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Psychopathology Flashcards

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1
Q

What is the definition/diagnosis of Psychopathology?

A

NOT a diagnosis.

Categorised as Antisocial Personality Disorder in DSM-5.

Diagnosis for APD - individuals who violate the rights of others without remorse (APA, 2013)

Criteria for diagnosis are behavioural and don’t unclude underlying traits believed to be central to psychopathy.

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2
Q

What do some researchers disagree about the definition/diagnosis of psychopathy?

A

They suggest that psychopathy is distinct and separate from APD.
How;
- they aren’t neurotic (don’t suffer from anxiety or depressive disorders)
- are not psychotic (don’t suffer from bipolar/schiz)
- don’t suffer from emotional disturbances

Psychopathy is clinical construct characterised by constellation of interpersonal, affective and behavioural (lifestyle & antisocial) features

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3
Q

What is the definition of a Psychopath? (Hare Psychopathy Checklist)

A

Not disoriented or out of touch with reality, don’t experience delusions, hallucinations or subjective stress.
Psychopaths are rational and aware of what they are doing and why.
Their behaviour is the result of choice.

Clinically - psychopathy isn’t a mental disorder, it is a personality disorder.

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4
Q

What is the legal implications of psychopathy?

A

Personality Disorders aren’t considered to be a mental illness. DSM - doesn’t imply that personality disorders meet legal criteria for mental illness, disorder, or disability.

HOWEVER psychopathic disorder is included in the Mental Health Act 1983.
- persistent disorder or disability of the mind, which results in abnormally aggressive or irresponsible conduct on the part of the person concerned

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5
Q

What are the characteristics of a psychopath?

A
  • Sane, but amoral
  • No regard for others; seen as objects
  • No regard for society/societal norms
  • Lack empathy, remorse and guilt
  • lack normal emotional responses
  • are arrogant
  • good at hiding true selves/getting away with things
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6
Q

What is the prevalence of psychopathy in the population?

A
  • 1-2% of the general population are estimated to have elevated psychopathic features (Neumann & Hare, 2007)
  • Most psychopaths are NOT offenders, as their behaviour may be socially unacceptable but stay within the law
  • They may be very successful: traits may be advantageous in some working environments e.g. corporate. - there are 4 x more psychopaths in the corporate world than general population (Babiak, 2010)
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7
Q

What is the prevalence of psychopathy in offenders?

A

Males;

  • 15-30% of offenders are psychopathic
  • most research focused on males

Women;
- 9-23% of offenders are psychopathic (Nicholls, 2005; Vitale, 2002)

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8
Q

How do we measure psychopathy?

A

Psychopathy Checklist: Revised, Screening Version, Youth Version

Hare Self-Report Psychopathy Scale

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9
Q

What is the Psychopathy Checklist: Revised (PCL-R; Hare, 1991)

A
  • 20 items scored on interview and file information
  • Each item rated as 0 (not present), 1 (possibly present) or 2 (definitely present) - range of score from 0-40
  • A cut-off score of 30/25 is used to distinguish those with psychopathy
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10
Q

What four factors does the Psychopathy Checklist: Revised relate to?

A

Interpersonal
- e.g. lying, self-worth

Lifestyle
- e.g. need for stimulation

Affective
- e.g. lack of remorse/guilt

Antisocial
- e.g. poor behavioural control

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11
Q

Evaluate the Psychopathy Checklist: Revised.

A
  • Excellent psychometric properties when used with male offenders and forensic patients
  • Reliability and validity with female offenders and psychiatric patients
  • Continuous score = dimensional disorder rather than clearly demarcated category
  • Measures unitary construct BUT has two distinct clusters of behaviour
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12
Q

What are the two clusters The Psychopathy Checklist: Revised deals with?

A

Two clusters;
1) Emotional Detachment - affective & interpersonal

2) Behavioural factors - antisocial & lifestyle

Behavioural factors accounts for a majority of predictive efficacy for violence

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13
Q

What is Primary psychopathy?

A
  • individuals that score HIGHER on PCL factor 1 (emotional)
  • Born psychopathy = biologically different
  • little or no emotion due to biological differences
  • low anxiety and fear
  • behaviour intentional
  • instrumental aggression
  • high self-perception
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14
Q

What is Secondary Psychopathy?

A
  • those who score higher on PCL-R factor 2 (antisocial)
  • made psychopathy = learnt/environmental
  • Emotional volatility = affective blunting may not be biological
  • may experience high anxiety
  • impulsive
  • reactive aggression
  • love grandiosity
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15
Q

What is the heritability for psychopathy?

A

Larsson, 2006

  • psychopathy may be heritable, and so it’s at least part genetically determined
  • Factor 1 shows strong genetic influence; Factor 2 also only IF strong in Factor 1 also. High F2 and Low F1 together shows a moderate genetic influence (Viding, 2005)
  • no single gene has been identified - likely to be multiple genes
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16
Q

What are the biological causes of psychopathy?

A

Brain structure/function

  • prefrontal cortex
  • amygdala
17
Q

What does the prefrontal cortex suggest about the cause of psychopathy?

A
  • PFC regulates behaviour, impulsivity etc
  • Bertsch, 2013; Koenigs 2012 - Psychopathy related to structural and functional abnormalities in PFC
  • Motzkin, 2011 - Psychopathy related to reduced connectivity in PFC, between PFC and Amygdala, leading to deficits in regulation of emotional and social behaviour
18
Q

What does the Amygdala suggest about the causes of psychopathy?

A
  • Amygdala signals affective salience of environmental stimuli
  • smaller in psychopathic individuals
  • may function differently, reduced response to negative emotionan (Kiehl, 2001)
19
Q

What environmental factors explain the cause of psychopathy?

A

Childhood Abuse and Trauma:

  • poor attachment and abuse (Frodi, 2001)
  • childhood abuse/ neglect (Luntz, 1994)
  • poor discipline/supervision and rejection by parents (Marshall, 1996)
  • abuse and neglect, age of first relational trauma related (Craparo, 2013)
20
Q

What is the Evolutionary cause of psychopathy?

A
  • psychopathic traits may confer competitive advantage
  • adaptive - traits of psychopathic individuals may succeed in variety of concepts e.g. business/politics
  • e.g. during stressful times in history, those immune to stress & anxiety may have have aid to survival
  • e.g. those who seek sensation may have encouraged migration & resource search
  • low prevalence may maintain psychopathy as evolutionary stable system
21
Q

What is suggested to be the key difference between criminality and successful psychopaths?

A

Self-Control

22
Q

What is the relationship between psychopathy and Criminality?

A
  • psychopathy predictor of violence
  • offenders start at younger age
  • 20-25 times more likely to be in prison
  • more likely to commit more/variety of crimes
  • more violent
  • use predatory/instrumental violence
  • more difficult to treat
  • highly correlated with incarceration
23
Q

What is the relationship between psychopathy and violent crime?

A

Kruh, 2005
- associated with unprovoked violence in juveniles

Checkley, 1976
- more instrumental violence - controlled, purpose, used to attain external goal e.g. money

  • 62% of male prison population is violent offenders
  • 78% of incarcerated psychopaths are violent
  • offending behaviour does NOT decrease with age for violent psychopaths
24
Q

What is the difference between Instrumental and Reactive violence?

A

Instrumental - controlled, purposeful, external goal e.g. money

Reactive - impulsive, emotional-driven as response to perceived thread (Meloy, 1997)

25
Q

What is the relationship between sadistic violence and sexual offending?

A
  • more likely to use sadistic violence (Holt, 1999)
  • 25%-45% of rapist are psychopaths; sexual psychopaths don’t focus on type of victim, but opportunity; all sex offenders high on PCL Factor 1 (Porter, 2000)
  • 97% of sexual murderers are psychopaths (Firestone, 1998)
  • Psychopathic sexual-homicide offenders score higher on emotional detachment (Factor 1) (Firestone, 2009)
26
Q

What is the relationship between psychopaths and homicide?

A
  • more likely to minimise instrumentality of their murders (despite Porter 2007 research that their murders were MORE instrumental 93% than others)
  • Woodworth (2002) propose ‘selective impulsivity’ explanation - impulse behaviour may not be as uncontrollable as thought - they may get satisfaction from planning/committing instrumental act of violence
27
Q

What are the treatments for psychopathy?

A
  • psychopathy is generally believed to be untreatable - psychoanalysis, group therapy, client-centred therapy, psychodrama, psychosurgery, electroshock therapy, drug therapy = ineffective
  • talking therapies who accept they need help and willing to participate - however psychopaths dont believe they have psychological problems, and aren’t typically distressed
  • direct physical therapy - how to repair abnormal brain function isn’t understood
  • some therapies may exacerbate psychopathic tendencies and recidivism (Harris, 1991)
  • decompression treatment may help with juveniles
28
Q

How likely are psychopaths to recidivate?

A

Psychopaths more likely to recidivate than non-psychopaths.

Hemphill, Hare & Wong, 1998.

  • after 9 months = those scoring high on PCL-R had been reconvicted : 15% low scorers were reconvicted
  • after 3 months = high scorers had 80% recidivism rate : 30% low scorers had been reconvicted
29
Q

What is the relationship between recidivism and violent crime?

A

Rice & Harris 1997
Violent Crime
- in 1st year = 25% high psychopaths rearrested for violent offence
- After 20 years = 90% of high psychopaths had reoffended with violent crime (40% low)

Violent Sexual Offences
- After 10 years = 75% of high psychopaths committed further violent sexual crimes

30
Q

How likely are psychopaths to get away with their crime?

A
  • more likely than any other forensic patients to feign mental illness and deceive in insanity evaluations (Gacano, 1995)
  • more successful in applications for conditional relieve, more likely to violate conditions for release (Porter, 2009)
  • Psychopathic homicidal offenders more likely to deny charges, to be convicted of involuntary manslaughter and to receive permission to appeal sentence (Hare, 2009)

Forensic and Criminal Psychology (4 decks)

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