Psychopathy: What is psychopathic disorder

“In addition to the inability to love, it psychopath He always demonstrates a general emotional poverty.
Although it happens that sometimes it agitates, you have access to anger, you get excited, burst into tears or opens in deep speeches seasoned with pained words on its misfortunes and follies, to observe it carefully, you realize that what we are witnessing is more a promptness of expression than a feeling force“.

(Hervey Cleckley, The Mask of Sanity)

Psychopathy: Symptoms and characteristics

The Psychopathic disorder (psychopathy) It is characterized by a durable patterns of anti -social behaviors that begin in childhood. It is the first personality disorder historically recognized in psychiatry and boasts a long clinical tradition. It is characterized by a series of interpersonal, emotional and behavioral factors listed below:

1. Loquacial/superficial charm: The psychopath is often a fun and pleasant converser, capable of telling unlikely but convincing stories, which put it in good light in the eyes of others;
2. Grandiose sense of the self: psychopathy is characterized by a high opinion of its value and characteristics;
3. Need of stimuli/propensity to boredom: The psychopath is rapidly bored and tends to seek behavioral or emotional re-activation by taking on risk behaviors;
4. Pathological lie: usually has a remarkable promptness and ability to lie;
5. Manipulativeness: can make use of the fraud to defraud, deceive or manipulate others, in order to achieve a personal purpose perceived as advantageous;
6. Absence of remorse/guilt: psychopathy may occur absence of concern for the negative consequences of one’s actions;
7. Superficial affectivity: emotions are often theatrical, superficial and short -lived;
8. Behavioral control deficit: the psychopath can be angry or irritable, as well as responding to frustration with verbally aggressive behavior or violent conduct;
9. Impulsiveness: In psychopathy the lack of reflection, planning and premeditation may be present.

Neurobiological characteristics of psychopathy

The neurobiological models of the psychopathy They focused on the peculiar functioning of the limbic and paralimbic structures, in particular amygdala and ventromedial prefrontal cortex, trying to shed light on the association between dysfunctions against these areas and lack/lack of empathy and behavior regulation.

There are mainly two theses that have attempted to explain why the people with psychopathy They do not normally prove empathy and sense of guilt: (a) the hypothesis of the empathic deficit (Blair 1995) and (b) that of the lack fearfulness (propensity for fear) (Hare 1970; Kochanska 1997; Lykken 1995; Patrick 1994).

According to the hypothesis of the “empathic deficit” there would be an anomaly in the functioning of the amygdala which would make it difficult/absent the recognition of the emotions of others such as anxiety and sadness. The second thesis claims that at the base of the disorder there is an alteration of the amygdala that would manifest itself in the scarce fearfulness (low reactivity to harmful or threatening stimuli). It would imply insufficient sensitivity to punishments and, consequently, a limited relevance attributed to moral rules.

Emotional characteristics of psychopathy

The psychopaths They show difficulties in processing emotional information and empathically respond to others. This deficit could be the basis of the success that these individuals often have in manipulating and deceiving other people, being convincing.

The absence of emotional reciprocity and empathy, or the reduction in intensity with which emotions are experienced and represented, could explain the peculiar persuasion capacity that connotes these individuals: lacking in empathy, in fact, the psychopathic people They would be more able to represent their victim as “an object to use”, managing not to feel remorse or guilt for the consequences of their actions.

Cognitive characteristics of psychopathy

The basic schemes of themselves, of others and the world of psychopaths They seem to be characterized by rigidity and inflexibility: the psychopath sees himself as strong and autonomous, while others as weak and passable of exploitation (prey). It is typically present a bias for which the malicious intentions of others are overeximate. The psychopath will therefore tend to pay attention, minimizing the risk of victimization and becoming an aggressor himself.

The scientific literature explored the skills of moral judgment in psychopathy, trying to understand if the person affected by this problem is or not capable of distinguishing “what is right” from “what is morally wrong”.

The results of the research have highlighted how people suffering from psychopathy mainly exhibit personal utilitarian moral judgments: this would explain the tendency to make violations of the rules and social norms in order to obtain advantages for itself. According to this perspective, the psychopath would generally be hyper-concentrated on the goal and, consequently, would not be able to keep the “moral” costs of one’s conduct in debt.

Role of empathy in psychopathy

Empathy normally exerts an inhibition effect on aggressive behavior since it represents an emotional experience shared between two human beings. According to Feshbach and Feshbach (1969) individuals capable of carefully assuming the perspective of the other are more inclined to implement prosocial actions rather than aggressive conduct.

The difficulty observed in psychopathic subjects To represent and “feel” the emotional experience of the other was interpreted by other scholars as the consequence of an active and aware distraction from the victim’s gaze, that the antisocial person would voluntarily put in place in order to inhibit the natural activation of prosocial feelings and therefore be able to maintain a cold and sufficiently detached attitude.

In fact, the ability to grasp the fear or sadness of another is not necessarily accompanied by a positive attitude: the empathic resonance of the suffering of others can even be at the service of “immoral” desires. It follows that, rather than having an empathy deficit, psychopaths could have “antisocial purposes” and not give so much weight to the representation of the suffering of the other, empathic or intellectual that is, rather than the representation of their personal purpose (Mancini, Capo and Colle, 2009).

Evolutionary paths of the psychopathic personality

The evolutionary history of psychopathic people is generally characterized by experiences of parenting dysfunctional, as described by patterson and collaborators (1991; 1998). According to the “coercion theory” the psychopathic behavior It would be learned within the family and then generalized to other contexts and situations. The scarcely collaborative behaviors of children would be the consequence of the coercive interactions between parents and children.

Some examples of dysfunctional parenting are: inconsistent discipline or, on the contrary, excessively severe; low supervision and monitoring; insufficient expression of the affection; High number of negative verbalizations and high expressed emotion (Cornah et al. 2003; Portier and Day 2007).

From the research of patterson and colleagues (1991) it is clear that the parents of subjects with psychopath They rarely exercise significant and contingent punishment to the aggressive and non -collaborative behavior that intend to reduce, moreover, do not provide instructions to the child through opposing stimuli. If they do, this is implemented on the emotional wave of the moment (an angry attitude, exaggeration of the punishment then portrayed, inconsistency in managing contingencies, etc.). Furthermore, from the longitudinal studies carried out by patterson and collaborators (1998), it was also highlighted that the coercive interactions just described between parents and children predict aggressive relationships with peers and affiliation to deviant groups in adolescent age.

Implications for the treatment of psychopathy

From the point of view of the prognosis and treatment, it was observed (Robbins, Tipp, Przybeck, 1991) that the Antisocial and psychopathic tendencies They tend to decrease naturally over the years, especially when they overcome forty-cyssal years of age (Black, 1999) and that criminal actions or, at least, violent crimes, normally tend to withdraw. The behavioral components of psychopathy They are usually more likely to benefit from the treatment than it happens for the traits of personality typical of the disorder (Dazzi and Madeddu, 2009).

The ability to experience empathy can be a crucial element for a more favorable prognosis (Streeck-Fisher, 1998) in treatment of psychopathy. We have seen how the scarce sense of guilt of psychopathic subjects and the low propensity to respect social and ethical norms can also be explained as the result of particular evolutionary experiences that have prepared the subject to the creation and maintenance of specific purposes and beliefs such as:

1. propensity to perceive the other hostiles, iniquitous and rejecting;
2. Experience of the authority as unjust and inadequate to the role (excessively controlling or laxist and disinterested);
3. Investment on dominance and aversion to heteronomy;
4. Experiences of non -belonging and diversity with respect to the general group of peers.

Evidently, marry the thesis of the “structural deficit” of the psychopathy Or that founded on purposes and beliefs implies numerous differences on the clinical level. Considering the scarce sense of guilt as the effect of specific experiences with authority and with peers, rather than as the expression of a cognitive deficit, it implies, in fact, preferring rehabilitation interventions to recover lacking mental functions (training focused on the theory of mind and empathy), specific procedures addressed to:

• induce the subject to understand the nature and reasons of one’s behavior through a review of one’s evolutionary history;
• Promote more positive experiences of the authority (highlighting, for example, the protective and supervisory function with respect to mutual rights and duties);
• manage action-reaction contingencies in order to make the consequences of the action certain and predictable both in reference to the “punishments” (certainty of the penalty) and to the deserved “earnings”;
• reduce the bias hostile attributive;
• Encourage the construction of a social role (attitudes, skills, etc.) useful for promoting belonging and cooperation;
• make the pleasure and functionality of affiliation and prosociality experience;
• connect the personal value and the good image with the behavior ethically

Essential bibliography

• Blair, R., Jones, L., Clark, F. and Smith, M. (1997). The Psychopathic Individual: A Lack of Responsiveness to Distress Cues? Psychophysiology 34, 192–8.
• Crititenden, PM (1994). New prospects on attachment: theory and practice in high risk families. Guerini, Milan.
• Mancini, F. & Gangemi, A. (2006). The Role of Responsibility and Fear of Guilt in Hypothesis-Testing. Journal of Behavior Therapy and Experimental Psychiatry 37 (4), 333-346.
• Moffitt, Te (1993). Teenascence-limited and life-course-persistent antisocial behavior: a developmental taxonomy. Psychological Review 100, 4, 674-70.
• Patterson, gr, Capaldi, D. & Bank, L. (1991). An Early Starter Model of Predicting Delinquency. In DJ Pepler and Kh Rubin (EDS), The Development and Treatment of Childhood Aggression. Erlbaum, New York.