Psychopathy, or psychopathic personality, is a personality construct characterized by impaired empathy and remorse, and persistent antisocial behavior, along with bold, disinhibited, and egocentric traits. These traits are often masked by superficial charm and immunity to stress, which create an outward appearance of normality. Hervey M. Cleckley, an American psychiatrist, influenced the initial diagnostic criteria for antisocial personality reaction/disturbance in the Diagnostic and Statistical Manual of Mental Disorders (DSM), as did American psychologist George E. Partridge. The DSM and International Classification of Diseases (ICD) subsequently introduced the diagnoses of antisocial personality disorder (ASPD) and dissocial personality disorder (DPD), respectively, stating that these diagnoses have been referred to (or include what is referred to) as psychopathy or sociopathy. The creation of ASPD and DPD was driven by the fact that many of the classic traits of psychopathy were impossible to measure objectively. Canadian psychologist Robert D. Hare later re-popularized the construct of psychopathy in criminology with his Psychopathy Checklist. Although no psychiatric or psychological organization has sanctioned a diagnosis titled "psychopathy", assessments of psychopathic characteristics are widely used in criminal justice settings in some nations and may have important consequences for individuals. The study of psychopathy is an active field of research. The term is also used by the general public, popular press, and in fictional portrayals of psychopaths. While the abbreviated term "psycho" is often employed in common usage in general media along with "crazy", "insane", and "mentally ill", there is a categorical difference between psychosis and psychopathy.
Definition
Concepts
There are multiple conceptualizations of psychopathy, including Cleckleyan psychopathy (Hervey Cleckley's conception entailing bold, disinhibited behavior, and "feckless disregard") and criminal psychopathy (a meaner, more aggressive and disinhibited conception explicitly entailing persistent and sometimes serious criminal behavior). The latter conceptualization is typically used as the modern clinical concept and assessed by the Psychopathy Checklist. The label "psychopath" may have implications and stigma related to decisions about punishment severity for criminal acts, medical treatment, civil commitments, etc. Efforts have therefore been made to clarify the meaning of the term. It has been suggested that those who share the same emotional deficiencies and psychopathic features, but are properly socialized, should not be designated as 'psychopaths'. The triarchic model suggests that different conceptions of psychopathy emphasize three observable characteristics to various degrees. Analyses have been made with respect to the applicability of measurement tools such as the Psychopathy Checklist (PCL, PCL-R) and Psychopathic Personality Inventory (PPI) to this model.
Boldness. Low fear including stress-tolerance, toleration of unfamiliarity and danger, and high self-confidence and social assertiveness. The PCL-R measures this relatively poorly and mainly through Facet 1 of Factor 1. Similar to PPI fearless dominance. May correspond to differences in the amygdala and other neurological systems associated with fear. Disinhibition. Poor impulse control including problems with planning and foresight, lacking affect and urge control, demand for immediate gratification, and poor behavioral restraints. Similar to PCL-R Factor 2 and PPI impulsive antisociality. May correspond to impairments in frontal lobe systems that are involved in such control. Meanness. Lacking empathy and close attachments with others, disdain of close attachments, use of cruelty to gain empowerment, exploitative tendencies, defiance of authority, and destructive excitement seeking. The PCL-R in general is related to this but in particular some elements in Factor 1. Similar to PPI, but also includes elements of subscales in impulsive antisociality. Psychopathy has been conceptualized as a hybrid condition marked by a paradoxical combination of superficial charm, poise, emotional resilience, and venturesomeness on the outside but deep-seated affective disturbances and impulse control deficits on the inside. From this perspective, psychopathy is at least in part characterized by psychologically adaptive traits. Furthermore, according to this view, psychopathy may be linked to at least some interpersonally successful outcomes, such as effective leadership, business accomplishments, and heroism.
Measurement An early and influential analysis from Harris and colleagues indicated that a discrete category, or taxon, may underlie PCL-R psychopathy, allowing it to be measured and analyzed. However, this was only found for the behavioral Factor 2 items they identified, child problem behaviors; adult criminal behavior did not support the existence of a taxon. Marcus, John, and Edens more recently performed a series of statistical analyses on PPI scores and concluded that psychopathy may best be conceptualized as having a "dimensional latent structure" like depression. Marcus et al. repeated the study on a larger sample of prisoners, using the PCL-R and seeking to rule out other experimental or statistical issues that may have produced the previously different findings. They again found that the psychopathy measurements do not appear to be identifying a discrete type (a taxon). They suggest that while for legal or other practical purposes an arbitrary cut-off point on trait scores might be used, there is actually no clear scientific evidence for an objective point of difference by which to label some people "psychopaths"; in other words, a "psychopath" may be more accurately described as someone who is "relatively psychopathic". The PCL-R was developed for research, not clinical forensic diagnosis, and even for research purposes to improve understanding of the underlying issues, it is necessary to examine dimensions of personality in general rather than only a constellation of traits. The PCL-R test has been used to determine "true" or primary psychopaths (individuals that score a 30 or higher on the PCL-R test). Primary psychopaths are distinguished from secondary psychopaths, and contrast with those who are legitimately considered antisocial.
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