TASK 4 - PSYCHOPATHY: A BRAIN
DISORDER?
WHAT IS PSYCHOPATHY? SYMPTOMS, CAUSES, TREATMENTS (RED)
INSIDE THE MIND OF A PSYCHOPATH (KIEHL & BUCKHOLTZ)
Psychopathy is often overlooked by mental health mainstream (e.g., not included in the
DSM-V)
Often false impression that psychopathy & antisocial personality disorder (ASPD) are
the same
Only 1 in 5 people with ASPD is a psychopath
Symptoms Lack of empathy, guilt, remorse
Often cover up deficiencies with a ready & engaging charm
Don’t show classic signs of mental illness
Seems like they have learning disability that impairs emotional development
Not good at detecting emotions in another person’s voice, facial
expressions
Trouble making appropriate moral value judgements & putting
breaks on their impulses
Attentional problems
Trouble shifting gears, even when current strategy for obtaining their
goal is failing
Don’t take in information when their attention is otherwise engaged
Normal physiological responses to unpleasant stimuli, except when
their attention is directed elsewhere
Causes Their brain processes information differently
Treatment Early intervention could be critical BUT few efforts have been made in that
direction
Psychopathy is often believed to be untreatable
Decompression therapy
Treatment for juvenile offenders with psychopathic tendencies
Intensive one-on-one therapy, requires several hours per day
Aimed at ending the vicious cycle in which punishment for bad behaviour
inspires more bad behaviour, which in turn is punished
Youth were 50% less likely to engage in violent crime after decompression
therapy compared to regular treatment at juvenile correctional
facilities
The longer decompression treatment, the better the outcome
, Might only work for youth with low to moderate psychopathy scores
THE CRIMINAL PSYCHOPATH: HISTORY, NEUROSCIENCE, TREATMENT, AND ECONOMICS (KIEHL &
HOFFMAN)
Psychopathy typically emerges early in childhood & affects all aspects of a sufferer’s life
Just less than 1% of all noninstitutionalised males aged 18 & above are psychopaths
Twice as common as schizophrenia, anorexia, bipolar disorder, paranoia
Symptoms Shallow effect, irresponsibility, impulsivity
Need virtually constant stimulation does not mix well with tedium of
prison
Notoriously parasitic
Anger never far from the surface
Early signs – early behavioural problems & juvenile delinquency
Causes not well understood BUT interactive model accepted by many
Causes are partly genetic (biological) & partly environmental
Hare (1990) – no detectable difference in family backgrounds of
incarcerated psychopaths & non-psychopaths
Treatment Often seen as untreatable
Talking therapies – aimed at patients who know they need help (NOT
psychopaths)
Some treatments make matters worse – group therapy led to higher
violent recidivism in psychopaths (study from 1991)
Sig. progress especially in treatment of juveniles with early indications of
psychopathy
HISTORY OF PSYCHOPATHY
Psychopathy has always been a part of human society – can be seen in e.g., Greek &
Roman mythology
Not a cultural artifact of demands of advancing civilisation
Psychopathy is a worldwide problem
Psychopaths have hidden from psychiatry – even today psychopathy is not included in
DSM-V
Term psychopathy gained clinical traction through 1st third of 1900s
German School of psychopathy expanded the diagnosis to include people who were
depressed, weak-willed, excessively shy & insecure
True psychopath became academically hidden
PSYCHOPATHY & THE DSM
DISORDER?
WHAT IS PSYCHOPATHY? SYMPTOMS, CAUSES, TREATMENTS (RED)
INSIDE THE MIND OF A PSYCHOPATH (KIEHL & BUCKHOLTZ)
Psychopathy is often overlooked by mental health mainstream (e.g., not included in the
DSM-V)
Often false impression that psychopathy & antisocial personality disorder (ASPD) are
the same
Only 1 in 5 people with ASPD is a psychopath
Symptoms Lack of empathy, guilt, remorse
Often cover up deficiencies with a ready & engaging charm
Don’t show classic signs of mental illness
Seems like they have learning disability that impairs emotional development
Not good at detecting emotions in another person’s voice, facial
expressions
Trouble making appropriate moral value judgements & putting
breaks on their impulses
Attentional problems
Trouble shifting gears, even when current strategy for obtaining their
goal is failing
Don’t take in information when their attention is otherwise engaged
Normal physiological responses to unpleasant stimuli, except when
their attention is directed elsewhere
Causes Their brain processes information differently
Treatment Early intervention could be critical BUT few efforts have been made in that
direction
Psychopathy is often believed to be untreatable
Decompression therapy
Treatment for juvenile offenders with psychopathic tendencies
Intensive one-on-one therapy, requires several hours per day
Aimed at ending the vicious cycle in which punishment for bad behaviour
inspires more bad behaviour, which in turn is punished
Youth were 50% less likely to engage in violent crime after decompression
therapy compared to regular treatment at juvenile correctional
facilities
The longer decompression treatment, the better the outcome
, Might only work for youth with low to moderate psychopathy scores
THE CRIMINAL PSYCHOPATH: HISTORY, NEUROSCIENCE, TREATMENT, AND ECONOMICS (KIEHL &
HOFFMAN)
Psychopathy typically emerges early in childhood & affects all aspects of a sufferer’s life
Just less than 1% of all noninstitutionalised males aged 18 & above are psychopaths
Twice as common as schizophrenia, anorexia, bipolar disorder, paranoia
Symptoms Shallow effect, irresponsibility, impulsivity
Need virtually constant stimulation does not mix well with tedium of
prison
Notoriously parasitic
Anger never far from the surface
Early signs – early behavioural problems & juvenile delinquency
Causes not well understood BUT interactive model accepted by many
Causes are partly genetic (biological) & partly environmental
Hare (1990) – no detectable difference in family backgrounds of
incarcerated psychopaths & non-psychopaths
Treatment Often seen as untreatable
Talking therapies – aimed at patients who know they need help (NOT
psychopaths)
Some treatments make matters worse – group therapy led to higher
violent recidivism in psychopaths (study from 1991)
Sig. progress especially in treatment of juveniles with early indications of
psychopathy
HISTORY OF PSYCHOPATHY
Psychopathy has always been a part of human society – can be seen in e.g., Greek &
Roman mythology
Not a cultural artifact of demands of advancing civilisation
Psychopathy is a worldwide problem
Psychopaths have hidden from psychiatry – even today psychopathy is not included in
DSM-V
Term psychopathy gained clinical traction through 1st third of 1900s
German School of psychopathy expanded the diagnosis to include people who were
depressed, weak-willed, excessively shy & insecure
True psychopath became academically hidden
PSYCHOPATHY & THE DSM
