Psychopathy as Psychopathology

Question 1

Definition: psychopath

Answer 1

Individual characterized by limited affective experiences, known to act impulsively and often antisocially, but seems calm and at ease in the presence of others. Overrepresented in criminal samples.

Question 2

16 criteria for psychopathy

Answer 2

1. Superficial charm and good intelligence
2. Absence of delusions and other signs of irrational thinking
3. Absence of nervousness or psychoneurotic manifestations
4. Unreliability
5. Untruthfulness and insincerity
6. Lack of remorse or shame
7. Inadequately motivated antisocial behavior
8. Poor judgment and failure to learn by experience
9. Pathological egocentricity and incapacity for love
10. General poverty in major affective reactions
11. Specific loss of insight
12. Unresponsiveness in general interpersonal relations
13. Fantastic and uninviting behavior with drink and sometimes without
14. Suicide rarely carried out
15. Sex life impersonal, trivial, and poorly integrated
16. Failure to follow any life plan

Question 3

Assessment

Answer 3

Most commonly used: Psychopathy Checklist-Revised (PCL-R).

16 criteria split into 20 items, rated on a scale of 0-2 (non-applicable to applicable). Scores range from 0-40. 30 or more is the cut off. Generalized for white, North American males.

Question 4

Prevalence

Answer 4

15-49% among North American male offenders. Rates tend to be lower for female samples, as low as 9-20%.

Question 5

Psychological models

Answer 5

• Fearlessness or insensitivity to punishment
• Impulsivity, callousness, absence of neurosis due to deficits in BIS (behavioral inhibition system)
• Amygdala abnormalities

Question 6

Treatment

Answer 6

Prognosis is poor and most individuals are relatively untreatable. Attempts to increase empathy and responsible for peers. However, new skills almost increase ability to manipulate and control others. Most individuals resistant to treatment.

Success stories:

• Adolescent therapy aimed to increase motivation and positive emotion and decrease callousness has helped.
• Altering mother’s harsh and inconsistent parenting has helped children and adolescents
• When reductions in violence were examined, psychopathic responses decreased

Suggestions:

• De-emphasize treatments geared toward building social skills or empathy. Create behavior modification programs with the goal of reducing harm
• Expand interventions for children and adolescents, given they are more likely to respond positively
• Turn to research on etiology to devise treatment for particular deficits