Psychopathy

Under a psychopathy ( coined from Greek ψυχή, psyche, "soul" and πάθος, páthos, "suffering"; each ancient Greek pronunciation ) is understood in forensic psychology and psychiatry a severe form of antisocial / antisocial personality disorder, which said in its expression personality disorder surpasses. In the classification systems DSM -IV and ICD-10 diagnosis is not recorded.

Definition

Psychopathy refers to a severe personality disorder that is accompanied by those concerned with the substantial or complete lack of empathy, social responsibility and conscience. Psychopaths are at first glance, sometimes charming, they know how to make superficial relationships. They are sometimes very manipulative to achieve their goals. Often there is a lack psychopaths on long-term goals, they are impulsive and irresponsible. Psychopathy is associated with antisocial behavior, so that often the diagnosis of antisocial / antisocial personality disorder can be made.

Historical

The first description of modern Psychopathiebegriffes Hervey M. Cleckley is attributed, who presented a differentiated description of the disorder in his book The Mask of Sanity, 1941. The development was mainly driven by Robert D. Hare, who also developed the most today related diagnostic procedures the Psychopathy Checklist (PCL -R ).

Demarcation for antisocial personality disorder

The concept of psychopathy includes specific personality traits and antisocial behaviors, whereas the antisocial personality disorder includes only the latter. A proportion of 50 to 80% among prisoners has an antisocial personality disorder, whereas less than 15 % can be classified as psychopathic.

Neurobiology

For the psychopathy could be shown that different brain regions have a structural or functional deficit. The brain mass in the prefrontal and orbitofrontal cortex is reduced. This is among other things associated with unsatisfactory social norm understanding and lack of guilt. Furthermore, it was described a dysregulation of amygdala function. It is believed that this important social learning functions are impaired. In addition, a hippocampal dysfunction could be demonstrated. This is associated with poor fear conditioning and affective regulation. Other brain regions are - probably as a result of the defects described - also affected. About dysregulation of interconnect structures in the affected regions is speculated.

When psychopaths increased dopamine and serotonin levels were observed. This may lead to disinhibition of aggressive impulses. Decreased cortisol levels were also observed. On the other hand are no clear data on a disturbance of the testosterone balance.

It is believed that the dysfunction and dysregulation has been applied in early childhood.

Sub-dimensions

The Psychopathy Checklist by Robert D. Hare distinguishes between two dimensions of psychopathy with the following points:

Dimension 1: ausnützerisch

• Tricky eloquent Blender with superficial charm
• Greatly exaggerated self-esteem
• Pathological lying (pseudo Logie )
• Fraudulent, manipulative behavior
• Superficial feelings
• Callousness, lack of empathy
• Lack of willingness and ability to take responsibility for own actions

Dimension 2: impulsive

• Stimulation needs ( hunger for experience ), constant feeling of boredom
• Parasitic lifestyle
• Inadequate behavioral control
• Earlier behavioral problems
• Lack of realistic, long-term goals
• Impulsiveness
• Irresponsibility
• Devaluation of other people
• Juvenile delinquency
• Probation violation on parole

( Not allocated to one of the sub-dimensions ) Further points

• Promiscuity
• Many short-term marriage-like relationships
• Polytropic ( multiform ) Crime

Psychopathy and crime

In one study, a selection of North American prison population was tested using the Hare Psychopathy Checklist on. It made ​​male prisoners on a scale of 0-40 a mean of 22.87, while women achieved a mean of 12.10. Age, skin color and intelligence quotient were however no significant differences.

Therapy

It is discussed whether treatment of psychopaths is meaningful. Usually it takes place in prisons in Germany in appropriate social therapeutic institutions. Most treatment programs are now aligned behavior therapy and cognitive- behavioral. It is reported that psychopaths well respond differently to therapy. In some cases, an increased rate of recurrence is reported after therapy. In general, psychopaths are harder to treat than nichtpsychopathische offenders. From a neurobiological perspective, the transcranial magnetic stimulation and pharmacological methods are proposed, although both methods have not yet been explored in detail.

Extension of the concept of psychopathy -

In newer, even popular science books, the concept of psychopathy is further extended. There are also types of personalities exemplified that are not delinquent, but manipulative and reduces empathic behavior show. In the working group of the British, today inquiring in the U.S. on NIMH psychologist James Blair, a current revision of the concept of psychopathy go back. Blair understands the diagnosis of psychopathy as a special, going back to an emotional disability form of behavioral disorder ( conduct disorder) or antisocial personality disorder ( antisocial personality disorder ), as they are listed in the DSM- IV and ICD-10. The main distinguishing feature of psychopathy is to Blair emphasized the instrumental, object-and goal -driven nature of the observed aggression. In contrast, there is a predominantly reactive aggression in the majority of instances of anti- social behavior.