PSYC 2400: Psychopathy

Contents

1. 1. Defining Psychopathy
2. 2. Assessing Psychopaths
   1. 2.1 PCL-R: Psychopathy-Checklist Revised
3. 3. Psychopaths… (and why it’s important)
   1. 3.1 And Violence
   2. 3.2 In Youth
4. 4. Treating Psychopaths
5. 5. What Makes a Psychopath?
   1. 5.1 Nature vs. Nurture?
   2. 5.2 Does Family Matter?
   3. 5.3 Cognitive and Affective Models of Psychopathy

Recommended books to read:

• Without Conscience — by Robert Hare
  This is a great, quick read. I read this in between taking PSYC2400 and PSYC3402 (also taught by Craig Bennell) and when the psychopathy lecture came up again, I remembered everything from the book.
• Snakes in Suits — by Paul Babiak and Robert Hare
  If you read this and Without Conscience, you'll notice that the introductions are quite similar. The rest of this book is very different though. They've split up the sections with narrative acts (i.e., a mini-play) to help humanize the examples. Aside from the anecdotal evidence of psychopaths found in the workplace, I thought this was a good book for dealing with particularly troublesome coworkers - psychopathic or not.
• In the Belly of the Beast — by Jack Henry Abbottt
  This book depresses me when I read it (I haven't finished it yet). It's a mash-up of the correspondance between a journalist and Jack Henry Abbott. Read it, if only to get a better understanding of a psychopaths ability to rationalize and justify (there's no judgment in that comment either - we all reationalize and justify our actions, regardless of their effect on others).
• The Mask of Sanity (PDF) — by Hervey Cleckley
  Haven't read it yet…

And for more information on Hare: www.hare.org.

1. Defining Psychopathy

Psychopath: a person with a collection of interpersonal, affective and behavioural characteristics including Interpersonal, Affective, Lifestyle and Antisocial deficits (manipulation, lack of remorse or empathy, impulsivity and antisocial behaviours). These do not necessarily have to be criminals – can be politicians, judges, etc and they may not even be committing any crimes.

Base Rate: indication of the prevalence of a specific problem (psychopathy) within a specific population (serial killers):

• 90% of serial killers are psychopathic (study: overestimate because he applied the tools to people described in the media – proxy methodology).
• 1% of the general population are psychopaths (reliable estimate).
• 10-25% of the prison population are psychopaths.
• 44% of cop killers are psychopaths.
• 20% of male prisoners score above 30 (mean=22).
• 14% of female prisoners score above 30 (mean=19).

Antisocial Personality Disorder (APD): (suffers from the lifestyle deficits) characterized by a history of behaviour in which the rights of others are violated; they have demonstrated conduct disorder by age 15 and display at least 3 of the following symptoms after 15:

• Repeat criminal acts;
• Deceitfulness;
• Impulsivity ;
• Irritability;
• Reckless behaviours;
• Irresponsibility, and
• Lack of remorse.

APD places more emphasis on antisocial behaviours than the PCL-R. Nearly all psychopathic offenders meet the criteria for APD but most offenders diagnosed with APD are not psychopaths. 60-80% of prisoners have APD.

2. Assessing Psychopaths

There are a few:

• Experience Impressions “In my clinical opinion”: based on their experience, training, case-by-case.
  Though used, it’s frowned upon mostly because clinicians are inaccurate.
• Self-Report Inventories: MMPI, MCI, PPI.
  Psychopaths can lie on self-report inventories so they’re not great.
• Informant Rating: ASPD. Where you get information about the person via other sources. (Resolves the self-report problems).
• Structured Clinical: DSM-IV (equated to antisocial personality disorder, though psychopathy and APD are different), PCL-R, PCL:YV (youth version).
  Best approach.

2.1 PCL-R: Psychopathy-Checklist Revised

PCL-R: the most popular method of assessing psychopathy in adults (Dr. Hare); the assessment instrument is as follows...

• 20 items scored using a semi-structured interview and a review of file information to assess the following three features:
• Interpersonal Features: glib/superficially charming, grandiose/inflated self-worth, manipulative.
• Affective Features: shallow emotions, lack of guilty, callous.
• Behavioural (Lifestyle) Features: impulsivity, antisocial acts, poor anger control, criminal behaviours.
• 3-point scale to measure psychopaths (2, scoring over 30 to 40), mixed – most criminals (1, scoring between 20 and 30) and non-psychopaths (0, scoring between 0 and 20).

3. Psychopaths... (and why it’s important)

3.1 And Violence

Motives for Murder study: examining the relationship between psychopathy and how murders are committed by dividing them into Reactive (unplanned, crimes of passion, extreme provocation) and Instrumental (planned, settle a score).

• Results: of the people exhibiting Low PCL-R scores, Reactive murders were more likely; of the people exhibiting High PCL-R scores, Instrumental murders are more likely.

Re-offender study: retrospective assessment of male offenders; they examined the release decision without knowing what the PCL-R score; they looked at parole releases and mandatory supervision (statutory – after serving ⅔ of sentence) releases.

• Results: people re-offend as PCL-R score increases; statutory releases increase the likelihood of re-offending.

3.2 In Youth

Juvenile Death Penalty study: hypothesis – if the person is labelled a psychopath, how does it affect the jury? Two cases were presented: psychopathic and non-psychopathic.

• Result: Psychopathic condition – more likely to select death penalty and less likely to support rehabilitation.

4. Treating Psychopaths

Most clinicians believe psychopaths are not treatable, so what do we treat? (Biological deficits? Personality deficits? Behavioural deficits?)

Failure Following Treatment Study (Rice, Harris, and Cormier – 1992): examined the effects of intensive therapeutic treatment on violent psychopaths and non-psychopathic forensic psychiatric patients.
Results:

• Untreated Non-Psychopaths – recidivism rate was 39%;
• Treated Non-Psychopaths – recidivism rate was 22%;
• Untreated Psychopaths – recidivism rate was 55%;
• Treated Psychopaths – recidivism rate was 77%.

Take-away point: meaning that treatment increased recidivism in psychopaths and psychopaths re-offend at a higher rate.

5. What Makes a Psychopath?

Short Answer: we don’t know. Most of the brain-imaging scans are used to examine emotional deficits.

5.1 Nature vs. Nurture

Few longitudinal studies have examined the psychopathic differences between identical twins (same genes and environment), fraternal twins (50% same genes and same environment), biological siblings (similar genes and same environment) and adoptive siblings (different genes and same environment).

Results from available studies: identical twins had similar PPI (Psychopathic Personality Inventory) results than fraternal twins; genetic influences accounted for 29% and 59% of the variances for the different PPI subscales.

Take-away point: genetics may play an influence but environment may influence how these traits are expressed.

5.2 Does Family Matter?

• Abused Children: after a 20-year longitudinal study, abused children had a slightly higher PCR-R score.
• Best Predictors: having a criminal parent, a son with a father who is uninvolved, low family income, disrupted family and experiencing physical neglect.

Take-away point: we are still not certain which environmental factors conclusively contribute to psychopathy.

5.3 Cognitive and Affective Models of Psychopathy

Cognitive Model: theorizes that psychopaths have a response modulation deficit, in that they fail to use contextual cues that are peripheral to a dominant response in order to regulate their behaviour – which may be why they don’t learn to avoid punishment.

Affective Model: theorizes that psychopaths have a deficit in the experience of certain critical emotions that guide prosocial behaviour and inhibit deviance.

• Lexicon Decision Task study: an experiment designed to examine the disconnect between emotional and neutral words (neutral, nonsense, positive and negative); you answer the question “Was what you saw a word?”
• Results: Non-psychopaths: significantly quicker reaction times to emotional content; Psychopaths: statistically, no difference in reaction times.
  In a similar experiment with substance abusers, when reviewing brain scans, we can determine that psychopathic brain activity was localized to the posterior regions, suggesting that they are performing the task in a superficial manner – very little high-level processing.

Take-away point: suggests a definite biological deficit exist in psychopaths.

• Startle Blink: an experiment designed to examine the reflexes when something unexpected occurs in three separate cases – the magnitude of the blink (how hard it is), the startle blink is stronger with a negative emotional state and weaker with a positive emotional state.
• positive emotional state (babies, pets, erotic), negative emotional state (snake, weapons, mutilation) and neutral emotional state (objects).
• Result: Non-psychopaths showed increased blinks to unpleasant – pleasant (low), neutral (middle) and unpleasant (high) whereas psychopaths showed increased reaction to neutral – unpleasant (low), pleasant (middle), and neutral (high).

Take-away point: emotions play little role in a psychopath’s thinking, language and behaviours.