Psychopathy  

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:''[[Fictional portrayals of psychopaths in film]], [[Fictional portrayals of psychopaths in literature]]'' :''[[Fictional portrayals of psychopaths in film]], [[Fictional portrayals of psychopaths in literature]]''
-'''Psychopathy''' and '''psychopathology''', are terms in contemporary [[criminology]], [[psychiatry]], [[psychology]] and [[the media]] used for a [[severe]] form of [[antisocial personality disorder]]. A focus of this wiki are [[fictional portrayals of psychopaths]]. A good introduction to the subject is ''[[The Mask of Sanity]]''.  
-== Psychopathology ==+'''Psychopathy''' is a [[personality disorder]] characterized by a pervasive pattern of disregard for, or violation of, the rights of others. It is defined in different ways, but can involve a lack of empathy or remorse, false emotions, selfishness, grandiosity or deceptiveness; it can also involve impulsiveness, irritability, aggression, or inability to perceive danger and protect one`s self.
 + 
 +However, there is no consensus about the symptom criteria for psychopathy, and no psychiatric or psychological organization has
 +sanctioned a diagnosis of “psychopathy” itself.'
 + 
 +The current version of the [[Diagnostic and Statistical Manual of Mental Disorders]] includes a diagnosis of [[antisocial personality disorder]] (ASPD), and states that this is also known as psychopathy. Nevertheless, the [[DSM-V]] working party is recommending the addition of a subtype specifically termed 'psychopathic'. The [[ICD-10]] diagnostic criteria of the [[World Health Organization]] has a [[Dissocial personality disorder]], which it states includes the psychopathic personality. The term 'sociopathic' is also often treated as equivalent, having been introduced as an alternative term indicating social causation. However, most psychopathy measures are different from the criteria for ASPD in that ASPD focus on observable behavior while psychopathy measures also include more indirect personality judgements.
 + 
 +Psychologist [[Robert Hare (psychologist)|Robert Hare]] has been a particular champion of the concept of psychopathy, based largely on a characterization introduced by Hervey Cleckley mid 20th century. The [[Hare Psychopathy Checklist]] is a standard ratings tool most often used in forensic settings to assess psychopathy. A study by Hare and colleagues suggested that one to two percent of the US population score high enough on a screening version of the scale to be considered potential psychopaths The diagnosis of antisocial personality disorder covers two to three times as many prisoners as are rated as psychopaths on Hare's scale.
 + 
 +According to some, there is little evidence of a cure or effective treatment for psychopathy; no medications can instill empathy, and psychopaths who undergo traditional [[talk therapy]] might become more adept at manipulating others and more likely to commit crime. Others suggest that psychopaths may benefit as much as others from therapy. According to [[Robert Hare (psychologist)|Hare]], psychopathy stems from as yet unconfirmed genetic neurological predispositions and as yet unconfirmed social factors in upbringing. A review published in 2008 indicated multiple causes, and variation in causes between individuals.
 + 
 +Despite being unused as the main term in diagnostic manuals, the term 'psychopath' is still used by some [[mental health professionals]] and by the general public, popular press and in [[Fictional portrayals of psychopaths|fictional portrayals]]. Despite the similarity of the names, psychopaths are rarely [[psychotic]]. Although psychopathy is associated with and in some cases defined by conduct problems, criminality or violence, most psychopaths are not violent.
 +==History==
 +In very general terms, behaviors related to a modern concept of 'antisocial personality' have been informally noted in a brief [[Vignette (literature)|vignette]] by [[Theophrastus]] in [[Ancient Greece]], whose ''The Unscrupulous Man'' "will go and borrow more money from a creditor he has never paid ... When marketing he reminds the butcher of some service he has rendered him and, standing near the scales, throws in some meat, if he can, and a soup-bone. If he succeeds, so much the better; if not, he will snatch a piece of tripe and go off laughing".<ref>Millon, T., Simonsen, E., Birket-Smith, M. Historical Conceptions of Psychopathy in the United States and Europe. In T. Millon & E. Simonsen (Eds.) [http://books.google.co.uk/books?id=LSiBsdxcGigC&vq=Historical+conceptions+of+psychopathy&source=gbs_navlinks_s Psychopathy: Antisocial, criminal, and violent behavior] New York, NY, US: Guildford Press</ref> Figures of [[insanity]] (e.g. [[Vagabond (person)|vagabonds]], [[libertines]], the 'mad') have often, at least since the 18th century, represented an image of darkness and threat to society, as would later 'the psychopath', a mixture of concepts of dangerousness, evil and illness.<ref>Federman, C. Holmes, D. Jacob, JD (2009) [http://montclair.academia.edu/CaryFederman/Papers/705855/Deconstructing_the_Psychopath_A_Critical_Discursive_Analysis Deconstructing the psychopath: a critical discursive analysis] Cultural Critique, 72</ref>
 + 
 +Clinical concepts that might in some aspects be related to theories of psychopathy today are thought to have emerged in the early 19th century. In 1801, [[Philippe Pinel]] described, without moral judgement, patients who appeared mentally unimpaired but who nonetheless engaged in impulsive and self-defeating acts. He described this as ''Manie sans délire'' (insanity without confusion or delusion) or ''la folie raisonnante'' (rational insanity), and his anecdotes generally described people carried away by ''instincte fureur'' (instinctive fury). [[Benjamin Rush]] wrote in 1812 about individuals with an apparent 'perversion of the moral faculties' which he saw as a sign of innate defective organization. He also saw such people as objects of compassion whose mental alienation could be helped, even if that needed to be in prisons or what he referred to as the 'christian system of criminal jurisprudence'.<ref name=Toch/> In 1835 [[James Cowles Prichard]] developed a broad diagnostic category [[moral insanity]], referring to 'madness' of emotional or moral dispositions without significant delusions or hallucinations. Prichard generally referred more to eccentric behavior than out of control passions, though his diagnosis became widely used. None of these concepts are directly comparable to later diagnostic categories of psychopathy in the specific sense, or even to personality disorders. Moreover, 'moral' did not necessarily refer at that time to morality, it could just mean psychological or emotional.<ref>{{cite journal|last=Whitlock|first=F. A.|title=A Note on Moral Insanity and Psychopathic Disorders|journal=Psychiatric Bulletin|date=1 April 1982|volume=6|issue=4|pages=57–59|doi=10.1192/pb.6.4.57}}</ref>
 + 
 +The (pseudo) scientific study of individuals thought to lack a conscience flourished in the latter half of the 19th century. Notably, [[Cesare Lombroso]] rejected the view that criminality could occur in anyone and sought to identify particular "[[born criminal]]s" whom he thought showed certain physical signs, such as proportionately long arms or a low and narrow forehead.<ref>[http://www.springerlink.com/content/d186445v73407582/ Mythos and Mental Illness: Psychopathy, Fantasy, and Contemporary Moral Life (2008)]</ref><ref>{{cite journal |author=Benning TB |title=Neuroimaging psychopathy: lessons from Lombroso |journal=The British Journal of Psychiatry |volume=183 |issue= |pages=563–4 |year=2003 |month=December |doi=10.1192/bjp.183.6.563|url=http://bjp.rcpsych.org/content/183/6/563}}</ref> Towards the turn of the 20th century, [[Henry Maudsley]] had begun writing about the "moral imbecile", moral insanity and 'criminal psychosis'. He saw these as genetic disorders for which individuals could be neither punished nor reformed by the correctional system, and applied the concepts to what he saw as a lower [[Social class|class]] of chronic offenders who he described in various negative ways by comparison to "the higher industrial classes".<ref>[http://books.google.com/books?id=Q_dai69OlFkC&pg=PA77&lpg=PA77#v=onepage&q=&f=false The pathology of mind] (1895) by [[Henry Maudsley]], Chapter 3, p. 77</ref><ref name=Toch>Toch, H. Chapter 9: Psychopathy or Antisocial Personality in Forensic Settings. In T. Millon & E. Simonsen (Eds.) (2002) [http://books.google.co.uk/books?id=LSiBsdxcGigC&vq=Historical+conceptions+of+psychopathy&source=gbs_navlinks_s Psychopathy: Antisocial, criminal, and violent behavior] New York, NY, US: Guildford Press</ref>
 + 
 +In 1891 [[Julius Ludwig August Koch]] formally introduced the concept of 'psychopathic inferiority' (psychopathischen minderwertigkeiten). This also referred to diverse kinds of dysfunction or strange conduct in the absence of obvious mental illness or retardation. Koch was a [[Christian]] and influenced by the [[degeneration]] theory popular at the time, though he referred to both congenital and acquired types. Habitual criminality was only a small part of his concept, but the public soon used the shortened version 'inferiors' to refer to anyone supposedly suffering from an inherent disposition toward crime.<ref>Philipp Gutmann [http://ajp.psychiatryonline.org/article.aspx?articleID=97643 Julius Ludwig August Koch (1841–1908)] American Journal of Psychiatry 2007 164:35-35</ref><ref name=Wetzell2000> Richard F. Wetzell (2000) [http://books.google.co.uk/books?id=iGW7QLJmuwoC&source=gbs_navlinks_s Inventing the criminal: a history of German criminology, 1880-1945] Pg 56 & 145</ref>
-'''Psychopathology''' is a term which refers to [[either]] the study of [[mental illness]] or mental distress, or the manifestation of behaviors and experiences which may be indicative of mental illness or psychological [[impairment]]. 
===See also=== ===See also===
* [[Delusion]] * [[Delusion]]

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Psychopathy is a personality disorder characterized by a pervasive pattern of disregard for, or violation of, the rights of others. It is defined in different ways, but can involve a lack of empathy or remorse, false emotions, selfishness, grandiosity or deceptiveness; it can also involve impulsiveness, irritability, aggression, or inability to perceive danger and protect one`s self.

However, there is no consensus about the symptom criteria for psychopathy, and no psychiatric or psychological organization has sanctioned a diagnosis of “psychopathy” itself.'

The current version of the Diagnostic and Statistical Manual of Mental Disorders includes a diagnosis of antisocial personality disorder (ASPD), and states that this is also known as psychopathy. Nevertheless, the DSM-V working party is recommending the addition of a subtype specifically termed 'psychopathic'. The ICD-10 diagnostic criteria of the World Health Organization has a Dissocial personality disorder, which it states includes the psychopathic personality. The term 'sociopathic' is also often treated as equivalent, having been introduced as an alternative term indicating social causation. However, most psychopathy measures are different from the criteria for ASPD in that ASPD focus on observable behavior while psychopathy measures also include more indirect personality judgements.

Psychologist Robert Hare has been a particular champion of the concept of psychopathy, based largely on a characterization introduced by Hervey Cleckley mid 20th century. The Hare Psychopathy Checklist is a standard ratings tool most often used in forensic settings to assess psychopathy. A study by Hare and colleagues suggested that one to two percent of the US population score high enough on a screening version of the scale to be considered potential psychopaths The diagnosis of antisocial personality disorder covers two to three times as many prisoners as are rated as psychopaths on Hare's scale.

According to some, there is little evidence of a cure or effective treatment for psychopathy; no medications can instill empathy, and psychopaths who undergo traditional talk therapy might become more adept at manipulating others and more likely to commit crime. Others suggest that psychopaths may benefit as much as others from therapy. According to Hare, psychopathy stems from as yet unconfirmed genetic neurological predispositions and as yet unconfirmed social factors in upbringing. A review published in 2008 indicated multiple causes, and variation in causes between individuals.

Despite being unused as the main term in diagnostic manuals, the term 'psychopath' is still used by some mental health professionals and by the general public, popular press and in fictional portrayals. Despite the similarity of the names, psychopaths are rarely psychotic. Although psychopathy is associated with and in some cases defined by conduct problems, criminality or violence, most psychopaths are not violent.

Contents

History

In very general terms, behaviors related to a modern concept of 'antisocial personality' have been informally noted in a brief vignette by Theophrastus in Ancient Greece, whose The Unscrupulous Man "will go and borrow more money from a creditor he has never paid ... When marketing he reminds the butcher of some service he has rendered him and, standing near the scales, throws in some meat, if he can, and a soup-bone. If he succeeds, so much the better; if not, he will snatch a piece of tripe and go off laughing".<ref>Millon, T., Simonsen, E., Birket-Smith, M. Historical Conceptions of Psychopathy in the United States and Europe. In T. Millon & E. Simonsen (Eds.) Psychopathy: Antisocial, criminal, and violent behavior New York, NY, US: Guildford Press</ref> Figures of insanity (e.g. vagabonds, libertines, the 'mad') have often, at least since the 18th century, represented an image of darkness and threat to society, as would later 'the psychopath', a mixture of concepts of dangerousness, evil and illness.<ref>Federman, C. Holmes, D. Jacob, JD (2009) Deconstructing the psychopath: a critical discursive analysis Cultural Critique, 72</ref>

Clinical concepts that might in some aspects be related to theories of psychopathy today are thought to have emerged in the early 19th century. In 1801, Philippe Pinel described, without moral judgement, patients who appeared mentally unimpaired but who nonetheless engaged in impulsive and self-defeating acts. He described this as Manie sans délire (insanity without confusion or delusion) or la folie raisonnante (rational insanity), and his anecdotes generally described people carried away by instincte fureur (instinctive fury). Benjamin Rush wrote in 1812 about individuals with an apparent 'perversion of the moral faculties' which he saw as a sign of innate defective organization. He also saw such people as objects of compassion whose mental alienation could be helped, even if that needed to be in prisons or what he referred to as the 'christian system of criminal jurisprudence'.<ref name=Toch/> In 1835 James Cowles Prichard developed a broad diagnostic category moral insanity, referring to 'madness' of emotional or moral dispositions without significant delusions or hallucinations. Prichard generally referred more to eccentric behavior than out of control passions, though his diagnosis became widely used. None of these concepts are directly comparable to later diagnostic categories of psychopathy in the specific sense, or even to personality disorders. Moreover, 'moral' did not necessarily refer at that time to morality, it could just mean psychological or emotional.<ref>Template:Cite journal</ref>

The (pseudo) scientific study of individuals thought to lack a conscience flourished in the latter half of the 19th century. Notably, Cesare Lombroso rejected the view that criminality could occur in anyone and sought to identify particular "born criminals" whom he thought showed certain physical signs, such as proportionately long arms or a low and narrow forehead.<ref>Mythos and Mental Illness: Psychopathy, Fantasy, and Contemporary Moral Life (2008)</ref><ref>Template:Cite journal</ref> Towards the turn of the 20th century, Henry Maudsley had begun writing about the "moral imbecile", moral insanity and 'criminal psychosis'. He saw these as genetic disorders for which individuals could be neither punished nor reformed by the correctional system, and applied the concepts to what he saw as a lower class of chronic offenders who he described in various negative ways by comparison to "the higher industrial classes".<ref>The pathology of mind (1895) by Henry Maudsley, Chapter 3, p. 77</ref><ref name=Toch>Toch, H. Chapter 9: Psychopathy or Antisocial Personality in Forensic Settings. In T. Millon & E. Simonsen (Eds.) (2002) Psychopathy: Antisocial, criminal, and violent behavior New York, NY, US: Guildford Press</ref>

In 1891 Julius Ludwig August Koch formally introduced the concept of 'psychopathic inferiority' (psychopathischen minderwertigkeiten). This also referred to diverse kinds of dysfunction or strange conduct in the absence of obvious mental illness or retardation. Koch was a Christian and influenced by the degeneration theory popular at the time, though he referred to both congenital and acquired types. Habitual criminality was only a small part of his concept, but the public soon used the shortened version 'inferiors' to refer to anyone supposedly suffering from an inherent disposition toward crime.<ref>Philipp Gutmann Julius Ludwig August Koch (1841–1908) American Journal of Psychiatry 2007 164:35-35</ref><ref name=Wetzell2000> Richard F. Wetzell (2000) Inventing the criminal: a history of German criminology, 1880-1945 Pg 56 & 145</ref>

See also

Psychopathy

Though in widespread use as a psychiatric term, psychopathy has no precise equivalent in either the DSM-IV-TR, where it is most strongly correlated with antisocial personality disorder, or the ICD-10, where it is correlated with dissocial personality disorder. --Jahsonic, Nov 2006

History

The current concept of psychopathy has been thematically linked to writings by Theophrastus, a student of Aristotle in Ancient Greece, whose description of The Unscrupulous Man is said to embody the characteristics of psychopathy:

"The Unscrupulous Man will go and borrow more money from a creditor he has never paid ... When marketing he reminds the butcher of some service he has rendered him and, standing near the scales, throws in some meat, if he can, and a soup-bone. If he succeeds, so much the better; if not, he will snatch a piece of tripe and go off laughing."

In 1801, Philippe Pinel described patients who were mentally unimpaired but nonetheless engaged in impulsive and self-defeating acts. He saw them as la folie raisonnante ("insane without delirium") meaning they fully understood the irrationality of their behavior but continued with it anyway.

The scientific study of individuals thought to lack a conscience flourished in the latter half of the 19th century. Notably, Cesare Lombroso rejected the view that criminality could occur in anyone and instead sought to identify particular "born criminals" whom he thought showed certain physical defects.

By the turn of the 20th century, Henry Maudsley had begun writing about the "moral imbecile", and was arguing such individuals could not be rehabilitated by the correctional system. Maudsley included the psychopath's immunity to the reformational effects of punishment, owing to their refusal to anticipate further failure, and punishment. In 1904, Emil Kraepelin described four types of personalities similar to antisocial personality disorder. By 1915 he had identified them as defective in either affect or volition, dividing the types further into different categories, only some of which correspond to the current descriptions of antisocial personality disorder.

In 1909, Birnbaum introduced the term "sociopathic", intended to emphasize the social causes of antisocial behavior.

The Mask of Sanity by Hervey M. Cleckley, M.D., first published in 1941, is considered a seminal work which provided a vivid series of case studies of individuals (mostly prisoners) described by Cleckley as psychopathic. Cleckley proposed 16 characteristics of psychopathy. The title refers to the "mask" of normality that Cleckley thought concealed the disorganization or mental disorder of what he saw as the psychopathic person.

A 1977 study, however, found little relationship with the characteristics commonly attributed to psychopaths and concluded that the concept was being used too widely and loosely.

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders incorporated various concepts of psychopathy/sociopathy/antisocial personality in early versions but, starting with the DSM-III in 1980, used instead a diagnosis of antisocial personality disorder. This was based on some of the criteria put forward by Cleckley but operationalized in behavioral terms and more specifically related to conduct and criminality. The World Health Organization's ICD incorporates a similar diagnosis of Dissocial Personality Disorder. Both the DSM and the ICD state that psychopathy (or sociopathy) are synonyms of their diagnosis.

However, there remained no international agreement on the diagnosis of psychopathy. One author referred to it in 1987 as an "infinitely elastic, catch-all category". In 1988, Blackburn wrote in the British Journal of Psychiatry that the concept as commonly used in psychiatry is little more than a moral judgement masquerading as a clinical diagnosis, and argued that it should be scrapped.

Robert Hare developed a Psychopathy Checklist in 1980 based on the psychopath construct advanced by Cleckley, and later revised it in the 1990s (including the removal of two items). While the official diagnostic manuals had moved away from the concept as being too vague and difficult to reliably assess, Hare's questionnaire would be increasingly used in research studies on psychopathy mainly in forensic (criminal) settings.


Psychopathy is currently defined in psychiatry and clinical psychology as a condition characterized by lack of empathy or conscience, and poor impulse control or manipulative behaviors. It is a term derived from the Greek psyche (soul, breath hence mind) and pathos (to suffer), and was once used to denote any form of mental illness, often being confused with psychosis.

See also




Unless indicated otherwise, the text in this article is either based on Wikipedia article "Psychopathy" or another language Wikipedia page thereof used under the terms of the GNU Free Documentation License; or on research by Jahsonic and friends. See Art and Popular Culture's copyright notice.

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