Psychopathy
Psychopathy, or psychopathic personality, is a personality construct characterized by impaired empathy and remorse, persistent antisocial behavior, along with bold, disinhibited, and egocentric traits. These traits are often masked by superficial charm and immunity to stress, which create an outward appearance of normality.
Hervey M. Cleckley, an American psychiatrist, influenced the initial diagnostic criteria for antisocial personality reaction/disturbance in the Diagnostic and Statistical Manual of Mental Disorders, as did American psychologist George E. Partridge. The DSM and International Classification of Diseases subsequently introduced the diagnoses of antisocial personality disorder and dissocial personality disorder, respectively, stating that these diagnoses have been referred to as psychopathy or sociopathy. The creation of ASPD and DPD was driven by the fact that many of the classic traits of psychopathy were impossible to measure objectively. Canadian psychologist Robert D. Hare later re-popularized the construct of psychopathy in criminology with his Psychopathy Checklist.
Although no psychiatric or psychological organization has sanctioned a diagnosis titled "psychopathy", assessments of psychopathic characteristics are widely used in criminal justice settings in some nations and may have important consequences for individuals. The study of psychopathy is an active field of research. The term is also used by the general public, popular press, and in fictional portrayals of psychopaths. While the abbreviated term "psycho" is often employed in common usage in general media along with "crazy", "insane", and "mentally ill", there is a categorical difference between psychosis and psychopathy.
Signs and symptoms
Socially, psychopathy typically involves extensive callous and manipulative self-serving behaviors with no regard for others and often is associated with repeated delinquency, crime, and violence. Mentally, impairments in processes related to affect and cognition, particularly social mental processes, have also been found. Developmentally, symptoms of psychopathy have been identified in young children with conduct disorder and suggest at least a partial constitutional factor that influences its development.Primary features
There is disagreement over which features should be considered part of psychopathy, with researchers identifying around 40 traits supposedly indicative of the construct, though the following characteristics are almost universally considered central.Core traits
In 2001, David J. Cooke and Christine Michie proposed a three-factor model of the Psychopathy Checklist-Revised, which has seen widespread application in other measures, such as the Youth Psychopathic Traits Inventory and Antisocial Process Screening Device.- Arrogant and deceitful interpersonal style: impression management or superficial charm, inflated and grandiose sense of self-worth, pathological lying/deceit, and manipulation for personal gain.
- Deficient affective experience: lack of remorse or guilt, shallow affect, callousness and lack of empathy, and failure to accept responsibility for one's own actions.
- Impulsive and irresponsible lifestyle: impulsivity, sensation-seeking and risk-taking, irresponsible and unreliable behavior, financially parasitic lifestyle, and a lack of realistic, long-term goals.
Low anxiety and fearlessness
The importance of low anxiety/fearlessness to psychopathy has historically been underscored through behavioral and physiological studies showing diminished responses to threatening stimuli. However, it is not known whether this is reflected in the reduced experience of state fear or where it reflects impaired detection and response to threat-related stimuli. Moreover, such deficits in threat responding are known to be reduced or even abolished when attention is focused on the threatening stimuli.
Offending
Criminality
In terms of simple correlations, the PCL-R manual states that an average score of 22.1 has been found in North American prisoner samples, and that 20.5% scored 30 or higher. An analysis of prisoner samples from outside North America found a somewhat lower average value of 17.5. Studies have found that psychopathy scores correlated with repeated imprisonment, detention in higher security, disciplinary infractions, and substance misuse.Psychopathy, as measured with the PCL-R in institutional settings, shows in meta-analyses small to moderate effect sizes with institutional misbehavior, post-release crime, or post-release violent crime, with similar effects for the three outcomes. Individual studies give similar results for adult offenders, forensic psychiatric samples, community samples, and youth. The PCL-R is poorer at predicting sexual re-offending. This small to moderate effect appears to be largely due to the scale items assessing impulsive behaviors and past criminal history, which are well-established but very general risk factors. The aspects of core personality often held to be distinctively psychopathic generally show little or no predictive link to crime by themselves. For example, Factor 1 of the PCL-R and Fearless Dominance of the PPI-R have a smaller or no relationship to crime, including violent crime. In contrast, Factor 2 and Impulsive antisociality of the PPI-R are associated more strongly with criminality. Factor 2 has a relationship of similar strength to that of the PCL-R as a whole. The antisocial facet of the PCL-R is still predictive of future violence after controlling for past criminal behavior, which, together with results regarding the PPI-R, which by design does not include past criminal behavior, suggests that impulsive behaviors are an independent risk factor. Thus, the concept of psychopathy may perform poorly when attempted to be used as a general theory of crime.
Violence
Studies have suggested a strong correlation between psychopathy scores and violence, and the PCL-R emphasizes features that are somewhat predictive of violent behavior. Researchers, however, have noted that psychopathy is dissociable from and not synonymous with violence.It has been suggested that psychopathy is associated with "instrumental aggression", also known as predatory, proactive, or "cold-blooded" aggression, a form of aggression characterized by reduced emotion and conducted with a goal differing from but facilitated by the commission of harm. One conclusion in this regard was made by a 2002 study of homicide offenders, which reported that the homicides committed by homicidal offenders with psychopathy were almost always primarily instrumental, significantly more than the proportion of those committed by non-psychopathic homicidal offenders, with the instrumentality of the homicide also correlated with the total PCL-R score of the offender as well as their scores on the Factor 1 "interpersonal-affective" dimension. However, contrary to the equating of this to mean exclusively "in cold blood", more than a third of the homicides committed by psychopathic offenders involved some component of emotional reactivity as well. In any case, FBI profilers indicate that serious victim injury is generally an emotional offense, and some research supports this, at least concerning sexual offending. One study has found more serious offending by non-psychopathic offenders on average than by offenders with psychopathy, and another has found that the Affective facet of the PCL-R predicted reduced offense seriousness.
Studies on perpetrators of domestic violence find that abusers have high rates of psychopathy, with the prevalence estimated to be at around 15-30%. Furthermore, the commission of domestic violence is correlated with Factor 1 of the PCL-R, which describes the emotional deficits and the callous and exploitative interpersonal style found in psychopathy. The prevalence of psychopathy among domestic abusers indicate that the core characteristics of psychopathy, such as callousness, remorselessness, and a lack of close interpersonal bonds, predispose those with psychopathy to committing domestic abuse, and suggest that the domestic abuses committed by these individuals are callously perpetrated rather than a case of emotional aggression and therefore may not be amenable to the types of psychosocial interventions commonly given to domestic abuse perpetrators.
Some clinicians suggest that assessment of the construct of psychopathy does not necessarily add value to violence risk assessment. A large systematic review and meta-regression found that the PCL performed the poorest out of nine tools for predicting violence. In addition, studies conducted by the authors or translators of violence prediction measures, including the PCL, show, on average, more positive results than those conducted by more independent investigators. Several other risk assessment instruments can predict future crime with an accuracy similar to that of the PCL-R, and some are considerably easier, quicker, and less expensive to administer. This may even be done automatically by a computer, based on data such as age, gender, number of prior convictions, and age at first conviction. Some of these assessments may also identify treatment changes and goals, identify quick changes that may help short-term management, identify more specific kinds of violence that may be at risk, and establish specific probabilities of offending for specific scores. Nonetheless, the PCL-R may remain popular for risk assessment due to its pioneering role and extensive research using it.
The U.S. Federal Bureau of Investigation reports that psychopathic behavior is consistent with traits common to some serial killers, including sensation seeking, a lack of remorse or guilt, impulsivity, the need for control, and predatory behavior. It has also been found that the homicide victims of psychopathic offenders were disproportionately female in comparison to the more equitable gender distribution of victims of non-psychopathic offenders.