Primary and Secondary Psychopathy

Psychopathy in the Cinematic World

When we hear the word “psychopathy” images of different movie characters pop in our minds. Cold heartedness, higher intelligence and aggressiveness being their primary characteristics (Hesse, 2019). They are either on a murder spree or plotting against other humans. Bloodshed, criminal activity and interpersonal issues are their hallmark. Simply put, a human monster on the loose is psychopathy personified in the world of cinema. But all these portrayals of the psychopaths merely scratch the surface of a much graver issue. This also justifies the potential prejudicial impact of the term in legal proceedings (Davis, Frederick, & Corcoran, 2020).

Busting the Myth

Scientifically, psychopathy is described and divided in a variety of ways owing to differences in biological, psychological and behavioral aspects. Based on literature, psychopathy is divided into two distinct types i.e. primary and secondary. Primary psychopathy has a characteristic emotional deficiency. This implies that the parts of the brain that are involved in behavioral and emotional responses are hampered along with the ability to react to environmental changes. Serotonin level in such a case is hyper-stable. Secondary psychopathy on the other hand is characterized by emotional disturbance owing to physiological changes that are in line with environmental aspects like malfunctioning of the prefrontal cortex (the area of the brain that deals with cognitive control) and deficiency of serotonin. Both of these types vary in terms of traits, personalities and causal physiological mechanisms. Each of the categories are further divided into separate continuums. Primary psychopaths lie on the continuum of controlled to disinhibited while secondary psychopaths lie on the continuum of detached to unstable (Yildirim & Derksen, 2015). Bringing in the nature vs nurture debate, it is theorized that primary psychopathy is due to nature while secondary is due to nurture.

Emotional callousness is the core feature of psychopathy. Psychopathy research (Del Gaizo & Falkenbach, 2008) has shown that primary psychopathy and associated traits are positively related with the ability to accurately perceive fearful faces and positive affect while at the same time it is negatively associated with negative affect. This means that primary psychopaths can not only detect and recognize fearful faces but can also fully perceive positive emotional states while they struggle with recognizing negative emotional states. In contrast, traits associated with secondary psychopathy were not associated with positive affect or emotional recognition but they were found to be positively related to negative affect. Which means that secondary psychopaths are less able to perceive positive emotional states but can perceive negative emotional states.

Developmental Trajectory

A study on male adolescent offenders revealed that individuals with high psychopathy scores manifested more negative traits in personality and were deemed to be more prone to dangerousness as compared to those who had lower psychopathy scores (Lee, Salekin, & Iselin, 2010). But how do these traits develop? And what is their trajectory?

There are multiple views based on evidence provided by research. Findings of a study comprising of 362 individuals revealed that primary psychopathy and related traits in men were associated with avoidant attachment style and controlling mothers, whereas secondary psychopathy and related traits were associated with anxious attachment style and uncaring parents. When it comes to women, primary psychopathy was found to be associated with anxious and avoidant attachment style along with uncaring fathers while secondary psychopathy was not associated with any attachment style or parental bonding (Blanchard & Lyons, 2016).

A recent study conducted with a sample of 338 normal adults within an age range of 18-70 years has found avoidant attachment style, positive reappraisal of situations and blaming others as predictors of primary psychopathy. On the other hand risk factors associated with secondary psychopathy were anxious attachment and the cognitive distortion of catastrophizing (Kyranides & Neofyto, 2021).

Differentiating between Primary and Secondary Psychopathy

Primary and secondary psychopathy has been operationalized and distinctively defined earlier in this article but the question remains as to what criteria or measures can be used to draw a line between the heterogenous groups of primary and secondary psychopaths. The answer lies in the research from University of Wisconsin-Madison. Newman, MacCoon, Vaughn, and Sadeh (2005) conducted the research on 517 male inmates from different prisons in Wisconsin. The participants varied in terms of age (45 years or less), IQ levels (70 or above), security of prisons they were currently at (minimum, medium and maximum) and psychopathy. Different assessment measures were utilized. Individuals with a score of 30 or more on Psychopathy checklist (PCL-R) along with a score of 11 or less on the Welsh Anxiety Scale (WAS) were categorized as primary psychopaths whereas individuals having a PCL-R score of 30 or more along with score of 12 or more on the WAS were categorized as secondary psychopaths. The relationship of the two groups with the behavioral inhibition system (BIS, i.e. to move away from unpleasant things or avoid aversive stimuli) and behavioral activation system (BAS, i.e. to move towards desirable things or seeking pleasant stimuli) was seen.

Data was collected on other measures as well and statistical analyses were applied. Results showed that primary psychopathy was associated with lower levels of BIS and normal levels of BAS. This means that primary psychopaths cannot avoid aversive stimuli as effectively as normal people but can seek pleasure just like normal people. Results also revealed that secondary psychopaths have higher levels of BAS and normal levels of BIS. In other words, they have a tendency to go beyond the bounds of most people to achieve pleasure.

These findings were contradictory to those of another study (Hughes, Moore, Morris, & Corr, 2012) that was conducted on normal students. The results showed that low BIS activity was related with both primary and secondary types of psychopathy. The fun seeking aspect of BAS was positively associated with secondary psychopathy and negatively with primary psychopathy while the reward sensitivity and drive aspect of BAS was associated with primary psychopathy.


With the vast literature available on the construct of psychopathy, it is hard to reach a committed consensus and draw a rigid line between traits associated with primary and secondary psychopathy. As the scientific literature grows, our ability to distinguish between and understand these groups will improve, allowing researchers and clinicians to better identify and predict psychopaths. Please add a comment to discuss psychopathy and the research summarized in this article.


Blanchard, Alyson, and Minna Lyons. 2016. “Sex Differences between Primary and Secondary Psychopathy, Parental Bonding, and Attachment Style.” Evolutionary Behavioral Sciences 10 (1): 56–63.

Gaizo, Ariel L. Del, and Diana M. Falkenbach. 2008. “Primary and Secondary Psychopathic-Traits and Their Relationship to Perception and Experience of Emotion.” Personality and Individual Differences 45 (3): 206–12.

Hesse, Morten. 2009. “Portrayal of Psychopathy in the Movies.” International Review of Psychiatry 21 (3): 207–12.

Hughes, Katie A., Roger A. Moore, Paul H. Morris, and Philip J. Corr. 2012. “Throwing Light on the Dark Side of Personality: Reinforcement Sensitivity Theory and Primary/Secondary Psychopathy in a Student Population.” Personality and Individual Differences 52 (4): 532–36.

Kyranides, Melina Nicole, and Louiza Neofytou. 2021. “Primary and Secondary Psychopathic Traits: The Role of Attachment and Cognitive Emotion Regulation Strategies.” Personality and Individual Differences 182 (November): 111106.

Lee, Zina, Randall T. Salekin, and Anne Marie R. Iselin. 2009. “Psychopathic Traits in Youth: Is There Evidence for Primary and Secondary Subtypes?” Journal of Abnormal Child Psychology 2009 38:3 38 (3): 381–93.

Newman, Joseph P., Donal G. MacCoon, Leah J. Vaughn, and Naomi Sadeh. 2005. “Validating a Distinction between Primary and Secondary Psychopathy with Measures of Gray’s BIS and BAS Constructs.” Journal of Abnormal Psychology 114 (2): 319–23.

Authored by

Marva Sohail Benjamin Silber

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