Lecture 2:The antisocial (“psychopathic”) The antisocial (“psychopathic”)

personalitypersonality

The “psychopath” sees himself as the innocent victim of The “psychopath” sees himself as the innocent victim of a cruel and oppressive world – other people are to blame a cruel and oppressive world – other people are to blame for his problems. Others exist for his gratification – they for his problems. Others exist for his gratification – they are either an annoyance to be gotten rid of, or else a are either an annoyance to be gotten rid of, or else a “resource” for his self-gratification…but is he just, in “resource” for his self-gratification…but is he just, in everyday parlance, a bastard?everyday parlance, a bastard?

Elliot Ness

Contrating views on the concept of Contrating views on the concept of “psychopathy”“psychopathy”

Like love, a many-splendoured thing” (Howard, 198?)Like love, a many-splendoured thing” (Howard, 198?) ““The categorical concept of psychopath is…merely a The categorical concept of psychopath is…merely a

convenient fiction…” Blackburn, 1993)convenient fiction…” Blackburn, 1993) ““A label that lacks all scientific and jurisprudential legitimacy. A label that lacks all scientific and jurisprudential legitimacy.

To retain the concept is morally insane; death to it.” To retain the concept is morally insane; death to it.” (Caradino, 1998)(Caradino, 1998)

““the biggest, most serious and most controversial medico-the biggest, most serious and most controversial medico-legal and social problem…They (psychopaths) are the legal and social problem…They (psychopaths) are the sports of the human race…They are devoid of affection, are sports of the human race…They are devoid of affection, are cold, heartless, callous, cynical, and show a lack of cold, heartless, callous, cynical, and show a lack of judgement & forethought which is almost beyond belief…. judgement & forethought which is almost beyond belief…. Conduct abnormality of such a degree & type as to Conduct abnormality of such a degree & type as to constitute the greatest potential danger to the individual constitute the greatest potential danger to the individual & his victim& his victim” (Anonymous psychiatrist, 196?)” (Anonymous psychiatrist, 196?)

SOCIAL DEVIANCE PERSONAL DEVIANCE

PARTRIDGE: SOCIOPATHY PRITCHARD- C19TH

‘MORAL INSANITY’

DSM-III-R SCHNEIDER-A.P.D PSYCHOPATHIC PERSONALITIES

BLACKBURN: PRIMARY VS SECONDARY

ZUCKERMAN:P-Imp-USS McCORD & McCORD

CLECKLEY: MASK OF SANITY

HARE: PC

SOCIAL INTERPERSONAL-DEVIANCE AFFECTIVE

Affective Interpersonal

Pritchard (1837): Moral insanityPritchard (1837): Moral insanity ““Intellectual faculties appear to have sustained Intellectual faculties appear to have sustained

little or no injury, while the disorder is manifest little or no injury, while the disorder is manifest principally or alone, in the state of the feelings, principally or alone, in the state of the feelings, temper or habits…the moral and active temper or habits…the moral and active principles of the mind are strangely perverted principles of the mind are strangely perverted and depraved; the power of self-government is and depraved; the power of self-government is lost or greatly impaired; and the individual is lost or greatly impaired; and the individual is found to be incapable, not of talking or found to be incapable, not of talking or reasoning upon any subject proposed to him…reasoning upon any subject proposed to him…but of conducting himself with decency and but of conducting himself with decency and impropriety in the business of lifeimpropriety in the business of life””

Cleckley: The Mask of Sanity Cleckley: The Mask of Sanity (1955)(1955)

Superficial charm & good intelligence;Superficial charm & good intelligence; Absence of delusions/irrational thinking;Absence of delusions/irrational thinking; Absence of psychoneurosis;Absence of psychoneurosis; Unreliability;Unreliability; Untruthfulness & insincerity;Untruthfulness & insincerity; Lack of remorse or shame;Lack of remorse or shame; Inadequately motivated antisocial behaviour;Inadequately motivated antisocial behaviour; Poor judgement/failure to learn from experience;Poor judgement/failure to learn from experience; Pathological egocentricity & incapacity for love;Pathological egocentricity & incapacity for love; General poverty of affect;………….General poverty of affect;………….

Cleckley’s criteria (cont’d)Cleckley’s criteria (cont’d)

Loss of insight;Loss of insight; Unresponsiveness in general interpersonal Unresponsiveness in general interpersonal

reactions;reactions; Fantastic & uninviting behaviour with drink Fantastic & uninviting behaviour with drink

and sometimes without.and sometimes without. Suicide rarely carried out;Suicide rarely carried out; Sex life impersonal, trivial & poorly integrated;Sex life impersonal, trivial & poorly integrated; Failure to follow any life-plan.Failure to follow any life-plan.

Psychopathy checklist (PCL): 2 Psychopathy checklist (PCL): 2 factorsfactors

1 Interpersonal/Affective: “selfish, callous 1 Interpersonal/Affective: “selfish, callous & remorseless use of others”& remorseless use of others”

2 Chronic ASB: “chronically unstable & 2 Chronic ASB: “chronically unstable & antisocial lifestyle”antisocial lifestyle”

Factor 1: Interpersonal-AffectiveFactor 1: Interpersonal-Affective Glibness and Superficial CharmGlibness and Superficial Charm Egocentricity/grandiose sense of self-worthEgocentricity/grandiose sense of self-worth Pathological lying and deceptionPathological lying and deception Conning/Lack of SincerityConning/Lack of Sincerity Lack of affect and emotional depthLack of affect and emotional depth Callous/Lack of empathyCallous/Lack of empathy Failure to accept responsibility for own actionsFailure to accept responsibility for own actions Drug or alcohol not direct cause of antisocial behaviourDrug or alcohol not direct cause of antisocial behaviour

Factor 2: Social devianceFactor 2: Social deviance Proneness to boredom/Low Frustration toleranceProneness to boredom/Low Frustration tolerance Parasitic Life-styleParasitic Life-style Short-tempered/Poor Behaviour ControlsShort-tempered/Poor Behaviour Controls Early behaviour problemsEarly behaviour problems Lack of realistic long-term plansLack of realistic long-term plans ImpulsivityImpulsivity Irresponsible behaviour as a parentIrresponsible behaviour as a parent Frequent marital relationshipsFrequent marital relationships Juvenile DelinquencyJuvenile Delinquency Poor probation or parole riskPoor probation or parole risk Many types of offenseMany types of offense

But: 3 factor model seems to fit But: 3 factor model seems to fit the data best….the data best….

Factor 1Factor 1: : InterpersonalInterpersonal: superficial, : superficial, grandiose;grandiose;

Factor 2Factor 2: : AffectiveAffective: lack of remorse, : lack of remorse, empathy; failure to accept responsibility for empathy; failure to accept responsibility for actions.actions.

Factor 3Factor 3: : BehaviouralBehavioural: Impulsive/poor : Impulsive/poor behavioural controls.behavioural controls.

PSYCHOPATHY

Conceptual issues/assessment

Psychosocial Correlates

Biological correlatesCross-cultural aspects

RecidivismSuccessful vs. unsuccessful

Treatment & Rehabilitation

Relationship to DSM-III Pers. Dis.

Developmental antecedents

1) Prevalence of psychopathy across 1) Prevalence of psychopathy across cultures?cultures?

2) Appropriate PCL cut-off for 2) Appropriate PCL cut-off for ‘diagnosing’ psychopathy: does it vary ‘diagnosing’ psychopathy: does it vary across cultures?across cultures?

3) Is the expression of psychopathy 3) Is the expression of psychopathy dependent on cultural context, or does its dependent on cultural context, or does its aetiology vary across cultures?aetiology vary across cultures?

Prevalence of psychopathy across Prevalence of psychopathy across cultures…cultures…

Does vary: prevalence lower in European Does vary: prevalence lower in European countries (15% of prison inmates in countries (15% of prison inmates in Scotland) than in N. American prison Scotland) than in N. American prison samples (25%), BUT..samples (25%), BUT..

While interpers. and social deviance While interpers. and social deviance factors vary cross-culturally, the affective factors vary cross-culturally, the affective factor factor doesn’tdoesn’t: this is “the pan-cultural core : this is “the pan-cultural core of psychopathy”, whose aetiology of psychopathy”, whose aetiology presumably is cross-cuturally invariantpresumably is cross-cuturally invariant

Are there neurobiological substrates Are there neurobiological substrates of personality disorders, e.g. of personality disorders, e.g.

psychopathy?psychopathy? It probably doesn’t make sense to look for a It probably doesn’t make sense to look for a

specific brain correlate of e.g. psychopathy;specific brain correlate of e.g. psychopathy; It makes more sense to look for It makes more sense to look for specificspecific

neurocognitive processing deficits, e.g. in neurocognitive processing deficits, e.g. in processing of affective material (in the case processing of affective material (in the case of psychopaths) or deficits in affective self-of psychopaths) or deficits in affective self-control, e.g. a lack of ability to delay control, e.g. a lack of ability to delay gratification.gratification.

Psychopathy: Issues arisingPsychopathy: Issues arising What about “successful (non-criminal) psychopaths”?What about “successful (non-criminal) psychopaths”? Medico-legal issues:Medico-legal issues: Are they “mad”, “bad” or what?Are they “mad”, “bad” or what? How to deal with them?How to deal with them? UK Gov’t programme: “Dangerous & Severe Pers. Dis” UK Gov’t programme: “Dangerous & Severe Pers. Dis”

(DSPD): See Issues in Forensic Psychology #4, B.P.S., 2003 (DSPD): See Issues in Forensic Psychology #4, B.P.S., 2003 and and http://www.http://www.dspdprogrammedspdprogramme..govgov..ukuk

Are psychopaths treatable? The majority of the literature on Are psychopaths treatable? The majority of the literature on therapeutic outcome with psycho’s is pessimistic, but see therapeutic outcome with psycho’s is pessimistic, but see “Development of a Programme for Violent Psychopathic “Development of a Programme for Violent Psychopathic Offenders” (available from above website). Uses CBT and Offenders” (available from above website). Uses CBT and skills training to target the dynamic risk factors associated skills training to target the dynamic risk factors associated with an individual’s violent behaviourwith an individual’s violent behaviour

Criteria for DSPD: Any of the Criteria for DSPD: Any of the following must apply:following must apply:

Very High Psychopathy (PCL >/= 30)Very High Psychopathy (PCL >/= 30) High Psychopathy (PCL 25-29) + at least 1 High Psychopathy (PCL 25-29) + at least 1

DSM PD other than ASPDDSM PD other than ASPD Two or more DSM pers. dis. DiagnosesTwo or more DSM pers. dis. Diagnoses Individual must present with:Individual must present with: High risk (>50% chance of (re)offendingHigh risk (>50% chance of (re)offending Severe personality disorder (as above)Severe personality disorder (as above) Risk is linked to the personality disorderRisk is linked to the personality disorder

Are psychopaths treatable?Are psychopaths treatable?

The majority of the literature on The majority of the literature on therapeutic outcome with psycho’s is therapeutic outcome with psycho’s is pessimistic, but see “pessimistic, but see “Development of a Development of a Programme for Violent Psychopathic Programme for Violent Psychopathic OffendersOffenders” (available from website: ” (available from website: http://www.http://www.dspdprogrammedspdprogramme..govgov..ukuk))

Uses CBT and skills training to target the Uses CBT and skills training to target the dynamic risk factors associated with an dynamic risk factors associated with an individual’s violent behaviourindividual’s violent behaviour

Are “psychopaths” not Are “psychopaths” not just complete and utter just complete and utter

bastards?bastards?““A label that lacks all scientific and A label that lacks all scientific and

jurisprudential legitimacy. To retain the jurisprudential legitimacy. To retain the concept is morally insane; death to it.” concept is morally insane; death to it.”

(Caradino, 1998)(Caradino, 1998)

So does the term So does the term “psychopathy” and the “psychopathy” and the

tests used to measure it tests used to measure it (e.g. PCL)…..(e.g. PCL)…..

…………represent the medicalisation of represent the medicalisation of bastardry?bastardry?

But on the other hand, But on the other hand, psychopathy has been psychopathy has been

called……called……““the biggest, most serious and most controversial the biggest, most serious and most controversial

medico-legal and social problem…They (psychopaths) medico-legal and social problem…They (psychopaths) are the sports of the human race…They are devoid of are the sports of the human race…They are devoid of

affection, are cold, heartless, callous, cynical, and show affection, are cold, heartless, callous, cynical, and show a lack of judgement & forethought which is almost a lack of judgement & forethought which is almost beyond belief…. beyond belief…. Conduct abnormality of such a Conduct abnormality of such a

degree & type as to constitute the greatest potential degree & type as to constitute the greatest potential danger to the individual & his victimdanger to the individual & his victim” (Anonymous ” (Anonymous

psychiatrist, 196?)psychiatrist, 196?)

Case of Mr WK: see Hand-outCase of Mr WK: see Hand-outIs he likely to re-offend?Is he likely to re-offend?

31-year-old male31-year-old male Section 121(2)(b)(ii) CJASection 121(2)(b)(ii) CJA Charged with: RapeCharged with: Rape Attempted rapeAttempted rape Indecent assaultIndecent assault

W.K.: FAMILY HISTORY:W.K.: FAMILY HISTORY:

Parents separated when W was 2 monthsParents separated when W was 2 months 7 siblings7 siblings Disorganised chaotic childhoodDisorganised chaotic childhood Foster care at age 6 years and then again age Foster care at age 6 years and then again age

14 yrs.14 yrs. Fighting, theft, truanting from an early ageFighting, theft, truanting from an early age Left school at 15 yrs with no qualificationsLeft school at 15 yrs with no qualifications Minimal contact with family over the last 10 Minimal contact with family over the last 10

yearsyears