What is Psychopathy?

What is psychopathy?

Society has used the term psychopathy for quite some time. Psychopathy is a focal point of several movies and attracts public attention and fear. Circumstances involving psychopaths committing extreme violence shock the public. There are multiple perspectives on psychopathy, and it is highly researched. Psychopathy is a neuropsychiatric condition affecting a lack of behavior control, emotional responses, impulse control, and often anti-social behavior. Psychopathy involves many characteristics, which include, but are not limited to:

• insincere charm,
• not trustworthy or reliable,
• self-centered,
• bold/fearless,
• manipulative,
• callous disregard for others,
• anti-social tendencies,
• sexually deviant behavior,
• lack of conformity to social norms, and
• lack of empathy or remorse.

Individuals with psychopathy represent a significant percentage of incarcerated people. Research suggests that psychopaths comprise approximately 15 to 20 percent of the prison population (Babiak et al., 2012). It is important to note that not all psychopaths participate in criminal behavior. Many psychopaths hold positions in society across various career fields. Psychopathy is gender indifferent, racial indifferent, and affects individuals of all cultural and socioeconomic backgrounds.

How does psychopathy develop?

Research suggests that psychopathy is a condition that results from developmental and genetic factors. Neuroscience research discovered that psychopathy often occurs in people with brain dysfunction. Brain dysfunction disrupts an individual’s ability to recognize appropriate emotional responses and inhibits behavior control. Symptoms of psychopathy may present during childhood; however, children are often not identified as psychopaths because they are still developing, and the symptoms could be associated with the body’s natural maturing process. With that being said, psychopathy is most commonly identified in adults.

What conditions may be associated with psychopathy?

Although psychopathy is not defined as a mental health disorder, it is often related to diagnosable mental health conditions. Individuals affected by psychopathy often meet the criteria for a diagnosable mental health disorder. Some personality theories have indicated that psychopathy is the far end of antisocial personality disorder (ASPD). It encompasses many of the ASPD’s symptoms or traits. It has been said that all psychopaths are antisocial, but not all antisocial individuals are psychopaths. Psychopathy may also be associated with other personality disorders, which include:

• borderline personality disorder (BPD) and
• narcissistic personality disorder (NPD).

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) identifies personality disorders as a pattern of behavior that deviates from norms, is persistent, begins in adolescence or adulthood, and results in distress in life. The personality disorders mentioned above involve a malfunction of the psychological system.

How is an individual assessed for psychopathy?

The currently recognized assessment tool for psychopathy in clinical and forensic practice is Hare’s Psychopathy Checklist-Revised (PCL-R). The PCL-R is standardized, consisting of 20 categories, and rates an individual on a three-point scale. Psychopathy can be broken down into two factors: factor one, which includes interpersonal/affective, and factor two, which includes chronic social deviance. These factors can be found in the PCL-R assessment tool. This assessment tool focuses on behavior and personality characteristics. Mental health professionals gather information from a psychological interview, official record review, and assessment of collateral information. The totality of this information is then applied to the PCL-R assessment tool. It is common for individuals suffering from psychopathy to engage in criminal behavior. Therefore, the legal system and forensic clinicians (psychologists and psychiatrists) utilize the PCL-R assessment in criminal proceedings. The PCL-R assessment tool can also apply to other circumstances such as family court cases, risk assessments, offender treatment assessments, and death penalty cases. Clinicians who use the PCL-R assessment receive special training and must have specific experience.

How is psychopathy treated?

Due to the complex nature of psychopathy, a clearly defined treatment option has not been identified. Individuals with psychopathy may not respond favorably to treatment, increasing the likelihood of continued criminal behaviors. As of this point, there is no cure for psychopathy. Individuals suffering from psychopathy may have a brain dysfunction; therefore, treatment efforts focus on restoring normal brain function. Treatment involves techniques to improve brain function in addition to the use of pharmacology (medicine). Treatment techniques may include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), substance abuse treatment, and efforts aimed at improving social skills. Treatment efforts seek to restore the affected individual. Restoring the affected individual can reduce the potential for violence in the community.

When to seek emergency help?

Immediately call 911 or your local emergency number if you or someone you know is thinking about self-harm, suicide, homicide, or are in psychiatric distress. If you are with someone thinking about hurting themselves, stay with the person to keep them safe until emergency services arrive at your location.

• 988 Suicide & Crisis Lifeline (Call or Text 988)
• Veterans Crisis Line (1-800-273-8255, Press 1 to talk)
• Text Hello to 741741

For non-emergency services in LA County (the entry point for mental health services with the Los Angeles County Department of Mental Health), use the following telephone number.

• LACDMH ACCESS LINE: 800-854-7771

If you are interested in a psychological evaluation by one of our psychologists at Vienna Psychological Group, book your free 30-minute consultation here.

To learn more about mental health and forensic psychology, check out our blog library here and our podcast, The Forensic Psychologist Podcast, hosted by Dr. Vienna on Spotify and Apple Podcasts.

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This blog aims to answer general questions and assist readers in better understanding psychopathy. This blog is not intended to provide medical, psychiatric, or legal advice.

References:

Anderson, N. E., & Kiehl, K. A. (2014). Psychopathy: developmental perspectives and their implications for treatment. Restorative neurology and neuroscience, 32(1), 103–117. https://doi.org/10.3233/RNN-139001.

Babiak, P. et al. (2012). Psychopathy: An important forensic concept for the 21st century. FBI Law Enforcement Bulletin. https://leb.fbi.gov/articles/featured-articles/psychopathy-an-important-forensic-concept-for-the-21st-century.

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed. text revision).

Hare, R. D. (2003). The psychopathy checklist–Revised. Toronto, ON, 412.

Marcus, D. K., Fulton, J. J., & Edens, J. F. (2013). The two-factor model of psychopathic personality: evidence from the psychopathic personality inventory. Personality disorders, 4(1), 67–76. https://doi.org/10.1037/a0025282.