The Psychopath Test

I recently read a book that I found to be vastly interesting called, “The Psychopath Test”. It was written by a journalist who became interested in psychopathy after he learned about an instrument used by clinicians to measure psychopathy in clinical populations, called the “Hare Psychopathy Checklist” (PCL-R), created by Bob Hare, a Canadian Psychologist. The book itself is a bit all over the place as it chronicles the author’s journey as he pursues further understanding of the concept of psychopathy and how it fits in with the world of mental health professionals and mass media.

So, in the realm of personality disorders, psychopathy is sharply reminiscent of antisocial personality disorder. In this book the author, Jon Ronson, travels all over the United Kingdom and the United States interviewing psychologists, psychiatrists and psychopaths themselves, one of which is housed in the Dangerous and Severe Personality Disorder Unit at the infamous Broadmoore Psychiatric Hospital in West Berkshire. “The Psychopath Test” is written from the perspective of a lay person with no training in the field of mental health, which, honestly shows. However, I think the author’s viewpoint and journey toward discovery of what psychopaths are all about is refreshing. Besides that, I bring this book up because I think it brings a unique perspective discusses an interesting measurement for assessing psychopathology. I highly suggest you read it if psychopathology interests you!

 The central theme of the book is the “Psychopath Test” or the PCL-R. Ronson compares all of his experiences with psychopaths and clinicians alike to the scale and assess everyone he meets on their lack empathy, superficial charm and risk-taking behavior (He gets a bit obsessive). The PCL-R is a 20 item inventory of personality traits and behaviors coupled with a semi-structured interview. The items are scored on a three point scale and a value of 0 is assigned if an item does not apply to the person being rated, 1 if it applies somewhat, 2 if it fully applies.

In addition to lifestyle and criminal behavior, which are assessed by a trained and licensed professional, the checklist assesses:

glib and superficial charm,

grandiosity

failure to accept responsibility for own actions

poor behavioral controls

many short-term marital relationships

juvenile delinquency

revocation of conditional release

criminal versatility

irresponsibility

denial

parasitic lifestyle

sexual promiscuity

early behavior problems

lack of realistic long-term goals

failure to accept responsibility for own actions

many short-term marital relationships

juvenile delinquency

revocation of conditional release

criminal versatility

 

Look familiar? That’s probably because Hare’s checklist corresponds swimmingly with the DSM Criteria for Antisocial Personality Disorder:

A.    Diagnostic Criteria 301.7 (F60.2) A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by three (or more) of the following: Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure. Impulsivity or failure to plan ahead. Irritability and aggressiveness, as indicated by repeated physical fights or assaults. Reckless disregard for safety of self or others. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another. The individual is at least age 18 years. There is evidence of conduct disorder with onset before age 15 years. The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder.

Hare’s stance on the antisocial/psychopath debate is that the two are distinct as most criminals would meet the diagnosis for anti-social personality disorder. He believes that around only about 20% of incarcerated criminals would meet criteria, whereas 80-85% of your average prisoners could be easily diagnosed with antisocial personality disorder. The PCL-R is used to assess people housed mainly in secure psychiatric units and prisons. It is often used to help decide which patients or prisoners should be granted parole, be detained or be released. It is also used as a prediction tool to calculate which antisocials, or psychopaths, are likely to reoffend. However, interrater reliability on this measure isn’t great especially between personality trait scores and its reliability and validity have come into question in recent years. Even so, it’s still fascinating. 

So, as I’ve said before, I highly recommend the book. And as an incentive to read it I’ll give you an incentive to spark your curiosity: Ronson details traveling from the UK to Florida State University on his quest to learn more about psychopaths. One of the people Ronson interviews in the book as a potential psychopath lives in Tallahassee and is a prominent member of the community. In fact, one of FSU’s buildings is named after him after he donated $10 million to its constructions (I know doesn’t sound very psychopathic, but just trust me). 

And, of course I can't forget PJ's contribution to this week's post. Which was a combination of stalking and or hunting the door jamb, and clawing my roommates door. Making as much noise as possible while doing so, per usual.

Have a great week!

Kim