The origins of criminality as a feature of sociopathy (part 3)

Because it largely captures people who commit crimes, either sociopathic or non, the PCL-R is both over-inclusive of non-sociopathic criminals and under-inclusive of non-criminal sociopaths. (Id, citing Lilienfeld, 1994.) At best, research based on the PCL-R can be characterized as “a literature on unsuccessful psychopathy.” Id. However not all sociopaths are unsuccessful. Rather the “great majority of psychopaths” have (Id, quoting Hercz, 2001, ¶ 11.) via their “ individual differences in talents and opportunities” channeled their psychopathic tendencies not into criminality, but into heroism, worldly success, etc. Id, citing Cleckley, 1976; Harkness & Lilienfeld, 1997; Lilienfeld, 1998; Lykken, 1995. Hare himself has conceded, most sociopaths are not criminals.

Although Hare never filed suit, he successfully delayed publication of Skeem and Cooke’s article by three years. He was also roundly criticized as improperly interfering with the peer review process. In an article titled “Fear Review,” Scientific American writes : “’It was [a] shock,’ Skeem says of Hare's legal threat. ‘this is not about Professor Hare, and it's only incidentally about the Psychopathy Checklist,’ she says. ‘The focus was really on how we could move the field forward.’”

Hare conceded in his response to Skeem and Cooke that the PCL-R does not embody the concept of psychopathy, nor is criminality a necessary component, but there are only twenty factors and three of them specifically deal with criminality: “criminal versatility”, “juvenile delinquency” and “revocation of conditional release” (revoked parole). Another is “many short-term marital relationships”. Only half of the factors track Cleckley sociopathy.

How did non-Cleckley traits enter the PCL-R?

[B]ecause participants in the PCL development sample were criminals rather than nonincarcerated patients or nonpatients, it seems likely that the initial candidate pool included many more deviance-related items, such that [Cleckley’s] positive adjustment indicators dropped out in the selection process. The result is that the PCL-R, compared with Cleckley’s original diagnostic criteria, contains items that are uniformly indicative of deviancy and psychological maladjustment.

Patrick, et al. (2009).

Studying exclusively criminals and then assuming sociopathy must be related to criminality seems like an obvious sampling error. If I exclusively studied my church congregation for sociopathy, could I properly infer a connection between sociopathy and organized religion? Even Hare admits “the majority of psychopaths aren't criminal,” so how could he be satisfied basing his test exclusively on criminals?

Despite round criticism from the psychological community, the PCL-R’s psychopath has left a lasting academic and public impression. Notwithstanding mounting research to the contrary, the dominant popular view of sociopathy is Hare’s criminal recidivist remorseless killer. This is the psychopathy of Hollywood murder movies. I too am scared of such a person, although I haven’t yet encountered one.

Modern researchers remain divided between Cleckley’s carefree bon vivant and Hare, Rollins, McCord and McCord’s criminal deviant.  While Cleckley’s view of sociopaths amounted to emotional colorblindness, Hare et al. depict a “bad egg” rife with moral rottenness – a severely emotionally damaged individual characterized by a loveless and guiltless existence of unrestrained malice for fellow man. Id. Where Cleckley saw “boldness,” they see “meanness.” Where Cleckley saw a lack of connection to the sociopath’s own feelings and the feelings of others, they see a vicious disregard for the feelings of others. Id. Cleckley sought to understand underlying thought patterns, they sought to label external behavior. Cleckley saw a potential patient, they see a social predator. Cleckley saw a problem for which he was seeking a cure.[i] They see a problem that needs to be identified and isolated to protect society, or as Hare has said:

Measurement and categorization are, of course, fundamental to any scientific endeavor, but the implications of being able to identify psychopaths are as much practical as academic. To put it simply, if we can't spot them, we are doomed to be their victims, both as individuals and as a society.

Hare’s remorseless criminal psychopath is associated with “Factor 2 psychopathy”. While Factor 1 traits track Cleckley’s sociopath, Factor 2 adds new traits largely associated with deviance. Not surprisingly, there is little correlation between Factor 2 and Factor 1 traits. In fact, some flatly contradict each other:

•         High aggression, impulsivity, and sensation seeking. Harpur et al., (1989); Hare, (1991).
•         Aggression provoked by reactionary anger. Patrick & Zempolich, (1998); Porter & Woodworth, (2006).
•         High levels of alcohol and drug dependence. Hare, (2003); Smith & Newman, (1990).
•         Deviant behavior.  Hall et al. (2004)
•         High disinhibition and boredom, anger, alienation, distress at negative everyday events. Id.
•         Low conscientiousness and low interest in achievement. Id.
•         Low personal socioeconomic status. Id.
•         Historic and future crimes against people, including violent crimes. Skeem, Mulvey, and Grisso (2003)
•         High aggressiveness. Id.
•         Low agreeableness and lower connection to or interaction with other people. Id.
•         High FFM neuroticism (worrying or negative feelings about everyday incidents), low FFM agreeableness, and low conscientiousness.

o   Interestingly, these are exactly opposite of the Factor 1 results for these categories.

Patrick, et al. (2009).

How can the same group be characterized by both high emotional reactiveness and low emotional reactiveness? Are they angry anxious drug addicts or are they happy-go lucky charmers? Are they impulsive sadist below-the-poverty-line loners or socially dominant Machiavellian CEOs? Are we looking at violent offenders who have a hard time regulating their overpowering emotions or feckless opportunists who have a hard time feeling their own or others’ emotions? Are they primarily emotionally or intellectually driven? Reactive or proactive?

As researchers have posited, the same group can’t really be both, unless we’re talking about two or more separate but related things. Perhaps, as some have suggested, one thing is more nature and the other nurture. Some say one is a sociopath and the other is a psychopath. Or one is a primary sociopath and the other a secondary sociopath. Some say they have the same underlying cause, but only manifest differently. For example, that sociopathy manifests itself naturally in boldness, and meanness is only what happens when you combine sociopath plus risk factors, e.g. childhood neglect or abuse, low socioeconomic status, low education, single parent household, etc. When Cleckley’s emotional blindness is given prosocial outlets, they argue, it can lead to “social efficacy, imperturbability, and tolerance of danger” and if not, “impulsivity, rebelliousness, alienation, and aggression.” Id. This would explain the shared traits (fearlessness and boldness) you see between criminal and non-criminal sociopaths as well as the differences in behavior between the two.[ii]

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[i] Cleckley’s position was that he knew of no treatment, but he blamed it in part on the collective evasion of the issue by the psychological community and society at large rather than any definitive evidence of there being no treatment:

Although I spared no effort to make it plain that I did not have an effective therapy to offer, the earlier editions of this book led to contact with psychopaths of every type and from almost every section of the United States and Canada. Interest in the problem was almost never manifested by the patients themselves. The interest was desperate, however, among families, parents, wives, husbands, brothers, who had struggled long and helplessly with a major disaster for which they found not only no cure and no social, medical, or legal facility for handling, but also no full or frank recognition that a reality so obvious existed.

….the psychopath presents an important and challenging enigma for which no adequate solution has yet been found. Although still in the unspectacular and perforce modest position of one who can offer neither a cure nor a well-established explanation, I am encouraged by ever increasing evidence that few medical or social problems have ever so richly deserved and urgently demanded a hearing.

Cleckley, “Mask of Sanity”.

[ii] See, e.g.:

“The boldness component of psychopathy, which is tapped weakly and incompletely by the items of the PCL-R, is important to distinguish in turn from the meanness component, which is well represented in the PCL-R. One reason is that the distinction between boldness and meanness is crucial to reconciling Cleckley’s conception of psychopathy with that advanced by more criminologically oriented theorists (e.g., McCord & McCord, 1964; Robins, 1966). Another is that boldness, although phenotypically distinct from meanness, appears to share a key etiologic substrate (i.e., diminished fear capacity). This raises the important developmental question, discussed in the last major section below, of what intersecting etiologic factors give rise to meanness as opposed to boldness in temperamentally fearless individuals.

Yet another reason is that the construct of boldness is likely to be of unique importance in understanding so-called “successful psychopaths”: individuals exhibiting high levels of charm, persuasiveness, imperturbability, and venturesomeness who achieve success in society as military, political, or corporate-industrial leaders (cf. Lykken, 1995).”

Patrick, et al. (2009).

Diagnosing Logan and Jake Paul as sociopaths?

I was aware of this at the time they came out but didn't have anything to really say. But I stumbled upon this article by Self , "What Mental Health Experts Want You to Know Before Watching the Buzzy New YouTube Series ‘The Mind of Jake Paul’,: that interviewed some of our friend researchers that I thought had some good information :

Although the word pops up in everyday conversation, it is not actually a medical term, Steven Siegel, M.D., professor and chairman of psychiatry and the behavioral sciences at the Keck School of Medicine of USC, tells SELF.

“We try to avoid the term because it just doesn’t have any formal meaning. It’s a colloquial word and it’s not used consistently,” Scott Lilienfeld, Ph.D., professor of psychology at Emory University, tells SELF.

“It has no clinical content,” Ronald Schouten, M.D., J.D., director of the Law & Psychiatry Service of the Massachusetts General Hospital and associate professor of psychiatry at Harvard Medical School, tells SELF. “It’s used as an epithet.”

As Dr. Siegel explains, sociopath is generally a label that some people give someone they believe is a bad person.

Sociopathy is really an outdated, slippery term for what is known today as antisocial personality disorder (ASPD), according to the American Psychological Association (APA). As Morton notes in episode two, “The Dark Side of Jake Paul,” ASPD is the technical term most clinicians prefer to use today. (The terms are still sometimes used interchangably, according to the National Institutes of Health).

“Antisocial personality disorder is psychiatry's way of trying to classify people without using the pejorative or derogatory terms,” Dr. Siegel explains. “It’s a way of commenting on a pervasive pattern of behavior that spans someone's adult life and that may inform why they experience life the way they do.”
***
“personality disorders are notoriously difficult to diagnose,” Katherine Dixon-Gordon, Ph.D., a clinical psychologist and assistant professor in the department of Psychological and Brain Sciences at the University of Massachusetts Amherst, tells SELF. “This diagnosis is a really complex thing to undertake, and requires these long interviews.”

Even having all the relevant information doesn’t always ensure a reliable diagnosis. “They are so complicated that even among psychologists and psychiatrists, we can’t agree on how to diagnose personality disorders,” Dixon-Gordon says. “Even when we undertake these incredibly complicated interviews with people, experts don't always agree.” She explains that two well-qualified clinicians could evaluate the same person and not necessarily come away with the same assessment.

In reality, the behaviors some experts may link to ASPD span a spectrum. “All of these personality disorders describe being at an extreme end of a spectrum of normal human behaviors,” Dr. Siegel says. Dixon-Gordon adds, “By definition, [personality disorders] represent maladaptive variance of normative personality functioning. So often that line between what’s adaptive and what’s maladaptive and what’s normative and non-normative is a difficult one to find.”

In episode two, Morton cites a statistic that one in 25 people is a sociopath. (This stat is arguably outdated and was derived from several studies dating back to the ‘90s.) While there are not many reliable epidemiological studies on how prevalent ASPD is—although several experts noted that figure sounds high—Lilienfeld argues that the stat is misleading for a different reason.

“Saying ‘one in 25’ implies that [people with ASPD] are different in kind, rather than in degree, from the rest of us,” Lilienfeld says. “In my view, there’s no real distinction in nature that clearly tells you [if somebody has ASPD or not]. There’s no categorical cutoff. It’s almost like asking, ‘How many people are tall?’ Depends on where you draw the cutoff for tall.”

Dixon-Gordon makes a similar argument. “In the same way that the cutoff for whether or not you have high cholesterol changes from year to year, these [diagnostic cutoffs] change,” she explains.

These complicated, nebulous aspects of personality disorders mean that attempting to diagnose them even in a professional setting requires extreme care and caution. “All of these things are reasons why diagnosis is so, so nuanced and complex and contextual,” Dixon-Gordon says, “and really requires [...] not jumping to conclusions.”

Interestingly some of the researchers quoted worry that the webseries is trying to glamourize what they describe as a "dangerous" disorder. But maybe watching were concerned about the opposite, that it was attempting to demonize and stigmatize. So much so that Shane Dawson included an apology at the beginning of episode 3:

“I do actually want to apologize because there was some backlash from people feeling offended and feeling like I was making a horror movie out of an illness or a disorder. And I 100% understand [...] to treat a person like a scary monster is like, not cool, and I shouldn’t have done that. So I apologize for that genuinely.”

Presidential psychopath

This is an ok Time Magazine article about a study looking at psychopathic traits in U.S. presidents, paritcularly fearless dominance, which, not surprisingly, can either be seen as courage or folly depending on the situation:


“An easy way to think about it is as a combination of physical and social fearlessness,” says Scott Lilienfeld, lead author of the study and professor of psychology at Emory University. “People high in boldness don’t have a lot of apprehension about either physical or social things that would scare the rest of us.”

He adds, “It’s often a kind of resilience because you don’t show lot of anxiety or frustration in the face of everyday life challenges.” While that sounds like a necessity for dealing with the daily crises that face the White House, from hurricanes to threats from rogue nuclear nations, the same trait in psychopaths is also associated with callousness, indifference to negative consequences and impulsive antisocial behavior.


It talks a lot about how presidents are not actually likely to be psychopaths because they have to delay gratification so much. But perhaps the most interesting part of the article was this:

“My mentor, David Lykken, argued that psychopaths and heroes are ‘twigs off of the same branch.’ It may be that the fearless dominance or boldness that sometimes gives rise to psychopathy might also sometimes give rise to heroism,” says Lilienfeld.

Psychopath myths

From Scientific American, author of the book "50 Great Myths of Popular Psychology," Scott Lilienfeld, discusses some myths and misconceptions about psychopaths. Some of the highlights:

• Few disorders are as misunderstood as is psychopathic personality.
• Research also suggests that a sizable number of psychopaths may be walking among us in everyday life. Some investigators have even speculated that “successful psychopaths”—those who attain prominent positions in society—may be overrepresented in certain occupations, such as politics, business and entertainment. Yet the scientific evidence for this intriguing conjecture is preliminary.
• Psychopathy seems to be present in both Western and non-Western cultures, including those that have had minimal exposure to media portrayals of the condition.

Here are the myths:

1. All psychopaths are violent. Research by psychologists such as Randall T. Salekin, now at the University of Alabama, indicates that psychopathy is a risk factor for future physical and sexual violence. Moreover, at least some serial killers—for example, Ted Bundy, John Wayne Gacy and Dennis Rader, the infamous “BTK” (Bind, Torture, Kill) murderer—have manifested numerous psychopathic traits, including superficial charm and a profound absence of guilt and empathy. Nevertheless, most psychopaths are not violent, and most violent people are not psychopaths. . . . Regrettably, the current (fourth, revised) edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders Text Revision (DSM-IV-TR), published in 2000, only reinforces the confusion between psychopathy and violence. It describes a condition termed antisocial personality disorder (ASPD), which is characterized by a longstanding history of criminal and often physically aggressive behavior, referring to it as synonymous with psychopathy. Yet research demonstrates that measures of psychopathy and ASPD overlap only moderately.
2. All psychopaths are psychotic. In contrast to people with psychotic disorders, such as schizophrenia, who often lose contact with reality, psychopaths are almost always rational.
3. Psychopathy is untreatable. . . . Although psychopaths are often unmotivated to seek treatment, research by psychologist Jennifer Skeem of the University of California, Irvine, and her colleagues suggests that psychopaths may benefit as much as nonpsychopaths from psychological treatment. Even if the core personality traits of psychopaths are exceedingly difficult to change, their criminal behaviors may prove more amenable to treatment.

Preattentive processing

This was an interesting article discussing the progression of recent research that focused first on fearlessness as an explanation for much of psychopath's behaviors, then to attentional deficiencies (psychopaths don't direct their attention to scary things as much as neurotypicals), and most recently deficits in pre-attentive processing. From the Huffington Post and the author of "On Second Thought: Outsmarting Your Mind's Hard-Wired Habits":

Patrick Sylvers, of the University of Washington, working with Patricia Brennan and Scott Lilienfeld of Emory, suspected that psychopaths may suffer from a deficit in "preattentive processing" -- the constant, automatic scanning of one's surroundings that takes place outside of conscious awareness. Theoretically, if children lack this basic cognitive machinery, they would never learn to decode normal signs of danger, and without this acquired fear, they would fail to socialize into adults with conscience.
***
The scientists gave the boys a visual test that measures unconscious emotional processing. Specifically, they wanted to see if the test subjects, compared with normal boys of the same age, were slower to become aware of fearful faces that were flashed rapidly -- so rapidly that they were not registered by the conscious mind. If so, this would be evidence that the troubled boys are not automatically assimilating threatening cues in their world. They also flashed happy, disgusted and neutral faces for comparison.

The results, reported online in the journal Psychological Science, were clear and provocative. Indeed, they comprise the first evidence ever that kids with psychopathic traits have a significant deficiency in their automatic, unconscious processing of certain cues -- especially fear cues, but also cues for disgust. Fear and disgust are closely related in the primitive mind, and the findings suggest that these troubled kids have a fundamental impairment in recognizing -- "in the blink of an eye" -- any kind of social danger. So perhaps the childhood roots of Hannibal Lecter's murderous personality lay not in fearlessness itself, nor even in his conscious thought processes, but rather in his general social cluelessness.

I hadn't heard the term pre-attentive processing, so I looked at the Wikipedia article for it and wasn't surprised to see that it is also associated with those on the autism spectrum. Apart from that, I still am not quite sure why the lack of preattentive processing would cause attentional problems. Presumably it's because certain things never even show up on the sociopath's radar, so of course they would never consciously/attentively register them?

The subject area is ripe for exploration. If this is a primary causal factor in sociopathic behavior, can this be treated? For instance, the wiki article suggests that by consciously focusing on particular tasks, preattentive processing will improve for information related to those specific tasks. How do preattentive processing defects relate (if at all) to sociopath/autistic supersensitivities or the concept of hyperfocus? Is it like how paraplegic people have super strong arms to compensate for the lost use of their legs? And on a more personal level, could this explain why my learning curve is shaped like an exponential function instead of a gradual increase, i.e. extremely flat at the beginning then sloping steeply up?

As I've said before, I really relate to the attentional theories for sociopathy, I'm very curious to see where this new research leads us.

A quick word on the who wrote the blurb -- this is the guy who advocates in his book that people force more thoughts out of their subconscious and into the conscious mind, something that I have always done both naturally and explicitly. You almost wonder if this guy is not a sociopath himself, or at least has trained himself to see the world more sociopathically. By the way, if you're interested in becoming similarly more sociopathic, Amazon tells me there are a slew of reading options including (according to one reviewer): THE ART OF CHOOSING, THE INVISIBLE GORILLA, THE HIDDEN BRAIN, PREDICTABLY IRRATIONAL, or MISTAKES WERE MADE (BUT NOT BY ME)

The abstract for the paper is here.

Sociopaths = sadists?

The NY Times reports on recent research about the "‘Everyday Sadists’ Among Us." The research suffers from a large degree of circularity, that is people who respond yes to questions like “I enjoy mocking losers to their face,” “I enjoy hurting people,” and “In car racing, it’s the accidents I enjoy most” also tend to be more engaged in killing bugs or inflicting loud white noise on opponents in a game? Ok. Not revolutionary or enlightening, in fact that may be the least controversial finding you'll read today.

What's more interesting is the characterization of how sadism fits into other related disorders like sociopathy:

In 2002, Dr. Paulhus and colleagues had proposed a cluster of traits they called the Dark Triad: narcissism, psychopathy, and Machiavellianism. The traits are present in many people not currently in jail or in therapy.
***He has been investigating if everyday sadism should be added to the cluster — a Dark Tetrad.

“Psychopaths want to get things from people and don’t care about hurting them to do so,” he said. “Yet sadists look for opportunities to hurt people, and prolong it for their own pleasure.”

Studies also indicate that sadists will choose to hurt people without provocation, even if the act takes time and effort — the only reward being the pleasure of inflicting cruelty.

So psychopaths aren't necessarily sadists according to Dr. Paulus. But who are the sadists then? And how many are there? The sample size of the experiment was too small to make any sort of guesses about how much of the population is an "everyday sadist." But out of the jobs that people could volunteer for, over half chose to take part in bug killing rather than clean toilets or endure pain from ice water. So are over half of us sadists? Maybe even more because some sadists might happen to love (or fear) bugs? Or less because some people who love to kill bugs aren't necessarily getting off on the bugs pain, but may be into something else (sense of empowerment?).

Possibly the most interesting thing about this research is its attempt to pathologize yet another trait (sadism) that seems to actually be common in the general population. For instance, they list enjoyment of hockey fights and schadenfraude as clear examples of sadism. I guess that makes almost every sports fan and suburban housewife a sadist? It's pretty clear why people would rather think it was an isolated disorder rather than acknowledge its actual prevalence. As sociopath researcher Scott Lilienfeld said: “We prefer to think, ‘There’s sadists, and then there’s the rest of us.’ ”

The attempt to villainize some forms of enjoyment of violence/suffering while ignoring that most of the population watches violent media, plays violent video games, and has engaged in some form of intentional violence or hurtful activity reminds me of the song "Trouble" from the Music Man. The song features the protagonist making huge distinctions between the honorable game of billiards and the degrading game of pool in order to stir the people up into a morality frenzy of us vs. them: "Well, either you're closing your eyes to a situation you do not wish to acknowledge or you are not aware of the caliber of disaster indicated by the presence of a pool table in your community." Replace "pool" with "sociopath," "sadist" or the "scientific" label du jour helping to keep normal folk in a different category from evil doers, and it's basically a perfect parallel?