comparison Scale

the sample classi ed by psychopathy typology are presented in Table 2. All

Internalized shame (shame-proneness)

Table 2 Means, standard deviations and t-tests of social comparison evaluations

Group Means Comparisons

(n = 23) (n = 17) (n = 10) P P and S

Total SC 74.39 58.35 69.90 3.31*** n.s.

Analyses of group differences in shame showed that secondary psy-

Legal P S Non-P Male* Male** Affective***

(n = 23) (n = 17) (n = 10)

Angriness 4.39 6.53 4.60

(2.81) (2.53) (3.44)

Note: Standard deviations (SD) in parentheses

Anger in response to provocation

Table 5 Comparisons of intensity of anger to provocation in primary (P), secondary

Group means Comparisons

Scales M M M t, df (38) t, df (48)

Fairness 15.00 13.88 13.10 n.s. n.s.

Humiliation 13.84 12.55 11.83 n.s. n.s.

Key * p < 0.05; ** p < 0.01; all t-tests 1-tailed

ratings) correlate positively with ratings of intensity of anger in response to

Total < Anger to provocation subscales >

Shame, social rank and antisocial personality

correlate significantly with the ‘acting-out’ variables measured by the

Antisocial Personality Scales

Rank and anger

In regard to anger, primary psychopaths rate themselves as signi cantly less

personally provocative status attacks.

1998) which carries the psychopath beyond an aggression threshold. Recent

Rank and impression management

intensity to provocation yet an inverse relationship between rank and per-

the sample classi ed by psychopathy typology are presented in Table 2. All

Legal P S Non-P Male* Male Affective*

In regard to anger, primary psychopaths rate themselves as signi cantly less