Psychopathy is a mental disorder characterized primarily by a lack of empathy and remorse, shallow emotions, egocentricity, and deceptiveness. Psychopaths are highly prone to antisocial behavior and abusive treatment of others, and are very disproportionately responsible for violent crime. Though lacking empathy and emotional depth, they often manage to pass themselves off as average individuals by feigning emotions and lying about their past.
Until the 1980s, the term formally referred to a
personality disorderPersonality disorders, formerly referred to as character disorders, are a class of personality types and behaviors. Personality disorders are noted on Axis II of the Diagnostic and Statistical Manual of Mental Disorders or DSM-IV-TR of the American Psychiatric Association.Personality disorders are...
characterized by the inability to form human attachment and an abnormal lack of
empathyEmpathy is the capacity to recognize and, to some extent, share feelings that are being experienced by another sapient or semi-sapient being. Someone may need to have a certain amount of empathy before they are able to feel compassion. The English word was coined in 1909 by E.B...
, masked by an ability to appear outwardly normal. The publication of the
Diagnostic and Statistical Manual of Mental DisordersThe Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
third edition (DSM-III) changed the name of this mental disorder to
antisocial personality disorderAntisocial personality disorder is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition , as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood...
, and also broadened the diagnostic criteria considerably by shifting from clinical inferences to behavioral diagnostic criteria. However, the DSM-V working party is recommending a revision of antisocial personality disorder (ASPD) to include "Antisocial/Psychopathic Type", with the diagnostic criteria having a greater emphasis on character than on behavior. The
ICD-10The International Statistical Classification of Diseases and Related Health Problems, 10th Revision is a medical classification list for the coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases, as maintained by the...
diagnostic criteria of the
World Health OrganizationThe World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
also lacks psychopathy as a personality disorder. The 1992 manual included
dissocial (antisocial) personality disorderAntisocial personality disorder is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition , as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood...
, which encompasses
amoralMoral nihilism is the meta-ethical view that nothing is moral or immoral. For example, a moral nihilist would say that killing someone, for whatever reason, is neither inherently right nor inherently wrong...
, antisocial, asocial, psychopathic, and sociopathic personalities.
Despite being currently unused in diagnostic manuals, psychopathy and related terms such as
psychopath are still widely used by mental health professionals and laymen alike. In particular,
NATO has funded a series of Advanced Study Institutes on psychopathy, both before and after the publication of DSM-III. Researcher
Robert HareRobert D. Hare, C.M. , is a researcher in the field of criminal psychology. He developed the Psychopathy Checklist and Psychopathy Checklist Revised , used to diagnose cases of psychopathy and also useful in predicting the likelihood of violent behavior...
has been a particular champion of the term; his
Hare Psychopathy ChecklistIn contemporary research and clinical practice, Robert D. Hare's Psychopathy Checklist-Revised is the psycho-diagnostic tool most commonly used to assess psychopathy...
is the standard tool for differentiating between those with antisocial personality disorder and the subset who are psychopaths. According to this scale the prevalence of antisocial personality disorder is two to three times that of psychopathy.
According to a chapter about treatment in Christopher J. Patrick's
Handbook of Psychopathy, there is little evidence of a cure or any effective treatment for psychopathy; no medications can instill empathy, and psychopaths who undergo traditional talk therapy might become more adept at manipulating others and more likely to commit crime. Others suggest that psychopaths may benefit as much as others from therapy, at least in terms of effect on behavior even if not on the central personality traits. According to
HareRobert D. Hare, C.M. , is a researcher in the field of criminal psychology. He developed the Psychopathy Checklist and Psychopathy Checklist Revised , used to diagnose cases of psychopathy and also useful in predicting the likelihood of violent behavior...
, the consensus among researchers in this area is that psychopathy stems from a specific
neurological disorderA neurological disorder is a disorder of the body's nervous system. Structural, biochemical or electrical abnormalities in the brain, spinal cord, or in the nerves leading to or from them, can result in symptoms such as paralysis, muscle weakness, poor coordination, loss of sensation, seizures,...
which is present from birth, although a 2008 review indicated multiple causes and variation between individuals. Hare estimates that about one percent of the US population are psychopaths.
Despite the similarity of the names, psychopaths are rarely psychotic.
History
The current concept of psychopathy has been thematically linked to writings by
TheophrastusTheophrastus , a Greek native of Eresos in Lesbos, was the successor to Aristotle in the Peripatetic school. He came to Athens at a young age, and initially studied in Plato's school. After Plato's death he attached himself to Aristotle. Aristotle bequeathed to Theophrastus his writings, and...
, a student of
AristotleAristotle was a Greek philosopher and polymath, a student of Plato and teacher of Alexander the Great. His writings cover many subjects, including physics, metaphysics, poetry, theater, music, logic, rhetoric, linguistics, politics, government, ethics, biology, and zoology...
in
Ancient GreeceAncient Greece is a civilization belonging to a period of Greek history that lasted from the Archaic period of the 8th to 6th centuries BC to the end of antiquity. Immediately following this period was the beginning of the Early Middle Ages and the Byzantine era. Included in Ancient Greece is the...
, whose description of
The Unscrupulous ManThe Unscrupulous Man is one of Theophrastus's Characters. The first description of a psychopath, he was a glib, pathological liar with no remorse or guilt for his actions....
is said to embody the characteristics of psychopathy:
In 1801,
Philippe PinelPhilippe Pinel was a French physician who was instrumental in the development of a more humane psychological approach to the custody and care of psychiatric patients, referred to today as moral therapy...
described patients who were mentally unimpaired but nonetheless engaged in impulsive and self-defeating acts. He saw them as
la folie raisonnante ("insane without delirium") meaning they fully understood the irrationality of their behavior but continued with it anyway.
The scientific study of individuals thought to lack a conscience flourished in the latter half of the 19th century. Notably,
Cesare LombrosoCesare Lombroso, born Ezechia Marco Lombroso was an Italian criminologist and founder of the Italian School of Positivist Criminology. Lombroso rejected the established Classical School, which held that crime was a characteristic trait of human nature...
rejected the view that criminality could occur in anyone and instead sought to identify particular "born criminals" whom he thought showed certain physical defects.
By the turn of the 20th century,
Henry MaudsleyHenry Maudsley was a pioneering British psychiatrist.-Biographical sketch:Henry Maudsley was born on an isolated farm near Giggleswick in the North Riding of Yorkshire and educated at University College London. He was an outstandingly brilliant medical student, collecting ten Gold Medals and...
had begun writing about the "moral imbecile", and was arguing such individuals could not be rehabilitated by the correctional system. Maudsley included the psychopath's immunity to the reformational effects of punishment, owing to their refusal to anticipate further failure, and punishment. In 1904,
Emil KraepelinEmil Kraepelin was a German psychiatrist. H.J. Eysenck's Encyclopedia of Psychology identifies him as the founder of modern scientific psychiatry, as well as of psychopharmacology and psychiatric genetics. Kraepelin believed the chief origin of psychiatric disease to be biological and genetic...
described four types of personalities similar to antisocial personality disorder. By 1915 he had identified them as defective in either affect or volition, dividing the types further into different categories, only some of which correspond to the current descriptions of antisocial personality disorder.
In 1909,
BirnbaumBirnbaum may refer to:* Birnbaum an der Warthe and Kreis Birnbaum , a city and county in Posen district, Poland* Birnbaum , an unincorporated area in the district of Kronach, Bavaria, Germany...
introduced the term "sociopathic", intended to emphasize the social causes of antisocial behavior.
The Mask of SanityThe Mask of Sanity is a book written by Hervey Cleckley, M.D., first published in 1941, describing the clinical interviews of Cleckley with incarcerated psychopaths. It is considered a seminal work and the most influential clinical description of psychopathy in the 20th century...
by
Hervey M. CleckleyDr. Hervey Milton Cleckley was an American psychiatrist and pioneer in the field of psychopathy. His book, The Mask of Sanity, originally published in 1941, provided the most influential clinical description of psychopathy in the 20th Century...
,
M.D.Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...
, first published in 1941, is considered a seminal work which provided a vivid series of case studies of individuals (mostly prisoners) described by Cleckley as psychopathic. Cleckley proposed 16 characteristics of psychopathy. The title refers to the "mask" of normality that Cleckley thought concealed the disorganization or mental disorder of what he saw as the psychopathic person.
A 1977 study, however, found little relationship with the characteristics commonly attributed to psychopaths and concluded that the concept was being used too widely and loosely.
The
American Psychiatric AssociationThe American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...
's
Diagnostic and Statistical Manual of Mental DisordersThe Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
incorporated various concepts of psychopathy/sociopathy/antisocial personality in early versions but, starting with the DSM-III in 1980, used instead a diagnosis of
antisocial personality disorderAntisocial personality disorder is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition , as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood...
. This was based on some of the criteria put forward by Cleckley but operationalized in behavioral terms and more specifically related to conduct and criminality. The
World Health OrganizationThe World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
's ICD incorporates a similar diagnosis of Dissocial Personality Disorder. Both the DSM and the ICD state that psychopathy (or sociopathy) are synonyms of their diagnosis.
However, there remained no international agreement on the diagnosis of psychopathy. One author referred to it in 1987 as an "infinitely elastic, catch-all category". In 1988, Blackburn wrote in the
British Journal of PsychiatryThe British Journal of Psychiatry is a peer-reviewed medical journal published monthly by the Royal College of Psychiatrists containing original research, systematic reviews, commentaries on contentious articles, short reports, a comprehensive book review section, and a correspondence column...
that the concept as commonly used in psychiatry is little more than a moral judgement masquerading as a clinical diagnosis, and argued that it should be scrapped.
Hare developed a Psychopathy Checklist in 1980 based on the psychopath
constructConstructivist epistemology is an epistemological perspective in philosophy about the nature of scientific knowledge. Constructivists maintain that scientific knowledge is constructed by scientists and not discovered from the world. Constructivists claim that the concepts of science are mental...
advanced by Cleckley, and later revised it in the 1990s (including the removal of two items).
Etymology
The word "psychopathy" comes from the
GreekGreek is an independent branch of the Indo-European family of languages. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. Its writing system has been the Greek alphabet for the majority of its history;...
words psykhe (mind, mental) and pathos (suffering, feeling).
Characteristics
The prototypical psychopath has deficits or deviance in several areas:
interpersonal relationshipAn interpersonal relationship is an association between two or more people that may range from fleeting to enduring. This association may be based on limerence, love, solidarity, regular business interactions, or some other type of social commitment. Interpersonal relationships are formed in the...
s,
emotionEmotion is a complex psychophysiological experience of an individual's state of mind as interacting with biochemical and environmental influences. In humans, emotion fundamentally involves "physiological arousal, expressive behaviors, and conscious experience." Emotion is associated with mood,...
, and
behaviorBehavior or behaviour refers to the actions and mannerisms made by organisms, systems, or artificial entities in conjunction with its environment, which includes the other systems or organisms around as well as the physical environment...
. Psychopaths gain satisfaction through
antisocialAntisocial personality disorder is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition , as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood...
behavior, and do not experience shame, guilt, or remorse for their actions.
Psychopaths lack a sense of guilt or remorse for any harm they may have caused others, instead
rationalizingIn psychology and logic, rationalization is an unconscious defense mechanism in which perceived controversial behaviors or feelings are logically justified and explained in a rational or logical manner in order to avoid any true explanation and made consciously tolerable by plausible means...
the behavior, blaming someone else, or denying it outright. Psychopaths also lack empathy towards others in general, resulting in tactlessness, insensitivity, and contemptuousness. Psychopaths can have a superficial charm about them, enabled by a willingness to say anything to anyone without concern for accuracy or truth. Shallow affect also describes the psychopath's tendency for genuine emotion to be short-lived, glib and egocentric, with an overall cold demeanor. They tend to be impulsive and irresponsible, often failing to keep a job or defaulting on debts. Studies in 2010 at
Vanderbilt UniversityVanderbilt University is a private research university located in Nashville, Tennessee, United States. Founded in 1873, the university is named for shipping and rail magnate "Commodore" Cornelius Vanderbilt, who provided Vanderbilt its initial $1 million endowment despite having never been to the...
revealed that psychopaths seek rewards regardless of consequences or risk, characterised by high
impulsivityImpulsivity is a personality trait characterized by the inclination of an individual to initiate behavior without adequate forethought as to the consequences of their actions, acting on the spur of the moment. Eysenck and Eysenck related impulsivity to risk-taking, lack of planning, and making up...
.
Hare, whose
Hare Psychopathy ChecklistIn contemporary research and clinical practice, Robert D. Hare's Psychopathy Checklist-Revised is the psycho-diagnostic tool most commonly used to assess psychopathy...
is widely used, describes psychopaths as "intraspecies predators". R.I. Simon also uses the word predator to describe psychopaths. Elsewhere Hare and others write that psychopaths "use charisma, manipulation, intimidation, sexual intercourse and violence" to control others and to satisfy their own needs. Hare states that: "Lacking in
conscienceConscience is an aptitude, faculty, intuition or judgment of the intellect that distinguishes right from wrong. Moral judgement may derive from values or norms...
and
empathyEmpathy is the capacity to recognize and, to some extent, share feelings that are being experienced by another sapient or semi-sapient being. Someone may need to have a certain amount of empathy before they are able to feel compassion. The English word was coined in 1909 by E.B...
, they take what they want and do as they please, violating social
normsSocial norms are the accepted behaviors within a society or group. This sociological and social psychological term has been defined as "the rules that a group uses for appropriate and inappropriate values, beliefs, attitudes and behaviors. These rules may be explicit or implicit...
and expectations without guilt or remorse". He previously stated that: "What is missing, in other words, are the very qualities that allow a human being to live in social harmony".
According to Hare, many psychopaths are superficially charming, and can excellently mimic normal human emotion; some psychopaths can blend in, undetected, in a variety of surroundings, including corporate environments.
Lack of empathy
Psychopaths possess a general lack of empathy; they are simply unable to understand the emotional states of other people, except in a purely detached, intellectual sense. When an empathetic person sees someone else in pain or distress, he instinctively feels distress as well, but a psychopath never does. Thus, psychopaths can commit acts of stunning cruelty and callousness because they are not deterred by any unpleasant reaction to their victims' suffering. A violent psychopath can mutilate a person with all the emotion of a chef carving up a turkey. A psychopathic con man can swindle his parents out of their life savings and not give a second thought to the ruin he has left them in. Because the experiences of others provoke no emotion in psychopaths, they regard others as little more than objects for their personal gratification.
Shallow emotions
Psychopaths do not feel emotions as deeply as an average person. Though they are not completely unemotional, their emotions are so shallow that some clinicians have described them as mere "
proto-emotions: primitive responses to immediate needs."
Psychopaths do not feel fear as deeply as normal people and do not manifest any of the normal physical responses to threatening stimuli. For instance, if a normal person were accosted in the street by a gun-wielding mugger, he might sweat, tremble, lose control of his bowels or vomit. Psychopaths feel no such sensations, and are often perplexed when they observe them in others. Psychopaths' lack of fear makes them often reckless risk-takers. This is not to say they are oblivious to the potential consequences of their actions. Rather, the thought of pain and punishment does not provoke an emotional reaction in them and thus has a weak restraining effect.
Psychopaths do not feel love and are incapable of forming emotional bonds with people. Though a psychopath can sometimes charm a person into being infatuated with him, he cannot reciprocate the feelings, only feign them. Though they derive pleasure from sexual encounters, these relations are superficial and impersonal.
Although psychopaths do not feel deep emotions, they will often claim to experience them so as to appear normal. However, because they poorly understand emotion, their act is sometimes clumsy. Their choice of words may be incongruous with the context or their tone of voice. For instance, a psychopath may express
griefGrief is a multi-faceted response to loss, particularly to the loss of someone or something to which a bond was formed. Although conventionally focused on the emotional response to loss, it also has physical, cognitive, behavioral, social, and philosophical dimensions...
over the recent death of a parent, but deliver his words in a monotone voice that betrays his indifference. Psychopaths may often put on short-lived, dramatic displays of emotion, such as fits of rage, only to quickly revert to a calm state moments later. This often leaves some observers with the impression that they are play-acting.
In conversations, psychopaths cannot intuitively understand the impact their words should have on others or themselves. They instead read their listeners' reactions for cues as to how they should emote. For instance, Hare writes of a convicted murderer who described his murders in a totally dispassionate, bland manner until he noticed the horrified expression of the interviewer, at which point he started feigning remorse and distress over his crimes.
Researchers have conducted brain scans on psychopaths while exposing them to emotionally-charged words such as "
rapeRape is a type of sexual assault usually involving sexual intercourse, which is initiated by one or more persons against another person without that person's consent. The act may be carried out by physical force, coercion, abuse of authority or with a person who is incapable of valid consent. The...
", "
murderMurder is the unlawful killing, with malice aforethought, of another human being, and generally this state of mind distinguishes murder from other forms of unlawful homicide...
", and "
loveLove is an emotion of strong affection and personal attachment. In philosophical context, love is a virtue representing all of human kindness, compassion, and affection. Love is central to many religions, as in the Christian phrase, "God is love" or Agape in the Canonical gospels...
". In a normal person, these words will provoke activity in the
limbic systemThe limbic system is a set of brain structures including the hippocampus, amygdala, anterior thalamic nuclei, septum, limbic cortex and fornix, which seemingly support a variety of functions including emotion, behavior, long term memory, and olfaction. The term "limbic" comes from the Latin...
, which governs emotions. Psychopaths showed no such activity. They react to emotionally-charged words as if they were neutral words (e.g. "
treeA tree is a perennial woody plant. It is most often defined as a woody plant that has many secondary branches supported clear of the ground on a single main stem or trunk with clear apical dominance. A minimum height specification at maturity is cited by some authors, varying from 3 m to...
", "
chairA chair is a stable, raised surface used to sit on, commonly for use by one person. Chairs are most often supported by four legs and have a back; however, a chair can have three legs or could have a different shape depending on the criteria of the chair specifications. A chair without a back or...
", "
spoonA spoon is a utensil consisting of a small shallow bowl, oval or round, at the end of a handle. A type of cutlery , especially as part of a place setting, it is used primarily for serving. Spoons are also used in food preparation to measure, mix, stir and toss ingredients...
"). They do, however, show activity in the brain areas associated with language processing, suggesting that their response is more cognitive than emotional.
Lying and manipulation
Psychopaths are incorrigible and consummate liars. They frequently and readily lie to get what they want, to impress people, or to simply appear normal, and they do so with such skill that even experienced interrogators are sometimes fooled. This talent lies in a confident presentation that never betrays signs of anxiety, hesitation, or shame, even when they're confronted with contradictory evidence or inconvenient questions. This frequently baffles their listeners and distracts them from the inconsistencies in their words. They believe the psychopath is honest because it is hard for them to believe a liar can be so bold and unflappable.
Average people typically feel anxiety when they lie, hesitating with their words especially when confronted. When a psychopath lies, however, they are completely indifferent to the possibility of being caught in a lie. When they're caught in a lie, they are rarely perplexed or embarrassed. Without hesitating, they will simply rework the tale so that it appears consistent.
Some psychopaths also possess great charm and a great ability to manipulate others. They have fewer social inhibitions, are
extrovertedThe trait of extraversion-introversion is a central dimension of human personality theories.Extraverts tend to be gregarious, assertive, and interested in seeking out external stimulus. Introverts, in contrast, tend to be introspective, quiet and less sociable. They are not necessarily loners but...
, dominant, and confident. They are not afraid of causing offense, being rejected, or being put down. When these things do happen, they tend to dismiss them and are not discouraged from trying again. Thus, psychopaths practice manipulation harder than most people and tend to become very good at it.
It should be noted that not all psychopaths are smooth charmers. Often due to poor upbringing, some lack the necessary social grace and education to impress people. Such psychopaths tend to rely more on intimidation, coercion, and violence to get their way.
Psychopaths see other people as objects for their personal gratification. They often adopt a parasitic lifestyle, conning people out of their wealth and resources. They have been known to seduce people simply to obtain money and sex, or fabricate tales of misfortune to obtain money from relatives and friends. When the victim is no longer useful or profitable, psychopaths coldly abandon them.
Semantic aphasia
A psychopath's power to deceive stems more often from his presentation (body language, confidence, etc.) than from the content of their speech. In fact, the tales psychopaths weave are often riddled with inconsistencies, contradictions and semantic irregularities. The first reason for this is the often improvisational nature of their lying. When caught in a lie or confronted with unexpected questions, they simply rework their tale to fit the new facts without pausing to think things through. The second reason is that psychopaths appear to have difficulty properly integrating the language and emotional components of their thoughts, and thus fail to notice contradictions in their speech. Hervey Cleckley, a pioneer researcher in psychopathy, called this "semantic aphasia". Consider this statement by
serial killerA serial killer, as typically defined, is an individual who has murdered three or more people over a period of more than a month, with down time between the murders, and whose motivation for killing is usually based on psychological gratification...
Ted BundyTheodore Robert "Ted" Bundy was an American serial killer, rapist, kidnapper, and necrophile who assaulted and murdered numerous young women during the 1970s, and possibly earlier...
when asked about his drug habits:
In the above dialogue, Bundy alternately denies and admits to using drugs and is never firm about his preferences, suggesting he had difficulty in maintaining a cohesive line of thinking when assembling his words. Another psychopathic inmate once told Hare: "I had to steal sometimes to get out of town, yeah, but I'm not a fucking criminal."
Impulsivity, irresponsibility
Psychopaths are impulsive by nature. They do not deeply recognize the risk of being caught, disbelieved or injured as a result of their behavior. They seek quick satisfaction and thrills. Their crimes are often spur-of-moment affairs.
Psychopaths live day-to-day, changing their plans frequently and generally do not have any realistic long-term goals. Psychopaths often claim to have ambitious goals in life, but fail to appreciate the work, skill and discipline it would take to achieve them. Hare writes of one psychopathic inmate who planned to become a professional swimmer after release, despite the fact he was in his late 30s and overweight. They are known to break off relationships, change plans, and quit jobs on a whim. A characteristic life pattern is of bouncing from one job to another and sometimes in and out of prison. They are generally not embarrassed or concerned about their lack of achievement in their lives.
Psychopaths are commonly irresponsible. In the workplace, they are known for erratic performance, frequent absences,
embezzlementEmbezzlement is the act of dishonestly appropriating or secreting assets by one or more individuals to whom such assets have been entrusted....
, and untrustworthiness. They are financially irresponsible, often living beyond their means, incurring debt and defaulting on loans. They often neglect their children. They often have unprotected sex, siring children that they abandon and transmitting
STDsSexually transmitted disease , also known as a sexually transmitted infection or venereal disease , is an illness that has a significant probability of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex...
. When they get in trouble due to their negligence, they typically blame other people or external factors. They do not hesitate to exploit the resources of friends and family to get themselves out of trouble, such as being bailed out of jail.
Psychopaths often fail to learn from past experiences and do not modify their behavior to avoid trouble. They often pursue the same old bad habits despite having suffered retribution and humiliation numerous times. Punishment and rehabilitation have no positive effect on them, and their condition is considered untreatable. The rate of
recidivismRecidivism is the act of a person repeating an undesirable behavior after they have either experienced negative consequences of that behavior, or have been treated or trained to extinguish that behavior...
among psychopaths is roughly double that of normal criminals, with the rate for violent recidivism being roughly three times higher than normal.
Low tolerance for boredom
Psychopaths have a low tolerance for boredom and an excessive need for excitement and stimulation. They frequently break rules, commit crimes, and risk their safety for the sake of cheap thrills. In the workplace, they routinely shirk duties they find unexciting, and even quit jobs on a whim. They are more likely than unaffected people to abuse drugs.
Poor behavior controls
Psychopaths are notorious for their hair-trigger tempers. They are highly reactive to perceived insults and slights, and throw tantrums over trivialities. Their tantrums are often short-lived, and they can revert to a perfectly calm state moments later. Although their aggression is poorly inhibited, it is generally not uncontrolled. Their aggression lacks the intense emotional turmoil normal people feel when they lose their temper, and thus they do not actually go "mad with rage".
Remorselessness
Psychopaths have a total lack of remorse for the abuses they commit. Even when they are aware of the consequences of their actions, they frequently rationalize their behavior so as to
minimizeMinimisation is a type of deception involving denial coupled with rationalisation in situations where complete denial is implausible. It is the opposite of exaggeration....
the seriousness or shrug off
responsibilityMoral responsibility usually refers to the idea that a person has moral obligations in certain situations. Disobeying moral obligations, then, becomes grounds for justified punishment. Deciding what justifies punishment, if anything, is a principle concern of ethics.People who have moral...
. They often
blame their victimsVictim blaming occurs when the victim of a crime, an accident, or any type of abusive maltreatment are held entirely or partially responsible for the transgressions committed against them. Blaming the victim has traditionally emerged especially in racist and sexist forms...
for their own crimes; "he shouldn't have provoked me" and "suckers deserve to be swindled" are common sayings.
Egocentricity and grandiosity
Psychopaths have extremely inflated
self-esteemSelf-esteem is a term in psychology to reflect a person's overall evaluation or appraisal of his or her own worth. Self-esteem encompasses beliefs and emotions such as triumph, despair, pride and shame: some would distinguish how 'the self-concept is what we think about the self; self-esteem, the...
. Their egocentricity is comparable to that of
narcissistsNarcissistic personality disorder is a personality disorder in which the individual is described as being excessively preoccupied with issues of personal adequacy, power, prestige and vanity...
, and indeed it is occasionally hard to distinguish the two conditions from each other. They think they are the center of the universe and see themselves as superior beings. They often appear arrogant, opinionated, domineering, and cocky. A psychopath always thinks he is the smartest person in the room and has no respect for the differing opinions of others. Psychopaths have an exaggerated sense of entitlement. They expect large rewards for mediocre efforts, apply for important jobs despite lacking qualifications, demand authority and privileges above their rank, and are ungrateful. It is not uncommon for psychopaths to describe their victims as weak, inferior beings who deserve to be taken advantage of.
Psychopaths often claim to have grand goals in life and believe they can be anything they want to be. These claims are often unrealistic, given their track record for irresponsibility. They show little appreciation for the hard work, discipline, devotion, and talent required to achieve their ambitions. As an example, Hare wrote of one psychopathic inmate who planned to become a professional swimmer after release, despite the fact he was in his late 30s and overweight. These grand goals often change as psychopaths are notoriously fickle, abandoning projects when they become frustrating or boring. Psychopaths are unashamed and dismissive of the legal, financial, or personal problems in their lives. They blame everyone and everything but themselves for their failures - bad luck, an unfair system, unsupportive colleagues, etc. - or they might dismiss their old projects as wastes of time. They may even portray their bad qualities as virtues: many psychopaths brag about their criminal versatility, the number of crimes they got away with, and their talent for deception.
Intelligence
Hare and Neumann (2008) state that there is at most only a weak association between psychopathy and IQ. "Moreover, there is no obvious theoretical reason why the disorder described by Cleckley or other clinicians should be related to intelligence; some psychopaths are bright, others less so."
Facial affect recognition
In a 2002 study, David Kosson and Yana Suchy,
et al. asked psychopathic inmates to name the emotion expressed on each of 30 faces. Compared to the control group, psychopaths had a significantly lower rate of accuracy in recognizing disgusted facial affect but a higher rate of accuracy in recognizing anger. Additionally, when "conditions designed to minimize the involvement of right-hemispheric mechanisms" (i.e., sadness) were used, psychopaths had more difficulty accurately identifying emotions. This study did not replicate Blair,
et al. (1997)'s findings that psychopaths are specifically less sensitive to nonverbal cues of fear or distress.
Vocal affect recognition
In a 2002 experiment, Blair, Mitchell,
et al. used the Vocal Affect Recognition Test to measure psychopaths' recognition of the emotional intonation given to connotative neutral words. Psychopaths tended to make more recognition errors than controls with a particularly high rate of error for sad and fearful vocal affect.
Stroop tasks
A study on Stroop tasks found that there is "a circumscribed attentional deficit in psychopathy that hinders the use of unattended information that is (a) not integrated with deliberately attended information and (b) not compatible with current goal-directed behavior."
Childhood precursors
Psychopathic tendencies can sometimes be recognized in childhood or early adolescence. If recognized, a diagnosis of
Conduct DisorderConduct disorder is psychological disorder diagnosed in childhood that presents itself through a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate norms are violated...
, or possibly the related
Oppositional Defiant DisorderOppositional defiant disorder is a diagnosis described by the Diagnostic and Statistical Manual of Mental Disorders as an ongoing pattern of disobedient, hostile and defiant behavior toward authority figures which goes beyond the bounds of normal childhood behavior...
, may be given. However, while these childhood signs have been found in a significantly higher proportion of psychopaths than in the general population, it must be stressed that not all the subjects of such childhood diagnoses turn out to be psychopaths as adults, or even disordered at all. Therefore, psychopathy is not normally diagnosed in children or adolescents, and some jurisdictions explicitly forbid diagnosing minors with psychopathy and similar personality disorders. This is because such a diagnosis "fails to capture the emotional, cognitive, and interpersonality traits — egocentricity and lack of remorse, empathy, or guilt - that are so important in the diagnosis of psychopathy."
Children showing strong psychopathic precursors often appear immune to punishment; nothing seems to modify their undesirable behavior. Consequently parents usually give up, and the behavior worsens.
The following childhood indicators are to be seen not as to the type of behavior, but as to its relentless and unvarying occurrence. Not all must be present concurrently, but at least a number of them need to be present over a period of years. These indicators are sufficient - but not necessary - indicators of possible psychopathy.
- An extended period of bedwetting
Nocturnal enuresis, commonly called bedwetting, is involuntary urination while asleep after the age at which bladder control usually occurs. Nocturnal enuresis is considered primary when a child has not yet had a prolonged period of being dry...
past the preschool years, not due to any identified medical problem.
- Sadism, often expressed as cruelty to animals
Zoosadism is a term coined by Ernest Borneman referring to pleasure derived from cruelty to animals. Zoosadism is part of the Macdonald triad, a set of three behaviors that are a precursor to sociopathic behavior.-Research:...
.
- Pathological firesetting
Pyromania in more extreme circumstances can be an impulse control disorder to deliberately start fires to relieve tension or for gratification or relief. The term pyromania comes from the Greek word πῦρ . Pyromania and pyromaniacs are distinct from arson, the pursuit of personal, monetary or...
, lacking in obvious homicidal intent.
- Lying, often without discernible objectives, extending beyond a child's normal impulse not to be punished. These lies are so extensive it is often impossible to know lies from truth.
- Theft and truancy.
- Aggression towards peers and relatives. The aggression can include physical and verbal abuse, getting others into trouble, or a campaign of psychological torment.
The three indicators —
bedwettingEnuresis refers to an inability to control urination. Use of the term is usually limited to describing individuals old enough to be expected to exercise such control.Types of enuresis include:* Nocturnal enuresis* Diurnal enuresis...
,
cruelty to animalsCruelty to animals, also called animal abuse or animal neglect, is the infliction of suffering or harm upon non-human animals, for purposes other than self-defense. More narrowly, it can be harm for specific gain, such as killing animals for food or for their fur, although opinions differ with...
and
firestartingPyromania in more extreme circumstances can be an impulse control disorder to deliberately start fires to relieve tension or for gratification or relief. The term pyromania comes from the Greek word πῦρ . Pyromania and pyromaniacs are distinct from arson, the pursuit of personal, monetary or...
, known as the
Macdonald triadThe Macdonald triad is a set of three behavioral characteristics that are associated with sociopathic behavior. The triad was first identified by J.M...
— were first described by J.M. MacDonald as "red flag" indicators of psychopathy and future episodic aggressive behavior. However, subsequent research has found that bedwetting is not a significant factor.
The question of whether young children with early indicators of psychopathy respond poorly to intervention, compared to conduct-disordered children without these traits, has only recently been examined in controlled clinical research. The
empiricalEmpiricism is a theory of knowledge that asserts that knowledge comes only or primarily via sensory experience. One of several views of epistemology, the study of human knowledge, along with rationalism, idealism and historicism, empiricism emphasizes the role of experience and evidence,...
findings from this research have been consistent with broader anecdotal evidence, pointing to poor treatment outcomes. Many of the above characteristics can be paralleled in bullying at school and elsewhere.
Evolutionary explanations
Researchers within
evolutionary psychologyEvolutionary psychology is an approach in the social and natural sciences that examines psychological traits such as memory, perception, and language from a modern evolutionary perspective. It seeks to identify which human psychological traits are evolved adaptations, that is, the functional...
have proposed several evolutionary explanations for psychopathy. One is that psychopathy represents a frequency-dependent, socially parasitic strategy. This may work as long as there are few other psychopaths in the community since more psychopaths means increasing the risk of encountering another psychopath as well as non-psychopaths likely adapting more countermeasures against cheaters.
Genetics
Genetic factors may generally influence the development of psychopathy while environmental factors affect the specific traits that predominate.
A 2005
twin studyTwin studies help disentangle the relative importance of environmental and genetic influences on individual traits and behaviors. Twin research is considered a key tool in behavioral genetics and related fields...
found that children with antisocial behavior can be classified into two groups: those who also had high "callous-unemotional traits" were "under extremely strong
geneA gene is a molecular unit of heredity of a living organism. It is a name given to some stretches of DNA and RNA that code for a type of protein or for an RNA chain that has a function in the organism. Living beings depend on genes, as they specify all proteins and functional RNA chains...
tic influence and no influence of shared environment" while those who were ranked low of those traits were under both "moderate genetic and shared environmental influence."
Neuroanatomy
"The
amygdalaThe ' are almond-shaped groups of nuclei located deep within the medial temporal lobes of the brain in complex vertebrates, including humans. Shown in research to perform a primary role in the processing and memory of emotional reactions, the amygdalae are considered part of the limbic system.-...
is crucial for stimulus-reinforcement learning and responding to emotional expressions, particularly fearful expressions that, as reinforcers, are important initiators of stimulus-reinforcement learning. Moreover, the amygdala is involved in the formation of both stimulus-punishment and stimulus-reward associations. Individuals with psychopathy show impairment in stimulus-reinforcement learning (whether punishment- or reward-based) and responding to fearful and sad expressions. It is argued that this impairment drives much of the syndrome of psychopathy (Blair, 2008).
People scoring ≥25 in the Psychopathy Checklist Revised, with an associated history of violent behavior, appear to have significantly reduced microstructural integrity in their
uncinate fasciculusThe uncinate fasciculus is a white matter tract in the human brain that connects parts of the limbic system such as the hippocampus and amygdala in the temporal lobe with frontal ones such as the orbitofrontal cortex. Its function is unknown though it is affected in several psychiatric conditions...
—
white matterWhite matter is one of the two components of the central nervous system and consists mostly of myelinated axons. White matter tissue of the freshly cut brain appears pinkish white to the naked eye because myelin is composed largely of lipid tissue veined with capillaries. Its white color is due to...
connecting the amygdala and
orbitofrontal cortexThe orbitofrontal cortex is a prefrontal cortex region in the frontal lobes in the brain which is involved in the cognitive processing of decision-making...
. The more extreme the psychopathy, the greater the abnormality.
Recent studies have triggered theories on determining whether there is a biological relationship between the brain and psychopathy. One theory suggests that psychopathy is associated with both the amygdala, which is associated with emotional reactions and emotional learning, and the
prefrontal cortexThe prefrontal cortex is the anterior part of the frontal lobes of the brain, lying in front of the motor and premotor areas.This brain region has been implicated in planning complex cognitive behaviors, personality expression, decision making and moderating correct social behavior...
, associated with impulse control, decision-making, emotional learning and behavioral adaptation. Some studies have shown there is less "
gray matter"Gray Matter" is a short story by Stephen King, first published in the October 1973 issue of Cavalier magazine, and later collected in King's 1978 collection Night Shift. It is set in the same area as King's novel Dreamcatcher.-Setting:...
" in these areas in psychopaths than in non-psychopaths.
There is DT-MRI evidence of breakdowns in the
white matterWhite matter is one of the two components of the central nervous system and consists mostly of myelinated axons. White matter tissue of the freshly cut brain appears pinkish white to the naked eye because myelin is composed largely of lipid tissue veined with capillaries. Its white color is due to...
connections between these two important areas in a small
BritishThe United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
study of nine criminal psychopaths. This evidence suggests that the degree of abnormality was significantly related to the degree of psychopathy and may explain the offending behaviors.
A 2008 review found various abnormalities (based on group differences from average) reported in the literature, centered on a
prefrontalThe prefrontal cortex is the anterior part of the frontal lobes of the brain, lying in front of the motor and premotor areas.This brain region has been implicated in planning complex cognitive behaviors, personality expression, decision making and moderating correct social behavior...
-temporo-
limbicThe limbic system is a set of brain structures including the hippocampus, amygdala, anterior thalamic nuclei, septum, limbic cortex and fornix, which seemingly support a variety of functions including emotion, behavior, long term memory, and olfaction. The term "limbic" comes from the Latin...
circuit — regions that are involved in emotional and learning processes, as well as many other processes. However, the authors report that the people classed as "psychopathic" cannot in fact be seen as a homogeneous group (i.e. as all having the same characteristics), and that the associations between structural changes and psychopathic characteristics do not enable causal conclusions to be drawn. They conclude that psychopathic characteristics involve multifactorial processes including neurobiological,
geneticGenetics , a discipline of biology, is the science of genes, heredity, and variation in living organisms....
, epidemiological, and sociobiographical (the person's life in society) factors.
Psychopaths do have an elevated probability of being
left-handed.
Neurotransmitters and hormones
High levels of
testosteroneTestosterone is a steroid hormone from the androgen group and is found in mammals, reptiles, birds, and other vertebrates. In mammals, testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands...
combined with low levels of
cortisolCortisol is a steroid hormone, more specifically a glucocorticoid, produced by the adrenal gland. It is released in response to stress and a low level of blood glucocorticoids. Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat,...
have been theorized as contributing factors. Testosterone is "associated with approach-related behavior, reward sensitivity, and fear
reduction". Cortisol increases "the state of fear, sensitivity to punishment, and withdrawal behavior". Injecting testosterone "shift[s] the balance from punishment to reward sensitivity", decreases fearfulness, and increases "responding to angry faces". Some studies have found that antisocial and aggressive behaviors are associated with high testosterone levels but it is unclear if psychopaths have high testosterone levels. A few studies have found psychopathy to be linked to low cortisol levels.
High testosterone levels combined with low serotonin levels may increase violent aggression. Some research suggests that testosterone alone does not cause aggression but increases dominance-seeking behaviors. Low serotonin is associated with "impulsive and highly negative reactions" which, if combined with high testosterone, may cause aggression if an individual becomes frustrated.
Psychopathy was also associated in two studies with an increased ratio of
HVAHomovanillic acid is a major catecholamine metabolite...
(a
dopamineDopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their...
metabolite) to 5-HIAA (a
serotoninSerotonin or 5-hydroxytryptamine is a monoamine neurotransmitter. Biochemically derived from tryptophan, serotonin is primarily found in the gastrointestinal tract, platelets, and in the central nervous system of animals including humans...
metabolite).
Several animal studies note the role of
serotonergicSerotonin or 5-hydroxytryptamine is a monoamine neurotransmitter. Biochemically derived from tryptophan, serotonin is primarily found in the gastrointestinal tract, platelets, and in the central nervous system of animals including humans...
functioning in impulsive aggression and antisocial behavior.
A 2010 British study found that a large 2D:4D
digit ratioThe digit ratio is the ratio of the lengths of different digits or fingers typically measured from the bottom crease where the finger joins the hand to the tip of the finger. It has been suggested by some scientists that the ratio of two digits in particular, the 2nd and 4th , is affected by...
, an indication of high prenatal
estrogenEstrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...
exposure, was a "positive correlate of psychopathy in females, and a positive correlate of callous affect (psychopathy sub-scale) in males".
Diagnosis
The
classification of mental disordersThe classification of mental disorders, also known as psychiatric nosology or taxonomy, is a key aspect of psychiatry and other mental health professions and an important issue for consumers and providers of mental health services...
, also known as psychiatric
nosology or
taxonomyTaxonomy is the science of identifying and naming species, and arranging them into a classification. The field of taxonomy, sometimes referred to as "biological taxonomy", revolves around the description and use of taxonomic units, known as taxa...
, is a key aspect of
psychiatryPsychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
and other
mental health professionsA mental health professional is a health care practitioner who offers services for the purpose of improving an individual's mental health or to treat mental illness. This broad category includes psychiatrists, clinical psychologists, clinical social workers, psychiatric nurses, mental health...
and an important issue for consumers and providers of mental health services.
Hare Psychopathy Checklist
Psychopathy is most commonly assessed with the
PCL-R, which is a clinical rating scale with 20 items. Each of the items in the PCL-R is scored on a three-point (0, 1, 2) scale according to two factors.
PCL-R Factor 2 is associated with behavioral deficits or antisocial lifestyle, more specifically: reactive anger, anxiety, increased risk of suicide, criminality, and impulsive violence.
PCL-R Factor 1, in contrast, is associated with personality deficits or aggressive narcissism, more specifically: extraversion and positive affect. Factor 1, the so-called core personality traits of psychopathy, may even be beneficial for the psychopath (in terms of nondeviant social functioning). Both case history and a semi-structured interview are used in the analysis.
Because an individual's scores may have important consequences for his or her future, the potential for harm if the test is used or administered incorrectly is considerable. The test can only be considered valid if administered by a suitably qualified and experienced clinician under controlled conditions.
PCL-R items
The following findings are for research purposes only, and are not used in clinical diagnosis. These items cover the affective, interpersonal, and behavioral features. Each item is rated on a score from zero to two. The sum total determines the extent of a person's psychopathy.
Factor 1: Aggressive narcissism
- Glibness/superficial charm
- Grandiose sense of self-worth
- Pathological lying
- Cunning/manipulative
- Lack of remorse or guilt
- Emotionally shallow
- Callous/lack of empathy
- Failure to accept responsibility for own actions
Factor 2: Socially deviant lifestyle
- Need for stimulation/proneness to boredom
- Parasitic lifestyle
- Poor behavioral control
- Promiscuous sexual behavior
- Lack of realistic, long-term goals
- Impulsiveness
- Irresponsibility
- Juvenile delinquency
Juvenile delinquency is participation in illegal behavior by minors who fall under a statutory age limit. Most legal systems prescribe specific procedures for dealing with juveniles, such as juvenile detention centers. There are a multitude of different theories on the causes of crime, most if not...
- Early behavioral problems
- Revocation of conditional release
- Many short-term marital relationships
- Criminal versatility
One issue related to the assessment of individuals who may exhibit affective, interpersonal, and behavioral features associated with psychopathy is the ability to overcome gender myths when the psychopathy features are present in females.
The Hare Psychopathy Checklist-Revised has both percentiles and T-score tables for male and female offenders.
DSM and ICD
There are currently two widely established systems for classifying mental disorders — Chapter V of the International Classification of Diseases (ICD-10) produced by the
World Health OrganizationThe World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
(WHO) and the
Diagnostic and Statistical Manual of Mental DisordersThe Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
(DSM-IV) produced by the
American Psychiatric AssociationThe American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...
(APA). Both list categories of disorders thought to be distinct types, and have deliberately converged their codes in recent revisions so that the manuals are often broadly comparable, although significant differences remain.
While previous versions of the DSM listed psychopathy as a personality disorder, currently it is not an diagnosis in these classifications. Labeling a person as a psychopath involves forensic measurement, using a diagnostic tool such as the
Hare Psychopathy ChecklistIn contemporary research and clinical practice, Robert D. Hare's Psychopathy Checklist-Revised is the psycho-diagnostic tool most commonly used to assess psychopathy...
(PCL-R). The PCL-R is widely considered the "gold standard" for assessing psychopathy. Psychopathy is most strongly correlated with DSM-IV
antisocial personality disorder (ASPD)Antisocial personality disorder is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition , as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood...
, and the
ICD-10The International Statistical Classification of Diseases and Related Health Problems, 10th Revision is a medical classification list for the coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases, as maintained by the...
antisocial personality disorder and dissocial personality disorder (DPD). However, the PCL-R criteria for identifying a psychopath are stricter than the diagnostic criteria for ASPD or DPD; psychopaths represent a subset of those with ASPD, and psychopaths' traits are more severe. A psychopath will score high on both PCL-R factors, whereas someone with ASPD who is not a psychopath will score high only on Factor 2.
Some researchers are critical of the changed diagnostic criteria. Antisocial personality disorder is diagnosed via behavior and social deviant behaviors, whereas a diagnosis of psychopathy also includes affective and interpersonal personality factors. The
Hare Psychopathy ChecklistIn contemporary research and clinical practice, Robert D. Hare's Psychopathy Checklist-Revised is the psycho-diagnostic tool most commonly used to assess psychopathy...
is better able to predict future criminality, violence, and recidivism than the diagnosis of ASPD using the DSM-III-R. Robert D. Hare writes that there are also differences between psychopaths and others on "processing and use of linguistic and emotional information" while such differences are small between those diagnosed with ASPD and not. However, the Hare Psychopathy Checklist requires the use of a rather long interview and availability of considerable additional information as well as depending in part on judgements of character rather than observed behavior. Hare writes that the field trials for the DSM-IV found personality traits judgements to be as reliable as those diagnostic criteria relying only on behavior but that the personality traits criteria were dropped in part because it was feared that the average clinician would not use them correctly. Hare criticizes the instead used DSM-IV criteria for being poorly empirically tested. In addition, the introductory text description describes the personality characteristics typical of psychopathy, which Hare argues make the manual confusing and actually containing two different sets of criteria. He also argues that confusion regarding how to diagnose ASPD, confusion regarding the difference between ASPD and psychopathy, as well as the differing future prognoses regarding recidivism and treatability, may have serious consequences in settings such as court cases where psychopathy is often seen as aggravating the crime.
The DSM-V working party is recommending a revision of antisocial personality disorder to include "Antisocial/Psychopathic Type", with the diagnostic criteria having a greater emphasis on character than on behavior.
Cleckley Checklist
In his 1941 book,
Mask of Sanity,
Hervey M. CleckleyDr. Hervey Milton Cleckley was an American psychiatrist and pioneer in the field of psychopathy. His book, The Mask of Sanity, originally published in 1941, provided the most influential clinical description of psychopathy in the 20th Century...
introduced 16 behavioral characteristics of a psychopath:
- Superficial charm
Superficial charm is "the tendency to be smooth, engaging, charming, slick, and verbally facile."The phrase often appears in lists of attributes of psychopathic personalities, such as in Hervey Cleckley's The Mask of Sanity and Robert Hare's Hare Psychopathy Checklist.Associated expressions are...
and good "intelligence"*
- Absence of delusions and other signs of irrational thinking*
- Absence of nervousness or psychoneurotic
Neurosis is a class of functional mental disorders involving distress but neither delusions nor hallucinations, whereby behavior is not outside socially acceptable norms. It is also known as psychoneurosis or neurotic disorder, and thus those suffering from it are said to be neurotic...
manifestations*
- Unreliability
- Untruthfulness and insincerity
- Lack of remorse
Remorse is an emotional expression of personal regret felt by a person after he or she has committed an act which they deem to be shameful, hurtful, or violent. Remorse is closely allied to guilt and self-directed resentment...
and shameShame is, variously, an affect, emotion, cognition, state, or condition. The roots of the word shame are thought to derive from an older word meaning to cover; as such, covering oneself, literally or figuratively, is a natural expression of shame....
- Inadequately motivated antisocial behavior
- Poor judgment and failure to learn by experience
- Pathologic egocentricity and incapacity for love
Love is an emotion of strong affection and personal attachment. In philosophical context, love is a virtue representing all of human kindness, compassion, and affection. Love is central to many religions, as in the Christian phrase, "God is love" or Agape in the Canonical gospels...
- General poverty in major affective reactions
- Specific loss of insight
- Unresponsiveness in general interpersonal relations
- Fantastic and uninviting behavior with drink and sometimes without
- Suicide
Suicide is the act of intentionally causing one's own death. Suicide is often committed out of despair or attributed to some underlying mental disorder, such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse...
threats rarely carried out*
- Sex life
Human sexual activities or human sexual practices or human sexual behavior refers to the manner in which humans experience and express their sexuality. People engage in a variety of sexual acts from time to time, and for a wide variety of reasons...
impersonal, trivial, and poorly integrated
- Failure to follow any life plan.
*These characteristics have since been depreciated.
Primary-secondary distinction
Primary psychopathy was defined by those following this theory as the root disorder in patients diagnosed with it, whereas secondary psychopathy was defined as an aspect of another psychiatric disorder or social circumstances. Today, primary psychopaths are considered to have mostly Factor 1 traits from the
PCL-R (arrogance, callousness, manipulativeness, lying) whereas secondary psychopaths have a majority of Factor 2 traits (impulsivity, boredom proneness, irresponsibility, lack of long-term goals).
The primary psychopath engages in antisocial behavior as a result of a genetic-biological predisposition directed by particular psychodynamic forces that occur in infancy. The secondary psychopath's antisocial behavior is the result of strictly environmental forces (e.g., membership in a deviant group) that occur at developmental stages beyond infancy. The fundamental distinction between the two is the ability to attach emotionally to others and to experience the natural anxiety associated with human attachment. The primary psychopath forms no attachments as a result of early developmental obstruction, and thus is capable of harming others with little or no anxiety. The secondary psychopath forms human attachments, possibly to deviant subgroups, or not. However, whether or not the secondary psychopath appears to be attached to others, emotional connection to other human beings is present.
Secondary psychopaths show normal to above-normal
physiologicalPhysiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
responses to (perceived) potential threats; their crimes tend to be unplanned and impulsive with little thought of the consequences. According to those using this theory, this type have hot tempers and are prone to reactive aggression. They experience normal to above-normal levels of anxiety but are nevertheless highly stimulus-seeking and have trouble tolerating boredom. Their lifestyle may lead to
depressionDepression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...
and even
suicideSuicide is the act of intentionally causing one's own death. Suicide is often committed out of despair or attributed to some underlying mental disorder, such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse...
.
Mealey uses the term "primary psychopathy" to differentiate between psychopathy that is
biologicalBiology is a natural science concerned with the study of life and living organisms, including their structure, function, growth, origin, evolution, distribution, and taxonomy. Biology is a vast subject containing many subdivisions, topics, and disciplines...
in origin and "secondary psychopathy" that results from a combination of
geneA gene is a molecular unit of heredity of a living organism. It is a name given to some stretches of DNA and RNA that code for a type of protein or for an RNA chain that has a function in the organism. Living beings depend on genes, as they specify all proteins and functional RNA chains...
tic and environmental influences. Lykken prefers sociopathy to describe the latter.
Sellbom and Ben-Porath (2005) describe the distinction:
This distinction closely resembles the distinction between instrumental and impulsive/reactive crime/violence in the field of
criminologyCriminology is the scientific study of the nature, extent, causes, and control of criminal behavior in both the individual and in society...
.
Joseph P. Newman
et al., who use this concept of psychopathy, have validated David T. Lykken's conceptualization of psychopathy subtypes in relation to Gray's behavioral activation system and behavioral inhibition system. Newman
et al. found measures of primary psychopathy to be negatively correlated with Gray's behavioral inhibition system, a construct intended to measure behavioral inhibition from cues of punishment or nonreward. In contrast, measures of secondary psychopathy to be positively correlated with Gray's behavioral activation system, a construct intended to measure sensitivity to cues of behavioral approach.
Psychopathy vs. sociopathy
Hare writes that the difference between sociopathy and psychopathy may "reflect the user's views on the origins and determinates of the disorder." The term sociopathy may be preferred by sociologists that see the causes as due to social factors. The term psychopathy may be preferred by psychologists who see the causes as due to a combination of psychological, genetic, and environmental factors.
David T. LykkenDavid Thoreson Lykken was a behavioral geneticist and Professor Emeritus of Psychology and Psychiatry at the University of Minnesota...
proposes psychopathy and sociopathy as two distinct kinds of
antisocial personality disorderAntisocial personality disorder is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition , as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood...
. He believes psychopaths are born with temperamental differences such as impulsivity, cortical underarousal, and fearlessness that lead them to risk-seeking behavior and an inability to internalize
social normsSocial norms are the accepted behaviors within a society or group. This sociological and social psychological term has been defined as "the rules that a group uses for appropriate and inappropriate values, beliefs, attitudes and behaviors. These rules may be explicit or implicit...
. On the other hand, he claims sociopaths have relatively normal temperaments; their personality disorder being more an effect of negative sociological factors like parental neglect, delinquent peers,
povertyPoverty is the lack of a certain amount of material possessions or money. Absolute poverty or destitution is inability to afford basic human needs, which commonly includes clean and fresh water, nutrition, health care, education, clothing and shelter. About 1.7 billion people are estimated to live...
, and extremely low or extremely high intelligence. Both personality disorders are the result of an interaction between genetic predispositions and environmental factors, but psychopathy leans towards the hereditary whereas sociopathy tends towards the environmental.
Three-factor model
Recent statistical analysis using
confirmatory factor analysisIn statistics, confirmatory factor analysis is a special form of factor analysis. It is used to test whether measures of a construct are consistent with a researcher's understanding of the nature of that construct . In contrast to exploratory factor analysis, where all loadings are free to vary,...
by Cooke and Michie indicated a three-factor structure, with those items from factor 2 strictly relating to antisocial behaviour (criminal versatility, juvenile delinquency, revocation of conditional release, early behavioural problems, and poor behavioural controls) removed from the final model. The remaining items are divided into three factors: Arrogant and Deceitful Interpersonal Style, Deficient Affective Experience, and Impulsive and Irresponsible Behavioural Style.
Hare and colleagues have published detailed critiques of the Cooke & Michie hierarchical ‘three’-factor model, citing severe statistical problems. Hare and colleagues note that the Cooke & Michie model actually contains ten factors, and results in impossible parameters (negative variances). Hare and colleagues also note conceptual problems with this model.
Discrete vs. continuous
As part of the larger debate on whether personality disorders are distinct from normal personality, or if they are extremes on various dimensions of normal personality, is the debate on whether psychopathy represents something "qualitatively different" from normal personality, or a "continuous dimension" shading from normality into severely psychopathic. Otto Kernberg believed psychopathy should fall under a spectrum of pathological
narcissismNarcissism is a term with a wide range of meanings, depending on whether it is used to describe a central concept of psychoanalytic theory, a mental illness, a social or cultural problem, or simply a personality trait...
, that ranged from narcissistic personality on the low end,
malignant narcissismMalignant narcissism has been described as "an extreme form of antisocial personality disorder that is manifest in a person who is pathologically grandiose, lacking in conscience and behavioral regulation, and with characteristic demonstrations of joyful cruelty and sadism".Malignant narcissism is...
in the middle, and psychopathy at the high end.
Early taxonometric analysis from Harris and colleagues indicated a discrete category may underlie psychopathy, but this was only found for the behavioural Factor 2 items, indicating this analysis may be related to Antisocial Personality Disorder rather than psychopathy per se. Marcus, John, and Edens more recently performed a series of statistical analysis on previously attained PCL–R and PPI scores and concluded psychopathy may best be conceptualized as having a "dimensional latent structure" like
depressionMajor depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
.
Comorbidity
Psychopaths may have various other mental conditions, although, in contrast to people with
antisocial personality disorderAntisocial personality disorder is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition , as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood...
,
comorbidityIn medicine, comorbidity is either the presence of one or more disorders in addition to a primary disease or disorder, or the effect of such additional disorders or diseases.- In medicine :...
among psychopaths is generally found to be low.
Substance abuseA substance-related disorder is an umbrella term used to describe several different conditions associated with several different substances .A substance related disorder is a condition in which an individual uses or abuses a...
has been associated with psychopathy, particularly Factor 2 (anti-social behaviour), but not Factor 1 (emotional) scores of the PCL-R.
Conduct disorderConduct disorder is psychological disorder diagnosed in childhood that presents itself through a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate norms are violated...
and attention deficit hyperactivity disorder (ADHD) have both been associated with psychopathy; which may be explained by disruption to
dorsolateral prefrontal cortexThe dorsolateral prefrontal cortex , according to a more restricted definition, is roughly equivalent to Brodmann areas 9 and 46. According to a broader definition DL-PFC consists of the lateral portions of Brodmann areas 9 – 12, of areas 45, 46, and the superior part of area 47. These regions...
. This area is associated with
executive functionThe executive system is a theorized cognitive system in psychology that controls and manages other cognitive processes. It is responsible for processes that are sometimes referred to as the executive function, executive functions, supervisory attentional system, or cognitive control...
, which is affected in all three disorders.
There is some evidence of an association between
ASPDAntisocial personality disorder is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition , as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood...
and other personality disorders (i.e.
histrionicHistrionic personality disorder is defined by the American Psychiatric Association as a personality disorder characterized by a pattern of excessive emotionality and attention-seeking, including an excessive need for approval and inappropriately seductive behavior, usually beginning in early...
,
narcissisticNarcissistic personality disorder is a personality disorder in which the individual is described as being excessively preoccupied with issues of personal adequacy, power, prestige and vanity...
and
borderline personality disorderBorderline personality disorder is a personality disorder described as a prolonged disturbance of personality function in a person , characterized by depth and variability of moods.The disorder typically involves unusual levels of instability in mood; black and white thinking, or splitting; the...
s), however, evidence for a link with psychopathy is more tentative.
Anxiety may be associated positively with antisocial behaviour, but it is inversely associated with Factor I (emotional) scores on the PCL-R. Depression is inversely associated with psychopathy. There is no conclusive evidence for a link between psychopathy and schizophrenia.
It has been suggested that psychopathy may be comorbid with several other diagnoses than these; however, limited work on comorbidity has been carried out. This may be because of difficulties in using inpatient groups from certain institutions to assess comorbidity, owing to the likelihood of some bias in sample selection. Furthermore, comorbidity may be more reflective of poor
discriminant validityIn psychology, discriminant validity tests whether concepts or measurements that are supposed to be unrelated are, in fact, unrelated.Campbell and Fiske introduced the concept of discriminant validity within their discussion on evaluating test validity. They stressed the importance of using both...
of categories in the DSM-IV than reflective of underlying aetiologically separate conditions.
Psychopathy and Sexual Deviance
Sexual preferences are usually considered deviant when they stray statistically from the norm and, when acted on, tend to inflict unwanted harm on oneself or others (Lalumière & Quinsey, 1999). In a study conducted by Barbaree et al. (1994) using Penile Plethysmography, psychopaths showed more increased penile blood flow than did controls upon being shown deviant visual and auditory stimuli. This may be due to the psychopath’s complete disregard for social norms and lack of attachment to others. The desire to be socially accepted is so deeply ingrained into the minds and personalities of average humans, that to some extent this dictates our sexual feelings. While the psychopath will attempt to blend in, their undisclosed desires are completely uninhibited by social standards.
There is also evidence to suggest that psychopathic sexual offenders use more violence against their victims than do nonpsychopathic sexual offenders, suggesting that the psychopath may have a higher propensity to be sexually sadistic. Woodworth et al. (2003) examined the correlation between PCL-R scores and types of aggression expressed in a sample of 38 sexual murderers. 84.7% of these individuals scored in the moderate to high range (scores significantly higher than those of a group of nonsexual murderers). Also, murders committed by psychopaths (those with a score of 20 or above) showed more gratuitous and sadistic violence than those of nonpsychopaths. 82.4% of psychopaths committed sadistic violence against their victims, compared to only 52.6% of nonpsychopaths.
Epidemiology
It is estimated that approximately one percent of the general population are psychopaths. A 2009 British study reported a community prevalence of 0.6%, consistent with the estimate given by the screening version of the psychopathy checklist.
The psychologist
Robert HareRobert D. Hare, C.M. , is a researcher in the field of criminal psychology. He developed the Psychopathy Checklist and Psychopathy Checklist Revised , used to diagnose cases of psychopathy and also useful in predicting the likelihood of violent behavior...
in his book, "Without Conscience: The Disturbing World of Psychopaths Among Us", argues that psychopathy has a genetic predisposition. He goes on to state that many psychopaths have a pattern of mating with, and quickly abandoning women, and as a result, have a high
fertilityFertility is the natural capability of producing offsprings. As a measure, "fertility rate" is the number of children born per couple, person or population. Fertility differs from fecundity, which is defined as the potential for reproduction...
rate. These children may inherit a predisposition to psychopathy. Hare describes the implications as chilling.
Among criminals
A 2002 literature review of studies on mental disorders in prisoners stated that 47% of male prisoners and 21% of female prisoners had anti-social personality disorder. According to an unsourced article in popular science magazine
Scientific AmericanScientific American is a popular science magazine. It is notable for its long history of presenting science monthly to an educated but not necessarily scientific public, through its careful attention to the clarity of its text as well as the quality of its specially commissioned color graphics...
, studies indicate that about 25% of prison inmates meet diagnostic criteria for psychopathy. A 2009 study of British prisoners found a prevalence for "categorically diagnosed psychopathy" of 7.7% in men and 1.9% in women.
HomicideHomicide refers to the act of a human killing another human. Murder, for example, is a type of homicide. It can also describe a person who has committed such an act, though this use is rare in modern English...
s by psychopaths were almost always (93.3%) done in "cold blood" and premeditated in a 2002 study. For non-psychopaths the figure was 48.4% due to a much larger share of "crimes of passion".
Despite having several characteristics that may seem useful to terrorists, there is little evidence that the majority of terrorists are psychopaths. Other characteristics such self-centeredness, unreliability, poor behavioral controls, and unusual behaviors may be disadvantages or make psychopaths unwilling to sacrifice themselves for a perceived higher cause. Indeed, the increased narcissism may produce the attitude that there is no higher cause than the pleasure of the psychopath.
A 2011 study of conditional releases for Canadian male federal offenders found that psychopathy was related to more violent and non-violent offences but not more sexual offences. For child molesters psychopathy was associated with more offences. Despite "their extensive criminal histories and high recidivism rate", psychopaths showed "a great proficiency in persuading parole boards to release them into the community." "High-psychopathy offenders (both sexual and non-sexual offenders) were about 2.5 times more likely to be granted conditional release than non-psychopathic offenders."
Clinical management
In practice, mental health professionals rarely treat psychopathic personality disorders as they are often considered untreatable and no interventions have proved to be effective. However, some of the difficulty has been attributed to the lack of clarity about the concept and diagnosis of psychopathy; the threat of danger to staff, or deceit or poor motivation from patients; and a lack of follow-up to test effectiveness. Despite pessimism, as of 1999, treatment of patients still takes place in a variety of psychiatric hospitals and secure units, and the research has indicated that some individuals do show some improvements when the right treatment is identified, and that longer periods of therapy often produce better results.
It has been shown that punishment and behavior modification techniques do not improve the behavior of psychopaths. Psychopathic individuals have been regularly observed to become more cunning and better able to hide their behaviour. It has been suggested that traditional therapeutic approaches actually make psychopaths more adept at manipulating others and concealing their behavior. They are generally considered to be not only incurable but also untreatable.
However, some researchers suggest that psychopaths can benefit as much as others from psychological treatment, at least in terms of criminal behaviors even if not on the central personality traits. For example, one therapeutic approach to juveniles reports reduced re-offending over a two year period compared to usual care.
United Kingdom
In the
United KingdomThe United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
, "Psychopathic Disorder" was legally defined in the Mental Health Act (UK) as, "a persistent disorder or disability of mind (whether or not including significant impairment of intelligence) which results in abnormally aggressive or seriously irresponsible conduct on the part of the person concerned." This term, which did not equate to psychopathy, was intended to reflect the presence of a personality disorder, in terms of conditions for detention under the Mental Health Act 1983. With the subsequent amendments to the Mental Health Act 1983 within the
Mental Health Act 2007The Mental Act 2007 is an Act of the Parliament of the United Kingdom. It amends the Mental Health Act 1983 and the Mental Capacity Act 2005. It applies to people in England and Wales. Most of the Act was implemented on 3 November 2008....
, the term 'psychopathic disorder' has been abolished, with all conditions for detention (e.g. mental illness, personality disorder, etc.) now being contained within the generic term of 'mental disorder'.
In
EnglandEngland is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
and
WalesWales is a country that is part of the United Kingdom and the island of Great Britain, bordered by England to its east and the Atlantic Ocean and Irish Sea to its west. It has a population of three million, and a total area of 20,779 km²...
, the diagnosis of dissocial personality disorder is grounds for detention in secure
psychiatric hospitalPsychiatric hospitals, also known as mental hospitals, are hospitals specializing in the treatment of serious mental disorders. Psychiatric hospitals vary widely in their size and grading. Some hospitals may specialise only in short-term or outpatient therapy for low-risk patients...
s under the
Mental Health ActThe Mental Health Act 1983 is an Act of the Parliament of the United Kingdom which applies to people in England and Wales. It covers the reception, care and treatment of mentally disordered persons, the management of their property and other related matters...
if they have committed serious crimes, but since such individuals are disruptive for other patients and not responsive to treatment this alternative to
prisonA prison is a place in which people are physically confined and, usually, deprived of a range of personal freedoms. Imprisonment or incarceration is a legal penalty that may be imposed by the state for the commission of a crime...
is not often used.
United States
Psychopathy has quite separate legal and judicial definitions that should not be confused with the medical definition. The American Psychiatric Association is vigorously opposing any non-medical or legal definition of what purports to be a medical condition "without regard for scientific and clinical knowledge." Various states and nations have at various times enacted
lawLaw is a system of rules and guidelines which are enforced through social institutions to govern behavior, wherever possible. It shapes politics, economics and society in numerous ways and serves as a social mediator of relations between people. Contract law regulates everything from buying a bus...
s specific to dealing with psychopaths.
In the
United StatesThe United States of America is a federal constitutional republic comprising fifty states and a federal district...
, approximately 20 states currently have provisions for the
involuntary civil commitmentInvoluntary commitment or civil commitment is a legal process through which an individual with symptoms of severe mental illness is court-ordered into treatment in a hospital or in the community ....
for
sex offenderA sex offender is a person who has committed a sex crime. What constitutes a sex crime differs by culture and by legal jurisdiction. Most jurisdictions compile their laws into sections such as traffic, assault, sexual, etc. The majority of convicted sex offenders have convictions for crimes of a...
s or
sexual predatorThe term sexual predator is used pejoratively to describe a person seen as obtaining or trying to obtain sexual contact with another person in a metaphorically "predatory" manner. Analogous to how a predator hunts down its prey, so the sexual predator is thought to "hunt" for his or her sex partners...
s, under
Sexually violent predator actsIn the United States, sexually violent predator laws permit states or the federal government to confine someone already in custody, after the sentence has been completed, if the person has a "mental abnormality" or personality disorder and who is likely to engage in sexual offenses if released...
, avoiding the use of the term "psychopath." These statutes and provisions are controversial and are being reviewed by the U.S. Supreme Court as a violation of a person's
Fourteenth AmendmentThe Fourteenth Amendment to the United States Constitution was adopted on July 9, 1868, as one of the Reconstruction Amendments.Its Citizenship Clause provides a broad definition of citizenship that overruled the Dred Scott v...
rights. (See
Foucha v. LouisianaFoucha v. Louisiana, 504 U.S. 71 , was a U.S. Supreme Court case in which the court addressed the criteria for the continued commitment of an individual who had been found not guilty by reason of insanity...
for an example.)
Washington
Washington State LegislatureThe Washington State Legislature is the state legislature of the U.S. state of Washington. It is a bipartisan, bicameral body, composed of the lower Washington House of Representatives, composed of 98 Representatives, and the upper Washington State Senate, with 49 Senators.The State Legislature...
defines a "Psychopathic personality" to mean "the existence in any person of such hereditary, congenital or acquired condition affecting the emotional or volitional rather than the intellectual field and manifested by anomalies of such character as to render satisfactory social adjustment of such person difficult or impossible." The same statute defines the "sexual psychopath" as "any person who is affected in a form of psychoneurosis or in a form of psychopathic personality, which form predisposes such person to the commission of
sexual offensesA sex offender is a person who has committed a sex crime. What constitutes a sex crime differs by culture and by legal jurisdiction. Most jurisdictions compile their laws into sections such as traffic, assault, sexual, etc. The majority of convicted sex offenders have convictions for crimes of a...
in a degree constituting him a menace to the health or safety of others" for prison sentencing purposes in the Sentencing Reform Act of 1981.
California
CaliforniaCalifornia is a state located on the West Coast of the United States. It is by far the most populous U.S. state, and the third-largest by land area...
enacted a psychopathic offender law in 1939, since greatly outmoded and revised, that defined a psychopath solely in terms of offenders with a predisposition "to the commission of sexual offenses against children." A 1941 law attempted to further clarify this to the point where anyone examined and found to be psychopathic was to be committed to a state hospital and anyone else was to be sentenced by the courts. However, these laws were enacted years before the American Psychiatric Association began publishing the
Diagnostic and Statistical Manual of Mental DisordersThe Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
which is used today for diagnosis and does not include "psychopathic offender". Hence, these laws are of historical interest only.
See also
- Autistic psychopathy
- Evil
Evil is the violation of, or intent to violate, some moral code. Evil is usually seen as the dualistic opposite of good. Definitions of evil vary along with analysis of its root motive causes, however general actions commonly considered evil include: conscious and deliberate wrongdoing,...
- Fictional portrayals of psychopaths
Psychopaths in popular fiction and movies generally possess a number of standard characteristics which are not necessarily as common among real-life psychopaths...
- The Mask of Sanity
The Mask of Sanity is a book written by Hervey Cleckley, M.D., first published in 1941, describing the clinical interviews of Cleckley with incarcerated psychopaths. It is considered a seminal work and the most influential clinical description of psychopathy in the 20th century...
External links
- Official web site of Sociopathic
- AUDIO Interview with Dr. Martha Stout, author of The Sociopath Next Door on the Living Hero podcast, November 2010.
- Handbook of Psychopathy (2007) on Google Books.
- The Mask of Sanity, 5th Edition, PDF of Cleckley's seminal book
- Without Conscience Official web site for Dr. Robert Hare
- Malatesti, L, Psychopathy in Psychiatry and Philosophy: An Annotated Bibliography
- RCMP Gazette Vol. 66, Issue 3 2004, The psychopathic offender
- Understanding The Psychopath: (Key Definitions & Research)
- The Paradox of Psychopathy (uses DSM diagnostic categories of Antisocial personality disorder)
- Managing Dangerous People with Severe Personality Disorder | volume=410 | issue=6826}} – brain imaging studies venture into the legal minefield of research into criminal psychopathy.
- AUDIO The Unreal World of Narcissists and Sociopaths, with host Jari Chevalier for Living Hero. Numerous experts, including Nina W. Brown, Linda Martinez-Lewi, Gabor Mate, Martha Stout, Philip Zimbardo