Australasian Science: Australia's authority on science since 1938

A Blind Eye to Love

The eyes convey a vast range of emotional cues.

The eyes convey a vast range of emotional cues that help us get along with, and understand, each other

By Bob Beale

Lack of interest in holding a mother’s gaze may be an early indicator of problems to come, such as serious crime, violence and drug-taking.

Asked to picture a psycho­path, you might conjure up a horror movie character: someone prone to violence or even serial murder, coldly scrutinising you with unblinking eyes.

In fact, only a tiny proportion of psychopaths are killers: most psychopaths are involved in far more mundane criminality or callous exploitation of other people for their own ends, notes Prof Mark Dadds of the University of NSW School of Psychology.

Psychopaths are antisocial and emotionally cold, and new evidence indicates that a core feature is that they lack a natural propensity to focus on the eyes of other people.

Our natural interest in the eyes of other people holds important clues to understanding the workings of both healthy and unhealthy minds, Dadds notes.

Eye contact is vital to normal human relations: from a parent’s stern look to lovers gazing at each other, the eyes convey a vast range of emotional cues that help us get along with, and understand, each other.

“Our inherent interest in the eyes of other people lies at the origin of empathy, connectedness and attachment, and some of the earliest evolved parts of our brains are dedicated to driving our attention to the eyes of other people,” says Dadds.

Recent research led by Dadds suggests that impairments in human eye contact may be reliable signs of psychological

problems detectable in even very young children.

It has long been recognised, for example, that children with autism have poor eye contact even with people who are very close to them. People with high levels of social anxiety have their attention involuntarily captured by other people’s eyes in a way that can be threatening and unpleasant.

A team lead by Dadds is interested in children with significant behavioural disorders commonly diagnosed as having oppositional defiant disorder (ODD) or conduct disorder, which are characterised by repetitive patterns of aggressive, hostile and antisocial behaviour. These children represent the most common mental health problem in children and, although some overcome their problems, they are at increased risk for a multitude of outcomes including criminality, all forms of adult mental illness, drug and alcohol abuse, and social disadvantage.

Dadds says this group seems to divide into children who are emotionally “hot”, who make up the majority of such children, and those who are emotionally “cold”. Children in the second group make poor eye contact with their mothers and don’t display or respond much to affection. The research suggests that while they are not psychopaths, it is as if they literally do not see the love in their mother’s eyes.

With John Brennan from the UNSW School of Psychiatry, David Hawes from the University of Sydney, and colleagues from the Institute of Psychiatry at King’s College, London, Dadds has conducted pioneering laboratory experiments using eye-tracking devices and video cameras to record how much eye contact such children make with their parents during free and emotional talk interactions, and when the mothers are consciously trying to express their love for them.

The studies involved more than 100 children aged between 4 and 16 years of age who have been diagnosed with ODD. They were screened to exclude other significant mental, medical or developmental issues, and their mothers had no significant psychiatric or addiction problems.

They were compared with control groups of children with no mental health or behavioural problems. All the children were from the same regions of rural NSW, Sydney and South London, and from mixed socioeconomic backgrounds. The experiments were conducted “blind”, meaning that observers were not told to which group each child belonged.

Parents and children were discreetly observed by camera and two-way mirrors as they played and talked freely for about 30 minutes in a room equipped with toys and furniture. The mothers were then instructed by telephone to look into their child’s eyes and express their love in whatever way felt most natural for them.

Mothers’ levels of affection and eye contact did not differ between those with healthy or children with behaviour problems. Thus it is unlikely that differences in warmth and engagement from mothers could explain differences in the children.

Children with ODD showed lower levels of returned affection than those in the control group, but some of them – those ranked highly for having what are known as “callous unemotional” or cold traits – showed uniquely low levels of gazing at the eye region of parents. During the love task, the children with the cold traits showed little interest in sharing gazes with their mothers. All other children showed the natural propensity to “lock gaze” with loved ones.

“This is a sub-group of kids who are quite different,” says Dadds. “They are low on emotion and they don’t connect with authority figures. It’s not clearly due to problems in the discipline they are receiving. Research from the UNSW team and overseas groups suggests that the style, stability and quality of parenting have relatively little impact on these children. Indeed, the reverse seems to be true – that these kids have a significant impact on their parents.”

These findings support a growing awareness among psychologists that children who exhibit aggressive and anti­social behaviour are not a homogenous group, and that a “one-size- fits-all” treatment is not appropriate. At present the treatment of choice for ODD is evidence-based

positive-parenting strategies. These findings indicate that differences in emotionality need to be considered in fine-tuning the specific ways parents are helped to communicate, discipline and lovingly engage with these children.

About one in 10 children has significant behaviour problems like this. The researchers say that most of these aggressive and antisocial children fall into what they call the “hot” group – they are impulsive, emotional and given to overly hostile interpretations of the world, but they have normal levels of empathy and are largely reactive in their aggression. They show normal interest in, and reactions to, eye contact. In fact, high levels of emotion in these children can be associated with eye contact that is interpreted as overly intense, at times even threatening, and inflammatory of their emotions.

The much smaller “cold group” – one or two children in 100 – is under-emotional and shows problems with empathy. These children are reactive and proactive or even predatory in their aggression. It is thought that many such children go on to become involved in serious crime, violence and drug-taking. It is this group where the lack of eye contact seems particularly significant.

Adolescents and adults with psychopathic traits are known to have problems recognising and responding normally to fear and distress in the faces, postures and sounds made by other people. Dadds’ research indicates that these problems may stem from a basic problem with paying attention to the most human parts of the environment, such as the eyes of other people.

This idea – that psychopathy may in part be a problem of what people pay attention to – is new and highly controversial but coincides with emerging work with adults. It has long been known that adult psychopaths show diminished, conditioned startle responses, an inflexible and reliable eye blink that reflects fear. Researchers working with psychopathic prisoners in the US, for example, have recently reported that when psychopaths have their attention drawn to critical aspects of fear stimuli, they show normal startle responses.

Dadds’ team showed similar results with boys displaying cold traits: under “free-viewing conditions” these boys have problems recognising fear in other people. This impairment disappears, however, when they are specifically asked to focus on the eye region of faces showing the emotion.

It has long been thought that psychopaths are essentially incapable of feeling normal emotions like love, fear and remorse – at least, not towards other people. But Dadds says that this is contradicted by the recent finding that psychopaths show startle responses and can recognise fear in others if their attention can be drawn to the relevant cues. In short, they may not be incapable of fear – and perhaps other responses to external stimuli – but don’t feel things because they fail to pay attention to stimuli that elicit normal emotional reactions.

“It’s early days yet but we think we may be on the verge of something exciting here,” says Dadds. “A healthy brain is profoundly drawn to biologically relevant cues, and the eyes of other people provide so many of those cues. It’s one of the fundamental building blocks of becoming a feeling, decent human being.

“Newborn boys and girls are ‘hard- wired’ to orient towards a face and start to make eye contact. Parents are quick to reciprocate, lock eye gaze, and begin the long journey of learning to concentrate on, interpret and care about what other people feel. But what happens if you have a simple error in that system?”

Could it be, he asks, that such an error leads to a cascade of deficits, a failure to develop that normal “empathy, connectedness and attachment” that makes us so wonderfully human?

Bob Beale is Public Affairs Manager at the University of NSW Faculty of Science.