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Psychopathy

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Theoretically, psychopathy is a three-faceted disorder involving interpersonal, affective and behavioral characteristics.

Interpersonally, psychopaths are manipulative, grandiose, egocentric and forceful. Affectively, they are shallow and non-empathetic; they do not experience empathy, guilt or remorse. Behaviorally, they are impulsive, irresponsible and sensation-seeking.


Assessing for psychopathy

In contemporary research and clinical practice, psychopathy is most commonly assessed with the Hare Psychopathy Checklist- Revised (PCL-R), which is a clinical rating scale with 20 items. Each of the items in the PCL-R is scored on a three-point scale according to specific criteria through file information and a semi-structured interview. Score 0 if the trait is absent, 1 if it is possibly or partially present and 2 if it is present. The item scores are summed to yield a total score ranging from 0 to 40 which is then considered to reflect the degree to which they resemble the prototypical psychopath. A score > 30 supports a diagnosis of psychopathy.

The items are as follows:

Interpersonal dimension

  • Glibness/superficial charm
  • Grandiose sense of self-worth
  • Pathological lying
  • Cunning/manipulative
  • Lack of remorse or guilt
  • Shallow affect
  • Callous/lack of empathy
  • Failure to accept responsibility for own actions

Affective dimension

  • Need for stimulation/-proneness to boredom
  • Parasitic lifestyle
  • Poor behavioral controls
  • Early behavioral problems
  • Lack of realistic, long-term goals
  • Impulsivity
  • Irresponsibility
  • Juvenile delinquency
  • Revocation of conditional release

Behavioral dimension

  • Promiscuous sexual behavior
  • Many short-term marital relationships
  • Criminal versatility

A note of caution: the test must be administered by a trained mental health practitioner under controlled conditions for it to have any validity.