Psychopathy Flashcards

1
Q

Who first described the concept of psychopathy and what did he refer to it as?

A

Pinel (1801) - mania without delirium

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2
Q

What did psychopathy used to refer to?

A

Almost any mental or behavioural dysfunction

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3
Q

What did Cleckley describe a psychopath as?

A

Someone who appears outwardly normal but underneath has a semantic neuropsychiatric defect

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4
Q

Who developed the checklist for psychopathy?

A

Cleckley

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5
Q

Who developed the PCL-R and whose work was it based off?

A

Hare based off Cleckley’s work

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6
Q

Why might the PCL-R be limited in it’s use?

A

It was based on criminal psychopaths

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7
Q

How can psychopathy be assessed?

A

Interviews, personlaity questionnaires, structured diagnosis (PCL-R), self-report measures

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8
Q

Does the DSM-V include psychopathy?

A

No - it confuses ASPD and psychopathy

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9
Q

What is the main difference between ASPD and psychopathy?

A

ASPD criterion is mainly criminal behaviours, criminality is not true for all psychopaths

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10
Q

What is needed to complete the PCL-R?

A

Extensive file information and interview (ideally with 2 people)

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11
Q

How many items are in the PCL-R and how are they rated?

A

20 rated from 0 (absent) to 2 (definitely)

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12
Q

What is the average PCL-R score in the general population?

A

Between 2 and 4

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13
Q

What is the cut-off score for psychopathy in the PCL-R?

A

30

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14
Q

What are the two facets of the PCL-R?

A

Factor 1 - affective/interpersonal style
Factor 2 - behavioural lifestyle

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15
Q

What are the 4 (more recent) facets of the PCL-R?

A

Interpersonal
Affective
Lifestyle
Antisocial

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16
Q

What facets relate to the proposed factors of psychopathy?

A

Facet 1 relates to primary psychopathy and facet 2 relates to secondary psychopathy

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17
Q

What did Yildrim and Derksen (2015) hypothesise about primary and secondary psychopathy?

A

Primary - emotional deficiency (limbic hyporesponsivity)
Secondary - emotional disturbance (impairment of frontal cortex)

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18
Q

What are primary and secondary psychopaths?

A

Primary - innate condition, stereotypical psychopath, emotionless
Secondary - trauma-induced, more out of control, more emotional disturbance

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19
Q

Which factor of psychopathy is more similar to ASPD?

A

Factor 2 - secondary psychopath

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20
Q

What did Gray et al. (2019) find in terms of impulsivity and psychopathy?

A

Found the results support the idea of primary and secondary psychopathy.

Secondary psychopathy scored higher on impulsivity, vice versa for primary psychopathy

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21
Q

What are some limitations of the PCL-R?

A

Interviews are open to manipulation.

Antisocial should not be part of the diagnosis - may just be a conseqeunce of the personality features rather than core for diagnosis.

PCL-R holds a lot of consequences - e.g., death penalty

It’s hard to administer - need specialist training

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22
Q

Name some alternatives to the PCL-R.

A

SPR4 - based on the PCL-R four facet model.

PPI-R - based on factor analysis.

TriPM

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23
Q

What factors are included in the PPI-R?

A

Fearless dominance and self-centred impulsivity.

Maybe cold heartedness.

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24
Q

What is the TriPM based on?

A

Theory of end-phenotypes - boldness, meanness and disinhibition

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25
Q

What did Hart et al. (1988) find when looking at the psychopathy and violence?

A

80% of those with high psychopathy returned to prison during examination period.

True for 60% medium psychopathy and 20% low psychopathy.

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26
Q

What did Hare et al. (2000) find when looking at psychopathy and reconviction rates?

A

High psychopathy - a lot more reconnections both general and violent crimes. A lot more violent crimes though than low psychopathy

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27
Q

What did Woodworth and Porter (2002) find when classifying homicides and psychopathy?

A

Nearly all homicides committed by psychopaths were cold-blooded.

Homicides for psychopaths was pretty evenly reactive and proactive.

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28
Q

Is psychopathy a relevant idea for women?

A

Yes - psychopathy measures just as predictive of future crimes and violence for women as for men

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29
Q

What did Viding et al. (2005) find in terms of genetics and psychopathy?

A

(UK) Genes account for 70% of the individual differences in CU traits.

Genetic contribution was highest when CU traits were combined with antisocial behaviour (Factor 1)

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30
Q

What did Wootton et al. (1997) find in terms of the enviornment and the development of psychopathy?

A

The worse the parenting, the more conduct problems.

Except for those with CU traits - they had higher conduct problems and parenting had no effect on this.

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31
Q

Is it true that psychopaths cannot be treated?

A

Unknown but programs now aren’t designed with psychopaths in mind so this might explain the difficulty in treating at the moment.

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32
Q

What did Rice et al. (1992) find when looking at prisoners being released from a therapeutic community in Canada?

A

Treatment for non-psychopaths decreased reconvictions.

Treated psychopaths were convicted more.

Could be becuase it taught them how to manipulate people.

33
Q

What is the problem with the Rice et al. (1992) study looking at therapeutic community and reconvicitons?

A

Cannot randomise groups, could be that the more manipulative psychopaths took part

34
Q

How do psychopaths behave in prison (Hobson et al., 2000)?

A

PCL-R predicts disturbing behaviours.

Behaviours in groups - intellectualises, turns everything into a debate, evasive, tells lies

Behaviours on the wing - seeks attention, targets vulnerable staff, manipulates others for own needs

35
Q

What are the 3 main theories of psychopathy?

A
  1. Dysfunctional amygdala (Blair)
  2. Paralimbic dysfunction (Kiehl)
  3. Response modulaiton hypothesis (Newman)
36
Q

What is the dysfunctional amygdala hypothesis (Blair)?

A

An emotional problem - poor processing of emotional material and therefore insensitivity to punishment.

Disability to process emotion

37
Q

What is the paralimbic dysfunction hypothesis (Kiehl)?

A

An emotional problem - inability to use emotion to guide behaviour and poor decision making.

Ability to process emotion just not use it correctly.

38
Q

What is the response modulation hypothesis (Newman)?

A

Attentional problem - deficit in processing ‘secondary’ information, emotion may not be processed if not the focus of attention

39
Q

What does skin conductance measure and what does in normally show in neurotypicals?

A

Arousal of an aversive stimulus.

Increase in SCR in response to an aversive stimulus.

40
Q

What did Hare et al. (1978) find when looking at SCR in psychopaths?

A

Aversive stimulus causes the same SCR for normal and psychopaths but during the wait (when you know the stimulus is coming), those high in psychopathy showed smaller SCR

41
Q

What is the startle response and how can it be measured?

A

Defensive relfex measured by looking at eye blink response with electrodes

42
Q

What did Patrick et al. (1993) find when looking at the startle response in psychopaths?

A

High psychopathy showed normal response to pleasent and no increase to unpleasant compared to controls.

Found that the lack of emotional modulation of startle appears to be driven mainly by Factor 1.

43
Q

What did Esteller et al. (2016) find when looking at the startle response in people high on boldness?

A

Boldness was associated with reduced startle response to threat stimuli but there was no effect of other affective images shown prior (e.g., mutilations).

Meanness and disinhibition showed no significant results.

44
Q

What did Herpertz et al. (2001) find in terms of the startle response in psychopathy and other PDs?

A

The result found in psychopaths doesn’t generalise to other PDs.

45
Q

Why is the lexical decision task used in psychopathy?

A

It is a measures the theory that psychopaths cannot understand the emotions of stimuli.

46
Q

What did Williamson et al. (1991) find when looking at the lexical decision task performance of psychopaths and what does it suggest?

A

Psychopaths do not have the faster response to emotional words that non-psychopaths display.

Suggests there is a disconnection with the connotative meaning of the words.

47
Q

What does the attentional theory of psychopathy reject?

A

The idea that there is an emotional deficit.

48
Q

What did Dadds et al. (2008) demonstrate that supports the attentional theory of psychopathy?

A

Children with psychopathic tendencies were poor at spotting facial expressions but they also failed to spend time looking at the individual’s eyes.

When they were forced to look at the eyes, this deficit disappeared.

49
Q

What did Newman et al. (2010) show using the startle response which supports the attentional theory of psychopathy?

A

There was no effect of anticipating the aversive stimulus when they were focused on the cue which would give them this information.

When they were focused on an alternate cue, which did not give information about expecting the aversive stimulus, there was a reduced startle response.

Claims this holds for Factor 1 and 2.

50
Q

What did Gray et al. (2022) find when looking at the auditory startle response and who was the sample and why?

A

Sample were men in the community - measuring pupillary response and offenders often have confounds which can effect this response (e.g., drug use).

Found a reduced effect of negative sounds in psychopathy - confined to the meanness scale of the TriPM and the affective component of the SRP.

51
Q

What has been found in terms of psychopathy and emotion recognition?

A

No consistent evidence in this area - if there even is an effect would be difficult to tell if it was a genuine sensitivity or just a bias.

52
Q

What is an example of the research done in the area of psychopathy and emotion recognition and what did they find?

A

Blair et al. (2005) found psychopaths made significantly more errors and took longer to recognise fearful emotions. Data for this may not have been analysed in the least bias way though.

53
Q

What is the general finding around psychopathy and neuropsychological performance?

A

Psychopaths show little dysfunction on most neuropsychological tests.

54
Q

Which tests did Lapierre et al. (1995) find were effected in psychopathy and which brain region are these related to?

A

Olfactory test (smell discrimination), go/no-go task (responding when they shouldn’t), and maze test (cheating to finish the maze).

Related to the orbitofrontal cortex.

55
Q

What was found when looking at psychopathy and the Iowa Gambling task and what brain region is related to this?

A

Psychopathic group go for the high risk option and do nto change this strategy, controls start with the same strategy but change to the low-risk option after a while (unconscious emotion).

Related to the orbitofrontal cortex.

56
Q

What was found related to psychopathy and the Tower of London task and the Hayling and Brixton (Bagshaw et al., 2014)?

A

Tower on London - psychipathy associated with lack of planning - don’t spend more time planning for the harder tasks like the neurotypicals do.

Brixton - psychopaths have no trouble detecting the ‘rule’ but do have trouble ‘sticking to the rule’ - try to ‘beat the system’

57
Q

Which two brain regions are thought to be important in psychopathy?

A

Amygdala and frontal cortex

58
Q

What did Raine et al. (1994) find in the prefrontal cortex and why might it be relevant to psychopaths?

A

Reduced activity and volume.

Found in murders where the crime was classed as ‘predatory’ - this could be argued to be psychopathy.

59
Q

What has been found in terms of the amygdala in psychopaths (Yang et al., 2006)?

A

Reduced amygdala size - may be greater for Factor 1 than 2.

60
Q

What did Decety et al. (2014) find when looking at brain responses to ‘dynamic’ facial expressions in psychopaths?

A

Reduced brain activity in fear, sad, happy, and pain expressions.

In the face perception areas and extended network. No amygdala difference but greater response in insula.

61
Q

What did Harenski et al. (2010) find when looking at brain activity during moral judgements in psychopathy?

A

Reduced activity in the vmPFC and anterior temporal cortex.

62
Q

Which features of psychopathy are the ones which distinguish it from ASPD?

A

Affective and interpersonal

63
Q

What is the prevalence of psychopathy in the general population vs prison populations?

A

1% vs 16-25%

64
Q

Which DSM cluster does psychopathy co-occur with?

A

Cluster B - ASPD, borderline PD, narcissistic PD

65
Q

When seperating psychopathy into Factor 1 and 2, which is associated with high and which is associated with low internalising problems?

A

Factor 1 - low internalising problems.
Factor 2 - high internalising problems.

66
Q

Genetic studies have identified which systems with psychopathy and what do they suggest?

A

Serotonergic and oxytocinergic.

Contribute to reduced emotional reactivity and capacity for attachment to others.

67
Q

What has been suggested when looking at the gene-environment interaction and parenting in psychopathy?

A

Parents with genetic variants that predispose them to psychopathic behaviour have increased risk of engaging in begative and harmful parenting and might pass some genetic variants to their offspring.

68
Q

What are some environmental risk factors associated with psychopathy?

A

Prenatal maternal stress, child maltreatment during childhood and adolescence, harsh parental discipline during childhood and adolescence, negative parental emotions, disorganised parent-child attachment, disrupted family functioning.

69
Q

What are the overall findings about psychopathy and grey matter differences?

A

Reduced volume in the PFC, hippocampus and amygdala

70
Q

In terms of the PCL-R can an individual have a high score on a couple of items and be considered psychopathic?

A

No - have to have elevated scores across all facets

71
Q

Why are self-report measures not effective in psychopathy?

A

Psychopaths tend to engage in impression management and dissimulation

72
Q

What term should be used when describing psychopathy in children?

A

Limited prosocial emotions

73
Q

What treatment is recommended for reducing childhood conduct problems and possibly prevent psychopathy?

A

Parent management training (PMT)

74
Q

What is PMT underpinned by?

A

Models that emphasise the importance of improving effectiveness and consistency of parental discipline to produce child behavioural change.

75
Q

What has been suggested to enhance treatment outcomes in children wiht CU traits when the modificaiton is made?

A

Emphasising individualised positive reinforcement over punishment.

76
Q

What are areas of concern during psychopathy prevention options?

A

Poor motivation to change, manipulation, high rates of aggression and violence

77
Q

Why might psychopathic management be difficult?

A

Elevated psychopathic traits has been associated with reduced treatment cooperation

78
Q

What has been found in terms of medication as a treatment for psychopathy?

A

No reliable evidence - suggestion of quetiapine, lithium, phenytoin, and serotonin reuptake inhibitiors reducing aggression

79
Q

What is the attitude towards psychological interventions for psychopathy?

A

General pessimism