Healthy Line: Psychopathy: Myths, Realities, and Implications

Psychopathy: A Comprehensive Exploration of the Disorder

Introduction

Psychopathy is a very well researched but poorly understood personality disorder in criminology and psychology. Psychopathy is a condition that is often confused with antisocial personality disorder (ASPD), but it is a specific disorder with the collection of constellation interpersonal, affective, and behavioral characteristics, namely superficial charm, absence of empathy, manipulativeness, and impulsivity.

This paper gives a detailed discussion of psychopathy including its definition, history, diagnostic criteria, neurobiological basis, subtypes and issues of treatment. We will also discuss the social consequences of psychopathy such as psychopathy in criminality and psychopathy in business.

 

1. Defining Psychopathy

Psychopathy is a severe personality disorder, characterized by a long-term antisocial trait, reduced empathy, and lack of remorse, and bold and disinhibited characters. In contrast to ASPD, where the emphasis is made on the behavioral deviance, psychopathy is characterized by the combination of the emotional deficit and overt antisocial behavior.

The Psychopathy Checklist-Revised (PCL-R) is the most popular instrument to measure psychopathy and was created by Dr. Robert Hare. It assesses characteristics in two important dimensions:

·        Factor 1 (Interpersonal/Affective Traits):

o   Glibness/superficial charm

o   Grandiose sense of self-worth

o   Pathological lying

o   Lack of remorse or guilt

o   Shallow affect

o   Callousness/lack of empathy

o   Failure to accept responsibility

·        Factor 2 (Socially Deviant Lifestyle Traits):

o   Liveliness/ susceptibility to boredom

o   Parasitic lifestyle

o   Weak controls of behavior

o   Early behavior difficulties

o   Absence of unrealistic long time objectives

o   Impulsivity

o   Irresponsibility

o   Juvenile delinquency

o   Criminal versatility

 

A score of high on the PCL-R (usually 30+/40) is an indication of psychopathy and the higher the score the more risk of violent recidivism.

 

2. Historical Background

The psychopathy concept has taken hundreds of years to develop:

·        Early Descriptions (19th Century):

o   Mania without delirium In 1801, Philippe Pinel wrote of mania without delirium individuals who do not reason abnormally but have severe moral weaknesses.

o   James Cowles Prichard (1835) referred to the emotionally cold but intellectually normal as having moral insanity.

·        20th Century Developments:

o   The Mask of Sanity (1941) by Hervey Cleckley defined major characteristics of psychopathy and contrasted apparent sociability and inner deficiency.

o   The PCL-R (1980s) developed by Robert Hare standardized diagnosis and turned the diagnosis into measurable traits.

 

3. Psychopathy vs. Sociopathy vs. ASPD

Even though they are used interchangeably, the terms are different in meaning:

 

Term	Definition
Psychopathy	A neurobiological disorder that is characterized by emotional impoverishment, glibness, and predation.
Sociopathy	More colloquial term; suggests antisocial as a result of environment (upbringing, trauma etc.).
ASPD (DSM-5)	A wider diagnosis which is oriented on chronic antisocial behavior (e.g. criminality, aggression) without necessarily involving emotional deficits.
Key Difference:	All persons with ASPD are not psychopaths, but a majority of psychopaths fit the criteria of ASPD.

 

4. Neurobiological Underpinnings

The studies indicate that psychopathy is based on brain disorders:

·        Amygdala Dysfunction: The diminished activity leads to a poor fear conditioning and empathy.

·        Deficits of prefrontal cortex: Bad impulse control and poor decision making.

·        Smaller Grey Matter: The structural variations in regions that control morality and emotion.

·        Genetic Factors: Heritability is 50-60 per cent as estimated by twin studies.

These results favor the opinion that psychopathy is a neurodevelopmental disorder rather than a result of bringing up.

 

5. Subtypes of Psychopathy

Psychopaths are not all violent criminals. Scholars single out subtypes:

A. Primary Psychopathy (Low-Anxiety Psychopathy)

·        Traits: bold domination, strong confidence and low anxiety.

·        Behavior: Manipulative without being violent (e.g. corporate psychopaths).

B. Secondary Psychopathy (High-Anxiety Psychopathy)

·        Characteristics: Hot tempered, volatile, and violent.

·        Behavior: Higher chances of being involved in criminal activities.

C. Successful Psychopaths

·        Personality: Very clever and deceitful.

·        Behavior: Succeed in prestigious jobs (e.g. CEO, politicians).

 

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6. Psychopathy in Criminal Behavior

Psychopaths are disproportionately represented in jails (15-25 percent of prisoners compared with ~1 percent of the general population). Important criminal networks:

·        Violent Offending: Increased tendency of instrumental (premeditated) violence.

·        Recidivism: No response to rehabilitation; high recidivism levels.

·        Fraud, corporate exploitation: White-Collar Crime.

Serial Killers & Psychopathy:

·        Scores on the PCL-R were high of many notorious serial killers (e.g., Ted Bundy and John Wayne Gacy).

·        They were so attractive that they could get away with it over decades.

 

7. Corporate Psychopathy

Not every psychopath is a criminal, some of them are successful in business:

·        Characteristics: Cruel ambition, charm, readiness to use other people.

·        Effect: Poisonous leadership, bad morals in decision making.

·        Prevalence: It is estimated that 3-4 percent of executives are psychopathic.

 

8. Can Psychopathy Be Treated?

Apparently, psychopathy is notoriously recalcitrant to treatment because of:

·        The absence of remorse (there is no motivation to change).

·        Manipulative act (pretending to make progress).

·        Inadequate learning of emotions.

 

Potential Approaches:

·        Cognitive Behavioral Therapy (CBT): It is behavioral oriented.

·        Reward-based prosocial behavior systems Contingency Management.

·        Pharmacotherapy: Anti-impulsivity / anti-aggressive drugs (not very successful).

Recidivism Prevention:

·        Early treatment of conduct-disordered youngsters.

·        Close monitoring of the dangerous criminals.

 

9. Ethical and Societal Implications

·        Legal System: Are psychopaths to be held completely responsible even though they have different brains?

·        Corporate Screening: Is Psychopathic Screening in Employment Appropriate?

·        In the media: glorification vs. reality (ex: American psycho, Dexter).

 

10. Conclusion

Psychopathy is one of the most complicated and frightful disorders in psychology. It is embedded in the neurobiology and is marked by lack of emotions and anti-social behavior makes it very challenging to treat and be managed in the society. Whereas some psychopaths end up as violent criminals; others manipulate themselves into high places in the society causing a path of psychological devastation.

It is possible that future studies will reveal more effective interventions, yet at this point psychopathy is a grim reminder of the worst parts of human personality.