Understanding Psychopathy trough the study of long-term violent offenders

Sammanfattning: Psychopathy describes a collection of personality traits that logically would facilitate violent, criminal behavior. This dissertation deals with issues that might shed light on how to treat or prevent this socially devastating personality disorder: the conceptualization of the disorder; how psychopathic offenders compare with nonpsychopathic offenders; and whether there are some psychopathic offenders who might be more amenable to treatment than others. The four studies use data from a sample of about 400 violent offenders who wereassessed in a national prison unit. The first study dealt with the definition of psychopathy. Using exploratory and confirmatory factor analyses of PCL-R scores, we compared the traditional 17- item, two-factor model with a more recently proposed 13-item, three-factor model. Exploratory factor analysis showed that the 13 items yielded three easily interpretable factors: an interpersonal factor, an affective factor, and a behavioral/lifestyle factor. Confirmatory factor analysis showed that this model had a significantly closer fit to the data than the traditional 17-item, two-factor model. The second and third studies compared psychopathic with nonpsychopathic offenders. In the second study we tested whether psychopathic more than nonpsychopathic offenders had histories of hyperactivityimpulsivity- attention problems (HIA) and conduct problems (CP). We used their retrospective reports of conduct problems before the age of 15 and HIA before the age of 10. The results showed that a combination of childhood HIA and CPwas typical for psychopathic but not nonpsychopathic offenders. The third study tested the hypothesis that intelligence is positively correlated with severity of criminal development in psychopathic criminals and negatively correlated in nonpsychopathic criminals. That pattern would provide a way of explaining the discrepancy between Cleckley’s view and later empirical work and open the door to new ideas about prevention and treatment. For non-psychopaths, higher totalintelligence scores, particularly verbal intelligence, meant a later start in violent crime. For those diagnosed as psychopaths, however, this association was reversed. The fourth study investigated whether meaningful subtypes of psychopathy could be identified. Model-based cluster analysis of Revised Psychopathy Checklist (PCLR Hare, 2003) and trait anxiety scores in the psychopathic subgroup (n = 124; PCL-R > 29) revealed two clusters, which we labeled primary and secondary. Secondary psychopaths had greater trait anxiety and fewer psychopathic traits than primary psychopaths, but comparable levels of antisocial behavior. They also had more borderline personality features, poorer interpersonal functioning, and more symptoms of major mental disorder than primary psychopaths. Psychopathy is a complex and in some ways mysterious disorder, and little is known about how it develops. Taken together, these studies provide some clues that might ultimately lead to ways of preventing the development of psychopathy. Early HIA problems apparently put children in a risk group. Apparently, high intelligence plays a role in the most problematic cases, and the disorder can develop in the presence of anxiety. Although the idea is not without problems, adult psychopaths who are high on anxiety might be more amenable to treatment than those who are not.