Stupid text glitch.

Just a little follow-up before we get started.

Part 1: http://imgur.com/gallery/bQWq1

[Thanks for spotting my spelling error! *commits seppuku*]

First off, a massive thank you to everyone who read, upvoted, commented and sent me messages about my original post. It was very gratifying to know I was not the only one who felt irked by the pop-psych post and I now feel truly vindicated.

However, I need to address the point at which I ended the last post concerning the PCL-R. As you may know, I wrote the original post to discredit an infographic and I hoped AT BEST the 19 people who left markers on my comment http://i.imgur.com/9usYO8a.png?2 would see it. If I had known it would receive the amount of views it did AND reach the front page, I would NOT have ended on such a vague note.

This is because I logged in this morning and found several messages stating that people had read the PCL-R and thought they might be a psychopath. Many people in the comments were saying the exact same thing! I think "A little knowledge is a dangerous thing" is the apt phrase. This post will continue to discuss the PCL-R (and critique!) and explain why just recognising that you share similarities with its items does NOT automatically make you a psychopath. Remember, do NOT self-diagnose, leave it to a professional.

Disclaimer: I studied Psychology and Criminal Behaviour BSc. and I now study Abnormal and Clinical Psychology MSc. - I am still a student and almost by definition I am neither infallible, nor am I an expert in this field. As always, If you do find something questionable, let me know and I'll amend it if you've good evidence. I am not capable of diagnosing you or anyone else, so please don't ask. - All your other messages were lovely :) My apologies if I haven't got around to answering everyone's comments/messages yet, there were a LOT!

Right, part 2!

In this post I shall discuss:

1.) Scoring the PCL-R

2.) Discussion and Criticism of the PCL-R

3.) Researchers' Definitions of Psychopathy

4.) Female Psychopaths

5.) Biology of Psychopathy aka Nature vs. Nurture

6.) Treating a Psychopath

7.) References

1.) Scoring the PCL-R

As you can see above, this image is a version of the PCL-R. As you can also see, it has instructions at the top which state:

"For each of the 20 characteristics, give a score of 0 if it does not apply, 1 if it applies partially and 2 if it is a perfect match."

Now you see why it was very premature for people to start diagnosing themselves (generally not a smart thing to do anyway) based off simply the items I gave in the last post.

There is a maximum score of 40, assuming an individual scores 2 on all 20 items. In the UK, a score of 25 is the minimum for a diagnosis of psychopathy. In America, the minimum score is 30... That is not the only peculiarity the PCL-R contains.

Now, of course you're likely going to want to take the 'test' and I can't stop you. Some of you probably Googled it yesterday in fact. So, if you do take it, bear in mind it does NOT automatically mean you have high levels of psychopathy unless you have also been reviewed by a clinician (preferably more than one). You also have to be 18 for an official diagnosis and the behaviours have to be enduring, like personality is (although even this is debatable).

The Social Desirability Bias pretty much prevents honest answers from a single test anyway, not to mention that some of you (and you know secretly who you are) will actually WANT to be thought of as psychopaths and will therefore be very generous in your scoring.

Oh, and I scored... 2/40, go me. Although self-judgement makes this highly biased...

2.) Discussion and Criticism of the PCL-R

In psychology, tests which assess the mental state, behaviour, personality or learning ability are referred to as "psychometric tests". A lot of companies use psychometric tests when evaluating candidates for job interviews... sometimes unwisely.

All psychometric tests should be assessed on their validity and reliability. They should also be declared fit for purpose. A diagnosis which is purely based off a psychometric test is probably not well-founded. Context is very important for the diagnosis of psychological conditions, especially conditions which fluctuate an individual's behaviour or mood. A person gripped by depression will likely answer the questions differently than when they are in a manic state, for example. (Nice succinct article on reliablity and validity removed because I think it triggered imgur to remove the text from my post!)

The PCL-R is host to a number of criticisms. For example, just look at how vague and varied some of the items are. Secondly, as some of you already spotted, many of these are symptoms are shared with several other mental health disorders. Finally, even the personality of the professional marking the score has been shown to have an impact (Miller et al, 2011). Finally, Dr. Hare also recieves royalties for the official use of his PCL-R, which might lead some to suspect he has an ulterior motive for keeping it afloat and in popular use.

3.) Researchers' Definitions of Psychopathy

As mentioned in part 1, neither the ICD, nor the DSM classify psychopathy as a standalone condition. So how do we know it exists? Well, I was also careful to make sure that I specified that those two collections don't contain everything and they are still being routinely updated. Unsurprisingly, some psychologists do feel that psychopathy is distinct enough to warrant its own placement and its own definition. Here are two such definitions:

“Personality disorder defined by a constellation of affective and behavioural symptoms. The symptoms of psychopathy include shallow affect; lack of empathy, guilt and remorse; irresponsibility; impulsivity; and poor planning and decision-making.” (Kiehl & Hoffman, 2010).

“Personality disorder characterized by enduring antisocial behaviour, diminished empathy and remorse, and disinhibited or bold behaviour. It may also be defined as a continuous aspect of personality.” (Skeem, Polaschek, Patrick, & Lilienfeld, 2011).

Although they both appear to have far fewer criteria than the symptoms of APD/DPD, they both state that they are personality disorders, albeit at the extreme end.

I've only mentioned a small amount of research in these posts. However, given the wealth of research on the subject, I would tentatively state that "psychopaths exist"... but that they are HEAVILY misrepresented and often misdiagnosed. Generally speaking, they are neither the monsters that the media portray, nor the highly successful intellectuals... of course, there will be exceptions.

4.) Female Psychopaths

Often overlooked, there is evidence which sates that female psychopaths differ from their male counterparts in two key areas of their behaviour. Whereas men tend to blackmail, women with high levels of psychopathy are more likely to flirt and seduce. Whereas men are more likely to resort violence, women prefer character assassination (Forouzan & Cooke, 2005).

Also, it might come as a surprise, but there are far fewer women with high levels of psychopathy than men. Those that do posses measurable levels score far lower on the PCL-R (Jackson, Rogers, Neumann, Lambert (2002).

5.) Biology of Psychopathy aka Nature vs. Nurture

One of the fundamental arguments in psychology itself is known as Nature vs. Nurture. Namely, were we born this way, was it how we were raised, or was it a combination of both which now determine our personality and behaviour? Some people are actually against the idea of a biological or genetic cause for the condition since they fear it gives an individual a 'license' to display antisocial behaviour, falling back on the excuse of "I can't help it, it's genetic".

One of the only points the infographic was correct on was a study it mentioned which showed that 60% of twins raised apart still develop the callous and unemotional traits that define psychopathy even though they no longer shared a common environment (Frick & White, 2008)

There is also evidence that specific genes may influence the likelihood of an individual being prone to behaviours we would call psychopathic (Glenn, 2011). However, the researcher does state:

"(...) in the context of additional genetic and environmental factors."

One of my favourite interviews is with an American neuroscientist, professor James Fallon. He ACCIDENTALLY discovered he has the genetic markers and abnormalities in areas of the brain associated with psychopathy. It is a very interesting listen http://www.bbc.co.uk/news/health-25116826 and is just under 5 minutes.

So to conclude, there is some evidence for a genetic predisposition towards psychopathy. However, if you listened to the radio feature, you will also know that the environment in which you are raised plays a very important role.

6.) Treating a Psychopath

So an offender has a high level of psychopathy and has committed a serious crime... can they be successfully rehabilitated? Well, the short answer is yes. The treatment of individuals with high levels of psychopathy is actually a rather divisive issue among the psychology community. There are studies that say it's a lost cause and then there's the ones I'll describe. The problem is that a lot of the studies which brand psychopaths a 'lost cause' are using a standard therapy, NOT one specifically designed for their patients.

Treatment is associated with relatively slower and lower rates of serious recidivism in a study which did a follow-up 2 years after release (Caldwell et al., 2006). Psychopathic patients appear as likely as non-psychopathic patients to benefit from adequate doses of treatment, in terms of violence reduction (Skeem, Monahan, Mulvey, 2002). Okay, perhaps they won't be model citizens, but then plenty of people who are released from prison go on to re-offend and are unlikely to even have measurable levels of psychopathy.

Treating psychopaths isn't easy though, due to their very manipulative and superficial nature they often do very well at parole hearings...

7.) References

I may have missed a few. If I have and you'd like them, just let me know which ones they are and I'll see what I can do!

Caldwell, M., Skeem, J., Salekin, R., & Van Rybroek, G. (2006). Treatment Response of Adolescent Offenders With Psychopathy Features A 2-Year Follow-Up. Criminal Justice and Behavior, 33(5), 571-596.

Glenn, A. L. (2011). The other allele: Exploring the long allele of the serotonin transporter gene as a potential risk factor for psychopathy: A review of the parallels in findings. Neuroscience & Biobehavioral Reviews, 35(3), 612-620.

Forouzan, E., & Cooke, D. J. (2005). Figuring out la femme fatale: Conceptual and assessment issues concerning psychopathy in females. Behavioral sciences & the law, 23(6), 765-778.

Frick, P. J. and White, S. F. (2008), Research Review: The importance of callous-unemotional traits for developmental models of aggressive and antisocial behavior. Journal of Child Psychology and Psychiatry, 49: 359–375.

Jackson, R. L., Rogers, R., Neumann, C. S., & Lambert, P. L. (2002). Psychopathy in female offenders an investigation of its underlying dimensions. Criminal Justice and Behavior, 29(6), 692-704.

Kiehl, K. A., & Hoffman, M. B. (2010). Criminal Psychopath: History, Neuroscience, Treatment, and Economics, The. Jurimetrics, 51, 355-397.

Miller, A. K.; Rufino, K. A.; Boccaccini, M. T.; Jackson, R. L.; Murrie, D. C. (2011). "On Individual Differences in Person Perception: Raters' Personality Traits Relate to Their Psychopathy Checklist-Revised Scoring Tendencies".

Skeem, J. L., Monahan, J., & Mulvey, E. P. (2002). Psychopathy, treatment involvement, and subsequent violence among civil psychiatric patients. Law and human behavior, 26(6), 577.

Seal pup tax!

Well, that's it, that's all I've got.

Now, it kind of goes without saying, but I have barely scratched the surface of an area in which there are hundreds of studies and meta-analyses. I've skimmed on certain areas and maybe provided too much detail in others. Please bear in mind that I'm trying to be concise where I can, after all, this is imgur.

This started to discredit one silly infographic... and I think I achieved that. Remember, be sceptical of what you read on here. Don't be convinced by slick infographics whether it's weight-lifting, or psychology. Always consider the source and check the references! And please please please don't self-diagnose.

If you have questions, feel free to contact me or leave a comment and I'll get back to you when I can.