Effects of co-occurring psychotic experiences and psychopathic tendencies on social cognitive functioning


This project will identify the consequences of co-occurring psychotic experiences and psychopathic tendencies for social cognitive functioning, a known risk factor for violence among patients with a mental disorder.

Although the majority of individuals with a mental disorder are never violent, epidemiological evidence suggests that those with psychosis are at an increased risk for violence compared with the general population, placing them at greater risk for heightened levels of distress, increased stigma and risk of incarceration, loss of social contacts, and loss of employment. Disturbances in social cognition, for example, theory of mind and emotion recognition, represent a major risk factor for violence among those with psychosis. However, a large proportion of men who are violent and experience psychosis also present with co-occurring antisocial personality pathology or psychopathic tendencies. A lack of knowledge about the effects of these co-occurring disorders may account for mixed findings in the literature, and impacts negatively on the development of effective interventions for reducing violence and subsequent distress among patients with a mental illness.

A potential explanation for the increased risk of violence among patients with psychosis and co-occurring psychopathic tendencies is that these patients experience a ‘double dose’ of deficit leading to greater cognitive impairment. However, our recent work is intriguing in that it highlights benefits of co-occurring psychosis and psychopathic tendencies on understanding of others’ mental states in a sample of community adults (Gillespie et al., 2017), and among patients with a diagnosis of schizophrenia and a history of violence (Abu-Akel et al., 2015). Although seemingly paradoxical, these findings make more sense if one considers that an increased understanding of others’ mental states may facilitate more predatory and instrumental forms of aggression (Gillespie et al., 2018).

In order to understand precisely how these effects are mediated, we need to know what the effects of co-occurring psychosis and psychopathic tendencies are on social cognitive functioning (e.g., theory of mind); we need to know whether these effects extend beyond social-cognition to other operations that are important for successful social interaction (e.g., response inhibition and saliency processing); and we need to know what the effects of this co-occurrence are on clinician rated levels of social, occupational, and psychological functioning in a forensic patient sample.

To date, there is limited evidence on the effects of co-occurring disorders, and existing models emphasize a double dose of deficit explanation that is not supported by recent findings. This project will take an experimental approach to answering these questions, using existing and newly developed computerised paradigms to examine social-cognitive and related abilities in forensic and non-forensic samples. The findings will lead to the development of a new theoretical model to understand the effects of co-occurring psychosis and psychopathic tendencies on social cognitive abilities in order to inform psychological intervention among patients with a history of violence. These findings will be disseminated to the scientific community via the publication of journal articles, while existing networks will ensure the timely dissemination and translational impact of our findings. 

To apply for this opportunity please send a CV, cover letter (with research statement), and references to steven.gillespie@liverpool.ac.uk with the email subject title as ’Psychopathy and Psychosis PhD studentship’


Open to students worldwide

Funding information

Funded studentship

This studentship is funded by the School of Psychology, University of Liverpool.



Abu-Akel, A., Heinke, D., Gillespie, S. M., Mitchell, I. J., & Bo, S. (2015). Metacognitive impairments in schizophrenia are arrested at extreme levels of psychopathy: The cut-off effect. Journal of Abnormal Psychology, 124(4), 1102-1109. doi: http://dx.doi.org/10.1037/abn0000096

Gillespie, S. M., Mitchell, I. J., & Abu-Akel, A. M. (2017). Autistic traits and positive psychotic experiences modulate the association of psychopathic tendencies with theory of mind in opposite directions. Scientific Reports, 7(1), 6485.  doi: 10.1038/s41598-017-06995-2

Gillespie, S. M., Kongerslev, M. T., Sharp, C., Bo, S., & Abu-Akel, A. M. (2018). Does affective theory of mind contribute to proactive aggression in boys with conduct problems and psychopathic tendencies? Child Psychiatry & Human Development. doi: https://doi.org/10.1007/s10578-018-0806-8


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