Monday, July 29, 2013

What is sociopathy?


Introduction

Sociopathy is a clinical condition marked by a pattern of disturbed interpersonal, emotional, and behavioral functioning. It is characterized by remorselessness, manipulativeness, lack of concern for the welfare of others, deceit, shallow emotional experience, and poor impulse control. Sociopaths tend to be superficially charming and often make a good first impression on others. Nevertheless, they are typically egocentric, dishonest, and irresponsible, often without apparent motivation. They tend to be callous, externalize blame, and fail to learn from negative consequences. Many authors use the term “sociopathy” interchangeably with psychopathy.












History

Georgia psychiatrist Hervey Cleckley’s classic book The Mask of Sanity (1941) was the first to delineate the core features of the syndrome. Cleckley described sociopathy as characterized by a mask of normalcy that conceals a pernicious mental disorder, and he listed sixteen criteria as essential features of this condition. Among these criteria are the presence of superficial charm, the absence of delusions and nervousness, a lack of remorse and shame, irresponsibility, and untruthfulness.


Cleckley depicted sociopaths as appearing to be relatively normal. They are not psychotic (out of touch with reality); rather, in the words of nineteenth century British physician James Cowles Prichard, they are “morally insane,” meaning they have a core deficit in conscience. Sociopaths’ personality characteristics, such as poor impulse control and callousness, render many of them prone to violence. Nevertheless, the view that all sociopaths engage in violent behavior—or that all violent people are sociopaths—is a misconception. As an attractive and intelligent young man, Theodore “Ted” Bundy, the prolific U.S. serial killer of the 1970s, fit the profile of a typical sociopath. However, the fact that Bundy was violent does not mean he was sociopathic. Instead, his charm, callousness, deceit, and lack of empathy and guilt are what mark him as a bona fide sociopath. Indeed, some authors have suggested that sociopathic characteristics may be expressed in a variety of ways, with a few individuals being extremely violent, others moderately violent, and still others even entirely nonviolent. Moreover, at least some sociopaths may be drawn to socially adaptive occupations, like politics, business, and contact sports, although systematic research on this conjecture is lacking.


Cleckley’s rich clinical descriptions catalyzed research on sociopathy. In 1957, University of Minnesota psychologist David Lykken demonstrated that sociopaths showed diminished responses to a buzzer that was paired repeatedly with an electric shock. Based on this finding, Lykken proposed that the core deficit of sociopaths is fearlessness. This lack of fear, he proposed, gives rise to the other features of the disorder, such as lack of guilt and poor impulse control, which depend on at least a modicum of fear for adequate socialization. As a consequence, psychopaths often display a failure of passive avoidance learning—learning to inhibit responses that lead to punishment. The finding that sociopaths are relatively fearless has since been replicated in a host of studies, although the hypothesis that fearlessness is the major cause of sociopathy remains controversial.




Prevalence of the Condition

Although sociopaths make up an estimated 1 percent of the general population, they are overrepresented in prisons, with around 25 percent of incarcerated men meeting research criteria for the condition. Most individuals who meet the criteria for sociopathy are men, although the causes of this gender difference remain unknown. Sociopathy appears to be a cross-cultural phenomenon. Research by Harvard University anthropologist Jane Murphy has shown that conditions similar or identical to sociopathy appear to be present in remote regions of Alaska and Nigeria that have had scant exposure to Western culture.




Relation to Antisocial Personality Disorder

The American Psychiatric Association’s
Diagnostic and Statistical Manual of Mental Disorders: DSM-5
(2013) contains the diagnosis of antisocial personality disorder (ASPD), a condition that shares many characteristics with sociopathy. The two are not synonymous, however, as antisocial personality disorder designates a persistent pattern of antisocial and criminal infractions. Therefore, its diagnosis emphasizes behavioral indicators, whereas sociopathy emphasizes core personality traits. Some sociopaths are guiltless, dishonest, manipulative, and egocentric, but they display little or no history of criminal behavior.


Lykken posited that psychopathy and sociopathy are two distinct kinds of antisocial personality disorder, with the former primarily deriving from temperamental and biological differences and the latter primarily from negative sociological influences, such as poor parenting and exposure to delinquent peer groups. According to Lykken, both conditions predispose toward antisocial behavior and callous disregard of others, but stem from different causes. Nevertheless, many or most researchers use the terms psychopathy and sociopathy interchangeably.




Assessment of Sociopathy

The most widely used assessment tool for sociopathy is University of British Columbia psychologist Robert Hare’s Psychopathy Checklist-Revised (PCL-R). The PCL-R consists of twenty items derived in part from the Cleckley criteria. Each item is scored zero to two, based on a standardized clinical interview and criminal files. The PCL-R has been widely used in criminal populations, as scores above thirty are strong predictors of recidivism and violence.


The PCL-R, however, can be unwieldy to administer, requiring comprehensive interviews and file review. Further, the PCL-R may not be suited for detecting psychopathy among noninstitutional populations, in which some individuals may exhibit the key personality features of sociopathy while refraining from criminal behavior or avoiding detection by the legal system. Although the high levels of sociopathic traits in prison samples are expedient for research purposes, exclusive reliance on criminal samples may result in a failure to detect important characteristics that buffer some sociopaths against criminal behavior, such as adequate impulse control or intelligence. Promising attempts have been made to detect the core personality characteristics of sociopathy using self- or peer-rating scales. With the aim of constructing a measure of sociopathic personality traits in noninstitutional populations, Emory University psychologist Scott Lilienfeld developed the Psychopathic Personality Inventory (PPI). The PPI-R and several other self-report measures show promising but preliminary validity for the assessment of sociopathy.




Response to Treatment

Traditionally, sociopaths have been viewed as nonresponsive to treatment. Indeed, sociopaths are often viewed as incurable and therefore in need of control rather than treatment. Sociopaths’ emotional detachment and manipulativeness may often impede psychotherapy. However, this widespread clinical conviction may perpetuate the paucity of interventions aimed at curtailing sociopaths’ antisocial behavior. Jennifer Skeem of the University of California, Irvine, has found that sociopaths are as likely as nonsociopaths to respond to violence reduction interventions. More research directed toward understanding the development, nature, and causes of sociopathy, and the conditions under which sociopaths may respond to interventions, is essential before sociopathy can be effectively controlled in society.




Bibliography


Blair, R. J. R., Derek Mitchell, and Karina Blair. The Psychopath: Emotion and the Brain. Malden, Mass.: Blackwell, 2005. Print.



Cleckley, Hervey. The Mask of Sanity. 5th ed. Augusta, Ga.: Emily S. Cleckley, 1988. Print.



Derber, Charles. Sociopathic Society: A People's Sociology of the United States. Boulder: Paradigm, 2013. Print.



Edens, John F. "Examining the Prevalence, Role, and Impact of Evidence Regarding Antisocial Personality, Sociopathy, and Psychopathy in Capital Cases: A Survey of Defense Team Members." Behavioral Sciences and the Law 30.3 (May/June 2012): 239–55. Print.



Felthous, Alan R., and Henning Sass. The International Handbook of Psychopathic Disorders and the Law. Chichester: John Wiley, 2012. Print.



Hare, Robert D. Without Conscience: The Disturbing World of the Psychopaths Among Us. New York: Guilford Press, 1999. Print.



Lykken, David T. The Antisocial Personalities. Hillsdale, N.J.: Lawrence Erlbaum, 1995. Print.



Patrick, Christopher J., ed. Handbook of Psychopathy. New York: Guilford Press, 2006. Print.

No comments:

Post a Comment

How does the choice of details set the tone of the sermon?

Edwards is remembered for his choice of details, particularly in this classic sermon. His goal was not to tell people about his beliefs; he ...