Psychopathic traits have been linked to anomalies in experiencing fear and anxiety. It remains unclear, however, to what extent fear and anxiety levels are useful parameters to effectively distinguish between subtypes of psychopathy. Therefore, we aimed to elucidate whether different psychopathic phenotypes (primary and secondary psychopathy) can be delineated based on fear/anxiety levels. To investigate associations between psychopathic traits and conscious experiences of fear and/or anxiety a systematic qualitative review of studies was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seventeen studies were included in the review. We found some evidence for attenuated fear/anxiety levels in primary psychopathy. In secondary psychopathy, the experience of fear/anxiety seemed rather intact. Moreover, primary psychopathy might be associated with a more positive appraisal of the conscious feeling of fear. We reason that consciously experienced fear and anxiety are distinctly related to primary and secondary psychopathy. Due to a lack of consistent and comprehensive operationalizations of fear and anxiety, however, conclusions about their potential to differentiate psychopathic subtypes should be drawn with caution.

中文翻译：

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无所畏惧但焦虑？关于恐惧和焦虑水平对精神病亚型分类的效用的系统评价

心理变态特征与经历恐惧和焦虑的异常有关。然而，目前尚不清楚恐惧和焦虑水平在多大程度上是有效区分精神病亚型的有用参数。因此，我们旨在阐明是否可以根据恐惧/焦虑水平来描述不同的精神病表型（原发性和继发性精神病）。为了调查精神病特征与恐惧和/或焦虑的意识体验之间的关联，按照系统评价和元分析的首选报告项目指南对研究进行了系统的定性评价。该评价纳入了 17 项研究。我们发现了一些证据表明原发性精神病患者的恐惧/焦虑水平减弱。在继发性精神病中，恐惧/焦虑的体验似乎相当完整。此外，原发性精神病可能与对有意识的恐惧感更积极的评价有关。我们推断，有意识地经历恐惧和焦虑与原发性和继发性精神病明显相关。然而，由于缺乏对恐惧和焦虑的一致和全面的操作，应谨慎得出关于它们区分精神病亚型的潜力的结论。