A Little Clarity on Psychopaths

Given the plethora of crime shows on television, the term “psychopath” has become a word that is tossed around through media portrayals as well as in everyday conversation relatively often.  Criminal Minds, Dexter, and Law & Order: Special Victims Unit are all examples of television series where this word comes into play on a regular basis.  Interestingly enough, however, this term is more often than not used incorrectly.  Accordingly, the purpose of this posting is to provide a little clarity on the construct of psychopathy.
First of all, for simplicity purposes in this posting, I will refer to individuals manifesting psychopathic tendencies as “psychopaths.”  You should know, however, that there is some debate in the field of psychology as to whether or not this is the best way to characterize an individual with psychopathic traits.  Some consider individuals to either be or not be a psychopath, and therefore consider psychopathy to be a discrete taxon.  Others disagree, and suggest that there is a continuum along which individuals with psychopathic traits fall, and therefore there is no distinct cutoff that would divide the non-psychopaths from the psychopaths.  Instead, individuals would have low to moderate to high levels of psychopathic traits.  Despite more recent evidence suggesting that psychopathy really is dimensional in nature (http://www.ncbi.nlm.nih.gov/pubmed/16492104), for the sake of conciseness, we’ll be using the term “psychopath” for now.

Second, what is psychopathy?  Hervey Cleckley’s The Mask of Sanity in 1941 is considered to be one of the first valuable forays delving into the construct of psychopathy.  Since that initial point, psychological research has progressed forward and much has been learned about the series of affective, interpersonal, and behavioral personality traits that distinguish psychopaths from non-psychopaths.  Specifically, psychopaths are hypothesized to typically demonstrate higher levels of superficial charm, manipulation, narcissism, irresponsibility, and impulsivity in addition to a lack of guilt and empathy.  Although they are estimated to comprise only approximately 1% of the general population, psychopaths are believed to commit higher rates of more severe and violent high-risk crimes than non-psychopaths (http://www.ncbi.nlm.nih.gov/pubmed/19345418).  For example, within a sample of prisoner inmates, psychopaths had significantly higher levels of criminal offenses and committed a wider variety of criminal offenses than non-psychopaths (http://www.ncbi.nlm.nih.gov/pubmed/2212275).  In addition, after controlling for multiple other variables associated with recidivism, psychopathy was found to significantly predict antisocial outcomes (e.g., general and violent recidivism) from adolescence to young adulthood (http://www.ncbi.nlm.nih.gov/pubmed/18489214).  This study and others are also indicative of psychopathic traits being relatively stable across the lifespan (http://www.ncbi.nlm.nih.gov/pubmed/14696028).

Psychopathic behavior is believed to consist of four underlying factors: emotional (e.g., lack of remorse or guilt; shallow affect), interpersonal (e.g., glibness, pathological lying, narcissistic), lifestyle (sensation seeking, impulsive), and antisocial (e.g., juvenile delinquency, criminal tendencies) (http://www.ncbi.nlm.nih.gov/pubmed/18370617).   The first factor of these four collections of traits has been termed callous-unemotional (CU) traits.  CU traits are defined as individual deficits in empathy, remorse, and emotionality and have been dedicated more attention in research endeavors than the other psychopathy facets (http://www.ncbi.nlm.nih.gov/pubmed/18221345).  Generally speaking, CU traits have been shown to very strongly predict subgroups of antisocial individuals with more extreme levels of negative outcomes across the board.  For example, youth with CU traits display more severe and stable conduct problems and delinquency than youth without CU traits (http://www.ncbi.nlm.nih.gov/pubmed/16118993).  Given that CU traits seem to be a strong predictor of antisocial outcomes, many researchers have begun to focus on manifestations of CU traits across time in order to determine how psychopathic traits develop and whether it’s possible to intervene early in high-risk subgroups of children and adolescents ((http://www.ncbi.nlm.nih.gov/pubmed/18221345; http://www.ncbi.nlm.nih.gov/pubmed/17716093).  Current research is working to determine whether early treatment efforts may potentially reduce the negative outcomes typically associated with psychopathy in these at-risk individuals.

Lastly, a common misperception exists as to the distinction between individuals who meet diagnostic criteria for Antisocial Personality Disorder and those who would be considered psychopaths.  Contrary to popular belief, empirical evidence suggests that these two constructs are not synonymous.  Robert Hare, a leading psychopathy researcher, argues that, although many individuals who are psychopathic are often also diagnosed with Antisocial Personality Disorder, the reverse is not true.  Only a select few individuals with Antisocial Personality Disorder are also considered psychopaths (http://www.ncbi.nlm.nih.gov/pubmed/16904507).  Hare contends that a great deal of the confusion over the distinction between Antisocial Personality Disorder and psychopathy is due to the failure of the last few revisions of the Diagnostic and Statistical Manual of Mental Disorders to differentiate between the two constructs (http://www.psychiatrictimes.com/dsm-iv/content/article/10168/54831).  Researchers are presently investigating whether psychopathy should more adequately be viewed as a subtype of antisocial personality disorder or whether they are two distinct categories with some overlap (http://www.ncbi.nlm.nih.gov/pubmed/20455611).  More research is needed, however, to more adequately clarify the exact relation between those who meet diagnostic criteria for Antisocial Personality Disorder and psychopaths.

I hope that these few comments on psychopaths have been informative.  Next time you watch Dexter or Law & Order: SVU, you’ll be a little bit more well-versed in what constitutes use of the term “psychopath.”