Psychopathy

Question 1

Define psychopathy

Answer 1

• Severe persoanlity disorder
• Linked to anti-social PD
• Lack of emotion, disregard for others, lack of control
• Coid et al found about 0.5% of general population are psychopaths and 8% of prison population are
• All psychopaths are diagnosed with ASPD but only around a third of people with ASPD are diagnosed with psychopaths
• Not a mental illness, not in DSM

Question 2

Characteristics of psychopaths

Answer 2

• ASPD = more anti-social behaviour, impulsivity
• Psychopathy = more psychological
• Cleckley (1976) found psychopaths offend for no reason, show no remorse, loyal to no one, often take part in troubling sexual and harmful behaviour
• Over 90% of serial sexual offenders and serial killers are psychopaths
• Lack empathy and conscience
• Manipulative
• Don’t want to change their behaviour
• Gain pleasure exploiting/manipulating others and seeing others suffer
• Low bore down threshold, stimulus-seeking behaviour often leads to drug/alcohol abuse
• Low frustration threshold

Question 3

Subtypes of psychopaths

Answer 3

Primary psychopaths - psychological, emotional, cognitive, biological differences from general population
Secondary psychopaths - commit anti-social behaviour and violent behaviour, severe emotional problems and inner conflicts, demonstrate more emotional instability and impulsivity, more aggressive and violent
Dyssocial psychopaths - display aggressiveness, anti-social behaviour that has been learned from subculture e.g. gangs, families, terrorist groups

Question 4

Psychopathy and DSPD

Answer 4

• End of 20th century, Dangerous and Severe Personality Disorder was adopted in UK
• Represent those in high security prisons, secure hospitals, serious offenders with PDs
• Intended to preface the term ‘psychopath’

Question 5

Psychopathy in children

Answer 5

• Children who show persistent anti-social behaviour are diagnose with conduct disorder
• In adolescence they are diagnosed with anti-social PD

Question 6

Psychopathy assessment

Answer 6

• PCL-R is most widely used assessment tool
• Designed by Hare, 1994
• Semi-structured interview and file review
• 20 items; each scored 0, 1 or 2
• Max. score of 40; score of 30+ indices psychopathy
• Two factors are discussed; interpersonal features and lifestyle/anti-social features
• PCL-R may not be appropriate for diagnosing psychopaths who don’t engage in violent behaviours
• Many psychopaths engage in anti-social behaviour but not criminal behaviour

Question 7

Psychopathy in females

Answer 7

• Significantly lower rates in women compared to men
• Tend to have less psychopathic traits than men and score less on PCL-R
• May present psychopathy in a different way to men
• Tend to be more subtle so go unnoticed

Question 8

Biological basis for psychopathy

Answer 8

• Genetic factors e.g. impairment of emotion, disruption of function of the amygdala
• Limits social cognition e.g. weakens punishment learning, poor moral socialisation, increased resilience on aggression
• Gregory et al (2015) found reduced grey matter in frontal lobe

Question 9

Facial expression recognition and psychopathy

Answer 9

• Often have problems recognising facial expressions of emotions esp. fear
• Inability of psychopaths to detect expressions communicating distress, fear, sadness, which leaves them vulnerable to continuing fear-inducing behaviour
• Children with psychopathic traits show deficits in recognising fearful and sad expressions; found they focus on most rather than eyes
• Thought to be due to low levels of activity in amygdala

Question 10

Eye scans and psychopathy

Answer 10

• General population have pupil enlargement when viewing negative images; psychopaths don’t
• Have a normal reaction to viewing positive images
• Show that psychopaths have a difficulty understanding negative emotions, no emotions in general

Question 11

Family factors and psychopaths

Answer 11

• Damage to frontal lobe (that can lead to psychopathy) can be due to abuse in childhood
• Parental conflict, neglect, abuse, rejection, harsh punishment, inconsistent punishment

Question 12

Attachment and psychopathy

Answer 12

• Direct link between insecure attachments and psychopathy

- `Insecure attachments more linked anti-social PD than psychopathy

Question 13

Therapy and psychopathy

Answer 13

A therapist must:

• Be consistently vigilant regarding manipulation
• Assume the patient’s account contains fabrication
• Assume psychopathic traits are pathological liars
• Realise client will have no insight and won’t care about future
• Assume client will have no concern for victims or the effects of their acts
• Not expect a work alliance with the psychopath
• Ensure that they are in charge of reinforcement, not the psychopath
• Realise that the therapy is likely to fail

Question 14

Treatment and punishment for psychopaths

Answer 14

• Punishment rarely effects their behaviour
• Punishment doesn’t deter them as they don’t fear it
• Only consider positive outcomes of behaviour and don’t think about negative consequences
• Respond poorly to punishment, lack motivation, don’t want to change, many drop out of treatment
• Hostile and resilient to feedback
• Verbally and emotionally abusive
• Threatening and intimidating towards staff and other patients