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Psych 230 > Chapter 11 > Flashcards

Chapter 11 Flashcards

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1
Q

Pinel’s view on psychopathy - 1801

A

“manie sans delikre” - madness without delusions

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2
Q

what is psychopathy

A

a clinical syndrome characterizeed by a callous, selfish, remorseless use of individuals disregard for the feelings and concerns of others

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3
Q

cleckley’s metaphor of electrcity conductor

A

on their own they might get up to their own tasks but when they are around other people that it when it a problem

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4
Q

James Prichard view on psychopathy - 1883

A

moral insanity - patients who commited illegal/immoral acts - knew what they were doing but didn’t care

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5
Q

16 clecklian criteria description

A

the psychopath checklist is based on this
- This list was made by observations of cleckley
- These are more correlates of psychopathy rather than factors of it

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6
Q

16 clecklian criteria

A
  • Superficial charm and good “intelligence”
  • Absence of delusions and other signs of irrational thinking
  • Absence of “nervousness” or psychoneurotic manifestations
  • Unreliability
  • Untruthfulness and insincerity
  • Lack of remorse and shame
  • Inadequately motivated antisocial behavior
  • Poor judgment and failure to learn by experience
  • Pathologic egocentricity and incapacity for love
  • 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 rarely carried out
  • Sex life impersonal, trivial, and poorly integrated
  • Failure to follow any life plan
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7
Q

Factor 1 - first dimension - interpersonal/affective characteristics

A

-How people relate to other people – social and interactions with others
–The personality traits of psychopathy
- Superficial and Glib
- Egocentric and Grandiose
- Pathologically Deceitful and
- Lacks Guilt and Remorse
- Shallow Emotions
- Callous Lack of Empathy

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7
Q

development of PCL - robert hare

A

– Cleckley’s criteria were operationalized in the form of a research scale for assessing psychopathy.

– Called the Psychopathy Checklist (PCL), measuring a constellation of emotional, interpersonal, and behavioral characteristics.

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8
Q

Julius Koch view on psychopathy

A

psychopathic inferiority - personality disorder - primarily biologically predetermined rather than enviroment

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9
Q

Emil Kraepelin

A

first to suggest there may be diff types of psychopathy
- born criminals
- morbid liars
- spendthrifts
- vagabonds

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10
Q

main problem of psychopathy in the 18th century

A

became wastebasket category - including different mental/personality disorder

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11
Q

George Partridge view on psychopathy

A

was being applied to many diverse disorders and replaced with sociopathy
- delinquent
- inadequate
- emotionally unstable

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12
Q

Karpman + Ariet

A

defined psychopathy as a personality disorder
- early onset of antisocial behaviours
- a need for immediate gratification
- high self worth
- impulsive + irresponsible
- lacking anxiety
- being callous

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13
Q

Hervey Cleckley definition of psychopathy

A

appearing normal yet lacking in remorse/empathy - impulsive, deceptive, grandiose
- mask of sanity
- a lack of emotional reaction
- partial psychopath or psychopath as psychiatrist
- provided the first detailed clinical descriptions

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14
Q

cultural differences of psychopathy

A

NA + Oceania higher on lifestyle features
Western Europe - higher on affective features
Western europe + Africa + South Asia - anti-social features
- outside of NA lower than isnide - UK is the lowest

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15
Q

DSM - I definiton of psychopathy

A

chronically anti-social, lacking loyalty, was callous, lacking judgement, immature, rationlize their anti-social behaviours

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16
Q

DSM-I classification of psychopathy

A

sociopath

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17
Q

DSM - II classification of psychopathy

A

antisocial personality

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18
Q

DSM -III

A

antisocial personality disorder - behaviour vs personality since behaviour is better for clinical assesments

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19
Q

DSM - 5

A

must be diagnosed with conduct disorder + show 3/7 adult symptoms

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20
Q

international classification of psychopathy

A

dissocial personality disorder - more of the interpersonal + attractive features

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21
Q

why are the voices of psychopathics ignored

A

difficulty in obtaining access to participants
privacy and ability

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22
Q

can psychopaths detect vulnerability

A

yes, they can identify previous abuse by gait cues

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23
Q

psychopaths identifying vulnerability stats

A

sexual/violent crimes ident. + gait cues by Factor 1
sexual/violent crimes ident. by Factor 2

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24
Q

Models for the causes of psychopathy

A

affective deficit model
attention model
developmental models
genetic models
brain based models

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25
Q

affective deficit model

A

there is a core deficit of something in psychopaths either
- emotion - general theory of emotional deficit
- fear - low fear hypothesis
- biological emotion processes - specific emotion deficit theory

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26
Q

low fear hypothesis - affective deficit model

A

not responsive to punishment and won’t avoid anti-social behaviour

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27
Q

general theory of emotional deficit

A

general lack of ability to experience + appreciate emotion

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28
Q

specific emotional deficit theory + intergration emotion systems theory

A

impairment to recognize sadness + distress
focuses on amygdala + ventromedial prefrontla cortex
emotion does not inhibit violence

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29
Q

attention model

A

focuses on cognitive rather than emotional
reponse modulation deficit

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30
Q

response modulation deficit

A

once individuals have focused their attention on certain features, won’t modify response - explains why emotion does not affect violence

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31
Q

developmental models

A

importance of emotion in development of consience AND key role of parents - make connection between misbehaviour + impose sanctions
different methods for callous emotional traits AND impulsive conduct

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32
Q

developmental model for callous/emotional traits

A

born with predisposition to fearlessness = insensitive, little arousal, ignore consequences

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33
Q

developmental model for impulsive conduct problems

A

inadequate socializing enviroments, low intelligence, no inhibition, lack of planning = antisocial acts

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34
Q

genetic models

A

consistently found a large significant heritable component to psychopathic traits - children, adolescents, and adults
strong genetic influence
no evidence for sex differences

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35
Q

brain based models

A

neuroimaging - reduction in prefrontal, rostral temporal, and ventral frontal lobe grey matter

  • less hippocampus
  • less amygdala
  • less volume in the anterior cingulate cortex
  • reduced connectivity between ventral frontal and amygdala
  • reduced connectivity between dorsal frontal cortex and limbic system
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36
Q

critics of self report

A
  • psychopathic clients are dishonest
  • they don’t have enough insight
  • asking about emotion without ever having it
37
Q

advantages of self report

A

measure unobservable
easy quick and inexpensive
detect invalid reasoning
interrater reliability

38
Q

examples of self report for psychopathy

A

psychopathic personality inventory
self report psychopathy scale
triarchic psychopathy measure

39
Q

rater based assesments for psychopathy

A

more resources - interview, collateral info, inter rater reliability
forensic settings
- hare psychopathy checking list, and screening version
- comprehensive assessment of psychopathic personality

40
Q

4 types of ways asses psychopathic traits in youth

A
  • youth psychopathic traits inventory
  • antisocial process screening device
  • inventory of callous/unemotional traits
  • hare psychopathy checking
41
Q

concerns of labelling psychopathic children

A

negative consequences
traits are common features of normally developing youth
stability of psychopathic traits from childhood to adolescence and on to adulthood

42
Q

cluster A of DSM 5

A

eccentric and odd behaviour

43
Q

cluster B of DSM 5

A

dramatic, emotional, and erratic behaviour

44
Q

Cluster C of DSM 5

A

anxious and dearful

45
Q

factor 2 - antisocial lifestyle - criminal behaviour + lifestyle components

A
  • impulsive
  • poor behaviour controls
  • need for excitement
  • lack of responsibility
  • early behaviour problems turns into adult antisocial behaviour
46
Q

3 ways of assesing psychopathy

A

– 1.) Psychopathy Checklist-Revised (PCL-R; Hare,1991, 2003) and the Screening Version (SV; Hart, Cox,& Hare, 1995) – best way to assess psychopathy
– 2.) Self-Report Inventories
– 3.) DSM-5 Antisocial Personality Disorder Criteria

47
Q

DSM - 5 antisocial personality disorder criteria issues with asses psychopathy

A

inapproporiate way – does not exist here – defines psychopathy as sociopathy – factor 2 without the factor 1 characteristics

48
Q

PCL-R assessing process

A
  • Broad characteristics split into 20 different characteristics
  • Scored using file information & semi-structured interview
  • Each item follows 3-point scale: 0, 1, or 2
  • Scores range from 0 to 40
  • A minimum score of 30 required for diagnosis; 25 often used for research purposes d/t low balling F1
49
Q

high for factor 1

A

people who skirt the law - high for factor 1 - might not act out in illegal ways

50
Q

why can’t psychopaths only have factor 2

A
  • People with antisocial behaviour cannot differentiate between characteristics of themselves versus screwing other people over
51
Q

how many factors in psychopathy

A

– 2 factors (Interpersonal and affective characteristics; Chronic antisocial behavior)
- – 4 facets (Interpersonal, Affective, Lifestyle, Antisocial; PCL-R 2nd ed.; Hare, 2003)

52
Q

association between SRI’s and PCL-R

A
  • Medium to large associations (r = .30-.50) between SRIs and PCL-R
53
Q

problems with SRI

A

– 1.) Old measures primarily assess Factor 2 – PPIP do better than this but they don’t test deceitfulness – realize what you are trying to measure and will not answer honestly
– 2.) SRIs inadequately control for deceitfulness
– 3.) Psychopathic persons lack insight into emotional and personal characteristics

54
Q

is psychopathy similar to antisocial personality disorder (DSM-5)

A
  • Pervasive pattern of disregard for and violation for the rights of others, since age 15, as indicated by three (or more) of the following:
  • 5 of these factor 2 – more lifestyle
  • Only a couple of them focus on factor 1
  • Failure to conform to social norms
  • Deceitfulness
  • Impulsivity or failure to plan ahead
  • Irritability and aggressiveness
  • Reckless disregard for safety of self or others
  • Consistent irresponsibility
  • Lack of remorse
55
Q

argument against PCL-R

A

predictive validity for institutional violence is poor and field reliability is weak

56
Q

field reliability

A

– can two separate clinicians arrive at basically the same score on the tool

57
Q

aversial allegiance

A

defence = lower score, prosecution = higher score

58
Q

counterargument for PCL-R invalidity

A

Meta-analyses demonstrate PCL-R has satisfactory predictive validity for institutional violence and field reliability, particularly when not administered in adversarial contexts

59
Q

interclass correlation

A

0.75 = good

60
Q

PCL-R in high stake hearings

A

– ICC lower in high stakes proceedings than routine correctional samples
– Issue of adversarial allegiance – in high stakes
* PCL-R ratings biased depending on the side retaining the clinician
– Critique of “poor” field reliability (actually “good” to “excellent”)
- Below 0.4 for poor

61
Q

PCL-R used to assess risk for institutional violence

A

PCL-R/SV robust small to medium effects for predicting institutional violence; weak predictor not substantiated

62
Q

mad or bad

A

– Psychopathic persons are not psychotic or “crazy”.
– Comorbidity with major mental illness is rare.
– Understand the law and can be held accountable for their actions.

63
Q

how well does PCL-R predict violence

A

– 85-97% of psychopaths - at least one violent crime.
– Approximately 50-75% recidivism rate for non-sexual violence - that is a lot
– Psychopathic persons more likely to commit acts of assault, vandalism, kidnapping, armed robbery, fighting, and to have used a weapon.

 More likely to have prior and future convictions for crimes of violence.
– No more likely to commit murder or sexual assault than nonpsychopathic men

64
Q

why psychopaths have equal chance of murder and sexual assault compared to non psychopaths

A
  • 2nd degree murder – occurs in emotional context – psychopathy usually does not drive the motive for this crime
  • Sexual crime – also an emotional component that is only somewhat correlated with psychopathy
65
Q

which factor greatily predicts recidivism

A

2

66
Q

why does factor 2 greatly predict recidivism

A

associated more with central 8 - especially past history

67
Q

biological markers for psychopath

A
  • amygdala disfunction
  • orbitofrontal cortex disfunction - hyperarousal
  • aversive conditioning and learning
  • genetics - inherited psychopathic tendencies
  • neurochemical - lack or influex of certain neurochemicals
  • low autonomic arousal and diminished startle reflex
  • low left hemisphere language organization
68
Q

what did ben karpman propose in terms of subtypes of psychopathy

A

idioparhic - primary subtype of psychopathy usually genetically based
symptomatic - secondary subtype of psychopathy with underlying mental condition and trauma

69
Q

latent class analysis

A

clusters of people who group together on a tool

70
Q

how are subtypes created

A

latent class anaylsis

71
Q

number of subtypes in psychopathy

A

2-4

72
Q

primary subtype of psychopathy proposed by karpman

A

clecklian psychopathy
callous and unemotional features + interpersonal features
* Low anxiety, high fearlessness
* Low emotional distress
* High narcissism
* Less responsive to intervention
* Larger neurobiological component
* Higher proportion in Caucasian persons

73
Q

secondary subtype of psychopathy proposed by karpman

A
  • Characterized by high anxiety
  • Other types of emotional distress and mental health concerns (e.g., depression)
  • More responsive to treatment
  • Higher proportion in ethnic minorities
  • Greater aggression, delinquency, institutional infractions
74
Q

cleckley 1941 - conclusion on treatment of psychopathy

A

Cleckley, 1941
“…we do not at present have any kind of psychotherapy that can be relied upon to change the psychopath fundamentally.” p 438-439

75
Q

suedfeld and landon - conclusion on psychopathic treatment

A

‘‘review of the literature suggests that a chapter on effective treatment should be the shortest in any book concerned with psychopathy. In fact, it has been suggested that one sentence would suffice: No demonstrably effective treatment has been found’’ (p. 347)

76
Q

harris and rice - treatment of psychopaths

A

…no effective interventions yet exist for psychopaths. Indeed, some treatments that are effective for nonpsychopaths actually increase the risk represented by psychopaths.’’ (p. 563 in Patrick, 2006 Ed.)

77
Q

ontario study on psychopathic treatment in a mental health facility

A
  • Therapeutic community setting
  • Locked in a small group handcuffed together – confront each other
  • Administered hallucinogenic medicine
    Results
  • Two groups: treatment or not then divded into psychopathic or non
  • High psychopathic + treatment– ¾ reoffended
  • Non psychopathic + treatment – did not reoffend
  • theatrogenic effect – treatment makes it worse
78
Q

problem with ontario therapy

A

did not follow RNR

79
Q

why have earlier studies produced negative outcomes

A

Characteristics of
Ineffective Programs?
* Little or no staff supervision
– Put psychopathic men in charge of running programs
Don’t follow RNR
* Over-treating the offenders
* Mixing high and low risk offenders
* Failure to target criminogenic need
* Inappropriate therapeutic foci
* Unresponsive interventions
– Nude encounter groups
– LSD used to reduce defensiveness

80
Q

what did salekin conclude that a treatment needed for psychopathy

A
  • Updated 2002 meta-analysis – added 9 new studies
  • Much improved study designs and intervention
    – Structured risk/psychopathy assessment & outcome evaluation, use RNR principles
    – Long term follow up
  • Some with positive treatment effects
  • Reduction in violence and reoffending with treatment.
  • Literature definitely moving in the right direction…
  • Most were evidence involved and CBT
  • Structured psychopathic assess
  • Structures risk assess
81
Q

negative therapeutic correlates

A

– Decreased treatment progress
– Increased dropout – higher score on facets and lower change on treatment
– Weaker working alliances, especially the bond between client and therapist – affective facet had signifact inverse relationships with change in therapy
- Affective – most callous unemotional traits = more likely to dropout, least treatment change, weakest working alliances

82
Q

what should be the goal of psychopathic treatment

A

want people to be less violence - hurt fewer people - prosocial needs

83
Q

how much can each factor of psychopathy change

A

factor 1 is stable over age groups
factor 2 declines over age

84
Q

why is factor 1 not a great predictor of violence

A

doesnt change over life span and isnt focusing on criminogenic needs

85
Q

two component model for the treatment of psychopathic clients

A
  • Component 1 – Interpersonal Component
    – Manage Factor 1 as a responsivity issue – adapt services to tolerate and manage charcateristics WITHOUT focusing all intervention on these
  • Component 2 – Criminogenic component
    – Target criminogenic needs (linked to Factor 2) as per the risk and need principles
  • Central 8
  • All symptoms are common targets for intervention
86
Q

behaviours that interfere with therapy of psychopaths

A
  • Manipulative behavior, lying, conning
  • Irresponsibility
  • Staff splitting
  • Glibness, superficial charm
  • Flirtatious, sexualized, inappropriate behaviors
  • Attempts or threats of self harm
  • Anger, abusiveness, aggression, and intimidation
87
Q

factor 1 treatment implications

A
  • Manage treatment interfering behaviors (as responsivity characteristics) to ensure program integrity
    – Careful staff selection, training, support & supervision
    – Team work & team coherence
    – Build working alliance, use motivational interviewing approaches
    – Boundary maintenance
    – Monitor offender activities
88
Q

factor 2 treatment implications

A
  • Treatment should focus on changing PCL-R Factor 2 (antisociality) characteristics to reduce violence
  • Use dynamic risk assessment tools to assess criminogenic needs
  • Use CBT/skills training to address thoughts, feelings and behaviors linked to violence/sexual violence
89
Q

clearwater and ABC Programs - VRS-SO Assessed Treatment Change and Sexual and Violent Recidivism in a High Risk Treated Sexual Offense Sample

A
  • 156 treated men with sexual offense history attended Clearwater Program
    – High intensity, CBT/RNR based program
    – VRS-SO used to assess risk and change in treatment
    – PCL-R used to assess psychopathy (M = 20.2, SD = 7.4)
  • Followed up a mean 10 years post-release
    Eb above 1 = recidividm, lower than 1 = not recidivism
    15-20% reduction in sexual and violent recividivism
90
Q

clearwater and ABC programs - VRS Assessed Treatment Change and Violent Recidivism in a
High Risk, Psychopathic Sample

A
  • 152 treated violent federally sentenced men attended the Aggressive Behaviour Control (ABC) Program
  • High intensity, CBT/RNR based risk reduction treatment
  • VRS used to assess risk and change in treatment
  • 94% VRS score >50; mean score =61
  • (DSPD VRS mean score = 61 [Kirkpatrick et al., 2009])
  • 64%, PCL-R >25
  • 27% PCL-R > 30; sample mean PCL-R = 26
  • (DSPD mean 28.3 [Kirkpatrick et al., 2009])
  • 8-10% reduction in overall violent recidivism

Psych 230 (5 decks)

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