Pathological Antisocial Personality Disorder and Psychopathy
PSYCHOPATHY WHAT YOU THOUGHT ABOUT HUMANS WAS NOT TRUE..
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Transcript of PSYCHOPATHY WHAT YOU THOUGHT ABOUT HUMANS WAS NOT TRUE..
PSYC
HOPATH
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WH
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CONCEPTUALIZING PSYCHOPATHY
Insanity without delirium (Philippe Pinel) Behaviour w/o remorselessness
The Mask of Sanity (Hervey Cleckley) An intelligent person Poverty of emotions No sense of shame, superficially charming,
manipulative, irresponsible behaviour Without Conscience (Robert Hare)
Intra-species predators Charming, manipulative, violent
Modern Definition Psychopathy is a personality disorder A constellation of symptoms
DEFINING PSYCHOPATHY
Psychopaths
(10-25%)
APD(65-80%)
All Offende
rs
(100%)
Hart (2000)
DEFINING PSYCHOPATHY
Antisocial Personality or Psychopathy
Most (not all) psychopaths are antisocial personalities BUT
Not all antisocial personalities are psychopaths
MEASURING PSYCHOPATHY
Factor 1:Interpersonal/
Affective Features
Factor 2:Socially Deviant Lifestyle
•Impulsive & irresponsible•Delinquent & antisocial
•Narcissistic & dominant•Low empathy & anxiety S.D.Hart (2000)
DEFINING PSYCHOPATHY
Psychopathy
Interpersonal* Arrogant* Deceitful
Lifestyle* Boredom* Parasitic
*Irresponsible
Antisocial* Early Beh Prob
•Juvenile Delinquency• Criminal Versatility
Affective* Lacks Emotion* Lacks Empathy
Factor 1 Factor 2
DEFINITIONS
Difficulties processing, understanding and using emotional material
Deficit in processing emotional information
Their linguistic processes seem relatively superficial and the subtle more abstract meanings and nuances of language seem to escape them (Cleckly, 1976, Hare 2003)
He knows the words but not the music (Hare, 2003)
MOVIE CLIP
http://topdocumentaryfilms.com/i-psychopath/
THE PSYCHOPATH
Fail to understand the affective meaning of words (emotional words) but understand the dictionary meaning of words
They take longer to process emotional words rather than neutral words (like a second language)
They have more difficulty recognizing fearful content in spoken language
Psychopaths were more likely to attribute happiness to an individual who had committed intentional harm (when evaluating emotional stories and trying to determine how someone would feel)
Psychopaths rely on listeners to pay attention to how things are said more than what was said
PERSONALITY DISORDER VS DISTINCT PATHOLOGY
Biological studies consistently show differing reactions in brain scans
Psychopathy may be associated with anomalies in various structures and circuits in the brain
BIOLOGY OF PSYCHOPATHS
Genetic Factors
• Temperament
Brain Structures
• Dysfunction of the paralimbic system--a system that includes parts of the temporal and frontal lobes (2006, Kiehl)
• Defects in frontal lobe processing
• Amygdala dysfunction (abnormal structure, 2011, Boccardi)
• Differences in temporal gyrus (differences in perceptions of emotions in facial stimuli)
• Associated with abnormalities of processing conceptually abstract material.
BIOLOGY OF PSYCHOPATHS
Peripheral Nervous System Research
• Low skin conductance (attenuated cues of impending pain or punishment – “I just put it out of my mind”, less reaction to distressing images)
Autonomic Nervous System Research
• Autonomically and cortically underaroused
• Deficient in avoidance learning (show little fear in anticipation of an unpleasant or painful stimuli)
Integration of activities between the two hemispheres may be deficient
CRITERIA FOR PSYCHOPATHY ACCORDING TO HARE (2003)Hare PCL-R most widely used
measure for Psychopathy
Gold standard for assessment
Important element in trials involving serious offenses
Conducted by well trained professionals
Based on file review or clinical interview (with collateral sources)
DEFINITION ACCORDING TO HARE (PCL-R)
FACTOR 1: Interpersonal/
EmotionalGlibness/Superficial
CharmGrandiosePathological LyingConning/ManipulativeLack of Remorse or
GuiltCallous/Lack of
EmpathyShallow AffectFailure to Accept
Responsibility for Own Actions
FACTOR 2: Socially Deviant Lifestyle
Need for StimulationParasitic LifestylePoor Behavioural ControlsEarly Behavioural ProblemsLack of Realistic, Long-term GoalsImpulsivityIrresponsibilityJuvenile DelinquencyRevocation of Conditional ReleaseAlso…Criminal Versatility; Many
Short Term Marital Relationships, Promiscuous Sexual Behavior
PSYCHOPATHY IN CHILDREN?
Concerns• Labeling at young age• More likely to be transferred to adult court
system• Self-fulfilling prophecy with providers
Importance of early identification• Treatment• Avoid societal and individual repercussions
THE WHITE COLLAR PSYCHOPATH
CEO’s, corporate presidents, Stock market, Fraudsters …
4% of corporate professionals had a PCL R score of 30 + (N = 203; Babiak, 2010)
If you were a psychopath who wanted to avoid jail where would you go?
OFFENDING PATTERNS
#1 Type of Criminality
Psychopaths are more likely to commit violent offences
Psychopaths were five times more likely to commit a violent offence (Serin & Amos, 1995).
Psychopathic offender, compared to non-psychopathic offender, more likely to kill males who are strangers.
The violence of psychopaths has atypical motivations
Instrumental Violence, Sadistic Impulsive, Opportunism
OFFENDING PATTERNS
#2 Stability of Criminality About ½ of criminal psychopaths show
a reduction in non-violent crime by age 35 or 40 years Harpur and Hare (1994)
Offenders who ranged in age from 16 to 70 years assessed on the PCL-R
Scores on Factor 2 of the PCL-R decreased with age.
Scores on Factor 1 of the PCL-R were stable
Age-related changes in behaviour are not related with changes in the affective/interpersonal traits.
OFFENDING PATTERNS
#3 Frequency of Criminality Psychopaths are high-density
offenders. They commit more crimes, have higher rates of recidivism, and re-offender faster than other offenders.
Hart, Kropp, and Hare (1988): Administered PCL-R to 231 inmates High PCL-R – 90% re-offended Mid PCL-R – 60% re-offended Low PCL-R – 30% re-offended
RISK
Psychopathy is the biggest predictor of violent reoffending
High PCL-R offenders are 2.5 Times more likely to get parole (Porter, 2009)
SEXUAL DEVIANCE + PSYCHOPATHY = HUGE PROBLEM!
Hart et al. (1988) offenders on conditional release – any reoffenseSurvival Curves
Low
High
Middle
Quinsey et al. (1993) Survival Curves for male rapists and child molesters
Psychopaths
Non Psychopaths
WORKING WITH THE PSYCHOPATH
DOES TREATMENT WORK?WHAT TO EXPECT?HOW TO REACT?IN PEOPLE WITH A LONG
HISTORY OF CRIMINAL BEHAVIORS, RULE OUT PSYCHOPATHY FIRST
TREATMENT AND PSYCHOPATHYGroup therapy and insight-oriented therapy make
psychopathy worse Learning about empathy can help them to develop better ways of
manipulating, deceiving and using people Doesn’t help them understand themselves.
Other treatment possibilities? Don’t focus on characteristics that can’t be changed (e.g. not emotional
reactions, empathy). Focus on their motivations (not altruism, but short-term self-interest,
excitement, sense of power) (Thronton & Blud, 2007) Focusing on how behaving prosocially can get them what they want; focus
on their strengths (Hare, 2003) Give them those reinforcements for good behaviors… (make sure that it is
a true reinforcement for THEM – not what you would assume would be a reinforcement!)
SELF CARE WHEN WORKING WITH PSYCHOPATHSRecall last clip of movie…
Very difficult to not attend to information provided to you by psychopaths
Recall their need for manipulation
Have a set plan before you enter the room
Relaxation, strong inner self-concept, let some things go
Identify your vulnerabilities before hand
One psychopath a day is lots to deal with …
WANT MORE INFORMATION?
www.hare.orgfor research papers on many
facets of Psychopathy