Psychopathy

Man working at his table in front of large window, rear viewPsychopathy is characterized by symptoms that affect mood, behavior, and interpersonal relationships. Specifically, those with psychopathy typically demonstrate impulsive behavior, a narcissistic or self-centered perspective, chronic violations of legal or social rules, and a lack of empathy and guilt.

Understanding Psychopathy

Psychopathy is a somewhat disputed condition. It can be considered a mental health condition, but it is not in fact listed as such in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 instead lists the diagnosis of antisocial personality disorder, and it is this condition that is often referred to as psychopathy or sociopathy.

The primary characteristic of antisocial personality disorder is a pervasive pattern of disregard for the rights of others. This may be expressed as failure to conform with laws, deceitfulness, impulsivity, aggression, reckless disregard for safety, chronic irresponsibility or failure to honor obligations, or lack of remorse about hurting others. In order to be diagnosed with antisocial personality disorder, an individual must be at least 18 years old and must have demonstrated symptoms by the time they were 15 years old.

While the term psychopath is often used in the media to describe people who commit violent crimes without remorse, in reality, those with psychopathy are not necessarily violent. Psychopathy indicates a lack of remorse about  the act of manipulating or taking advantage of others in order to benefit in some way. While some people with psychopathy do commit violent crimes, others may simply use their superficial charm and ability to manipulate to get ahead. In fact, research shows that psychopathic personality traits are disproportionately represented among CEOs.

The Difference Between Psychopathy and Sociopathy

Although the terms psychopathy and sociopathy both denote a lack of empathy and are often used interchangeably, there are some important distinctions between the two concepts. First, individuals with sociopathy have a conscience (though a weak one), while individuals with psychopathy lack one. In other words, a person who is sociopathic might know they are doing something wrong, and may experience some remorse, but will generally do what they want anyway. An individual with psychopathy, on the other hand, will feel no sense of guilt or wrongdoing.

People who have sociopathy tend to act more impulsively, and they may be perceived by others as reckless or ill-tempered. Individuals with psychopathy are often perceived as charming, intelligent, and likable, as they typically have an ability to mimic emotions they do not necessarily feel in order to blend in with others and build trust.

Types of Psychopathy

Canadian researcher Robert D. Hare developed the Psychopathy Checklist Revised or PCL-R, a scale that measures psychopathy. This scale measures a general state of psychopathy, and researchers have further distinguished two distinct subtypes. The first, psychopathy with emotional detachment, is characterized by interpersonal and mood symptoms such as lack of remorse or a self-centered outlook. The second subtype is characterized by the prevalence of psychopathic behaviors, such as impulsivity and antisocial conduct, that violate legal, social, or moral norms.

Though some people may believe psychopathy to be something a person either has or does not have, this condition is more accurately viewed when considered as a spectrum. It is possible to have only some psychopathic traits, and some individuals may experience minor tendencies toward psychopathy while others may have more moderate to severe characteristics.

Psychopathy and Gender

Males are far more likely to be diagnosed with antisocial personality disorder or psychopathic traits. However, more research is necessary to determine if psychopathic traits appear more frequently in male individuals or if men are simply more likely to actually be diagnosed with antisocial personality. As existing research has traditionally focused on males with psychopathy, the condition is much less understood in individuals of other genders. It is possible that characteristics of psychopathy may be expressed in different ways across genders, which may perhaps lead it to be mistaken for other mental health conditions or personality disorders in diagnosis.

What Causes Psychopathy?

The amygdala, the part of the brain responsible for emotions, is believed to play a role in psychopathy. One study found people with antisocial personality disorder all possessed some manner of deformation in the amygdala. The physical reactions displayed by individuals who have psychopathic traits or antisocial personality are thought to result from these brain differences.

For example, most people experience an increase in heart rate and respiration, and sometimes perspiration, when they see violence in a movie or on television. Those who have psychopathic characteristics, on the other hand, do not experience the physical response of fear typical of most people, and they may actually become calmer when exposed to violence. This calm reaction may lead to fearless and reckless behavior.

Can Psychopathy Be Treated?

Professionals in the field often disagree on whether psychopathy is a condition that can be treated. Many believe no therapy or medication can fundamentally change the brains of those with psychopathy, but others believe there are techniques that can be effective in reducing antisocial behaviors, especially when an individual recognizes these behaviors and chooses to seek help.

One such technique is the Decompression Model, developed by staff at the Mendota Juvenile Treatment Center in Wisconsin. This treatment technique emphasizes the ways in which positive reinforcement can be used to shape behavior. Because individuals who have psychopathic traits do not typically respond to or learn from punishment, this technique involves providing a reward for every positive, pro-social behavior an individual demonstrates. Research has shown this type of treatment may reduce both recidivism and the likelihood of a person committing a violent crime in the first place.

According to the DSM-5, the symptoms of antisocial personality tend to remit over the course of life, especially during and beyond the fourth decade of life. However, the DSM-5 notes this remission typically only involves a decrease in antisocial behaviors, not a full reduction of all symptoms.

References:

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM 5 (5th ed.). Arlington, VA: American Psychiatric Publishing, Inc.
  2. Pomeroy, R. (2014, July 11). Can psychopaths be cured? Retrieved from http://www.realclearscience.com/blog/2014/07/can_psychopaths_be_cured.html
  3. Psychopathy: What is psychopathy? (n.d.). Retrieved from http://law.jrank.org/pages/1884/Psychopathy-What-psychopathy.html
  4. Robinson, K. M. (2014, August 24). Sociopath vs. psychopath: What’s the difference? Retrieved from http://www.webmd.com/mental-health/features/sociopath-psychopath-difference#1
  5. Venosa, A. (2015, November 11). Psychopath definition may be different than you thought: 7 facts about psychopaths. Retrieved from http://www.medicaldaily.com/psychopath-definition-may-be-different-you-thought-7-facts-about-psychopaths-361112

Last Updated: 03-17-2017

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