Lecture 8: Psychopathic Personality

Question 1

What percentage of violent criminals are psychopaths?

Answer 1

• Psychopaths are not all violent criminals
  
  • A very small minority of the population are psychopaths
  • Among this population, probably 50% are nonviolent and noncriminal
  • A remaining 25% may be criminals but nonviolent
  • The remaining 25% who are criminal and violent exhibit these behaviours for a large variety of reasons/due to many different disorders
• While there are violent psychopaths, in general it’s just a personality cluster/disorder
  
  • It might make you at a high risk for violence—but not necessarily

Question 2

How was psychopathy defined in the first DSM?

Answer 2

• In 1952 the first DSM came out—argued that Cleckley’s affective/interpersonal aspect of the definition was not sufficiently apparent
  
  • DSM renamed it sociopathic personality disturbance (in DSM I and II), which was later renamed in DSM III, IV, and V as Antisocial Personality Disorder
• The DSM definition was greatly based on behaviour & case history
  
  • Instead of affective and interpersonal features which are very important to the description of the psychopath
  • This fixation can be problematic b/c behaviours can be motivated by a wide variety of reasons (e.g. do you often kick a cat b/c it runs in front of you or you go out looking for cats to kick?)
• Hare’s conceptualization of the Psychopath is more in line with the original definitions and is the standard today (and what we call them)

Question 3

How is psychopathy understood in modern times?

Answer 3

• Psychopathy is is a personality disorder
  
  • It’s a continuous variable measured by Hare’s Psychopathy Checklist (PCL)
  • Based on personality traits and observable behaviour
• The current edition of the PCL-R officially lists four factors (1.a, 1.b, 2.a, and 2.b)
• Primary psychopaths are considered to have an emphasis on Factor 1 traits
• Secondary psychopaths have an emphasis on Factor 2 traits

Question 4

What are the two factor clusters in Hare’s Psychopathy Checklist Revised (PCL-R)?

Answer 4

• Factor 1—Personality/affective (emotional) and interpersonal features
  
  • “Selfish, callous and remorseless use of others”
• Factor 2—Case history, behaviour
  
  • “Chronically unstable, antisocial and socially deviant lifestyle”

Question 5

What defines primary psychopaths (Factor 1a and 1b)?

Answer 5

• narcissistic personality disorder (NPD): a pervasive pattern of grandiosity, need for admiration, and a lack of empathy
• histrionic personality disorder (HPD): a pattern of excessive emotionality and attention-seeking, including an excessive need for approval and inappropriate seductiveness

Question 6

What defines secondary psychopaths (Factor 2a and 2b)?

Answer 6

• antisocial personality disorder (ASPD): “a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood”
• criminality: a propensity towards crime

Question 7

What is the difference between a sociopath and a psychopath?

Answer 7

• The term sociopath somewhat still applies to Antisocial Personality Disorder
• We can think of the sociopath as an individual who has an “anti-society” orientation, such that he or she does not adhere to societal rules but still may have a conscience of some sort

Question 8

How is the PCL-R scored?

Answer 8

• 21-item clinical rating scale—each reflects a symptom/characteristic of psychopathy
• The items are rated on a 3-point scale
  
  • 0 = item doesn’t apply
  • 1 = item applies somewhat
  • 2 = item definitely applies
  • Clinician can qualify this by saying “although I give this person a 2, it’s probably more of a 100”
    
    • e.g. If the item was how much you like baking, someone who bakes as a hobby and is a professional baker would both get a 2, but the professional baker would actually be much higher
• The items are rated on the basis of the person’s lifetime functioning
  
  • Not solely on the basis of the person’s present state
  • This state may be atypical of his/her usual functioning due to extreme situational factors or an exacerbation of acute psychopathology
• The items are summed to yield total scores, ranging from 0 to 42, that reflect the degree to which an individual resembles the prototypical psychopath
  
  • Scoring PCL-R items requires clinical judgement and inference, as well as the ability to carry out the task in an objective, professional manner
• A cutoff score of 30+ (in some studies 25) is used to diagnose psychopathy
  
  • The PCL-R items are scored on the basis of an individual’s functioning over most of the life span
  • This means that a clinician or researcher who wants to measure change in psychopathic symptomatology during incarceration cannot use the PCL-R

Question 9

What does Factor 1a of the PCL-R generally encompass and what are the four items?

Answer 9

• Factor 1a: Narcissism
• 1) Glibness and Superficial Charm
  
  • Likely has engaging conservations and interpersonal behaviour around others
• 2) Grandiose Sense of Self-Worth
  
  • Inflated ego, self assured and opinionated
• 3) Pathological Lying
  
  • Lies with ease, is seldom embarrassed when caught lying
  • Often motivated by extrinsic gain
• 4) Conning/Manipulative
  
  • Uses scams that are motivated by personal gain
  • Often cons/scans their own family members

Question 10

What does Factor 1b of the PCL-R generally encompass and what are the four items?

Answer 10

• Factor 1b: Histrionic
• 5) Lack of Remorse or Guilt
  
  • Not just that they don’t feel guilt but that they almost feel disdain for their victims
• 6) Shallow Affect
  
  • Acts in ways inconsistent with displayed/stated emotions
  • Emotions appear insincere and dramatic, shallow, and short lived
• 7) Callous / Lack of Empathy
  
  • Others are seen as objects to be manipulated
  • Appreciation of suffering of others is merely abstract
• 8) Failure to Accept Responsibility for Own Actions
  
  • Rationalizes and excuses deviant behaviour by placing blame on the victims or the circumstances

Question 11

What does Factor 2a of the PCL-R generally encompass and what are the five items?

Answer 11

• Factor 2a: Behavioural
• 9. Need for Stimulation / Proneness to Boredom
• 10. Parasitic Lifestyle
      * Presents as helpless or uses threats/coercion
• 11. Lack of Realistic Long Term Goals
• 12. Impulsivity
• 13. Irresponsibility

Question 12

What does Factor 2b of the PCL-R generally encompass and what are the five items?

Answer 12

• Factor 2b: Case History
• 14. Juvenile Delinquency
• 15. Poor Behavioural Controls
      * Often responding to frustration and criticism with violence or verbal abuse
      * Behaviour seems inappropriate in context
• 16. Revocation of Conditional Release
• 17. Early Behavioural Problems
      * Before age of 12 serious conduct problems
• 18. Criminal Versatility
      * A diversity of types of criminal offenses, regardless if the person has been arrested or convicted for them

Question 13

What are the three independent items in the PCL-R?

Answer 13

• Independent from others in Factor 1 and 2 as well as each other, but are still correlated to the psychopath checklist
• 19. Promiscuous Sexual Behaviour
• 20. Many Short Term Marital Relationships
      * Lack of commitment to a long-term relationship reflected in inconsistent, undependable, and unreliable commitments in life
      * Including formal common-law or marriage
• (*NEW*) 21. Acquired Behavioural Sociopathy / Sociological Conditioning
  
  • A person relying on sociological strategies and tricks to deceive

Question 14

Can you treat psychopaths?

Answer 14

• Treatment has little efficacy among psychopaths
  
  • We often only find out that people are psychopaths once they’ve committed a crime, and at that point it’s kind of late to intervene
• Early intervention (childhood)?
  
  • How do you know a kid is going to be a psychopath later on in life?