1. Psychopathy
Chapter 4

2. Nature of the Psychopath
debate about the nature of psychopathy revealed in the various labels for it
Antisocial personality disorder, dyssocial personality, sociopathy
Cleckley (1941) criteria:
superficial charm, absence of “nervousness”, unreliability, untruthfulness and insincerity, lack of remorse or shame, inadequately motivated , poor judgment and failure to learn by experience, general poverty in major affective reactions, specific loss of insight, unresponsiveness in interpersonal relations, and failure to follow any life plan

3. Common Definition: the Psychopathy Checklist-Revised
20 item symptoms rating scale
requires clinical/expert judgment
data obtained from 2 primary sources
review of collateral information (required)
interview/observation (recommended)

4. PCL-R: Factor 1 Glibness/superficial charm
Grandiose sense of self-worth
Pathological lying
Conning/manipulative
Lack of remorse or guilt
Shallow affect
Callous/lack of empathy
Failure to accept responsibility for own actions

5. PCL-R: Factor 2 Need for stimulation/proneness to boredom
Parasitic lifestyle
Poor behavioral controls
Early behavioral problems
Lack of realistic, long-term goals
Impulsivity
Irresponsible
Juvenile delinquency
Revocation of conditional release

6. Additional PCL-R Items
Promiscuous sexual behavior
Many short-term marital relationships
Criminal versatility

7. Types of psychopathy Primary psychopathy Secondary psychopathy
Prototypical psychopathy
Antisocial acts, irresponsible, lacking empathy, superficially charming
Secondary psychopathy
Not inherent, cause lies in factors such as low intelligence, some sort of social disadvantage, and impulsivity driven by anxiety

8. Antisocial Personality Disorder (APD) and Psychopathy
APD is listed formally in the DSM-IV TR but the PCL-R items are listed under the associated features
APD diagnostic criteria are more behavioral while psychopathy criteria are behavioral and interpersonal/affective
Prevalence rates for APD are higher in correctional samples and the community than psychopathy

9. Relationship of Criminal Behavior and Violence
General Violence and Criminal Behavior
Single biggest risk factor for violence
Commit more violent crimes
Commit proportionally more instrumental violence as compared to reactive
More likely to inflict serious harm but less likely to murder
Different motivations for violence
More likely to victimize strangers
Burnout not associated with later violence

10. Sexual Violence May have increased risk for sexual violence
Sexual promiscuity
Lack of responsiveness in relationships
Predictive of sexual recidivism
Higher PCL-R scores commit more frequent and more severe levels of violent sexual offenses
10-15% of child molesters and 40-50% of rapists are psychopaths

11. Violence in Civil Psychiatric Patients
Risk of violence much lower than general offenders
Importance of psychopathy civil psychiatric patients is less obvious
Psychopathy is a strong predictor of violence even in less violent samples

12. Violence in Domestic Violence Perpetrators
Psychopathy of offenders with a history of domestic violence might be useful in predicting future violence
Studies differ in terms of domestic abusers or one who has committed domestic violence offenses
Relationship between psychopathy and domestic violence is not yet clear

13. What else do we know about psychopathy?
Interpersonal/Affective
Cognition/Learning
Biological Basis
Treatment

14. Interpersonal/Affective
Deficits in non verbal emotional processing
Language appears to be superficial
Seem to lack affective cognitions
Exhibit less fear and anxiety
Pseudo/sham emotions
Pathological deceit
Con and manipulate people

15. Cognition/Learning Passive-avoidance learning
failure to learn to from behaviors that punish
general cognitive impulsiveness and hypersensitivity to rewards
Narrowed attentional focus
specific deficit in automatic processing that results in unresponsiveness to contextual cues

16. Biological basis
May demonstrate reduced fear in anticipation of unpleasant or painful stimuli
Do not exhibit global neuropsychological deficits
Exhibit functional brain deficits
Cerebral cortexes are less active
Fail to use certain parts while processing emotional stimuli

17. Treatment of Psychopaths
May be less likely to form emotional attachments needed for effective psychotherapy
Stay in program for shorter periods of time
Less motivated
Violence for treated psychopaths (77%) is higher than untreated psychopaths (55%)
Gives them insight into the emotions of others, making them more “effective” criminals
Recent studies are challenging the beliefs that treatment is ineffective for psychopaths

18. Special Groups Women & Psychopathy Probably valid as a construct
Prevalence 11-23%
Mean PCL-R score for incarcerated women = 13-18
Factor structure appears to be different for women than men, may exhibit symptoms differently
Relationship to recidivism not shown to be as strong as with men, but may be related to rapid recidivism

19. Ethnic and Cross Cultural Differences
Comparisons between Caucasian and African-American offenders
Preliminary evidence is not suggestive of dramatic differences
There are significant different cross-culturally
Lower prevalence rates and mean PCL-R scores outside of North America

20. Children and Adolescents
Need to be careful when extended the construct to children and adolescents
PCL:YV is the comparison measure
Appears to be a viable construct with similar properties as it does in adults
Debate about appropriateness of diagnosis

21. Legal and Ethical Implications
Significant increase in the admission of the PCL-R into courts
Discrepancy between legal and clinical definitions of psychopathy
Capital sentencing
Represents the most prevalent use of psychopathy
Only a small correlation between PCL-R score and institutional violence and
Profound impact on jurors