Psychopathy, Antisocial Personality Disorder and offending behaviour- Part 1

Question 1

What does autonomic abnormalities come under?

Who made the PCL-R tool?

What does the PCL-R stand for?

What is it an assessment for?

What kind of effort is it?

Answer 1

Neurobiological abnormalities.

Robert Hare.

Psychopathy checklist revised.

Psychopathy.

Multidisciplinary team effort.

Question 2

How are psychopaths like at the interpersonal level?

How are psychopaths like at an affective level?

How are psychopaths like at a behavioural level?

When do psychopaths feel remorse?

What is shallow affect?

Answer 2

Arrogant, superficial, grandiose and manipulative.

Lack empathy, guilt or remorse and shallow effect.

Irresponsible, impulsive and thrill seeking.

When caught.

Feeling no emotions when you expect someone too.

Question 3

Psychopathy assessment (PCL-R):

How many items are on this scale?

How is each item scored?

Where does information inputted into this assessment come from?

How long should the information used should have been collected for?

Answer 3

0 to 2;

• 0 = not present.
• 1 = partially present.
• 2 = fully present.

Prison files + semi-structured interviews.

Throughout their life- is a developmental disorder which starts young.

Question 4

Continuation from information about the PCL-R:

What is the highest score you can get?

What is the cut off point (threshold) to say someone has psychopathy in the UK?

How should you score?

Answer 4

25.

Score on a continuum of severity- rather than saying once you reach the threshold, you have psychopathy.

Question 5

Continuation from information about the PCL-R:

What happened to the PCL-R?

How many factors are there?

How many facets are there?

What goes under factor 1?

What goes under factor 2?

Answer 5

Changed after studies were conducted.

2; Factor 1 + factor 2.

Interpersonal (facet 1) + Affective (facet 2).

Lifestyle (facet 3) + Antisocial (facet 4).

Question 6

Continuation from information about the PCL-R:

What is facet 1?

What is facet 2?

What is facet 3?

What is facet 4?

Answer 6

Arrogant and deceitful interpersonal style.

Deficient affective experience.

Impulsive, irresponsible, parasitic lifestyle.

Antisocial manifestations.

Question 7

Psychopathy- Misconceptions:

Who is classed as a successful psychopath?

Can you score high on psychopathy assessment and still not be a criminal?

Answer 7

Commit crimes but are not caught- have no history of criminal conviction or violence.

Yes- evidence- 1% of the normative population are like this.

Question 8

Continuation from psychopathy misconceptions:

What is two words people confuse a lot?

What is the difference between them?

What can happen?

Answer 8

Psychopath and psychotic.

Psychopaths- rational not delusional- know right from wrong.
Psychotics- Delusional + hallucinations (no reality).

Co morbid in the same individual- could have been a psychopath but is now delusional.

Question 9

Continuation from psychopathy misconceptions:

What is not synonymous?

How much offenders with psychopathy would meet the criteria for the diagnosis of ASPD?

Why?

How much individuals with ASPD meet the criteria for psychopathy?

Why?

Answer 9

Psychopathy and ASPD.

90%.

Score high on facet 3 and 4- kind of have ASPD.
High in psychopathy- have an antisocial aspect to you.

25%.

Meet factor 2 but not 1.
ASPD- should have a diagnosis of CD- since young.

Question 10

Psychopathy subtypes:

What is the first subtype of psychopathy?

How are people with primary psychopathy like?

Answer 10

Primary.

1) Affective deficit is heritable.
2) Low level of anxiety.
3) Engage in instrumental/proactive aggression.

Question 11

Continuation with psychopathy subtypes:

What is the second subtype of psychopathy?

How are people with secondary psychopathy like?

Answer 11

Secondary.

1) Affective deficit- result of- early environmental risk factors like parental abuse.
2) High level of anxiety + emotionally volatile.
3) Reactive + motivated by hate/revenge.

Question 12

Continuation with psychopathy subtypes:

What is the last subtype?

What is the difference between a successful and unsuccessful psychopath?

What do successful psychopaths still have?

What do successful psychopaths also have?

What would that be considered?

Answer 12

Successful vs unsuccessful.

No criminal conviction vs criminal conviction.

Symptomatology.

Good neurobiological functioning- good executive functioning- smart.

Protective factor.

Question 13

Psychopathy as a neurodevelopmental disorder:

What can psychopathy be considered?

What is a core feature of adult psychopathy?

What does this involve?

What else are defining characteristics of psychopathy?

Has the previous been studied in children and adolescences?

Why?

Answer 13

A neurodevelopmental disorder.

Callous unemotional traits.

Lack of guilt, lack of empathy and shallow affect.

Factor 1 + 2- especially interpersonal + affective facets.

Yes.

To see if you can develop this disorder early life- precursor of it in younger people.

Question 14

Continuation from psychopathy as a neurodevelopmental disorder:

What are the two subtypes of youths with conduct problems?

Is the previous a basis of being a neurodevelopmental disorder?

What is factor 1 referred to when we speak about children specifically?

Answer 14

1) CD + high callous unemotional traits.
2) CD + low callous unemotional traits.

Yes.

Callous unemotional traits.

Question 15

Continuation from psychopathy as a neurodevelopmental disorder:

Which type is at risk of developing full blown adult syndrome of psychopathy?

What does it predict later on?

For those with CP and LCU, what is aggressive behaviour like?

Answer 15

Those with conduct problems + high callous unemotional traits.

Delinquency, aggressive and antisocial behaviours + reactive and instrumental aggression.

Reactive.

Question 16

The limited prosocial emotions specifier to conduct disorder in DSM-5:

Why was callous unemotional traits included in the DSM-5?

What has this been named in the DSM?

What must they meet?

Answer 16

Due to research- with children + adolescences- with CD.

Limited prosocial emotions specifier to CD.

Full criteria for conduct disorder.

Question 17

Continuation from the limited prosocial emotions specifier to conduct disorder in DSM-5:

What must they show?

How much must they show?

Who can clinicians ask about these characteristics?

What can this specifier do?

Answer 17

1) Lack of guilt.
2) Lack of empathy.
3) Shallow affect.
4) Unconcerned about performance- e.g. school.

Two or more of those characteristics.

Child, parent or teacher.

Which child with CD is at risk of developing psychopathy later in life.

Question 18

Psychopathy prevelance:

What population is psychopathy high among?

Where else is psychopathy prevalent in?

Coid et al (2009)- screening (survey)- in households- in England, Wales and Scotland find?

Answer 18

Prisoners.

Forensic psychiatric patients.

Psychopathy is rare, affecting less than 1% of the population.

Question 19

Psychopathy and offending:

Comparing those with psychopathy and those without, what have psychopaths been convicted of?

What do psychopaths have?

Is this per year spent in the community?

Answer 19

At least one violent crime.

Higher number of convictions for violent offences.

Yes.

Question 20

Continuation of psychopathy and offending:

How likely are psychopaths to reoffend within a year of release compared to non-psychopaths?

What else are they likely to do within a year of release compared to non-psychopaths?

Answer 20

3x more likely.

4x more likely to violently reoffend.

Question 21

Continuation of psychopathy and offending:

What do offenders with psychopathy have significantly high rates of conviction for?

Who are they more likely to assault in comparison to non-psychopaths?

Answer 21

Robbery + assault + aggressive behaviour in prison.

Male strangers.

Question 22

Continuation of psychopathy and offending:

What is a psychopaths violence more likely to be motivated by compared to non-psychopaths?

Why do people with other types of mental illnesses usually commit violent offences?

What else is psychopathy related to?

How else is the PCL-R used besides it being an assessment?

Answer 22

Revenge.

In the moment- emotionally driven- rather than planned.

Sexual offending.

To predict reoffending once people are discharged (risk assess).

Question 23

Autonomic abnormalities in psychopathy:

What is the assumption?

What has been looked at in those with psychopathy?

Answer 23

Emotions- represent cognitive interpretations- of physiological changes- made in response to arousing stimuli- in environment.

Relation between- emotions + autonomic nervous system + endocrine system functioning.

Question 24

Continuation autonomic abnormalities in psychopathy:

What do those with psychopathy do differently to others?

What do psychopaths display?

Is this a specific characteristic of them?

Answer 24

Process emotions.

Poor emotionality (do not know what they are feeling) + lack of fear (in the anticipation of aversive stimuli).

Yes.

Question 25

Autonomic abnormalities in psychopathy- Heart rate:

What do convicted psychopaths have?

When do psychopaths show lower blood pressure?

What are the cardiovascular abnormalities seen in psychopaths linked to?

Answer 25

Lower resting heart rates.

Before + during emotional stimulation.

Factor 1 + related to a fearlessness and sensation-seeking.

Question 26

Continuation autonomic abnormalities in psychopathy- Heart rate:

What might abnormalities reflect?

What is the two characteristics related to factor 1?

Answer 26

Interaction between- autonomic nervous system + brain circuits- have high levels of visceral functioning.

Poor emotionality + processing of emotions in others.

Question 27

Autonomic abnormalities in psychopathy- Electrodermal activity:

What goes under autonomic control?

What do psychopaths, sociopaths and youth with conduct problems show?

When do psychopaths show this poor electrodermal responsivity?

What does the inability to produce appropriate autonomic response to anticipation of aversive stimuli lead to?

What is electrodermal activity essentially?

Answer 27

Electrodermal activity

Low resting levels of electrodermal activity.

When anticipating punishments + in aversive conditioning tasks.

Leads psychopaths to being unresponsive to threats of punishment.

Skin conductance.

Question 28

Autonomic abnormalities in psychopathy- Startle response:

What do psychopaths have?

What don’t psychopaths do when shown unpleasant images?

What other two groups show this?

How can startle response be measured?

Answer 28

Reduced startled responses- to emotional stimuli.

Don’t show the normal exaggerated blink potentiation- when looking at unpleasant images.

Non-offenders with psychopathic traits + youths with CP and HCU traits.

By placing electrodes around the eye.

Question 29

Endrocrine abnormalities in psychopathy:

What kind of abnormalities do psychopaths have?

Do they have a high or low level of cortisol?

What might this low level do?

Who else is this seen in?

Answer 29

Cortisol abnormalities.

Low.

Make them insensitive to punishment.

Non-offenders with psychopathic traits.

Question 30

Psychopathy - Neuropsychological Evidence:

What leads to aggressive behaviour + poor decision making?

What does this all support?

Answer 30

Brain damage- leading to changes in personality- leads to that.

Malfunctioning in some brain regions is related to behaviours in psychopathy.

Question 31

Psychopathy - neuropsychological evidence:

Where do they have a dysfunction?

State 5 areas adult psychopaths + youths with CP/HCU have impairments in.

Does dysfunction in the vmPFC cause the above processes?

Answer 31

Ventromedial prefrontal cortex (vmPFC).

Decision making, response reversal, extinction, facial emotion recognition and moral judgement.

Yes.

Question 32

Continuation from Psychopathy - neuropsychological evidence:

Having a lesion in the vmPFC, what behaviour does this lead to?

What are psychopathic individuals more likely to display?

Answer 32

Aggression- that is reactive (threat related) + directed towards objects.

Reactive + premeditated aggression- against others.

Question 33

Continuation from Psychopathy - neuropsychological evidence:

What is reactive related to?

What about instrumental aggression?

Answer 33

Inability of the vmPFC- reinforcement- environment.

Impairment- in emotional learning + processing distress cues.

Question 34

Continuation from Psychopathy - neuropsychological evidence:

What is a key area?

What can happen in this area?

As a result of dysfunction in this area, what do those with psychopathy + youths with CP/HCU have issues with?

Answer 34

Amygdala.

A dysfunction.

1) Emotional response - to threatening stimuli.
2) Ability to learn reward from punishment.
3) Processing of emotional facial expressions.