Week 21 Lecture Psychopathology III Flashcards
Psychopaths
(People with psychopathy)
Ted Bundy
Bernie Madoff
James Fallon
ALL behave very differently
Psychopathy
What is it?
What is it not?
What it is
*Used in criminal justice & forensic settings
Personality Disorder
* Antisocial behaviour (violates social norms)
- lack of empathy
- remorseless
- deceitful
- selfish
- manipulative
- violent
- Perceived as a “severe” presentation of Antisocial Personality Disorder by some, but not all
What it isn’t
- A clinical diagnosis: not in the DSM OR ICD-10
- Not in DSM since 1980, replaced with ASPD
Psychopathy Stats
Prevalence
- Community samples:
- 1.2% of men
- 0.3-0.7% of women
- Rare, but as common as bulimia, 2x more common than bipolar disorder
More common in institutionalized samples:
* ~11% of forensic psychiatric population
* ~ 25% of correctional population
Sociopathy
- Also not a diagnostic category
- Depends on who you ask: some distinctions are based on etiology: biological (psychopathy) vs. developmental (sociopathy)
E.g. Robert Hare:
* Sociopathy: non-normative moral system
* Psychopathy: lack empathy
* Some claim they are interchangeable
Antisocial Personality disorder
Replaced Psychopathy in DSM III
Socially irresponsible behaviour that violate
others’ rights:
- Breaking laws
- Lying
- Impulsivity
- Physical aggression
- Disregard for the safety of others
- Lack of remorse
High overlap, but only about ~1/3 of those with ASPD would meet the criteria for Psychopathy
Psychopaths (anti-social personality disorder) in crime
- Commit different crimes
- Mostly instrumental - violence and aggression used in service of an another act (not emotional, no personal vandetta)
- Homicides: 93% vs. 48% among non-psychopathic offenders
- More likely to involve weapons & violence
- More unrelated & stranger victims
- More self-reported sadistic sexual violence
- 3x ↑ recidivism (likely to reoffend a crime)
- BUT 2.5x more likely to get conditional release
People with psychopathy engage in more
- More substance abuse
- Smoke more cigarettes
- Employment instability
- Homelessness
- Risky sex
- Divorce
- Poor parental quality
- Poorer physical health
- Die at a younger age, from more violent causes
Assessing Psychopathy
Checklist-Revised (PCL-R; Hare, 2003)
Factor ONE
Factor TWO
Administered by trained professional in interview & in reference to records (e.g. criminal records)
- Typically used among criminal offenders
- Cutoff: 30/40
- Most people score <5
- Scores on 2 factors
FACTOR ONE: Interpersonal-affective
Facet 1: Interpersonal
- Superficial charm
- Grandiose self-worth
- Pathological lying
- Manipulative
Facet 2: Affective
- Lack of remorse
- Emotionally shallow
- Lack of empathy
- Failure to take responsibility for actions
FACTOR TWO: Antisocial Deviance
Facet 3: Lifestyle
- Prone to boredom
- Parasitic lifestyle
- Lack of realistic long-term goals
- Impulsive
- Irresponsible
Facet 4: Antisociality
- Poor behaviour control
- Early behaviour problems
- Juvenile Delinquency
- Revocation of conditional release
- Criminal Versatility
Assessing Psychopathy
Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996)
Used among non-criminal samples
- Thought to capture more “adaptive” expression
8 subscales
154 items
SUBSCALES - Fearless dominance
- Social potency
- Stress immunity
- Fearlessness
SUBSCALES - Self-centered impulsivity
- Carefree non-planfullness
- Impulsive nonconformity
- Machiavellian egocentricity (lack of empathy, feeling of connection to others)
- Blame externalization
Psychopathy Triarchic Model
- Disinhibition
* Difficulty regulating emotion & weak behavioural constraint
e.g., “I jump into things without thinking” - Boldness
* Dominance, emotional resiliency, adventurous/risk taking
e.g., “I am a born leader” - Meanness
* Cruel, predatory, destructive
e.g., “I don’t mind if someone I dislike gets hurt”
Causal Factors - Emotionally-focused Theories
Psychopathy is the Impairment in emotional system
- Reduced eye blink startle response
Not scared or startled during test, they don’t fear consequences - Impaired recognition of emotional facial expressions
- Reduced amygdala activity in response to fearful faces
- Deficits in fear-based conditioning
- Reduced connectivity between vmPFC & amygdala
Causal Factors - Cognitive-attentional Theories
Psychopathy is the ignorance of emotional system
Emotions only processed for their goals
- States that individuals with psychopathy pay less attention to emotional information, unless it is central to their goal-directed behaviour
E.g. Baskin-Sommers et al., 2011 - Startle responses in individuals with psychopathic traits
- Are inhibited when threat-related information (e.g. cue to a shock) was unimportant to the main task (IDing the case of letters)
- Are not different from controls when threat-related information was central to the task (IDing colour of cue associated with shock)
Potential Causes
Genetics in Psychopathy
- Moderately-to-highly heritable
~50% of the variance in psychopathy commonly endorsed
Not one gene, but many candidates
- Tuvblad et al. (2014) Twin Study: up to 70% of the variance explained by genetic factors
- Beaver et al., (2004) Adoption Study:
criminal father = 8.5x more likely in male adoptees
* No effect for daughters/mothers
Potential Causes
Environmental Correlates in Psychopathy
- Having a convicted parent
- Physical neglect
- Low paternal involvement
- Maternal depression
- Low parental warmth
- Abuse
- Harsh discipline
BUT, potential role of gene-environment correlation
Potential Causes
Brain Injuries in Psychopathy
“Acquired Sociopathy” or “Pseudopsychopathy”
- Traumatic injury to prefrontal cortex, amygdala
- Earlier age of trauma may result in worse outcomes
*Brain injury will cause different levels of psychopatholigic traits
E.g. Olsen & Vaugh (2023): TBI predicts callous-unemotional & impulsive irresponsible traits among juvenile offenders
